Poulsom Hannah, Charles Peter J
Division of Immunology, Hammersmith Hospitals NHS Trust, and Kennedy Institute of Rheumatology, Imperial College, London, UK.
Clin Rev Allergy Immunol. 2008 Feb;34(1):4-10. doi: 10.1007/s12016-007-8016-3.
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.
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.
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.
Antibodies to MCV are a specific and sensitive marker for the diagnosis of RA.
在过去5年中，针对瓜氨酸化抗原的抗体已出现并确立为类风湿关节炎（RA）的诊断标志物。最初，这些抗体是使用合成肽检测到的，该合成肽经过了多次修饰，以提供一种灵敏度为65 - 80%、特异性大于95%的诊断测试。抗瓜氨酸波形蛋白抗体于1994年首次被描述为RA的一种高度特异性标志物（抗Sa）。然而，尚无针对这些抗体的简便检测方法。
我们研究了使用基于酶联免疫吸附测定（ELISA）的方法，以突变的瓜氨酸波形蛋白（MCV）抗原（德国美因茨的欧根泰克公司）来评估该抗体在RA中的诊断和预后效用。
在74%的RA患者血清中检测到抗MCV抗体（特异性96%），2%的系统性红斑狼疮患者、14%的干燥综合征患者和2%的硬皮病患者血清中也检测到该抗体。健康献血者血清中未检测到抗MCV抗体。早期（<2年）或慢性（>2年）疾病的RA患者中检测到抗体的频率没有差异。早期RA患者在52周期间抗MCV抗体浓度没有显著变化。单独使用甲氨蝶呤或甲氨蝶呤加英夫利昔单抗的两个治疗组之间，随着时间推移未观察到显著变化。
抗MCV抗体是诊断RA的一种特异性和敏感性标志物。
