Artikel
Prevalence of anti-Ro52 in Sjögren’s disease: a single center cross sectional study
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Autoren
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Hannah Schenker
- Universitätsklinikum Erlangen, Medizinische Klinik 3, Rheumatologie und Immunologie, Erlangen
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Larissa Valor Mendez
- Universitätsklinikum Erlangen, Medizinische Klinik 3, Rheumatologie und Immunologie, Erlangen
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Johannes Knitza
- Universitätsklinikum Erlangen, Rheumatologie und klinische Immunologie, Erlangen
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Jürgen Rech
- Universitätsklinikum Erlangen, Medizinische Klinik 3, Rheumatologie und Immunologie, Erlangen
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Georg Schett
- Universitätsklinikum Erlangen, Medizinische Klinik 3, Rheumatologie und Immunologie, Erlangen
| Veröffentlicht: | 8. Oktober 2019 |
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Gliederung
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Background: Sjögren’s syndrome (SjS) is an autoimmune disorder characterized by inflammation and destruction of exocrine glands. The presence of autoantibodies (AA) against Ro52/TRIM21, an RNP complex binding to the stem-loop structure of human cytoplasmic RNA, might be relevant in the SjS pathogenesis. It has been suggested that distinguishing between antibody reactivity against Ro60 and Ro52/TRIM21 could be helpful in terms of evaluating clinical course, features and even pre-symptomatic stages of the disease [1].
Methods: In this cross-sectional study we evaluated 179 patients with primary SjS according to the ACR classification criteria who had been admitted between December 2008 and December 2018 to our outpatient clinic. All patients had ANA titers higher than 1:320 [2] in at least two positive determinations for any pattern. ANA, anti-Ro52/TRIM21, anti-Ro60, anti-La and rheumatoid factor (RF) were tested by immunoblot (Euroimmun, Lübeck, Germany).
Results: In our cohort the median age at diagnosis was 57 years (range: 20-85 years) with a clear dominance of females (n=160, 89%). The most frequently reported ANA patterns were speckled (93%), while only few patients had a homogeneous (6%) pattern. 177/179 (98%) were positive for anti-Ro52/TRIM21, 159/179 (88%) for anti-Ro60, 127/179 (79%) for anti-La and 94/179 (52%) showed RF reactivity. 76/179 (42%) patients showed all four reactivities (anti-Ro52/TRIM21, anti-Ro60, anti-La and RF). Out of these 76 patients, 11 (6%) patients exhibited Raynaud's syndrome, 25 (13%) exhibited arthritis/arthralgia, 31 (17%) had hypergammaglobulinemia, 13 (7%) had hypocomplementemia and 26% had elevated free kappa/lambda chains as typical clinical and laboratory features described in SjS.
Conclusion: Our results showed that anti-Ro52/TRIM21 but not anti-Ro60 is present in virtually all patients with SjS and had the most prevalent antibody reactivity. This finding needs to be considered in the current classification criteria of SjS [2], which include the presence of anti-Ro60 rather than anti-Ro52/TRIM21. Including the anti-Ro52/TRIM21 measurement in larger cohorts and longitudinal studies would improve the understanding of its pathogenic role and help to define more specific diagnostic and therapeutic strategies.
