Longitudinal Study of Patients with Anticentromere Antibody

Abstract

As has previously been reported by many investigators the anticentromere antibody is considered to be a useful serologic marker for the CREST (calcinosis, Raynaud’s phenomenon, esophageal involvement, sclerodactyly and telangiectasia) variant of systemic sclerosis. However, this antibody also appears in other conditions. By screening antinuclear antibody tests using HEp-2 cells as substrate, 39 patients were shown to have the anticentromere antibody. These patients were divided into 4 groups: group 1 = 17 patients with systemic sclerosis; group 2 = 9 patients with Raynaud’s phenomenon alone; group 3 = 7 patients with other connective-tissue diseases, and group 4 = 6 patients with conditions other than those present in groups 1–3. Follow-up over years revealed that some patients suffering solely from Raynaud’s phenomenon (group 2) developed the symptoms of systemic sclerosis. In contrast, of the patients who did not have Raynaud’s phenomenon (group 4), none developed any symptom suggesting systemic sclerosis. We suggest that the simultaneous presence of Raynaud’s phenomenon and the anticentromere antibody predicts the occurrence of systemic sclerosis. In contrast, the presence of the anticentromere antibody alone cannot necessarily be used to predict the development of systemic sclerosis.

Early Detection of Scleroderma Spectrum Disorders in Patients with Raynaud’s Phenomenon

“…Kallcnberget al [21] reported that ANA was detected in 62% of patients with RP, and the fre quency of positive ANA correlated with the number of organs affected and the severity of RP; ANA was present in 28% of patients without systemic involvement, whereas 75% of patients with organ involvement had positive ANA. More importantly, the presence of specific ANA such as ACA and anti-Scl-70 antibody has been shown to be a strong prognostic indicator for evolution into scleroderma disorders, as reported by our group and other investigators [13,16]. In the present study, we found that 56% of patients with RP had positive ANA, and most had positive specific ANA such as ACA.…”

“…We have previously reported that patients with only RP and positive ACA at the first evaluation had developed skin sclerosis by the time of the follow-up evaluation more than 5 years later [16]. We therefore consider that patients with RP and ACA have a much higher chance of developing scle roderma and should be considered to belong to the scle roderma spectrum disorder group.…”

Protein blotting

“…P-proteins (phosphorylated ribosomal proteins) are generally present in multiple copies on the ribosome and have isoelectric points in the range of 3 to 5, in contrast to most ribosomal proteins which are single copy and basic. A typical profile of an anti-ribosomal P-protein antibody specificity is composed of 3 antigens of 37kD (protein PO), 18kD (protein PI) and 15kD (protein P2) [92]. An additional band of approximately 20kD is often present as well.…”

Anticentromere Antibody and Raynaud’s Phenomenon

“…Clofazimine enhances the phagocytic and antimicrobial activity of human neutrophils and macrophages, by increasing lysosomic enzyme levels [ 1). This drug has also immunosuppressor and anti-inflammatory properties.…”

“…In a recent issue of Dermalologica, Takehara et al [1] have pub lished a longitudinal study about patients with anticcntromcre antibody (ACA). They showed that cases with the simultaneous presence of ACA and Raynaud's phenomenon tend to exhibit the clinical signs of systemic sclerosis during the disease course [1|.…”