Abstract

ObjectiveThe significance of anti-dense fine speckles 70 (DFS70) antibodies in systemic lupus erythematosus (SLE) is still unclear, especially in lupus nephritis (LN) patients. We investigated the prevalence, clinical and pathological relevance of anti-DFS70 antibodies in LN patients.MethodsAnti-DFS70 antibodies were measured using enzyme-linked immunosorbent assays in 377 biopsy-proven LN patients, 268 non-LN SLE patients, 232 chronic kidney disease (CKD) patients, and 78 healthy individuals (HI). Demographic, clinical, and pathological parameters were compared between LN patients with and without anti-DFS70 antibodies. Stepwise multivariable logistic regression was performed to identify covariates associated with anti-DFS70 antibodies.ResultsThe prevalence of anti-DFS70 antibodies in LN (19.6%) was comparable to non-LN SLE patients (19.8%, P=0.9630), but was significantly higher than CKD patients (13.4%, P=0.0468) and HI (9.0%, P=0.0252). Using multivariable logistic regression analysis, the titer of anti-double-stranded DNA (dsDNA) antibodies (adjusted odds ratio=1.002, 95% confidence interval 1.001-1.003, P=0.004) was associated with positive anti-DFS70 antibodies in LN patients. In addition, anti-DFS70 antibodies were more prevalent in proliferative LN (22.0%, 68/309) compared to membrane LN patients (10.2%, 6/59, P=0.0376). Furthermore, LN patients with positive anti-DFS70 antibodies had significantly higher activity index (AI) compared to patients who were negative (8.0 vs 6.0, P=0.0131). However, the chronicity index was similar between the groups (3.0 vs 3.0, P=0.8412).ConclusionAnti-DFS70 antibodies were not associated with LN development in SLE patients but were associated with anti-dsDNA antibodies, proliferative LN, and renal AI. This suggests their potential to serve as a non-histological biomarker for LN subclass and activity status.

Highlights

  • The presence of antinuclear antibodies (ANA) recognizing intracellular antigens is a hallmark of lupus nephritis (LN), the most frequent manifestation of systemic lupus erythematosus (SLE) resulting in increased morbidity and mortality [1, 2]

  • The prevalence of anti-dense fine speckles 70 (DFS70) antibodies in LN patients (19.6%, 74/377) was similar to NLN-SLE patients (19.8%, 53/268, P=0.9630), but significantly higher compared to healthy individuals (HI) (9.0%, 7/78, P=0.0252) and chronic kidney disease (CKD) patients (13.4%, 31/232, P=0.0468)

  • Among the patients with CKD, 33.3% (2/6) purpuric nephritis (PPN), 18.2% (2/11) diabetic nephropathy (DN), 15.8% (9/57) IgA nephropathy (IgAN), 11.8% (14/ 119) nephrotic syndrome (NS), 11.4% (4/35) primary membranous nephropathy (PMN) and 0% (0/4) vasculitis-associated nephritis (VAN) were positive for anti-DFS70 antibodies

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Summary

Objective

The significance of anti-dense fine speckles 70 (DFS70) antibodies in systemic lupus erythematosus (SLE) is still unclear, especially in lupus nephritis (LN) patients. Clinical and pathological relevance of anti-DFS70 antibodies in LN patients

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