Anti-MCV in Rheamatoid Arthritis Clinical Trial
Official title:
Diagnostic Value of Antibodies Against a Modified Citrullinated Vimentin in Patients With Rheumatoid Arthritis
The aim of this work is to evaluate the diagnostic value of anti-MCV antibodies in rheamatoid arthritis patients and to correlate its relationtion disease activity and manifestations.
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by joint
inflammation, subsequent joint destruction leading to loss of joint function, and disability.
Joint erosions develop quickly in 25 % of RA patients during the first 3 months of the
disease and in about 75% of patients during the first 2years .
Early therapeutic intervention with synthetic disease-modifying antirheumatic drugs (sDMARD)
and biological agents that target specific molecules can prevent joint damage and improve the
prognosis of the disease. Since these therapies can have potential toxic effects ,it is very
important that practitioners diagnose early and reliably the disease, especially the more
aggressive forms, in order to select the appropriate treatment for patients.
Early diagnosis of RA can be challenging. During the last 15 years, there has been
significant progress on the pathogenesis of RA with the discovery of antibodies against
citrullinated protein antigens (ACPAs). ACPA production is associated with the HLA-DRB1
shared epitope, cigarette smoking, and periodontitis .
ACPAs have been shown to predict joint damage and are associated with more severe disease and
extra-articular manifestations . In order to better identify RA patients at earlier stages,
new 2010 classification criteria for RA by the American College of Rheumatology
(ACR)/European League against Rheumatism (EULAR) include rheumatoid factor (RF) and ACPAs .
The most common commercial assay for the detection of ACPAs is anti-cyclic citrullinated
peptide (anti-CCP) test, which uses synthetic cyclic citrullinated peptides that mimic RA
epitopes.
Citrullination occurs also in other autoimmune diseases .
. Indeed, histone citrullination may lead to the release of neutrophil extracellular traps,
and juxtaposition of citrullinated histones with infectious pathogens, complement and immune
complexes may compromise tolerance of nuclear autoantigens and promote autoimmunity .
Antibodies to other citrullinated peptides or proteins have been suggested as good candidates
for diagnosing RA.
Anti-MCV antibodies have been recommended to be better diagnostic marker for early arthritis
.
Vimentin is an intermediate filament that is widely expressed by mesenchymal cells and
macrophages and easy to detect in the synovium. Modification of the protein occurs in
macrophages undergoing apoptosis, and antibodies to citrullinatedvimentin may emerge if the
apoptotic material is inadequately cleared .
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