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. 2017 Jun;69(6):922-926.
doi: 10.1002/acr.22978.

Risk of Digital Vascular Events in Scleroderma Patients Who Have Both Anticentromere and Anti-Interferon-Inducible Protein 16 Antibodies

Zsuzsanna H McMahan  1 , Frederick M Wigley  1 , Livia Casciola-Rosen  1
Affiliations

Risk of Digital Vascular Events in Scleroderma Patients Who Have Both Anticentromere and Anti-Interferon-Inducible Protein 16 Antibodies

Zsuzsanna H McMahan et al. Arthritis Care Res (Hoboken). 2017 Jun.

Abstract

Objective: To evaluate whether scleroderma patients who are double-positive for anti-interferon-inducible protein 16 (anti-IFI-16) antibodies and anticentromere (anti-CENP) antibodies are at increased risk for significant digital vascular events relative to patients positive for anti-CENP antibodies alone.

Methods: Sera from 165 scleroderma patients who tested positive for anti-CENP antibodies upon clinical evaluation were reassayed for both anti-CENP and anti-IFI-16 antibodies using enzyme-linked immunosorbent assay testing. Patients who were positive for anti-CENP antibodies alone were then compared to patients who were double-positive for both anti-IFI-16 and anti-CENP antibodies. The association between a history of significant digital vascular events (digital pits, ischemic digital ulcers, and/or gangrene) and double-positive antibody status was examined using chi-square tests. After completion of univariate analysis, multivariable analyses were done to adjust for clinically relevant covariates.

Results: Of the 165 anti-CENP antibody positive patients, 21 (12.7%) also had anti-IFI-16 antibodies. Patients who were double-positive for anti-CENP and anti-IFI-16 antibodies were more likely to have had digital pits, ischemic digital ulcers, and/or gangrene (P = 0.03). After adjustment for clinically relevant covariates (age, cutaneous subtype, disease duration, and smoking), double-positive patients remained at significantly higher odds of having severe Raynaud's phenomenon (odds ratio 3.5 [95% confidence interval 1.1-11.1]; P = 0.03).

Conclusion: Scleroderma patients who are double-positive for antibodies recognizing CENP and IFI-16 are significantly more likely to have significant digital vascular events during the course of their disease. This study provides further evidence that anti-CENP and anti-IFI-16 antibodies are disease biomarkers that may be used for risk stratification of vascular events in scleroderma.

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Conflict of interest statement

Conflicts of interest: None of the authors has received any financial support or other benefits from commercial sources for the work reported in this manuscript, nor do any of the other authors have any financial interests which could create a potential conflict of interest, or the appearance thereof.

Figures

Figure 1
Figure 1
Anti-IFI-16 antibody levels are higher in patients with digital ulcers and gangrene than in comparator groups. Levels of anti-IFI-16 antibodies in anti-centromere antibody positive patients with scleroderma were assessed by ELISA and quantified by optical density (OD). Median anti-IFI-16 antibody levels were highest in patients with ischemic digital ulcers and digital gangrene.
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