The diagnostic benefit of antibodies against ribosomal proteins in systemic lupus erythematosus
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Advances in Rheumatology
RESEARCH
Open Access
The diagnostic benefit of antibodies against ribosomal proteins in systemic lupus erythematosus Zhen-rui Shi1, Yan-fang Han1, Jing Yin2, Yu-ping Zhang1,3, Ze-xin Jiang1,4, Lin Zheng1, Guo-zhen Tan1* and Liangchun Wang1*
Abstract Background: Anti-ribosomal P (anti-Rib-P) antibody is a specific serological marker for systemic lupus erythematosus (SLE) and routinely tested by targeting the common epitope of three ribosomal proteins of P0, P1 and P2. This study aimed to investigate if testing antibodies against individual ribosomal protein, but not the common epitope, is required to achieve the best diagnostic benefit in SLE. Methods: The study included 82 patients with SLE and 22 healthy donors. Serum antibodies were determined by ELISA and immunoblot. Results: The prevalence of each antibody determined by ELISA was 35.4% (anti-Rib-P), 45.1% (anti-Rib-P0), 32.9% (anti-Rib-P1) and 40.2% (anti-Rib-P2) at 99% specificity, respectively. Of 53 patients with negative anti-Rib-P antibody, 21 (39.6%) were positive for anti-Rib-P0, 9 (17.0%) for anti-Rib-P1 and 12 (22.6%) for anti-Rib-P2 antibody. The positive rate of anti-Rib-P antibody detected by ELISA was close to the results by immunoblot (33.4%). Patients with any of these antibodies were featured by higher disease activity and prevalence of skin rashes than those with negative antibodies. Moreover, each antibody was particularly related to some clinical and laboratory disorders. The distribution of subclasses of IgG1–4 was varied with each antibody. Anti-Rib-P0 IgG1 and IgG3 were strongly correlated with disease activity and lower serum complement components 3 and 4. Conclusions: Anti-Rib-P antibody is not adequate to predict the existence of antibodies against ribosomal P0, P1 and P2 protein. The examination of antibodies against each ribosomal protein is required to achieve additional diagnostic benefit and to evaluate the association with clinical and serological disorders as well. Keywords: Systemic lupus erythematosus, Diagnosis, Anti-ribosomal P antibodies
Introduction A broad spectrum of autoantibodies was detected in systematic lupus erythematosus (SLE). Of them, antinuclear (ANA), anti-Smith (anti-Sm) and anti-doublestranded DNA (anti-dsDNA) antibodies are included in the American College of Rheumatology (ACR) classification criteria for SLE [1]. Anti-ribosomal P (anti-Rib-P) antibody is not listed in the criteria, but specifically detected in SLE * Correspondence: [email protected]; [email protected] 1 Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang Rd W, Guangzhou 510120, China Full list of author information is available at the end of the article
patients instead of the other autoimmune diseases and healthy subjects [2, 3]. It was suggested to be an additional biomarker for SLE, especially for those with negative anti-dsDNA or anti-Sm antibodies to fulfill the ACR criteria [4, 5]. The prevalence of anti-Rib-P antibody is about 15–40% in SLE patien
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