TY - JOUR T1 - Microarray testing in patients with systemic lupus erythematosus identifies a high prevalence of CpG DNA-binding antibodies JF - Lupus Science & Medicine JO - Lupus Sci Med DO - 10.1136/lupus-2021-000531 VL - 8 IS - 1 SP - e000531 AU - Tammo Brunekreef AU - Maarten Limper AU - Rowena Melchers AU - Linda Mathsson-Alm AU - Jorge Dias AU - Imo Hoefer AU - Saskia Haitjema AU - Jacob M van Laar AU - Henny Otten Y1 - 2021/10/01 UR - http://lupus.bmj.com/content/8/1/e000531.abstract N2 - Objective Many autoantibodies are known to be associated with SLE, although their role in clinical practice is limited because of low sensitivity and weak associations with clinical manifestations. There has been great interest in the discovery of new autoantibodies to use in clinical practice. In this study, we investigated 57 new and known antibodies and their potential for diagnostics or risk stratification.Methods Between 2014 and 2017, residual sera of all anti-dsDNA tests in the UMC Utrecht were stored in a biobank. This included sera of patients with SLE, patients with a diagnosis of another immune-mediated inflammatory disease (IMID), patients with low (non-IMID) or medium levels of clinical suspicion of SLE but no IMID diagnosis (Rest), and self-reported healthy blood bank donors. Diagnosis and (presence of) symptoms at each blood draw were retrospectively assessed in the patient records with the Utrecht Patient-Oriented Database using a newly developed text mining algorithm. Sera of patients were analysed for the presence of 57 autoantibodies with a custom-made immunofluorescent microarray. Signal intensity cut-offs for all antigens on the microarray were set to the 95th percentile of the non-IMID control group. Differences in prevalence of autoantibodies between patients with SLE and control groups were assessed.Results Autoantibody profiles of 483 patients with SLE were compared with autoantibody profiles of 1397 patients from 4 different control groups. Anti-dsDNA was the most distinguishing feature between patients with SLE and other patients, followed by antibodies against Cytosine-phosphate-Guanine (anti-CpG) DNA motifs (p<0.0001). Antibodies against CMV (cytomegalovirus) and ASCA (anti-Saccharomyces cerevisiae antibodies) were more prevalent in patients with SLE with (a history of) lupus nephritis than patients with SLE without nephritis.Conclusion Antibodies against CpG DNA motifs are prevalent in patients with SLE. Anti-CMV antibodies are associated with lupus nephritis.Data are available on reasonable request. The data underlying this article cannot be shared publicly for privacy reasons. The data will be shared on reasonable request to the corresponding author. ER -