Study On The Relationship Between Autoantibodies And Clinical Phenotype In Systemic Sclerosis

Objective(s): By analyzing the relationship between systemic sclerosis(SSc)specific autoantibodies and their phenotypes,we investigated the value of SSc specific autoantibodies in predicting organ involvement,evaluating disease,and predicting prognosis.Methods: A total of 116 patients with SSc from the rheumatology and Immunology Department of the First People’s Hospital of Yunnan Province from December 2020 to December 2022 were selected.The general information,clinical phenotype and laboratory indicators of the patients were retrospectively analyzed,and statistical methods such as Chi-square test,Mann-Whitney U test and logistic regression analysis were used for analysis.Results:1.A total of 116 patients with SSc were included in this study,including 29 males and 87 females.Male: Female =1:3,diffuse cutaneous SSc(dc SSc)65 cases(56.03%),limited cutaneous SSc(lc SSc)51 cases(43.97%),dc SSc: lc SSc≈1.27:1,in which male patients showed more dc SSc(22/29 cases).2.There were 58 SSc patients with anti topoisomerase I antibody positive(anti Scl-70 antibody or ATA),including 39 cases of dc SSc(67.24%)and 19 cases of lc SSc(32.76%).There were 58 SSc patients with ATA negative,including 26 cases of dc SSc(44.83%)and 32 cases of lc SSc(55.17%).There was significant difference in clinical classification between the two groups(P<0.05).There was no significant difference in gender,ethnicity,age,onset age and course of disease between the two groups(P>0.05).3.Among the patients with ATA positive SSc,there were 43 patients(74.14%)complicated with Interstitial lung disease(ILD)and 22 patients(37.93%)complicated with digital ulcers(DUs),which were significantly different in ILD and DUs with ATA negative SSc(P<0.05).There was no significant difference in other microvascular lesions,heart,gastrointestinal tract,kidney,joint and muscle involvement between the two groups(P>0.05).4.In SSc patients with ATA positive,red blood cell distribution width(RDW),blood sedimentation rate(ESR),immunoglobulin G(Ig G)and low density lipoprotein cholesterol(LDL)levels were higher than those of the ATA negative SSc patients(P<0.05).In SSc patients with ATA positive,the levels of complement C3 and albumin(ALB)were lower than those of the ATA negative SSc patients(P<0.05).There was no significant difference in thyroid function,renal function,creatine kinase,tumor markers,or coagulation function between the two groups(P>0.05).5.By multivariate regression analysis,the results showed that:ATA positive is positively correlated with ILD(OR 3.212;95%CI 1.373,7.516),DUs(OR 3.704;95%CI1.379,9.950)and Ig G(OR1.113;95% CI 1.002,1.236),and negatively correlated with complement C3(OR 0.066;95%CI 0.007,0.609).6.There is no significant difference in general information and clinical phenotype between ATA single positive group and ATA and ACA coexisting group(P>0.05).There is significant difference in ILD between anti centromere antibody(ACA)single positive group and ATA and ACA coexisting group(P<0.05).Conclusion(s):1.Compared with patients with ATA negative SSc,patients with ATA positive SSc have more diffuse cutaneous systemic sclerosis as the clinical classification,which is more likely to be accompanied by pulmonary fibrosis and finger ulcers.On laboratory indicators,patients are more likely to suffer from blood sedimentation rate,red blood cell distribution width,immunoglobulin G,and low density lipoprotein cholesterol increase,as well as complement C3 and albumin decrease.2.Multivariate regression analysis showed that ATA positivity was an independent factor affecting pulmonary fibrosis,digital ulcers,immunoglobulin G and complement C3.3.Compared with SSc patients with ACA single positive,SSc patients with ATA and ACA are more likely to have pulmonary interstitial fibrosis.