Diagnostic utility and clinical relevance of anti-MCV and anti-CCP antibodies in rheumatoid arthritis

Abstract

Rheumatoid arthritis (RA) is a persistent autoimmune disorder where serological biomarkers play a crucial role in diagnosis and monitoring disease activity. Antibodies targeting cyclic citrullinated peptides (anti-CCP), mutated citrullinated vimentin (anti-MCV), and rheumatoid factor are commonly used serological markers for RA. However, their respective diagnostic efficacies and potential for mutual complementation remain incompletely understood. This study investigates the diagnostic performance of these three antibodies and their association with disease progression in RA. A total of 257 RA patients who visited Jinhua Hospital Affiliated with Zhejiang University between March and December 2019 were enrolled. Serum specimens were analyzed for anti-CCP, anti-MCV antibodies, and RF levels using chemiluminescence immunoassay (CLIA) and rate nephelometry. The results indicated that the specificity of anti-CCP (94.2%) was higher than that of anti-MCV (84.4%) and RF (84.8%). Furthermore, anti-MCV antibody levels were significantly link to disease duration and morning stiffness. Additionally, anti-MCV and anti-CCP demonstrated differing associations with extra-articular manifestations of RA. The study suggests that anti-MCV antibodies hold significant potential as adjunctive biomarkers in RA, complementing anti-CCP antibodies to improve diagnostic accuracy and provide new insights for early diagnosis and disease monitoring in RA.

Keywords: Anti-CCP; Anti-MCV; Diagnostic performance; Disease progression; Rheumatoid arthritis; Serological markers.

Fig. 1

Flowchart of inclusion and exclusion criteria for RA patients. Note This flowchart illustrates the screening process for hospitalized RA patients between March 1, 2019, and December 30, 2019

Fig. 2

Flowchart of antibody detection procedures and decision-making process. Note This flowchart outlines the operational steps and decision-making process for detecting anti-CCP antibodies, anti-MCV antibodies, and RF

Fig. 3

Gender distribution and age comparison of RA patients. Note A Bar chart showing the gender distribution in the RA group, disease control group, and healthy control group; B bar chart showing the mean age of the RA group, disease control group, and healthy control group. p < 0.01: **; p < 0.0001: ****

Fig. 4

ROC curve analysis of anti-MCV, anti-CCP, and RF in RA diagnosis

Fig. 5

Relationship between anti-MCV antibody and morning stiffness in RA patients. Note Bar chart showing the distribution of morning stiffness in anti-MCV antibody-positive and negative groups. The difference between the two groups was statistically significant (χ² = 4.326, p = 0.038). p < 0.05: *

Fig. 6

Interrelationships among anti-MCV antibody, anti-CCP antibody, and RF in RA patients. Note This figure illustrates the positive rates of antibody combinations in RA patients

Fig. 7

Relationship between anti-MCV antibody, anti-CCP antibody, RF, extra-articular manifestations, and overlap syndromes in RA patients. Note A Distribution of extra-articular manifestations in anti-MCV antibody, anti-CCP antibody, and RF positive and negative groups; B distribution of overlap syndromes in anti-MCV antibody, anti-CCP antibody, and RF positive and negative groups. p < 0.01: **; not significant: “ns”