Op0217 anti-Ro52 Antibodies Are Associated With Higher Disease Severity in Patients With Sjögren Disease Through Activation of the Interferon Pathway

Abstract

BackgroundThe diagnosis of primary Sjögren Disease (SjD) is currently based on a combination of clinical, histological and biological findings [1]. Current thinking supports anti-Ro60 antibodies as the most specific serum marker, while the impact of anti-Ro52 remains unclear [2].ObjectivesThe aim of this study was to characterize the clinical, serological, biological, transcriptomic and interferon profiles of SjD patients according to their anti-Ro52 status and discuss the role of anti-Ro52 in the prognosis of SjD.MethodsSjD patients were recruited from the European PRECISESADS (378 patients) [3] and the independant Brittany DIApSS cohorts (160 patients) [4]. Four groups were defined: double negative (Ro52-/Ro60-), isolated anti-Ro52 positive (Ro52+), isolated anti-Ro60 positive (Ro60+), and double positive (Ro52+/Ro60+) patients. Clinical information, disease activity, and biological markers linked to disease severity were evaluated. Transcriptome data on whole blood by RNAseq and Type I and type II interferon signatures [5,6] were analyzed for PRECISESADS SjD patients.ResultsIn both cohorts, arthritis, parotidomegaly, and biological markers (hypergammaglobulinemia, rheumatoid factor and inflammation) [7] were significantly more frequent in the double positive group as compared to other groups. ESSDAI, a score representing systemic activity [8], was also significantly higher in double positive patients compared to the others. Transcriptome analysis demonstrated that anti-Ro52 positivity was associated with a strong interferon pathway activation as the lead cause to explain the clinical associations.ConclusionTaken together, these results suggest that SjD patients with anti-Ro52 positivity adopt a more severe phenotype as compared to their negative counterparts, independently of anti-Ro60 positivity.References[1]Brito-Zerón P, Baldini C, Bootsma H, Bowman SJ, Jonsson R, Mariette X, et al. Sjögren syndrome. Nat Rev Dis Primer. 2016 Jul 7;2(1):1–20.[2]Decker P, Moulinet T, Pontille F, Cravat M, De Carvalho Bittencourt M, Jaussaud R. An updated review of anti-Ro52 (TRIM21) antibodies impact in connective tissue diseases clinical management. Autoimmun Rev. 2022 Mar;21(3):103013.[3]Soret P, Le Dantec C, Desvaux E, Foulquier N, Chassagnol B, Hubert S, et al. A new molecular classification to drive precision treatment strategies in primary Sjögren’s syndrome. Nat Commun. 2021 Jun 10;12(1):3523.[4]Cornec D, Jousse-Joulin S, Pers JO, Marhadour T, Cochener B, Boisramé-Gastrin S, et al. Contribution of salivary gland ultrasonography to the diagnosis of Sjögren’s syndrome: toward new diagnostic criteria? Arthritis Rheum. 2013 Jan;65(1):216–25.[5]Kirou KA, Lee C, George S, Louca K, Papagiannis IG, Peterson MGE, et al. Coordinate overexpression of interferon-alpha-induced genes in systemic lupus erythematosus. Arthritis Rheum. 2004 Dec;50(12):3958–67.[6]Chiche L, Jourde-Chiche N, Whalen E, Presnell S, Gersuk V, Dang K, et al. Modular transcriptional repertoire analyses of adults with systemic lupus erythematosus reveal distinct type I and type II interferon signatures. Arthritis Rheumatol Hoboken NJ. 2014 Jun;66(6):1583–95.[7]Baldini C, Pepe P, Quartuccio L, Priori R, Bartoloni E, Alunno A, et al. Primary Sjögren’s syndrome as a multi-organ disease: impact of the serological profile on the clinical presentation of the disease in a large cohort of Italian patients. Rheumatology. 2014 May 1;53(5):839–44.[8]Brito-Zerón P, Kostov B, Solans R, Fraile G, Suárez-Cuervo C, Casanovas A, et al. Systemic activity and mortality in primary Sjögren syndrome: predicting survival using the EULAR-SS Disease Activity Index (ESSDAI) in 1045 patients. Ann Rheum Dis. 2016 Feb;75(2):348–55.Acknowledgements:NIL.Disclosure of InterestsNone Declared.