ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 786

Antibodies Against Drp-4 and Macropain Subunit C2 As a Potential Marker Of Aosd

Niklas T. Baerlecken1, Nils Pursche2, Torsten Witte3, Reinhold E. Schmidt1, Marius Hoepfner1, Frank Moosig4, Wolfgang L. Gross5, Eugen Feist6 and Dirk Foell7, 1Clinical Immunology and Rheumatology, Medical University Hannover, Hannover, Germany, 2Clinical Immunology and Rheumatology, Medical University of Hannover, Hannover, Germany, 3Clinical Immunology and Rheumatology, Medical University Hannover, Hanover, Germany, 4Vasculitis Clinic, Klinikum Bad Bramstedt & University Hospital of Schleswig Holstein, Bad Bramstedt, Germany, 5Dept of Clinical Rheumatology, Medical University at Lubeck, Lubeck, Germany, 6Department of Rheumatology and Clinical Immunology, Charité University Medicine, Berlin, Germany, 7Department of Pediatric Rheumatology and Immunology, University of Muenster, Muenster, Germany

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Title: Miscellaneous Rheumatic Diseases

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Making the diagnosis of adult-onset Still’s disease (AOSD) is mainly based on the exclusion of inflammatory, infectious and malignant diseases. There are no specific clinical or laboratory findings for AOSD. Therefore, we aimed to identify new autoantibodies as diagnostic tools for AOSD.

Methods:

As a screening procedure, we studied sera of 3 patients with AOSD using a protein array loaded with more than 28000 human recombinant proteins (imagenes biolifesciences, Berlin). Sera of patients with spondyloarthritis (SpA), rheumatoid arthritis (RA), eosinophilic granulomatosis with polyangiitis, granulomatosis with polyangiitis (GPA), HIV infection, B-NHL, chronic regional pain syndrome, giant cell arteritis (GCA), polymyalgia rheumatica (PMR), multiple sclerosis, osteoarthritis, Takayasu arteritis and sarcoidosis served as controls.

In the next step, we next established ELISAs in order to measure the respective autoantibodies in larger patient numbers.

Results:

Using the protein array, we detected IgG antibodies against the two new autoantigens Macropain subunit C2 and DRP-4 in 2/3 AOSD patients, respectively, but in none of the 50 controls.

Using the ELISA, we measured autoantibodies binding to peptides of Macropain subunit C2 and Dihydropyrimidinase-related protein 4 (DRP-4) in the sera of patients with AOSD and other inflammatory disorders. The results are summarized in the table (AOSD* = patients with active AOSD before the onset of treatment, systemic JIA = systemic juvenile idiopathic arthritis, PsoA = psoriatic arthritis, BD = blood donors):

  AOSD (n=78) AOSD* (n=39) systemic JIA (n=50) SpA/ PsoA (n=58) RA (n=66) GPA (n=29)
MP + DRP-4 43% 56% 0% 19% 5% 10%
MP 54% 59% 0% 24% 9% 10%
DRP-4 43% 56% 3% 28% 8% 10%
 
  PMR/ GCA (n=60) Sjögren’s syndrome (n=29) SLE (n=38) febrile infections (n=63) Malignant Disease (n=37) BD (n=147)
MP + DRP-4 15% 0% 5% 18% 3% 1%
MP 22% 0% 11% 21% 3% 1%
DRP-4 20% 3% 8% 21% 5% 2%

Conclusion:

The new autoantibodies against Macropain subunit C2 and DRP-4 are associated with AOSD and may be useful as a diagnostic tool of AOSD. In addition, these markers clearly differentiate AOSD from systemic juvenile idiopathic arthritis.

Disclosure:

N. T. Baerlecken,
None;

N. Pursche,
None;

T. Witte,
None;

R. E. Schmidt,
None;

M. Hoepfner,
None;

F. Moosig,
None;

W. L. Gross,
None;

E. Feist,
None;

D. Foell,
None.

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