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Multicentric evaluation of a second generation assay to detect antiviral citrullinated peptide antibodies: a collaborative study by the Forum Interdisciplinare per la Ricerca nelle Malattie Autoimmuni
  1. N Bizzaro1,
  2. F Allegri2,
  3. C Alpini3,
  4. A Doria4,
  5. R Gerli5,
  6. M Lotzniker6,
  7. A Mathieu7,
  8. G Morozzi8,
  9. F Bellisai8,
  10. V Riccieri9,
  11. M Tampoia10,
  12. P Migliorini11
  1. 1Laboratorio di Patologia Clinica, Ospedale S. Antonio, Tolmezzo, Italy
  2. 2Allergologia e Immunologia Clinica, Ospedale Civile, Brescia, Italy
  3. 3Fondazione IRCCS, Policlinico S. Matteo, Pavia, Italy
  4. 4Divisione di Reumatologia, Università di Padova, Padova, Italy
  5. 5Dipartimento di Medicina Clinica e Sperimentale, Centro per lo Studio delle Malattie Reumatiche, Università di Perugia, Perugia, Italy
  6. 6Laboratorio Analisi, Ospedale Civile, Legnano, Italy
  7. 7Istituto di Reumatologia, Università di Cagliari, Cagliari, Italy
  8. 8Dipartimento di Medicina Clinica e Scienze Immunologiche, Sezione di Reumatologia, Policlinico Le Scotte, Università di Siena, Siena, Italy
  9. 9Dipartimento di Medicina Interna e Specialità Mediche, Università “Sapienza”, Rome, Italy
  10. 10Patologia Clinica I, Policlinico Consorziale, Bari, Italy
  11. 11Immunologia Clinica, Dipartimento di Medicina Interna, Università di Pisa, Pisa, Italy
  1. Correspondence to Dr Nicola Bizzaro, Laboratory of Clinical Pathology, Ospedale S. Antonio via Morgagni, 18 33028 Tolmezzo (UD), Italy; nicola.bizzaro{at}


Aims A novel immunoenzymatic assay using viral citrullinated peptides derived from Epstein–Barr virus-encoded proteins (viral citrullinated peptide 2 (VCP2)) has been developed and evaluated by means of a multicentre collaborative study.

Methods Three hundred nine sera from patients with established rheumatoid arthritis (RA), 36 with early arthritis, 12 with juvenile arthritis and 453 controls were tested for VCP2 and cyclic citrullinated peptide (CCP) antibodies.

Results The VCP2 assay showed 78.3% sensitivity and 97.1% specificity. VCP2 and CCP had a high concordance rate in patients with RA (88%) and controls (97%). However, 36 RA sera were positive in the CCP assay but negative on VCP2, and two RA sera reacted only on VCP2.

Conclusions The new VCP2 assay is endowed with high sensitivity and specificity. VCP2-positive RA sera are mostly but not completely contained in the CCP-positive population. Studies are in progress to establish whether the VCP2 assay can detect clinically distinct subsets of patients with RA.

  • Autoimmune laboratory investigations
  • rheumatoid arthritis
  • autoantibody
  • autoimmunity

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  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.