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Abstract
Rheumatoid factor (RF) is currently used in the diagnosis of rheumatoid arthritis (RA). The discovery of anticitrullinated protein autoantibodies has led to the development of various new tests, such as anti-cyclic citrullinated peptide (anti-CCP) antibodies, and anti-mutated citrullinated vimentin (anti-MCV) antibodies, to diagnose RA. The aims of this study were to determine the sensitivity and specificity of anti-MCV antibodies in comparison with anti-CCP antibodies and RF in Omani Arab patients with RA and compare our findings with published values from different ethnic groups. The sensitivity of anti-MCV antibodies was 72% with 87% specificity. For anti-CCP antibodies the sensitivity was 52% and the specificity was 97%. The sensitivity of RF was 57% with 94% specificity. Anti-CCP antibodies have higher diagnostic specificity and positive predictive value than RF and anti-MCV antibodies. Anti-MCV antibodies have the highest sensitivity when compared to anti-CCP antibodies and RF. Anti-MCV antibodies do not appear to be very useful in the diagnosis of RA. However, long-term study is required to find out whether anti-MCV antibodies can be used as predictive test for incidence of RA.
Highlights
Rheumatoid arthritis (RA) is a chronic systemic inflammatory autoimmune disease characterized by chronic joint inflammation that often leads to destruction of bone and cartilage, as well as the presence of autoantibodies including rheumatoid factor (RF) and highly RA-specific anti-cyclic citrullinated peptide antibodies [1]
We found that anti-MCV antibodies have the highest sensitivity, and anti-CCP antibodies have the highest specificity
Many studies have evaluated the presence of anti-MCV, anti-CCP antibodies, and RF in RA patients
Summary
Rheumatoid arthritis (RA) is a chronic systemic inflammatory autoimmune disease characterized by chronic joint inflammation that often leads to destruction of bone and cartilage, as well as the presence of autoantibodies including rheumatoid factor (RF) and highly RA-specific anti-cyclic citrullinated peptide (anti-CCP) antibodies [1].RF and anti-CCP antibodies have been shown to be present prior to the appearance of clinical symptoms of arthritis suggesting that the initial immune dysregulation in RA occurs years before symptomatic disease [2]. Anti-mutated citrullinated vimentin (antiMCV) antibodies have been recommended to be better diagnostic marker for early arthritis [5]. Several studies demonstrated that anti-MCV antibodies have the same specificity as anti-CCP antibodies, but with better sensitivity [6,7,8]. Showed that anti-MCV antibodies have a comparable sensitivity but lower specificity than anti-CCP antibodies, and concluded that anti-MCV antibodies do not appear to be very useful in the diagnosis of RA [7]. Like anti-CCP antibodies, anti-MCV antibodies are suitable for the early diagnosis of RA, with comparable sensitivity (55.3% versus 59.3%, resp.), specificity (92.1 versus 92.3%, resp.), and positive predictive value (95.8% versus 96.1%, resp.) [8]
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