title: 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.
abstract: 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.
authors.affiliation: Programas de Doctorado en Farmacología y en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, JAL, Mexico.
authors.forename: Miriam Lizette
authors.initials: ML
authors.lastname: Díaz-Toscano
authors.affiliation: Hospital General Regional 180 IMSS Tlajomulco, JAL, Mexico.
authors.forename: Eva Maria
authors.initials: EM
authors.lastname: Olivas-Flores
authors.affiliation: Programas de Doctorado en Farmacología y en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, JAL, Mexico.
authors.forename: Soraya Amali
authors.initials: SA
authors.lastname: Zavaleta-Muñiz
authors.affiliation: Unidad de Investigación en Epidemiología Clínica y División de Investigación en Salud, UMAE, Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO), IMSS, Guadalajara, JAL, Mexico ; Programa de Doctorado en Salud Púbica CUCS, Guadalajara, JAL, Mexico.
authors.forename: Jorge Ivan
authors.initials: JI
authors.lastname: Gamez-Nava
authors.affiliation: Departamento de Fisiologia, CUCS, Universidad de Guadalajara, Guadalajara, JAL, Mexico.
authors.forename: Ernesto German
authors.initials: EG
authors.lastname: Cardona-Muñoz
authors.affiliation: Programas de Doctorado en Farmacología y en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, JAL, Mexico.
authors.forename: Manuel
authors.initials: M
authors.lastname: Ponce-Guarneros
authors.affiliation: Programa de Servicio Social en Investigación, Secretaria de Salud, Guadalajara, JAL, Mexico.
authors.forename: Uriel
authors.initials: U
authors.lastname: Castro-Contreras
authors.affiliation: Unidad de Investigación en Epidemiología Clínica y División de Investigación en Salud, UMAE, Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO), IMSS, Guadalajara, JAL, Mexico ; Decanato Ciencias de la Salud, Universidad Autónoma de Guadalajara, Mexico.
authors.forename: Arnulfo
authors.initials: A
authors.lastname: Nava
authors.affiliation: Unidad de Investigación en Epidemiología Clínica y División de Investigación en Salud, UMAE, Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO), IMSS, Guadalajara, JAL, Mexico ; Departamento de Fisiologia, CUCS, Universidad de Guadalajara, Guadalajara, JAL, Mexico.
authors.forename: Mario
authors.initials: M
authors.lastname: Salazar-Paramo
authors.affiliation: Dirección de la División de Disciplinas para el Desarrollo, Promoción y Preservación de la Salud, CUCS, Universidad de Guadalajara, Mexico.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Celis
authors.affiliation: Programas de Doctorado en Farmacología y en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, JAL, Mexico.
authors.forename: Nicte Selene
authors.initials: NS
authors.lastname: Fajardo-Robledo
authors.affiliation: Departamento de Fisiologia, CUCS, Universidad de Guadalajara, Guadalajara, JAL, Mexico.
authors.forename: Esther Guadalupe
authors.initials: EG
authors.lastname: Corona-Sanchez
authors.affiliation: Programa de Doctorado en Salud Púbica CUCS, Guadalajara, JAL, Mexico ; Departamento de Medicina Interna-Reumatología, Hospital General Regional 110, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, JAL, Mexico ; Avenida Salto del Agua 2192, Colonia Jardines del Country, Guadalajara, Mexico.
authors.forename: Laura
authors.initials: L
authors.lastname: Gonzalez-Lopez
mesh_terms: D000328:Adult; D000906:Antibodies / Q000097:blood / Q000276:immunology / Q000302:isolation & purification*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D002956:Citrulline / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000097:blood / Q000276:immunology; D012213:Rheumatic Fever / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D014746:Vimentin / Q000276:immunology*
chemical_list: D000906:Antibodies; D010456:Peptides, Cyclic; D014746:Vimentin; D002956:Citrulline