Diagnostic Value of Anti-Mutated Citrullinated Vimentin versus Anti-Keratin Anti-Bodies in Early Diagnosis of Rheumatoid Arthritis

Abstract

Background : Rheumatoid arthritis (RA) is a chronic autoimmune disease that is associated with many auto-antibodies such as rheumatoid factor (RF), Antiperinuclear factor (APF) , anti-citrullinated peptides and antikeratin antibodies (AKA). Objectives:This study aimed to measure the serum level of anti- mutated citrullinated vimentin antibodies(anti-MCV) and detection of AKA in serum of RA patients.Also,for comparison between the results of anti-MCV and AKA in diagnosis of early RA and their correlation with disease activity. Methodology: This study included 30 patients with RA ,30 patients with other rheumatic diseases and 30 matching healthy controls. Patient’s assessment measures involved the disease activity score (DAS-28) and visual analogue scale (VAS) . serum samples were collected from patients and controls for measurement of anti-MCV and detection of AKA using enzyme linked immunosorbant assay (ELISA) and indirect immunofluorescent (IIF)) technique respectively. Results: anti-MCV and AKA were significantly higher in patients compared to controls (p<0.001). Serum levels of anti-MCV show insignificant correlation with age and sex.while,it correlates significantly with disease duration, erythrocyte sedimentation rate(ESR), DAS28 and VAS (p<0.001). The sensitivity and specificity of anti-MCV test in RA patients at disease duration ≤ 2 years were 84.2 % and 86 % respectively.AKA show insignificant correlation with age ,sex, disease duration ,ESR but correlated significantly with DAS28 and VAS (p=0.005).The sensitivity and specificity of AKA test in RA patients of disease duration ≤ 2 years were 68.4 % and 68.3% respectively.Conclusion: Anti-MCV and AKA have a role in the pathogenesis of RA,the serum level of anti-MCV antibodies was significantly higher in RA patients than in healthy controls.Anti-MCV and AKA could be a useful marker for early diagnosis and follow up of RA patients, they also reflect both activity and severity of RA.Anti-MCV antibody ELISA test was more sensitive and specific than AKA IIF test,it is a quantitative test while AKA IIF is a screening test and needs a trained personnel. So, Anti-MCV antibody ELISA test is better for early diagnosis , follow up and assessment of therapy response.Further studies are needed for evaluation of different RA markers in order to reach early diagnosis and treatment for this disabling disease.