Relationship between autoantibody clustering and clinical subsets in SLE: cluster and association analyses in Hong Kong Chinese
Relationship between autoantibody clustering and clinical subsets in SLE: cluster and association analyses in Hong Kong Chinese
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DOI：
10.1093/rheumatology/kes261
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发表时间：
2013-02-01
期刊：
影响因子：
5.5
通讯作者：
Lau, Yu-Lung
中科院分区：
文献类型：
--
作者：
Li, Philip Hei;Wong, Wilfred Hing Sang;Lau, Yu-Lung
Objective.本研究旨在探讨SLE患者中自身抗体簇的存在及其与临床亚型的关系。分析了1928例香港SLE患者的数据。使用聚类分析，将患者按自身抗体分组为簇。然后比较每个聚类之间各种临床表现的频率。在没有任何预先聚类的情况下，单独进行个体自身抗体与临床表现之间以及临床表现之间的关联分析。三个独立的自身抗体集群进行了鉴定，每个具有显着不同的临床表现。聚类1的特点是抗dsDNA和肾脏疾病的患病率最高，但其他临床表现的频率最低。第2类以抗Smith抗体、抗RNP抗体和aPL抗体为主，颧骨皮疹、口腔溃疡、关节炎和浆膜炎的患病率更高。第3组以抗Ro和抗La为特征，盘状皮疹、光敏性和血液学受累的患病率更高。个体关联分析也显示了类似的结果。聚类2和聚类3的患者关系更为密切，而聚类1的患者关系更为明显，仅与肾脏疾病相关，与其他临床表现呈负相关或不相关。我们的结论是，自身抗体聚集和临床亚型存在于我们的地方SLE患者。这些簇可被视为相关自身抗体和临床表现的双极谱。在一端是抗dsDNA和肾脏疾病的过度代表的患者，而在另一端是两个不同的自身抗体簇（抗Sm/抗RNP/aPL和抗Ro/抗La）与其他临床表现重叠。
Objective. This study aims to identify the existence of, and relationship between autoantibody clusters and clinical subsets in Chinese SLE patients.Methods. Data from 1928 SLE patients from Hong Kong were analysed. Using cluster analysis, patients were grouped by autoantibodies into clusters. The frequencies of various clinical manifestations were then compared between each cluster. Separate association analyses between individual autoantibodies and clinical manifestations as well as between clinical manifestations were also performed without any prior clustering.Results. Three separate autoantibody clusters were identified, each with significantly different clinical manifestations. Cluster 1 was characterized by anti-dsDNA and the greatest prevalence of renal disorder but the lowest frequencies of other clinical manifestations. Cluster 2 was represented by the predominance of anti-Smith, anti-RNP and aPL, with greater prevalence of malar rash, oral ulcers, arthritis and serositis. Cluster 3 was characterized by anti-Ro and anti-La with greater prevalence of discoid rash, photosensitivity and haematological involvement. Individual association analysis also revealed similar findings. Patients of clusters 2 and 3 were more closely related, while cluster 1 was more distinct, associated with renal disorder only and negatively associated or not associated with other manifestations.Conclusion. We conclude that autoantibody clustering and clinical subsets exist in SLE patients of our locality. These clusters may be viewed as a bipolar spectrum of related autoantibody and clinical manifestations. At one end are patients with over-representation of anti-dsDNA and renal disorder, while at the other end are two distinct autoantibody clusters (anti-Sm/anti-RNP/aPL and anti-Ro/anti-La) with overlapping of other clinical manifestations.