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Vol. 21. Issue 3.
(March 2025)
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Vol. 21. Issue 3.
(March 2025)
Original article
Role of the anti-RO/SSA antibody in patients with systemic lupus erythematosus
Papel del anticuerpo anti-Ro/SSA en los pacientes con lupus eritematoso sistémico
Paula Pérez Jiméneza, Laura Tío Barrerab, José Luis Andréu Sánchezc, Tarek Carlos Salman-Monted,e,
Corresponding author
tareto4@gmail.com

Corresponding author.
, Irene Carrión-Barberàd,e
a Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
b Hospital del Mar Medical Research Institute, IMIM, Barcelona, Spain
c Department of Rheumatology, Hospital Universitario Puerta de Hierro de Majadahonda, Madrid, Spain
d Department of Rheumatology, Hospital del Mar, Barcelona, Spain
e Hospital del Mar Clinical Expertise Unit in Systemic Autoimmune Diseases and Vasculitis, Spain
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Tables (6)
Table 1. Results of the demographic and therapeutic variables by disease group and differences observed between them.
Tables
Table 2. Results of the clinical variables by disease group and differences observed between them. DILD: diffuse interstitial lung disease.
Tables
Table 3. Results of the analytical variables by disease group and differences observed between them.
Tables
Table 4. Results of the demographic and therapeutic variables according to the expressed anti-Ro antibody profile and differences observed between groups.
Tables
Table 5. Results of the clinical variables according to the expressed anti-Ro antibody profile and differences observed between groups.
Tables
Table 6. Results of the analytical variables according to the expressed anti-Ro antibody profile and differences observed between groups.
Tables
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Abstract
Background

Patients with systemic lupus erythematosus (SLE) and anti-Ro+ antibody frequently pose a diagnostic and therapeutic challenge for the specialist, as they frequently present sicca syndrome, overlapping with Sjögren's syndrome (SS). To date, the clinical and prognostic variability that this antibody confers on SLE patients is not well characterized.

Objectives

To investigate the possible clinical, analytical, therapeutic and prognostic implications of anti-Ro antibody in SLE. Furthermore, we analyzed the possible implications of the expressed anti-Ro profile (subunit 52, 60 or both) on the disease phenotype.

Methods

The medical records of patients with anti-Ro+ and - SLE, primary SS and SLE/SS overlap have been reviewed.

Results

Anti-Ro+ SLE presents less arthritis, low C4, expression of DNA Crithidia and need for bolus corticosteroids than anti-Ro− SLE, but more xerophthalmia, xerostomia, expression of anti-La, anti-cyclic citrullinated peptide and overlap with other rheumatological entities. Anti-Ro+ SLE and the overlap group behave similarly for multiple variables. SS group shows a higher expression of β2-microglobulin compared to the overlap group. Anti-Ro52+ patients associate more Raynaud's phenomenon than anti-Ro60+ patients. The latter express more lupus anticoagulant and antiphospholipid antibodies than the group with both subunits.

Conclusions

The presence of anti-Ro+ in patients with SLE provides clinical and analytical differences compared to patients with anti-Ro− SLE and SLE/SS. anti-Ro+ SLE and the overlap group behave similarly, but present differential characteristics that postulate them as separate phenotypes of the disease. The different serological profiles of anti-Ro confer specific clinical and analytical characteristics in patients with SLE and SS.

Keywords:
Systemic lupus erythematosus
Anti-Ro
Autoantibodies
Overlap syndrome
Sjögren syndrome
Abbreviations:
ACL-G
ACL-M
ACR
ANA
Anti-CCP
Anti-dsDNA
Anti-RNP
Anti-TNFα
Anti-β2GPPP
APS
BMI
DILD
EULAR
PHT
SLE
SLICC
SS
Resumen
Antecedentes

Los pacientes con lupus eritematoso sistémico (LES) y anticuerpos anti-Ro+ suponen con frecuencia un reto diagnóstico y terapéutico para el especialista, ya que presentan, con frecuencia, síndrome seco, solapado con síndrome de Sjögren (SS). Hasta la fecha, la variabilidad clínica y pronóstica que confiere este anticuerpo a los pacientes con LES no está bien caracterizada.

Objetivos

Investigar las posibles implicaciones clínicas, analíticas, terapéuticas y pronósticas del anticuerpo anti-Ro en el LES. Además, analizamos las posibles implicaciones del perfil anti-Ro expresado (subunidad 52, 60 o ambas) en el fenotipo de la enfermedad.

Métodos

Se han revisado las historias clínicas de los pacientes con LES anti-Ro+ y −, SS primario y solapamiento LES/SS.

Resultados

El LES anti-Ro+ presenta menos artritis, bajo C4, expresión de ADN Crithidia y necesidad de corticoides en bolo que el LES anti-Ro-, pero más xeroftalmia, xerostomía, expresión de anti-La, antipéptido cíclico citrulinado y solapamiento con otras entidades reumatológicas. El LES anti-Ro+ y el grupo solapado se comportan de forma similar para múltiples variables. El grupo SS muestra mayor expresión de β2-microglobulina respecto al grupo solapado. Los pacientes anti-Ro52+ asocian más fenómeno de Raynaud que los pacientes anti-Ro60+. Estos últimos expresan más anticuerpos anticoagulantes lúpicos y antifosfolípidos que el grupo con ambas subunidades.

Conclusiones

La presencia de anti-Ro+ en los pacientes con LES aporta diferencias clínicas y analíticas respecto a los pacientes con LES anti-Ro- y LES/SS. El LES anti-Ro+ y el grupo solapado se comportan de forma similar, pero presentan características diferenciales que los postulan como fenotipos separados de la enfermedad. Los diferentes perfiles serológicos de anti-Ro confieren características clínicas y analíticas específicas en los pacientes con LES y SS.

Palabras clave:
Lupus eritematoso sistémico
Anti-Ro
Autoanticuerpos
Síndrome de superposición
Síndrome de Sjögren

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