Systemic lupus erythematosus (SLE) is a multi-systemic autoimmune
disease leading to immunological aberrations and excessive multiple autoantibody
production. The aim of this study was to investigate the prevalence of
multiple autoantibodies in SLE patients utilizing the multiplex system method.
We analyzed the presence of elevated titers of anti-Ro, anti-La, anti-RNP,
anti-Sm, anti-Jo1, anti-centromere, anti-Scl-70, anti-histone, and anti-dsDNA
antibodies in 199 serum samples (113 SLE patients, 86 healthy donors). We
compared the type, level and number of autoantibodies and the correlation
the autoantibody profile and disease severity utilizing the SLEDAI score.
Elevated titers of at least one autoantibody were detected in 48% of 42 SLE
patients. Elevated titers of anti-Ro antibodies were most commonly detected. The
distribution of specific autoantibodies was: anti-Ro- 23.8%, anti-dsDNA- 19%,
anti-histone- 19%, anti-RNP- 14.2%, anti-La antibodies- 11.9%, anti-Sm- 7.1%,
anti-Scl 70-4.7%, and anti-centromere- 2.4%. Utilizing ROC analysis, the sensitivity
and specificity of anti-DNA antibodies at a cutoff value of 34 IU/ml were 87.1% and
79.4% respectively. Elevated titers of anti-Jo1 antibody were not detected. There
was a correlation with the titer of anti-Ro antibodies and disease activity by the
SLEDAI score. Seven patients harbored one autoantibody only, 15 patients
harbored 2-3 autoantibodies, 3 patients harbored 4-5 autoantibodies, and one
patient harbored 6 autoantibodies. A correlation between the number of
autoantibodies per patient and disease severity was found. One patient with
a multitude of
autoantibodies had severe lupus and a myriad of clinical manifestations.
In conclusion, the multiplex system is specific and sensitive, provides
an autoantibody profile in a single test, and may be useful as a diagnostic
test for SLE. Elevated anti-Ro antibodies are associated with
severe disease. An autoantibody load may be indicative of more severe disease.