AB1325 The frequency of anti-dfs70 autoantibodies in japanese women with peri- and post-menopausal arthralgia
Authors: K. Miyachi, A. Ihar, B. Sasse, M.Y. Choi, M.J. Fritzler
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The antinuclear antibody (ANA) test is often used as a screening test to aid in the diagnosis of systemic lupus erythematous (SLE and other systemic autoimmune rheumatic diseases (SARD). However, recently it was reported that a certain autoantibody referred to as anti-dense fine speckled 70 (DFS70) are much more common (up to 25%) of non-SARD and healthy individuals but rare &lt;5%) in SLE and certain SARD. The frequency of anti-DFS70 is even lower (i.e. &lt;1%) if monospecific anti-DFS70 antibodies are found. Some reports suggested that anti-DFFS70 are more common in younger females, suggesting that hormonal factors may be responsible for the cognate B cell response. <h3>Objectives</h3> The primary objective of our study was to determine the frequency of ant-DFS70 in menopausal women who were referred for evaluation of undifferentiated arthritis (UA). <h3>Methods</h3> 282 women including 105 with UA and an age range of 27~91 years (mean=60.3) were enrolled. Menopausal women were divided into pre-, peri-, and post-menopausal stages according to menstrual regularity. (E2), Follicle stimulating hormone (FSH), rheumatoid factor (RF), ANA (by indirect immunofluorescence (IIF) (MBL) anti-cyclic citrullinated peptide antibody (ACPA: MBL ELISA) and C-reactive protein (CRP) were included in the serology workup. Postmenopausal arthralgia was designated PoMA and perimenopausal arthralgia PeMA. <h3>Results</h3> In PoMA women who received HRT for two months estradiol levels increased, FSH levels decreased and the joint pain visual analogue scale was reduced by 70%, as compared to baseline. Similarly in PeMA women, administration of 600 mg tocopherol N daily had the same efficacy as that observed in PoMA. The overall frequency of anti-DFS70 of 26.7% (28/105) in PoMA and PeMA women was significantly higher than that in UA females who were diagnosed with rheumatoid arthritis (RA) (7/65:10.8%) or primary Sjogren's syndrome (SjS) (3/31: 9.7%) (p&lt;0.05). In addition, anti-DFS70 Ab was observed primarily in low titer (1:40 – 1:160) ANA positive sera. On the other hand, higher titer ANAs (titer &gt;1/320) were observed in the females that were diagnosed as systemic lupus erythematosus (SLE) (30%) or primary SjS (48.4%), the majority of whom had lower titers of anti-DFS70, although several sera contained both high titer ANA and anti-DFS70 (see figure). <h3>Conclusions</h3> Anti-DFS70 was found in higher frequency in PeMA and PoMA women than in women who developed a defined systemic autoimmune rheumatic disease such as SLE, SjS or RA. This is the first study to suggest that the presence of this autoantibody may reflect oestrogen fluctuations or deficiency. A negative association between ANA titer and anti-DFS70 levels by ELISA remains to be confirmed in larger studies. <h3>References</h3> [1] M. Mahler, P. L. Meroni, L. E. Andrade, M. Khamashta, N. Bizzaro, C. A. Casiano, and M. J. Fritzler. Towards a better understanding of the clinical association of anti-DFS70 autoantibodies. Autoimmun. Rev. 15:198–201, 2016. [2] K. Conrad, N. Rober, L. E. Andrade, and M. Mahler. The Clinical Relevance of Anti-DFS70 Autoantibodies. Clin. Rev. Allergy Immunol. 52:202–216, 2016. <h3>Disclosure of Interest</h3> K. Miyachi Shareholder of: none, Grant/research support from: none, Consultant for: none, A. Ihar: None declared, B. Sasse: None declared, M. Y. Choi: None declared, M. J. Fritzler: None declared