anti-MCV Antibodies Research Articles

Evaluation of disease activity markers in relation to dry eye disease in patients with rheumatoid arthritis

PurposeThe aim of this study was to correlate the presence of anti-cyclic citrullinated peptide (anti-CCP) and anti-mutated citrullinated vimentin (anti-MCV) antibodies with rheumatoid disease activity and dry eye disease in patients with rheumatoid arthritis (RA).Patients and methodsA total of 69 patients were evaluated for the activity of RA using the Disease Activity Score (DAS-28), erythrocyte sedimentation rate, and C-reactive protein. We used the Health Assessment Questionnaire-Disability Index to assess functional disability. Anti-CCP and anti-MCV antibodies were measured using enzyme-linked immunosorbent assay technique. We assessed dry eye symptoms using Ocular Surface Disease Index (OSDI) questionnaire. Clinical tests used for dry eye assessment included Schirmer’s test, tear breakup time test, and ocular surface fluorescein staining.ResultsAnti-CCP antibody serum levels significantly correlated with DAS (r=0.46, P=0.036), Schirmer’s test (r=0.40, P=0.038), and ocular surface fluorescein staining (r=0.6, P=0.04). Anti-MCV antibody serum levels correlated with DAS (r=0.5, P=0.04), ocular surface fluorescein staining (r=0.9, P=0.007), and OSDI score (r=0.3, P=0.03). DAS showed a nonsignificant correlation with OSDI score and all tests of dry eye. OSDI score significantly correlated with Schirmer’s test (P=0.036).ConclusionDry eye is the most common ocular manifestation in our investigated patients with RA. Dry eye disease existence is not correlated with disease activity, hence all patients with RA should be regularly examined for dye eye regardless of disease severity. Rheumatologists could use the OSDI questionnaire for screening dry eye disease in patients with RA. The presence of anti-CCP and anti-MCV antibodies may denote the existence of dry eye disease and correlates with RA disease activity.

Evaluation of anti-mutated citrullinated vimentin antibodies, anti-cyclic citrullinated peptide antibodies in patients with rheumatoid arthritis in comparison with other rheumatic diseases; a nephrology point of view

Introduction: Rheumatoid arthritis (RA) is one of the most common autoimmune rheumatic disease with a chronic and progressive inflammatory disorder manifestations leading to articular cartilage damage, and disability, and also renal involvement. It seems that recruitment of tests based on high specific and sensitive serological immunobiomarkers removes these mentioned gaps. Additionally, the results of laboratory tests, assist to reach an accurate prognosis and real estimation of the patient’s clinical statue especially hospitalized individuals in intensive care units. Objectives: The aim of this study is assessment and titration of some autoantibodies as anti-mutated citrullinated vimentin (anti-MCV), anti-cyclic citrullinated peptides (anti- CCP), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in RA patients in comparison to patients with other forms of rheumatologic diseases. Patients and Methods: This descriptive study was conducted from January to June 2012 in Zanjan province on 100 patients with RA and 100 patients with other rheumatic disease that were randomly selected. All necessary data of clinical history for the patients was extracted from their medical records. After delivering antecubital venous blood (7 mL) to hematology ward of laboratory, quantative ELISA test was performed for autoantibodies. Results: Anti-MCV tests showed 72% positivity in RA group compared to 10% positivity in other group of rheumatic diseases. There was a significant correlation between positivity of anti-MCV and RA disease. Mean anti-MCV titer is 236.23 ± 2.319 U/mL in RA group and 28.75 ± 0.432 U/mL in other disease group. In this study anti-MCV antibodies had diagnostic sensitivity of 81.7% (versus anti-CCP), diagnostic specificity of 72.22%, positive and negative predictive value 93.05% and 46.42%, respectively. Conclusion: According to results of this study, not only anti-MCV measurement but also anti-CCP assist to early diagnosis of RA. Results of the recent study could not show definite correlation between anti-MCV and disease activity. The result of this study may be helpful for renal involvement in RA patients, whereas evaluation on this aspect of RA patients seems essential.

Periarticular Bone Loss in Arthritis Is Induced by Autoantibodies Against Citrullinated Vimentin.

Periarticular bone loss is a long known but yet insufficiently understood phenomenon in patients with rheumatoid arthritis. This study investigated whether autoimmunity against citrullinated proteins is causally involved in triggering periarticular bone loss. Periarticular bone loss was studied in the standard antigen-induced arthritis (AIA) mouse model with methylated bovine serum albumin (mBSA) as well as a modified model with mutated citrullinated vimentin (MCV) alone or in combination with mBSA. Periarticular bone loss, subchondral osteoclastogenesis, as well as local expression of cytokines, osteoclast genes, and peptidyl-arginine deiminase (PAD) enzymes were assessed after arthritis induction. Immune cell and osteoclast precursor infiltration were detected in the periarticular bone marrow and local lymph nodes. In addition, periarticular bone loss was assessed upon challenge of mice with purified anti-MCV antibody. Despite inducing a milder form of arthritis than mBSA, MCV triggered significant periarticular bone loss associated with an increased infiltration of osteoclast precursors and mature osteoclasts in the periarticular bone marrow. MCV enhanced the expression of the osteoclast inducers RANKL and M-CSF, the cytokines IL-8, IL-1, IL-6, and TNF-α, as well as PAD2 and PAD4 enzymes in the periarticular bone marrow. Furthermore, also anti-MCV antibody challenge induced significant periarticular bone loss and local osteoclastogenesis in the mice. Autoimmunity against citrullinated vimentin triggers periarticular bone loss by osteoclast activation in the bone marrow. These findings may explain why periarticular bone loss is already found very early in the disease course of patients with rheumatoid arthritis. © 2017 American Society for Bone and Mineral Research.

Anti-mutated citrullinated vimentin antibodies in antiphospholipid syndrome: diagnostic value and relationship with clinical features

•Anti-MCV antibodies can be found in APS patients and are associated with the presence of arthritis. •Anti-vimentin/cardiolipin is strongly associated with the presence of thrombosis (both arterial and venous). •Citrullination occurs in APS, participate in disease pathogenesis, and influence clinical picture.

Type-III interferons and rheumatoid arthritis: Correlation between interferon lambda 1 (interleukin 29) and antimutated citrullinated vimentin antibody levels

Aim: To assess serum type III or lambda (λ) interferons (IFN) levels and its clinical and laboratory associations in rheumatoid arthritis (RA). Methods: A cross-sectional study including 43 patients with RA (86% females; age 45.3 ± 10.3 years) and 43 healthy individuals was performed. Clinical data including disease activity, acute-phase reactants, rheumatoid factor and anticyclic citrullinated peptide (anti-CCP) antibodies were collected. Serum IFNλ1, IFNλ2, IFNλ3, CXCL8 and anti-mutated citrullinated vimentin (anti-MCV) antibody levels were measured. Results: Patients with RA had higher IFNλ1 (113.5 ± 118.6 pg/mL versus 55.9 ± 122.3 pg/mL; p < 0.0001) and IFNλ2 (245.4 ± 327.7 pg/mL versus 5.1 ± 11.0 pg/mL; p = 0.009) levels than controls, but not IFNλ3 levels. Notably, IFNλ1 levels were found to be higher in both patients with active disease (124.9 ± 135.9 pg/mL; p < 0.001) and quiescent disease (99.0 ± 93.7 pg/mL; p < 0.01), while IFNλ2 levels were higher only in patients with active disease (264.0 ± 356.1 pg/mL; p = 0.02). A noteworthy association between serum IFNλ1 levels and anti-MCV antibody titers (Spearman's rho coefficient 0.36, 95% CI 0.36 to 0.61; p = 0.02) was observed. Conclusion: Serum IFNλ1 and IFNλ2 levels are abnormally elevated in patients with RA and the former are linearly associated with circulating anti-MCV antibody levels. These results may place type-III IFN as an attractive new therapeutic target in RA.

Anti CCP and Anti MCV Antibodies are Marker of Arthritis in Systemic Lupus Erythematosus and Scleroderma

Anti CCP and Anti MCV Antibodies are Marker of Arthritis in Systemic Lupus Erythematosus and Scleroderma

Anti-MCV antibodies predict radiographic progression in Greek patients with very early (

This study aimed to assess the diagnostic and prognostic value of anti-mutated citrullinated vimentin (MCV) antibodies in very early rheumatoid arthritis (VERA) and in established rheumatoid arthritis (RA). Seventy-one patients with undifferentiated arthritis (UA) of <3months duration, 141 with established RA, 53 with other rheumatic diseases, and 40 healthy individuals were included in the study. Anti-MCV, anti-cyclic citrullinated peptide (CCP) antibodies, and rheumatoid factor (RF) were determined and hand radiographs were recorded. Patients were assessed prospectively for 2years, and hand radiographs were repeated. Diagnostic performance of anti-MCV was studied with receiver operating characteristic (ROC) curves and evaluation of sensitivity, specificity, and likelihood ratios. Forty-six percent of UA patients progressed to RA at 2years. In VERA patients, sensitivity of anti-MCV was 52%, compared to 44% of anti-CCP and 37% of RF, while specificity was 91%, compared to 91% of RF and 84% of anti-CCP. Anti-MCV were detected in 25% of VERA patients negative for both anti-CCP and RF. In established RA, anti-MCV did not sustain its diagnostic performance. By multivariable analysis, anti-MCV, but not anti-CCP or RF, showed significant correlation with radiographic progression in VERA patients. In established RA, anti-MCV, anti-CCP, and RF were associated with active disease (p≤0.03) and joint damage (p≤0.004). By multivariate analysis, the strongest factors for radiographic damage were disease duration (p=0.000), HAQ score (p=0.000), and RF (p=0.002). In conclusion, in patients with very early UA, anti-MCV predict both progression to RA and radiological damage, and therefore, anti-MCV antibody testing may be useful in every day practice.

Role of anti-mutated citrullinated vimentin antibodies in chronic hepatitis C patients and its relation to HCV associated arthritis

Aim of the workTo determine the frequency of anti-mutated citrullinated vimentin (anti-MCV) antibodies in chronic hepatitis C virus (HCV) patients and its relation to HCV associated arthritis. Patients and methodsThe study included 60 HCV patients and 30age and sex matched control. Patients were subgrouped according to the presence and absence of associated arthritis. Laboratory investigations were performed and anti-MCV antibodies were measured. ResultsThe age of the patients ranged between 29 and 75years (mean 57.65±8.49years) and they were 38 males (63.3%) and 22 females (36.7%) M:F 1.7:1. 32 (53.3%) patients had arthritis while the remaining 28 (46.7%) did not. There was a significantly higher anti-MCV antibody level in the patients (median 250ug/L; range 175–375ug/L) compared to the control (p<0.001). There was no significant difference in the anti-MCV antibodies between HCV patients with and without arthritis (p=0.15). The HCV patients without arthritis had a significantly higher level of anti-MCV antibody (median 200ug/L, range 175–375ug/L) than the control (median 30ug/L, range 5–15ug/L) (p<0.001) and the area under the curve (AUC) was 0.85 (95% CI 0.69–1, p=0.004). When the cut-off value for anti-MCV antibody was set at 57.5ug/L, clinical sensitivity was 80% and specificity was 80% between those without arthritis and the control. There was no significant correlation between anti-MCV antibody with various studied parameters in the HCV patients. ConclusionAnti-MCV antibody is significantly increased in HCV patient and has no role in diagnosing HCV-associated arthritis.

Anti-MCV and anti-CCP antibodies-diagnostic and prognostic value in children with juvenile idiopathic arthritis (JIA).

The goal of the study was to evaluate the diagnostic and prognostic value of anti-mutated citrullinated vimentin (anti-MCV) antibodies in juvenile idiopathic arthritis (JIA) comparing to anti-cyclic citrullinated peptide (anti-CCP). Thirty children with confirmed JIA diagnosis and 20 children as a control group were included into the study. Serum and synovial fluid levels of anti-CCP, anti-MCV, and immunoglobulin M rheumatoid factor (IgM-RF) antibodies have been assessed. Anti-MCV was positive in 11/30 (36.6%), whereas anti-CCP positivity was found in 12/30 (40%) children with JIA. Among 11 children with JIA positive for anti-MCV, five (45.5%) were also positive for anti-CCP and among 18 JIA children negative for anti-CCP, six (33.33%) were also anti-MCV positive. Six out of 30 JIA children were found to be IgM-RF positive. In general, two out of all those 11 anti-MCV-positive patients demonstrated oligoarthritis and 9/11 had polyarticular type of onset. Anti-MCV serum concentration correlated positively with anti-CCP (p=0.004). Almost 60% of children in early stage of JIA were anti-MCV positive. Levels of anti-CCP antibodies correlated positively with the disease activity (p=0.0014) and radiological outcome (p=0.00017). In all synovial fluid samples, the concentration of autoantibodies was under the cut-off values. The results of our study indicate that anti-MCV as well as anti-CCP antibodies may be helpful in the diagnosis of JIA, especially in the early course of the disease. Anti-MCV antibodies could identify a group of children with JIA which is negative for anti-CCP antibodies and RF. However, it appears that in JIA, anti-CCP rather than anti-MCV antibodies have impact on radiographic changes.

Hearing impairment in patients with rheumatoid arthritis: association with anti-citrullinated protein antibodies.

It has been suggested that hearing impairment (HI) is one of the extra-articular features of rheumatoid arthritis (RA). Nevertheless, the prevalence and nature of HI in RA is still uncertain. The objectives were to study hearing function in patients with RA using audiometric tests and to examine whether HI correlates with autoantibodies. Hearing functions were investigated in 43 consecutive RA patients and 23 control subjects (less than 60years old). Their sera were evaluated for the presence of rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), and anti-mutated citrullinated vimentin (anti-MCV) antibodies. HI was observed in 46.5% of RA patients and in 30.4% of control subjects, p = 0.32. HI was characterized as sensorineural in 80 and 85.7% of RA patients and control subjects with HI, respectively, p = 1.00. RA patients had a worse hearing threshold for air conduction at 6kHz in the right ear (p = 0.019) and had a decreased amplitude of otoacoustic emissions (OAEs) at 2kHz bilaterally (p = 0.04) compared with control subjects. In the RA group, patients with and without HI were 80 and 34.78% anti-CCP positive, respectively, p = 0.008. RA patients with and without HI were 85 and 43.48% anti-MCV positive, respectively, p = 0.013. HI in RA patients was mainly sensorineural and was associated with anti-CCP and anti-MCV antibodies.

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

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.

Anti CCP and Anti MCV antibodies in Rheumatological disorders other than Rheumatoid arthritis

Anti CCP and Anti MCV antibodies in Rheumatological disorders other than Rheumatoid arthritis

Predictive value of autoantibodies from anti-CCP2, anti-MCV and anti-human citrullinated fibrinogen tests, in early rheumatoid arthritis patients with rapid radiographic progression at 1 year: results from the ESPOIR cohort

ObjectivesWe compared the ability of antibodies against cyclic citrullinated peptides (anti-CCP2), against mutated citrullinated vimentin (anti-MCV) and against citrullinated fibrinogen (AhFibA) to predict 1 year rapid radiographic progression (RRP; total...

Diagnostic accuracy of anti-MCV and anti-CCP antibodies in rheumatoid arthritis: A meta-analysis.

The purpose of this study was to compare the diagnostic performance of anti-mutated citrullinated vimentin (anti-MCV) and anti-cyclic citrullinated peptide (anti-CCP) antibodies in rheumatoid arthritis (RA). We searched the Medline, Embase, and Cochrane library databases and performed two meta-analyses on the diagnostic accuracy of anti-MCV and anti-CCP in patients with RA compared to healthy controls. We identified 12 studies that included a total of 2003 RA patients and 831 healthy controls for the meta-analysis. The pooled sensitivity and specificity of anti-MCV were 68.6% [95% confidence interval (CI) 66.6-79.7] and 94.2% (95% CI 92.4-96.7) and those of anti-CCP were 61.7% (95% CI 59.5-63.8) and 97.1% (95% CI 96.7-98.1), respectively. Anti-MCV PLR, NLR, and DOR were 12.99 (95% CI 8.013-21.27), 0.297 (95% CI 0.238-0.369), and 47.78 (95% CI 28.59-79.84), and those for anti-CCP were 16.71 (95% CI 11.42-24.47), 0.378 (95% CI 0.325-0.439), and 54.20 (95% CI 31.65-92.82), respectively. The AUC of anti-MCV was 0.886, and its Q* index was 0.817, indicating modest accuracy, while the AUC of anti-CCP was 0.946, and its Q* index was 0.885. The sensitivity of anti-MCV was significantly higher than that of anti-CCP in the diagnosis of RA (difference 0.069, 95% CI 0.039-0.098, p < 0.0001), but the specificity of anti-MCV was lower than that of anti-CCP (difference -0.029, 95% CI -0.051 to -0.006, p = 0.012). The Q* index of anti-MCV was significantly lower than that of anti-CCP (difference -0.068, 95% CI -0.070 to -0.065, p < 0.0001). Our meta-analysis demonstrates that anti-MCV is more sensitive but less specific, and has lower diagnostic accuracy than anti-CCP in RA, although anti-MCV and anti-CCP showed comparable high PLRs.

Anti-Mutated Citrullinated Vimentin Antibody and Rheumatoid Factor (Prevalence and Association) in Rheumatoid Arthritis Patients; Saudi and Non-Saudi

background: The aims of this study were to assess the prevalence of anti-mutated citrullinated vimentin (MCV) antibodies and rheumatoid factor (RF) and to evaluate their association in rheumatoid arthritis patients, both Saudi and non-Saudi. Retrospectively, we studied 280 rheumatoid arthritis patients, at King Abdulaziz University Hospital. The antibodies were measured by enzyme linked immunosorbent assay and rheumatoid factor by nephelometry. The 280 patients included 196 Saudis and 84 non-Saudis, 88% females and 12% males, and the mean age was 45.3 years (SD = 14.3). Prevalence of rheumatoid factor was 141/280 (50%) divided as 93/196 (47.5%) Saudis and 48/84 (57%) non-Saudis, with no significant differences (p > 0.05). Prevalence of mutated citrullinated vimentin antibodies was 165/280 (58.2%) divided as 121/196 (61.7%) Saudis and 44/84 (52.4%) non-Saudis, with no significant differences (p > 0.05). Among RF -ve patients, considerable numbers were anti-MCV +ve, and vice versa. Also, among the anti-MCV -ve patients, considerable numbers were RF +ve, and vice versa. In all cohorts and in Saudi and non Saudi patients, anti-MCV positivity was significantly associated with RF positivity (odds ratio (OR) 3.15; 95% CI 1.9, 5.19/p = 0.000); ESR and CRP were high with significant correlation (p < 0.005) with each other, with RF positivity but not with anti-MC positivity. Anti-MC positivity showed no significant correlation with age and gender. In this cohort of patients, anti-MCV antibodies are a useful diagnostic tool for RA, but its combination with RF is essential. Both markers are significantly associated. Larger scale studies are recommended. Correlation of anti-MCV with treatment and with disease activity still has to be published.

Diagnostic value of anti-MCV antibodies for ankylosing spondylitis

Objective To investigate the diagnostic value of anti-mutated citrullinated vimentin（anti-MCV） and anti-cyclic citrullinated peptide（anti-CCP） antibodies for ankylosing spondylitis (AS), and to establish a new diagnostic method of AS based on anti-citrullinated protein/peptide antibodies（ACPAs） detection. Methods Totally 121 AS patients(AS group), 97 rheumatoid arthritis（RA） patients(RA group)and 103 healthy people(control group) were enrolled for the detection of serum levels of anti-MCV and anti-CCP antibodies using ELISA method as a diagnostic test. HLA-B27 in AS patients was tested by flow cytometry, and RF-IgM in RA and AS patients was detected by immune rate nephelometry. Receiver operating characteristics (ROC) curve was used to analyze the diagnostic value and to determine the cut-off value. Anti-MCV and anti-CCP antibodies among each group were compared by Mann-Whitney U test, Chi-square test or Fisher′s exact test was used to compare positive rate. Results The anti-MCV levels in AS group ［11.60 (12.36-25.83) U/ml］were significantly higher than control group ［11.60(8.41-13.54）U/ml ］,U=2 413,P<0.001, while the levels of anti-CCP had no difference between the two groups ［AS group 6.22 （4.30-8.07）U/ml］, and control group ［6.01(3.77-7.58)U/ml］, respectively; U=5 421,P=0.094. The calculated area under the ROC curve of anti-MCV was 0.806,and 14.67 U/ml was the optimal cut-off value with sensitivity of 0.645 and specificity of 0.942. In both HLA-B27 positive and negative AS patients, anti-MCV antibodies levels and positive rate were significantly higher than control group using new cut-off value above （U=133.5, P=0.001; U=2 279.5,P<0.001). Sensitivity of the combination detection of anti-MCV and anti-CCP (MCV+CCP－) or RF-IgM (MCV+RF－) were 60.3% (73/121), 62.8% (76/121) and specificity were 89.7% (87/97), 90.7% (88/97) respectively in differential diagnosis of AS and RA, which were significantly higher than anti-MCV detection alone in specificity (16.5%,16/97). Conclusions Anti-MCV could be a new biomarker for the diagnosis of AS. With high sensitivity and specificity, anti-MCV has an equal diagnostic efficiency in HLA-B27 positive and negative AS patients using our new cut-off value. Additionally， the combination detection of anti-MCV and anti-CCP or RF-IgM could be an effective method for differential diagnosis of AS and RA.（Chin J Lab Med,2014,37: 455-458） Key words: Spondylitis,ankylosing; Peptides,cyclic; Vimentin; Mutation; Rheumatoid factor

AB0284 The Diagnostic Utility of Anti-Mutated Citrullinated Vimentin Antibodies, Anti-Cyclic Citrullinated Peptide Antibodies and Rheumatoid Factor in Rheumatoid Arthritis

BackgroundAntibodies against citrullinated peptides have gained special importance in the diagnosis of rheumatoid arthritis (RA) (1,2).ObjectivesThis study aims to investigate the diagnostic sensitivity and specificity of anti-mutated citrullinated vimentin (anti-MCV)...

AB0039 The Frequency of Acpa-Specific B Cells in the Circulating Memory B Cell Pool of Patients with Rheumatoid Arthritis

BackgroundRheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by the presence of autoantibodies (AA) such as rheumatoid factor (RF) and anti-citrullinated peptide antibodies (ACPAs). These AA do not...

Comparison of two assays to determine anti-citrullinated peptide antibodies in rheumatoid arthritis in relation to other chronic inflammatory rheumatic diseases: assaying anti-modified citrullinated vimentin antibodies adds value to second-generation anti-citrullinated cyclic peptides testing.

Determination of anti-citrullinated peptide antibodies (ACPA) plays a relevant role in the diagnosis of rheumatoid arthritis (RA). To date, it is still unclear if the use of several tests for these autoantibodies in the same patient offers additional value as compared to performing only one test. Therefore, we evaluated the performance of using two assays for ACPA: second-generation anti-citrullinated cyclic peptides antibodies (anti-CCP2) and anti-mutated citrullinated vimentin (anti-MCV) antibodies for the diagnosis of RA. We compared three groups: RA (n = 142), chronic inflammatory disease (CIRD, n = 86), and clinically healthy subjects (CHS, n = 56) to evaluate sensitivity, specificity, predictive values, and likelihood ratios (LR) of these two assays for the presence of RA. A lower frequency of positivity for anti-CCP2 was found in RA (66.2%) as compared with anti-MCV (81.0%). When comparing RA versus other CIRD, sensitivity increased when both assays were performed. This strategy of testing both assays had high specificity and LR+. We conclude that adding the assay of anti-MCV antibodies to the determination of anti-CCP2 increases the sensitivity for detecting seropositive RA. Therefore, we propose the use of both assays in the initial screening of RA in longitudinal studies, including early onset of undifferentiated arthritis.

Anti-Mutated Citrullinated Vimentin (Anti-MCV) Antibodies as a Diagnostic Aid for Rheumatoid Arthritis

Background: This study aimed to evaluate the role of anti-MCV antibodies in the diagnosis of RA and correlate anti-MCV with other markers of disease activity. Subjects and methods: The study was carried out on 70 individuals, categorized as follows; 40 patients diagnosed as rheumatoid arthritis (RA) (Group I), 15 patients diagnosed as osteoarthritis disease (OA) (Group II) and their results were compared to 15 apparently healthy persons as control group (Group III). All participants were subjected to careful history taking, general examination, routine laboratory investigations, in addition to, anti-cyclic citrullinated peptide (anti-CCP) and anti-mutated citrullinated vimentin (anti-MCV) assays. Results: Anti-CCP and anti-MCV values were significantly higher in group I when compared to group II and III (Pvalue 27.5 U/ml at which Sensitivity was 99.1, Specificity was 93.3, PPV was 97.8 and NPV was 99.8. The AUC (area under the curve) value for anti-MCV was 0.997. There were highly significant positive correlations between anti-MCV, anti-CCP and ESR in group I (P-value<0.001 and 0.001). Anti-CCP and anti-MCV were significantly higher in RF positive patients compared to RF negative patients (P-values=0.005 and 0.011 respectively), while no significant differences in anti-CCP and anti-MCV were found between CRP positive and CRP negative patients in group I. Conclusion: Anti-MCV is an excellent marker for early diagnosis of RA with high sensitivity and specificity especially when other markers are negative. The use of anti-MCV and anti-CCP collectively give the best result for the diagnosis of rheumatoid disease.