anti-ro/ssa 52 antibodies in autoimmune diseases coordinator: monica copotoiu md,phd first author:...
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ANTI-Ro/SSA 52 ANTIBODIES IN
AUTOIMMUNE DISEASES
Coordinator: Monica Copotoiu MD,PhD First author: Gabriela Mihai Coauthors: Isabela Micu, Mihaela Budianu, Andrea
Lőrincz
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Defining criteria for autoimmune diseases
Witebsky's postulatesˡ:
1. An autoimmune reaction is identified in the form of autoantibody or cell-mediated immune reaction
2. The corresponding antigen is known3. An analogous response causes a similar disease
in experimental animals
ˡ Rose, N. R., C. Bona. 1993. Defining criteria for autoimmune diseases (Witebsky’s postulates revisited). Immunol. Today
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Anti-Ro/SSA 52 antibodies(aSSA52)
• aSSA52 are one of the most frequently detected antibodies against Extractable Nuclear Antigen(ENA)ˡ
• Clinically,the presence of aSSA52 has been reported in various rheumatic diseases but also in other autoimmune diseases.
ˡ Ryusule Yoshimi et al. Clinical and Pathological Roles of Ro/SSA Autoantibody System. Clinical and Developmental Immunology Volume 2012
1
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aSSA52 and Autoimmune diseases association
aSSA52 and AD association according to the literatureˡ
Polymyositis/Dermatomyositis (PM/DM)
Systemic Lupus Erythematosus (SLE)
Sjogren syndrome (SjS)
Undifferentiated connective tissue disease (UCTD)
Systemic Sclerosis (SSc)
Rheumatoid Arthritis (RA)
Neonatal Lupus Erythematosus (NLE)
Primary biliary cirrhosis (PBC)
Autoimmune Hepatitis I (AIH I)
ˡDefendenti C et al. Clinical and laboratory aspects of Ro/SSA-52 autoantibodies.Autoimmune Rev 2011 Jan
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aSSA52 detection.Extractable Nuclear Antigen (ENA) panel
Anti-Rnp/Sm Anti-Cenp B
Anti-Sm Anti-PCNA
Anti-SSA(Ro) Anti-DsDNA
Anti-SSA-Ro52 Anti-Nucleosome
Anti-SSB(La) Anti-Histone
Anti-Scl-70 Anti Ribosomal P protein
Anti-PM-Scl Anti AMA-M2
Anti-Jo-1
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Objective
Our purpose is to study the clinical significance and immunological association in patients displaying aSSA52 in various autoimmune diseases(AD).
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Material and Method
• single center• Mureș County Emergency Clinical
Hospital,Rheumatology Division• retrospective and prospective(2013-2015)• 41 patients• ENA immunoblotting panels analysis
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Material and method
Autoimmune Disease (AD) was defined when a patient displayed one of these:
1.Systemic Lupus Erythematosus(SLE)2.Polymyositis/Dermatomyositis(PM/DM)3.Sjogren Syndrome(SjS)4.Rheumatoid Arthritis(RA)5.Systemic Sclerosis(SSc)6.Unedifferentiated Connective tissue disease(UCTD)
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Material and method
Inclusion criteria Exclusion criteria
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Results
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Gender distribution through connective tissue diseases(CTD)
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Gender distribution
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Mean age of onset of CTDs between aSSA52- and aSSA52+ groups
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Distribution of aSSA52 through CTDs
P value=0.058
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Extractable nuclear antigen (ENA) antibodies distribution
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25
2912
22
710
77
22
0 10 20 30 40
Rnp/SmSm
SSARoSSBLaScl 70
PM-SclJo-1
dsDNANucleosom
HistoneRib P prot
AMA-2
ENA
Pan
el a
nti
bo
die
s
Percentage %
aSSA52 associated auto-antibodies
(p-0.01)
(p-0.03)
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Interstitial pulmonary fibrosis (IFP) prevalence in positive and negative aSSA52 groups
12.2%7.3%
58.5%
22%
P-0.059 (ns)
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Distribution of IPF through Connective tissue diseases (CTDs) in aSSA52+ group
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Clinical manifestations in CTDs and aSSA52
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Study limitations
In our study, only a few patients had inclusion criteria (n=41) and the small sample size limits the power of the study.
Differences between aSSA52+ and aSSA52- groups regarding CTDs features were not significant perhaps due to low absolute numbers which limit the statistical analysis.
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Conclusions
• It seems that the presence of aSSA52 are associated with IPF in CTDs.
• The most prevalent autoimmune diseases associating aSSA52 are PM and SLE.
• It is recommended to monitor aSSA52 in patiens diagnosed with CTDs in order to predict the outcome.
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