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BioMed Research International
Volume 2014 (2014), Article ID 198198, 6 pages
Research Article

Comparison of Two Assays to Determine Anti-Citrullinated Peptide Antibodies in Rheumatoid Arthritis in relation to Other Chronic Inflammatory Rheumatic Diseases: Assaying Anti-Modified Citrullinated Vimentin Antibodies Adds Value to Second-Generation Anti-Citrullinated Cyclic Peptides Testing

1Programas de Doctorado en Farmacología y en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, JAL, Mexico
2Hospital General Regional 180 IMSS Tlajomulco, JAL, Mexico
3Unidad de Investigación en Epidemiología Clínica y División de Investigación en Salud, UMAE, Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO), IMSS, Guadalajara, JAL, Mexico
4Programa de Doctorado en Salud Púbica CUCS, Guadalajara, JAL, Mexico
5Departamento de Fisiologia, CUCS, Universidad de Guadalajara, Guadalajara, JAL, Mexico
6Programa de Servicio Social en Investigación, Secretaria de Salud, Guadalajara, JAL, Mexico
7Decanato Ciencias de la Salud, Universidad Autónoma de Guadalajara, Mexico
8Dirección de la División de Disciplinas para el Desarrollo, Promoción y Preservación de la Salud, CUCS, Universidad de Guadalajara, Mexico
9Departamento de Medicina Interna-Reumatología, Hospital General Regional 110, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, JAL, Mexico
10Avenida Salto del Agua 2192, Colonia Jardines del Country, Guadalajara, Mexico

Received 5 March 2014; Revised 30 April 2014; Accepted 23 May 2014; Published 15 June 2014

Academic Editor: Juan-Manuel Anaya

Copyright © 2014 Miriam Lizette Díaz-Toscano et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Determination of anti-citrullinated peptide antibodies (ACPA) plays a relevant role in the diagnosis of rheumatoid arthritis (RA). To date, it is still unclear if the use of several tests for these autoantibodies in the same patient offers additional value as compared to performing only one test. Therefore, we evaluated the performance of using two assays for ACPA: second-generation anti-citrullinated cyclic peptides antibodies (anti-CCP2) and anti-mutated citrullinated vimentin (anti-MCV) antibodies for the diagnosis of RA. We compared three groups: RA ( ), chronic inflammatory disease (CIRD, ), and clinically healthy subjects (CHS, ) to evaluate sensitivity, specificity, predictive values, and likelihood ratios (LR) of these two assays for the presence of RA. A lower frequency of positivity for anti-CCP2 was found in RA (66.2%) as compared with anti-MCV (81.0%). When comparing RA versus other CIRD, sensitivity increased when both assays were performed. This strategy of testing both assays had high specificity and LR+. We conclude that adding the assay of anti-MCV antibodies to the determination of anti-CCP2 increases the sensitivity for detecting seropositive RA. Therefore, we propose the use of both assays in the initial screening of RA in longitudinal studies, including early onset of undifferentiated arthritis.