Clinical associations of anti-Smith antibodies in PROFILE: a multi-ethnic lupus cohort

Abstract

The aim of this study was to determine the association of anti-Sm antibodies with clinical manifestations, comorbidities, and disease damage in a large multi-ethnic SLE cohort. SLE patients (per American College of Rheumatology criteria), age ≥16 years, disease duration ≤10 years at enrollment, and defined ethnicity (African American, Hispanic or Caucasian), from a longitudinal US cohort were studied. Socioeconomic-demographic features, cumulative clinical manifestations, comorbidities, and disease damage (as per the Systemic Lupus International Collaborating Clinics Damage Index [SDI]) were determined. The association of anti-Sm antibodies with clinical features was examined using multivariable logistic regression analyses adjusting for age, gender, ethnicity, disease duration, level of education, health insurance, and smoking. A total of 2322 SLE patients were studied. The mean (standard deviation, SD) age at diagnosis was 34.4 (12.8) years and the mean (SD) disease duration was 9.0(7.9)years; 2127 (91.6 %) were women. Anti-Sm antibodies were present in 579 (24.9 %) patients. In the multivariable analysis, anti-Sm antibodies were significantly associated with serositis, renal involvement, psychosis, vasculitis, Raynaud's phenomenon, hemolytic anemia, leukopenia, lymphopenia, and arterial hypertension. No significant association was found for damage accrual. In this cohort of SLE patients, anti-Sm antibodies were associated with several clinical features including serious manifestations such as renal, neurologic, and hematologic disorders as well as vasculitis.

Peripheral Blood B Cell Depletion after Rituximab and Complete Response in Lupus Nephritis

“…Baseline anti-Smith positivity was also associated with complete peripheral depletion. Anti-Smith is the most specific antibody in SLE and has been associated with more severe features and poor outcomes (38)(39)(40). It is unclear why this association was found, but if it were to be reproduced in subsequent studies then further investigation into the relationship would be warranted.…”

Chinese SLE Treatment and Research Group (CSTAR) Registry: prevalence and risk factors for chronic scarring alopecia in patients with systemic lupus erythematosus

“…Anti-Smith (anti-Sm) antibodies is a highly speci c autoantibody in SLE, directly against seven Smith proteins that constitute the small nuclear ribonucleoprotein particles [21,22]. Besides acting as a SLE classi cation criterion, anti-Sm antibody has been found to be related with speci c subsets of system involvements [23] and disease activity [24]. In terms of skin manifestation, previous research revealed that anti-Sm antibody was associated with photosensitivity, malar rash and discoid rash [25,26].…”

Native ancestry is associated with optic neuritis and age of onset in hispanics with multiple sclerosis

“…In a recent study using genetic admixture in Hispanics, having a higher proportion of Native American ancestry was found to be associated with severe diabetic retinopathy, alluding to the possible genetic effect on diabetes’ manifestation . Studies of systemic lupus erythematous have also identified an increase in autoantibody reactivity in non‐Whites, leading to shifts in the understanding that genetically determined ancestry is involved in the biological processes that increase lupus prevalence and disease severity. Thus, we propose that future studies should incorporate multiethnic cohorts and genetic ancestry to better address markers of disease process in both ON and MS.…”