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Evidence of negative autoantibodies rare among SSc patients
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Autoantibody negative systemic sclerosis was uncommon among patients with the disease and generally resulted in good prognoses compared with patients who showed positivity, according to recent data.
Researchers conducted a cross-sectional study of 874 patients with systemic sclerosis enrolled in the Canadian Scleroderma Research Group to test autoantibodies using indirect immunofluorescence (IIF), ELISA; addressable laser bead immunoassay (ALBIA); line immunoassay (LIA); and a sensitive immunoprecipitation (IP) assay. The patients were divided into three groups: antinuclear antibodies/extractable nuclear antigens (ANA/ENA) negative if ANA was negative by IIF and ENA was negative by ELISA, ALBIA, LIA and IP; ANA positive/ENA negative if ANA was positive by IIF, but ENA was negative by ELISA, ALBIA, LIA and IP; and others if ANA was positive by IIF and any autoantibody was detected by ELISA, ALBIA, LIA or IP in assays.
Fifteen patients (1.7%) were autoantibody negative by IIF, ELISA, LIA and IP; 16 were ANA positive (1.8%) by IIF, but negative by ELISA, ALBIA, LIA and IP; and 37 (4.2%) were ANA positive by IIF, autoantibody negative by immunoassays, but had autoantibodies identified by IP. Less than 2% of patients were autoantibody negative.
Overall, ANA negative/ENA negative patients had less organ involvement than ANA positive/ENA positive patients, and autoantibody-negative patients had less severe disease than positive patients, according to results.
“Autoantibody-negative SSc is rare and, if it is to be considered as a separate entity, appears to be associated with a favorable prognosis,” the researchers concluded. “Whether the autoantibody profiles of autoantibody-negative subjects are more labile or whether the absence of detectable autoantibodies persists and is to be viewed as a favorable prognostic factor are questions to be addressed by future longitudinal studies.”
Disclosure: Researcher Marvin J. Fritzler, PhD, MD, reports he is a consultant to Immuno Concepts and INOVA Diagnostics.
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