title: Clinical and serological associations of ribosomal P autoantibodies in systemic lupus erythematosus: prospective evaluation in a large cohort of Italian patients.
abstract: OBJECTIVE
  To verify the association of ribosomal anti-P antibodies (anti-P), as detected by a sensitive ELISA, with serological findings and clinical manifestations, including neuropsychiatric involvement evaluated according to the American College of Rheumatology (ACR) nomenclature, in a large cohort of patients with systemic lupus erythematosus (SLE).
  
  
  METHODS
  Anti-P were evaluated in the serum of 149 consecutive Italian SLE patients by an ELISA using a multiple antigen peptide carrying four copies of a common P0, P1 and P2 epitope. A complete laboratory evaluation and clinical examination were performed in each patient. In addition, all patients underwent an accurate neuropsychiatric and neuropsychological assessment performed by trained specialists according to the 1999 ACR suggestions.
  
  
  RESULTS
  Serum anti-P were detected in 18/149 patients (12.1%). The anti-P prevalence was similar (11.7%) when the analysis was performed in a larger series of sera including 82 additional SLE patients, who were not included in the clinical study. The age of anti-P-positive patients at disease onset was less than 33 yr and, in comparison with the anti-P-negative patients, these patients showed more active disease activity and a higher prevalence of photosensitivity and malar and discoid rash. A strong association between IgG anticardiolipin antibodies and anti-P was also found. However, anti-P were associated with neither neuropsychiatric syndromes nor cognitive impairment.
  
  
  CONCLUSIONS
  This study does not seem to confirm the described association of anti-P with SLE neuropsychiatric manifestations. However, it supports the anti-P association with different skin manifestations as well as the presence of anticardiolipin in a subset of patients with SLE characterized by early disease onset.
authors.affiliation: Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Perugia, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Gerli
authors.forename: L
authors.initials: L
authors.lastname: Caponi
authors.forename: A
authors.initials: A
authors.lastname: Tincani
authors.forename: R
authors.initials: R
authors.lastname: Scorza
authors.forename: M G
authors.initials: MG
authors.lastname: Sabbadini
authors.forename: M G
authors.initials: MG
authors.lastname: Danieli
authors.forename: V
authors.initials: V
authors.lastname: De Angelis
authors.forename: M
authors.initials: M
authors.lastname: Cesarotti
authors.forename: M
authors.initials: M
authors.lastname: Piccirilli
authors.forename: R
authors.initials: R
authors.lastname: Quartesan
authors.forename: P
authors.initials: P
authors.lastname: Moretti
authors.forename: C
authors.initials: C
authors.lastname: Cantoni
authors.forename: F
authors.initials: F
authors.lastname: Franceschini
authors.forename: I
authors.initials: I
authors.lastname: Cavazzana
authors.forename: L
authors.initials: L
authors.lastname: Origgi
authors.forename: M
authors.initials: M
authors.lastname: Vanoli
authors.forename: E
authors.initials: E
authors.lastname: Bozzolo
authors.forename: L
authors.initials: L
authors.lastname: Ferrario
authors.forename: A
authors.initials: A
authors.lastname: Padovani
authors.forename: O
authors.initials: O
authors.lastname: Gambini
authors.forename: L
authors.initials: L
authors.lastname: Vanzulli
authors.forename: D
authors.initials: D
authors.lastname: Croce
authors.forename: S
authors.initials: S
authors.lastname: Bombardieri
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D017153:Antibodies, Anticardiolipin / Q000097:blood; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D015800:Protozoan Proteins; D012269:Ribosomal Proteins / Q000276:immunology*; D018709:Statistics, Nonparametric
chemical_list: D017153:Antibodies, Anticardiolipin; D001323:Autoantibodies; D015415:Biomarkers; C064601:L12E protein, Trypanosoma cruzi; D015800:Protozoan Proteins; D012269:Ribosomal Proteins