Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by the formation of antigen–antibody complexes which trigger an immune response. We investigate certain autoantibodies including nucleosome, double-stranded DNA (dsDNA), Smith, ribonucleoprotein, and Sjögren’s syndrome-related antigens, and examine their associations with disease activity, damage accrual, and SLE-related clinical and serological manifestations in patients with SLE. We conducted a cross-sectional study with a total 293 patients (90.4% female, mean age 46.87±12.94 years) and used the Systemic Lupus Erythematosus Disease Activity Index 2000 and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) to evaluate disease activity and disease-related damage, respectively. Systemic Lupus Erythematosus Disease Activity Index scores were significantly higher in anti-nucleosome-positive (3.87±2.72 vs 2.52±2.76, p=0.004) and anti-dsDNA-positive (3.08±2.91 vs 2.04±2.48, p=0.010) patients compared with patients without these antibodies. SDI scores were also significantly higher in anti-nucleosome-positive patients (1.61±1.99 vs 0.89±1.06, p=0.004). The presence of antinucleosome (p=0.019) and anti-dsDNA antibodies (p=0.001) both correlated significantly with the incidence of nephritis; anti-La antibodies were associated with arthritis (p=0.022), and we also observed a relationship between the presence of antinucleosome antibodies and leukopenia (p=0.011). Patients with antinucleosome or anti-dsDNA antibodies had a higher disease activity and were likely to have nephritis. Antinucleosome was also associated with more damage accrual. A greater understanding of these autoantibodies could lead to the development of new approaches to more accurate assessments of SLE.
Footnotes
Contributors All authors read and approved the final version of the manuscript. NO-O and BR-M contributed equally to this work. MC-R performed patient’s nutritional assessments, analyzed and interpreted the data and wrote the manuscript. GP-G analyzed the data, performed statistical analyses and reviewed/edited manuscript. J-LC-R, RR-F, MM-A, MC-C performed patient recruitment, clinical assessment and reviewed the manuscript. NO-C contributed to the conception and study design, patient recruitment and reviewed/edited manuscript. BR-M contributed to the conception, study design, and data interpretation and reviewed/edited manuscript.
Funding This study was supported by the grant PI0523-2016 from Consejería de Igualdad, Salud y Políticas Sociales (Junta de Andalucía).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement
Data are available upon reasonable request.
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