The prevalence and determinants of anti-DFS70 autoantibodies in an international inception cohort of systemic lupus erythematosus patients

Author:

Choi M Y1,Clarke A E1,St Pierre Y2,Hanly J G3,Urowitz M B4,Romero-Diaz J5,Gordon C6,Bae S-C7,Bernatsky S8,Wallace D J9,Merrill J T10,Isenberg D A11,Rahman A11,Ginzler E M12,Petri M13,Bruce I N14,Dooley M A15,Fortin P16,Gladman D D4,Sanchez-Guerrero J17,Steinsson K18,Ramsey-Goldman R19,Khamashta M A20,Aranow C21,Alarcón G S22,Manzi S23,Nived O24,Zoma A A25,van Vollenhoven R F26,Ramos-Casals M27,Ruiz-Irastorza G28,Lim S S29,Kalunian K C30,Inanc M31,Kamen D L32,Peschken C A33,Jacobsen S34,Askanase A35,Buyon J36,Mahler M37,Fritzler M J1

Affiliation:

1. University of Calgary, Cumming School of Medicine

2. Research Institute of the McGill University Health Centre

3. Division of Rheumatology, Department of Medicine and Department of Pathology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada

4. Lupus Program, Centre for Prognosis Studies in The Rheumatic Disease and Krembil Research Institute, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada

5. Instituto Nacional de CienciasMédicas y Nutrición, Mexico City, Mexico

6. Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK

7. Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea

8. Divisions of Rheumatology and Clinical Epidemiology, McGill University Health Centre

9. Cedars-Sinai/David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

10. Department of Clinical Pharmacology, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA

11. Centre for Rheumatology, Department of Medicine, University College London, UK

12. Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA

13. Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

14. Arthritis Research UKCentre for Epidemiology, Centre for Musculoskeletal Research, The University of Manchester; and NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre; Manchester, UK

15. Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA

16. Division of Rheumatology, Centre Hospitalier Universitaire de Québec et Université Laval, Québec City, Canada

17. Mount Sinai Hospital and University Health Network, University of Toronto, Canada

18. Center for Rheumatology Research, Landspitali University hospital, Reykjavik, Iceland

19. Northwestern University and Feinberg School of Medicine, Chicago, IL, USA

20. Lupus Research Unit, The Rayne Institute, St Thomas' Hospital, King's College London School of Medicine, UK, London, UK

21. Feinstein Institute for Medical Research, Manhasset, NY, USA

22. Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

23. Allegheny Health Network, Pittsburgh Pennsylvania

24. Department of Rheumatology, University Hospital Lund, Lund, Sweden

25. Lanarkshire Centre for Rheumatology, Hairmyres Hospital, East Kilbride, Scotland UK

26. Unit for Clinical Therapy Research (ClinTRID), Karolinska Institute, Stockholm, Sweden

27. Josep Font Autoimmune Diseases Laboratory, IDIBAPS, Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Spain

28. Autoimmune Diseases Research Unit, Department of Internal Medicine, BioCruces Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Barakaldo, Spain

29. Emory University School of Medicine, Division of Rheumatology, Atlanta, Georgia, USA

30. UCSD School of Medicine, La Jolla, CA, USA

31. Division of Rheumatology, Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey

32. Medical University of South Carolina, Charleston, South Carolina, USA

33. University of Manitoba, Winnipeg, Manitoba, Canada

34. Department of Rheumatology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark

35. Hospital for Joint Diseases, NYU, Seligman Centre for Advanced Therapeutics, New York NY

36. New York School of Medicine, New York, US

37. Inova Diagnostics Inc., San Diego, CA, USA

Abstract

Autoantibodies to dense fine speckles 70 (DFS70) are purported to rule out the diagnosis of SLE when they occur in the absence of other SLE-related autoantibodies. This study is the first to report the prevalence of anti-DFS70 in an early, multinational inception SLE cohort and examine demographic, clinical, and autoantibody associations. Patients were enrolled in the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort within 15 months of diagnosis. The association between anti-DFS70 and multiple parameters in 1137 patients was assessed using univariate and multivariate logistic regression. The frequency of anti-DFS70 was 7.1% (95% CI: 5.7–8.8%), while only 1.1% (95% CI: 0.6–1.9%) were monospecific for anti-DFS70. In multivariate analysis, patients with musculoskeletal activity (Odds Ratio (OR) 1.24 [95% CI: 1.10, 1.41]) or with anti-β2 glycoprotein 1 (OR 2.17 [95% CI: 1.22, 3.87]) were more likely and patients with anti-dsDNA (OR 0.53 [95% CI: 0.31, 0.92]) or anti-SSB/La (OR 0.25 [95% CI: 0.08, 0.81]) were less likely to have anti-DFS70. In this study, the prevalence of anti-DFS70 was higher than the range previously published for adult SLE (7.1 versus 0–2.8%) and was associated with musculoskeletal activity and anti-β2 glycoprotein 1 autoantibodies. However, ‘monospecific’ anti-DFS70 autoantibodies were rare (1.1%) and therefore may be helpful to discriminate between ANA-positive healthy individuals and SLE.

Publisher

SAGE Publications

Subject

Rheumatology

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