RMD open · 2025
Autoantibodies directed against the angiotensin II type 1 receptor and the endothelin-1 type A receptor in patients with systemic sclerosis.
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van der Wouden Katherine E, Ahmed Saad, van Oostveen Wieke M, Hoekstra Eva M, Liem Sophie I E, Huizinga Tom W J, Toes René E M, Voskuyl Alexandre E, Riemekasten Gabriela, Fehres Cynthia M, Vonk Madelon, de Vries-Bouwstra Jeska K
Аннотация
OBJECTIVES: To evaluate the clinical applicability of autoantibodies (AAbs) measured by ELISA against the angiotensin II type 1 receptor (AT1R) and endothelin-1 type A receptor (ETAR) in systemic sclerosis (SSc) patients.
METHODS: Serum samples from n=279 SSc patients from the Leiden Systemic Sclerosis cohort, n=42 patients with primary Raynaud's phenomenon, n=24 patients with rheumatoid arthritis and n=20 healthy controls were tested for anti-AT1R- and anti-ETAR AAbs. Levels were compared between groups with Mann-Whitney U tests or Kruskal-Wallis tests. Risk ratios and Kaplan-Meier analyses were used to determine associations between AAbs and disease manifestations or all-cause mortality. Analyses were repeated in an independent cohort with n=310 SSc patients from the Radboud University Medical Center.
RESULTS: AAbs against AT1R and ETAR could be detected by ELISA in the sera of all groups tested. Levels were slightly higher in the SSc group compared with the pooled non-SSc group (p=0.043). No associations could be found between anti-AT1R AAbs or anti-ETAR AAbs and disease manifestations or all-cause mortality. In the Radboud cohort, patients with diffuse cutaneous SSc (p=0.001) and interstitial lung disease (p=0.007) had higher median anti-ETAR AAb levels. Patients who died during follow-up had lower levels of anti-AT1R- (p=0.005) and anti-ETAR AAbs (p=0.020).
CONCLUSIONS: We confirm positive ELISAs for anti-AT1R AAbs and anti-ETAR AAbs in the sera of several patient groups and healthy controls. Previously described associations with disease manifestations and all-cause mortality could not be confirmed in our cohorts. Based on the current study, the determination of these AAbs is of limited predictive value in clinical practice.
METHODS: Serum samples from n=279 SSc patients from the Leiden Systemic Sclerosis cohort, n=42 patients with primary Raynaud's phenomenon, n=24 patients with rheumatoid arthritis and n=20 healthy controls were tested for anti-AT1R- and anti-ETAR AAbs. Levels were compared between groups with Mann-Whitney U tests or Kruskal-Wallis tests. Risk ratios and Kaplan-Meier analyses were used to determine associations between AAbs and disease manifestations or all-cause mortality. Analyses were repeated in an independent cohort with n=310 SSc patients from the Radboud University Medical Center.
RESULTS: AAbs against AT1R and ETAR could be detected by ELISA in the sera of all groups tested. Levels were slightly higher in the SSc group compared with the pooled non-SSc group (p=0.043). No associations could be found between anti-AT1R AAbs or anti-ETAR AAbs and disease manifestations or all-cause mortality. In the Radboud cohort, patients with diffuse cutaneous SSc (p=0.001) and interstitial lung disease (p=0.007) had higher median anti-ETAR AAb levels. Patients who died during follow-up had lower levels of anti-AT1R- (p=0.005) and anti-ETAR AAbs (p=0.020).
CONCLUSIONS: We confirm positive ELISAs for anti-AT1R AAbs and anti-ETAR AAbs in the sera of several patient groups and healthy controls. Previously described associations with disease manifestations and all-cause mortality could not be confirmed in our cohorts. Based on the current study, the determination of these AAbs is of limited predictive value in clinical practice.