Role of the anti-RO/SSA antibody in patients with systemic lupus erythematosus

Background

Patients with systemic lupus erythematosus (SLE) and anti-Ro+ antibody frequently pose a diagnostic and therapeutic challenge for the specialist, as they frequently present sicca syndrome, overlapping with Sjögren's syndrome (SS). To date, the clinical and prognostic variability that this antibody confers on SLE patients is not well characterized.

Objectives

To investigate the possible clinical, analytical, therapeutic and prognostic implications of anti-Ro antibody in SLE. Furthermore, we analyzed the possible implications of the expressed anti-Ro profile (subunit 52, 60 or both) on the disease phenotype.

Methods

The medical records of patients with anti-Ro+ and - SLE, primary SS and SLE/SS overlap have been reviewed.

Results

Anti-Ro+ SLE presents less arthritis, low C4, expression of DNA Crithidia and need for bolus corticosteroids than anti-Ro− SLE, but more xerophthalmia, xerostomia, expression of anti-La, anti-cyclic citrullinated peptide and overlap with other rheumatological entities. Anti-Ro+ SLE and the overlap group behave similarly for multiple variables. SS group shows a higher expression of β2-microglobulin compared to the overlap group. Anti-Ro52+ patients associate more Raynaud's phenomenon than anti-Ro60+ patients. The latter express more lupus anticoagulant and antiphospholipid antibodies than the group with both subunits.

Conclusions

The presence of anti-Ro+ in patients with SLE provides clinical and analytical differences compared to patients with anti-Ro− SLE and SLE/SS. anti-Ro+ SLE and the overlap group behave similarly, but present differential characteristics that postulate them as separate phenotypes of the disease. The different serological profiles of anti-Ro confer specific clinical and analytical characteristics in patients with SLE and SS.