PT  - JOURNAL ARTICLE
AU  - ROBBY ENGELMANN
AU  - JAN BRANDT
AU  - MARTIN EGGERT
AU  - KIRSTEN KARBERG
AU  - ANDREAS KRAUSE
AU  - GUNTHER NEECK
AU  - BRIGITTE MUELLER-HILKE
TI  - The Anti-mutated Citrullinated Vimentin Response Classifies Patients with Rheumatoid Arthritis into Broad and Narrow Responders
AID  - 10.3899/jrheum.081263
DP  - 2009 Dec 01
TA  - The Journal of Rheumatology
PG  - 2670--2674
VI  - 36
IP  - 12
4099  - http://www.jrheum.org/content/36/12/2670.short
4100  - http://www.jrheum.org/content/36/12/2670.full
SO  - J Rheumatol2009 Dec 01; 36
AB  - 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’ 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.