Antibodies to citrullinated vimentin are a specific and sensitive marker for the diagnosis of rheumatoid arthritis.
BACKGROUND
The last 5 years have seen the emergence and establishment of antibodies to citrullinated antigens as the diagnostic marker for rheumatoid arthritis (RA). Initially, these were detected using a synthetic peptide, which has undergone a number of modifications to give a diagnostic test with a sensitivity of 65-80% and a specificity of >95%. Antibodies to citrullinated vimentin were first described in 1994 as a highly specific marker for RA (anti-Sa). However, no easily performed assay for these antibodies has been available.


METHODS
We have examined the use of a ELISA-based assay with a mutated citrullinated vimentin (MCV) antigen (Orgentec, Mainz, Germany) to assess the diagnostic and prognostic utility of this antibody in RA.


RESULTS
Antibodies to MCV were detected in the sera of 74% RA patients (specificity 96%), 2% systemic lupus erythematosus, 14% Sjögren's syndrome, and 2% scleroderma. Anti-MCV was not detected in sera from healthy blood donors. There was no difference in the frequency of antibodies detected in RA patients with early (<2 years) or chronic (>2 years) disease. There was no significant variation in anti-MCV antibody concentrations in early RA patients over a 52-week period. No significant change was observed with time between the two treatment groups of methotrexate alone or methotrexate plus infliximab.


CONCLUSIONS
Antibodies to MCV are a specific and sensitive marker for the diagnosis of RA.
Poulsom
Hannah
H
Division of Immunology, Hammersmith Hospitals NHS Trust, and Kennedy Institute of Rheumatology, Imperial College, London, UK.
Charles
Peter J
PJ
D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000276:immunology; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D009154:Mutation; D010456:Peptides, Cyclic / Q000276:immunology*; D012680:Sensitivity and Specificity; D014746:Vimentin / Q000276:immunology*
D001323:Autoantibodies; D015415:Biomarkers; D010456:Peptides, Cyclic; D014746:Vimentin; C487763:cyclic citrullinated peptide