Anti-nucleosome antibodies in systemic lupus erythematosus patients: Relation to anti-double stranded deoxyribonucleic acid and disease activity

Abstract

Aim of the workTo measure the level of anti-nucleosome (anti-NCS) antibodies in systemic lupus erythematosus (SLE) patients and to evaluate their relation with anti-double stranded deoxyribonucleic acid (anti-dsDNA) antibodies and SLE disease activity. Patients and methods66 Egyptian SLE patients were investigated for the detection of anti-NCS antibodies and anti-dsDNA antibodies. Disease activity was assessed using the SLE disease activity index (SLEDAI) and the European consensus lupus activity measurement (ECLAM). ResultsThe median age of the patients was 25.5years (12–48years) and disease duration 3years (1month to 26years). anti-NCS antibody was found in 48 (72.7%) patients. Non-significant difference was found between both those positive or negative anti-NCS antibodies regarding the clinical features apart from fever (p=0.019). Lupus nephritis was present in 35/48(72.9%) of those with positive and in 11/18 (61.1%) of those with negative anti-NCS (p=0.35) A significant correlation was found between anti-NCS antibodies with SLEDAI (r=0.36, p=0.003) and ECLAM (r=0.29, p=0.019). No significant relation was found between anti-NCS antibodies and clinical features of SLE, apart from fatigue (r=0.3, p=0.015). A significant correlation with hypocomplementemia (C3 r=−0.37, p=0.002 and C4 r=−0.32, p=0.018) and anaemia (r=−0.32, p=0.009). anti-dsDNA antibodies were detected in 35(53%) SLE patients; 70.8% of those with positive and 5.6% of those with negative anti-NCS antibodies. ConclusionAnti-NCS antibodies could play a role in the pathogenesis of SLE and is related to disease activity. Its association with anti-dsDNA antibodies and its presence in those with negative anti-ds DNA may aid in the diagnosis of SLE.