Department of Dermatology, University of Texas Southwestern Medical Center, Dallas.
JAMA Dermatol. 2013 Oct;149(10):1159-65. doi: 10.1001/jamadermatol.2013.4207.
Small studies have implicated the association of specific autoantibodies with morphea subtype or severity, but no large-scale studies have been conducted. This prospective case-control study confirmed the presence of antinuclear antibodies (ANAs) and other autoantibodies in morphea but found they are of limited significance.
To determine the prevalence of ANAs, extractable nuclear antigens such as antihistone antibodies (AHAs), and anti-single-stranded DNA antibodies (ssDNA abs) in patients with morphea vs a healthy control population and their association with clinical measures of morphea severity.
DESIGN, SETTING, AND PARTICIPANTS: Nested case-control study, conducted at the University of Texas Southwestern Medical Center, Dallas, and University of Texas Health Science Center, Houston. Study participants included individuals enrolled in the Morphea in Adults and Children (MAC) cohort and Scleroderma Family Registry and DNA Repository.
Prevalence of ANAs, AHAs, ssDNA abs in patients with morphea vs matched controls and association of the presence of autoantibodies with clinical indicators of morphea severity.
The prevalence of ANAs, AHAs, and ssDNA abs in patients with morphea was 34%, 12%, and 8%, respectively. Antinuclear antibodies and AHAs, but not ssDNA abs, were present more frequently in cases than in controls. There was no difference in ANA prevalence among morphea subtypes. Among patients with linear morphea, the presence of autoantibodies was associated with clinical indicators of severe morphea including functional limitation (ssDNA ab, P = .005; and AHA, P = .006), extensive body surface area involvement (ssDNA ab, P = .01; and ANA, P = .005), and higher skin scores (ANA, P = .004). The presence of autoantibodies was not associated with clinical measures of morphea activity.
Our results demonstrate that ANAs and AHAs are more prevalent among patients with morphea but are of limited clinical utility except in linear morphea, where their presence, although infrequent, is associated with greater lesion burden and functional impairment.
一些小型研究提示，特定的自身抗体与硬斑病的亚型或严重程度有关，但尚未开展大规模研究。这项前瞻性病例对照研究证实硬斑病患者存在抗核抗体（ANA）和其他自身抗体，但发现这些抗体的临床意义有限。
确定硬斑病患者ANA、可提取核抗原（如抗组蛋白抗体（AHA））和抗单链 DNA 抗体（ssDNA abs）的患病率，并与硬斑病严重程度的临床指标相关联。
设计、地点和参与者：在达拉斯德克萨斯大学西南医学中心和休斯顿德克萨斯大学健康科学中心进行的嵌套病例对照研究。研究参与者包括参加成人和儿童硬斑病（MAC）队列和硬皮病家族登记处和 DNA 库的个体。
硬斑病患者与匹配对照者中自身抗体的患病率，以及自身抗体的存在与硬斑病严重程度的临床指标的关联。
硬斑病患者的 ANA、AHA 和 ssDNA abs 的患病率分别为 34%、12%和 8%。病例组中存在 ANA 和 AHA，但不存在 ssDNA abs 的比例高于对照组。硬斑病各亚型的 ANA 患病率无差异。在线状硬斑病患者中，自身抗体的存在与严重硬斑病的临床指标相关，包括功能受限（ssDNA ab，P =.005；和 AHA，P =.006）、广泛的体表面积受累（ssDNA ab，P =.01；和 ANA，P =.005）和更高的皮肤评分（ANA，P =.004）。自身抗体的存在与硬斑病活动的临床指标无关。
我们的结果表明，ANA 和 AHA 在硬斑病患者中更为常见，但除了在线状硬斑病中，其临床意义有限，尽管其存在频率较低，但与更大的病变负担和功能障碍相关。
