Antinucleosome antibodies in primary antiphospholipid syndrome: a hint at systemic autoimmunity?
BACKGROUND
Antinucleosome antibodies (anti-NCS) are reported to be highly sensitive and specific for systemic lupus erythematosus (SLE) and to correlate with disease activity. They may appear in early stages of the disease, in particular before anti-dsDNA antibodies, being a potential marker for identifying patients susceptible to SLE. Patients with primary antiphospholipid syndrome (PAPS) may develop full-blown SLE but there is no evidence for markers predictive for that.


OBJECTIVE
To evaluate whether anti-NCS may be predictors for full-blown or lupus like disease (LL) in a cohort of PAPS patients.


METHODS
A multicentric cohort of 105 PAPS patients was tested for IgG/IgM anti-NCS by using a home made assay with H1-stripped chromatin as antigen.


RESULTS
Eighty-one out of 105 (77%) of the patients were positive for anti-NCS; medium-high titre results were present only in 49/105 (46%). Anti-NCS were more frequently detected in PAPS+LL, but no relationship with clinical/serological features was found, except for a weak correlation with anti-dsDNA antibodies. Two PAPS patients evolved into full-blown SLE during the follow-up and displayed high titre anti-NCS many years before.


CONCLUSIONS
Our findings suggest that anti-NCS might be added to the mosaic of autoimmune phenomena characterizing PAPS patients and in particular those with more chance to evolve to SLE.
Andreoli
Laura
L
Rheumatology and Clinical Immunology Unit, Spedali Civili, Piazzale Spedali Civili 1, University of Brescia, 25123 Brescia, Italy.
Pregnolato
Francesca
F
Burlingame
Rufus W
RW
Allegri
Flavio
F
Rizzini
Silvia
S
Fanelli
Valentina
V
Radice
Antonella
A
Corace
Caterina
C
Sinico
Renato Alberto
RA
Meroni
Pier Luigi
PL
Tincani
Angela
A
D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood* / Q000276:immunology; D016736:Antiphospholipid Syndrome / Q000276:immunology* / Q000503:physiopathology; D015551:Autoimmunity; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology; D008180:Lupus Erythematosus, Systemic / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009707:Nucleosomes / Q000276:immunology*
D000974:Antibodies, Antinuclear; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D009707:Nucleosomes