Department of Medical Science, Allergy and Clinical Immunology Unit, Mauriziano Hospital, University of Turin, Turin, Italy.
Department of Laboratory Medicine, Mauriziano Hospital, Turin, Italy.
Front Immunol. 2024 Aug 16;15:1390642. doi: 10.3389/fimmu.2024.1390642. eCollection 2024.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterized by a variety of both signs and symptoms; it mainly affects women of childbearing age, with an estimated prevalence of 24/100,000 people in Europe and North America. SLE is often described as an antibodies-driven disease as its clinical manifestations are usually associated with the presence or the absence of specific antibodies.
To evaluate clinical manifestations in patients with SLE and to assess the relationship with the presence of specific antibodies by using real-world data.
A retrospective study was performed; the 2019 EULAR/ACR Classification Criteria for Systemic Lupus Erythematosus were used to classify patients with SLE. Data concerning serological profiles (which included Antinuclear antibodies - ANA, anti dsDNA, anti-Ro/SS-A, anti-La/SS-B, anti-Smith) were gathered along with medical records of clinical manifestations. Complement levels were also tested for possible clinical correlations. χ² or Fisher's exact tests were utilized to establish associations between autoantibodies and symptoms. The odds ratios (OR) and their 95% confidence intervals (CI) were computed. No correction was made for multiple testing; only a p-value 0.01 ≤ was considered significant.
One-hundred and twenty-seven patients (n=127, mean age 53.43 ± 14.02) were enrolled in this study. Anti-dsDNA antibodies were found to be statistically significant for both malar rash and proteinuria; anti-Ro/SSA antibodies showed an association with photosensitivity and pericarditis; furthermore, a strong association was found between anti-Ro antibodies and proteinuria, but only if anti-dsDNA antibodies were present as well. Patients who tested positive for anti-La/SSB antibodies correlated with a threefold increase in the risk of developing pericarditis. Lastly, anti-Smith appeared to be associated with NPSLE as well as an increased risk for both autoimmune hemolytic anemia and thrombocytopenia.
In our study, many associations confirmed those found in previous studies; however, new relationships between antibodies and clinical manifestations were found thus indicating the need for additional evaluations to assess these correlations further.
系统性红斑狼疮（SLE）是一种慢性自身免疫性疾病，其特征为多种体征和症状；它主要影响育龄妇女，据估计在欧洲和北美，患病率为每 10 万人中有 24 人患病。SLE 通常被描述为一种抗体驱动的疾病，因为其临床表现通常与特定抗体的存在或缺失有关。
使用真实世界的数据评估 SLE 患者的临床表现，并评估与特定抗体存在的关系。
进行了一项回顾性研究；使用 2019 年 EULAR/ACR 系统性红斑狼疮分类标准对 SLE 患者进行分类。收集了与血清学特征（包括抗核抗体 - ANA、抗双链 DNA 抗体、抗 Ro/SS-A 抗体、抗 La/SS-B 抗体、抗 Smith 抗体）相关的数据，以及临床表现的病历。还检测了补体水平以寻找可能的临床相关性。使用 χ²或 Fisher 精确检验来确定自身抗体与症状之间的关联。计算了比值比（OR）及其 95%置信区间（CI）。未对多次检验进行校正；仅当 p 值≤0.01 时才认为具有统计学意义。
本研究共纳入 127 例患者（n=127，平均年龄 53.43 ± 14.02 岁）。抗 dsDNA 抗体与蝶形红斑和蛋白尿均呈统计学显著相关；抗 Ro/SSA 抗体与光过敏和心包炎相关；此外，在存在抗 dsDNA 抗体的情况下，抗 Ro 抗体与蛋白尿之间存在很强的相关性。抗 La/SSB 抗体阳性的患者患心包炎的风险增加了三倍。最后，抗 Smith 似乎与 NPSLE 以及自身免疫性溶血性贫血和血小板减少症的风险增加相关。
在我们的研究中，许多关联证实了之前的研究结果；然而，还发现了抗体与临床表现之间的新关系，这表明需要进行额外的评估以进一步评估这些相关性。
