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Anti-SSA Ro52 and anti-Ro60 autoantibodies: association with clinical phenotypes
C. Mazeda1, N. Oliveira2, C. Abreu3, V. Fraga4, I. Maduro5, A. Saraiva6, L. Inês7, C. Ferreira8, A.M. Correia9, R. Nicolau10, F. Farinha11, I. Villanueva12, D. Jesus13, P. Abreu14, A. Neto15, J. Silva Dinis16, A. Barcelos17
- Department of Rheumatology, Centro Hospitalar Baixo Vouga, Aveiro; Egas Moniz Health Alliance Academic Clinical Center, Aveiro; and EpiDoc Unit, Nova Medical School, NOVA University Lisbon, Portugal. carolina_m43@hotmail.com
- Department of Mathematics, Universidade de Aveiro, Portugal.
- Department of Rheumatology, Hospital Garcia de Orta, Almada, Portugal.
- Department of Rheumatology, Hospital Garcia de Orta, Almada, Portugal.
- Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra, Portugal.
- Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra, Portugal.
- Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra, and Faculty of Health Sciences, Universidade da Beira Interior, Covilhã, Portugal.
- Department of Rheumatology, Hospital de Braga, Portugal.
- Department of Rheumatology, Hospital de Braga, Portugal.
- Department of Rheumatology, Centro Hospitalar e Universitário São João, Porto, Portugal.
- Department of Rheumatology, Hospital Distrital de Santarém, Portugal.
- Department of Clinical Pathology, Hospital Distrital de Santarém, Portugal.
- Faculty of Health Sciences, Universidade da Beira Interior, Covilhã, and Department of Rheumatology, Centro Hospitalar de Leiria, Portugal.
- Department of Rheumatology, ULS Castelo Branco, Portugal.
- Department of Rheumatology, Hospital Dr. Nélio Mendonça, Funchal, Portugal.
- Department of Rheumatology, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal.
- Department of Rheumatology, Centro Hospitalar Baixo Vouga, Aveiro; Egas Moniz Health Alliance Academic Clinical Center, Aveiro; and EpiDoc Unit, Nova Medical School, NOVA University Lisbon; and Comprehensive Health Research Center, Universidade NOVA de Lisboa, Portugal.
CER17289
2024 Vol.42, N°7
PI 1474, PF 1479
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PMID: 38530658 [PubMed]
Received: 11/11/2023
Accepted : 02/02/2024
In Press: 26/03/2024
Published: 18/07/2024
Abstract
OBJECTIVES:
Anti-SSA autoantibodies can be differentiated according to their antigenic target proteins as anti-Ro60 (60 kDa) or anti-Ro52 (52 kDa). Anti-SSA(Ro60) antibodies are clearly associated with connective tissue diseases (CTD), but the clinical significance of anti-SSA(Ro52) antibodies remains unclear. The aim of the present study was to analyse the disease phenotype of patients with anti-Ro52 and/or anti-Ro60 antibodies.
METHODS:
A multicentre, cross-sectional study was carried out of positive anti-Ro52 and/or Ro60 antibodies patients followed at 10 Rheumatology centres from January 2018 until December 2021. Patients were categorised into 3 groups: group 1 (Ro52+/Ro60-); group 2 (Ro52-/Ro60+); group 3 (Ro52+/Ro60+). Antinuclear antibodies were evaluated by indirect immunofluorescence assay and further screened for anti-extractable nuclear antigen (ENA) antibodies. Demographicsand clinical data were compared between the 3 groups, by patients’ medical chart review. Univariate analysis was performed and subsequently logistic regression was used to identify intergroup differences and calculate the odds ratio with a 95% confidence interval (95% CI).
RESULTS:
We included 776 patients [female: 83.1%; median age: 59 (46-71) years]. Groups 1, 2, and 3 comprised 31.1%, 32.6%, and 36.3% of the patients, respectively. Anti-Ro52 antibody alone was more frequently associated with non-rheumatic diseases, older age, and men (p<0.05). Among patients with CTD, the diagnosis of systemic lupus erythematosus is 3 and 2 times more prevalent in groups 2 and 3, respectively, than in group 1 [OR 2.8 (95% CI 1.60, 4.97), p<0.001; OR 2.2 (95% CI 1.28, 3.86), p<0.01]. In group 2, the diagnosis of undifferentiated CTD is more frequent than in the other groups. Group 1 was more frequently associated with inflammatory myositis than group 2 [OR 0.09 (95% CI 0.01, 0.33), p<0.001] or group 3 [OR 0.08 (95% CI 0.01, 0.29), p<0.001]. Group 1 was also more frequently associated with arthritis (p<0.01), interstitial lung disease (p<0.01), and myositis (p<0.01).
CONCLUSIONS:
Anti-Ro52+ antibody alone is frequently found in patients with non-rheumatic diseases. In addition, anti-Ro52+ antibody is also prevalent in patients with CTD and associated with clinical phenotypes that are different from anti-Ro60+ antibody.
