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Anti-telomere antibodies in systemic lupus erythematosus: a new ELISA test for anti-DNA with potential pathogenetic implications

Department of Medicine/Division of Rheumatology, Cedars-Sinai Medical Center and UCLA School of Medicine, Los Angeles, CA, USA

E-M Salonen

Helsinki University, Helsinki, Finland

E Avaniss-Aghajani

Department of Biology, UCLA School of Medicine, Los Angeles, CA, USA

R Morris

Rheumatology Diagnostics Laboratory, Inc., Los Angeles, CA, USA

A L Metzger

N Pashinian

Department of Medicine/Division of Rheumatology, Cedars-Sinai Medical Center and UCLA School of Medicine, Los Angeles, CA, USA

Background: Telomeric hexamer repeats (TTAGGG/CCCTAA)_n are highly repetitive sequences of DNA. They cap the termini of eukaryotic chromosomes and stabilize them, preventing degradation or fusion. Anti ds-DNA is one of the most specific tests for systemic lupus erythematosus (SLE). Of related importance, a preliminary report has suggested that anti-telomere antibodies are also highly specific for the presence of SLE.

Methods: 220 patients with SLE, 79 with rheumatoid arthritis (RA), 54 with other rheumatic diseases and 99 healthy controls were tested for anti-telomere antibody as measured by enzyme immunoassay detecting 30and 60-mer telomeric repeats (5 ± 10 hexamers). 48 of the 220 SLE patients charts were abstracted for 90 separate clinical, laboratory and treatment parameters. Comparisons were made between SLE and non-SLE patients, and within the lupus group for telomere positivity and among the latter 48 patients for anti-DNA (Farr) levels and SLEDAI scores.

Results: Anti-telomere antibody was present in 48.6% of the overall SLE group (220), 71% of our cohort (48), 11% with primary Sjogren's (2=18), 7.6% with RA (6=79) and 2% of normal controls (2=99) (P < 0.001 comparing SLE to all other groups). In the 48 patient cohort, anti-telomere antibody was more sensitive than anti-dsDNA (Farr) (71% vs 50%), but did not correlate with other clinical parameters, SLEDAI scores, or other autoantibodies.

Conclusions: The detection of anti-telomere antibody appears to be more sensitive and may be as specific as anti-dsDNA (Farr) in SLE. The detection of telomeric repeats may be as accurate as other anti-DNA assay methodologies and more specific for the presence of SLE. The immunogenic potential of telomere biology related to the pathogenesis and/or diagnosis of SLE deserves further investigation.

Key Words: lupus erythematosus • systemic • anti-DNA • telomere • anti-telomere antibody

Lupus, Vol. 9, No. 5, 328-332 (2000)
DOI: 10.1191/096120300678828343


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