Anti-ribosomal P protein antibodies detected by immunoblotting in patients with connective tissue diseases: their specificity for SLE and association with IgG anticardiolipin antibodies

doi:10.1136/ard.59.12.975

Annals of the Rheumatic Diseases 2000;59:975-981; doi:10.1136/ard.59.12.975

Ann Rheum Dis 2000;59:975-981 ( December )

Extended report

Anti-ribosomal P protein antibodies detected by immunoblotting in patients with connective tissue diseases: their specificity for SLE and association with IgG anticardiolipin antibodies A Ghirardello^a, A Doria^a, S Zampieri^a, R Gerli^b, E Rapizzi^a, P F Gambari^a

^a Division of Rheumatology, Department of Medical and Surgical Sciences, University of Padova, Padova, Italy, ^b Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy

Correspondence to: Dr A Doria, Division of Rheumatology, Department of Medical and Surgical Sciences, University of Padova, Policlinico Universitario, Via Giustiniani 2, 35128 Padova, Italy adoria{at}ux1.unipd.it

Accepted for publication 26 April 2000

OBJECTIVE $---$ To assess the prevalence and clinical and serological associations of anti-ribosomal P protein antibodies (anti-P antibodies)in patients with connective tissue diseases (CTDs) and investigatethe immunobiological nature of autoantibody clustering in whichanti-P antibodies play apart.
METHODS $---$ IgG anti-P antibodies in the sera of 267 patients with CTDs and 31 healthy subjects were analysed by immunoblotting performedon cytoplasmic extract of Raji cells. 60 patients with systemiclupus erythematosus (SLE), 32 systemic sclerosis, 46 primary Sjögren'ssyndrome, 16 poly/dermatomyositis, 11 rheumatoid arthritis, 8undifferentiated CTD, 72 overlap CTD, and 22 primary antiphospholipidsyndrome were studied. Anti-P antibodies were affinity purifiedby elution from nitrocellulose bound antigen and tested by ELISAfor their binding activity tocardiolipin.
RESULTS $---$ Anti-P antibodies were detected in 16 (6%) patients and in none of the controls: 12/60 SLE (20%) and 4/80 undifferentiated/overlappatients with CTD (5%). A close association of IgG antibodieswith P proteins and with cardiolipin was seen in lupus sera (p=0.0009,odds ratio 18.33). Anti-P antibodies from 9 of 12 anti-P lupusserum samples could be affinity purified and none of the affinitypurified fractions cross reacted with ELISA plate coatedcardiolipin.
CONCLUSIONS $---$ Anti-P immunoreactivity is a specific marker of SLE and lupus-like disease and its detection is recommended as a powerfuldiagnostic tool. Anti-P antibodies are strongly clustered withIgG anticardiolipin antibodies in lupus sera, even if they areindependently elicited. This suggests that their cognate autoantigensplay a part in a common pathogenetic pathway inSLE.

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