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Anti-CarP may signal disease activity in patients with Sjögren’s syndrome
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The presence of elevated autoantibodies against carbamylated proteins may be associated with disease activity in patients with primary Sjögren’s syndrome, according to a recently published study.
A group of 78 patients with primary Sjögren’s syndrome (pSS) were enrolled from the Bergen cohort evaluated at the Haukeland University Hospital in Bergen, Norway between 2011 and 2015. Patients were matched for sex and approximate age with 74 healthy participants enrolled through the hospital’s blood bank. Participants in both groups were about 93% women and the median patient age was 65 compared to 56 in the healthy group. Methotrexate or hydroxychloroquine were administered to 23% of patients at the time of serum collection, and minor salivary gland biopsies were obtained from 68 patients.
Serum analysis showed that autoantibodies against carbamylated proteins (anti-CarP) were significantly higher in patients with pSS (26.9%) compared to healthy individuals (6.8%) and were associated with higher focus scores, the presence of germinal center-like structures, low stimulated salivary flow and reduced tear flow. Correlation analyses confirmed the findings but the association with tear flow did not remain significant. Higher titers of rheumatoid factor (RF) and increased levels of 2-microglobulin, immunoglobulin (Ig) G and IgM were seen in patients with high levels of anti-CarP antibodies.
Ectopic germinal center-like structures were present in 38.9% of patients with anti-CarP antibodies compared to 14% in patients without the antibodies. Patients with anti-CarP antibodies had 9.2 times higher odd of having ectopic germinal center-like structures after adjustments were made for age, disease duration, RF, anti-Ro/SSA and anti-La/SSB in multivariate logistic regression analysis compared to patients seronegative for anti-CarP antibodies. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
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