Could Compensatory Autoantibody Production Affect Rheumatoid Arthritis Etiopathogenesis?

Silverman, Gregg J.

doi:10.1002/art.41673

Cited by 1 publication

(1 citation statement)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other “natural autoantibodies” that are largely of the IgM class and bind many self- and non-self-antigens prevented proteinuria and reduced kidney immune complex deposition in a murine lupus model [ 57 ]. The specificity of ANAs occurring in healthy people is poorly characterized [ 1 ] and, as suggested by Silverman [ 58 ], a positive ANA test in some settings could represent the tip of the iceberg of circulating natural autoantibodies.…”

Section: Discussionmentioning

confidence: 99%

Clinical diagnoses associated with a positive antinuclear antibody test in patients with and without autoimmune disease

Zanussi,

Zhao,

Wei

et al. 2023

BMC Rheumatol

View full text Add to dashboard Cite

Background Antinuclear antibodies (ANA) are antibodies present in several autoimmune disorders. However, a large proportion of the general population (20%) also have a positive test; very few of these individuals will develop an autoimmune disease, and the clinical impact of a positive ANA in them is not known. Thus, we test the hypothesis that ANA + test reflects a state of immune dysregulation that alters risk for some clinical disorders in individuals without an autoimmune disease. Methods We performed high throughput association analyses in a case–control study using real world data from the de-identified electronic health record (EHR) system from Vanderbilt University Medical Center. The study population included individuals with an ANA titer ≥ 1:80 at any time (ANA +) and those with negative results (ANA-). The cohort was stratified into sub-cohorts of individuals with and without an autoimmune disease. A phenome-wide association study (PheWAS) adjusted by sex, year of birth, race, and length of follow-up was performed in the study cohort and in the sub-cohorts. As secondary analyses, only clinical diagnoses after ANA testing were included in the analyses. Results The cohort included 70,043 individuals: 49,546 without and 20,497 with an autoimmune disease, 26,579 were ANA + and 43,464 ANA-. In the study cohort and the sub-cohort with autoimmune disease, ANA + was associated (P ≤ 5 × 10–5) with 88 and 136 clinical diagnoses respectively, including lupus (OR ≥ 5.4, P ≤ 7.8 × 10–202) and other autoimmune diseases and complications. In the sub-cohort without autoimmune diseases, ANA + was associated with increased risk of Raynaud’s syndrome (OR ≥ 2.1) and alveolar/perialveolar-related pneumopathies (OR ≥ 1.4) and decreased risk of hepatitis C, tobacco use disorders, mood disorders, convulsions, fever of unknown origin, and substance abuse disorders (OR ≤ 0.8). Analyses including only diagnoses after ANA testing yielded similar results. Conclusion A positive ANA test, in addition to known associations with autoimmune diseases, Raynaud’s phenomenon, and idiopathic fibrosing alveolitis related disorders, is associated with decreased prevalence of several non-autoimmune diseases.

show abstract

Section: Discussionmentioning

confidence: 99%