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Abstract
IntroductionThe aim of our study was to investigate the association between arthritic disease activity and antibodies to mutated citrullinated vimentin (anti-MCV), because such a relation has been suggested.MethodsAnti-MCV levels were measured in 162 patients with early arthritis (123 with rheumatoid arthritis and 39 with undifferentiated arthritis) at baseline and at 1 and 2 years of follow up. Disease activity was measured using the disease activity score (Disease Activity Score based on 28 joints [DAS28]) and serum C-reactive protein. General estimation equation analysis was used to assess the relation between anti-MCV levels and DAS28 over time.ResultsBoth, anti-MCV levels and DAS28 exhibited a significant decrease during the first and second year. However, the association between anti-MCV levels and DAS28, adjusted for dependency on sequential measurements within one individual, was very low (β = 0.00075). In a population of patients with rheumatoid arthritis or undifferentiated arthritis, anti-MCV had a specificity of 92.3% and a sensitivity of 59.3% when using the recommended cut-off of 20 U/ml. Specificity and sensitivity of antibodies against second-generation cyclic citrullinated peptide, using the recommended cut-off value of 25 U/ml, were 92.1% and 55.3%, respectively. Anti-MCV-positive early arthritis patients had significantly higher Sharp-van der Heijde score, erythrocyte sedimentation rate and C-reactive protein levels than did anti-MCV-negative patients at all time points (P < 0.005), but DAS28 was higher in anti-MCV-positive patients at 2 years of follow up only (P < 0.05).ConclusionBecause the correlation between anti-MCV levels and parameters of disease activity was very low, we conclude that it is not useful to monitor disease activity with anti-MCV levels.
Highlights
The aim of our study was to investigate the association between arthritic disease activity and antibodies to mutated citrullinated vimentin, because such a relation has been suggested
In a population of patients with rheumatoid arthritis or undifferentiated arthritis, anti-mutated citrullinated vimentin (MCV) had a specificity of 92.3% and a sensitivity of 59.3% when using the recommended cut-off of 20 U/ml
Anti-MCV-positive early arthritis patients had significantly higher Sharp-van der Heijde score, erythrocyte sedimentation rate and C-reactive protein levels than did anti-MCV-negative patients at all time points (P < 0.005), but DAS28 was higher in anti-MCV-positive patients at 2 years of follow up only (P < 0.05)
Summary
The aim of our study was to investigate the association between arthritic disease activity and antibodies to mutated citrullinated vimentin (anti-MCV), because such a relation has been suggested. Two types of serological markers are used in the early diagnosis of rheumatoid arthritis (RA): antibodies to the Fc part of human IgG (rheumatoid factor) and antibodies to citrullinated protein/peptide antigens (ACPAs). Rheumatoid factor is not specific to RA, because it is present in patients suffering from other autoimmune and/or infectious diseases and are found in apparently healthy elderly patients [1]. Since the first description of RA-specific antibodies to citrullinated peptides, several citrullinated proteins have been proposed as physiological targets for ACPA specificity, such as fibrin [2], Epstein-Bar virus nuclear antigen [3], α-enolase [4] and vimentin [5]. Anti-CCP2 level has a good diagnostic and prognostic value [6], but in one study [7] no relation between anti-CCP2
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