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Anti-nucleosome antibodies outperform traditional biomarkers as longitudinal indicators of disease activity in systemic lupus erythematosus
Open accessAbstract
OBJECTIVE: The aim of this study was to determine whether anti-nucleosome antibodies function as activity-specific biomarkers in SLE. METHODS: Fifty-one patients were recruited and followed prospectively with periodic clinical and biochemical assessments over a 14-month period. Disease activity was determined by the SLEDAI-2K. Anti-nucleosome antibody levels were measured by an ELISA and its utility as an activity-specific biomarker as compared with that of anti-dsDNA antibodies and C3 was assessed both at baseline and in longitudinal analysis. RESULTS: Anti-nucleosome antibodies were significantly elevated in SLE patients vs controls and showed a moderate positive correlation with disease activity. The utility of anti-nucleosome antibodies in identifying patients with active disease in a cross-sectional analysis was comparable to that of anti-dsDNA antibodies and C3. Analysis of variance demonstrated that the level of anti-nucleosome antibodies and C3 varied significantly with changes in disease activity over time. Changes in clinical state were not mirrored by changes in anti-dsDNA antibodies. In time-dependent analysis, anti-nucleosome antibodies showed a better fit over time than anti-dsDNA antibodies and C3. In pairwise comparisons, C3 and anti-nucleosome antibodies outperformed other models, including the conventional pairing of C3 and anti-dsDNA antibodies, however, no biomarker alone or as a group accurately predicted impending remissions or exacerbations. CONCLUSION: Anti-nucleosome antibodies demonstrate greater fidelity as a biomarker for changes in SLE disease activity than traditional biomarkers, supporting the routine monitoring of this antibody in clinical practice.
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dsDNA antibodies are among the most commonly detected ANAs in SLE and correlate with disease activity and especially renal involvement.
“As double-stranded DNA (dsDNA) antibodies are among the most commonly detected ANAs in SLE, reported to correlate also with disease activity and especially renal involvement (6-9)”
From Anti-dsDNA Testing Specificity for Systemic Lupus Erythematosus: A Systematic Review. (2022) · cites this paper as [8]
The cross-sectional analysis reports anti-dsDNA positivity in 39 of 50 SLE patients (78%) and a correlation with global disease activity. The Discussion links proliferative renal lesions to simultaneous positivity for anti-dsDNA and anti-nucleosome antibodies, but does not establish the claimed association between anti-dsDNA antibodies alone and especially renal involvement. No page numbers are available in our copy. (LLM, conf=0.86)
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Metadata
- Authors
- Li, T., Prokopec, S. D., Morrison, S., Lou, W., Reich, H., Gladman, D., Urowitz, M., Scholey, J., Fortin, P. R., Boutros, P. C., Wither, J., & Landolt-Marticorena, C.
- Affiliations
- Ontario Institute for Cancer Research (CA)
- ORCID
- Venue
- Rheumatology
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-09-05
- Volume
- 54
- Issue
- 3
- Pages
- 449-457
- ISSN
- 1462-0324 (ISSN-L)
- 1462-0332
- PMC
- PMC4334682
- OpenAlex
- W2141500677
- Cited by
- 49
- References
- 24
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 1 · 2023: 3 · 2022: 6 · 2021: 5 · 2020: 6 · 2019: 3 · 2018: 4 · 2017: 6 · 2016: 4 · 2015: 4 · 2014: 1
- FWCI
- 4.15
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Lara D. Veeken (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University Health Network
- Ontario Institute for Cancer Research
- Government of Ontario
- Arthritis Society
- University of Toronto
- Canadian Institutes of Health Research (QNT #78341)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Rheumatology › Systemic Sclerosis and Related Diseases
- Health Sciences › Medicine › Rheumatology › Vasculitis and related conditions
- Keywords
- anti-nucleosome antibodies, systemic lupus erythematosus, disease activity markers, anti-dsDNA antibodies, complement C3, SLEDAI-2K, longitudinal disease monitoring
- MeSH terms
- Adolescent, Adult, Aged, Antibodies, Anti-Idiotypic, Complement C3, Cross-Sectional Studies, DNA, Female, Humans, Longitudinal Studies, Lupus Erythematosus, Systemic, Male, Middle Aged, Nucleosomes, Prospective Studies, Sensitivity and Specificity, Severity of Illness Index, Time Factors, Biomarkers, Young Adult
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