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Systemic Lupus Erythematosus (SLE)
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
Clinically, most patients with this syndrome suffer from polyarthralgias and systemic symptoms. They do not experience renal and CNS involvement. Their pattern of auto-antibodies is distinctive in that they are all ANA positive with anti-histone antibodies present in the majority (95%). Anti-dsDNA antibodies are absent.
Infliximab
Published in John Y. M. Koo, Ethan C. Levin, Argentina Leon, Jashin J. Wu, Alice B. Gottlieb, Moderate to Severe Psoriasis, 2014
Ethan C. Levin, John Y. M. Koo, Alice B. Gottlieb
Autoantibodies/Lupus-Like Syndrome Infliximab therapy is associated with the development of autoantibodies, including anti-nuclear (ANA), anti-double-stranded DNA (anti-dsDNA), and anti-nucleosome antibodies [52]. This has been reported in multiple disease states, including psoriasis, psoriatic arthritis, Crohn’s disease, and rheumatoid arthritis [53–55]. Although many patients on infliximab develop autoantibodies, it is rarely associated with the onset of systemic lupus erythematosus (SLE) [56,57]. Moreover, anti-histone antibodies, which are often positive in drug-induced lupus, are rarely detected [58]. The clinical significance of these antibodies is not fully understood. Some studies have shown an association between the development of antinuclear antibodies and loss of response to infliximab [44,54,55]; other studies have failed to confirm this association [52].
Significance of co-positivity for anti-dsDNA, -nucleosome, and -histone antibodies in patients with lupus nephritis
Published in Annals of Medicine, 2023
Sung-Eun Choi, Dong-Jin Park, Ji-Hyoun Kang, Shin-Seok Lee
Autoantibodies in SLE have diagnostic relevance and are associated with certain clinical manifestations and disease activity [4]. In particular, several autoantibodies play a role in the development and progression of LN. Pathological analyses of renal tissues have identified autoantibodies targeted against antigens such as DNA, histone and nucleosome [5,6]. The existence of anti-dsDNA, anti-nucleosome and/or anti-histone antibodies is associated with proliferative glomerulonephritis and LN activity [7–9]. An association of the presence of a single autoantibody type with the development of LN has been demonstrated in LN patients, and the presence of multiple autoantibodies has been suggested in the development and progression of LN. The coexistence of anti-dsDNA, anti-nucleosome and anti-histone antibodies is frequently observed in LN patients, and simultaneous positivity for these autoantibodies is presumed to have a greater risk of developing proliferative form of LN and worse renal outcome compared to single positivity. Thus, we explored whether LN patients with co-positivity with anti-dsDNA, anti-nucleosome, and anti-histone (3-pos) antibodies have higher disease activity and more active renal histopathology than those without co-positivity. We also evaluated whether the higher global and renal activity is associated with a worse renal outcome.
Clinical use of anti-histone antibodies in idiopathic and drug-induced lupus
Published in Immunological Medicine, 2022
Histones may become ‘exposed’ through the formation of apoptotic blebs or neutrophil extracellular traps (NETs) [5]. Either through excess formation, reduced clearance and/or post-translational modification, histones may become immunogenic [6,7]. Furthermore, recent attention has turned to the role of epigenetic modifications of these proteins in the rendering of immunogenicity and hence, the formation of anti-histone antibodies (AHAs) [8,9]. Deliberate post-translational modification of histones may be done therapeutically in inflammatory disorders. Murine systemic lupus erythematosus (SLE) models injected with an inhibitor of histone deacetylase attenuated renal pathology compared to a vehicle control [10]. This may be through, in part, the reduction of autoreactive plasma cells and autoantibodies [11].
Cutaneous lupus erythematosus induced by drugs - novel insights
Published in Expert Review of Clinical Pharmacology, 2020
Robert Borucki, Victoria P. Werth
DI-SCLE is associated with positive antinuclear antibodies anti-Ro/SS-A and anti-La/SS-B antibodies, just as idiopathic SCLE [1,3,10,11]. Anti-histone antibodies are commonly found with DI-SLE but less frequently with DI-SCLE[12]. Laurinaviciene et al (2017) found that 8 of 46 patients with DI-CLE tested for anti-histone antibodies were positive. Interestingly, of these eight patients, four had a prior diagnosis of SLE. A review by Lowe et al (2011) found anti-histone antibodies in one-third of DI-CLE cases that tested for it[3]. There is also a distinct genetic association with HLA haplotypes A1, B8, and DR3 [13,14]. There are a broad range of histopathologic features found in SCLE, including interface dermatitis, apoptosis, basement membrane thickening, and dermal mucin[15]. Immune complex deposition can also be seen at the dermoepidermal junction, which is indistinguishable from idiopathic SCLE[16].