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Autoantibody profiles correlated with lupus development
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Autoantibody profiles using more than 80 specificities correlated with early disease progression in patients with lupus, according to a study.
In a retrospective study, researchers analyzed serum samples from 22 patients (mean age at enrollment, 48.5 years; 86% female) with four or fewer systemic lupus erythematosus (SLE) diagnostic criteria (mean baseline criteria, 2.1). The patients were evaluated for changes in clinical and autoantibody profiles by using a slide-based array of autoantigens that measured immunoglobulin (Ig) G and IgM autoantibodies.
Three patients, all women who were younger (mean age, 30 years) than the rest of the cohort, added criteria during the study to be diagnosed with SLE or SLE renal disease. In a clustering algorithm, IgG autoreactivity for the three patients showed greater increases compared with those who did not progress to diagnoses (P=.047), but IgM did not. Proliferating cell nuclear antigen, beta 2 microglobulin, C1q and hemocyanian were among IgG specificities higher at baseline for the three (P<.019). Those that progressed to SLE or SLE renal disease also had significant increases in La/SSB and liver cystosol type 1 IgG autobodies (P≤.0072). The two subsets had highly different scores (P=1.38x10-7) in a quantitative risk profile generated from baseline demographic and autoantibody variables.
Study limitations included small sample size and a short evaluation period, the researchers cautioned.
“These findings suggest the feasibility of developing a simple diagnostic that could be applied by nonspecialists to screen for lupus and permit effective triage for specialty care,” the researchers said. “Ultimately, application of these tools to the design of preclinical treatment strategies designed to ameliorate or prevent manifestations of SLE should be considered.”
Disclosure: Nancy J. Olsen, MD, has equity interest in ArthroChip LLC and research grants from Roche and Savient Pharmaceuticals. David R. Karp, MD, PhD, has research grants from Human Genome Sciences and Centocor.
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