Unique Correlation Between Mutated Citrullinated Vimentine IgG Autoantibodies and Markers of Systemic Inflammation in Rheumatoid Arthritis Patients

Abstract

Rheumatoid arthritis (RA) is the most common inflammatory systemic autoimmune disease, primarily affecting the peripheral joints. Anti-mutated citrullinated vimentin autoantibodies (anti-MCV) of IgG isotype were shown to be a useful diagnostic marker of RA especially in RA patients who were anti-cyclic citrullinated protein autoantibodies (anti-CCP) negative. Nevertheless, published data correlates rheumatoid factor (RF), anti-CCP or anti-MCV antibodies with either erythrocyte sedimentation rate (ESR) or serum C-reactive protein (CRP) as markers of disease activity, not investigated the possible correlations of RA autoantibodies towards ESR and CRP in comparison. Herein, we aim to evaluate the usefulness of anti-MCV as a dependable marker in established RA compared with anti-CCP and RF antibodies and to examine correlations between RF, anti-CCP and anti-MCV antibodies towards ESR and serum CRP. Serum RF-IgA, RF-IgM, anti-CCP and anti-MCV levels were measured in 30 patients with RA and 40 patients with other autoimmune diseases (non-RA) compared with 20 normal subjects. Specificity, sensitivity and AUC for RF antibodies, anti-CCP and anti-MCV were calculated towards RA diagnosis. Our results showed that ESR and CRP had significantly higher values in both RA and non-RA patients compared with our healthy controls with observed significant increment in RA patients compared with non-RA patients. An important finding from our study is that 33.3 % of RA patients were anti-CCP negative but being positive towards anti-MCV. Also, in-between 36.7 up to 40 % of RA patients were RF-IgA and RF-IgM negative while being anti-MCV positive. Anti-MCV antibodies showed the highest specificity and sensitivity (97.5 and 86.6 %, respectively) towards RA diagnosis with the highest AUC value (0.920) compared with anti-CCP and RF antibodies. Correlation analyses revealed that there was no significant correlation between ESR along with CRP towards RF-IgA, RF-IgM and anti-CCP while profound highly significant correlation exhibited between ESR and CRP towards anti-MCV data (r = 0.879 and 0.994, respectively). Thus, our data suggest that the assessment of serum anti-MCV autoantibodies along with ESR and CRP considered as a simple laboratory regime for monitoring RA patients to assess and follow-up disease activity. The addition of anti-MCV autoantibodies to serologic markers in the ACR/ EULAR classification criteria for RA will add points for patients with negative anti-CCP and RF antibodies.

Diagnostic value of the anti-Sa antibody compared with the anti-cyclic citrullinated peptide antibody in rheumatoid arthritis

“…There were no significant differences in disease duration and Steinbrocker radiographic stage between anti‐Sa positive and anti‐Sa negative patients with RA. This may be explained by the reported association of the marker with disease activity at the time of obtaining the patient's blood sample . Surprisingly, there was no correlation between anti‐Sa and CRP or ESR in our study.…”

Autoantibody and metalloproteinase activity in early arthritis

“…40% of RA RF (−) patients were found to have increased levels of these antibodies. Additionally, the presence of a-Sa was found to be positively correlated with ESR and CRP [27]. It is suggested that a-Sa level is a better indicator of radiographic progression risk than a-CCP level [28].…”

Evaluation of anti-mutated citrullinated vimentin antibodies, anti-cyclic citrullinated peptide antibodies in patients with rheumatoid arthritis in comparison with other rheumatic diseases; a nephrology point of view

“…Rheumatoid arthritis (RA) is one of the most common autoimmune rheumatic disease of an ambiguous and complicated etiology characterized by a chronic, multisystemic and progressive inflammatory disorder affecting synovial joints (1,2), leading to functional capacity diminution, articular cartilage damage (3)(4)(5), deformity, disability and substantial economic costs (6)(7)(8)(9). The global prevalence of RA ranges between 0.5%-1% varies upon gender, population and ethnicity mostly in developing countries in young women and elderly people (3,5,10).…”

“…Rheumatoid arthritis (RA) is one of the most common autoimmune rheumatic disease of an ambiguous and complicated etiology characterized by a chronic, multisystemic and progressive inflammatory disorder affecting synovial joints (1,2), leading to functional capacity diminution, articular cartilage damage (3)(4)(5), deformity, disability and substantial economic costs (6)(7)(8)(9). The global prevalence of RA ranges between 0.5%-1% varies upon gender, population and ethnicity mostly in developing countries in young women and elderly people (3,5,10). Above all, due to the aggressive nature and severity of the clinical manifestations of the disease process, also inaccuracy in the RA early diagnosis after symptoms onset, it is potentially recommended to differentiate between persistent RA and other forms of rheumatic diseases; while early diagnostics and prognostics approaches leads to prevent unwanted irreversible joint damages (8,11,12).…”