Relationship between autoantibody clustering and clinical subsets in SLE: cluster and association analyses in Hong Kong Chinese

Li, Philip H.; Wong, Wilfred Hing Sang; Lee, Tsz Leung; Lau, Chak Sing; Chan, Tak Mao; Leung, Alexander Moon Ho; Tong, Kwok Lung; Tse, Niko Kei Chiu; Mok, Chi Chiu; Wong, Sik Nin; Lee, Ka Wing; Ho, Marco Hok Kung; Chong, Chun Yin; Wong, Raymond Woon Sing; Mok, Mo Yin; Ying, Shirley King Yee; Fung, Samuel; Lai, Wai Ming; Yang, Wanling; Lau, Yu‐Lung

doi:10.1093/rheumatology/kes261

Cited by 44 publications

(32 citation statements)

References 36 publications

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“…In addition, the presence of anti-RNP appeared to predict an approximately 8-fold increase in the SLE flare incidence during the same follow-up period. Moreover, our results suggested that the presence of anti-RNP at diagnosis is associated a greater incidence of arthritis and rash and may significantly promote the development of arthritis, rash, and mucosal ulcers, thus contributing to SLE flare according to the SLEDAI-2K definition, a finding that was consistent with the results of a previous study [9]. On the other hand, in contrast to previously reported results, the incidence of diffuse interstitial lung disease and pulmonary arterial hypertension did not differ according to the presence of anti-RNP [10].…”

Section: Discussionsupporting

confidence: 92%

“…In contrast, we assumed that the presence of anti-Smith antibodies might be predictive of SLE flare in the early phase of disease, as all 11 patients with anti-Smith antibodies were also anti-RNP-positive. Anti-Smith antibodies and anti-RNP might be simultaneously detected at a high rate in SLE patients, as these autoantibodies were classified and analyzed in the same cluster in previous studies [9,17]. In the present study; however, anti-Smith antibodies were only detected in patients having anti-RNP, and therefore we could not distinguish the direct effect of anti-Smith antibodies from the mutual effect of both types of autoantibodies.…”

Section: Discussioncontrasting

confidence: 55%

“…According to previous studies, the presence of anti-RNP was thought to correlate with typical symptoms of MCTD, Raynaud's phenomenon, and mild renal diseases in SLE patients [6,8]. In addition, SLE patients with anti-RNP were found to more frequently manifest malar rash, arthritis, and serositis [9], as well as a much higher prevalence of pulmonary hypertension or lung fibrosis higher SLE Disease Activity Index (SLEDAI) scores, compared to SLE patients without anti-RNP [10,11]. However, to our knowledge, few studies have clarified the association between anti-RNP and changes in SLE activity, especially SLE flares, during a considerable follow-up period.…”

Section: Introductionmentioning

confidence: 97%

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The Presence of Anti-ribonucleoprotein at Diagnosis Is Associated with the Flare during the First Follow-up Year in Korean Patients with Systemic Lupus Erythematosus

et al. 2016

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Objective. The aim of this study was to examine whether the presence of anti-ribonucleoprotein (anti-RNP) antibodies at diagnosis is associated with systemic lupus erythematosus (SLE) flares in newly diagnosed patients during the first year of follow-up. Methods. The medical records of 71 newly diagnosed SLE patients without other concomitant autoimmune disease, serious infection, or malignancy were reviewed retrospectively. SLE flares were defined according to the SLE Disease Activity Index 2000. Patients were divided into 2 groups according to the presence or absence of anti-RNP, and variables were compared between the groups. Results. During the first year of follow-up, SLE patients with anti-RNP at diagnosis more frequently presented with mucosal ulcers (p=0.003), rash (p=0.001), and arthritis (p=0.007), compared to those without anti-RNP. The SLE flare incidence was remarkably higher in patients with anti-RNP than in those without anti-RNP (62.5% vs. 23.1%, p=0.001). SLE patients with anti-RNP at diagnosis had a significantly higher risk of ever experiencing a SLE flare during the first year of follow-up, compared to those without anti-RNP (odds ratio=8.250). Conclusion. In conclusion, SLE patients with anti-RNP at diagnosis were more than 8-fold more likely to experience an SLE flare during the first year of follow-up. (J Rheum Dis 2016;23:154-160)

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 55%

Section: Introductionmentioning

confidence: 97%

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The Presence of Anti-ribonucleoprotein at Diagnosis Is Associated with the Flare during the First Follow-up Year in Korean Patients with Systemic Lupus Erythematosus

et al. 2016

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“…In a recent and very large study from China, 1928 patients with SLE from five different centres were studied according to serological profiles 50. The presence of anti-dsDNA was found to be associated with renal disorder, serositis and haematological involvement.…”

Section: Discussionmentioning

confidence: 99%

Associations between antinuclear antibody staining patterns and clinical features of systemic lupus erythematosus: analysis of a regional Swedish register

et al. 2013

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ObjectiveAntinuclear antibody (ANA) analysis by immunofluorescence (IF) microscopy remains a diagnostic hallmark of systemic lupus erythematosus (SLE). The clinical relevance of ANA fine-specificities in SLE has been addressed repeatedly, whereas studies on IF-ANA staining patterns in relation to disease manifestations are very scarce. This study was performed to elucidate whether different staining patterns associate with distinct SLE phenotypes.DesignObservational cohort study.SettingOne university hospital rheumatology unit in Sweden.ParticipantsThe study population consisted of 222 cases (89% women; 93% Caucasians), where of 178 met ≥4/11 of the 1982 American College of Rheumatology (ACR-82) criteria. The remaining 20% had an SLE diagnosis based on positive IF-ANA (HEp-2 cells) and ≥2 typical organ manifestations at the time of diagnosis (Fries’ criteria).Outcome measuresThe IF-ANA staining patterns homogenous (H-ANA), speckled (S-ANA), combined homogenous and speckled (HS-ANA), centromeric (C-ANA), nucleolar (N-ANA)±other patterns and other nuclear patterns (oANA) were related to disease manifestations and laboratory measures. Antigen-specificities were also considered regarding double-stranded DNA (Crithidia luciliae) and the following extractable nuclear antigens: Ro/SSA, La/SSB, Smith antigen (Sm), small nuclear RNP (snRNP), Scl-70 and Jo-1 (immunodiffusion and/or line-blot technique).Results54% of the patients with SLE displayed H-ANA, 22% S-ANA, 11% HS-ANA, 9% N-ANA, 1% C-ANA, 2% oANA and 1% were never IF-ANA positive. Staining patterns among patients meeting Fries’ criteria alone did not differ from those fulfilling ACR-82. H-ANA was significantly associated with the 10th criterion according to ACR-82 (‘immunological disorder’). S-ANA was inversely associated with arthritis, ‘immunological disorder’ and signs of organ damage.ConclusionsH-ANA is the dominant IF-ANA pattern among Swedish patients with SLE, and was found to associate with ‘immunological disorder’ according to ACR-82. The second most common pattern, S-ANA, associated negatively with arthritis and organ damage.

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“…Unfortunately, the detailed definition of each element was not provided in the study (63). Cluster analysis and principal analysis have been used in other autoimmune diseases to establish subgroups (64)(65)(66). Our group used data mining technique to explore subgroup clusters of MG and confirmed existence of some subgroups in the above-mentioned subgroup classifications (unpublished data).…”

Section: Subgroups Of Myasthenia Gravis (Mg)mentioning

confidence: 99%

Precision medicine in myasthenia graves: begin from the data precision

Hong

Xie

et al. 2016

Ann. Transl. Med.

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Myasthenia gravis (MG) is a prototypic autoimmune disease with overt clinical and immunological heterogeneity. The data of MG is far from individually precise now, partially due to the rarity and heterogeneity of this disease. In this review, we provide the basic insights of MG data precision, including onset age, presenting symptoms, generalization, thymus status, pathogenic autoantibodies, muscle involvement, severity and response to treatment based on references and our previous studies. Subgroups and quantitative traits of MG are discussed in the sense of data precision. The role of disease registries and scientific bases of precise analysis are also discussed to ensure better collection and analysis of MG data.

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Relationship between autoantibody clustering and clinical subsets in SLE: cluster and association analyses in Hong Kong Chinese

Cited by 44 publications

References 36 publications

The Presence of Anti-ribonucleoprotein at Diagnosis Is Associated with the Flare during the First Follow-up Year in Korean Patients with Systemic Lupus Erythematosus

The Presence of Anti-ribonucleoprotein at Diagnosis Is Associated with the Flare during the First Follow-up Year in Korean Patients with Systemic Lupus Erythematosus

Associations between antinuclear antibody staining patterns and clinical features of systemic lupus erythematosus: analysis of a regional Swedish register

Precision medicine in myasthenia graves: begin from the data precision

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