@article {Engelmannjrheum.081263, author = {Robby Engelmann and Jan Brandt and Martin Eggert and Kirsten Karberg and Andreas Krause and Gunther Neeck and Brigitte Mueller-Hilke}, title = {The Anti-mutated Citrullinated Vimentin Response Classifies Patients with Rheumatoid Arthritis into Broad and Narrow Responders}, elocation-id = {jrheum.081263}, year = {2009}, doi = {10.3899/jrheum.081263}, publisher = {The Journal of Rheumatology}, abstract = {Objective Autoantibodies against citrullinated peptide antigens (ACPA) are routinely determined to diagnose rheumatoid arthritis (RA) and are predictive of a more severe course of the disease. We here set out to address an involvement of ACPA in the pathogenesis of RA and investigated the recognition pattern of antibodies against 2 citrullinated antigens in more detail. Methods The sera of 77 patients fulfilling the American College of Rheumatology criteria for RA were analyzed for subclass titers of anti-mutated citrullinated vimentin (MCV) and anticyclic citrullinated peptide (CCP) antibodies by combining subclass specific detection antibodies with commercially available CCP and MCV ELISA plates. Cross-reactivities between anti-MCV and anti-CCP antibodies were detected using a sequential ELISA system. Results IgG1, IgG3, and IgG4 titers among anti-MCV and anti-CCP antibodies correlated significantly. Cross-reactivity of MCV-specific antibodies against CCP could be detected in 8 of 16 patients{\textquoteright} sera; however, cross-binding of MCV-specific IgG4 was weaker compared to total IgG. Conclusion The inherent capacity of IgG4 to exchange F(ab) arms provides insight into the anti-MCV antibody diversity and suggests a classification of ACPA positive patients into broad and narrow responders.}, issn = {0315-162X}, URL = {https://www.jrheum.org/content/early/2009/10/29/jrheum.081263}, eprint = {https://www.jrheum.org/content/early/2009/10/29/jrheum.081263.full.pdf}, journal = {The Journal of Rheumatology} }