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Prevalence and clinical associations of anti-KU antibodies in patients with systemic sclerosis : a European EUSTAR - initiated multicentre case-control study
Rozman, Blaž, 1944- ...
Objectives: To determine the prevalence of anti-Ku antibodies in 625 patients with systemic sclerosis (SSc) from six European rheumatologic centres and to evaluate their clinical and serologic ...characteristics. Methods: Sera of 625 consecutive patients with either limited cutaneous or diffuse cutaneous SSc were tested for antibodies to Ku antigen together with other extractable nuclear antigens by counter-immunoelectrophoresis. A case-control design with calculation of Bootstrap 95% confidence intervals derived from anti-Ku negative control patients was used to evaluate clinical associations of anti-Ku antibodies. Sera of anti-Ku positive SSc patients and control group were additionally tested by immunofluorescence on Hep-2 cell substrates and line immunoassay. Results: Anti-Ku antibodies were found in sera of 14/625 (2.2%) SSc patients. Ten out of fourteen anti-Ku positive SSc patients had no other anti-ENA antibodies detected by counterimmuno-electrophoresis. Using the case control design, anti-Ku antibodies were significantly associated withmusculoskeletal manifestations such as clinical markers of myositis, arthritis, and joint contractures. In addition, a significant negative correlation of anti-Ku antibodies was found with vascular manifestation such as fingertip ulcers and teleangiectasias. There was a striking absence of anti-centromere antibodies as well as anti-PM/Scl antibodies in anti-Ku positive patients. As expected, anti-Scl-70 and punctate nucleolar immunofluorescence pattern were present only in single cases. Conclusion: Thisis the largest cohort to date focusing on the prevalence of anti-Ku antibodies in SSc patients. The case control approach was able to demonstrate a clinically distinct subset of anti-Ku positive SSc patients with only relative clinical differences in skeletal features. However, the notable exceptions were signs of myositis. (Abstract truncated at 2000 characters)
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