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Immunoserological parameters in SLE: high-avidity anti-dsDNA detected by ELISA are the most closely associated with the disease activity

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Abstract

We assessed the relationship between the serum levels of antibodies against double-stranded DNA (dsDNA), C1q, nucleosomes, histones, C3 and C4 complement components with one another, with organ involvement and overall disease activity in patients with systemic lupus erythematosus (SLE). One hundred seventy-five sera from 99 patients with SLE, 31 sera of patients with other connective tissue diseases, and 20 sera from healthy blood donors were tested. SLE disease activity was assessed by modified SLEDAI-2K (M-SLEDAI-2K), not including complement and anti-dsDNA descriptors. Anti-dsDNA antibodies were measured by indirect immunofluorescence on Crithidia luciliae (CLIFT), standard enzyme-linked immunosorbent assay (ELISA) and ELISA for high-avidity antibodies. The most significant risk factor for renal involvement were anti-C1q antibodies (OR = 3.88, p < 0.05), high-avidity anti-dsDNA antibodies for polyserositis (OR = 7.99, p < 0.01), anti-histone antibodies for joint involvement (OR = 2.75, p < 0.05), and low C3 for cytopenia (OR = 11.96, p < 0.001) and mucocutaneous lesions (OR = 3.32, p < 0.01). Multiple linear regression analysis showed that disease activity in SLE could be predicted by the levels of antibodies against dsDNA determined by standard (p < 0.05) and high-avidity (p < 0.001) ELISA, and inversely associated with concentration of C3 (p < 0.001). Using stepwise method, high-avidity anti-dsDNA antibodies were found to be in the closest association to M-SLEDAI-2K. Moreover, positive test for high-avidity anti-dsDNA antibodies appeared as an independent risk factor for moderately to severely active disease (M-SLEDAI-2K>5) (OR = 5.5, p < 0.01). The presence of high-avidity anti-dsDNA antibodies represented a risk for renal, joint, and most importantly for serosal involvement. Our results suggest that simple and reliable ELISA for high-avidity anti-dsDNA antibodies is the test of good clinical utility for the assessment of global SLE activity.

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Acknowledgments

This study was supported, in part, by the Ministry of Science of the Republic of Serbia, grant no. 175065

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Authors and Affiliations

  1. Clinic of Allergy and Immunology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Koste Todorovica 2, 11000, Belgrade, Serbia

    Sladjana Andrejevic & Branka Bonaci-Nikolic

  2. Institute of Rheumatology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Ivica Jeremic & Mirjana Sefik-Bukilica

  3. Institute of Biochemistry, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Ivica Jeremic

  4. Clinic of Dermatovenereology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Milos Nikolic

  5. Clinic of Nephrology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Biljana Stojimirovic

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  1. Sladjana Andrejevic
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Correspondence to Sladjana Andrejevic.

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Sladjana Andrejevic and Ivica Jeremic contributed equally to this work and should be considered co-first authors

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Andrejevic, S., Jeremic, I., Sefik-Bukilica, M. et al. Immunoserological parameters in SLE: high-avidity anti-dsDNA detected by ELISA are the most closely associated with the disease activity. Clin Rheumatol 32, 1619–1626 (2013). https://doi.org/10.1007/s10067-013-2330-3

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