Dr. Klareskog has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Wyeth, Schering-Plough, Bristol-Myers Squibb, Abbott, Roche, and Amgen. Dr. Rönnelid has received speaking fees (less than $10,000 each) from Schering-Plough, Wyeth, Pfizer, and Roche.
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Rheumatoid Arthritis Basic Science Studies
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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†
Article first published online: 28 DEC 2007
DOI: 10.1002/art.23188
Copyright © 2008 by the American College of Rheumatology
Additional Information
How to Cite
Mathsson, L., Mullazehi, M., Wick, M. C., Sjöberg, O., van Vollenhoven, R., Klareskog, L. and Rönnelid, J. (2008), 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, 58: 36–45. doi: 10.1002/art.23188
- †
Orgentec Inc. supplied anti-MCV kits for the study.
Publication History
- Issue published online: 28 DEC 2007
- Article first published online: 28 DEC 2007
- Manuscript Accepted: 7 SEP 2007
- Manuscript Received: 26 NOV 2006
Funded by
- Swedish Fund for Research Without Animal Experiments
- Agnes and Mac Rudberg Foundation
- King Gustav V's 80-Year Fund
- Signe and Reinhold Sund's Foundation for Rheumatological Research
- Swedish Rheumatism Association
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Abstract
Objective
The Sa autoantigen can be found in inflamed synovium of patients with rheumatoid arthritis (RA), and at least part of the humoral RA-specific anti-Sa response is directed against citrullinated vimentin. This study was undertaken to evaluate the sensitivity, specificity, and prognostic value of determination of levels of antibodies against modified citrullinated vimentin (anti-MCV) as compared with antibodies against cyclic citrullinated peptides (anti-CCP) in an inception cohort of patients with early RA.
Methods
Clinical data, radiographs, and measurements of levels of anti-MCV and anti-CCP antibodies were obtained in 273 patients with early RA at baseline, after 3 months, and after 1, 2, 3, and 5 years. Autoantibodies were also analyzed in 100 healthy controls.
Results
Of the 273 patients, 193 (70.7%) were anti-MCV positive and 158 (57.9%) were anti-CCP positive at the time of diagnosis, with nearly equal specificities (95% and 96%, respectively). Forty (14.7%) were anti-MCV positive only, and 5 (1.8%) were anti-CCP positive only. Anti-MCV–positive and anti-MCV–negative patients had similar disease activity at baseline, but presence of anti-MCV was predictive of subsequent high disease activity and continued radiographic progression. Changes in anti-MCV level showed stronger correlation with changes in clinical parameters than did changes in anti-CCP level. The subgroup of patients who were anti-MCV positive and anti-CCP negative showed a higher rate of radiographic destruction than did patients who were negative for both anti-MCV and anti-CCP.
Conclusion
These findings show that when patients with early RA are compared with healthy controls, analysis of anti-MCV yields greater sensitivity and unchanged specificity as compared with analysis of anti-CCP. Anti-MCV also appears to perform better than anti-CCP in identifying poor radiographic prognosis in patients with early RA.