The Effect of Anti-Scl-70 Antibody Determination Method on Its Predictive Significance for Interstitial Lung Disease Progression in Systemic Sclerosis.
The Effect of Anti-Scl-70 Antibody Determination Method on Its Predictive Significance for Interstitial Lung Disease Progression in Systemic Sclerosis.
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DOI：
10.1002/acr2.11398
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发表时间：
2022-04
影响因子：
3.4
通讯作者：
Assassi S
中科院分区：
文献类型：
--
作者：
Jandali B;Salazar GA;Hudson M;Fritzler MJ;Lyons MA;Estrada-Y-Martin RM;Charles J;Terracina KA;Mayes MD;Assassi S
本研究的目的是评估抗Scl-70（抗拓扑异构酶I）抗体对系统性硬化症（SSc）相关间质性肺疾病（ILD）患者第一年随访期间用力肺活量（FVC）下降的预测意义（通过三种不同方法测定）。对硬皮病结局研究中遗传与环境的比较队列中在入组时以及此后12 - 18个月内患有ILD（经影像学证实）和可用FVC%的患者进行了检查。所有患者在入组时的病程均为5年或更短。1年随访时FVC%的年百分比变化是结局变量。通过小牛胸腺提取物被动免疫扩散（ID）、荧光免疫测定（CIA）和线性印迹免疫测定（LIA）测定抗Scl-70抗体。纳入了91例患者，平均病程为2.36年。按ID列出的抗Scl-70抗体预测FVC%下降速度更快（B = −0.06，P = 0.04）。其他临床或血清学变量均不能显著预测ILD进展。有趣的是，CIA和LIA测定的抗Scl-70抗体并不是FVC下降的重要预测因素（分别为P = 0.26和0.64）。ID和LIA之间观察到的一致性水平为中等（κ = 0.568），而ID和CIA之间的一致性水平良好（κ = 0.66）。通过ID测定的抗Scl-70抗体预测SSc相关ILD患者的FVC下降更快。值得注意的是，相同抗体的CIA和LIA在其当前阳性临界值下均不能预测FVC下降率。抗Scl-70抗体检测之间观察到的差异可能对SSc-ILD的临床护理和试验富集策略具有相关意义。
The objective of this study was to assess the predictive significance of anti‐Scl‐70 (anti‐topoisomerase I) antibodies, as determined by three different methods, for decline in forced vital capacity (FVC) within the first year of follow‐up in patients with systemic sclerosis (SSc)‐related interstitial lung disease (ILD). Patients in the Genetics Versus Environment in Scleroderma Outcome Study cohort who had ILD (verified by imaging) and available FVC% at enrollment, plus 12 to 18 months thereafter, were examined. All patients had a disease duration of 5 years or less at enrollment. The annualized percentage change in FVC% at 1 year follow‐up was the outcome variable. Anti‐Scl‐70 antibodies were determined by passive immunodiffusion (ID) against calf thymus extract, chemiluminescent immunoassay (CIA), and line blot immunoassay (LIA). Ninety‐one patients with a mean disease duration of 2.36 years were included. Anti‐Scl‐70 antibodies by ID predicted a faster rate of FVC% decline (b = −0.06, P = 0.04). None of the other clinical or serological variables significantly predicted ILD progression. Interestingly, anti‐Scl‐70 antibodies as determined by CIA and LIA were not significant predictors of FVC decline (P = 0.26 and 0.64, respectively). The observed level of agreement between ID and LIA was moderate (κ = 0.568), whereas it was good between ID and CIA (κ = 0.66). Anti‐Scl‐70 antibodies determined by ID predicted faster FVC decline in patients with SSc‐related ILD. Notably, both CIA and LIA for the same antibody did not predict rate of FVC decline at their current cutoffs of positivity. The discrepancy observed between anti‐Scl‐70 antibody assays can have relevant implications for clinical care and trial enrichment strategies in SSc‐ILD.