Evaluation of the clinical performance of anti-mutated citrullinated vimentin antibody and 14-3-3 eta testing in rheumatoid arthritis.

IF 3.8 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Clinical chemistry and laboratory medicine Pub Date : 2024-11-07 DOI:10.1515/cclm-2024-1112
Heather A Nelson, Thomas B Martins, Abdulrahman Saadalla, Vijayalakshmi Nandakumar
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Abstract

Objectives: Early rheumatoid arthritis (RA) detection is crucial for improving patient prognosis. Anticyclic citrullinated peptide antibodies (anti-CCP) and rheumatoid factors (RF) support RA diagnosis but are undetectable in ∼20 % of cases. Recently, antibodies against mutated citrullinated vimentin (anti-MCV) and detection of 14-3-3 eta have emerged with implications for preclinical RA diagnosis and monitoring treatment. The objective of this study was to assess the clinical performance of anti-MCV antibodies and 14-3-3 eta in RA and to compare it to current RA criteria anti-CCP and RF markers, individually and in combination.

Methods: A retrospective chart review of 326 subjects submitted for RA serology testing identified 134 RA positive and 192 RA negative disease control individuals. Fifty healthy controls specimens were also included. Performance of anti-MCV and 14-3-3 eta, alone and combined with CCP3.1 and RF, was assessed.

Results: Anti-MCV had a sensitivity of 71 % and a specificity of 92 %. 14-3-3 eta had a sensitivity of 43 % and a specificity of 90 %. In comparison, CCP3.1 and RF displayed a sensitivity of 79 % and 84 % and a specificity of 92 % and 61 %, respectively. ROC curve analysis demonstrated CCP3.1 and anti-MCV had superior diagnostic performance compared to RF and 14-3-3 eta. In our cohort, anti-MCV and 14-3-3 eta failed to identify seronegative RA patients. Different combinations of double antibody positivity increased specificity at the cost of lost sensitivity.

Conclusions: Individually, 14-3-3 eta, anti-MCV and CCP3.1 assays had ≥90 % specificity in diagnosed RA patients, with better sensitivities for anti-MCV and CCP3.1 than 14-3-3 eta. Overall diagnostic performance of anti-MCV was similar to CCP3.1 and RF, all of which outperformed 14-3-3 eta in our cohort.

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评估类风湿性关节炎患者抗变异瓜氨酸波形蛋白抗体和 14-3-3 eta 检测的临床表现。
目的:早期发现类风湿性关节炎(RA)对改善患者预后至关重要。抗环瓜氨酸肽抗体(抗 CP)和类风湿因子(RF)有助于 RA 的诊断,但在 20% 的病例中检测不到。最近,出现了抗变异瓜氨酸波形蛋白抗体(抗MCV)和14-3-3 eta检测,这对临床前RA诊断和治疗监测具有重要意义。本研究旨在评估抗MCV抗体和14-3-3 eta在RA中的临床表现,并将其与目前RA标准中的抗CCP和RF标记物(单独或联合使用)进行比较:方法:对326名接受RA血清学检测的受试者进行回顾性病历审查,确定了134名RA阳性和192名RA阴性的疾病对照者。还包括 50 份健康对照标本。评估了抗-MCV 和 14-3-3 eta 单独或与 CCP3.1 和 RF 结合使用的效果:结果:抗-MCV 的敏感性为 71%,特异性为 92%。14-3-3 eta 的敏感性为 43%,特异性为 90%。相比之下,CCP3.1 和 RF 的敏感性分别为 79 % 和 84 %,特异性分别为 92 % 和 61 %。ROC 曲线分析表明,与 RF 和 14-3-3 eta 相比,CCP3.1 和抗-MCV 具有更高的诊断性能。在我们的队列中,抗-MCV 和 14-3-3 eta 未能识别血清阴性的 RA 患者。双抗体阳性的不同组合提高了特异性,但却失去了敏感性:结论:14-3-3 eta、抗-MCV 和 CCP3.1 检测法对已确诊 RA 患者的特异性≥90%,抗-MCV 和 CCP3.1 的敏感性优于 14-3-3 eta。抗-MCV的总体诊断性能与CCP3.1和RF相似,在我们的队列中,它们都优于14-3-3 eta。
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来源期刊
Clinical chemistry and laboratory medicine
Clinical chemistry and laboratory medicine 医学-医学实验技术
CiteScore
11.30
自引率
16.20%
发文量
306
审稿时长
3 months
期刊介绍: Clinical Chemistry and Laboratory Medicine (CCLM) publishes articles on novel teaching and training methods applicable to laboratory medicine. CCLM welcomes contributions on the progress in fundamental and applied research and cutting-edge clinical laboratory medicine. It is one of the leading journals in the field, with an impact factor over 3. CCLM is issued monthly, and it is published in print and electronically. CCLM is the official journal of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and publishes regularly EFLM recommendations and news. CCLM is the official journal of the National Societies from Austria (ÖGLMKC); Belgium (RBSLM); Germany (DGKL); Hungary (MLDT); Ireland (ACBI); Italy (SIBioC); Portugal (SPML); and Slovenia (SZKK); and it is affiliated to AACB (Australia) and SFBC (France). Topics: - clinical biochemistry - clinical genomics and molecular biology - clinical haematology and coagulation - clinical immunology and autoimmunity - clinical microbiology - drug monitoring and analysis - evaluation of diagnostic biomarkers - disease-oriented topics (cardiovascular disease, cancer diagnostics, diabetes) - new reagents, instrumentation and technologies - new methodologies - reference materials and methods - reference values and decision limits - quality and safety in laboratory medicine - translational laboratory medicine - clinical metrology Follow @cclm_degruyter on Twitter!
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