Anti-dsDNA titre in female systemic lupus erythematosus patients: relation to disease manifestations, damage and antiphospholipid antibodies

Background: Attempts are ongoing to unveil unresolved queries about anti-double-stranded deoxyribonucleic acid (anti-dsDNA), their precise pathogenic effects and to what extent blocking them would be a useful therapeutic goal. Objectives: The aim of the present study was to determine the anti-dsDNA antibodies titre in systemic lupus erythematosus (SLE) patients and investigate their relation to the disease characteristics, activity, damage and antiphospholipid autoantibodies (aPL). Methods: Seventy female SLE patients and 35 age- and sex-matched controls were included. The anti-dsDNA level and aPL were measured. Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI) were assessed. Results: The mean age of the patients was 27.55.1 years, disease duration 7.7 +/- 5.4 years, and SLEDAI and SLICC/ACR-DI scores were 6.8 +/- 8.04 and 1.2 +/- 1.3, respectively. Anti-dsDNA was positive in 61.4% of the patients and the titre (133.2 +/- 100.5IU/ml) was significantly higher compared to controls (22.03 +/- 17.2IU/ml) (p<0.0001). The anti-dsDNA level was significantly increased in those with musculoskeletal manifestations (p=0.007) and positive anti-2 glycoprotein (anti-2GP) (p=0.037) and decreased in those with neuropsychiatric manifestations (p=0.004) and those receiving cyclophosphamide (CYC) (p=0.013). The anti-dsDNA level tended to be higher in active patients. The anti-dsDNA titre significantly correlated with the erythrocyte sedimentation rate (p=0.001), anticardiolipin IgG and IgA antibodies (p=0.008) and anti-2GP IgG (p=0.03) and IgA (p=0.002) and inversely with the total leucocytic count (p<0.0001) and SLICC/ACR-DI (p=0.001). Conclusion; Anti-dsDNA is remarkably increased in SLE patients especially those with musculoskeletal manifestations and aPL. A protective role seems likely in those with neuropsychiatric manifestations and those receiving CYC and may form a shield against disease tissue damage.