Author(s): Poulsom H, Charles PJ
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Abstract BACKGROUND: The last 5 years have seen the emergence and establishment of antibodies to citrullinated antigens as the diagnostic marker for rheumatoid arthritis (RA). Initially, these were detected using a synthetic peptide, which has undergone a number of modifications to give a diagnostic test with a sensitivity of 65-80\% and a specificity of >95\%. Antibodies to citrullinated vimentin were first described in 1994 as a highly specific marker for RA (anti-Sa). However, no easily performed assay for these antibodies has been available. METHODS: We have examined the use of a ELISA-based assay with a mutated citrullinated vimentin (MCV) antigen (Orgentec, Mainz, Germany) to assess the diagnostic and prognostic utility of this antibody in RA. RESULTS: Antibodies to MCV were detected in the sera of 74\% RA patients (specificity 96\%), 2\% systemic lupus erythematosus, 14\% Sjögren's syndrome, and 2\% scleroderma. Anti-MCV was not detected in sera from healthy blood donors. There was no difference in the frequency of antibodies detected in RA patients with early (<2 years) or chronic (>2 years) disease. There was no significant variation in anti-MCV antibody concentrations in early RA patients over a 52-week period. No significant change was observed with time between the two treatment groups of methotrexate alone or methotrexate plus infliximab. CONCLUSIONS: Antibodies to MCV are a specific and sensitive marker for the diagnosis of RA.
This article was published in Clin Rev Allergy Immunol
and referenced in Journal of Clinical & Cellular Immunology