类风湿关节炎六种指标联合检测的临床意义

目的评价分析抗瓜氨酸化波形蛋白(MCV)抗体、抗葡萄糖-6-磷酸异构酶(GPI)抗体等六项指标在类风湿关节炎(RA)患者血清中的表达与疾病的相关性及应用价值。方法收集110例RA、26例SLE、23例强直性脊柱炎(OA)、20例干燥综合征(SS)患者和50名健康人血清标本,用ELISA检测血清中抗MCV、抗GPI和抗环瓜氨酸肽(CCP)抗体水平,采用间接免疫荧光法检测抗角蛋白(AKA)抗体,采用散射比浊法检测类风湿因子(RF)和hs-CRP水平。结果 4种抗体在RA患者组中的阳性率显著高于非RA疾病组和健康对照组。除AKA抗体阳性率较低(41.8%)外,其余抗体在RA组中的阳性率差异无统计学意义。结论抗MCV和抗GPI抗体诊断RA的敏感度最高;抗CCP抗体的特异性最高,AKA抗体具有较高的特异性,但敏感度最低,联合检测可弥补单项抗体检测造成的漏诊。     

抗CCP抗体和AKA在类风湿关节炎诊断的应用价值

目的 比较抗环瓜氨酸肽抗体(抗CCP抗体)和抗角蛋白抗体(AKA)在类风湿关节炎诊断中作用,探讨RA的早期诊断方法.方法 对已确诊的85例RA患者、74例非RA的自身免疫病患者同时测定抗CCP抗体(ELISA法)、AKA(间接免疫荧光检测).结果 抗CCP抗体对诊断RA的灵敏度和特异性分别为75.3％和93.2％;AKA对RA诊断的灵敏度和特异性分别为89.4％和85.14％.抗CCP抗体的灵敏度与AKA灵敏度差异无统计学意义(P＞0.05),特异性差异有统计学意义(P＜0.05);抗CCP抗体或AKA与二者联合检测的灵敏度差异有统计学意义(P＜0.05),特异性差异有统计学意义(P＜0.05).阳性预测值抗CCP抗体较高,阴性预测值以二者联合检测较好,Youden index二者联合检测比单独检测抗CCP抗体或AKA高.抗CCP抗体和AKA在检测RA组中抗CCP抗体和AKA同时阳性检出58例;抗CCP抗体或AKA阳性共检出85例.抗CCP抗体或AKA阳性率(96.5％)比二者同时阳性率(68.2％)大大提高.结论 抗CCP抗体、AKA对RA具有较好的灵敏度和高度的特异性,联合检测抗CCP抗体和AKA可作为早期RA患者及RF阴性RA患者的早期诊断指标.     

抗环瓜氨酸肽抗体检测在类风湿关节炎诊断中的价值

近年来的研究发现,抗纤聚蛋白抗体(AFA)、抗角蛋白抗体(AKA)、抗核周因子(APF)等对RA的诊断具有特异性,而且可用于类风湿关节炎(RA)的早期诊断[1]。2000年Shellekens等首次合成APF、AKA、AFA的共同抗原决定簇-环瓜氨酸肽(cyclic citrullinated peptide,CCP),建立了用ELISA检测RA患者的抗CCP抗体,发现该抗体在RA诊断     

联合检测HLA-DR4、抗CCP抗体和抗Sa抗体在类风湿关节炎诊断中应用价值

目的 探讨联合检测HLA-DR4、抗CCP抗体和抗Sa抗体在类风湿关节炎诊断中应用价值.方法 在2014年10月至2017年1月期间,选取我院就诊的109例RA患者作为研究对象,选取同期我院收治的94例非RA患者和90例健康体检者作为对照组.比较三组患者血清HLA-DR4、抗CCP抗体和抗Sa抗体的阳性率、三项指标联合检测对RA诊断学指标.结果 RA组患者血清HLA-DR4、抗CCP抗体和抗Sa抗体阳性率显著高于非RA组和对照组(P<0.05).在HLA-DR4、抗CCP抗体和抗Sa抗体三个指标中,抗CCP抗体的灵敏度和特异性最高(P<0.05).在联合检测中,HLA-DR4、抗CCP抗体和抗Sa抗体联合检测的灵敏度和特异性最高(P<0.05).结论 HLA-DR4、抗CCP抗体和抗Sa抗体联合检测可以提高对类风湿关节炎的诊断准确率,可作为临床辅助诊断手段.     

自身抗体和类风湿因子联合检测在类风湿性关节炎中的诊断价值

目的:探讨自身抗体和类风湿因子(Rheumatoid factor,RF)联合检测在类风湿性关节炎(Rheumatoid arthritis,RA)中的诊断价值.方法:选取2019年3月至2020年12月我院收治的RA患者119例,另选同期非RA风湿免疫性疾病患者及健康者各120例,分别纳入RA组、非RA组和对照组.分别采用速率散射比浊法、酶联免疫吸附试验和间接免疫荧光法检测各组RF、抗环瓜氨酸肽(Cyclic citrullinated peptide,CCP)抗体、抗角蛋白抗体(Anti-keratin antibody,AKA)及抗核周因子(Anti-perinuclear factor,APF),并计算阳性率,分析自身抗体与RF联合检测对RA的诊断价值.结果:RA组RF、抗CCP抗体、AKA、APF阳性率均高于非RA组和对照组(P<0.05).单独检测时,RF灵敏度最高,特异度最低(P<0.05);抗CCP抗体、AKA、APF灵敏度、特异度差异均无统计学意义(P>0.05).4项指标联合检测时较单独检测的灵敏度升高,特异度降低.结论:自身抗体和RF对诊断RA均有一定的临床意义,联合检测可提高诊断结果准确性,具有较高的诊断价值.     

抗突变型瓜氨酸波形蛋白抗体在诊断类风湿性关节炎中的意义

目的 探讨抗突变型瓜氨酸波形蛋白抗体(anti-mutated citrullinated vimentin antibody,Anti-MCV)在诊断类风湿性关节炎(rheumatoid arthritis,RA)中的价值.方法 选取确诊的RA患者51例(RA组)、非RA自身免疫性疾病患者36例(疾病对照组)和健康查体者30例(对照组)作为研究对象.根据临床资料计算DAS28评分,将RA组分为活动组和稳定组.采用酶联免疫吸附法(ELISA)检测血清中的抗MCV抗体、抗环瓜氨酸肽抗体(抗CCP抗体)及白细胞介素-6(IL-6)水平,采用免疫比浊法检测血清中C-反应蛋白(CRP)的浓度水平,并进行比较.结果 RA组抗MCV抗体的浓度水平显著高于非RA组和对照组(P均＜0.01);活动组抗MCV抗体的浓度水平显著高于稳定组和对照组(P均＜0.01);经Spearmau相关性分析,抗MCV抗体的浓度水平与CRP及IL-6呈正相关,而与DAS28无相关性;抗MCV抗体与抗CCP抗体的诊断效率无显著差异,但是灵敏度高于抗CCP抗体.结论 抗MCV抗体具有较高的灵敏度和特异性,并且能提示RA病情的活动情况,可以成为新的辅助RA诊断的血清学指标.     

抗CCP抗体、抗MCV抗体和类风湿因子在早期类风湿关节炎中的诊断价值

目的探讨抗CCP抗体、抗MCV抗体和类风湿因子在早期类风湿关节炎中的诊断价值。方法选择于2016年1月至2017年1月期间在我院就诊的早期类风湿关节炎(RA)患者及其他骨关节病患者各40例,并选择40名同期在我院体检的健康人作为研究对象。其中风湿关节炎患者设为RA组,其他骨关节病患者为疾病对照组,健康人为正常对照组。采用免疫透射比浊法、酶联免疫吸附法(ELISA)、免疫散射比浊法分别测定三组的抗环瓜氨酸肽(CCP)抗体、抗突变型瓜氨酸波形蛋白(MCV)抗体及IgM型类风湿因子(IgM-RF)水平,比较抗CCP抗体、抗MCV抗体、IgM-RF单独检测及三个指标联合检测对早期类风湿性关节炎的诊断价值。结果①RA组的抗CCP抗体、抗MCV抗体、IgM-RF水平均明显高于疾病对照组与正常对照组,差异具有统计学意义(P<0.05);疾病对照组与正常对照组间差异无统计学意义(P>0.05)。②RA组的抗CCP抗体、抗MCV抗体、IgM-RF及联合检测的阳性率均明显高于疾病对照组与正常对照组,差异具有统计学意义(P<0.05);疾病对照组与正常对照组间差异无统计学意义(P>0.05)。③联合检测的灵敏度及阴性预测值均明显高于抗CCP抗体、抗MCV抗体、IgM-RF单独检测,差异具有统计学意义;抗CCP抗体与抗MCV抗体的特异性及阳性预测值均明显高于IgM-RF及联合检测,差异具有统计学意义(P<0.05)。结论早期RA患者的血清中存在抗CCP抗体、抗MCV抗体、IgM-RF的高表达,且其灵敏度及特异性均较高,临床上可联合检测抗CCP抗体、抗MCV抗体及IgM-RF,以提高RA的早期诊断率。     

抗环瓜氨酸肽抗体在类风湿性关节炎诊断中的应用

目的　探讨抗环瓜氨酸肽 (CCP)抗体检测在类风湿性关节炎 (RA)诊断中的意义。方法　根据cDNA序列人工合成的CCP为抗原 ,用ELISA方法检测 2 18例 (RA 112例 ,非RA 76例及正常人 30例 )血清中的抗CCP抗体 ,并比较抗CCP抗体与类风湿因子 (RF)的相关性。结果　抗CCP抗体在RA组患者血清中的阳性率 4 9.1% ,明显高于非RA组 ( 3.94 % )和正常对照组 ( 0 .0 % ) ,经 χ2 检验P <0 .0 5。抗CCP抗体对诊断RA的敏感性和特异性分别为 4 9.1%、96 .1% ,阳性预测值和阴性预测值为 94 .8%、4 3.8%。在 112例确诊为RA患者的血清中抗CCP抗体与RF重叠阳性率为 85 .4 % ,两者含量呈正相关。结论　抗CCP抗体对RA具有很高的特异性 ,可视为新的RA血清学诊断指标     

抗环瓜氨酸肽抗体在预测类风湿性关节炎临床诊断中的应用

近年来,与类风湿性关节炎(RA)相关的自身抗体检测项目逐渐增多,比如抗核周因子抗体(APF)、抗角蛋白抗体(AKA)、抗聚角蛋白微粒蛋白抗体(APA)等,它们对RA的诊断都具有很高的特异性,并且可用于RA的早期诊断[1-3]。最新认为,上述几种抗体在化学结构上具有相似性,它们的表位都含有瓜氨酸[4]。2000年国外学者合成了环瓜氨酸肽(Cyclic citrullinated peptide,CCP),并利用ELISA在RA患者体内检测到了抗CCP抗体[5]。本文通过检测RA患者血清     

抗环瓜氨酸肽抗体检测对类风湿关节炎的临床诊断价值

目的探讨抗环瓜氨酸肽抗体（抗CCP抗体）检测对类风湿关节炎（RA）诊断的意义。方法采用酶联免疫吸附试验（ELISA）检测115份人血清的抗CCP抗体,同时采用免疫透射比浊法定量检测类风湿因子（RF）,包括40例RA患者,45例其它风湿病患者,30名正常人;并分析抗CCP抗体与RF实验结果之间的相关性。结果在40例RA病人中,抗CCP抗体的阳性率为80.0%,在其它风湿病人中的阳性率为7.0%,抗CCP抗体对RA的敏感性和特异性分别为80.0%、96.0%,其敏感性高于RF,但差异无统计学意义（P〉0.05）,特异性明显高于RF（P〈0.05）。联合应用抗CCP抗体与RF进行诊断,二者均阳性时敏感性为65.0%,特异性为97.3%。抗CCP抗体与RF实验结果之间无相关性。结论抗CCP抗体对RA具有较好的敏感性和很高的特异性,可与RF相互补充,联合检测可提高对RA早期诊断的准确性。     

Anti‐citrullinated glucose‐6‐phosphate isomerase peptide antibodies in patients with rheumatoid arthritis are associated with HLA‐DRB1 shared epitope alleles and disease activity

To identify and characterize anti‐citrullinated glucose‐6‐phosphate isomerase (GPI) peptide antibodies in patients with rheumatoid arthritis (RA). Nine GPI arginine‐bearing peptides in human GPI protein were selected and cyclic citrullinated GPI peptides (CCG‐1–9) were constructed. Samples were obtained from RA (n = 208), systemic lupus erythematosus (SLE) (n = 101), Sjögren's syndrome (SS; n = 101) and healthy controls (n = 174). Antibodies against CCG‐1–9 were measured, and anti‐citrullinated α‐enolase‐1 (CEP‐1), ‐cyclic citrullinated peptides (CCP) and ‐GPI proteins antibodies were also examined. Patients with RA were genotyped for HLA‐DRB1. The numbers of shared epitope (SE) alleles were counted and compared with those of the autoantibodies. Rabbit GPI was citrullinated with rabbit peptidylarginine deiminase and immunoblot analysis of RA sera performed. The levels of autoantibodies were compared before and after treatment with TNF antagonists in 58 RA patients. Anti‐CCG‐2, ‐4 and ‐7 antibodies were detected in 25·5, 33·2 and 37·0% patients with RA, respectively, and these antibodies were very specific for RA (specificity, 98·1–99·7%). Altogether, 44·2, 86·1 and 13·9% of RA sera were positive for anti‐CEP‐1, ‐CCP and ‐GPI protein antibodies, respectively. Anti‐CCG‐2, ‐4 and ‐7 antibodies were correlated with anti‐CCP and anti‐CEP‐1 antibodies and with the presence of HLA‐DRB1 SE alleles. Citrullinated GPI protein was detected using RA sera. Treatment with tumour necrosis factor antagonists reduced significantly the levels of anti‐CCG‐2 and ‐7 but not of anti‐CEP‐1 antibodies. This is the first report documenting the presence of anti‐CCG antibodies in RA. Anti‐CCG‐2 and ‐7 antibodies could be considered as markers for the diagnosis of RA and its disease activity.     

Autoantibodies recognizing citrullinated rat filaggrin in an ELISA using citrullinated and non-citrullinated recombinant proteins as antigens are highly diagnostic for rheumatoid arthritis

The objective of the study was to determine the diagnostic value for rheumatoid arthritis (RA) of anti-filaggrin autoantibodies (autoAb) recognizing citrullinated recombinant rat filaggrin (ACRF) in community cases of very early arthritis. To evaluate the diagnostic value of ACRF, were studied sera from patients with different classified rheumatic diseases and healthy subjects (group 1, n= 422) and 314 community cases of very early arthritis (group 2) that were classified as RA (n = 176), non-RA (n = 63) and undifferentiated (n = 75) arthritides after 1 years of follow-up. ACRF were measured using a new ELISA, with results expressed as the difference between the OD value obtained on citrullinated minus that on noncitrullinated rat filaggrin (differential ACRF; dACRF). For both groups, rheumatoid factors (RF), anti-keratin autoAb (AKA) and anti-perinuclear factor (APF) were tested; for group 2, anti-CCP autoAb were also tested. Different reactivity patterns against citrullinated and noncitrullinated filaggrin were observed. Almost all sera reacting with citrullinated but not noncitrullinated filaggrin were from RA patients. Among RA and non-RA sera that recognized both forms of filaggrin, a positive result was obtained only with RA sera. For groups 1 and 2, dACRF sensitivity was 58.4% and 30.7%, and specificity for RA was 99.5% and 98.4%, respectively. In group 2, dACRF specificity for RA was better than that of RF (92.1%), APF (95.2%), AKA (96.8%) and anti-CCP (95.2%). dACRF positive predictive value was high (98.2) and close to that given by the concomitant positivity of RF and anti-CCP autoAb. Despite a high positive correlation between AKA, APF, anti-CCP and dACRF test results, they were complementary since some sera were positive for only one test. Thus, in a community setting, anti-citrullinated rat filaggrin reactivity detected by a new ELISA, whose originality is based on the difference between serum's reactivities on the citrullinated and native forms of filaggrin, had a higher diagnostic value for RA than other autoAb.     

类风湿关节炎患者抗血管内皮细胞抗体、血管内皮生长因子和白细胞介素-17的检测及意义

目的 通过对类风湿关节炎(RA)患者血清抗血管内皮细胞抗体(AECA)、血浆血管内皮生长因子(VEGF)和白细胞介素-17(IL-17)的检测,旨在探讨AECA、VEGF、IL-17在RA患者发病、病情进展中的相关性及其内在联系.方法 采用间接免疫荧光法(IIF)和双抗体夹心酶联免疫吸附试验(ELISA)法检测86例RA、45例骨关节炎(OA)、30例健康对照AECA的阳性率和VEGF、IL-17水平,VEGF、IL-17水平与红细胞沉降率(ESR)、超敏C反应蛋白(hs-CRP)、类风湿因子(RF)等指标进行相关性分析.结果 RA患者AECA阳性率为8.1%,高于OA患者的阳性率2.2%(t:2.133,P<0.05)和健康对照的阳性率0(t=2.562,P<0.05);RA活动期AECA阳性率为16.7%,高于RA缓解期的阳性率3.6%(t=2.105,P<0.05);RA患者血浆IL-17和VEGF水平显著高于OA组(t=2.02、t=2.106,P<0.05)和健康对照组(t=2.413、t=2.469,P<0.05);RA患者活动期血浆IL-17和VEGF水平明显高于RA缓解组(t=2.315、t=2.232,P<0.05)及健康对照组(t:2.985、t=2.753,P<0.01);RA缓解组与健康对照组无明显差异(t=1.475、t=1.326,P>0.05);RA患者AECA滴度、血浆IL-17、VEGF水平与ESR、hs-CRP、RF的指标呈正相关.结论 AECA、VEGF、IL-17三者与RA的发病、病情活动存在一定的关系,IL-17、VEGF水平变化及AECA的滴度可作为临床观察RA病情活动、判断疗效及预后等方面的参考指标.     

类风湿关节炎患者抗血管内皮细胞抗体、血管内皮生长因子和白细胞介素-17的检测及意义

目的 通过对类风湿关节炎(RA)患者血清抗血管内皮细胞抗体(AECA)、血浆血管内皮生长因子(VEGF)和白细胞介素-17(IL-17)的检测,旨在探讨AECA、VEGF、IL-17在RA患者发病、病情进展中的相关性及其内在联系.方法 采用间接免疫荧光法(IIF)和双抗体夹心酶联免疫吸附试验(ELISA)法检测86例RA、45例骨关节炎(OA)、30例健康对照AECA的阳性率和VEGF、IL-17水平,VEGF、IL-17水平与红细胞沉降率(ESR)、超敏C反应蛋白(hs-CRP)、类风湿因子(RF)等指标进行相关性分析.结果 RA患者AECA阳性率为8.1%,高于OA患者的阳性率2.2%(t:2.133,P<0.05)和健康对照的阳性率0(t=2.562,P<0.05);RA活动期AECA阳性率为16.7%,高于RA缓解期的阳性率3.6%(t=2.105,P<0.05);RA患者血浆IL-17和VEGF水平显著高于OA组(t=2.02、t=2.106,P<0.05)和健康对照组(t=2.413、t=2.469,P<0.05);RA患者活动期血浆IL-17和VEGF水平明显高于RA缓解组(t=2.315、t=2.232,P<0.05)及健康对照组(t:2.985、t=2.753,P<0.01);RA缓解组与健康对照组无明显差异(t=1.475、t=1.326,P>0.05);RA患者AECA滴度、血浆IL-17、VEGF水平与ESR、hs-CRP、RF的指标呈正相关.结论 AECA、VEGF、IL-17三者与RA的发病、病情活动存在一定的关系,IL-17、VEGF水平变化及AECA的滴度可作为临床观察RA病情活动、判断疗效及预后等方面的参考指标.     

类风湿关节炎患者抗血管内皮细胞抗体、血管内皮生长因子和白细胞介素-17的检测及意义

目的通过对类风湿关节炎（RA）患者血清抗血管内皮细胞抗体（AECA）、血浆血管内皮生长因子（VEGF）和白细胞介素-17（IL-17）的检测,旨在探讨AECA、VEGF、IL-17在RA患者发病、病情进展中的相关性及其内在联系。方法采用间接免疫荧光法（IIF）和双抗体夹心酶联免疫吸附试验（ELISA）法检测86例RA、45例骨关节炎（OA）、30例健康对照AECA的阳性率和VEGF、IL-17水平,VEGF、IL-17水平与红细胞沉降率（ESR）、超敏C反应蛋白（hs．CRP）、类风湿因子（RF）等指标进行相关性分析。结果RA患者AECA阳性率为8．1％,高于OA患者的阳性率2．2％（t=2．133,P〈0．05）和健康对照的阳性率0（t=2．562,P〈0．05）;RA活动期AECA阳性率为16．7％,高于RA缓解期的阳性率3．6％（f=2．105,P〈0．05）;RA患者血浆IL-17和VEGF水平显著高于OA组（t=2．02、t=2．106,P〈0．05）和健康对照组（t=2．413、t=2．469,P〈n05）;RA患者活动期血浆IL—17和VEGF水平明显高于RA缓解组（t=2．315、t=2．232,P〈0．05）及健康对照组（仁2．985、t=2．753,P〈0．01）;RA缓解组与健康对照组无明显差异（t=1．475、t=1．326,P〉0．05）;RA患者AECA滴度、血浆IL-17、VEGF水平与ESR、hs—CRP、RF的指标呈正相关。结论AECA、VEGF、IL-17三者与RA的发病、病情活动存在-定的关系,IL-17、VEGF水平变化及AECA的滴度可作为临床观察RA病情活动、判断疗效及预后等方面的参考指标。     

Anti‐Citrullinated Peptide Antibodies in Sudanese Patients with Leishmania donovani Infection Exhibit Reactivity not Dependent on Citrullination

African patients with Leishmania donovani infections have signs of strong systemic inflammation and high levels of circulating immune complexes (IC) and rheumatoid factor (RF), all serologic markers of rheumatic disease. As inflammation in general is associated with citrullination, we sought to investigate ACPA responses in Sudanese Leishmania patients. Serum samples were collected from Sudanese patients with visceral leishmaniasis (VL) and post‐kala‐azar dermal leishmaniasis (PKDL) as well as from ACPA‐positive Sudanese rheumatoid arthritis patients and compared to healthy Sudanese controls. Levels of circulating C1q‐binding IC and anticyclic citrullinated peptide 2(CCP2) were investigated using ELISA, and RF was measured with nephelometry. C1q adsorption was carried out to investigate anti‐CCP2 content in IC. Citrulline specificity was evaluated with control plates with cyclic arginine‐containing control peptides. Leishmania‐infected patients had elevated levels of RF and circulating IC but also a significant increase in anti‐CCP2 (12%) as compared to healthy controls. Anti‐CCP2‐positive Leishmania patients displayed lower anti‐CCP2 levels than Sudanese patients with rheumatoid arthritis (RA), and anti‐CCP2 levels in Leishmania patients showed a continuum not resembling the dichotomous pattern seen in patients with RA. Whereas the anti‐CCP reactivity of Sudanese RA sera was strictly citrulline dependent, anti‐CCP2‐positive Leishmania sera reacted equally well with ELISA plates containing arginine control peptides. There was a strong correlation between anti‐CCP2 and circulating IC among the Leishmania patients, but IC depletion only marginally diminished anti‐CCP2 levels. Our findings stress the importance to interpret a positive CCP test carefully when evaluated in non‐rheumatic conditions associated with macrophage activation.     

类风湿关节炎四种自身抗体的检测及意义

为评估类风湿因子(rheumatoid factor,RF)、抗环瓜氨酸肽(cyclic citrullinated pepdide,CCP)抗体、抗Sa抗体和抗角蛋白抗体(anti-keratin antibody,AKA)自身抗体对类风湿关节炎(rheumatoid arthritis,RA)诊断的意义,采用速率散...     

Diagnostic value of anti-mutated citrullinated vimentin in comparison to anti-cyclic citrullinated peptide and anti-viral citrullinated peptide 2 antibodies in rheumatoid arthritis: An Italian multicentric study and review of the literature

In the last years, the detection of antibodies (Abs) against citrullinated peptides (ACPA) has largely replaced rheumatoid factor (RF) as the most helpful biomarker in the diagnosis of rheumatoid arthritis (RA). Current assays detect ACPA reactivity with epitopes on various different citrullinated proteins. Among these, anti-cyclic citrullinated peptide (CCP) Abs have been widely demonstrated to be an important diagnostic and prognostic tool because of their high specificity. Recently, citrullinated vimentin, a protein highly released in synovial microenvironment, has been identified as potential autoantigen in the pathophysiology of RA and an enzyme-linked immunosorbent assay (ELISA) for the detection of Abs directed against a mutated citrullinated vimentin (anti-MCV) was developed. Several recent studies evaluating the characteristics of anti-MCV in comparison to anti-CCP Abs, have given conflicting results. Anti-MCV have been demonstrated to perform better than anti-CCP as predictor of radiographic damage. Conversely, its additional diagnostic and prognostic role in comparison to anti-CCP in both early and established RA is controversial. Aim of this study was to evaluate the diagnostic performance of anti-MCV in RA and to compare it to anti-CCP and the recently developed assay targeting viral citrullinated peptide 2 (VCP2) in a large cohort of RA patients (n=285), healthy subjects and other disease controls (n=227). Anti-MCV resulted to have a sensitivity of 59% and a specificity of 92%. In comparison, anti-CCP and anti-VCP2 displayed a sensitivity of 77% and 61% and a specificity of 96% and 95%, respectively. Of interest, at the manufacturer recommended cutoff value of 20U/mL, a high percentage of healthy subjects as well as Epstein Barr (EBV) and hepatitis C (HCV) virus infected patients resulted anti-MCV positive. In our large cohort of RA patients, anti-MCV demonstrated lower sensitivity than anti-CCP and VCP2 test, thus not allowing to confirm previously published data. Moreover, the high rate of detection in infectious diseases limits its diagnostic value in undifferentiated arthritis.