Anti-Ro52 antibody testing influences the classification and clinical characterisation of primary Sjögren's syndrome.

Abstract

OBJECTIVES:

To evaluate how determination of antibodies against the Ro52 antigen influences the classification and clinical characterisation of patients with suspected primary Sjögren's syndrome (SS).

METHODS:

The cohort study included 187 patients who fulfilled at least four of the six 1993 SS classification criteria, including positive autoantibodies (antinuclear antibodies [ANA], rheumatoid factor [RF], anti-Ro/SSA and/or anti-La/SS-B antibodies) as mandatory criterium. Anti-Ro/SSA antibodies were tested by qualitative ELISA using a commercial assay. Anti-Ro52 antibodies were detected by a semiquantitative ELISA.

RESULTS:

Anti-Ro52 antibodies were found in 70/187 (37%) patients. A significant percentage of patients with anti-Ro/SSA antibodies were negative for anti-Ro52 antibodies (22%), while 13 patients (12%) were negative for anti-Ro/SSA antibodies but positive for anti-Ro52 antibodies, meaning that they fulfilled the 2002 SS criteria while avoiding the need for a salivary biopsy. Higher mean titers of anti-Ro52 antibodies were associated with severe scintigraphic involvement, positive salivary gland biopsy, parotid enlargement, anaemia, leukopenia and RF. A statistical correlation was found between anti-Ro52 titers and age, gammaglobulin levels, RF titers and serum IgA and IgG. Patients with positive anti-Ro/SSA and anti-Ro52 antibodies had a higher frequency of positive salivary gland biopsy, parotid enlargement and positive RF, and higher levels of serum IgG and IgA levels in comparison with patients with positive anti-Ro/SSA but negative anti-Ro52 antibodies.

CONCLUSIONS:

Anti-Ro52 antibodies were closely associated with the main clinical, histopathological and immunological features of primary SS. Anti-Ro52 autoantibody testing may help to identify a specific subset of SS patients with more aggressive disease, in whom a closer follow-up and earlier, more robust therapeutic management may be necessary.

• Authors: Soledad Retamozo, Miriam Akasbi, Pilar Brito-Zerón, Xavier Bosch, Albert Bove, Marta Perez-de-Lis, Iratxe Jimenez, Maria-Jose Soto-Cardenas, Miriam Gandia, Candido Diaz-Lagares, Odette Viñas, Antoni Siso, Roberto Perez-Alvarez, Jordi Yague, Manuel Ramos-Casals
• Journal: Clinical and experimental rheumatology (Clin Exp Rheumatol) 2012 Sep-Oct Vol. 30 Issue 5 Pg. 686-92 ISSN: 0392-856X [Print] Italy
• PMID: 22704838 (Publication Type: Journal Article)

Chemical References

• Antibodies, Antinuclear
• Biomarkers
• Ribonucleoproteins
• SS-A antibodies
• SS-A antigen
• SS-B antibodies
• Rheumatoid Factor

Topics

• Antibodies, Antinuclear (blood)
• Biomarkers (blood)
• Biopsy
• Chi-Square Distribution
• Enzyme-Linked Immunosorbent Assay
• Female
• Humans
• Logistic Models
• Male
• Middle Aged
• Multivariate Analysis
• Predictive Value of Tests
• Prognosis
• Rheumatoid Factor (blood)
• Ribonucleoproteins (immunology)
• Salivary Glands (immunology, pathology)
• Sjogren's Syndrome (blood, classification, diagnosis, immunology)