Autoantibodies: A Marker for Scleroderma Progression?

October 10, 2013

Autoantibodies to an estrogen receptor may represent promising markers for scleroderma progression, according to an Italian study.

Giovannetti A, Maselli A, Colasanti T, et al. 2013 Autoantibodies to Estrogen Receptor α in Systemic Sclerosis (SSc) as Pathogenetic Determinants and Markers of Progression, PLoS One; (2013) doi: 10.1371/journal.pone.0074332. First published online: September 18, 2013 (open access).

Autoantibodies to estrogen receptor α (anti-ERα) may trigger immune responses in systemic sclerosis (SSc), serving as a potential marker of scleroderma progression, Italian researchers say.

The study of anti-ERα antibodies in 71 consecutive SSc patients reveals serum immunoreactivity in 42% of the group (n=30) - but none among 90 matched healthy serum donor controls - plus a significant association between anti-ERα antibody values and key clinical parameters of disease activity and severity.

Among the SSc patients - predominantly women in their mid-50s with a median disease duration of 8 years - anti-ERα antibodies are twice as prevalent in those with a higher European Scleroderma Study Group (EScSG) activity index, compared with anti-ERα- negative patients. 

The study also finds anti-ERα serum antibodies are associated with diffuse SSc, anti-topoisomerase I antibodies (anti-Scl70 antibodies), and late capillaroscopic pattern in the disease.

Additionally, anti-ERα antibody positivity may be linked to greater susceptibility to apoptosis among T cells, leading to an autoantigen overload that initiates or perpetuates an autoimmune response and autoantibody-mediated tissue damage in diseases such as SSc, the researchers write.

Finally, the authors note that apoptotic T cells can trigger release of certain cytokines that play a key role in the pathogenesis of SSc.