title: Autoreactive IgE is prevalent in systemic lupus erythematosus and is associated with increased disease activity and nephritis.
abstract: The presence of autoantibodies in systemic lupus erythematosus, particularly those of the IgG subclass, have long been associated with disease onset and activity. Here we explored the prevalence of autoreactive IgE in SLE and its relevance to disease in French (n = 79) and United States (US) (n = 117) cohorts with a mean age of 41.5 ± 12.7 and 43.6 ± 15.3 years and disease duration of 13.5 ± 8.5 and 16.6 ± 11.9 years, respectively. Our findings show that approximately 65% of all SLE subjects studied produced IgE antibodies to the seven autoantigens tested. This positivity was increased to almost 83% when only those subjects with active disease were considered. SLE subjects who were positive for anti-dsDNA, -Sm, and -SSB/La -specific IgE showed a highly significant association in the levels of these antibodies with disease activity similar to that of the corresponding IgG's. A strong association of IgE autoantibodies with active nephritis was also found in the combined cohort analysis. A test of the predictive value of autoreactive IgE's and IgGs for disease activity (SLE Disease Activity Index (SLEDAI) ≥ 4) revealed that the best predictors were dsDNA-specific IgE and IgG, and that the age of an SLE subject influenced this predictive model. The finding argue that the overall levels of IgE autoantibodies, independently or in combination with IgG autoantibodies, may serve as indicators of active disease.
authors.affiliation: Laboratory of Molecular Immunogenetics, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Barbara
authors.initials: B
authors.lastname: Dema
authors.affiliation: Institut National de la Santé et de la Recherche Médicale U699, Université Paris Diderot, Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Pellefigues
authors.affiliation: Office of the Clinical Director, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Sarfaraz
authors.initials: S
authors.lastname: Hasni
authors.affiliation: Clinical Research Unit, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Faculté de Médecine site Bichat, Paris, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Gault
authors.affiliation: Laboratory of Molecular Immunogenetics, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Chao
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Laboratory of Molecular Immunogenetics, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Tiffany K
authors.initials: TK
authors.lastname: Ricks
authors.affiliation: Lymphocyte Biology Section, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Bonelli
authors.affiliation: Laboratory of Molecular Immunogenetics, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Jörg
authors.initials: J
authors.lastname: Scheffel
authors.affiliation: Institut National de la Santé et de la Recherche Médicale U699, Université Paris Diderot, Paris, France ; Department of Internal Medicine, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Faculté de Médecine site Bichat, Paris, France.
authors.forename: Karim
authors.initials: K
authors.lastname: Sacré
authors.affiliation: Department of Nephrology, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Faculté de Médecine site Bichat, Paris, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Jablonski
authors.affiliation: Department of Internal Medicine, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Faculté de Médecine site Bichat, Paris, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Gobert
authors.affiliation: Institut National de la Santé et de la Recherche Médicale U699, Université Paris Diderot, Paris, France ; Department of Internal Medicine, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Faculté de Médecine site Bichat, Paris, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Papo
authors.affiliation: Institut National de la Santé et de la Recherche Médicale U699, Université Paris Diderot, Paris, France ; Department of Nephrology, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Faculté de Médecine site Bichat, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Daugas
authors.affiliation: Sjogren's Syndrome Clinic, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Gabor
authors.initials: G
authors.lastname: Illei
authors.affiliation: Institut National de la Santé et de la Recherche Médicale U699, Université Paris Diderot, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Charles
authors.affiliation: Laboratory of Molecular Immunogenetics, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Juan
authors.initials: J
authors.lastname: Rivera
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood*; D001324:Autoantigens / Q000097:blood; D015331:Cohort Studies; D004247:DNA / Q000097:blood / Q000276:immunology; D005260:Female; D005602:France; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007074:Immunoglobulin G / Q000097:blood; D008181:Lupus Nephritis / Q000097:blood / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014481:United States
chemical_list: D000974:Antibodies, Antinuclear; D001324:Autoantigens; D007074:Immunoglobulin G; D007073:Immunoglobulin E; D004247:DNA