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Introduction Systemic sclerosis (SSc) pathogenesis involves immune imbalance and the generation of autoantibodies, although the underlying mechanisms remain incompletely understood.SSc-specific Autoantibodies have been associated with distinct clinical features and are considered important for predicting disease course and prognosis.Ethnic and racial differences may influence the clinical presentation and autoantibody profiles in SSc, but these associations require further investigation.Purpose: to evaluate the autoimmune antibody profile among different ethnic subgroups within Jewish patients with SSc and to examine their potential correlation with clinical manifestations.Material and Methods Eighty-eight consecutive Sc patients of Jewish origin (34 Ashkenazi, 42 Sephardic and 12 of mixed ancestry) were evaluated. Clinical and demographic data were collected through their medical records. The autoimmune antibody profile included: Scl-70 (anti-TOPO I), ACA (kinetochore proteins, CENP A; CENP B), anti-RNAP III (RNA polymerase III (RP11/RP155); Fibrillarin (U3 RNP) by line immunoassay; and nucleolar antigens: anti- Th/To; anti-Pm-Scl (PM-Scl100/Pm-Scl75), anti- Ku, anti-NOR90 by indirect immunofluorescence.Results Among the SSc of Ashkenazi origin (n = 34), 17 (50%) had diffuse SSc and 17(50%) had the limited type. The majority were women (, 33 (97%), with a mean age (60. 3+15.7). The mean disease duration was 7.4+7.3 years and the mean duration of Raynaud phenomenon was 8.0+7.6 years. Digital ulcers were reported in 12(35%), interstitial lung disease (ILD) in 7 (21%) and pulmonary arterial hypertension (PAH) in five (15%)Among non-Ashkenazi (Sephardic and mixed origin, n=54), 23 patients (49%) had diffuse type. A total of 48 patients (89%) were women with a mean age of 54.4+15.0 years. The mean disease duration was 10.0+10.8 years and the mean disease duration of Raynaud was 11.7+11.1 years. Digital ulcers occurred in 25(48%), ILD in 15 (29%) and PAH in 2 (4%).Ethnic disparities in autoimmune biomarkersInflammatory marker levels (CRP) were significantly higher in non-Ashkenazi group compare to SSc of Ashkenazi origin (p 0.03).Anti- Th/To were found exclusively among four patients of Ashkenazi origin (p=0.038).There was trend for higher prevalence of Ro-52 antibody (p=0.102) and RNA polymerase III antibody (p=0.1.75) in Ashkenazi group compare to non-Ashkenazi (Sephardic and mixed origin) SSc patients.Between Anti- Th/To positive patients 2 also had co-occurrence of Ro-52 antibody.No statistically significant differences were found in clinical and demographic data between groups.Conclusions Th/To antibody may be potential ethnogenetic marker or could be linked to HLA alleles more common in Ashkenazi population. Further larger studies are needed in order to confirm these observations.