Article Text

Download PDFPDF

Anti-Th/To antibodies in Italian scleroderma patients: clinical and immunological correlations and comparison with patients with anti-centromere antibodies
  1. A Ceribelli1,2,3,
  2. I Cavazzana1,
  3. P Airò1,
  4. A Tincani1,
  5. F Franceschini1,
  6. B A Pauley2,
  7. E K L Chan2,
  8. M Satoh3
  1. 1Rh eumatology Unit and Chair, Spedali Civili, Brescia, Italy
  2. 2Department of Oral Biology, University of Florida, Gainesville, USA
  3. 3Department of Medicine, University of Florida, Gainesville, USA

Statistics from


Anti-Th/To antibodies, found in 3–5% of patients with systemic sclerosis (SSc), recognise a nucleolar 7–2/8–2 RNA-protein complex. They are associated with limited SSc (lSSc) with lung involvement and reduced survival comparing with anticentromere (ACA) (+) patients. However, clinical studies on anti-Th/To are limited due to poor availability of serological tests. The aim of our study is to compare the clinical manifestations of patients with two autoantibodies associated with lSSc: anti-Th/To and ACA.

Abstract 22 Table 1


216 Italian SSc patients, followed between 2006 and 2008, were studied. Sera were tested by immunofluorescence for antinuclear antibodies, counterimmunoelectrophoresis for anti-ENA (anti-topo I, PM-Scl, Ku, U1RNP and others), and ELISA for anti-RNA polymerase III. Available sera (negative for all these) were also tested by immunoprecipitation (IP, protein analyses by 35S-methionine labelled cells; RNA analyses by urea-PAGE and silver staining). Specificities of autoantibodies were verified using reference sera. Charts were reviewed for clinical information.


Out of 216 patients, 67 were ACA (+) and 81 were anti-topo I (+). Among the remaining 68 patients, 15 were anti-RNAP III positive. Sera from 12 anti-nucleolar staining positive samples were available for IP: anti-Th/To antibodies were found in 8 of 12 patients (67%). They were all negative for ACA, anti-RNAP III and anti-ENA. Clinical features of eight anti-Th/To patients were compared with 67 ACA (+) patients. All except one ACA (+) patient had lSSc. Anti-Th/To patients were younger (p=0.0046), with a predominant male distribution (p=0.004) versus ACA (+) group. In anti-Th/To group, alveolitis (p=0.04), pericarditis (p=0.028) and puffy hands (p=0.0004) were more frequently detected. Both groups had low Medsger cardiopulmonary index and excellent 10-year survival.


Anti-Th/To are common in anti-nucleolar antibody positive Italian SSc patients. Both anti-Th/To and ACA patients had lSSc with excellent prognosis. Although impairment of pulmonary function appears mild, anti-Th/To group has frequent alveolitis and pericarditis. Testing for anti-Th/To should help to subset SSc patients and to follow-up properly.

View Abstract

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.