Anti-dsDNA Antibodies Correlated With Clinical, Laboratory Parameters in SLE
Anti-double-stranded DNA is remarkably increased in patients with SLE, especially in those with musculoskeletal manifestations and antiphospholipid antibodies.
Female patients with systemic lupus erythematosus (SLE), especially those with active disease who had musculoskeletal symptoms or positive antiphospholipid (aPL) antibodies, demonstrated higher titers of anti-double-stranded DNA (anti-dsDNA) antibodies, according to findings published in Lupus. In contrast, patients displaying neuropsychiatric manifestations or taking cyclophosphamide (CYC) had lower anti-dsDNA titers compared with controls.
The pathogenicity of SLE is complex and remains unclear, but anti-dsDNA antibodies are recognized as important disease-specific biomarkers. If implicated in SLE pathogenesis, they could prove to be a useful target, guiding pharmacotherapy. The researchers sought to evaluate correlations between anti-dsDNA titer levels and a host of clinical and laboratory disease parameters.
Researchers enrolled 70 patients with SLE (mean age, 27.5 years; mean disease duration, 7.7 years) and 35 age- and sex-matched healthy controls (mean age, 26.4 years). Serum anti-dsDNA titers and aPL status were measured in all participants, and patients' Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI) scores were calculated.
The SLEDAI and SLICC/ACR-DI patient scores were 6.80 ± 8.04 and 1.20 ± 1.30, respectively, with 61.4% displaying anti-dsDNA positivity. The mean patient anti-dsDNA titer was 133.20 ± 100.50 IU/mL, which was significantly higher compared with the control group (22.03 ± 17.20 IU/mL; P <.0001).
There was a positive association between anti-dsDNA levels and musculoskeletal manifestations, as well as the presence of anti-β glycoprotein (anti-β2GP) antibodies, with significantly increased titers in those with arthralgia/arthritis (P =.007) and anti-β2GP (P =.037). An inverse relationship existed between anti-dsDNA levels and neuropsychiatric symptoms (P =.004) as well as CYC therapy (P = .013).
Additional significant positive correlations were seen between anti-dsDNA levels and erythrocyte sedimentation rate (P=.001), anti-β2GP immunoglobulin (Ig)A (P = .002) and IgG (P =.03), and anticardiolipin IgA and IgG (P =.008 for both). Negative correlations were found between anti-dsDNA titers and SLICC/ACR-DI scores (P =.001) as well as total leukocyte count (P <.0001).
The presence of aPL antibodies and musculoskeletal manifestations was related to increased anti-dsDNA antibody titers, while CYC treatment and neuropsychiatric manifestations were associated with decreased anti-dsDNA levels. Future large-scale longitudinal trials were recommended, and the authors speculated, “A protective role of anti-dsDNA seems likely in those with neuropsychiatric manifestations and those receiving CYC and may form a shield against disease tissue damage.”
Gheita TA, Abaza NM, Hammam N, Mohamed AAA, El-Gazzar II, Eissa AH. Anti-dsDNA titre in female systemic lupus erythematosus patients: relation to disease manifestations, damage and antiphospholipid antibodies. Lupus. 2018;27(7):1081-1087.