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Abstract Number: 0344

Anti-gAChR Antibody as a Novel Biomarker for Lupus Enteritis in Systemic Lupus Erythematosus

Kuniyuki Aso1, Michihito Kono1, Keita Ninagawa1, Nobuya Abe1, Yuichiro Fujieda1, Masaru Kato1, Olga Amengual1, Kenji Oku1 and Tatsuya Atsumi2, 1Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan, 2Hokkaido University, Sapporo, Japan

Meeting: ACR Convergence 2021

Keywords: Autoantibody(ies), Disease Activity, prognostic factors, Systemic lupus erythematosus (SLE)

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Session Information

Date: Saturday, November 6, 2021

Title: SLE – Diagnosis, Manifestations, & Outcomes Poster I: Diagnosis (0323–0356)

Session Type: Poster Session A

Session Time: 8:30AM-10:30AM

Background/Purpose: Anti-ganglionic nicotinic acetylcholine receptor (gAChR) antibody (Ab) is associated with widespread autonomic dysfunction in autoimmune autonomic ganglionopathy. Although it is also detected in several autoimmune diseases, including systemic lupus erythematosus (SLE), the clinical significance of anti-gAChR Ab remains unclear. The aim of this study was to compare the clinical manifestation of lupus patients with anti-gAChR Ab.

Methods: This retrospective study comprised adult patients with SLE who visited Hokkaido University Hospital from 2007 through 2019. A luciferase immunoprecipitation assay was performed to measure anti-gAChRα3 and β4 subunits Ab in the sera of these patients. The effect of immunosuppressants on anti-gAChR Ab levels was also evaluated. The Mann-Whitney U test was used for comparison of continuous data, while the Fisher’s exact test was used for comparison of categorical variables. Predictors affecting clinical manifestations were assessed by logistic regression analysis. The cumulative recurrence rate was estimated by Kaplan-Meier analysis.

Results: Overall, 144 patients with SLE were enrolled in this study. The clinical manifestations of these patients included lupus nephritis (45.8%), neuropsychiatric SLE (31.9%), antiphospholipid syndrome (22.2%), pericarditis and/or pleuritis (18.8%), and lupus enteritis (LE, 14.6%, Figure). Among these patients, anti-gAChRα3 and β4 subunit Ab were positive for 29 (20.1%) and 8 (5.6%), respectively. The patients with anti-gAChRα3 Ab had LE more frequently than those without (37.9 vs. 8.7%, p< 0.001). The levels of anti-gAChRα3 Ab were significantly reduced (p = 0.001) after immunosuppressive treatment in the patients with LE. Logistic regression analysis revealed that anti-gAChRα3 Ab (odds ratio [OR] 11.1, 95% Confidence Interval [95%CI] 3.4-36.2, p< 0.001)and lupus cystitis (OR 16.3, 95%CI 2.07-127.8, p=0.006) were independent predictors for having LE. The ten-year cumulative LE relapse rate from the date of sera collection was significantly high in the patients with anti-gAChRα3 Ab compared to those without (27.0% vs. 2.3%, p< 0.001).

Conclusion: Anti-gAChRα3 Ab would be a new biomarker for the development and recurrence of LE in patients with SLE.

Figure. Lupus enteritis


Disclosures: K. Aso, None; M. Kono, GlaxoSmithKline plc, 5, Mitsubishi Tanabe, 5, Astellas, 5, Sanofi, 5, Taisho Pharmaceutical, 5, NIPPON SHINYAKU CO., LTD., 5, Taiju Life Social Welfare Foundation, 5, Kowa Company. Ltd., 5, Terumo Corporation, 5; K. Ninagawa, None; N. Abe, None; Y. Fujieda, None; M. Kato, GSK, 5, Actelion, 5; O. Amengual, None; K. Oku, None; T. Atsumi, AbbVie Japan GK, 2, 6, Astellas Pharma Inc., 5, 6, Bristol-Myers Squibb Co. Ltd, 6, Chugai Pharmaceutical Co. Ltd, 5, 6, Daiichi Sankyo Co. Ltd, 5, 6, Eisai Co. Ltd., 6, Eli Lilly Japan K.K, 6, Mitsubishi Tanabe Pharma Co.;, 5, 6, Pfizer Japan Inc, 2, 5, 6, Takeda Pharmaceutical Co. Ltd, 5, 6, UCB Japan Co. Ltd, 6, AstraZeneca plc, 2, Boehringer Ingelheim Co. Ltd, 2, Medical & Biological Laboratories Co. Ltd, 2, Novartis Pharma K.K, 2, Ono Pharmaceutical Co. Ltd, 2, Alexion Inc, 5, Otsuka Pharmaceutical Co., Ltd, 5, Gilead Sciences, Inc., 5, 6.

To cite this abstract in AMA style:

Aso K, Kono M, Ninagawa K, Abe N, Fujieda Y, Kato M, Amengual O, Oku K, Atsumi T. Anti-gAChR Antibody as a Novel Biomarker for Lupus Enteritis in Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/anti-gachr-antibody-as-a-novel-biomarker-for-lupus-enteritis-in-systemic-lupus-erythematosus/. Accessed .
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