Kaneko Yoshikatsu, Sato Hiroe, Wakamatsu Ayako, Kobayashi Daisuke, Sato Kaho, Kurosawa Yoichi, Hasegawa Eriko, Nakatsue Takeshi, Kuroda Takeshi, Narita Ichiei
Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Health Administration Center, Niigata University, Niigata, Japan.
Rheumatology (Oxford). 2024 May 2;63(5):1411-1421. doi: 10.1093/rheumatology/kead402.
We evaluated the association between anti-ribosomal P antibody (anti-RibP) titres and disease activity in Japanese SLE patients.
Eighty patients admitted and treated in Niigata University Hospital for new-onset or flare-up of SLE were included in this retrospective cross-sectional study. Clinical data were obtained from medical records at admission. The anti-RibP index, and cytokine and tryptophan metabolite levels were determined by ELISA.
Of the 80 SLE patients, 30 had anti-RibP. Anti-RibP presence was associated with a greater prevalence of skin rash and more severe inflammatory responses, demonstrated by higher inflammatory cytokine levels, hypocomplementemia, and accelerated tryptophan metabolism, in younger patients. The serum anti-RibP index was correlated with age at diagnosis, clinical indicators, initial prednisolone dose, and cytokines and tryptophan metabolite levels in univariate analysis. Multivariate analysis showed that the anti-RibP index was independently associated with the initial prednisolone dose and the prevalence of skin rash. The anti-RibP IgGs were mainly the IgG2 and IgG3 subclasses, and anti-RibP IgG3 was associated with hypocomplementemia, higher DAS, accelerated kynurenine pathway activity, and higher proinflammatory cytokine production. The coexistence of anti-dsDNA IgG and anti-RibP IgG2 or IgG3 accompanied higher IL-10 and IFN-α2 levels; furthermore, anti-RibP IgG3 coexistence with anti-dsDNA antibody contributed to the requirement for higher initial prednisolone doses and accelerated kynurenine pathway activity.
Anti-RibP was associated with clinical manifestations and parameters in SLE, and its index might be a useful indicator of disease severity. Anti-RibP IgG3 was the IgG subclass most strongly associated with the pathogenesis of SLE.
我们评估了日本系统性红斑狼疮（SLE）患者抗核糖体P抗体（抗RibP）滴度与疾病活动度之间的关联。
本回顾性横断面研究纳入了80例因SLE新发或病情复发而入住新潟大学医院接受治疗的患者。临床数据来自入院时的病历记录。通过酶联免疫吸附测定（ELISA）法测定抗RibP指数、细胞因子和色氨酸代谢产物水平。
80例SLE患者中，30例有抗RibP。抗RibP的存在与皮疹患病率较高以及更严重的炎症反应相关，在年轻患者中表现为炎症细胞因子水平升高、补体血症和色氨酸代谢加速。在单因素分析中，血清抗RibP指数与诊断时的年龄、临床指标、初始泼尼松龙剂量以及细胞因子和色氨酸代谢产物水平相关。多因素分析显示，抗RibP指数与初始泼尼松龙剂量和皮疹患病率独立相关。抗RibP IgG主要为IgG2和IgG3亚类，抗RibP IgG3与补体血症、更高的疾病活动评分（DAS）、犬尿氨酸途径活性加速以及促炎细胞因子产生增加相关。抗双链DNA（dsDNA）IgG与抗RibP IgG2或IgG3共存伴随着更高的白细胞介素-10（IL-10）和干扰素-α2（IFN-α2）水平；此外，抗RibP IgG3与抗dsDNA抗体共存导致需要更高的初始泼尼松龙剂量和犬尿氨酸途径活性加速。
抗RibP与SLE的临床表现和参数相关，其指数可能是疾病严重程度的有用指标。抗RibP IgG3是与SLE发病机制关联最密切的IgG亚类。
