The additional role of anti-nucleosome antibodies in the prediction of renal damage in systemic lupus erythematosus based on CSTAR (XXV).

IF 1.9 4区医学 Q3 RHEUMATOLOGY

Lupus Pub Date : 2024-08-01 Epub Date: 2024-06-09 DOI:10.1177/09612033241260231

Yufang Ding, Yangzhong Zhou, Jiuliang Zhao, Chanyuan Wu, Shangzhu Zhang, Nan Jiang, Junyan Qian, Li Zhang, Jing Li, Dong Xu, Xiaomei Leng, Qian Wang, Xinping Tian, Mengtao Li, Xiaofeng Zeng

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Abstract

Objectives: The predominant determinant of an unfavorable prognosis among Systemic Lupus Erythematosus (SLE) patients resides in the irreversible organ damage. This prospective cohort study aimed to identify the additional value of anti-nucleosome antibodies on organ damage accumulation in SLE patients.

Methods: Based on the Chinese SLE Treatment and Research group (CSTAR) registry, demographic characteristics, autoantibodies profiles, and clinical manifestations were collected at baseline. Follow-up data were collected by reviewing clinical records.

Results: Of 2481 SLE patients with full follow-up data, 663 (26.7%) were anti-nucleosome antibodies positive and 1668 (68.0%) were anti-dsDNA antibodies positive. 764 (30.8%) patients developed new organ damage during a mean follow-up of 4.31 ± 2.60 years. At baseline, patients with positive anti-nucleosome antibodies have a higher rate of lupus nephritis (50.7% vs 36.2%, p < .001). According to the multivariable Cox regression analysis, both anti-nucleosome (HR = 1.30, 95% CI, 1.09-1.54, p < .001) and anti-dsDNA antibodies (HR=1.68, 95% CI, 1.38-2.05, p < .001) were associated with organ damage accumulation. Anti-nucleosome (HR = 2.51, 95% CI, 1.81-3.46, p < .001) and anti-dsDNA antibodies (HR = 1.69, 95% CI, 1.39-2.06, p < .001) were independent predictors for renal damage. Furthermore, the combination of the two antibodies can provide more accurate information about renal damage in overall SLE patients (HR = 3.19, 95% CI, 2.49-4.10, p < .001) and patients with lupus nephritis at baseline (HR = 2.86, 95% CI, 2.29-3.57, p < .001).

Conclusion: Besides anti-dsDNA antibodies, anti-nucleosome antibodies can also provide information about organ damage accrual during follow-up. The ability of co-positivity of anti-nucleosome and anti-dsDNA antibodies in predicting renal damage may lead to additional benefits in the follow-up of these patients.

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基于CSTAR（XXV）的抗核糖体抗体在预测系统性红斑狼疮肾损害中的额外作用。

目的：系统性红斑狼疮（SLE）患者预后不良的主要决定因素是不可逆的器官损伤。这项前瞻性队列研究旨在确定抗核糖体抗体对系统性红斑狼疮患者器官损伤累积的额外价值：方法：根据中国系统性红斑狼疮治疗研究组（CSTAR）的登记资料，收集基线时的人口统计学特征、自身抗体谱和临床表现。结果：在 2481 名完全康复的系统性红斑狼疮（SLE）患者中，有 1.5%的患者在治疗过程中出现了自身抗体损伤：结果：在2481名有完整随访数据的系统性红斑狼疮患者中，663人（26.7%）抗核糖体抗体阳性，1668人（68.0%）抗dsDNA抗体阳性。在平均 4.31 ± 2.60 年的随访期间，764 名（30.8%）患者出现了新的器官损伤。基线时，抗核糖体抗体阳性患者的狼疮肾炎发病率更高（50.7% vs 36.2%，P < .001）。根据多变量考克斯回归分析，抗核糖体（HR=1.30，95% CI，1.09-1.54，p < .001）和抗dsDNA抗体（HR=1.68，95% CI，1.38-2.05，p < .001）与器官损伤累积有关。抗核糖体抗体（HR=2.51，95% CI，1.81-3.46，p < .001）和抗dsDNA抗体（HR=1.69，95% CI，1.39-2.06，p < .001）是肾损伤的独立预测因子。此外，这两种抗体的结合可为所有系统性红斑狼疮患者（HR = 3.19，95% CI，2.49-4.10，p < .001）和基线狼疮肾炎患者（HR = 2.86，95% CI，2.29-3.57，p < .001）的肾损害提供更准确的信息：结论：除了抗dsDNA抗体，抗核糖体抗体也能提供随访期间器官损伤累积的信息。结论：除了抗dsDNA抗体，抗核糖体抗体也能在随访过程中提供器官损伤的信息。抗核糖体抗体和抗dsDNA抗体同时阳性可预测肾脏损伤，这可能会给这些患者的随访带来额外的益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lupus 医学-风湿病学

CiteScore

4.20

自引率

11.50%

发文量

225

审稿时长

1 months

期刊介绍： The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…