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  • Clinical phenotype associations with various types of anti-dsDNA antibodies in patients with recent onset of rheumatic symptoms. Results from a multicentre observational study

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Biomarker studies
Clinical phenotype associations with various types of anti-dsDNA antibodies in patients with recent onset of rheumatic symptoms. Results from a multicentre observational study
  1. Michele Compagno1,
  2. Ole P Rekvig2,
  3. Anders A Bengtsson1,
  4. Gunnar Sturfelt1,
  5. Niels H H Heegaard3,
  6. Andreas Jönsen1,
  7. Rasmus Sleimann Jacobsen4,
  8. Gro Ø Eilertsen5,
  9. Christopher G Fenton2,
  10. Lennart Truedsson6,
  11. Johannes C Nossent5,7 and
  12. Søren Jacobsen4
  1. 1Section of Rheumatology, Department of Clinical Sciences, Lund University, Lund, Sweden
  2. 2Department of Biochemistry, Institute of Medical Biology, University of Tromsø, Tromsø, Norway
  3. 3Statens Serum Institut, Copenhagen, Denmark
  4. 4Department of Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
  5. 5Bone and Joint Research Group, Department of Clinical Medicine, Faculty of Health Science, University of Tromsø, Tromsø, Norway
  6. 6Department of Laboratory Medicine, Section of Microbiology, Immunology and Glycobiology, Lund University, Lund, Sweden
  7. 7Division of Medicine, Rheumatology Section, Royal Darwin Hospital, Darwin, Northern Territory, Australia
  1. Correspondence to Dr Michele Compagno; michele.compagno{at}med.lu.se

Abstract

Despite anti-dsDNA antibodies constitute a wide range of specificities, they are considered as the hallmark for systemic lupus erythematosus (SLE).

Objective To identify clinical phenotypes associated with anti-dsDNA antibodies, independently of any clinical diagnoses.

Methods Patients with recent onset of any rheumatic symptoms were screened for antinuclear antibodies (ANA). All ANA-positive and matching ANA-negative patients were examined, and their clinical phenotypes were registered, using a systematic chart formulated after consensus between the participating centres. All patients were tested for different anti-dsDNA antibody specificities with assays habitually used in each participating laboratory. Crithidia Luciliae Immuno Fluorescence Test (CLIFT) was performed three times (with two different commercial kits); solid and solution phase ELISA were performed four times. Associations between clinical phenotypes and results of anti-dsDNA assays were evaluated by linear regression analysis (LRA) and principal component analysis (PCA).

Results Totally, 292 ANA-positive and 292 matching ANA-negative patients were included in the study. A full dataset for statistical analysis was obtained in 547 patients. Anti-dsDNA antibodies were most frequently detected by ELISA. LRA showed that overall positivity of anti-dsDNA antibodies was associated with proteinuria and pleuritis. Alopecia was significantly associated only with CLIFT-positivity. Besides confirming the same findings, PCA showed that combined positivity of CLIFT and ELISA was also associated with lymphopenia.

Conclusions Our results show that different anti-dsDNA antibody specificities are associated with nephropathy, pleuritis, alopecia and lymphopenia, regardless of the diagnosis. It may challenge the importance of anti-dsDNA antibodies as a diagnostic hallmark for SLE.

  • Autoantibodies
  • Autoimmunity
  • Systemic Lupus Erythematosus
  • Lupus Nephritis
  • Autoimmune Diseases

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

https://doi.org/10.1136/lupus-2013-000007

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