Diagnostic Value of Antibodies Against a Modified Citrullinated Vimentin in Egyptian Patients with Rheumatoid Arthritis

Reem Hamdy Abdellatif Mohammed

doi:10.4172/2155-9899.1000154

Abstract

Objective: To investigate the sensitivity and specificity of sero-positivity to antibodies against modified citrullinated vimentin antibodies (anti-MCV) in comparison with anti-CCP2- in rheumatoid arthritis (RA) among Egyptians, considering the possible correlation to demographic and disease related features in the study group.Patients and methods: This study included forty patients with Rheumatoid arthritis (RA) and thirty matching healthy controls. Patients’ assessment measures involved the disease activity score (DAS-28), visual analogue scale (VAS) and health assessment questionnaire (HAQ). Thirty healthy subjects matched for age and sex served as a control group. Blood samples were obtained from patients and controls for erythrocyte sedimentation rate (ESR), C reactive protein (CRP), rheumatoid factor (RF). Anti-CCP2 and anti-MCV were determined using ELISA technique.Results: Estimated serum levels of anti-CCP2 and anti-MCV were significantly higher in patients compared to controls (p<0.001). Serum levels of anti-MCV didn’t show any significant variations with age, disease duration, duration of morning stiffness, number of swollen and tender joints, HAQ or ESR in patients with RA, yet serum levels of anti-MCV correlated significantly with DAS28, VAS and CRP (p<0.05). Anti-CCP2 correlated significantly with DAS28, VAS and CRP and ANA (p<0.05). Serum levels of anti-MCV and anti-CCP2 showed a consistently significant correlation with each other (r=0.483; p<0.001). Statistical analysis showed that anti-MCV had diagnostic specificity, sensitivity of 93.3%, 75.5%, respectively, while anti-CCP2 specificity, sensitivity of 98.1%, 85%, respectively.Conclusion: Serum anti-MCV as well as the anti-CCP-2 assay perform comparably well in the diagnosis of RA. In the high-specificity range, however, the anti-CCP2 assay appears to be superior to the anti-MCV test.

Highlights

Rheumatoid arthritis (RA) is a chronic, inflammatory, autoimmune, systemic disease, which primarily involves the joints, leading to inflammation, swelling, pain, stiffness, with inevitable progressive functional deterioration [1]
In the high-specificity range, the anti-CCP2 assay appears to be superior to the anti-MCV test
Several different autoantibodies with varying sensitivity and specificity have been found in the serum of patients with RA [3], rheumatoid factor (RF) has been identified for long as the only autoantibody related to RA and subsequently was included in the 1987 American College of Rheumatology (ACR) classification criteria for diagnosing established RA [4]

Summary

Introduction

Rheumatoid arthritis (RA) is a chronic, inflammatory, autoimmune, systemic disease, which primarily involves the joints, leading to inflammation, swelling, pain, stiffness, with inevitable progressive functional deterioration [1]. Several different autoantibodies with varying sensitivity and specificity have been found in the serum of patients with RA [3], rheumatoid factor (RF) has been identified for long as the only autoantibody related to RA and subsequently was included in the 1987 American College of Rheumatology (ACR) classification criteria for diagnosing established RA [4]. In the recent ACR/EULAR 2010 criteria for classifying patients with early arthritis as having RA we had another group of disease specific autoantibodies added to the criteria for establishing early diagnosis these were antibodies to cyclic citrullinated peptides which were lately proven to be highly specific to rheumatoid arthritis. It is found to be highly specific for early diagnosis (97%) as well as prognosis of RA regarding radiographic progression and erosive disease [8]

Methods

Results

Conclusion