Frequency of ANA and ANA/DFS70 in patients diagnosed with psoriasis compared with healthy population and its association with disease severity

Abstract

IntroductionPsoriasis (PsO) is a chronic multisystemic disease with an inflammatory phenotype involving skin compromise; PsO has no autoantibodies as biomarkers and is considered a seronegative disease. Otherwise, the correlation with autoantibodies such as antinuclear antibodies (ANA) has been described. Anti-DFS70 antibody presence has been proposed as essential in the exclusion process of systemic autoimmune rheumatic diseases (SARD) as a negative biomarker. ObjectiveTo evaluate ANA and ANA/DFS70 positivity and the autoantibody profile in a sizeable PsO population compared to healthy controls (HC) and its association with disease severity. Methodology and methodsA cross-sectional study was carried out in Colombian adult patients with a confirmed diagnosis of PsO and HC. Patient data from the PsO Clinic of the Dermatology Service of the Hospital Militar Central. ANA-HEp2 antibodies were determined by indirect immunofluorescence (IIF). Two confirmatory tests were performed on positive results (pattern AC-2) for the determination of ANA/DFS70-Knocked out for the psip gene) and CytoBead ANA/DFS70 by IIF. Data analysis was evaluated by bivariate statistics based on variables nature and normality tests. Subsequently, a binary logistic regression model was performed. The institutional ethics committee approved the study. ResultsPsO group were 79 patients; 45 (57%) were female, with a mean age of 52.3±17.9 years old, the vulgar PsO presentation was 97.5%, and 13.9% had psoriatic arthritis (PsA). Severe disease (PASI>10 points) was reported in 11.4%. The total number of positive ANA patients was 35 (44.3%). There was a significant difference between ANA positivity and BMI (p=.045) and severe disease (PASI>10) (p=.036). ANA positivity in PsO patients with higher ESR (AOR 1.08 CI95% 1.01–1.16 p=.044) and an association with PASI>10 points (AOR 7.34 CI95% 1.14–18.4 p=.038). Positive ANAS was present in seven (11.5%) HC. ANAS/DFS70 positivity was observed in only one PsO patient and three HC patients. ConclusionThe presence of ANAS in patients with PsO is significantly higher compared to the control group and is associated with greater severity of disease, higher levels of inflammatory markers, predominantly titer 1/80, and the AC4-fine granular pattern. The ANAS/DFS70 frequency in PsO patients was low, similar to that described in other references in the literature. The presence of ANAS/DFS70 in HC is confirmed with a higher frequency.