目的:抗Ro60和抗Ro52自身抗体常被用作干燥病的诊断生物标志物,但其在系统性红斑狼疮(SLE)中的临床意义尚不明确.
方法:根据抗Ro状态对符合SLE分类标准的患者进行研究。我们将Ro阳性(Ro+)定义为具有抗Ro60或抗Ro52阳性的人。患者特征和疾病结果,包括定义为始终达到SLEDAI2K≥10的高疾病活动状态(HDAS),调整平均SLEDAI(AMS),使用线性或逻辑回归比较了经时间校正的平均临床SLEDAI(不包括血清学活动).此外,研究了抗Ro60和抗Ro52的孤立或双重阳性。
结果:在409名患者中,47.2%为Ro+。Ro+患者主要是亚洲人,dsDNA阳性和低补体血症。他们显示出较高的HDAS可能性(OR1.65,95%CI1.10-2.48,p=0.015),AMS>4(OR1.84,1.18-2.88,p=0.007),更频繁地使用糖皮质激素(OR1.87,1.16-3.03,p=0.011)和免疫抑制剂(OR2.0,1.26-3.17,p=0.003)。此外,24.4%的Ro+患者出现干燥症状,高丙种球蛋白血症明显更为常见。多变量分析证实,亚洲种族,严重的耀斑,AMS,低补体血症,类风湿因子,蛋白尿,白细胞减少症,干燥症状与Ro阳性显著相关。
结论:抗Ro阳性与更高的疾病活动性和增加的治疗需求相关。Ro阳性与实验室异常相关,例如低补体血症和白细胞减少。这些发现强调了抗Ro60/Ro52测试在SLE临床评估中的重要性。
OBJECTIVE: Anti-Ro60 and anti-Ro52 autoantibodies are frequently used as diagnostic biomarkers for Sjogren\'s disease, but their clinical significance in systemic lupus erythematosus (SLE) is not well characterised.
METHODS: Patients fulfilling SLE classification criteria were studied according to their anti-Ro status. We defined Ro positivity (Ro+) as those who have either anti-Ro60 or anti-Ro52 positivity. Patient characteristics and disease outcomes, including High Disease Activity Status (HDAS) defined as an ever attainment of SLEDAI2K ≥10, adjusted mean SLEDAI (AMS), and time-adjusted mean clinical SLEDAI (excluding serologic activities) were compared using linear or logistic regressions. Furthermore, isolated or dual positivity of anti-Ro60 and anti-Ro52 were studied.
RESULTS: Out of 409 patients, 47.2% were Ro+. Ro+ patients were predominantly Asian, had positive dsDNA and hypocomplementemia. They showed a higher likelihood of HDAS (OR 1.65, 95% CI 1.10-2.48, p= 0.015), AMS > 4 (OR 1.84, 1.18-2.88, p= 0.007), and more frequent use of glucocorticoids (OR 1.87, 1.16-3.03, p= 0.011) and immunosuppressants (OR 2.0, 1.26-3.17, p= 0.003). Additionally, 24.4% of Ro+ patients experienced sicca symptoms, and hypergammaglobulinemia was significantly more common. Multivariate analysis confirmed that Asian ethnicity, severe flares, AMS, hypocomplementemia, rheumatoid factor, proteinuria, leucopenia, and sicca symptoms were significantly linked to Ro positivity.
CONCLUSIONS: Anti-Ro positivity is associated with higher disease activity and increased treatment needs. Ro positivity correlates with laboratory abnormalities such as hypocomplementemia and leucopenia. These findings highlight the importance of anti-Ro60/Ro52 testing in the clinical evaluation of SLE.