Serological and clinical profile of systemic sclerosis: analysis in a cohort of patients from a single center in Northern Italy

Abstract

Background: The purpose of this study was to identify the frequency of autoantibodies among patients affected by systemic sclerosis (SSc) in our Rheumatology Center and analyze the correlation between serological and clinical presentations.

Methods: An automated fluoro-enzyme-immunoassay is used for the qualitative detection of sixteen antibodies: anti-dsDNA, antiRo52, antiRo60, antiSS-B, antiTopoisomerasi-I, antiCENP-B, anti-fibrillarin, antiMi-2, anti-Sm, antiU1sn-RNP, antiRNP70, antiPm/Scl100, antiPCNA, antiJo-1, antiRibosomal-P, antiRNA-Polymerase-III. These parameters were further correlated with clinical presentation of the disease.

Results: One-hundred and six patients who fulfilled the ACR classification criteria of SSc have been screened. Similarly to the findings of other studies, a strong association between anti-Centromere antibodies and clinical indicators of better prognosis has been showed; conversely, the anti-Scl70 antibodies are associated with diffuse SSc and higher severity. Some antibodies (antiR052, antiU1RNP) are correlated with a diagnosis of autoimmune overlap. A protective effect of AntiCentromere regarding pulmonary fibrosis and skin ulcers has been shown (P<0.05). The presence of AntiScl70 correlated with cardiac involvement (arrhythmias, pericarditis and myocarditis) and the Anti-U1RNP correlated with the presence of skin ulcers.

Conclusions: The diagnostic importance of SSc antibodies against a variety of nuclear and cytoplasmic antigens has become increasingly recognized, as confirmed by the inclusion into 2013American College of Rheumatology (ACR)/the European League Against Rheumatism clinical classification criteria for SSc. A number of studies reported variable geographic rates of antibody prevalence in SSc, which may be related to either genetic or environmental factors. However, the association of specific antibodies with clinical manifestations continues to be claimed. New testing methods which include a wider spectrum of detectable antibodies may support the daily rheumatological and dermatological clinical practice in defining clinical subsets of disease and provide prognostic information.