From the Guidelines
Mutated citrullinated vimentin antibody (Anti-MCV) is a significant biomarker in the diagnosis of rheumatoid arthritis, particularly in patients who test negative for other antibodies, with a sensitivity of approximately 70-80% and specificity of 85-95% for RA diagnosis. The significance of Anti-MCV lies in its ability to detect rheumatoid arthritis in patients who may not test positive for rheumatoid factor (RF) or anti-cyclic citrullinated peptide (anti-CCP) antibodies 1. This antibody test measures antibodies against vimentin, a protein that undergoes post-translational modifications during inflammation, becoming a target for autoantibodies in RA. Some key points to consider when interpreting Anti-MCV results include:
- Elevated Anti-MCV levels often correlate with more aggressive disease and radiographic progression
- Normal values are typically below 20 U/mL, with values above this threshold suggesting RA
- The test should be interpreted alongside clinical findings and other laboratory tests, as no single biomarker is definitive for RA diagnosis
- Anti-MCV testing is particularly valuable in early disease stages when traditional markers may still be negative, potentially allowing for earlier therapeutic intervention and better long-term outcomes. In clinical practice, the use of Anti-MCV, in conjunction with other diagnostic tools, such as the Disease Activity Score using 28 joint counts (DAS28) and the Simplified Disease Activity Index (SDAI), can facilitate early diagnosis and treatment of rheumatoid arthritis, leading to improved patient outcomes 1.
From the Research
Significance of Mutated Citrullinated Vimentin Antibody (Anti-MCV)
- The anti-MCV antibody is a significant marker for the diagnosis of rheumatoid arthritis (RA) 2, 3, 4, 5, 6
- Studies have shown that anti-MCV antibodies have a high sensitivity and specificity for diagnosing RA, particularly in anti-CCP-negative patients 2, 3, 4, 6
- Anti-MCV antibodies have been found to correlate with disease activity and can be used to monitor the effects of infliximab therapy 3, 5
- The presence of anti-MCV antibodies has been associated with increased erosions, joint space narrowing, and a higher total sharp score in RA patients 5
- Anti-MCV antibodies may contribute to poor physical activity and more fatigue in RA patients beyond their established role in disease activity and erosion 5
Diagnostic Utility of Anti-MCV
- Anti-MCV antibodies have been shown to have a higher sensitivity than anti-CCP antibodies in diagnosing early RA cases 6
- The diagnostic sensitivity and specificity of anti-MCV antibodies have been compared to those of anti-CCP and RF antibodies in early versus established RA patients 6
- Anti-MCV antibodies have been found to have a positive correlation with ESR, CRP, and DAS 28, indicating their potential as a valuable marker for diagnosis and disease activity assessment 5, 6
Association with Disease Activity and Deformities
- Anti-MCV antibodies have been associated with increased disease activity and deformities in RA patients 5
- The presence of anti-MCV antibodies has been correlated with higher DAS 28 scores, indicating their potential as a marker for disease activity assessment 5, 6
- Anti-MCV antibodies may be useful in monitoring the effects of treatment and predicting disease outcomes in RA patients 3, 5