Anti-Smith antibody is associated with disease activity in patients with new-onset systemic lupus erythematosus
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Rheumatology International https://doi.org/10.1007/s00296-019-04445-y
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Anti‑Smith antibody is associated with disease activity in patients with new‑onset systemic lupus erythematosus Sung Soo Ahn1 · Seung Min Jung1 · Juyoung Yoo1 · Sang‑Won Lee1 · Jason Jungsik Song1 · Yong‑Beom Park1 Received: 11 July 2019 / Accepted: 11 September 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Although anti-Smith (Sm) antibody is a highly specific antibody for systemic lupus erythematosus (SLE), the significance of anti-Sm antibody in patients with SLE is unclear. This study aimed to evaluate the association between anti-Sm antibodies and disease activity in patients with new-onset SLE. We included patients who were tested for anti-Sm antibodies at SLE diagnosis and within 12 months after diagnosis. SLE disease activity index (SLEDAI) was obtained at the time of the antiSm antibody test. The baseline disease activity was compared between patients with and without anti-Sm antibodies. The longitudinal association between disease activity and anti-Sm antibodies was also evaluated in total patients and in those with anti-Sm antibodies. Among 92 patients who were tested for anti-Sm antibodies at SLE diagnosis, 67 and another 67 patients were followed up for the presence of anti-Sm antibodies at 6 and 12 months, respectively. Although the baseline SLEDAI was comparable in patients with and without anti-Sm antibodies, the serum level of anti-Sm antibody was significantly correlated with SLEDAI (P = 0.003). At 12 months, anti-Sm antibody positivity was associated with higher SLEDAI and anti-dsDNA titer (P = 0.002, both). In addition, the changes in anti-Sm antibody titer over 12 months were correlated with the alterations in SLEDAI (P = 0.029).Anti-Sm antibody was associated with the baseline disease activity and the alteration of disease activity in patients with new-onset SLE. Monitoring of anti-Sm antibody titer may help assess the disease activity in SLE. Keywords Systemic lupus erythematosus · Anti-Smith antibody · Disease activity · Systemic lupus erythematosus disease activity index
Introduction
This study was presented in the 13th International Congress on Systemic Lupus Erythematosus held in San Francisco, California, and in 2019 European Congress of Rheumatology held in Madrid, Spain. The abstract was included in the congress publications (Lupus Sci & Med 2019; 6(Suppl 1): A122, and Ann Rheum Dis 2019; 78(Suppl 2): AB0525, respectively).
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that predominantly affects women of reproductive age [1]. The hallmark of SLE is the excessive production of pathogenic antibodies recognizing self-antigens and the formation of antigen–antibody complexes that trigger the immune response to cause multiple organ injury [2]. Antinuclear antibodies (ANAs) are found in almost all patients with SLE, and a variety of anti-extractable nuclear antigen
* Seung Min Jung [email protected]
Jason Jungsik Song jsksong@yuh
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