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Anti-CSP (anti-citrullinated SR-A peptide antibody) is an autoantibody targeting the citrullinated scavenger receptor-A (SR-A) peptide, specifically the 305-325 epitope. Identified as a novel biomarker for rheumatoid arthritis (RA), it is particularly valuable for diagnosing patients who are negative for traditional markers such as anti-cyclic citrullinated peptide (anti-CCP) and rheumatoid factor (RF). Beyond its diagnostic utility, anti-CSP plays a pathogenic role in the disease by promoting inflammation in cartilage and exacerbating arthritis severity, as demonstrated in cartilage organoids and experimental mouse models. The antibody exhibits distinct glycosylation patterns in RA patients and its presence is associated with increased disease activity.
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