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Abstract
Purpose Systemic Lupus Erythematosus (SLE) patients can present a wide range of signs and symptoms, being arthritis, malar rash, fever, photosensitivity, nephropathy, neurological involvement, thrombocytopenia, thrombosis, lymphadenopathy some of the most common ones.
The 2019 EULAR/ACR classification criteria for systemic Lupus Erythematosus (SLE) includes the presence of anti-Sm antibodies, anti-dsDNA antibodies. Anti-dsDNA, anti-Sm and anti-Ribo-P antibodies are highly specific for SLE and depending on the assay used can correlate with some clinical manifestations. This study aimed to evaluate the association of anti-dsDNA, anti-Sm and anti-Ribo-P autoantibodies with clinical features (renal articular, skin, ocular, neurological, cardiac and hematological manifestations) in a Spanish SLE cohort.
Methods A total of 292 SLE patients were tested for anti-dsDNA, anti-Sm and anti-Ribo-P antibodies by the novel PMAT (research use only) (Inova Diagnostics, USA). The associations between anti-dsDNA, anti-Sm and anti-Ribo-P autoantibodies and clinical features (renal, articular, skin, ocular, neurological, cardiac and hematological manifestations) were assessed using Fisher´s exact test.
Results Of the 292 SLE samples, 32.9% (n=96) were positive for a single analyte (30.5% (n=89) were positive for Aptiva anti-dsDNA only, 1.7% (n=5) were positive for Aptiva anti-Sm only, and 0.7% (n=2) were positive for Aptiva anti-Ribo-P only). In addition, 2.7% (n=8) were positive for all three analytes and 7.5% (n=22) were positive for a combination of two analytes (Figure 1).
There were significant associations between anti-dsDNA autoantibodies and renal involvement (p=0.0007) and between anti-Sm autoantibodies and neurological manifestations (p=0.0091).
Sixty-three percent of SLE patients with renal involvement were positive for at least one of the SLE-specific autoantibodies (Figure 2) compared to thirty-eight percent of SLE patients without renal involvement (Figure 3).
Conclusion A strong association was observed between anti-dsDNA antibodies measured using Aptiva dsDNA PMAT and renal involvement and between anti-Sm antibodies and neurological manifestations. The presence of anti-dsDNA, anti-Sm and anti-Ribo-P autoantibodies were higher in patient with renal involvement.
Combination of anti-Ribo-P antibodies on SLE patients (n=292) as illustrated by an UpSet plot
Combination of anti-dsDNA, anti-Sm and anti-Ribo-P antibodies on SLE patients with renal involvement (n=62) as illustrated by an UpSet plot
Combination of anti-dsDNA, anti-Sm and anti-Ribo-P antibodies on SLE patients without renal involvement (n=230) as illustrated by an UpSet plot
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