A Long-term Follow-up of Autoantibodies in Systemic Lupus Erythematosus Patients

To evaluate the changes of antinuclear antibody(ANA)and other autoantibodies in patients with systemic lupus erythematosus(SLE),and the relationship between autoantibodies and disease activity. Methods ANA was tested in 71 active SLE patients at time of diagnosis(TD)and during follow-up.Other autoantibodies were examined in most patients including anti-dsDNA,anti-Sin,anti-RNP,anti-SSA/Ro,and anti-SSB/La antibodies.Disease activity was also assessed by SLE disease activity index.Result Patients were followed up from 6 months to 12 years.For ANA,during follow-up,23 of 71 patients(32.4%) changed to negative.Among 71 cases,the long-term analysis revealed a decrease in the prevalence of ANAs(TD:100%;follow-up:52.6%),anti-dsDNA antibody(TD:61.9%;follow-up:22.6%),and anti-Sin antibody(TD:27.8%;follow-up:17.5%)over time.Among these 23 ANA negative cases,18 were in disease remission,5 cases were still in active stage.Particularly,autoantibodies in 3 severe SLE patients turned to be negative before their death.The ratio of disease remission of ANA negative patients (78.3%)was significantly higher than ANA positive patients(43.8%,X~2=7.480,P=0.006).Positive correlation was found between change of ANA to negative and neuropsyehiatrie SLE(r=-0.250,P=0.036). Conclusions Our results have demonstrated that positivity of ANA is not completely associated with disease activity in SLE.With treatment,ANA may turn to be negative.Anti-Sm antibody may also turn to be negative.