Detection of autoantibodies against mutated citrullinated vimentin is part of

rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are invol ...

(RA) diagnostics, especially in sera negative for rheumatoid factor (RF negative sera). Anti-MCV antibodies are a member of the ACPA family, a group of the so-called antibodies to citrullinated protein/peptide antigens. Rheumatoid arthritis is an

autoimmune disorder An autoimmune disease is a condition arising from an abnormal immune response to a functioning body part. At least 80 types of autoimmune diseases have been identified, with some evidence suggesting that there may be more than 100 types. Nearly ...

. Detection of specific autoantibodies (antibodies directed against the body’s own tissue) such as rheumatoid factors and ACPAs may provide indication of the disease. In many cases, autoimmune diagnostics are crucial for diagnosing RA correctly and already in the disease’s early stages, when typical symptoms often are lacking but when medical therapy is most effective.

Basics

Citrullination is a modification of proteins where a

nitrogen Nitrogen is the chemical element with the symbol N and atomic number 7. Nitrogen is a nonmetal and the lightest member of group 15 of the periodic table, often called the pnictogens. It is a common element in the universe, estimated at se ...

in the

amino acid Amino acids are organic compounds that contain both amino and carboxylic acid functional groups. Although hundreds of amino acids exist in nature, by far the most important are the alpha-amino acids, which comprise proteins. Only 22 alpha a ...

arginine is replaced with an

oxygen Oxygen is the chemical element with the symbol O and atomic number 8. It is a member of the chalcogen group in the periodic table, a highly reactive nonmetal, and an oxidizing agent that readily forms oxides with most elements as ...

, converting it into

citrulline The organic compound citrulline is an α-amino acid. Its name is derived from ''citrullus'', the Latin word for watermelon. Although named and described by gastroenterologists since the late 19th century, it was first isolated from watermelon in 1 ...

. The modified (citrullinated) protein may be identified by as foreign, provoking an autoimmune inflammation response. Various kinds of citrullinated proteins have been detected in the joints of RA patients. One of these is Sa antigen, now known as mutated citrullinated vimentin (MCV). Citrullination of

vimentin Vimentin is a structural protein that in humans is encoded by the ''VIM'' gene. Its name comes from the Latin ''vimentum'' which refers to an array of flexible rods. Vimentin is a type III intermediate filament (IF) protein that is expresse ...

plays a decisive role in RA pathogenesis.

Significance

In rheumatology diagnostics, autoantibodies against mutated citrullinated vimentin (anti-MCV) are of prominent diagnostic and prognostic value. Their significance is greater than that of rheumatoid factor. Recently a serological

point-of-care test Point-of-care testing (POCT or bedside testing) is defined as medical diagnostic testing at or near the point of care—that is, at the time and place of patient care. This contrasts with the historical pattern in which testing was wholly or most ...

(POCT) for the early detection of RA has been developed. This assay combines the detection of rheumatoid factor and anti-MCV for diagnosis of rheumatoid arthritis and shows a sensitivity of 72% and specificity of 99.7%. Anti-MCV are used as efficient

biomarker In biomedical contexts, a biomarker, or biological marker, is a measurable indicator of some biological state or condition. Biomarkers are often measured and evaluated using blood, urine, or soft tissues to examine normal biological processes, p ...

s for estimating progress of rheumatoid arthritis. Main advantage of testing for anti-MCV is the early appearance of the anti-MCV antibodies, what allows for detection of early RA and submits adequate therapy just after the disease’s onset. Moreover, anti-MCV titres show strong correlation to disease activity, disease severity and the success of therapy.

References

{{reflist Arthritis