Diagnostic Value of Antibodies against a Modified Citrullinated Vimentin in Rheumatoid Arthritis


Aim of Work: To investigate the value of the detection of antibodies against modified citrullinated vimentin antibodies (anti-MCV) in comparison with anti-CCP2-for the diagnosis of rheumatoid arthritis (RA). Patients and Methods: The study Included Forty patients with Rheumatoid arthritis (RA). They under went assessment by the disease activity score (DAS-28), visual analogue scale (VAS) and health assessment questionnaire (HAQ). Thirty healthy subjects matched for age and sex served as a control group. Blood samples were obtained from patients and controls for erythrocyte sedimentation rate (ESR), C reactive protein (CRP), rheumatoid factor (RF). Anti-CCP2 and anti-MCV were determined using ELISA technique. Results: Estimated serum levels of anti-CCP2 and anti-MCV were significantly higher in patients compared to controls (p < 0.001). There were no significant correlations between anti-MCV levels and age, dis- ease duration, duration of morning stiffness, number of swollen and tender joints, HAQ or ESR in patients with RA, while serum levels correlates significantly with DAS28, VAS and CRP (p < 0.05). Anti-CCP2 correlates significantly with DAS28, VAS and CRP and ANA (p < 0.05). Serum anti-MCV and anti-CCP2 were significantly correlated with each other (r = 0.483; p < 0.001). The receiver operating characteristic (ROC) curve was drawn and it showed that anti-MCV had diagnostic specificity, sensitivity of 93.3%, 75.5%, respectively, while anti-CCP2 specificity, sensitivity of 98.1%, 85%, respectively. Conclusion: Serum anti-MCV 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.

Share and Cite:

S. El-Fetou and H. Abozaid, "Diagnostic Value of Antibodies against a Modified Citrullinated Vimentin in Rheumatoid Arthritis," Open Journal of Rheumatology and Autoimmune Diseases, Vol. 3 No. 4, 2013, pp. 185-191. doi: 10.4236/ojra.2013.34029.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] J. H. Pedersen-Lane, R. B. Zurier and D. A. Lawrence, “Analysis of the Thiol Status of Peripheral Blood Leukocytes in Rheumatoid Arthritis Patients,” Journal of Leukocyte Biology, Vol. 81, No. 4, 2007, pp. 934-941. http://dx.doi.org/10.1189/jlb.0806533
[2] G. Serre, “Autoantibodies to Filaggrin/Deiminated Fibrin (AFA) Are Useful for the Diagnosis and Prognosis of Rheumatoid Arthritis, and Are Probably Involved in the Pathophysiology of the Disease,” Joint Bone Spine, Vol. 68, No. 2, 2001, pp. 103-105. http://dx.doi.org/10.1016/S1297-319X(01)00259-7
[3] T. Mottonen, L. Paimela, M. Leirisalo-Repo, H. Kautiainen, J. Ilonen and P. Hannonen, “Only High Disease Activity and Positive Rheumatoid Factor Indicate Poor Prognosis in Patients with Early Rheumatoid Arthritis Treated with ‘Sawtooth’ Strategy,” Annals of the Rheumatic Diseases, Vol. 57, No. 9, 1998, pp. 533-539. http://dx.doi.org/10.1136/ard.57.9.533
[4] F. C. Arnett, S. M. Edworthy, D. A. Bloch, et al., “The American Rheumatism Association 1987 Revised Criteria for the Classification of Rheumatoid Arthritis,” Arthritis & Rheumatism, Vol. 31, No. 3, 1988, pp. 315-324. http://dx.doi.org/10.1002/art.1780310302
[5] I. Vallbracht, J. Rieber, M. Oppermann, F. Forger, U. Siebert and K. Helmke, “Diagnostic and Clinical Value of Anti-Cyclic Citrullinated Peptide Antibodies Compared with Rheumatoid Factor Isotypes in Rheumatoid Arthritis,” Annals of the Rheumatic Diseases, Vol. 63, No. 9, 2004, pp. 1079-1084. http://dx.doi.org/10.1136/ard.2003.019877
[6] G. A. Schellekens, B. A. de Jong, F. H. van den Hoogen, L. B. van de Putte and W. J. van Venrooij, “Citrulline Is an Essential Constituent of Antigenic Determinants Recognized by Rheumatoid Arthritis-Specific Autoantibodies,” The Journal of Clinical Investigation, Vol. 101, No. 1, 1998, pp. 273-281. http://dx.doi.org/10.1172/JCI1316
[7] B. Harrison, W. Thomson, D. Symmons, et al., “The Influence of HLA-DRB1 Alleles and Rheumatoid Factor on Disease Outcome in an Inception Cohort of Patients with Early Inflammatory Arthritis,” Arthritis & Rheumatism, Vol. 42, No. 10, 1999, pp. 2174-2183. http://dx.doi.org/10.1002/1529-0131(199910)42:10<2174::AID-ANR19>3.0.CO;2-G
[8] E. Lindqvist, K. Eberhardt, K. Bendtzen, D. Heinegard and T. Saxne, “Prognostic Laboratory Markers of Joint Damage in Rheumatoid Arthritis,” Annals of the Rheumatic Diseases, Vol. 64, No. 2, 2005, pp. 196-201. http://dx.doi.org/10.1136/ard.2003.019992
[9] E. R. Vossenaar, T. R. Radstake, A. van der Heijden, et al., “Expression and Activity of Citrullinating Peptidylarginine Deiminase Enzymes in Monocytes and Macrophages,” Annals of the Rheumatic Diseases, Vol. 63, No. 4, 2004, pp. 373-381. http://dx.doi.org/10.1136/ard.2003.012211
[10] H. Poulsom and P. J. Charles, “Antibodies to Citrullinated Vimentin Are a Specific and Sensitive Marker for the Diagnosis of Rheumatoid Arthritis,” Clinical Reviews in Allergy & Immunology, Vol. 34, No. 1, 2008, pp. 4-10. http://dx.doi.org/10.1007/s12016-007-8016-3
[11] J. Ursum, M. M. Nielen, D. van Schaardenburg, et al., “Antibodies to Mutated Citrullinated Vimentin and Disease Activity Score in Early Arthritis: A Cohort Study,” Arthritis Research & Therapy, Vol. 10, No. 1, 2008, p. R12. http://dx.doi.org/10.1186/ar2362
[12] J. T. Cassidy, J. E. Levinson, J. C. Bass, et al., “A Study of Classification Criteria for a Diagnosis of Juvenile Rheumatoid Arthritis,” Arthritis & Rheumatism, Vol. 29, No. 2, 1986, pp. 274-281. http://dx.doi.org/10.1002/art.1780290216
[13] H. Bang, K. Egerer, A. Gauliard, et al., “Mutation and Citrullination Modifies Vimentin to a Novel Autoantigen for Rheumatoid Arthritis,” Arthritis & Rheumatism, Vol. 56, No. 8, 2007, pp. 2503-2511. http://dx.doi.org/10.1002/art.22817
[14] R. Sghiri, E. Bouajina, D. Bargaoui, et al., “Value of Anti-Mutated Citrullinated Vimentin Antibodies in Diagnosing Rheumatoid Arthritis,” Rheumatology International, Vol. 29, No. 1, 2008, pp. 59-62. http://dx.doi.org/10.1007/s00296-008-0614-8
[15] C. Dejaco, W. Klotz, H. Larcher, C. Duftner, M. Schirmer and M. Herold, “Diagnostic Value of Antibodies against a Modified Citrullinated Vimentin in Rheumatoid Arthritis,” Arthritis Research & Therapy, Vol. 8, No. 4, 2006, p. R119. http://dx.doi.org/10.1186/ar2008
[16] R. K. Mallya and B. E. Mace, “The Assessment of Disease Activity in Rheumatoid Arthritis Using a Multivariate Analysis,” Rheumatology and Rehabilitation, Vol. 20, No. 1, 1981, pp. 14-17. http://dx.doi.org/10.1093/rheumatology/20.1.14
[17] M. L. Prevoo, M. A. van ‘t Hof, H. H. Kuper, M. A. van Leeuwen, L. B. van de Putte and P. L. van Riel, “Modified Disease Activity Scores That Include Twenty-Eight-Joint Counts. Development and Validation in a Prospective Longitudinal Study of Patients with Rheumatoid Arthritis,” Arthritis & Rheumatism, Vol. 38, No. 1, 1995, pp. 44-48. http://dx.doi.org/10.1002/art.1780380107
[18] G. Kleveland, T. Egeland and T. Lea, “Quantitation of Rheumatoid Factors (RF) of IgM, IgA and IgG Isotypes by a Simple and Sensitive ELISA. Discrimination between False and True IgG-RF,” Scandinavian Journal of Rheumatology, Vol. 75, 1988, pp. 15-24.
[19] K. Egerer, E. Feist and G. R. Burmester, “The Serological Diagnosis of Rheumatoid Arthritis: Antibodies to Citrullinated Antigens,” Deutsches Arzteblatt International, Vol. 106, No. 10, 2009, pp. 159-163.
[20] W. L. Gross, F. Moosig and P. Lamprecht, “Anticitrullinated Protein/Peptide Antibodies in Rheumatoid Arthritis,” Deutsches Arzteblatt International, Vol. 106, No. 10, 2009, pp. 157-158.
[21] T. Mimori, “Clinical Significance of Anti-CCP Antibodies in Rheumatoid Arthritis,” Internal Medicine, Vol. 44, No. 11, 2005, pp. 1122-1126. http://dx.doi.org/10.2169/internalmedicine.44.1122
[22] T. R. Mikuls, J. R. O’Dell, J. A. Stoner, et al., “Association of Rheumatoid Arthritis Treatment Response and Disease Duration with Declines in Serum Levels of IgM Rheumatoid Factor and Anti-Cyclic Citrullinated Peptide Antibody,” Arthritis & Rheumatism, Vol. 50, No. 12, 2004, pp. 3776-3782. http://dx.doi.org/10.1002/art.20659
[23] G. Keskin, A. Inal, D. Keskin, et al., “Diagnostic Utility of Anti-Cyclic Citrullinated Peptide and Anti-Modified Citrullinated Vimentin Antibodies in Rheumatoid Arthritis,” Protein & Peptide Letters, Vol. 15, No. 3, 2008, pp. 314-317. http://dx.doi.org/10.2174/092986608783744153
[24] A. J. Zendman, W. J. van Venrooij and G. J. Pruijn, “Use and Significance of Anti-CCP Autoantibodies in Rheumatoid Arthritis,” Rheumatology (Oxford), Vol. 45, No. 1, 2006, pp. 20-25. http://dx.doi.org/10.1093/rheumatology/kei111
[25] X. Liu, R. Jia, J. Zhao and Z. Li, “The Role of Anti-Mutated Citrullinated Vimentin Antibodies in the Diagnosis of Early Rheumatoid Arthritis,” Journal of Rheumatology, Vol. 36, No. 6, 2009, pp. 1136-1142. http://dx.doi.org/10.3899/jrheum.080796
[26] L. Mathsson, M. Mullazehi, M. C. Wick, et al., “Antibodies against Citrullinated Vimentin in Rheumatoid Arthritis: Higher Sensitivity and Extended Prognostic Value Concerning Future Radiographic Progression as Compared with Antibodies against Cyclic Citrullinated Peptides,” Arthritis & Rheumatism, Vol. 58, No. 1, 2008, pp. 36-45. http://dx.doi.org/10.1002/art.23188
[27] H. Morbach, H. Dannecker, T. Kerkau and H. J. Girschick, “Prevalence of Antibodies against Mutated Citrullinated Vimentin and Cyclic Citrullinated Peptide in Children with Juvenile Idiopathic Arthritis,” Clinical and Experimental Rheumatology, Vol. 28, No. 5, 2010, p. 800.
[28] L. Innala, H. Kokkonen, C. Eriksson, E. Jidell, E. Berglin and S. R. Dahlqvst, “Antibodies against Mutated Citrullinated Vimentin Are a Better Predictor of Disease Activity at 24 Months in Early Rheumatoid Arthritis than Antibodies against Cyclic Citrullinated Peptides,” Journal of Rheumatology, Vol. 35, No. 6, 2008, pp. 1002-1008.
[29] L. Damjanovska, M. M. Thabet, E. W. Levarth, et al., “Diagnostic Value of Anti-MCV Antibodies in Differentiating Early Inflammatory Arthritis,” Annals of the Rheumatic Diseases, Vol. 69, No. 4, 2010, pp. 730-732. http://dx.doi.org/10.1136/ard.2009.108456
[30] L. Soos, Z. Szekanecz, Z. Szabo, et al., “Clinical Evaluation of Anti-Mutated Citrullinated Vimentin by ELISA in Rheumatoid Arthritis,” Journal of Rheumatology, Vol. 34, No. 8, 2007, pp. 1658-1663.
[31] R. E. Petty, T. R. Southwood, P. Manners, et al., “International League of Associations for Rheumatology Classification of sion, Edmonton, 2001,” Journal of Rheumatology, Vol. 31, No. 2, 2004, pp. 390-392.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.