The role of anti-ribosomal P autoantibodies in the prediction of neuropsychiatric damage in systemic lupus erythematosus based on CSTAR cohort (XIV)

• Published in: Clinical rheumatology Vol. 41; no. 5; pp. 1371 - 1379
• Main Authors: Ding, Yufang, Zhao, Jiuliang, Qian, Junyan, Zhang, Li, Zhang, Shangzhu, Jiang, Nan, Li, Jing, Wu, Chanyuan, Wu, Qingjun, Xu, Dong, Leng, Xiaomei, Wang, Qian, Zhang, Wen, Tian, Xinping, Li, Mengtao, Zeng, Xiaofeng
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.05.2022; Springer Nature B.V
• Subjects: Antibodies; Autoantibodies; Cohort Studies; Humans; Lupus; Lupus Erythematosus, Systemic - diagnosis; Medicine; Medicine & Public Health; Neurological complications; Original Article; Patients; Prospective Studies; Registries; Rheumatology; Systemic lupus erythematosus; Anti-RibP antibody; Autoantibodies; Systemic lupus erythematosus; Organ damage
• ISSN: 0770-3198; 1434-9949; 1434-9949
• DOI: 10.1007/s10067-021-06034-6

Objectives To identify the predictive value of anti-ribosomal P protein (anti-RibP) antibodies on the accrual of neuropsychiatric damage in systemic lupus erythematosus (SLE) patients in a large cohort in the Chinese SLE Treatment and Research group (CSTAR) database. Methods This single-center prospective study was conducted based on data from the CSTAR registry. At baseline, we collected demographic characteristics, autoantibody profiles, clinical manifestations, disease activity status, and organ damage. Follow-up data were collected by reviewing clinical records and telephone interviews. Anti-RibP antibodies were identified by immunoblot containing all three native RibP (P0, P1, P2) antigenic proteins. Results Of 2395 SLE patients with complete follow-up data, 659 (27.5%) were anti-RibP antibody positive. At baseline, positive anti-RibP antibodies were associated with a higher proportion of neurological involvement (𝑃 < 0.05). During follow-up, patients with positive anti-RibP antibodies were more likely to accumulate neuropsychiatric damage (adjusted HR = 3.8, 95% CI 2.7–57), p < 0.001). What is more, the cumulative probability of new-onset neurological involvement increased gradually in anti-RibP antibody–positive patients. Conclusion Anti-RibP antibodies can provide information about not only organ involvement at baseline, but also neuropsychiatric damage accrual and new-onset neurological involvement during follow-up. We suggested that anti-RibP antibody detection should be done in the newly diagnosed SLE patients to predict organ involvement and even the accumulation of neuropsychiatric damage. Key Points • Positive anti-RibP antibodies were associated with baseline neurological involvement. • Baseline positive anti-RibP antibodies can predict the neuropsychiatric damage accrual and new-onset neurological involvement.