Thompson D, Juby A, Davis P
Department of Medicine, University of Alberta, Edmonton, Canada.
Lupus. 1993 Feb;2(1):15-9. doi: 10.1177/096120339300200104.
We have evaluated the autoantibody profiles in the sera of 117 patients with systemic lupus erythematosus (SLE) and compared and contrasted the clinical and laboratory features of the disease of patients segregated according to an autoantibody profile. Using this approach we are able to demonstrate that autoantibody profiles identified subsets of patients with SLE. Patients with a negative autoantibody profile had fewer clinical and laboratory features of their disease when compared to the other subsets of patients. In contrast, patients with profile A (anti-nDNA and/or anti-Sm antibodies) had a statistically significant increase in malar rash, renal and hematologic involvement and hypocomplementemia when compared to patients with a negative profile. Patients with profile B (anti-nRNP antibodies) had a clinical pattern of disease different from that of patients with profile A and had a statistically significant increase in Raynaud's phenomenon when compared to patients with a negative profile. Patients with profile C (anti-SSA and/or anti-SSB antibodies) had a statistically significant increase in lupus-related rashes and photosensitivity. None of the lupus patients reviewed in this study has profile D (antibodies to centromere and/or Scl-70), this profile being seen largely in patients with scleroderma or one of its variants. Both patients with profile E (anti-histone antibodies) had drug-induced lupus. We conclude that the use of autoantibody profiles defines subsets of patients with lupus that may have clinical, therapeutic and prognostic implications.
我们评估了117例系统性红斑狼疮（SLE）患者血清中的自身抗体谱，并根据自身抗体谱对患者进行分组，比较和对比了各组患者的疾病临床和实验室特征。通过这种方法，我们能够证明自身抗体谱可识别出SLE患者的不同亚组。与其他亚组患者相比，自身抗体谱呈阴性的患者其疾病的临床和实验室特征较少。相比之下，与自身抗体谱呈阴性的患者相比，A组（抗双链DNA和/或抗Sm抗体）患者的颧部红斑、肾脏和血液系统受累及补体低下的发生率有统计学意义的增加。B组（抗nRNP抗体）患者的疾病临床模式与A组患者不同，与自身抗体谱呈阴性的患者相比，雷诺现象的发生率有统计学意义的增加。C组（抗SSA和/或抗SSB抗体）患者狼疮相关皮疹和光敏感的发生率有统计学意义的增加。本研究中所评估的狼疮患者均无D组（抗着丝点和/或Scl-70抗体），该抗体谱主要见于硬皮病或其变异型患者。E组（抗组蛋白抗体）的两名患者均患有药物性狼疮。我们得出结论，使用自身抗体谱可定义狼疮患者的亚组，这可能对临床、治疗和预后具有重要意义。
