Diagnostic value of antibodies against a modified citrullinated vimentin in rheumatoid arthritisReport as inadecuate




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Arthritis Research and Therapy

, 8:R119

First Online: 19 July 2006Received: 05 May 2006Revised: 20 June 2006Accepted: 07 July 2006

Abstract

Antibodies directed against citrullinated vimentin are members of the family of autoantibodies reactive with citrullinated proteins and are among the most specific serological markers for the diagnosis of rheumatoid arthritis RA. This study was performed to test the diagnostic value of a newly developed enzyme-linked immunosorbent assay ELISA for the detection of antibodies against a genetically modified citrullinated vimentin anti-MCV in comparison with a second-generation anti-cyclic citrullinated peptides anti-CCP2 ELISA test system. Blinded sera from 631 patients 409 consecutive out-patients and 222 randomly selected stored sera with RA n = 164 and non-RA osteoarthritis n = 120, polymyalgia rheumatica-giant cell arteritis n = 80, spondyloarthritis n = 36, and other inflammatory rheumatic or non-inflammatory disease n = 67 were tested for the presence of anti-MCV and anti-CCP2 antibodies according to the manufacturers- instructions. The diagnostic performance of the anti-MCV was comparable with the anti-CCP2 assay for the diagnosis of RA according to the calculated area under the curve 0.824; 95% confidence interval CI 0.778–0.870 versus 0.818; 95% CI 0.767–0.869 as analysed by receiving operating characteristic curve. When categorised with a cutoff value of 20.0 U-ml as recommended by the manufacturer, sensitivity and specificity of the anti-MCV ELISA were 69.5% 95% CI 61.9%–76.5% and 90.8% 86.9%–93.8%, respectively, compared with 70.1% 62.5%–77.0% and 98.7% 96.7%–99.6% of the anti-CCP2 assay. Using the cutoff values of 19.0 U-ml and 81.5 U-ml for the anti-MCV test to obtain a sensitivity and specificity identical to the anti-CCP2 assay, showed a reduced specificity 89.8%; 85.8%–92.9% and sensitivity 53.7%; 45.7%–61.5%, respectively, of the anti-MCV ELISA compared with the anti-CCP2 test. In conclusion, the serum ELISA testing for anti-MCV antibodies as well as the anti-CCP-2 assay perform comparably well in the diagnosis of RA. In the high-specificity range, however, the anti-CCP2 assay appears to be superior to the anti-MCV test.

AbbreviationsACR= American College of Rheumatology

AKA= antikeratin antibody

anti-CCP= anti-cyclic citrullinated peptide

anti-MCV= anti-modified citrullinated vimentin

APF= antiperinuclear factors

AUC= area under the curve

CI= confidence interval

ELISA= enzyme-linked immunosorbent assay

Ig= immunoglobulin

IgM-RF= immunoglobulin M-rheumatoid factor

OA= osteoarthritis

PMR-GCA= polymyalgia rheumatica and-or giant cell arteritis

RA= rheumatoid arthritis

RF= rheumatoid factor

ROC= receiving operating characteristic

SD= standard deviation

SpA= spondyloarthritis.

Electronic supplementary materialThe online version of this article doi:10.1186-ar2008 contains supplementary material, which is available to authorized users.

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Author: Christian Dejaco - Werner Klotz - Heike Larcher - Christina Duftner - Michael Schirmer - Manfred Herold

Source: https://link.springer.com/







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