Journal
ARTHRITIS AND RHEUMATISM
Volume 58, Issue 2, Pages 541-546Publisher
WILEY-LISS
DOI: 10.1002/art.23191
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Funding
- NIAID NIH HHS [AI-071651, R01-AI-59893, L30 AI071651-01, R01 AI059893, L30 AI071651] Funding Source: Medline
- NIAMS NIH HHS [T32-AR-07517, T32 AR007517, N01AR42271] Funding Source: Medline
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Objective. The type I interferon (IFN) pathway is activated in many patients with systemic lupus erythematosus (SLE), and high serum levels of IFN are associated with anti-SSA/Ro autoantibodies. To investigate the clinical features associated with type I IFN production in vivo, we compared serum IFN activity in individuals with anti-SSA/Ro antibodies who were asymptomatic with that in individuals with clinical manifestations of SLE or Sjogren's syndrome (SS). Methods. Antibody-positive sera from 84 mothers of children with manifestations of neonatal lupus were studied for type I IFN activity, using a functional reporter cell assay. Maternal health status was characterized as asymptomatic, SS, SLE, pauci-SLE, or pauci-SS, based on a screening questionnaire, telephone interview, and review of medical records. The prefix pauci- indicates symptoms insufficient for a formal classification of the disease. Results. Only 4% of asymptomatic mothers had high serum type I IFN activity, compared with 73% with pauci-SLE (P = 5.7 X 10(-5)) 35% with SLE (P = 0.011), and 32% of patients with SS (P = 0.032). One of the 4 patients with pauci-SS had high levels of IFN. The majority of patients for whom longitudinal data were available had stable type I IFN activity over time, and changes in IFN activity were not clearly accompanied by changes in the clinical diagnosis. Conclusion. Patients with SLE, patients with pauci-SLE, and patients with SS are more likely to have high serum IFN activity than asymptomatic individuals with SSA/Ro autoantibodies, suggesting that these autoantibodies are insufficient for activation of the type I IFN pathway, and that disease-specific factors are important for type I IFN generation in vivo.
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