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Abstract
Objective:
Serologic support is important for the diagnosis of rheumatoid arthritis (RA). Anti-cyclic citrullinated peptide (anti-CCP) has relatively low sensitivity despite of high specificity for the diagnosis of RA. Anti-mutated citrullinated vimentin (anti-MCV) is an indirect solid phase enzyme immunoassay for the quantitative measeurement of IgG class autoantibodies against MCV, a novel serologic marker for an aid in the diagnosis of RA. We investigated a diagnostic value of anti-MCV in comparison with those of anti-CCP, and rheumatoid factors (IgM, IgG, and IgA RFs) in RA patients.
Methods:
Cohorts of 48 patients with RA and 50 patients with osteoarthritis (OA) were enrolled. All patients underwent standard examinations, including anti-MCV, anti-CCP, IgM RF, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). We measured IgG RF and IgA RF titers in 21 RA and 50 OA patients. The sensitivities and specificities of anti-MCV, anti-CCP, RFs were determined. Correlations with these markers, ESR and CRP were analyzed.
Results:
The sensitivity of anti-MCV, anti-CCP, and IgM RF were 89.6%, 89.6%, and 77.1%, respectively. The specificities of them were 96.0%, 96.0%, and 88%, respectively. Combination of two tests such as anti-MCV or anti-CCP positivity increased the sensitivity up to 93.8%. None of these markers showed significant correlation with ESR and CRP. Anti-MCV correlated with anti-CCP (r=0.596, p<0.01) and IgM RF (r=0.301, p=0.038).
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Table 1.
General characteristics of the cohorts
| RA | OA | |
|---|---|---|
| Patients number | 48 | 50 |
| Age (years) | 52.2±13.4 | 51.0±11.1 |
| Sex (male : female) | 5 : 43 | 7 : 43 |
| Disease duration (months) | 64.7±51.6 | NA |
| ESR (mm/hour) | 23.9±27.4 | 14.9±12.3 |
| CRP (mg/dL) | 7.2±11.0 | 3.0±7.1 |
Table 2.
Clinical sensitivity and specificity of anti-MCV and anti-CCP
Table 3.
Characteristics of serologic markers for the diagnosis of rheumatoid arthritis
| Serologic marker | Sensitivity (%) | Specificity (%) |
|---|---|---|
| Anti-MCV | 89.6 | 96.0 |
| Anti-CCP | 89.6 | 96.0 |
| Anti-MCV or anti-CCP | 93.8 | 94.0 |
| Anti-MCV and anti-CCP | 85.4 | 98.0 |
| IgM RF | 77.1 | 88.0 |
| IgG RF | 43.0 | 98.0 |
| IgA RF | 29.0 | 100 |
Table 4.
Correlations between anti-MCV, anti-CCP, RFs, ESR, and CRP
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