Association of anti-double-strander DNA antibodies and disease activity measuremenr in systemic lupus erythematosus

Abstract

Objective: To demonstrate the association between anti-double stranded DNA antibodies (anti-dsDNA Ab) and disease activity in systemic lupus erythematosus (SLE).

Methods: A 1-year study of the association between anti-dsDNA Ab titer and the Mexican Systemic Lupus Erythematosus Disease Activity Index (MEX-SLEDAI) in patients with SLE was performed.

Results: One hundred and seventy-three patients with SLE were included in the study. Positive anti-dsDNA Ab (anti-dsDNA Ab ≥1:10) were detected in 92 patients (53.2%) and negative anti-dsDNA Ab (anti-dsDNA Ab < 1:10) were detected in 81 patients (46.8%). In positive Ab group, the mean age at inclusion was 32.4±10.3 years, with the mean disease duration of 5.3±5.7 years. In negative Ab group, the mean age at inclusion was 34.0±10.4 years, with the mean disease duration of 6.7±6.1years. Both positive and negative Ab groups were predominately female. Three patterns of disease activity index according to MEX-SLEDAI scoring system were observed: Nine patients (9.8%) in the positive Ab group and 28 patients (34.6%) in the negative Ab group had inactive disease. Twenty patients (21.7%) in the positive Ab group and 8 patients (9.9%) in the negative Ab group were classified as probably active disease. Sixty-three patients (68.5%) in the positive Ab group and 45 patients (55.6%) in the negative Ab group had clearly active disease (p<0.001). Positive anti-dsDNA Ab was associated with several organ involvements: hematological 75% (p=0.011), mucocutaneous 40.2% (p=0.019) and musculoskeletal involvement 12.0% (p=0.047). However, this Ab was not related to renal manifestation (55.4%) in our study (p=0.426).

Conclusions: Positive anti-dsDNA Ab is mostly correlated with disease activity in SLE patients whereas negative titer cannot totally exclude disease flare. Positive titer is associated with hematological, mucocutaneous and musculoskeletal involvement but it is not correlated with renal manifestation.