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Arthritis Research & Therapy
Published in: Arthritis Research & Therapy 1/2018

Open Access 01-12-2018 | Research article

The presence of anti-nuclear antibodies alone is associated with changes in B cell activation and T follicular helper cells similar to those in systemic autoimmune rheumatic disease

Authors: Yuriy Baglaenko, Nan-Hua Chang, Sindhu R. Johnson, Waleed Hafiz, Kieran Manion, Dario Ferri, Babak Noamani, Dennisse Bonilla, Sina Rusta-Sellehy, Larissa Lisnevskaia, Earl Silverman, Arthur Bookman, Carolina Landolt-Marticorena, Joan Wither

Published in: Arthritis Research & Therapy | Issue 1/2018

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Abstract

Background

Diagnosis of systemic autoimmune rheumatic diseases (SARD) relies on the presence of hallmark anti-nuclear antibodies (ANA), many of which can be detected years before clinical manifestations. However, ANAs are also seen in healthy individuals, most of whom will not develop SARD. Here, we examined a unique cohort of asymptomatic ANA+ individuals to determine whether they share any of the cellular immunologic features seen in SARD.

Methods

Healthy ANA− controls and ANA+ (ANA ≥1:160 by immunofluorescence) participants with no SARD criteria, with at least one criterion (undifferentiated connective tissue disease (UCTD)), or meeting SARD classification criteria were recruited. Peripheral blood cellular immunological changes were assessed by flow cytometry and transcript levels of BAFF, interferon (IFN)-induced and plasma cell-expressed genes were quantified by NanoString.

Results

A number of the immunologic abnormalities seen in SARD, including changes in peripheral B (switched memory) and T (iNKT, T regulatory, activated memory T follicular helper) subsets and B cell activation, were also seen in asymptomatic ANA+ subjects and those with UCTD. The extent of these immunologic changes correlated with ANA titer or the number of different specific ANAs produced. Principal component analysis of the cellular data indicated that a significant proportion of asymptomatic ANA+ subjects and subjects with UCTD clustered  with patients with early SARD, rather than ANA− healthy controls.

Conclusions

ANA production is associated with altered T and B cell activation even in asymptomatic individuals. Some of the currently accepted cellular features of SARD may be associated with ANA production rather than the immunologic events that cause symptoms in SARD.
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Metadata
Title
The presence of anti-nuclear antibodies alone is associated with changes in B cell activation and T follicular helper cells similar to those in systemic autoimmune rheumatic disease
Authors
Yuriy Baglaenko
Nan-Hua Chang
Sindhu R. Johnson
Waleed Hafiz
Kieran Manion
Dario Ferri
Babak Noamani
Dennisse Bonilla
Sina Rusta-Sellehy
Larissa Lisnevskaia
Earl Silverman
Arthur Bookman
Carolina Landolt-Marticorena
Joan Wither
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 1/2018
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/s13075-018-1752-3

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