Lupus Progression to Be Predicted by Autoantibody Profiling?

Autoantibody profiles that use an expanded array of specificities were correlated with the risk of progressive disease in patients with lupus in a study reported in Arthritis Research & Therapy. The findings suggest that a simple diagnostic test could be developed that nonspecialists might apply to screening for lupus and that would permit effective triage for specialty care.

Researchers studied 22 patients with 4 or fewer diagnostic criteria for lupus for changes in clinical and autoantibody profiles after a mean follow-up period of 2.4 years. They used an array with more than 80 autoantigens to profile IgG and IgM autoantibodies and examined correlations with clinical disease progression.

Patients who progressed were all females and were younger than those who did not progress. IgG autoreactivity showed greater increases in the progressor group than in the nonprogressor group, but IgM autoreactivity did not. IgG specificities that were higher at baseline in progressors included proliferating cell nuclear antigen, 2-microglobulin, C1q, and hemocyanin. A quantitative risk profile generated from baseline demographic and autoantibody variables yielded highly different scores for the progressor and nonprogressor groups.

Identification of patients who are in early stages of lupus currently is done through clinical evaluation and is not facilitated greatly by available diagnostic tests, it was noted. Profiling for patient characteristics and antibody specificities that predict disease would enhance the ability of physicians to identify and manage early cases before the onset of organ-damaging illness.