Anti-Ro/SSA antibodies in rheumatoid arthritis: clinical and immunologic associations.
OBJECTIVE
To assess the prevalence of anti-Ro/SSA in RA and to analyse clinical and serological features of anti-Ro/SSA positive patients with RA.


METHODS
195 consecutive patients affected by RA were studied by counterimmunoelectrophoresis and ELISA for the detection of anti-Ro/SSA antibodies. Anti-Ro were found in 12 patients, with a prevalence of 6%. These 12 patients were pooled with other 15 patients known to have anti-Ro/SSA antibodies and RA, in order to evaluate their clinical and laboratory features.


RESULTS
Anti-Ro positive patients showed a common pattern of joint involvement at onset and a comparable progression of disease compared to anti-Ro negative subjects. In addition, extra-articular manifestations (such as xerophthalmia, xerostomia, scleritis, oral ulcers and amyloidosis) and peculiar autoantibody profile (hypergammaglobulinemia, anti-dsDNA and AMA) were found significantly associated to anti-Ro/SSA positivity. Even though DMARDs withdrawals were more frequently detected in anti-Ro/SSA patients, especially when using gold salts, no statistical difference between the two groups was detected. In addition, anti-TNFalpha treatment did not cause further progression of autoimmunity neither on laboratory nor on clinical ground.


CONCLUSIONS
Anti-Ro/SSA can be detected in about 6% of patients affected by RA. These patients presented a peculiar clinical picture characterised by extra-articular manifestations some of which are known to be anti-Ro/SSA correlated, while others are more disease-specific (amyloidosis, episcleritis). Anti-Ro/SSA are significantly associated with other autoantibodies not specific for RA such as anti-dsDNA and AMA. Treatment with anti-TNF drugs did not cause further progression of autoimmunity neither on laboratory nor on clinical ground.
Cavazzana
I
I
Clinical Immunology Unit and Chair, Spedali Civili, Brescia, Italy. cavazzana@bresciareumatologia.it
Franceschini
F
F
Quinzanini
M
M
Manera
C
C
Del Papa
N
N
Maglione
W
W
Comina
D
D
Radice
A
A
Sinico
R A
RA
Cattaneo
R
R
D000686:Amyloidosis / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D000974:Antibodies, Antinuclear / Q000097:blood*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D001323:Autoantibodies / Q000032:analysis / Q000276:immunology; D003378:Counterimmunoelectrophoresis; D004797:Enzyme-Linked Immunosorbent Assay; D005128:Eye Diseases / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D005260:Female; D006801:Humans; D006942:Hypergammaglobulinemia / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D008297:Male; D008875:Middle Aged; D008928:Mitochondria / Q000276:immunology; D019226:Oral Ulcer / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D015423:Scleritis / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D014985:Xerophthalmia / Q000150:complications / Q000175:diagnosis / Q000276:immunology
D000974:Antibodies, Antinuclear; D001323:Autoantibodies; C035356:SS-A antibodies