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Extended Autoantibody Panel in Turkish Patients with Early-Stage Systemic Sclerosis: Co-expressions and Their Influences on Clinical Phenotypes
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  • Duygu Temiz Karadag,
  • Andac Komac,
  • Yesim Erez,
  • Merih Birlik,
  • Alper Sarı,
  • Ali Akdoğan,
  • Bayram Farisogullari,
  • Gezmiş Kimyon,
  • EMRAH KOÇ,
  • DIDEM ARSLAN TAS,
  • Ahmet Karatas,
  • Suleyman Serdar Koca,
  • Nilgün Kasifoglu,
  • AYTEN YAZICI,
  • Kadir Mutlu Hayran,
  • Ayşe Çefle
Duygu Temiz Karadag
Kocaeli University School of Medicine

Corresponding Author:[email protected]

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Andac Komac
Kocaeli University
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Yesim Erez
Dokuz Eylül University
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Merih Birlik
Dokuz Eylül University
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Alper Sarı
Hacettepe University
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Ali Akdoğan
Hacettepe University
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Bayram Farisogullari
Hacettepe University
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Gezmiş Kimyon
Hatay Mustafa Kemal University
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EMRAH KOÇ
Cukurova University Faculty of Medicine
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DIDEM ARSLAN TAS
Cukurova University
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Ahmet Karatas
Firat University
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Suleyman Serdar Koca
Firat University
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Nilgün Kasifoglu
Eskisehir Osmangazi University
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AYTEN YAZICI
Kocaeli University
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Kadir Mutlu Hayran
Hacettepe University
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Ayşe Çefle
Kocaeli University
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Abstract

Background/aim: To investigate the frequency and clinical relevance of an extended autoantibody (ab) profile in patients with SSc. Materials and Methods: In this cross-sectional study, serum from 100 consecutive patients was subjected to indirect immunofluorescence (HEp-20-10/primate liver mosaic) and Systemic Sclerosis Profile by EUROIMMUN (Lübeck, Germany) to evaluate ANA and autoantibodies against 13 different autoantibodies in patients with SSc less than three years. Results: 93 of 100 patients were positive for ANA by indirect immunofluorescence (IIF). The prevalence of Anti-Scl70 ab was 41%, anti-centromere (ACA) 27%, and anti-RNA polymerase (RNAPIII) 15%. Scl70 was more associated with diffuse subtype (p<0.001), ILD (p<0.001), and high mRSS (p=0.002); ACA with limited disease (p<0.001), less ILD (p<0.001), overlap (p=0.017) and low mRSS (p=0.024); RNAPIII with diffuse disease (p=0.027), ILD (p=0.016) and high mRSS (p=0.001). Fifty-three patients showed single positivity (26 anti-Scl70, 16 ACA, 6 anti-RNAPIII, 1 anti-Ku ab, 1 anti-PM/Scl100, 2 anti-PM/Scl75, 1 anti-Ro52), whereas 32 patients had multiple auto-antibody positivities. Among common SSc-specific autoantibodies, Scl70 and RNAPIII showed the highest co-occurrence (n=4). One patient was simultaneously positive for anti-RNAPIII ab and ACA, and one was positive for ACA and Scl70. The clinical features were not statistically different between single and multiple autoantibody-positivity for common SSc-specific autoantibodies (ACA, Scl70, and RNAP III), except for digital ulcer in multi-antibody positive ACA group (p=0.019). Conclusion: Based on our results, co-expression of auto-antibodies is not uncommon in SSc patients. Although SSc-specific auto-antibodies generally show known clinical features, the clinical presentation of the co-expression in specific and non-specific auto-antibody positivity continues to be important.
27 Apr 2023Submitted to Immunity, Inflammation and Disease
16 May 2023Submission Checks Completed
16 May 2023Assigned to Editor
16 May 2023Review(s) Completed, Editorial Evaluation Pending
24 May 2023Reviewer(s) Assigned
06 Jul 2023Editorial Decision: Revise Major
28 Jul 20231st Revision Received
03 Aug 2023Submission Checks Completed
03 Aug 2023Assigned to Editor
03 Aug 2023Review(s) Completed, Editorial Evaluation Pending
03 Aug 2023Reviewer(s) Assigned
05 Nov 2023Editorial Decision: Accept