Systemic Lupus Erythematosus with and without Anti-dsDNA Antibodies: Analysis from a Large Monocentric Cohort.

Conti Fabrizio,Marocchi Elisa,Miranda Francesca,Valesini Guido,Perricone Carlo,Spinelli Francesca Romana,Ceccarelli Fulvia,Truglia Simona,Massaro Laura,Alessandri Cristiano

doi:10.1155/2015/328078

Abstract

Objectives. The anti-dsDNA antibodies are a marker for Systemic Lupus Erythematosus (SLE) and 70–98% of patients test positive. We evaluated the demographic, clinical, laboratory, and therapeutical features of a monocentric SLE cohort according to the anti-dsDNA status. Methods. We identified three groups: anti-dsDNA + (persistent positivity); anti-dsDNA ± (initial positivity and subsequent negativity during disease course); anti-dsDNA − (persistent negativity). Disease activity was assessed by the European Consensus Lupus Activity Measurement (ECLAM). Results. We evaluated 393 patients (anti-dsDNA +: 62.3%; anti-dsDNA ±: 13.3%; anti-dsDNA −: 24.4%). The renal involvement was significantly more frequent in anti-dsDNA + (30.2%), compared with anti-dsDNA ± and anti-dsDNA − (21.1% and 18.7%, resp.; P = 0.001). Serositis resulted significantly more frequent in anti-dsDNA − (82.3%) compared to anti-dsDNA + and anti-dsDNA ± (20.8% and 13.4%, resp.; P < 0.0001). The reduction of C4 serum levels was identified significantly more frequently in anti-dsDNA + and anti-dsDNA ± (40.0% and 44.2%, resp.) compared with anti-dsDNA − (21.8%, P = 0.005). We did not identify significant differences in the mean ECLAM values before and after modification of anti-dsDNA status (P = 0.7). Conclusion. Anti-dsDNA status influences the clinical and immunological features of SLE patients. Nonetheless, it does not appear to affect disease activity.

Highlights

Systemic Lupus Erythematosus (SLE) is an autoimmune disease, characterized by the production of a wide range of autoantibodies, resulting from polyclonal B cells activation, impaired apoptotic pathways, or idiotypic network dysregulation [1,2,3,4,5].The anti-double stranded DNA antibodies are considered a specific marker for SLE [6]
We evaluated 393 SLE patients [29M/ 364F (7.4%/92.6%); 386 (98.2%) Caucasian; mean age ± standard deviation (SD) 44.8 ± 13.0 years; mean disease duration ± SD 152.4 ± 104.4 months]
The results of the present study identified an association between the persistent or previous positivity for anti-dsDNA and specific clinical and immunological features

Summary

Introduction

Systemic Lupus Erythematosus (SLE) is an autoimmune disease, characterized by the production of a wide range of autoantibodies, resulting from polyclonal B cells activation, impaired apoptotic pathways, or idiotypic network dysregulation [1,2,3,4,5].The anti-double stranded DNA antibodies (anti-dsDNA) are considered a specific marker for SLE [6]. Due to the high frequency (ranging from 70% to 98%), sensitivity, and specificity (57.3% and 97.4%, resp.), the presence of these autoantibodies could be virtually diagnostic for SLE [2, 6]. Their identification in other pathological conditions and in healthy subjects is very rare (less than 0.5%) [7]. Several lines of evidence demonstrate the pathogenic role of anti-dsDNA antibodies These autoantibodies have been associated with kidney involvement, as demonstrated by their deposition in several renal structures in SLE patients with active nephritis, that is, glomeruli, subendothelial and subepithelial spaces, mesangium, basement membrane, and tubules [9]. Data from the literature demonstrate that the increase in anti-dsDNA serum levels could precede the relapse of disease, especially in terms of renal disease exacerbation [11, 12]

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Conclusion