Lupus Science & Medicine最新文献

{"title":"Disease activity trajectories in paediatric lupus and associations with socioeconomic factors and patient-reported pain.","authors":"Siobhan Case, C Larry Hill, Peter Shrader, Anne Dennos, Thomas Phillips, Laura Eve Schanberg, Emily von Scheven, Kamil Barbour, Andrea M Knight, Aimee Hersh, MaryBeth Son","doi":"10.1136/lupus-2025-001521","DOIUrl":"10.1136/lupus-2025-001521","url":null,"abstract":"<p><strong>Objective: </strong>Using data from participants with paediatric SLE (pSLE) in the Childhood Arthritis and Rheumatology Research Alliance Registry, we aimed to: (1) describe 2-year disease activity trajectories, measured by the SLE Disease Activity Index 2000 (SLEDAI 2K); (2) identify characteristics associated with each trajectory and (3) assess achievement of lupus low disease activity state (LLDAS) and associated baseline characteristics.</p><p><strong>Methods: </strong>Participants were diagnosed with pSLE within 12 months of baseline visit. Baseline sociodemographic, clinical and treatment characteristics were included in latent trajectory analyses. Associations between patient characteristics with trajectory groups and LLDAS were analysed with multinomial generalised logistic regression modelling.</p><p><strong>Results: </strong>1002 patients were screened; 553 were included for SLEDAI 2K and 269 for LLDAS analyses. SLEDAI 2K trajectories included (T1) low and stable, (T2) high and decreasing, (T3) intermediate and stable. In multinomial generalised logistic regression, baseline SLEDAI 2K score and insurance type were significantly associated with trajectories. 51% (136/269) of patients achieved LLDAS at least once in 24 months as compared with 17% (47/269) at first assessment. LLDAS attainment at both time points was predicted by lower pain interference scores; LLDAS attainment over 24 months was also associated with baseline American College of Rheumatology classification criteria, rituximab use at baseline and highest completed level of parent/guardian education.</p><p><strong>Conclusions: </strong>Disease activity trajectories in a pSLE cohort were predicted by baseline SLEDAI 2K and insurance. Only half of the patients achieved LLDAS during the 2-year study period, which was predicted by baseline characteristics including pain interference. The relationship between disease activity and socioeconomic factors and pain warrants further investigation to identify modifiable factors to reduce pSLE disease activity.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesenchymal stem cells improve ovarian function by suppressing fibrosis through CTGF/FAK signalling in systemic lupus erythematosus.","authors":"Haiwei Zhang, Hui Yang, Yingyi Wu, Yirui Shi, Min Xu, Yueyang Zhang, Hongwei Chen, Lingyun Sun","doi":"10.1136/lupus-2024-001468","DOIUrl":"10.1136/lupus-2024-001468","url":null,"abstract":"<p><strong>Objective: </strong>SLE is a multisystem autoimmune disease characterised by chronic inflammation and progressive organ damage, including ovarian dysfunction. This study investigated the therapeutic efficacy of umbilical cord-derived mesenchymal stem cells (UC-MSCs) in ameliorating ovarian impairment and restoring ovarian function through the inhibition of fibrosis in a lupus mouse model.</p><p><strong>Methods: </strong>Serum levels of sex hormones were quantified via ELISA. Ovarian tissue samples were histologically evaluated for follicle count and fibrosis via H&E and Masson's trichrome staining. Quantitative reverse-transcriptase-PCR, western blot, immunofluorescence and immunohistochemistry were employed to evaluate inflammatory cytokines, fibrotic factors, hormone receptors and signalling proteins. Primary granulosa cells (GCs) isolated from lupus mice (MRL/lpr) were cocultured with MSCs and the expression of fibrotic factors was analysed by western blot. Additionally, a human GC line (KGN) was used to further explore the relationships among connective tissue growth factor (CTGF), focal adhesion kinase (FAK)/FAK-Tyr576/577 phosphorylation and fibrosis. This was achieved through stimulation with recombinant CTGF, the CTGF antagonist FG-3019 or the FAK inhibitor SU6656.</p><p><strong>Results: </strong>UC-MSC transplantation significantly downregulated the expression of proinflammatory cytokines (<i>Tnf-α</i>, <i>Il-1β</i>) and fibrotic markers (<i>Ctgf</i>, <i>α-Sma</i>) while upregulating the expression of key hormone receptors (<i>Amh</i>, <i>Esr1</i>, <i>Esr2</i>). Additionally, a reduction in CD3⁺/CD4⁺ T-cell infiltration, C3 complement deposition and IgG levels was observed, accompanied by an increase in regulatory T cells. Further analysis revealed that fibrotic markers and FAK-Tyr576/577 phosphorylation were markedly suppressed in primary ovarian GCs following MSC transplantation. In vitro experiments demonstrated that recombinant CTGF promoted fibrogenesis in the human GC line KGN. Conversely, MSC treatment inhibited phosphorylated FAK-Tyr576/577 and downregulated the expression of Collagen 1 and α-SMA, suggesting that UC-MSCs alleviate ovarian fibrosis by suppressing FAK-Tyr576/577 phosphorylation.</p><p><strong>Conclusion: </strong>This study demonstrated that UC-MSC treatment ameliorated ovarian dysfunction and attenuated ovarian fibrosis in lupus mice by modulating the CTGF/FAK-Tyr576/577 phosphorylation pathway.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endotoxaemia in childhood-onset systemic lupus erythematosus induces low-density granulocytes and extracellular traps of innate immune cells.","authors":"Wilasinee Saisorn, Pornpimol Phuengmaung, Chanunya Santiworakul, Kent Doi, Pornpimol Rianthavorn, Asada Leelahavanichkul","doi":"10.1136/lupus-2025-001663","DOIUrl":"10.1136/lupus-2025-001663","url":null,"abstract":"<p><strong>Background: </strong>Endotoxaemia without infection in lupus is mentioned with the inconclusive clinical importance.</p><p><strong>Methods: </strong>With endotoxaemia and lupus activity (Systemic Lupus Erythematosus Disease Activity Index 2000 score), 46 patients with childhood-onset lupus were categorised into active lupus with endotoxaemia (n=14), inactive lupus with endotoxaemia (n=10), active lupus without endotoxaemia (n=10) and inactive lupus without endotoxaemia (n=12). The routine parameters (serum creatinine, urine sediments, proteinuria, complement, haematological aspects and histological activity index) were analysed with lupus activity and other parameters.</p><p><strong>Results: </strong>Serum cytokines (tumour necrosis factor (TNF)-α, interleukin (IL)-6, IL-8 and IL-10), serum citrullinated histone H3, cell-free DNA and bacterial-free DNA were not different among groups. The extracellular traps (ETs) in the peripheral blood mononuclear cell (PBMC) fraction, measured by immunofluorescence of myeloperoxidase (MPO) and neutrophil elastase (NE), were elevated in endotoxaemia regardless of lupus disease activity. Interestingly, low-density granulocytes (LDGs), the neutrophils in the PBMC fraction after gradient separation, were elevated in active lupus regardless of endotoxaemia but higher in the patients with positive endotoxaemia. Because endotoxaemia might be derived from the gut, the blood microbiome was measured, and the Burkholderia group was the representative bacteria in active lupus with endotoxaemia. The incubation of LPS or bacterial-free DNA with neutrophils from the healthy control altered these regular-density neutrophils to LDGs.</p><p><strong>Conclusion: </strong>Endotoxaemia presented in both active and inactive lupus (possibly correlated with some bacterial groups in the gut) that caused ETs in the PBMC fraction and LDGs. However, elevated LDGs were most prominent in endotoxaemia with active lupus.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Item-specific factors associated with damage accrual in systemic lupus erythematosus: insights from a multiethnic, multinational Latin American cohort.","authors":"Milena Mimica, Oslando Padilla, Guillermo Pons-Estel, Rosana Quintana, Oscar Neira, Luis Jose Catoggio, Veronica Saurit, Cristina Drenkard, Guillermo Berbotto, Mercedes A Garcia, Eduardo F Borba, Eloisa Bonfá, Emilia I Sato, Ana Carolina de O E Silva, Lilian Costallat, João Carlos Tavares Brenol, Gloria Vásquez, Oscar Uribe-Uribe, Antonio Iglesias, Marlene Guibert Toledano, Gil Reyes Llerena, Virginia Pascual-Ramos, Mary-Carmen Amigo, Leonor Barile-Fabris, Ignacio García De La Torre, Eduardo M Acevedo-Vazquez, María Inés Segami, Rosa Chacón-Díaz, María H Esteva-Spinetti, Graciela S Alarcon, Bernardo A Pons-Estel, Manuel F Ugarte-Gil, Loreto Massardo","doi":"10.1136/lupus-2025-001570","DOIUrl":"10.1136/lupus-2025-001570","url":null,"abstract":"<p><strong>Objective: </strong>To identify factors associated with individual Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) accrual items in 1385 patients from the Latin American SLE incident cohort (GLADEL (Grupo Latino Americano Del Estudio de Lupus)).</p><p><strong>Methods: </strong>Longitudinal cohort study. SDI assessed yearly, and damage accrual defined as a SDI change in any individual item during follow-up. Sociodemographic and clinical characteristics at entry, along with regular medication use up to the month prior to each damage item accrued, were analysed using multivariate Cox proportional hazard models with time-varying hazard risk effect performed. Models for overall damage and 10 items with at least 28 patients per item are reported.</p><p><strong>Results: </strong>New damage was accrued by 658 patients with SLE (48%) over a median of 54 months (p25-75: 29-71) of follow-up. Mestizo ethnicity, recent SLE Disease Activity Index (SLEDAI) and immunosuppressants were predictors of overall damage accrual, while antimalarials and rural residence were protectors; mixed effects were observed for SDI >0 and glucocorticoids (GCs) use. Protectors for scarring chronic alopecia (23.7% at 7 years follow-up) included older age, longer disease duration, diagnostic delay, SDI >0 and cytotoxic use. Proteinuria >3.5 g/24 hours (11.5% at 7 years follow-up) was associated with protective factors like older age, longer disease duration and higher GCs dose, while risk factors were Mestizo ethnicity, low medical coverage, higher SLEDAI scores and cytotoxic use. In addition, Mestizo ethnicity was a risk factor for estimated glomerular filtration rate <50% and end-stage renal disease (ESRD) whereas antimalarial protected from ESRD. GCs were risk factors for pericarditis, retinal change or optic atrophy but provided protection against proteinuria >3.5 g/24 hours. Recent disease activity and cytotoxic use were significant risk factors for additional items.</p><p><strong>Conclusions: </strong>Factors associated with damage accrual differ substantially by individual SDI items. Mestizo ethnicity and recent disease activity increased renal risks, while antimalarials were protective. GCs showed mixed effects. Item-specific strategies are crucial to mitigate long-term damage.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune-mediated thrombotic thrombocytopenic purpura with systemic lupus erythematosus: clinical features and outcome.","authors":"Júlia Weisinger, Raïda Bouzid, Jehane Fadlallah, François Provôt, Pascale Poullin, Véronique Le Guern, David Ribes, Nihal Martis, Yahsou Delmas, Sylvain Chantepie, Virginie Rieu, Ygal Benhamou, Gabriel Choukroun, Manon Marie, Ranta Dana, Agnès Veyradier, Bérangère S Joly, Paul Coppo","doi":"10.1136/lupus-2025-001691","DOIUrl":"10.1136/lupus-2025-001691","url":null,"abstract":"<p><strong>Objective: </strong>The association of immune-mediated thrombotic thrombocytopenic purpura (iTTP) and SLE was previously described, but patients with iTTP with coexistent SLE remain poorly characterised.</p><p><strong>Methods: </strong>We compared the clinical presentation and the outcome of patients with iTTP with coexistent SLE (SLE-iTTP) to an age-sex matched cohort of patients with idiopathic iTTP without SLE.</p><p><strong>Results: </strong>During the study period, 1409 patients with iTTP were recruited in our registry. Of these, 79 (6%) had a prior or concurrent diagnosis of SLE at the time of iTTP diagnosis, and 437 (31%) had detectable ANAs without other clinical features of SLE. When compared with idiopathic iTTP, patients with SLE-iTTP had more severe renal involvement, and cardiac involvement was more prevalent, whereas central nervous system involvement was less common. Patients with SLE-iTTP received more immunosuppressive agents. There was no difference in response categories during the acute phase. During follow-up, SLE-iTTP had superior ADAMTS13 relapse-free survival than idiopathic iTTP. Among patients with ANAs without other clinical features of SLE, 33 (8%) were diagnosed with SLE 27 months (IQR: 7-65 months) following iTTP diagnosis; 32 additional patients (7%) developed another systemic autoimmune disease. No patient from the idiopathic iTTP group developed clinical SLE during follow-up.</p><p><strong>Conclusion: </strong>Patients with iTTP are prone to develop autoimmune features, and patients with SLE-iTTP have distinct clinical features and outcome. Relapse-free survival seems better in patients with SLE-iTTP, underscoring the need for tailored management strategies in this population, including a specific follow-up to assess early features suggestive of SLE.</p><p><strong>Trial registration number: </strong>NCT00426686.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral glucocorticoid patterns use in moderate to severe active SLE: insights from the Spanish SPOCS data.","authors":"Iñigo Rua-Figueroa, Ricard Cervera, Mercedes Freire-González, Ana Isabel Turrión Nieves, Josefina Cortés-Hernández, Iván Castellvi, Julia Barbado Ajo, Tarek Salman, Jaime Calvo Alén, Nuria Lozano-Rivas, Norberto Ortego-Centeno, Monserrat Diaz-Encarnación, Bo Ding, Marta Galvez-Fernandez, Noemí Bahamontes-Rosa, José María Pego-Reigosa","doi":"10.1136/lupus-2025-001597","DOIUrl":"10.1136/lupus-2025-001597","url":null,"abstract":"","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, sociodemographic characteristics and spatial distribution of systemic lupus erythematosus in France: a nationwide study using health claims data with insights into hydroxychloroquine prescription patterns.","authors":"Jacques Pouchot, Laurence Mandereau-Bruno, Delphine Serra, Philippe Tangre, Panayotis Constantinou, Joël Coste","doi":"10.1136/lupus-2025-001519","DOIUrl":"10.1136/lupus-2025-001519","url":null,"abstract":"<p><strong>Objective: </strong>Our primary objective was to estimate an updated prevalence of SLE in France in 2020. We also explore the sociodemographic characteristics of patients with SLE, the social and spatial variability and also study and use hydroxychloroquine prescription patterns as an external validation for case ascertainment.</p><p><strong>Methods: </strong>We used the French national health data system, which covers almost all of the 67 million people living in France. Prevalent cases were identified among inpatients and people granted a long-term disease status, using the International Classification of Diseases, 10th Revision code for SLE. Filled prescriptions of hydroxychloroquine were also counted.</p><p><strong>Results: </strong>In 2020, we identified 54 804 patients with SLE; this corresponds to an overall prevalence of 81.6 per 100 000 people. The prevalence estimates were 137.0 per 100 000 in women and 22.5 per 100 000 in men. The highest standardised prevalences were observed in the French overseas departments and in the mainland departments to which people from these departments frequently migrate. Unexpectedly, we did not find an association between the prevalence of SLE in mainland France and a social deprivation index. A prescription of hydroxychloroquine was filled at least once for 67.7% of the patients overall and reached 86.7% of those aged between 20 and 24.</p><p><strong>Conclusions: </strong>Our study provides recent, accurate estimates of the prevalence and social and geographical distribution of SLE in France. We observed an almost twofold increase in prevalence, relative to a previous estimate (from 2010) based on the same database. The high proportion of patients receiving a prescription of hydroxychloroquine is in line with current treatment guidelines.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dialogue: Validation of eight endotypes of lupus based on whole-blood RNA profiles.","authors":"Lina-Marcela Diaz-Gallo","doi":"10.1136/lupus-2025-001628","DOIUrl":"10.1136/lupus-2025-001628","url":null,"abstract":"","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher PM2.5 exposure increases the risk of incident systemic lupus erythematosus: a prospective cohort study in Taiwan.","authors":"Yun-Ju Lai, Li-Jung Chen, Yu-Kai Lin, Su-Fen Wang, Mei-Ju Chen, Jason Jiunshiou Lee, Chu-Chieh Chen, Yi-Tui Chen, Ping-Yen Chung, Li-Fei Hsu, Kuei-Zuo Lai, Matthew N Ahmadi, Elif Inan-Eroglu, Nicholas A Koemel, Yung-Feng Yen, Po-Wen Ku","doi":"10.1136/lupus-2024-001385","DOIUrl":"10.1136/lupus-2024-001385","url":null,"abstract":"<p><strong>Background: </strong>The interaction between fine particulate matter (PM2.5) and genetic factors can lead to epigenetic modifications, potentially increasing the risk of SLE development. However, the impact of PM2.5 on incident SLE development remains unelucidated. This study investigated the effects of year-to-year variations in PM2.5 exposure on incident SLE risk in Taiwanese adults.</p><p><strong>Methods: </strong>In this longitudinal study, we followed up 268 254 adults from the Taiwan MJ cohort (2005-2017) for 9.8 years to identify incident SLE cases, ascertained from patients' clinical and laboratory reports. Residential address-specific annual PM2.5 concentrations were obtained from Taiwan Air Quality-Monitoring sites. We employed a time-dependent Cox regression model, considering death as a competing risk, to assess the impact of year-to-year variations of PM2.5 exposure on SLE development.</p><p><strong>Results: </strong>During 2 628 889 person-years of follow-up, 151 (0.1%) individuals developed new-onset SLE. Participants with higher levels of PM2.5 exposure (per 5 μg/m³ increase) had significantly higher risk of incident SLE (adjusted HR 3.35; 95% CI 2.94 to 3.82). We observed a significant positive linear relation between increasing level of PM2.5 exposure and higher risk of incident SLE in all individual subgroups after stratifying study subjects by age and sex (p<0.001).</p><p><strong>Conclusion: </strong>PM2.5 exposure emerged as a risk factor for incident SLE. Air pollution mitigation strategies should be considered as a preventive measure for SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical evaluation of the novel digital liquid chip method for anti-dsDNA detection in SLE.","authors":"Yina Bai, Rui Yu, Chiyuan Xue, Qian Wang, Xinping Tian, Xiaofeng Zeng, Mengtao Li, Chaojun Hu","doi":"10.1136/lupus-2025-001608","DOIUrl":"10.1136/lupus-2025-001608","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the diagnostic performance of the digital liquid chip method (DLCM) compared with indirect immunofluorescence (IIF) and chemiluminescent immunoassay (CLIA) for anti-double-stranded DNA (dsDNA) antibody detection in SLE.</p><p><strong>Methods: </strong>The retrospective study consecutively enrolled 1349 patients, including 698 with SLE and 651 with other autoimmune diseases at Peking Union Medical College Hospital. Anti-dsDNA antibodies were detected using IIF (EUROIMMUN, Luebeck, Germany), CLIA (YHLO, Shenzhen, China) and DLCM (Livzon, Zhuhai, China). The sensitivity, specificity and area under the curve (AUC) of each method and combination were compared at the recommended manufacturer cut-offs. The agreement between methods and the association between antibody levels and clinical characteristics including disease activity, complement levels and organ involvement were also evaluated.</p><p><strong>Results: </strong>All methods exhibited high specificity, while IIF performed best (98.5%), significantly greater than CLIA (96.3%) and DLCM (96.6%) (p < 0.05). CLIA demonstrated the highest sensitivity (48.1%), outperforming IIF (36.0%) and DLCM (41.4%) (p<0.001). Cohen's kappa indicated substantial positive agreement between DLCM and CLIA (κ=0.67), and moderate agreement between IIF and the other methods (κ=0.52-0.55). Combining IIF with DLCM or CLIA improved diagnosis performance, with IIF+CLIA achieving the highest sensitivity (54.0%), accuracy (74.1%) and AUC (0.75). Moreover, anti-dsDNA positivity was strongly associated with lower complement levels (C3: 0.71 vs 0.90 g/L in DLCM+ vs DLCM-, p<0.001) and moderate-severe disease activity (65.0% DLCM positive). DLCM uniquely predicted musculoskeletal involvement (55.3% vs 44.7%, p<0.01). However, the diagnostic performance for renal involvement was limited (sensitivity 46.9%, specificity 56.3%, AUC=0.52).</p><p><strong>Conclusions: </strong>DLCM demonstrated substantial agreement with CLIA and held potential for SLE diagnosis and monitoring. A multiassay strategy, using a sensitive assay like CLIA or DLCM for initial screening and a highly specific assay like IIF for confirmation, optimises diagnostic performance for anti-dsDNA antibody detection in SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}