Nasonova Research Institute of Rheumatology, Moscow, Russia.
Sechenov First Moscow State Medical University of the Ministry of Health Care of the Russian Federation (Sechenov University), Moscow, Russia.
Dokl Biochem Biophys. 2023 Aug;511(1):212-218. doi: 10.1134/S1607672923700266. Epub 2023 Oct 13.
The aim of our study was to assess the relationship between the changes of antinuclear autoantibodies (ANAs) and autoantibodies to topoisomerase 1 (anti-Topo 1) in systemic sclerosis (SSs) patients on rituximab (RTX) therapy. The prospective study included 88 patients (73 women) with a mean age of 47 (17-71) years. The mean disease duration was 5.9 ± 4.8 years. The mean follow-up period was more than 2 years (27 (12-42) months). We documented a statistically significant change in skin score, the disease activity index, improvement of pulmonary function and reduction of mean dose of prednisolone after RTX treatment. There was a significant decrease in the number of patients with high levels of ANA and overall decrease of the ANA and anti-Topo 1 levels. A moderate positive statistically significant correlation was found between ANA and anti-Topo 1 (r = 0.403). In the group of patients positive for anti-Topo 1 there were a more pronounced depletion of B lymphocytes, significantly higher increase in forced vital capacity and diffusion capacity, decrease in the disease activity index, compared with patients negative for anti-Topo 1. We observed the decline in the level of ANA and anti-Topo 1 in SSc patients after RTX therapy, and it was correlated by an improvement of the main outcome parameters of the disease. Therefore, anti-Topo 1 positivity could be considered as a predictor of a better response to RTX treatment, especially in SSc patients with hyperproduction of anti-Topo 1.
我们研究的目的是评估在系统性硬化症（SSc）患者接受利妥昔单抗（RTX）治疗时，抗核抗体（ANA）和拓扑异构酶 1 抗体（抗 Topo 1）变化之间的关系。这项前瞻性研究包括 88 名患者（73 名女性），平均年龄为 47（17-71）岁。平均疾病持续时间为 5.9±4.8 年。平均随访时间超过 2 年（27（12-42）个月）。我们记录到皮肤评分、疾病活动指数、肺功能改善和泼尼松龙平均剂量降低后有统计学意义的变化。ANA 水平高的患者数量以及 ANA 和抗 Topo 1 水平整体下降均有显著降低。ANA 和抗 Topo 1 之间存在中度正相关（r=0.403）。在抗 Topo 1 阳性的患者中，B 淋巴细胞耗竭更明显，用力肺活量和弥散量显著增加，疾病活动指数降低，与抗 Topo 1 阴性的患者相比。我们观察到 SSc 患者在接受 RTX 治疗后 ANA 和抗 Topo 1 水平下降，并且与疾病主要结局参数的改善相关。因此，抗 Topo 1 阳性可被视为对 RTX 治疗反应更好的预测因素，特别是在抗 Topo 1 高产生的 SSc 患者中。
