Rheumatology Medical News about early rheumatoid arthritis;anti-mutated citrullinated vimentin antibodies

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The role of anti-mutated citrullinated vimentin antibodies in the diagnosis of early rheumatoid arthritis
Journal of Rheumatology, 06/11/09

Liu X et al. – Study demonstrates that anti-mutated citrullinated vimentin (anti-MCV) is a novel diagnostic marker for early rheumatoid arthritis (RA). It may be more useful if the second-generation anti-cyclic citrullinated peptide antibodies (anti-CCP2) assay is performed concomitantly to diagnose pts with early RA.

Methods

Study evaluates the diagnostic value of anti-MCV in a large cohort of Chinese pts with early RA (<1 yr duration)
Subjects included in this study:
- 170 pts with early RA
- 66 with other rheumatic diseases
- 10 with infectious diseases, and
- 60 healthy individuals
Serum anti-MCV and anti-CCP2 were measured by ELISA, and RF was measured by rate nephelometry
Associated clinical data of pts with early RA were also evaluated
Disease activity was scored by DAS28, and the degree of radiological changes was assessed by Sharp score

Results

Prevalence of serum anti-MCV in pts with early RA (78.2%) was higher than that of other rheumatologic pts and pts with infectious diseases
- 12% (3/25) in systemic lupus erythematosus
- 9.5% (2/21) in primary Sjögren’s syndrome
- 10% (1/10) in systemic sclerosis
- 20% (2/10) in ankylosing spondylitis
- 12.5% (1/8) in viral hepatitis type B, and
- 0% (0/2) in tuberculosis
Anti-MCV was not found in the serum of healthy subjects
Sensitivities of anti-MCV, anti-CCP2, and RF tests for early RA were 78.2%, 61.8%, and 72.4%, respectively
Specificities were 93.4%, 96.3%, and 80.1%
Combination of anti-MCV and anti-CCP2 positivity showed a high specificity (97.8%) and positive predictive value (97.1%), but a low sensitivity (58.8%)
The sensitivity reached 81.2% when the union of anti-MCV and anti-CCP2 positivities was used as one combined criterion
Statistically, anti-MCV had correlation with anti-CCP2 and RF
In addition, it had an interesting correlation with radiological assessment
The anti-MCV had no correlation with other factors, such as ESR, CRP, antikeratin Ab, antiperinuclear factor, global VAS score for joint pain, IgA, IgG, IgM, C3, C4, hidden rheumatoid factor for IgA (HRFIgA), HRFIgG, and DAS28