Autoantibody clusters in childhood-onset systemic lupus erythematosus: Insights from a multicenter study with 912 patients

<b>Objective:</b> To identify clusters of autoantibodies in a large cSLE population and to verify possible associations between different autoantibody clusters and the following variables: demographic data, cumulative clinical and laboratory manifestations, disease activity, cumulative damage and mortality. <b>Methods:</b> A cross-sectional study was performed in 27 Pediatric Rheumatology University centers, including 912 cSLE patients. The frequencies of seven selected autoantibodies (anti-dsDNA, anti-Ro/SSA, anti-La/SSB, anti-Sm, anti-RNP, aCL IgM and/or IgG and LA) were used for cluster analysis using the K-means method. <b>Results:</b> Four distinctive antibody clusters were identified. Cluster 1 (<i>n</i> = 322; 35.31%) was characterized by anti-dsDNA (61.18%), low frequency of antiphospholipid antibodies (<10%), and lower frequency of cutaneous, articular manifestation (<i>p</i> < 0.05) and hypocomplementemia (<i>p</i> < 0.001) compared to the other groups. Cluster 2 (<i>n</i> = 158; 17.32%) comprised anti-dsDNA (93.04%), aCL (87.34%) and LA (39.87%) and higher frequencies of thrombocytopenia (<i>p</i> = 0.006) and antiphospholipid syndrome (<i>p</i> < 0.001) than the other clusters. Cluster 3 (<i>n</i> = 177; 19.41%) was characterized by anti-dsDNA (81.36%), anti-Sm (100%) and anti-RNP (44.63%) antibodies, as well as a higher frequency of proteinuria compared to cluster 4 (58.15% vs 56.13% vs 64.00% vs 49.80%, <i>p</i> = 0.031). Cluster 4 (<i>n</i> = 255; 27.96%) consisted of all 7 autoantibodies, with predominance of anti-dsDNA (72.55%), anti-Ro/SSA (89.8%) and anti-La/SSB (45.88%), with no specific clinical pattern, except by higher pulmonary damage (<i>p</i> = 0.017). <b>Conclusions:</b>Our study suggests that, within the context of cSLE, the coexistence of anti-dsDNA with antiphospholipid autoantibodies is linked to an elevated incidence of antiphospholipid syndrome. This association does not coincide with a proportionate increase in the occurrence of nephritis. Conversely, the cluster of anti-dsDNA with anti-Ro/SSA and anti-La/SSB antibodies was associated with pulmonary damage, requiring close surveillance.

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Publication Details

Journal
Lupus
Published
2025-01-27
DOI
https://doi.org/10.1177/09612033251317357
Citations
1
Primary Topic
Systemic Lupus Erythematosus Research
Type
article
Field-Weighted Citation Impact
1.67

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article

Autoantibody clusters in childhood-onset systemic lupus erythematosus: Insights from a multicenter study with 912 patients

Paulo F. Spelling, André Cavalcanti, Adriana Maluf Elias Sallum, Izabel M. Buscatti et al.
1 citations
Lupus
Systemic Lupus Erythematosus Research
1.67
article

Autoantibody clusters in childhood-onset systemic lupus erythematosus: Insights from a multicenter study with 912 patients

Paulo F. Spelling, André Cavalcanti, Adriana Maluf Elias Sallum, Izabel M. Buscatti, Luciana Martins de Carvalho, Clóvis A. Silva, Adriana Rodrigues Fonseca, Flávio Sztajnbok, Lúcia Maria Arruda Campos, Blanca Elena Ríos Gomes Bica, Teresa Cristina Martins Vicente Robazzi, Kátia Tomie Kozu, Vitor Trindade, Alexandre Archanjo Ferraro, Flávia Patrícia Sena Teixeira Santos, Ana Paula Sakamoto, Gláucia V. Novak, Verena Andrade Balbi, Eloísa Bonfá, Maria Carolina dos Santos, Carlos Nobre Rabelo, Marco F. Silva, Nádia Emi Aikawa, Magda Maria Sales Carneiro-Sampaio, Aline Garcia Islabão, Érica Naomi Naka Matos, Ana Paula Luppino Assad, Ana J Moraes, Roberto Marini, Ana C. Pitta, Evaldo G Sena, Luciano Junqueira Guimarães, Cláudia Saad Magalhães, Iloite Maria Scheibel, Maria Teresa Terreri, Fernanda J. Fiorot
article en
1 citations

Abstract

<b>Objective:</b> To identify clusters of autoantibodies in a large cSLE population and to verify possible associations between different autoantibody clusters and the following variables: demographic data, cumulative clinical and laboratory manifestations, disease activity, cumulative damage and mortality. <b>Methods:</b> A cross-sectional study was performed in 27 Pediatric Rheumatology University centers, including 912 cSLE patients. The frequencies of seven selected autoantibodies (anti-dsDNA, anti-Ro/SSA, anti-La/SSB, anti-Sm, anti-RNP, aCL IgM and/or IgG and LA) were used for cluster analysis using the K-means method. <b>Results:</b> Four distinctive antibody clusters were identified. Cluster 1 (<i>n</i> = 322; 35.31%) was characterized by anti-dsDNA (61.18%), low frequency of antiphospholipid antibodies (<10%), and lower frequency of cutaneous, articular manifestation (<i>p</i> < 0.05) and hypocomplementemia (<i>p</i> < 0.001) compared to the other groups. Cluster 2 (<i>n</i> = 158; 17.32%) comprised anti-dsDNA (93.04%), aCL (87.34%) and LA (39.87%) and higher frequencies of thrombocytopenia (<i>p</i> = 0.006) and antiphospholipid syndrome (<i>p</i> < 0.001) than the other clusters. Cluster 3 (<i>n</i> = 177; 19.41%) was characterized by anti-dsDNA (81.36%), anti-Sm (100%) and anti-RNP (44.63%) antibodies, as well as a higher frequency of proteinuria compared to cluster 4 (58.15% vs 56.13% vs 64.00% vs 49.80%, <i>p</i> = 0.031). Cluster 4 (<i>n</i> = 255; 27.96%) consisted of all 7 autoantibodies, with predominance of anti-dsDNA (72.55%), anti-Ro/SSA (89.8%) and anti-La/SSB (45.88%), with no specific clinical pattern, except by higher pulmonary damage (<i>p</i> = 0.017). <b>Conclusions:</b>Our study suggests that, within the context of cSLE, the coexistence of anti-dsDNA with antiphospholipid autoantibodies is linked to an elevated incidence of antiphospholipid syndrome. This association does not coincide with a proportionate increase in the occurrence of nephritis. Conversely, the cluster of anti-dsDNA with anti-Ro/SSA and anti-La/SSB antibodies was associated with pulmonary damage, requiring close surveillance.

LupusVol. 34(3)
Universidade Federal de Minas Gerais (BR), Universidade Federal do Rio de Janeiro (BR), Universidade Federal de Mato Grosso do Sul (BR), Universidade Federal da Bahia (BR), Universidade de Brasília (BR), Universidade de São Paulo (BR), Universidade Estadual de Campinas (UNICAMP) (BR), Universidade Federal de Pernambuco (BR), Irmandade da Santa Casa de Misericórdia de São Paulo (BR), Hospital Universitário Pedro Ernesto (BR), Hospital Universitário Evangélico de Curitiba (BR), Hospital Universitário Lauro Wanderley (BR), Hospital Universitário de Brasília (BR), Hospital Infantil Albert Sabin (BR), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (BR), Universidade Federal do Pará (BR), Universidade Estadual Paulista (Unesp) (BR), Universidade Federal de São Paulo (BR)
Fundação de Amparo à Pesquisa do Estado de São Paulo, Conselho Nacional de Desenvolvimento Científico e Tecnológico
Good health and well-being
Openalex Percentile: Top 21%
Systemic Lupus Erythematosus Research
1.67
DOIOpen Access PDFOpenAlex
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