AB0516 AUTOANTIBODY PROFILE ANALYSIS AND ITS ASSOCIATION WITH CLINICAL MANIFESTATIONS IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS
Authors: Elena Grau García, Francisco Miguel Ortiz Sanjuan, Cristobal Pávez Perales, Carmen Nájera Herranz, Inés Cánovas Olmos, Cristina Alcañiz Escandell, Inmaculada Chalmeta Verdejo, Marta De la Rubia Navarro, Jorge Juan Fragio-Gil, Roxana Gonzalez Mazario, Luis Gonzalez Puig, Jose Ivorra Cortés, Isabel Martínez Cordellat, Rosa Negueroles Albuixech, Jose Eloy Oller Rodríguez, Elvira Vicens Bernabeu, David Hervás Marín, Meritxell Fernandez Matilla, Nagore Fernández-Llanio, Juan Antonio Castellano Cuesta, Carmen Riesco Bárcena, Jose Andrés Román Ivorra
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Systemic lupus erythematosus (SLE) is an autoimmune systemic disease characterized by autoantibody production. The presence of some of them is related to specific clinical manifestations. Previous studies have classified SLE patients according to an autoantibody profile, associating them to specific clinical groups. <h3>Objectives:</h3> To define SLE patient groups according to an autoantibody profile and to analyze the correlation of these profiles to clinical manifestations, clinical activity and accumulated damage. <h3>Methods:</h3> A cross-sectional observational study of SLE patients diagnosed according to SLICC 2012 criteria was conducted. A clinical and analytical evaluation was performed in all cases. Clinical manifestations were described according to RELESSER study. We selected 8 autoantibodies to classify SLE patients in different subgroups according to autoimmune similar profiles: anti-dsDNA, anti-Sm, anti-RNP, anticardiolipin IgG o IgM (aCL IgG/M), anti-B2microglobulin IgG o IgM (aB2M IgG/M), lupus anticoagulant (LA), anti-Ro and anti-La. Biostatistical analysis was performed using software R and immunological profiles were created according to previous study of Artim-Esen B et al. 2014. <h3>Results:</h3> 142 SLE patients were evaluated (94.4% female) with a mean age at diagnosis of 33.29 (13.53) and a mean time of disease evolution of 15.82 (10.56) years. Mean SLEDAI score was 5.91 (5.6) and mean SLICC value 1.1 (1.46). Frequency of the selected autoantibodies was: ANAs 87.3% (n=124), anti-dsDNA 36.62% (n=52), anti-Sm 9.2% (n=13), anti-RNP 3.5% (n=5), aCL IgG/M 20.15% (n=27), aB2M IgG/M 21.88% (n=28), LA ANTI--LA? 26.27% (n=31), anti-Ro 45.07% (n=64) and anti-La 16.2% (n=23). Profile n°2 included SLE patients with anti-Sm/RNP positivity. Profile n°3 included patients with anti-Ro/La positivity and not included in profile n°2. Profile n°4 included patients with aCL IgG/M or aB2M IgG/M or LA positivity and not included in previous profiles. Profile n°5 included patients who exclusively showed anti-DNA positivity. Profile n°1 included all patients excluded from the other profiles. Depending on the results obtained, we analyzed autoantibody levels in order to assess its association with the presence of the described clinical affections. A significant association among hematological affection and high levels of anti-Ro (P&lt;0.0001), anti-La (P=0.022) and anti-Sm (P=0.018) was observed. We also observed a tendency of presenting a higher rate of mucocutaneous affection, musculoskeletal and renal affection and Sjögren syndrome in patients classified in Profile 3. <h3>Conclusion:</h3> Profile n°1 patients (absence of autoantibodies) were diagnosed earlier and had a longer disease evolution, whereas Profile n°5 patients (only anti-DNA positivity) were diagnosed at a mean age of 36 years and had a shorter disease evolution. We observed an association between the presence of anti-Ro/La and hematological affection, as well as high incidence of Sjögren syndrome in these subgroup of patients. <h3>Disclosure of Interests:</h3> None declared