From the Research
Anti-centromere antibodies (ACA) have a moderate sensitivity of approximately 20-40% for systemic sclerosis overall, but their sensitivity varies significantly depending on the disease subtype, with the highest sensitivity found in limited cutaneous systemic sclerosis (lcSSc), also known as CREST syndrome, at 50-90% 1. The sensitivity of ACA also depends on the testing method used, with immunofluorescence assays typically showing different sensitivity than ELISA-based tests.
- The presence of anti-centromere antibodies is associated with a better prognosis compared to other autoantibodies in systemic sclerosis, with lower risk of pulmonary fibrosis but higher risk of pulmonary hypertension 2.
- Testing for these antibodies should be part of a comprehensive autoantibody panel when systemic sclerosis is suspected, as they provide important prognostic information and help guide monitoring for specific complications.
- Despite moderate overall sensitivity, ACAs have excellent specificity (97-99%) for systemic sclerosis, making them valuable diagnostic markers when present 1.
- The sensitivity of ACA in diffuse cutaneous systemic sclerosis (dcSSc) is significantly lower, at only 5-10% 2.
- Recent studies have also identified ACA-positive subjects presenting with hypertensive emergency and renal dysfunction in the absence of skin manifestations, which may represent a novel entity 3.