Prevalence of systemic autoimmune rheumatic diseases and clinical significance of ANA profile: data from a tertiary hospital in Shanghai, China

Abstract

It is necessary and useful to explore prevalence of various systemic autoimmune rheumatic diseases (SARDs) in patients with suspicion of having SARDs and to characterize antinuclear antibodies (ANA) profile for identifying different populations (SARDs and non-SARDs). A total of 5024 consecutive patients with available medical records were investigated, whose sera had been tested for ANA profile, including ANA, anti-dsDNA and anti-extractable nuclear antigen (ENA) antibodies, between 31 January 2012 and 26 March 2014. Only 594 (11.8%) patients were diagnosed with SARDs of those suspected with SARDs. The prevalence of systemic lupus erythematosus (SLE) was highest (3.2%), followed by rheumatoid arthritis (RA) (2.5%), primary Sjögren's syndrome (pSS) (1.7%), ankylosing spondylitis (AS) (1.5%), etc. Of females, SLE also showed the highest prevalence (6%), while of males, AS showed the highest prevalence (1.9%). The prevalence of most SARDs was closely associated with age, except mixed connective tissue disease (MCTD), and the variation characteristics among different age groups were different among various SARDs. The prevalence of ANA was significantly increased in most SARD patients [especially in SLE, systemic sclerosis (SSc) and MCTD]. For anti-ENA antibodies, in contrast to some autoantibodies associated with multiple SARDs (e.g. anti-SSA, SSB, nRNP), others were relatively specific for certain diseases, such as anti-dsDNA, Sm, histone, nucleosome and Rib-P for SLE, anti-SCL-70 for SSc and anti-Jo-1 for polymyositis/dermatomyositis (PM/DM). Of note, ANA profile appeared to be of little significance for AS, ANCA-associated vasculitis (AAV), polymyalgia rheumatic (PMR), adult-onset Still's disease (ASD) and Behcet's disease (BD). The younger were more likely to have the presence of anti-dsDNA, Sm, histone or Rib-P for SLE, and anti-SSA for RA or MCTD. No significant differences for frequencies of ANA and anti-ENA autoantibodies were found between sexes in most SARDs, with the exception of RA and AS. The present study suggests that, of patients with SARDs-like clinical manifestations, the proportion of those with true SARDS is small, for most of whom tests for autoantibodies are necessary and useful to help make a prompt and precise diagnosis.

Genomic Variant in IL-37 Confers A Significant Risk of Coronary Artery Disease

“…The previous study observed that there was an interaction between IL-37 gene and alcohol drinking in ankylosing spondylitis patients in a case-only study 31 . Ankylosing spondylitis is one of the most common chronic inflammatory autoimmune diseases affecting the axial and/or peripheral skeleton with an estimated prevalence of 0.1–0.9% 32 . Chronic inflammation and cytokines play important roles in the pathogenesis of atherosclerosis and CAD.…”

Evidence of a distinct group of Black African patients with systemic lupus erythematosus

“…Furthermore, anti-PCNA antibodies may be a marker for cutaneous variants of SLE. Our study shows a need to (i) widen the panel of diagnostic antinuclear and anti-mitochondrial antigens used in African patients, (ii) further refine the predictive values of the ANA reactivity to different nuclear and mitochondrial antigens in order to differentiate SLE syndromes in African populations, and (iii) consider anti-PCNA reactivity, which has so far been largely excluded in Africa and elsewhere, 43 as a diagnostic marker for patients with SLE.…”

Types of Angiopathy in Experimental Autoimmune Disease in Rats

“…In the genesis of cardiac, pulmonary and renal vessels lesions act the activation of pro-inflammatory cytokines and violation of vascular endothelial function It should be noted that in the experimental autoimmune vascular pathology there is a complex system of protection of endothelial cells, which is directed to inhibition of pro-inflammatory cytokines, matrix metalloproteinases and C-dependent protein kinase [17]. Protection of nitrogen oxide relatively to endothelial dysfunction is negligible, and in the linear mice C57Bl/B6j, NZB/W and MRL/1 with immune disorders the additional input of autoantibodies to the basement membrane of vessels is accompanied by the generation of molecules of nitric oxide, but it does not prevent the adhesion of neutrophils to the endothelium of the capillaries and progression of the pathological process [18][19][20]. Bradykinin can suppress the signs of endothelial dysfunction in model of autoimmune systemic disease that enhances vasodilation [21,22].…”