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Anti-nucleosome and anti-chromatin antibodies are present in active systemic lupus erythematosus but not in the cutaneous form of the disease

Division of Clinical Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil; Division of Dermatology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil

LM da Silva

Division of Clinical Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil

FR Oliveira

Division of Clinical Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil

AMF Roselino

Division of Dermatology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil

P Louzada-Junior

Division of Clinical Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil plouzada{at}fmrp.usp.br

The objective of this study is to investigate the presence of anti-nucleosome (anti-NCS) and anti-chromatin (anti-CRT) antibodies in patients with cutaneous lupus erythematosus (CLE) compared with active and inactive systemic lupus erythematosus (SLE). A total of 154 subjects were evaluated: 54 patients presenting CLE, 66 patients with active SLE and 34 with inactive SLE. Lupus activity was assessed using the disease activity index (SLEDAI). Anti-NCS and anti-CRT antibodies were detected by enzyme-linked immunosorbent assay (ELISA). Only one of 54 patients with CLE tested positive for both anti-NCS and anti-CRT antibodies. The prevalence of anti-CRT antibodies was significantly higher in active SLE (84.8%) when compared with inactive SLE (26.4%) and CLE (1.8%) (P < 0.001). Anti-NCS antibodies were also more prevalent in active SLE patients (74.2%) than inactive SLE (11.7%) and CLE patients (1.8%) (P < 0.001). The presence of anti-CRT and anti-NCS antibodies was correlated to disease activity in patients with SLE (r = 0.4937, r = 0.5621, respectively). Furthermore, the detection of both antibodies was correlated with disease activity in patients with SLE who tested negative for anti-dsDNA antibodies (r = 0.4754 for anti-NCS and r = 0.4281 for anti-CRT). The presence of these two auto-antibodies was strongly associated with renal damage in patients with SLE (OR = 13.1, for anti-CRT antibodies and OR = 25.83, for anti-NCS antibodies). The anti-NCS and anti-CRT antibodies were not found in CLE. In patients with SLE, there is a correlation of these antibodies with disease activity and active nephritis. When compared with anti-dsDNA antibodies, anti-NCS and anti-CRT antibodies were more sensitive in detecting disease activity and kidney damage in lupus patients.

Key Words: anti-chromatin • anti-nucleosome • cutaneous lupus • SLEDAI • systemic lupus erythematosus

Lupus, Vol. 18, No. 3, 223-229 (2009)
DOI: 10.1177/0961203308096255


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