Müçteba Enes YAYLA, Ufuk İLGEN, Nurşen DÜZGÜN

An analysis of the relationship between autoantibodies and clinical findings in patients with systemic sclerosis

Background/aim: We aimed to investigate the prevalence of anti-RNA polymerase (RNAP) III and other autoantibodies in a group ofTurkish patients with systemic sclerosis (SSc) and their relation with clinical features.Materials and methods: The prevalence of anti-RNAP III and other autoantibodies was analyzed in 93 patients with SSc and controlgroups including 86 patients with systemic lupus erythematosus (SLE) and 65 healthy subjects, respectively. Their relationship withdiseases findings was assessed in a cross-sectional manner.Results: Prevalences of anti-RNAP III were 2/93 (2.2%) in SSc, 1/86 (1.2%) in SLE, and 1/65 (1.5%) in the healthy group and there was nodifference among groups (P > 0.999). Anti-Sm was significantly more common in SLE patients (P < 0.001), whereas antitopoisomerase Iand anticentromere protein B were significantly more common in SSc patients (P < 0.001). There was a significant association betweenantitopoisomerase I positivity and interstitial lung disease (P < 0.001), and interestingly there was also a significant association betweenanti-SS-A 52 positivity and the presence of digital ulcers in patients with SSc.Conclusion: Our data show that anti-RNAP III in SSc patients was low in frequency in a Turkish population.

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Mayes MD, Lacey JV, Beebe-Dimmer J, Gillespie BW, Cooper B, Laing TJ, Schottenfeld D. Prevalence, incidence, survival, and disease characteristics of systemic sclerosis in a large US population. Arthritis Rheumatol 2003; 48: 2246-2255.
Tan EM, Rodnan GP, Garcia I, Moroi Y, Fritzler M, Peebles C. Diversity of antinuclear antibodies in progressive systemic sclerosis. Arthritis Rheumatol 1980; 23: 617-625.
LeRoy EC, Black C, Fleischmajer R, Jablonska S, Krieg T, Medsger T Jr, Rowell N, Wollheim F. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol 1988; 15: 202.
Grassegger A, Pohla-Gubo G, Frauscher M, Hintner H. Autoantibodies in systemic sclerosis (scleroderma): clues for clinical evaluation, prognosis and pathogenesis. Wien Med Wochenschr 2008; 158: 19-28.
Meyer O, De Chaisemartin L, Nicaise-Roland P, Cabane J, Tubach F, Dieude P, Hayem G, Palazzo E, Chollet-Martin S, Kahan A et al. Anti-RNA polymerase III antibody prevalence and associated clinical manifestations in a large series of French patients with systemic sclerosis: a cross-sectional study. J Rheumatol 2010; 37: 125-130.
Kuwana M, Okano Y, Pandey JP, Silver RM, Fertig N, Medsger TA. Enzyme-linked immunosorbent assay for detection of Anti–RNA polymerase III antibody: analytical accuracy and clinical associations in systemic sclerosis. Arthritis Rheumatol 2005; 52: 2425-2432.
Nikpour M, Hissaria P, Byron J, Sahhar J, Micallef M, Paspaliaris W, Roddy J, Nash P, Sturgess A, Proudman S et al. Prevalence, correlates and clinical usefulness of antibodies to RNA polymerase III in systemic sclerosis: a cross-sectional analysis of data from an Australian cohort. Arthritis Res Ther 2011; 13: R211.
Santiago M, Baron M, Hudson M, Burlingame RW, Fritzler MJ. Antibodies to RNA polymerase III in systemic sclerosis detected by ELISA. J Rheumatol 2007; 34: 1528-1534.
Satoh T, Ishikawa O, Ihn H, Endo H, Kawaguchi Y, Sasaki T, Goto D, Takahashi K, Takahashi H, Misaki Y et al. Clinical usefulness of anti-RNA polymerase III antibody measurement by enzyme-linked immunosorbent assay. Rheumatology 2009; 48: 1570-1574.
Reveille JD, Solomon DH. Evidence-based guidelines for the use of immunologic tests: anticentromere, Scl-70, and nucleolar antibodies. Arthrit Care Res 2003; 49: 399-412.
Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A, Matucci-Cerinic M, Naden RP, Medsger TA, Carreira PE et al. 2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative. Arthritis Rheumatol 2013; 65: 2737-2747.
Bardoni A, Rossi P, Salvini R, Bobbio-Pallavicini F, Caporali R, Montecucco C. Autoantibodies to RNA-polymerases in Italian patients with systemic sclerosis. Clin Exp Rheumatol 2003; 21: 301-306.
Meyer OC, Fertig N, Lucas M, Somogyi N, Medsger TA. Disease subsets, antinuclear antibody profile, and clinical features in 127 French and 247 US adult patients with systemic sclerosis. J Rheumatol 2007; 34: 104-109.
Hesselstrand R, Scheja A, Shen G, Wiik A, Åkesson A. The association of antinuclear antibodies with organ involvement and survival in systemic sclerosis. Rheumatology 2003; 42: 534-540.
Bunn C, Denton C, Shi-Wen X, Knight C, Black C. Anti-RNA polymerases and other autoantibody specificities in systemic sclerosis. Rheumatology 1998; 37: 15-20.
Hamaguchi Y, Hasegawa M, Fujimoto M, Matsushita T, Komura K, Kaji K, Kondo M, Nishijima C, Hayakawa I, Ogawa F et al. The clinical relevance of serum antinuclear antibodies in Japanese patients with systemic sclerosis. Brit J Dermatol 2008; 158: 487-495.
Kang E, Lee E, Kim D, Im C, Lee H, Song Y. Anti-RNA polymerase antibodies in Korean patients with systemic sclerosis and their association with clinical features. Clin Exp Rheumatol 2005; 23: 731-732.
Kuwana M, Okano Y, Kaburaki J, Medsger TA, Wright TM. Autoantibodies to RNA polymerases recognize multiple subunits and demonstrate cross-reactivity with RNA polymerase complexes. Arthritis Rheumatol 1999; 42: 275-284.
Faucher B, Stein P, Granel B, Weiller P-J, Disdier P, Serratrice J, Harlé JR, Durand JM, Frances Y, Guis S et al. Low prevalence of anti-RNA polymerase III antibodies in a French scleroderma population: anti-RNA polymerase III scleroderma. Eur J Intern Med 2010; 21: 114-117.
Parker J, Burlingame R, Webb T, Bunn C. Anti-RNA polymerase III antibodies in patients with systemic sclerosis detected by indirect immunofluorescence and ELISA. Rheumatology 2008; 47: 976-979.
Salazar GA, Assassi S, Wigley F, Hummers L, Varga J, Hinchcliff M, Khanna D, Schiopu E, Phillips K, Furst DE et al. Antinuclear antibody-negative systemic sclerosis. Semin Arthritis Rheu 2015; 44: 680-686.
Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH, Heyse SP, Hirsch R, Hochberg MC, Hunder GG et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheumatol 1998; 41: 778-799.
Gunnarsson R, El-Hage F, Aaløkken TM, Reiseter S, Lund MB, Garen T, Norwegian MCTD Study Group, Molberg Ø. Associations between anti-Ro52 antibodies and lung fibrosis in mixed connective tissue disease. Rheumatology 2016; 55: 103- 108.
Rodriguez-Reyna TS, Hinojosa-Azaola A, Martinez-Reyes C, Nuñez-Alvarez CA, Torrico-Lavayen R, García-Hernández JL, Cabiedes-Contreras J. Distinctive autoantibody profile in Mexican Mestizo systemic sclerosis patients. Autoimmunity 2011; 44: 576-584.
Reveille JD, Fischbach M, McNearney T, Friedman AW, Aguilar MB, Lisse J, Fritzler MJ, Ahn C, Arnett FC; GENISOS Study Group. Systemic sclerosis in 3 US ethnic groups: A comparison of clinical , sociodemographic, serologic and immunogenetic determinants. Semin Arhtritis Rheu 2001; 30: 332-346.
Kuwana M, Kaburaki J, Okano Y, Tojo T, Homma M. Clinical and prognostic associations based on serum antinuclear antibodies in Japanese patients with systemic sclerosis. Arthritis Rheumatol 1994; 37: 75-83.
Kuwana M, Okano Y, Kaburaki J, Tojo T, Medsger TA. Racial differences in the distribution of systemic sclerosis-related serum antinuclear antibodies. Arthritis Rheumatol 1994; 37: 902-906.