류마티스관절염 환자에서 항-mutated Citrullinated Vimentin (MCV) 항체, 항-cyclic Citrullinated Peptide (CCP) 항체, 류마티스인자들의 진단적 유용성 비교

Abstract

Objective: Serologic support is important for the diagnosis of rheumatoid arthritis (RA). Anti-cyclic citrullinated peptide (anti-CCP) has relatively low sensitivity despite of high specificity for the diagnosis of RA. Anti-mutated citrullinated vimentin (anti-MCV) is an indirect solid phase enzyme immunoassay for the quantitative measeurement of IgG class autoantibodies against MCV, a novel serologic marker for an aid in the diagnosis of RA. We investigated a diagnostic value of anti-MCV in comparison with those of anti-CCP, and rheumatoid factors (IgM, IgG, and IgA RFs) in RA patients. Methods: Cohorts of 48 patients with RA and 50 patients with osteoarthritis (OA) were enrolled. All patients underwent standard examinations, including anti-MCV, anti-CCP, IgM RF, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). We measured IgG RF and IgA RF titers in 21 RA and 50 OA patients. The sensitivities and specificities of anti-MCV, anti-CCP, RFs were determined. Correlations with these markers, ESR and CRP were analyzed. Results: The sensitivity of anti-MCV, anti-CCP, and IgM RF were 89.6%, 89.6%, and 77.1%, respectively. The specificities of them were 96.0%, 96.0%, and 88%, respectively. Combination of two tests such as anti-MCV or anti-CCP positivity increased the sensitivity up to 93.8%. None of these markers showed significant correlation with ESR and CRP. Anti-MCV correlated with anti-CCP (r=0.596, p＜0.01) and IgM RF (r=0.301, p=0.038). Conclusion: Anti-MCV and anti-CCP showed high sensitivity and specificity for the diagnosis of RA. Combination of these markers increased the sensitivity without significant decrease in the specificity, suggesting they may be promising serologic markers for RA.