A volcanic explosion of autoantibodies in systemic lupus erythematosus: A diversity of 180 different antibodies found in SLE patients

doi:10.1016/j.autrev.2014.10.003

Autoimmunity Reviews

Volume 14, Issue 1, January 2015, Pages 75-79

https://doi.org/10.1016/j.autrev.2014.10.003 Get rights and content

Abstract

Recent research in systemic lupus erythematosus (SLE) yielded new antigens and antibodies in SLE patients. We describe the various autoantibodies that can be detected in patients with SLE.

A literature review, using the terms “autoantibody” and “systemic lupus erythematosus”, was conducted to search for articles on autoantibodies in SLE, their target antigens, association with disease activity and other clinical manifestations.

One hundred and eighty autoantibodies were so far described in SLE patients. These include autoantibodies that target nuclear antigens, cytoplasmic antigens, cell membrane antigens, phospholipid-associated antigens, blood cells, endothelial cells, and nervous system antigens, plasma proteins, matrix proteins, and miscellaneous antigens. The target of an autoantibody, the autoantigen properties, autoantibody frequencies in SLE, as well as clinical associations, and correlation with disease activity are described for all 180 autoantibodies.

SLE is so far the autoimmune disease with the largest number of detectable autoantibodies. Their production could be antigen-driven, the result of a polyclonal B cell activation, impaired apoptotic pathways, or the outcome of an idiotypic network dysregulation.

Introduction

Systemic lupus erythematosus (SLE) is a multi-systemic autoimmune disease that involves nearly every organ of the human body. It expands a wide spectrum of clinical manifestations ranging, for example, from mild arthritis through pericarditis and nephritis to life-threatening neuro-psychiatric symptoms [1], [2]. Over the years a huge number of autoantibodies were reported [3], [4]. These antibodies predict the development of the disease years before it is clinically overt [5], or noticeably also associated with the occurrence of the disease and/or with its specific manifestations [6].

Nonetheless, in contrast to other classical autoimmune diseases, the specific autoantigens in SLE are still unknown and it has also not been determined whether all the characteristic autoantibodies are pathogenic in SLE [7]. While various autoantibody panels were also detected in patients with rheumatoid arthritis [8], [9], Sjorgen syndrome [10] and antiphospholipid syndrome [4] there is no other autoimmune disease similar to SLE in regard to the number of autoantibodies found [6].

The aim of the current study was to conduct a literature search for autoantibodies in SLE to uncover in a comprehensive manner the different antibodies associated with SLE. We describe a total of 180 autoantibodies that are more prevalent in SLE, their autoantigen properties and prevalence in SLE and their correlation with disease activity or other clinical manifestations, as well as their potential significance in SLE pathogenesis.

Section snippets

Methods

The English-language medical literature was searched for original articles describing autoantibodies in SLE. Using Medline, the search words used were “autoantibody” and “systemic lupus erythematosus” and the years searched were 1960 to 2011 in the English language. The aim was to describe the various autoantibodies with respect to their target, the properties of the autoantigens targeted by these autoantibodies, and the prevalence of each of the autoantibodies in SLE, to determine if their

Results

We found a total of 180 antibodies that were reported in SLE, from a total of 12,040 articles found in PubMed. A detailed description of their prevalence, autoantigen properties, correlation with disease activity and clinical significance is outlined in the Supplementary material. Table 1 classifies the autoantibodies in a system-specific manner. Of the 180 reported here, 20 different antibodies exhibited some correlation with disease activity and are described in Table 1. One hundred and two

Discussion

In the current study we describe in detail all the autoantibodies that were described in systemic lupus erythematosus. The huge and diverse panel of autoantibodies significantly increased compared to other autoimmune diseases [4], [8], [9]. This re-introduces the question whether SLE is a single disease with varied phenotypes, or a similar phenotype that is associated with a variety of different diseases but with different pathogenic mechanisms [3]. Although the great number of autoantibodies

Take-home messages

•
SLE is a multi-systemic autoimmune disease characterized by a huge number of autoantibodies (around 180).
•
These autoantibodies are diverse regarding their prevalence and their clinical association with disease activity and with target-organ damage.
•
Some autoantibodies are specific for SLE, while most can also be detected in other diseases.
•
Monitoring the levels of a few autoantibodies might be important during the course of SLE.

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ReviewA volcanic explosion of autoantibodies in systemic lupus erythematosus: A diversity of 180 different antibodies found in SLE patients

Abstract

Introduction

Section snippets

Methods

Results

Discussion

Take-home messages

Autoimmun Rev

Autoimmun Rev

J Autoimmun

Semin Arthritis Rheum

Autoimmun Rev

J Autoimmun

J Autoimmun

Autoimmun Rev

Autoimmun Rev

Autoimmun Rev

J Autoimmun

J Autoimmun

J Autoimmun

Semin Arthritis Rheum

Autoimmun Rev

Best Pract Res Clin Rheumatol

Autoimmun Rev

Development of autoantibodies before the clinical onset of systemic lupus erythematosus

N Engl J Med

The mosaic of autoimmunity: genetic factors involved in autoimmune diseases—2008

Isr Med Assoc J

Autoantibodies to DEK oncoprotein in systemic lupus erythematosus (SLE)

Clin Exp Immunol

Systemic lupus erythematosus

N Engl J Med

Review
A volcanic explosion of autoantibodies in systemic lupus erythematosus: A diversity of 180 different antibodies found in SLE patients