The clinical significance of antibodies to ribosomal protein P (a-Rib-P) in patients with systemic lupus erythematosus and antiphospholipid syndrome

The aim – to determine the clinical significance of hyperproduction of antibodies to ribosomal protein P (a-Rib-P) in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS).

Material and methods. The study included 68 patients with reliable diagnoses of SLE and APS (SLE – 25, SLE+APS – 19, primary APS (PAPS) – 24). Young (35,1±10,2 years) women prevailed (72,1%). All patients were examined according to the standards recommended by the Association of Rheumatologists of Russia, and also examined by a psychiatrist. a-Rib-P was determined in all patients and 20 healthy donors, matched by gender and age, by enzyme immunoassay in blood serum.

Results. The concentration of a-Rib-P in patients was significantly higher than in healthy donors (0.004 [0.003; 0.015] vs 0.002 [0.002; 0.003] U/ml, respectively; p=0.002). Elevated a-Rib-P values were detected in 6 (13.6%) out of 44 patients with SLE, but were not detected in PAPS and in healthy donors. In patients with current neurological disorders (stroke/epilepsy/hyperkinesis), the concentration of a-Rib-P is statistically significantly higher than in their absence (0.004 [0.003; 0.021] vs 0.002 [0.002; 0.003] U/ml, respectively; p=0.001). The concentration of a-Rib-P is significantly higher in patients with SLE and elevated values of antibodies to double stranded DNA/anti-Smith antibodies (a-Sm), compared with those with normal values of these autoantibodies (0.005 [0.004; 0.106] vs 0.004 [0.002; 1.35], respectively; p=0.007 and 2.41 [0.058; 10.3] vs 0.005 [0.002; 0.012] U/ml, respectively; p=0.001). Patients with an increased a-Rib-P value had a significantly higher chance of skin (odds ratio (OR) – 17.0; p<0.001) lesions and a statistically insignificant – mucous lesions (OR=9.0), central nervous system lesion (OR=1.32), polyarthritis (OR=3.75), hematological imparements (OR=3.75), high SLE activity according to the SLEDAI-2K (Systemic Lupus Erythematosus Disease Activity Index 2000) (OR=4.33), bipolar affective disorder (OR=4.25), major depressive disorder (OR=1.4), elevated concentrations of a-Sm (OR=5.0), anti-cardiolipin/anti-β2 glycoprotein 1 antibodies (OR=2.61), anti-phosphatidylserine/prothrombin antibodies (OR=2.33) and anti-N-methyl-D-aspartate receptor antibodies (OR=2.2), as well as a high risk of thrombosis according to GAPSS (Global AntiphosPholipid Syndrome Score) (OR=3.77).

Conclusion. a-Rib-P are highly specific for patients with SLE and aren’t typical for patients with PAPS. They are associated with various clinical and laboratory manifestations of high SLE activity, primarily skin-mucosal, neurological, and immunological.

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