Guleva Dimitrina, Miteva Lyubka, Raykova Vessela, Dourmishev Lyubomir
Dimitrina Guleva, MD, Medical University of Sofia 1, Georgi Sofiiski Str, Sofia, Bulgaria;
Acta Dermatovenerol Croat. 2024 Dec;32(4):199-204.
Lupus erythematosus is an autoimmune disorder with various clinical manifestations. Depending on the clinical-immunological correlation different variants with a variable prognosis, multiple strategies for therapy and follow-up are described. Moreover, a regular immunological monitoring could help for a timely established aggravation of the disease from localized to systemic form. The aim of preset study was to analyze the antibody profile of patients with cutaneous manifestations in different subtypes of lupus erythematosus.
Sixty-seven Bulgarian patients with different clinical variants of lupus erythematosus, admitted in the Department of Dermatology in Alexandrovska University Hospital in Sofia between October 2017 and May 2021 were investigated and their data were compared to those of 63 persons control group. Several immune-serological markers as ANA, anti-dsDNA, anti-Sm, anti-SM/RNP, anti-histone, anti-C1q, anti-SSA/Ro, anti-SSA/Ro52, anti-SSA/Ro60 and anti-SSB/La were used. Statistical analysis was performed using the parametric analysis with SPSS for Windows 21.0 (IBM, SPSS statistics) software and receiver operating characteristic (ROC) curve and the area under the curve (AUC) analysis by MedCalc for Windows, version 20.0.23 statistical software.
A statistical significance (p<0.05) was found in all serological markers in LE comparing to the control group. Anti-C1q (p=0.06) had a tendency for a significance in the context of subacute cutaneous LE.Anti-SSA/Ro 52 and anti-SSA/Ro 60 were found to prevail significantly in patients with chronic cutaneous LE. Anti-dsDNA, anti-Sm, anti-Sm/RNP (p<0.05) were related straightly with systemic LE. All patients in our research with higher than 1:320 titers of ANA are found to have bad disease control.
Our data confirmed the strong association between anti-dsDNA, anti-Sm, anti-Sm/RNP and SLE, as well as anti-SSA/Ro 52 and anti-SSA/Ro 60 and subacute cutaneous LE. ANA is a relevant marker of lupus disease activity. All lupus patients with ANA higher than 320 titter had a bad disease control. Based on our results, ANA and anti-SSB/La could be used as follow-up markers for a disease conversion form CLE to SLE. Anti-SSB/La antibodies are found in higher prevalence in patients with discoid cutaneous LE.
红斑狼疮是一种具有多种临床表现的自身免疫性疾病。根据临床免疫学相关性，描述了具有不同预后的不同变体、多种治疗和随访策略。此外，定期的免疫学监测有助于及时发现疾病从局限性形式加重为全身性形式。本研究的目的是分析不同亚型红斑狼疮中皮肤表现患者的抗体谱。
对2017年10月至2021年5月期间在索非亚亚历山德罗斯卡大学医院皮肤科住院的67例患有不同临床变体红斑狼疮的保加利亚患者进行了调查，并将他们的数据与63人的对照组数据进行了比较。使用了几种免疫血清学标志物，如抗核抗体（ANA）、抗双链DNA（anti-dsDNA）、抗Sm、抗SM/RNP、抗组蛋白、抗C1q、抗SSA/Ro、抗SSA/Ro52、抗SSA/Ro60和抗SSB/La。使用适用于Windows 21.0的SPSS（IBM，SPSS statistics）软件进行参数分析，并使用适用于Windows的MedCalc 20.0.23统计软件进行受试者操作特征（ROC）曲线和曲线下面积（AUC）分析。
与对照组相比，红斑狼疮患者所有血清学标志物均具有统计学意义（p<0.05）。在亚急性皮肤型红斑狼疮中，抗C1q（p=0.06）有显著趋势。发现抗SSA/Ro 52和抗SSA/Ro 60在慢性皮肤型红斑狼疮患者中显著占优势。抗双链DNA、抗Sm、抗Sm/RNP（p<0.05）与系统性红斑狼疮直接相关。我们研究中所有抗核抗体滴度高于1:320的患者疾病控制不佳。
我们的数据证实了抗双链DNA、抗Sm、抗Sm/RNP与系统性红斑狼疮之间以及抗SSA/Ro 52和抗SSA/Ro 60与亚急性皮肤型红斑狼疮之间的密切关联。抗核抗体是狼疮疾病活动的相关标志物。所有抗核抗体高于320滴度的狼疮患者疾病控制不佳。根据我们的结果，抗核抗体和抗SSB/La可作为疾病从皮肤型红斑狼疮转变为系统性红斑狼疮的随访标志物。在盘状皮肤型红斑狼疮患者中发现抗SSB/La抗体的患病率更高。
