Diagnostic value of anti-topoisomerase I antibodies in a large monocentric cohort.

Abstract

INTRODUCTION:

In the present study, the detection of anti-topoisomerase I (anti-topo I) autoantibodies was evaluated for diagnosis and risk assessment of systemic sclerosis (SSc) patients in a well characterized large monocentric cohort.

METHODS:

Sera from patients with SSc (diffuse n = 96, limited n = 113), from patients with overlap syndromes (n = 51), from patients with other diseases associated with SSc (n = 20), as well as from disease controls (n = 487) were analysed for the presence of anti-topo I antibodies by line immunoblot assay and ELISA. Assessment of organ manifestations was performed as proposed by the European Scleroderma Trial and Research network.

RESULTS:

The applied test systems for the detection of anti-topo I antibodies revealed a diagnostic sensitivity for SSc of approximately 24% and a diagnostic specificity of at least 99.6%. The sensitivity to identify patients with diffuse SSc amounted to 60%. Patients with anti-topo I antibodies showed a higher burden of skin and lung fibrosis, contractures, electrocardiogram changes, as well as digital ulcers and had more active disease than antibody-negative patients. Signal strengths correlated only weakly with disease activity, with modified Rodnan skin score, with predicted forced vital capacity, and with predicted diffusion capacity levels (P = 0.01, rho = 0.234, rho = 0.413, rho = -0.215, rho = -0.219). High signal intensities were associated with an increased mortality in diffuse SSc patients (P = 0.003).

CONCLUSIONS:

Diagnosis and risk assessment of SSc patients can be supported by the detection of anti-topo I antibodies. Signal intensities as obtained by line immunoblot assay or ELISA can be used as a surrogate marker for fibrosis, active disease and worse prognosis.

• Authors: Katharina Hanke, Cornelia Dähnrich, Claudia S Brückner, Dörte Huscher, Mike Becker, Anthonina Jansen, Wolfgang Meyer, Karl Egerer, Falk Hiepe, Gerd R Burmester, Wolfgang Schlumberger, Gabriela Riemekasten
• Journal: Arthritis research & therapy (Arthritis Res Ther) Vol. 11 Issue 1 Pg. R28 ( 2009) ISSN: 1478-6362 [Electronic] England
• PMID: 19232127 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Autoantibodies
• Autoantigens
• Biomarkers
• DNA Topoisomerases, Type I

Topics

• Autoantibodies (blood)
• Autoantigens (immunology)
• Biomarkers (blood)
• Cross-Sectional Studies
• DNA Topoisomerases, Type I (immunology)
• Enzyme-Linked Immunosorbent Assay
• Female
• Humans
• Immunoblotting
• Male
• Middle Aged
• Prognosis
• Scleroderma, Systemic (blood, diagnosis, pathology)
• Sensitivity and Specificity