anti-ro/ssa 52 antibodies in autoimmune diseases coordinator: monica copotoiu md,phd first author:...
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ANTI-Ro/SSA 52 ANTIBODIES IN
AUTOIMMUNE DISEASES
Coordinator: Monica Copotoiu MD,PhD First author: Gabriela Mihai Coauthors: Isabela Micu, Mihaela Budianu, Andrea
Lőrincz
Defining criteria for autoimmune diseases
Witebsky's postulatesˡ:
1. An autoimmune reaction is identified in the form of autoantibody or cell-mediated immune reaction
2. The corresponding antigen is known3. An analogous response causes a similar disease
in experimental animals
ˡ Rose, N. R., C. Bona. 1993. Defining criteria for autoimmune diseases (Witebsky’s postulates revisited). Immunol. Today
Anti-Ro/SSA 52 antibodies(aSSA52)
• aSSA52 are one of the most frequently detected antibodies against Extractable Nuclear Antigen(ENA)ˡ
• Clinically,the presence of aSSA52 has been reported in various rheumatic diseases but also in other autoimmune diseases.
ˡ Ryusule Yoshimi et al. Clinical and Pathological Roles of Ro/SSA Autoantibody System. Clinical and Developmental Immunology Volume 2012
1
aSSA52 and Autoimmune diseases association
aSSA52 and AD association according to the literatureˡ
Polymyositis/Dermatomyositis (PM/DM)
Systemic Lupus Erythematosus (SLE)
Sjogren syndrome (SjS)
Undifferentiated connective tissue disease (UCTD)
Systemic Sclerosis (SSc)
Rheumatoid Arthritis (RA)
Neonatal Lupus Erythematosus (NLE)
Primary biliary cirrhosis (PBC)
Autoimmune Hepatitis I (AIH I)
ˡDefendenti C et al. Clinical and laboratory aspects of Ro/SSA-52 autoantibodies.Autoimmune Rev 2011 Jan
aSSA52 detection.Extractable Nuclear Antigen (ENA) panel
Anti-Rnp/Sm Anti-Cenp B
Anti-Sm Anti-PCNA
Anti-SSA(Ro) Anti-DsDNA
Anti-SSA-Ro52 Anti-Nucleosome
Anti-SSB(La) Anti-Histone
Anti-Scl-70 Anti Ribosomal P protein
Anti-PM-Scl Anti AMA-M2
Anti-Jo-1
Objective
Our purpose is to study the clinical significance and immunological association in patients displaying aSSA52 in various autoimmune diseases(AD).
Material and Method
• single center• Mureș County Emergency Clinical
Hospital,Rheumatology Division• retrospective and prospective(2013-2015)• 41 patients• ENA immunoblotting panels analysis
Material and method
Autoimmune Disease (AD) was defined when a patient displayed one of these:
1.Systemic Lupus Erythematosus(SLE)2.Polymyositis/Dermatomyositis(PM/DM)3.Sjogren Syndrome(SjS)4.Rheumatoid Arthritis(RA)5.Systemic Sclerosis(SSc)6.Unedifferentiated Connective tissue disease(UCTD)
Material and method
Inclusion criteria Exclusion criteria
Results
Gender distribution through connective tissue diseases(CTD)
Gender distribution
Mean age of onset of CTDs between aSSA52- and aSSA52+ groups
Distribution of aSSA52 through CTDs
P value=0.058
Extractable nuclear antigen (ENA) antibodies distribution
25
2912
22
710
77
22
0 10 20 30 40
Rnp/SmSm
SSARoSSBLaScl 70
PM-SclJo-1
dsDNANucleosom
HistoneRib P prot
AMA-2
ENA
Pan
el a
nti
bo
die
s
Percentage %
aSSA52 associated auto-antibodies
(p-0.01)
(p-0.03)
Interstitial pulmonary fibrosis (IFP) prevalence in positive and negative aSSA52 groups
12.2%7.3%
58.5%
22%
P-0.059 (ns)
Distribution of IPF through Connective tissue diseases (CTDs) in aSSA52+ group
Clinical manifestations in CTDs and aSSA52
Study limitations
In our study, only a few patients had inclusion criteria (n=41) and the small sample size limits the power of the study.
Differences between aSSA52+ and aSSA52- groups regarding CTDs features were not significant perhaps due to low absolute numbers which limit the statistical analysis.
Conclusions
• It seems that the presence of aSSA52 are associated with IPF in CTDs.
• The most prevalent autoimmune diseases associating aSSA52 are PM and SLE.
• It is recommended to monitor aSSA52 in patiens diagnosed with CTDs in order to predict the outcome.
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