Diagnostic value of antibodies against a modified citrullinated vimentin in rheumatoid arthritis
Diagnostic value of antibodies against a modified citrullinated vimentin in rheumatoid arthritis
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DOI：
10.1186/ar2008
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发表时间：
2006-01-01
影响因子：
4.9
通讯作者：
Herold, Manfred
中科院分区：
文献类型：
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作者：
Dejaco, Christian;Klotz, Werner;Herold, Manfred
针对瓜氨酸化波形蛋白的抗体是与瓜氨酸化蛋白反应的自身抗体家族的成员，并且是用于诊断类风湿性关节炎（RA）的最特异性血清学标志物之一。本研究旨在测试新开发的酶联免疫吸附试验（ELISA）与第二代抗环瓜氨酸肽（抗CCP 2）ELISA检测系统相比，用于检测转基因瓜氨酸波形蛋白（抗MCV）抗体的诊断价值。来自631例患者的盲态血清（409例连续门诊患者和222例随机选择的储存血清）RA（n = 164）和非RA（骨关节炎[n = 120]，风湿性多肌痛/巨细胞动脉炎[ n = 80]，脊柱关节炎[n = 36]，和其它炎性风湿性或非炎性疾病[n = 67]）中抗MCV和抗CCP 2抗体的存在。根据通过接收操作特征曲线分析的计算曲线下面积（0.824; 95%置信区间（CI）0.778-0.870 vs 0.818; 95% CI 0.767-0.869），抗MCV诊断RA的诊断性能与抗CCP 2检测试剂相当。当以20.0 U/ml的临界值分类时抗MCV ELISA的敏感性和特异性均为69.5%（95% CI 61.9%-76.5%）和90.8%（86.9%-93.8%），而抗CCP 2试验分别为70.1%（62.5%-77.0%）和98.7%（96.7%-99.6%）。使用19.0 U/ml和81.5 U/ml的临界值进行抗MCV检测，以获得与抗CCP 2检测相同的灵敏度和特异性，结果显示，与抗CCP 2检测相比，抗MCV ELISA的特异性（89.8%; 85.8%-92.9%）和灵敏度（53.7%; 45.7%-61.5%）分别降低。结论：ELISA法检测抗MCV抗体和抗CCP-2抗体对RA的诊断具有良好的临床应用价值。然而，在高特异性范围内，抗CCP 2试验似乎上级抗MCV试验。
Antibodies directed against citrullinated vimentin are members of the family of autoantibodies reactive with citrullinated proteins and are among the most specific serological markers for the diagnosis of rheumatoid arthritis (RA). This study was performed to test the diagnostic value of a newly developed enzyme-linked immunosorbent assay (ELISA) for the detection of antibodies against a genetically modified citrullinated vimentin (anti-MCV) in comparison with a second-generation anti-cyclic citrullinated peptides (anti-CCP2) ELISA test system. Blinded sera from 631 patients (409 consecutive out-patients and 222 randomly selected stored sera) with RA (n = 164) and non-RA (osteoarthritis [n = 120], polymyalgia rheumatica/giant cell arteritis [ n = 80], spondyloarthritis [n = 36], and other inflammatory rheumatic or non-inflammatory disease [n = 67]) were tested for the presence of anti-MCV and anti-CCP2 antibodies according to the manufacturers' instructions. The diagnostic performance of the anti-MCV was comparable with the anti-CCP2 assay for the diagnosis of RA according to the calculated area under the curve (0.824; 95% confidence interval (CI) 0.778-0.870 versus 0.818; 95% CI 0.767-0.869) as analysed by receiving operating characteristic curve. When categorised with a cutoff value of 20.0 U/ml (as recommended by the manufacturer), sensitivity and specificity of the anti-MCV ELISA were 69.5% (95% CI 61.9%-76.5%) and 90.8% (86.9%-93.8%), respectively, compared with 70.1% (62.5%-77.0%) and 98.7% (96.7%-99.6%) of the anti-CCP2 assay. Using the cutoff values of 19.0 U/ml and 81.5 U/ml for the anti-MCV test to obtain a sensitivity and specificity identical to the anti-CCP2 assay, showed a reduced specificity (89.8%; 85.8%-92.9%) and sensitivity (53.7%; 45.7%-61.5%), respectively, of the anti-MCV ELISA compared with the anti-CCP2 test. In conclusion, the serum ELISA testing for anti-MCV antibodies as well as the anti-CCP-2 assay perform comparably well in the diagnosis of RA. In the high-specificity range, however, the anti-CCP2 assay appears to be superior to the anti-MCV test.