Anti-mutated citrullinated vimentin antibodies in rheumatoid arthritis patients: Relation to disease activity and manifestations

Aim of the work: To evaluate the frequency of anti-mutated citrullinated vimentin antibodies (MCV) in rheumatoid arthritis (RA) patients and to correlate it with disease activity and various disease manifestations. Patients and methods: Fifty RA patients were recruited from the rheumatology and rehabilitation outpatient clinic, Kasr Al-Aini. Thirty healthy subjects served as controls. All patients were subjected to full history taking and clinical examination including general and joint assessment. Disease activity was assessed by the disease activity score (DAS-28) and functional ability was evaluated by the Modified Health Assessment Questionnaire (MHAQ). Anti-MCV and anti-cyclic citrullinated peptide (anti-CCP) were assayed by ELISA in patients and controls. Plain X-ray was performed on the hands and wrists and Sharp score was used to assess the erosions and joint space narrowing. Results: A highly significant elevation of serum anti-MCV in RA patients (135.82 +/- 126.81 U/ml) compared to controls (13.63 +/- 8.48 U/ml) (p < 0.0001) was found. Anti-MCV showed a sensitivity of 84% and specificity of 80%. There was a significant difference between anti-MCV positive and anti-MCV negative patients as regards MHAQ (1.07 +/- 0.74 vs. 0.52 +/- 0.37, p = 0.005) and Sharp erosion score (12.93 +/- 23.55 vs. 4 +/- 2.2, p = 0.02). Anti-CCP showed a sensitivity of 70% and specificity of 100%. There was a significant difference between the specificities of both markers (p = 0.03). There was no significant correlation of the anti-MCV with the clinical manifestations, MHAQ, DAS28 or Sharp score. Anti-MCV significantly correlated with anti-CCP (p < 0.0001). Conclusion: Anti-MCV test has a significant association with the functional disability and radiologic progression in RA and could be considered as a promising biomarker. (C) 2014 Production and hosting by Elsevier B.V. on behalf of Egyptian Society for Joint Diseases and Arthritis.