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Digital archive of theses discussed at the University of Pisa

 

Thesis etd-10162023-231605


Thesis type
Tesi di specializzazione (4 anni)
Author
FONZETTI, SILVIA
URN
etd-10162023-231605
Thesis title
The clinical significance of anti-Ro52 antibodies in Sjögren's Syndrome: a milder inflammatory phenotype at higher risk for fibrotic organ involvement
Department
MEDICINA CLINICA E SPERIMENTALE
Course of study
REUMATOLOGIA
Supervisors
relatore Prof.ssa Baldini, Chiara
relatore Prof.ssa Mosca, Marta
Keywords
  • Sindrome di Sjögren (Sjögren's Syndrome)
  • profilo anti-Ro/SSA (anti-Ro/SSA profile)
  • anti-Ro52 isolati (isolated anti-Ro52)
  • rischio fibrotico(fibrotic risk)
Graduation session start date
06/11/2023
Availability
Withheld
Release date
06/11/2093
Summary
Sjögren’s Syndrome is a complex disease with different clinical phenotypes ranging from glandular symptoms to a wide variety of extraglandular manifestations. Anti Ro/SSA antibodies are a serological hallmark of the disease and play a central role as a immunological disease biomarker and as a prognostic factor. Ro/SSA antigens consist of two different ribonucleoproteins: Ro60 and Ro52 also called TRIM21. Antibodies may target these two antigens separately. In connective tissue diseases distinct clinical features seem to be specifically associated with anti-Ro52 autoantibodies: for example, they were found to be associated with interstitial lung disease and autoimmune liver disease. However, few studies explicitly looked for distinct phenotypic features associated with anti-Ro/SSA single specificities, especially with isolated anti-Ro52 antibodies in Sjögren’s Syndrome.
We aimed to investigate the association between isolated anti-Ro52 antibodies and a specific subset of pSS. We evaluated glandular and extra-glandular manifestations both at disease onset and during the follow-up in pSS patients stratified according to the anti-Ro/SSA serologic profile.
Patients were stratified in four groups: seronegative, isolated anti-Ro52, isolated anti-Ro60 and both anti-Ro60/anti-Ro52. Demographic, clinical, biological, histological and instrumental data were compared among the groups. Patients with anti-Ro52 alone and the seronegatives were older than those with double positivity and with isolated anti-Ro60. Demographic features did not differ among the groups.
Oral and ocular functional tests were not found to differ significantly. The same was for PROs including ESSPRI, OHIP and OSDI. Patients with only anti-Ro52 antibodies were characterized by a lower prevalence of neutropenia, lymphadenopathy, hypergammaglobulinemia, Rheumatoid Factor and anti-La/SSB than double-positive patients. On the other hand, Ro-52 group was found to have the highest frequency of ILD and PBC. In conclusion, patients with isolated anti-Ro52 seem to represent a pSS subset characterized by a milder B-cell hyperactivity at higher risk for ILD, thus suggesting possible specific underlying molecular pathways.
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