Diagnostic value of antibodies against mutated citrullinated vimentin for rheumatoid arthritis.
OBJECTIVE
To compare the diagnostic efficiency of anti-MCV, anti-CCP2 and RF detection for patients with RA.


METHODS
Cross-sectional study of patients with established rheumatic disease: rheumatoid arthritis (RA; n=75), psoriatic arthritis (PsA; n=25), 27 patients with ankylosing spondylitis (AS; n=27) and connective tissue disease (CTD; n=17). Anti-CCP2, anti-MCV and RF were detected by enzyme-linked immunosorbent assays on stored serum according to the manufacturer's instructions.


RESULTS
IgM-RF had the highest sensitivity, but the positive likelihood ratio is just 1.43. The detection of anti-MCV has a higher sensitivity for RA (76%), a specificity similar to anti-CCP2 (96%) resulting in the lowest negative likelihood ratio (0.25). Anti-MCV levels correlate well with anti-CCP2 levels (R=0.74; p<0.01). The mean level of anti-MCV is significantly higher in RA than in other subgroups (395 U/ml versus 14.4 U/ml, χ2=61.0; p<0.001) and in each other subgroup (Mann-Whitney-Wilcoxon: U=239, p<0.001 for RA and PsA; U=215, p<0.001 for RA and AS; U=192, p<0.001 for RA and CTD). Among RA patients, anti-CCP2 levels have a dichotomous distribution whereas anti-MCV levels have a homogeneous distribution.


CONCLUSIONS
Anti-MCV could be a better test for diagnosing RA than anti-CCP2.
University Hospital North Norway, Rheumatology, Tromsø, Norway. emilio.besada@unn.no
Emilio
E
Besada
Cathrin
C
Nikolaisen
Hans
H
Nossent
D000328:Adult; D015535:Arthritis, Psoriatic / Q000097:blood / Q000175:diagnosis; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000175:diagnosis*; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003240:Connective Tissue Diseases / Q000097:blood / Q000175:diagnosis; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010456:Peptides, Cyclic / Q000235:genetics / Q000276:immunology*; D011237:Predictive Value of Tests; D012372:ROC Curve; D013167:Spondylitis, Ankylosing / Q000097:blood / Q000175:diagnosis; D014746:Vimentin / Q000276:immunology*
D001323:Autoantibodies; D015415:Biomarkers; D010456:Peptides, Cyclic; D014746:Vimentin; C487763:cyclic citrullinated peptide