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1.
Reumatismo ; 75(3)2023 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-37721348

RESUMO

Adenosine deaminase 2 deficiency (DADA2) is a rare monogenic vasculopathy caused by loss-of-function homozygous or compound heterozygous mutations in ADA2, formerly CECR1 (cat eye syndrome chromosome region 1) gene. The DADA2 phenotype is widely heterogeneous, and patients may present with fever, weight loss, livedo reticularis/racemosa, digital ischemia, cutaneous ulceration, peripheral neuropathy, abdominal pain, bowel perforation, and portal or nephrogenic hypertension. More specific manifestations include early-onset ischemic or hemorrhagic stroke, mild immunodeficiency and hypogammaglobinemia, cytopenia, and vision disturbances. Herein, we present the case of a young male with vasculitis associated with DADA2. The presence of HLA-B51 and the clinical features of this patient raised the question of similarities between ADA2 deficiency, Behçet's disease, and NOD2-associated diseases. Treatment of this rare monogenic disease is challenging and based on small case series. The long-term experience of this patient proved the difficulties of prednisone tapering and the lack of satisfactory therapeutic strategies.


Assuntos
Síndrome de Behçet , Vasculite , Humanos , Masculino , Síndrome de Behçet/complicações , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/tratamento farmacológico , Adenosina Desaminase/genética , Peptídeos e Proteínas de Sinalização Intercelular/genética , Vasculite/etiologia
2.
Reumatismo ; 71(1): 1-12, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30932437

RESUMO

Rheumatoid factor and antibodies against cyclic citrullinated peptides represent a diagnostic hallmark in rheumatoid arthritis (RA). However, over the last decades many other autoantibodies have been identified. Several proteins can trigger an aberrant autoimmune response in their native form while others acquire this feature after post-translational modifications such as citrullination, carbamylation or acetylation. It is of interest that also the enzymes catalyzing such post-translational modifications (e.g. the protein arginine deiminases) can transform themselves into autoantibodies in RA. The purpose of this review article is to provide an overview of relevant literature published over the last years regarding novel autoantibodies and their possible diagnostic and prognostic significance in RA.


Assuntos
Autoanticorpos/metabolismo , Citrulinação , Peptídeos Cíclicos/imunologia , Vimentina/imunologia , Anticorpos Antinucleares/imunologia , Anticorpos Antinucleares/metabolismo , Especificidade de Anticorpos , Artrite Reumatoide/imunologia , Autoanticorpos/imunologia , Antígenos Nucleares do Vírus Epstein-Barr/imunologia , Antígenos Nucleares do Vírus Epstein-Barr/metabolismo , Humanos , Hidrolases/imunologia , Hidrolases/metabolismo , Queratinas/imunologia , Fragmentos de Peptídeos/imunologia , Fragmentos de Peptídeos/metabolismo , Carbamilação de Proteínas , Fator Reumatoide , Vimentina/metabolismo , Proteínas Virais/imunologia , Proteínas Virais/metabolismo
3.
Reumatismo ; 70(2): 67-71, 2018 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-29976039

RESUMO

In recent years several antibodies against citrullinated peptides (ACPAs) have been identified in patients with rheumatoid arthritis (RA) and their pathogenic, diagnostic and prognostic significance is under intense investigation. Among ACPAs, those targeting citrullinated alpha enolase (anti-CEP1) have been identified in RA but data about their ability to predict the development of erosive disease are conflicting. Furthermore, no data are currently available concerning their possible association with extra-articular manifestations (EAMs) in RA. The aim of this study was to investigate the prevalence and significance of anti-CEP1 from a prognostic point of view. In this pilot study we confirmed that anti-CEP1 Abs are associated with higher prevalence of bone erosions, but we also provided the first evidence of an association between anti-CEP1 Abs and RA interstitial lung disease (ILD). These results provide the basis to investigate the association between anti-CEP1 Abs and EAMs in larger cohorts of RA patients to possibly confirm its role as biomarker for RA-ILD.


Assuntos
Anticorpos Antiproteína Citrulinada/sangue , Artrite Reumatoide/imunologia , Autoantígenos/imunologia , Doenças Pulmonares Intersticiais/imunologia , Fosfopiruvato Hidratase/imunologia , Idoso , Artrite Reumatoide/sangue , Artrite Reumatoide/epidemiologia , Biomarcadores , Comorbidade , Humanos , Doenças Pulmonares Intersticiais/sangue , Doenças Pulmonares Intersticiais/epidemiologia , Doenças Pulmonares Intersticiais/etiologia , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Prognóstico , Fumar/epidemiologia
4.
Reumatismo ; 70(4): 212-224, 2018 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-30570239

RESUMO

Rheumatoid arthritis (RA) is a chronic inflammatory disease that mainly affects the joints, though a consistent proportion of patients may also display extra articular manifestations (EAMs). From rheumatoid nodules to interstitial lung disease, from cardiovascular events to vasculitis, the spectrum of EAMs encompasses various conditions with different prognoses. EAMs may also occur as first RA manifestation, therefore the coordination with other health professionals, including general practitioners, is needed. The aim of this article is to provide an overview on EAMs in RA with particular focus on the recognised risk factors and the available recommendations for managing them, as well as comorbidities in RA patients.


Assuntos
Artrite Reumatoide/complicações , Humanos
5.
Reumatismo ; 69(3): 93-100, 2017 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-28933131

RESUMO

Although primary Sjögren's syndrome (pSS) is a mild indolent chronic disease mainly characterized by mucosal dryness in the majority of cases, a consistent subgroup of patients display extra-glandular manifestations. Virtually any organs and systems can be affected, leading to a more serious disease prognosis. Therefore, the prompt identification of patients at higher risk of extra-glandular manifestations is necessary to start a thorough follow up and an aggressive treatment. The aim of this review article is to provide an overview of epidemiological, clinical and serological features of extra-glandular manifestations in pSS as well as current knowledge about putative biomarkers useful in clinical practice.


Assuntos
Síndrome de Sjogren/patologia , Sistema Cardiovascular/patologia , Sistema Digestório/patologia , Humanos , Rim/patologia , Pulmão/patologia , Sistema Musculoesquelético/patologia , Sistema Nervoso/patologia , Especificidade de Órgãos , Síndrome de Sjogren/diagnóstico , Pele/patologia
6.
Clin Exp Immunol ; 184(3): 284-92, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26814615

RESUMO

Compelling evidence suggests that interleukin (IL)-17 and IL-17-producing cells play a pivotal role in the pathogenesis of primary Sjögren's syndrome (pSS). We investigated phenotypical and functional effects of the anti-CD20 antibody rituximab (RTX) on circulating and glandular IL-17-producing T cells in pSS. RTX is able to deplete glandular IL-17(+) CD3(+) CD4(-) CD8(-) double-negative (DN) and CD4(+) Th17 cells as well as circulating IL-17(+) DN T cells. A fraction of glandular and circulating IL-17(+) DN cells and CD4(+) T helper type 17 (Th17) cells co-expresses CD20 on the cell surface explaining, at least in part, such depletive capacity of RTX. The exposure to RTX does not rescue the in-vitro corticosteroid resistance of IL-17(+) DN T cells. Our results support further the therapeutic role in pSS of RTX that, despite its B cell specificity, appears able to also hamper IL-17-producing T cells in this disease.


Assuntos
Antígenos CD20/imunologia , Fatores Imunológicos/uso terapêutico , Interleucina-17/imunologia , Rituximab/uso terapêutico , Síndrome de Sjogren/tratamento farmacológico , Células Th17/efeitos dos fármacos , Corticosteroides/uso terapêutico , Adulto , Antígenos CD20/genética , Complexo CD3/genética , Complexo CD3/imunologia , Antígenos CD4/genética , Antígenos CD4/imunologia , Antígenos CD8/genética , Antígenos CD8/imunologia , Dexametasona/análogos & derivados , Dexametasona/uso terapêutico , Feminino , Expressão Gênica , Humanos , Interleucina-17/genética , Pessoa de Meia-Idade , Projetos Piloto , Cultura Primária de Células , Glândulas Salivares/efeitos dos fármacos , Glândulas Salivares/imunologia , Glândulas Salivares/patologia , Síndrome de Sjogren/genética , Síndrome de Sjogren/imunologia , Síndrome de Sjogren/patologia , Células Th17/imunologia , Células Th17/patologia
7.
Reumatismo ; 68(4): 167-175, 2016 12 31.
Artigo em Inglês | MEDLINE | ID: mdl-28299914

RESUMO

The etiopathogenesis of rheumatoid arthritis (RA) is not yet fully elucidated and the site of inflammation onset is still a matter of debate. The presence of autoantibodies as well as clinical manifestations, such as interstitial lung disease, before the onset of arthritis seems to be in favour of the hypothesis that initial pathogenic events take place in tissues other than the joint. In this review article we summarize the most recent literature on extra-synovial autoimmunity triggers eventually leading to RA, with particular focus on the role of the lung. To date, anti-cyclic citrullinated peptide antibodies (ACPAs) are considered central players in RA pathogenesis and represent the gold-standard for disease diagnosis. Lungs and mucosae are exposed to environmental stimuli such as dusts and smoke which have been shown to foster citrullination of peptides in lungs thereby triggering the production of ACPA. In addition, other mechanisms of disease pathogenesis independent of citrullination play an important role. Deeper knowledge of these processes could represent a huge step forward in the management of RA, with dramatic impact on diagnosis, prevention, prognostic stratification and treatment of the disease.


Assuntos
Artrite Reumatoide/patologia , Doenças Pulmonares Intersticiais/patologia , Autoanticorpos , Citrulina , Humanos , Prognóstico
9.
J Intern Med ; 278(2): 185-92, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25582881

RESUMO

OBJECTIVE: Systemic autoimmune diseases, in particular systemic lupus erythematosus and rheumatoid arthritis, are characterized by a high risk of premature cardiovascular (CV) events. Disease-related characteristics and traditional CV disease risk factors may contribute to atherosclerotic damage. However, there are limited data on the risk of overt CV events in primary Sjögren's syndrome (pSS). METHODS: We retrospectively analysed a cohort of patients with 1343 pSS. Disease-related clinical and laboratory data, traditional CV disease risk factors and overt CV events were recorded. Prevalence of traditional CV disease risk factors and of major CV events was compared between a subgroup of 788 female patients with pSS aged from 35 to 74 years and 4774 age-matched healthy women. RESULTS: Hypertension and hypercholesterolaemia were more prevalent, whereas smoking, obesity and diabetes mellitus were less prevalent, in women with pSS than in control subjects. Cerebrovascular events (2.5% vs. 1.4%, P = 0.005) and myocardial infarction (MI) (1.0% vs. 0.4%, P = 0.002) were more common in patients with pSS. In the whole population, central nervous system involvement (odds ratio (OR) 5.6, 95% confidence interval (CI) 1.35-23.7, P = 0.02) and use of immunosuppressive therapy (OR 1.9, 95% CI 1.04-3.70, P = 0.04) were associated with a higher risk of CV events. Patients with leucopenia had a higher risk of angina (P = 0.01). CONCLUSIONS: pSS is associated with an increased risk of cerebrovascular events and MI. Disease-related clinical and immunological markers may have a role in promoting CV events.


Assuntos
Doenças Cardiovasculares/epidemiologia , Medição de Risco/métodos , Síndrome de Sjogren/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Feminino , Seguimentos , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Síndrome de Sjogren/epidemiologia , Adulto Jovem
10.
Lupus ; 24(3): 315-20, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25297554

RESUMO

OBJECTIVE: The objective of this report is to investigate the prognostic value of minor salivary glands (MSG) assessment, routinely performed with hematoxilin-eosin (H&E) staining, for the diagnosis of primary Sjögren's syndrome (pSS). METHODS: We retrospectively evaluated clinical, serological and histological features of 794 pSS patients. H&E-stained sections were assessed using the Chisholm and Mason grading system and/or the focus score (FS). RESULTS: FS allowed the identification of a number of differences in the disease spectrum, and its prognostic role was further confirmed by quantifying the association between FS value and clinical/serological variables with binary logistic regression. Moreover, hypocomplementemia and FS resulted the only variables associated with lymphoma at univariate analysis, and FS appeared to be associated with lymphoma independently on complement fraction concentrations. Conversely, when patients were divided according to the Chisholm and Mason grading system, we failed to observe any significant difference between subgroups. CONCLUSION: In addition to its diagnostic role, our data seem to support that the routine assessment of MSG-FS with H&E staining is useful to predict at the time of diagnosis the adverse outcomes, such as lymphoma and extraglandular manifestations, that complicate the pSS course. On this basis, it should be recommended that an MSG biopsy be performed even in those patients displaying clinical and serological criteria, allowing the diagnosis of pSS independent of histological status.


Assuntos
Glândulas Salivares/patologia , Síndrome de Sjogren/patologia , Estudos Transversais , Amarelo de Eosina-(YS) , Feminino , Hematoxilina , Humanos , Masculino , Análise Multivariada , Prognóstico , Estudos Retrospectivos
11.
Scand J Rheumatol ; 44(1): 36-41, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25268749

RESUMO

OBJECTIVES: To determine the clinical and laboratory differences between cryoglobulinaemic and hypergammaglobulinaemic purpura in primary Sjögren's syndrome (pSS), in a large Italian multicentre cohort. METHOD: Patients were selected according to the following criteria: fulfilling the American-European classification criteria for pSS, serum cryoglobulin and gammaglobulin levels evaluated, and lack of hepatitis C virus (HCV) infection. Multinomial analyses were performed by distinguishing three groups of pSS: (i) purpura associated with cryoglobulinaemic vasculitis (CV), (ii) purpura associated with hypergammaglobulinaemic vasculitis (HGV), and (iii) pSS patients without purpura (pSS controls). Patients with purpura but without cryoglobulins or hypergammaglobulinaemia were excluded. RESULTS: A total of 652 patients were enrolled in this study. Group 1/CV comprised 23/652 patients (3.53%), group 2/HGV 40/652 patients (6.13%), and group 3/pSS controls 589/652 (90.34%). The three groups were found to be significantly different from each other (post-estimation test: group 1/CV vs. group 3/pSS controls: p < 0.0001; group 1/CV vs. group 2/HGV: p = 0.0001; group 2/HGV vs. group 3/pSS controls: p = 0.0003), thus confirming the different phenotypes of purpura in pSS.Multivariate analyses revealed that peripheral neuropathy (p < 0.001), low C4 (p < 0.001), leucopaenia (p = 0.01), serum monoclonal component (p = 0.02), and the presence of anti-SSB/La antibodies (p = 0.02) characterized CV whereas rheumatoid factor (p = 0.001), leucopaenia (p = 0.01), serum monoclonal component (p = 0.01), and anti-SSA/Ro antibodies (p = 0.049) were significantly associated with HGV. Lymphoma was associated only with CV. CONCLUSIONS: HGV is a cutaneous vasculitis, related to a benign B-cell proliferation, whereas CV is a systemic immune complex-mediated vasculitis with complement activation and a higher risk of lymphoma, thus confirming CV but not HGV as a prelymphomatous condition in pSS.


Assuntos
Crioglobulinemia/imunologia , Púrpura Hiperglobulinêmica/imunologia , Síndrome de Sjogren/imunologia , Adulto , Complexo Antígeno-Anticorpo/imunologia , Linfócitos B/imunologia , Estudos Transversais , Crioglobulinemia/sangue , Feminino , Humanos , Itália , Linfoma/sangue , Linfoma/imunologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Lesões Pré-Cancerosas/sangue , Lesões Pré-Cancerosas/imunologia , Prognóstico , Púrpura Hiperglobulinêmica/sangue , Estudos Retrospectivos , Síndrome de Sjogren/sangue , Vasculite/sangue , Vasculite/imunologia
12.
Reumatismo ; 67(3): 85-90, 2015 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-26876186

RESUMO

The interferon (IFN) signature, namely the overexpression of IFN-inducible genes is a crucial aspect in the pathogenesis of primary Sjögren's syndrome (pSS). The IFN-inducible IFI16 protein, normally expressed in cell nuclei, may be overexpressed, mislocalized in the cytoplasm and secreted in the extracellular milieu in several autoimmune disorders including pSS. This leads to tolerance breaking to this self-protein and development of anti-IFI16 antibodies. The aim of this study was to identify pathogenic and clinical significance of IFI16 and anti-IFI16 autoantibodies in pSS. IFI16 and anti-IFI16 were assessed in the serum of 30 pSS patients and one-hundred healthy donors (HD) by ELISA. IFI16 was also evaluated in 5 minor salivary glands (MSGs) of pSS patients and 5 MSGs of non-pSS patients with sicca symptoms by immunohistochemistry. Normal MSGs do not constitutively express IFI16. Conversely, in pSS-MSGs a marked expression and cytoplasmic mislocalization of IFI16 by epithelial cells was observed with infiltrations in lymphocytes and peri/ intra-lesional endothelium. pSS patients display higher serum levels of both IFI16 and anti-IFI16 autoantibodies compared to HD. Our data suggest that IFI16 protein may be involved in the initiation and perpetuation of glandular inflammation occurring in pSS.


Assuntos
Proteínas da Matriz Extracelular/imunologia , Interferon gama/imunologia , Proteínas Nucleares/imunologia , Fosfoproteínas/imunologia , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/imunologia , Autoanticorpos/sangue , Biomarcadores/sangue , Estudos de Casos e Controles , Proteínas da Matriz Extracelular/sangue , Feminino , Humanos , Pessoa de Meia-Idade , Proteínas Nucleares/sangue , Fosfoproteínas/sangue , Valor Preditivo dos Testes , Saliva/metabolismo , Glândulas Salivares Menores/imunologia , Sensibilidade e Especificidade , Síndrome de Sjogren/sangue
13.
Lupus ; 23(13): 1337-49, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25096066

RESUMO

Primary Sjögren's syndrome (pSS) is an autoimmune disorder affecting exocrine glands and characterized in most cases by a rather mild clinical picture. However, a subgroup of pSS patients experience systemic extraglandular involvement leading to a worsening of disease prognosis. Current therapeutic options for the treatment of pSS are mainly empirical, often translated by other autoimmune diseases, and recent systematic reviews have highlighted the lack of evidence-based recommendations for most of the drugs commonly employed in the spectrum of extraglandular involvement. Because of the well-established role of B-lymphocytes in the pathogenesis of pSS, a B-cell targeting therapy may represent a new and intriguing therapeutic approach; in this context, growing evidence suggests that B-cell depletion by rituximab (RTX) is also effective in pSS. Of interest, besides clinical efficacy, RTX also showed biologic effects, consistently affecting the inflammation and the lymphoid organization that occur in target tissue. Moreover, the good results observed in the published trials after RTX treatment in pSS should represent the starting point to develop evidence-based guidelines for the use of biologic therapy in this disease.


Assuntos
Anticorpos Monoclonais Murinos/uso terapêutico , Linfócitos B/efeitos dos fármacos , Fatores Imunológicos/uso terapêutico , Síndrome de Sjogren/tratamento farmacológico , Humanos , Contagem de Linfócitos , Rituximab
14.
Lupus ; 20(9): 928-35, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21613330

RESUMO

High levels of serum and/or plasma circulating DNA (cDNA) have been described in patients with systemic autoimmune diseases (SADs). However, the role of this molecule has not been clarified. Our aim was to evaluate plasma cDNA levels in 48 systemic lupus erythematosus (SLE) and 44 primary Sjögren's syndrome (SS) patients, as compared with healthy and rheumatoid arthritis (RA) subjects, and to analyse their correlation with disease activity, disease damage and clinical manifestations. Plasma DNA was extracted using Qiagen columns and quantified by real-time quantitative PCR. Disease activity and damage were evaluated in both diseases by analysis of clinical and laboratory findings. Our results showed that plasma cDNA levels were significantly higher in patients with SS (mean ± SE: 32.0 ± 7.3 ng/ml) and with SLE (35.0 ± 9.0 ng/ml) than in controls (5.1 ± 1.1 ng/ml) (p < 0.0001 for both). Disease activity index correlated with cDNA levels in SS (p = 0.02), but not in SLE, and SS subjects with active disease displayed significantly higher cDNA levels with respect to inactive patients (p < 0.05). No correlation was found between plasma cDNA levels and disease damage indexes in either SLE or SS. These results indicate that increased plasma cDNA levels can been demonstrated in SLE and in SS patients with respect to healthy subjects. Interestingly, although cDNA levels did not correlate with indexes of disease damage in these disorders, a significant correlation between cDNA concentrations and disease activity was observed in SS, but not in SLE, suggesting a possible role of cDNA as non-invasive marker of disease activity. The different results obtained in these SADs may be explained by distinct disease pathogenesis or the influence of immunosuppressive and corticosteroid therapy that, unlike in SS, is usually employed in SLE.


Assuntos
Biomarcadores/sangue , DNA/sangue , Síndrome de Sjogren , Adulto , Artrite Reumatoide/sangue , Artrite Reumatoide/genética , Artrite Reumatoide/fisiopatologia , Progressão da Doença , Feminino , Humanos , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/genética , Lúpus Eritematoso Sistêmico/fisiopatologia , Masculino , Pessoa de Meia-Idade , Síndrome de Sjogren/sangue , Síndrome de Sjogren/genética , Síndrome de Sjogren/fisiopatologia
16.
High Blood Press Cardiovasc Prev ; 24(4): 353-361, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28597352

RESUMO

Chronic inflammatory diseases (CID) are characterized by an increased risk of cardiovascular (CV) morbidity and mortality. Several mechanisms, including early acceleration of subclinical atherosclerotic damage, inflammatory markers and immune system deregulation factors, have been demonstrated to strictly interplay for development and progression of atherosclerosis. Moreover, traditional CV risk factors are likely to explain at least some of the excess of CV risk in these patients. Among traditional CV risk factors, compelling evidence suggests a higher incidence and prevalence of hypertension in patients with CID in comparison to the general population. Moreover, hypertension represents an important predictor of CV events in these patients. Pathogenic mechanisms underlying the rise of blood pressure in CID are multifactorial and still poorly investigated. Indeed, multiple disease-related factors may affect blood pressure control in these patients and hypertension may affect disease prognosis and increase CV risk. Better knowledge of the complex interplay between hypertension and CID will be important to elucidate pathogenic mechanisms and to improve CV outcome in these patients. Aim of this review is to highlight available evidence on the relationship between hypertension and CID and to elucidate the multiple factors that may affect blood pressure control in these disorders.


Assuntos
Pressão Sanguínea , Hipertensão/epidemiologia , Inflamação/epidemiologia , Adulto , Idoso , Doença Crônica , Feminino , Humanos , Hipertensão/imunologia , Hipertensão/mortalidade , Hipertensão/fisiopatologia , Incidência , Inflamação/imunologia , Inflamação/mortalidade , Inflamação/fisiopatologia , Mediadores da Inflamação/imunologia , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Medição de Risco , Fatores de Risco , Transdução de Sinais
17.
Clin Exp Rheumatol ; 21(6): 771-8, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14740459

RESUMO

Circulating autoantibodies against ribosomal proteins characterise a subset of patients with systemic lupus erythematosus. Following the identification of three phosphorylated proteins as the main ribosomal autoantigens recognised by these autoantibodies, several studies have been carried out in the last decade to set up a reliable and sensitive method of detecting anti-ribosome autoantibodies and disclosing their possible clinical relevance in the diagnosis and monitoring of symptoms and signs of the disease. Although a number of clinical associations have been proposed, contrasting results have emerged from these investigations. This review analyses the methodological problems linked with the various techniques used to detect anti-ribosome antibodies and provides a critical update of the clinical associations described in lupus patients to date.


Assuntos
Anticorpos Anti-Idiotípicos/imunologia , Autoantígenos/imunologia , Lúpus Eritematoso Sistêmico/imunologia , Proteínas Ribossômicas/imunologia , Anticorpos Anti-Idiotípicos/análise , Autoantígenos/análise , Biomarcadores/análise , Progressão da Doença , Feminino , Seguimentos , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico , Masculino , Prognóstico , Sensibilidade e Especificidade , Índice de Gravidade de Doença
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