Abstract
IntroductionIn this study, we sought to determine the diagnostic value and clinical laboratory associations of autoantibodies against recombinant ribosomal P0, P1 and P2 proteins and their native heterocomplex in systemic lupus erythematosus (SLE).MethodsAutoantibodies against recombinant ribosomal P proteins (aRibPR0, aRibPR1 and aRibPR2) and antibodies against native ribosomal P heterocomplex (aRibPNH) were determined in sera from patients with SLE (n = 163), systemic sclerosis (n = 66), Sjögren's syndrome (n = 54), rheumatoid arthritis (n = 90) and healthy donors (n = 100) using enzyme-linked immunosorbent assay. Test results were correlated to medical records, including the American College of Rheumatology criteria, the Systemic Lupus Erythematosus Disease Activity Index 2000, laboratory data and medications of all SLE patients.ResultsSensitivities of 22.0% for aRibPR0, 14.9% for aRibPR2, 14.3% for aRibPNH and 10.7% for aRibPR1 were obtained at a specificity of 99%. The assay for aRibPR0 detection demonstrated the best performance in receiver-operating characteristics analysis, with aRibPR0 detectable in 10% of anti-Smith antibody and anti-double-stranded DNA-negative sera at a specificity of 100%. ARibPR0 positivity was associated with lymphocytopenia. ARibPR1+ patients had significantly higher γ-glutamyl transpeptidase (GGT) levels than their aRibPR1- counterparts. No specific damage occurred in aRibP+ lupus patients compared with a group of age-, sex- and nephritis-matched aRibP- lupus patients within 3 years.ConclusionsThe determination of antibodies against ribosomal P proteins improves the diagnosis of SLE and should therefore be implemented in upcoming criteria for the diagnosis or classification of SLE. High titers of aRibPR0 can be associated with lymphocytopenia, and high titers of aRibPR1 can be associated with elevated GGT levels. So far, there is no evidence for a prognostic value of aRibPs for damage.
Highlights
In this study, we sought to determine the diagnostic value and clinical laboratory associations of autoantibodies against recombinant ribosomal P0, P1 and P2 proteins and their native heterocomplex in systemic lupus erythematosus (SLE)
In contrast to anti-Smith and anti-double-stranded DNA antibodies, anti-ribosomal P protein antibodies are not included in the current American College of Rheumatology (ACR) classification criteria for SLE [4,5]
Study participants Altogether 479 serum samples were obtained from the following groups: (1) patients with SLE (n = 163), who fulfilled the American College of Rheumatology (ACR) 1982 revised criteria for the classification of SLE [4], (2)
Summary
We sought to determine the diagnostic value and clinical laboratory associations of autoantibodies against recombinant ribosomal P0, P1 and P2 proteins and their native heterocomplex in systemic lupus erythematosus (SLE). Systemic lupus erythematosus (SLE) is a chronic, multifaceted rheumatic disease which is characterised by the generation of autoantibodies predominantly directed against nuclear proteins and nucleic acids [1,2]. Antibodies against cytoplasmatic antigens such as those binding to ribosomal P proteins (aRibPs) have been reported to be specific for SLE as well [2,3]. P proteins can exist as ribosome-free P0, P1 and P2 forms in the cytoplasm [6,7]. The P0-like protein is detectable in the plasma membranes of hepatocytes, lymphocytes and other cells [8,9,10,11]
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