Advances in understanding newer autoantibodies and their role as biomarkers in systemic lupus erythematosus

Abstract

Autoantibodies (AAs) were first associated with systemic lupus erythematosus (SLE) in the 1950s and since then > 155 have been described in SLE sera. Of these, only a few have achieved recognition as important biomarkers in the classification, diagnosis, prediction, prognosis and pathogenesis of the disease. Although some long-established AAs, such as anti-dsDNA, anti-Sm and anticardiolipin, have taken center stage in classification criteria and pathogenic studies, some of the newer and less understood AAs may have equally important disease relevance. This review will focus on evidence for: i) the importance of AAs as biomarkers for early disease; ii) a consideration that certain AAs should be added as serologic criteria for the classification and diagnosis of SLE and that present serologic criteria should be reevaluated; and iii) a role of AAs in the pathogenesis and prognosis of SLE.