Abstract
BackgroundSpecific autoantibodies are considered as an important marker in autoimmune rheumatic diseases and are of great value for the diagnosis and prognosis of systemic lupus erythematosus (SLE) patients. A total of eighteen autoantibodies were analyzed for their positivity in SLE patients and we evaluated the clinical relevance of the five most frequent autoantibodies: anti-dsDNA, anti-nucleosome, anti-histone, anti-Ro60, and anti-Ro52 on disease activity and renal affection in SLE Egyptian patients.ResultsImmunological profile and correlation of the five autoantibodies with disease activity and histopathological pattern of renal involvement were analyzed for 190 SLE patients. Lupus nephritis (LN) patients showed much worse constitutional and mucocutaneous manifestations than patients without nephritis. Autoantibody profile showed a significant increased frequency of anti-dsDNA, anti-nucleosome, anti-histone, anti-Ro-60, and anti-Ro52 antibodies in LN patients. The impact of the co-positivity of the autoantibodies on the renal function was obvious. Moreover, the disease activity increased by the increased frequency of autoantibodies positivity in LN patients. ROC curve analysis showed that anti-nucleosome had the highest sensitivity; 93% followed by anti-dsDNA 83.3% then anti-histone 73.8%, but anti-Ro60 and anti-Ro52 showed a humble sensitivity. Furthermore, the highest frequency of positivity for the five autoantibodies was found in class-III and class-IV LN patients.ConclusionDetection of anti-dsDNA, anti-nucleosome, anti-histone, and anti-Ro60 in SLE patients may be important for predicting disease progression and kidney affection. Moreover, anti-nucleosome and anti-dsDNA show high sensitivity and specificity for lupus nephritis, thus patients with four to five positive autoantibody panels should be kept under close monitoring as they may warrant considering aggressive therapy to control their disease and prevent renal damage.
Highlights
Specific autoantibodies are considered as an important marker in autoimmune rheumatic diseases and are of great value for the diagnosis and prognosis of systemic lupus erythematosus (SLE) patients
0.400 r correlation coefficient *Correlation is significant at p < 0.05 **Correlation is highly significant at p < 0.01 autoantibodies were implicated with the highest frequency, so we evaluated the alleged role for their use as biomarkers for SLE and their relationship with disease activity and renal affection
From receiver operating curve (ROC) curve analysis, we found that both anti nucleosome and antidsDNA had high sensitivity and specificity for Lupus nephritis (LN) with anti-nucleosome had a higher sensitivity than antidsDNA, and this in agreement with Abdel Gawad et al and Gutiérrez-Adrianzén et al [45, 46]
Summary
Specific autoantibodies are considered as an important marker in autoimmune rheumatic diseases and are of great value for the diagnosis and prognosis of systemic lupus erythematosus (SLE) patients. Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by a dysregulated immune system and manifested by the production of excessive pathogenic autoantibodies, which have a diagnostic application and are implicated in organ involvement [1]. Anti-dsDNA is suggested to be a good marker for the diagnosis of SLE and monitoring disease activity, anti-nucleosome is reported to provide a better indicator for disease activity [8, 9]. Previous studies revealed conflicting results regarding anti-histone considering it as a specific marker for the diagnosis of SLE with a comparable diagnostic value to anti-dsDNA while other studies revealed that it is sensitive but not specific for SLE [11]. Anti-Ro60 and antiRo52 are commonly detected in a variety of autoimmune diseases and are associated with various clinical manifestations [14]
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