Article
Correlation of anti-mutated citrullinated vimentin antibody serum levels with disease activity in rheumatoid arthritis
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Authors
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Melissa Rieger
- Sektion Rheumatologie und Klinische Immunologie, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München
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Margarethe Wüllner
- Sektion Rheumatologie und Klinische Immunologie, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München
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Hendrik Schulze-Koops
- Sektion Rheumatologie und Klinische Immunologie, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München
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Alla Skapenko
- Sektion Rheumatologie und Klinische Immunologie, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München
| Published: | February 5, 2019 |
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Outline
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Background: Anti-mutated citrullinated vimentin (MCV) antibodies are a highly specific marker for RA and are associated with disease activity.
Objective: Issue of this retrospective study was to assess a possible correlation between MCV antibody concentrations and disease activity measured by DAS28. Moreover, a possible predictive value of MCV antibody levels for future disease activity was evaluated.
Methods: Between 2008 and 2010 224 samples were analyzed with an anti-MCV-ELISA kit (Orgentec). In a retrospective evaluation 56 samples were matched to patients (n=30) with (I) a verified diagnosis of RA according to the EULAR/ACR classification criteria (2010) and (II) a documented disease activity as assessed by DAS28 (ESR) with three or four parameters (3P and 4P, respectively).
Results: The mean MCV antibody concentration was 375,9 [21,5–900,3] U/ml (n=40; 1st quartile (Q1) 21,5–61,2 U/ml, Q2 61,3–100,1 U/ml, Q3 100,2–226,4 U/ml, Q4 226,5–900,3 U/ml). There was no correlation between the MCV antibody levels and disease activity determined at the day of the clinical evaluation, neither by using absolute values nor by weighted quartiles. DAS28 4P values were noticeable higher than DAS28 3P for corresponding patients and sample time.
For analysis of the predictive value of MCV antibody levels, DAS28 4P was calculated at two successive visits after exclusion of patients with therapy modifications (n=15). Weighted quartiles were applied to DAS28 of both visits (first visit: Q1 0,62–2,1975; Q2 2,1976–3,31; Q3 3,22–4,8325; Q4 4,8326-6,53; second visit: Q1 1,18–1,935; Q2 1,936–2,165; Q3 2,166–2,406, Q4 2,407–5,24) and the MCV antibody concentration. The average time span between the two visits was 155 [7–209, n=11] days. A low MCV quartile correlated with a lower DAS28 in the following visit or a stable disease activity while MCV quartiles 3 and 4 correlated with a stable high DAS28 quartile or a progress in disease activity monitored in the following visit.
Conclusion: This analysis showed a correlation between the MCV antibody concentration and the disease activity in a successive visit. MCV antibody levels have a predictive value and patients with high serum levels should be closely monitored.
