Anti–DNase I Antibody: A New Serological Reactivity in Primary Sjögren Syndrome

BACKGROUND AND OBJECTIVEPrimary Sjögren syndrome (pSS) is a systemic autoimmune rheumatic disease that particularly affects exocrine glands. Dry eye is one of the most important features of this syndrome, and a recent study reported reduced deoxyribonuclease I (DNase I) activity in the tear of patie...

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Published in:	Journal of clinical rheumatology Vol. 26; no. 1; pp. 19 - 23
Main Authors:	Griffo, Priscilla, Viana, Vilma V. S. T., Pasoto, Sandra G., Leon, Elaine P., Bonfa, Eloisa
Format:	Journal Article
Language:	English
Published:	United States Lippincott Williams & Wilkins 01-01-2020 Copyright Wolters Kluwer Health, Inc. All rights reserved
Subjects:	Adult Age Factors Antibodies, Anti-Idiotypic - analysis Antibodies, Anti-Idiotypic - immunology Autoantibodies - immunology Autoimmune Diseases - diagnosis Cross-Sectional Studies Deoxyribonuclease I - immunology Dry Eye Syndromes - diagnosis Dry Eye Syndromes - immunology Enzyme-Linked Immunosorbent Assay - methods Female Humans Immunoglobulin G - blood Incidence Logistic Models Male Middle Aged Multivariate Analysis Prognosis Risk Assessment Severity of Illness Index Sex Factors Sjogren's Syndrome - immunology Sjogren's Syndrome - physiopathology
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Summary:	BACKGROUND AND OBJECTIVEPrimary Sjögren syndrome (pSS) is a systemic autoimmune rheumatic disease that particularly affects exocrine glands. Dry eye is one of the most important features of this syndrome, and a recent study reported reduced deoxyribonuclease I (DNase I) activity in the tear of patients with dry eye. We therefore postulated that patients with pSS might have antibodies targeting DNAse I. METHODSWe have evaluated in a cross-sectional study 85 patients with pSS (2002 American-European Consensus Group Criteria), 50 rheumatoid arthritis (RA) patients (1987 American College of Rheumatology Criteria) without sicca symptoms, and 88 healthy volunteers. IgG anti–DNase I was detected by enzyme-linked immunosorbent assay using as antigen bovine pancreas enzyme and confirmed by immunoblotting. RESULTSAge and sex were alike in the 3 groups (p > 0.05). Anti–DNase I was detected in 43.5% of the pSS patients. In contrast, this reactivity was absent in all RA patients (p = 0.0001). Additional comparison of pSS patients with (n = 37) or without (n = 48) anti–DNase I showed that the former group had higher IgG serum levels (2293.2 ± 666.2 vs 1483.9 ± 384.6 mg/dL, p = 0.0001) and greater rate of non–drug-induced leukopenia (43% vs 19%, p = 0.02). A multivariate logistic regression analysis identified that only IgG levels were independently associated with anti–DNase I. CONCLUSIONSWe describe a high frequency of anti–DNase I antibodies in pSS patients associated with higher serum IgG levels. The lack of this reactivity in RA patients without sicca symptoms suggests that this antibody may be helpful in the differential diagnosis of these diseases.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1076-1608 1536-7355
DOI:	10.1097/RHU.0000000000000905