Antibodies to extractable nuclear antigens (ENAS) in systemic lupus erythematosus patients: correlations with clinical manifestations and disease activity

  • Y. Emad | yasseremad68@gmail.com Rhumatology Department, Faculty of Medicine, Cairo University Cairo, Egypt.
  • T. Gheita Rhumatology Department, Faculty of Medicine, Cairo University Cairo, Egypt.
  • H. Darweesh Rhumatology Department, Faculty of Medicine, Cairo University Cairo, Egypt.
  • P. Klooster Faculty of Behavioral, Management and Social sciences, Department Psychology, Health and Technology, University of Twente, Enschede, Netherlands.
  • R. Gamal Rheumatology and rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
  • H. Fathi Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
  • N. El-Shaarawy Rheumatology and Rehabilitation Department, Suez Canal University, Ismailia, Egypt.
  • M. Gamil Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
  • M. Hawass Nephrology Department, Al-Shorta Hospital, Cairo, Egypt.
  • R.M. El-Refai Rhumatology Department, Faculty of Medicine, Cairo University Cairo, Egypt.
  • H. Al-Hanafi Clinical and chemical pathology department Faculty of Medicine, Cairo University, Cairo, Egypt.
  • S. Abd-Ellatif Department of Rheumatology and Rehabilitation at Al-Azhar University, Cairo, Egypt.
  • A. Ismail Dermatology department, Al-Azhar University, Cairo, Egypt.
  • J. Rasker Faculty of Behavioral, Management and Social sciences, Department Psychology, Health and Technology, University of Twente, Enschede, Netherlands.

Abstract

The aim was to explore possible correlations of antibodies to extractable nuclear antigens (ENA) with clinical manifestations and disease activity indices in systemic lupus erythematosus (SLE) patients. A total of 70 consecutive SLE patients (64 females) were included. Disease activity was assessed by SLE activity index (SLEDAI), and British Isles Lupus Assessment Group (BILAG). Anti-Ro/SSA correlated positively with, headache (r=0.24, p=0.04), blurring of vision (r=0.25, p=0.03) and SLEDAI (r=0.25, p=0.04) and negatively with C3 (r=–0.35, p=0.003). Anti-Ro/SSA correlated with anti La/SSB antibodies (r=0.69, p<0.001), but not with anti-DNA, anti-RNP and anti-Sm antibodies. Anti-La/SSB antibodies correlated with headache (r=0.26, p=0.03), SLEDAI (r=0.25, p=0.03) and negatively with C3 (r=–0.34, p=0.004). Anti-La/SSB did not correlate with anti-RNP or anti-Sm antibodies. Anti-Sm antibodies correlated with disease duration (r=0.34, p=0.003), 24 hours urinary proteins (r=0.31, p=0.008), SLEDAI (r=0.31, p=0.009), BILAG renal score (r=0.29, p=0.02) and negatively with age at onset (r=–0.27, p=0.02), WBCs (r=–0.29, p=0.014) and C4 (r=–0.25, p=0.049). In multivariate analyses, anti-Ro/SSA antibodies remained associated with headache, blurring of vision and C3 and anti-La/SSB antibodies remained associated with C3 and with headache. Anti-Sm antibodies were independently associated with disease duration and total SLEDAI scores, while anti-RNP antibodies remained significantly associated with BILAG mucocutaneous scores only. Antibodies to ENAs are associated with clinical aspects of SLE and may play a role in the assessment of disease activity. Insight into these ENAs may lead to new approaches to diagnostic testing, accurate evaluation of disease activity and lead to target approach for SLE.

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Published
2018-07-06
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Keywords:
Extractable nuclear antigens (ENA), Systemic lupus erythematosus (SLE), Disease activity, SLEDAI, BILAG.
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How to Cite
Emad, Y., Gheita, T., Darweesh, H., Klooster, P., Gamal, R., Fathi, H., El-Shaarawy, N., Gamil, M., Hawass, M., El-Refai, R., Al-Hanafi, H., Abd-Ellatif, S., Ismail, A., & Rasker, J. (2018). Antibodies to extractable nuclear antigens (ENAS) in systemic lupus erythematosus patients: correlations with clinical manifestations and disease activity. Reumatismo, 70(2), 85-91. https://doi.org/10.4081/reumatismo.2018.1027