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Clinical and Vaccine Immunology, January 2006, p. 77-83, Vol. 13, No. 1
1071-412X/06/$08.00+0     doi:10.1128/CVI.13.1.77-83.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

International Multicenter Evaluation of Autoantibodies to Ribosomal P Proteins

Michael Mahler,^1* Kai Kessenbrock,² Magdalena Szmyrka,³ Yoshinari Takasaki,⁴ Ignacio Garcia-De La Torre,⁵ Yehuda Shoenfeld,⁶ Falk Hiepe,⁷ Chen Shun-le,⁸ Carlos A. von Mühlen,⁹ Henning Locht,¹⁰ Peter Höpfl,¹¹ Allan Wiik,¹⁰ Westley Reeves,¹² and Marvin J. Fritzler¹³

Dr. Fooke Laboratorien GmbH, Neuss, Germany,¹ Department of Molecular Genetics, University of Heidelberg, Heidelberg, Germany,² Wroclaw University of Medicine, Wroclaw, Poland,³ Division of Rheumatology, Department of Medicine, Jutendo University, Tokyo, Japan,⁴ University of Guadalajara, Guadalajara, Mexico,⁵ Sheba Medical Center, Tel Aviv, Israel,⁶ Charite Humboldt University, Berlin, Germany,⁷ Shanghai Medical University, Shanghai, China,⁸ Pontifical Catholic University School of Medicine, Porto Allegre, Brazil,⁹ Statens Serum Institute, Copenhagen, Denmark,¹⁰ Sweden Diagnostics Deutschland GmbH, Freiburg, Germany,¹¹ University of Florida, Gainesville, Florida,¹² University of Calgary, Calgary, Alberta, Canada,¹³

Received 14 August 2005/ Returned for modification 5 October 2005/ Accepted 19 October 2005

Autoantibodies to the ribosomal phosphoproteins (Rib-P) are a serological feature of patients with systemic lupus erythematosus (SLE). The reported prevalence of anti-Rib-P antibodies in SLE ranges from 10 to 40%, being higher in Asian patients. The variation in the observed frequency may be related to a number of factors but is dependent in large part on the test system used to detect the autoantibodies. An association of anti-Rib-P with central nervous system involvement and neuropsychiatric manifestations of SLE has been controversial. In the present international multicenter study, we evaluated the clinical accuracy of a new sensitive Rib-P-specific enzyme-linked immunosorbent assay based on recombinant Rib-P polypeptides. The results showed that 21.3% of 947 SLE patients, but only 0.7% of 1,113 control patients, had a positive test result (P < 0.0001). The sensitivity, specificity, positive and negative predictive values, and diagnostic efficiency were determined to be 21.3%, 99.3%, 95.6%, 62.2%, and 65.3%, respectively. When evaluated in the context of participating centers, the prevalence of anti-Rib-P antibodies was found in descending frequency, as follows: China (35%) > Poland (34%) > Japan (28%) > United States (26%) > Germany (Freiburg; 23.3%) > Denmark (20.5%) > Germany (Berlin; 19%) > Mexico (15.7%) > Israel (11.7%) > Brazil (10%) > Canada (8%). The substantial data from this study indicate that the prevalence of anti-Rib-P antibodies may not be restricted to the genetic background of the patients or to the detection system but may depend on regional practice differences and patient selection. We confirm previously reported associations of antiribosomal antibodies with clinical symptoms and serological findings. Remarkably, we found a lower occurrence of serositis in Rib-P-positive lupus patients.

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* Corresponding author. Mailing address: Dr. Fooke Laboratorien GmbH, Mainstr. 85, 41469 Neuss, Germany. Phone: 049 2131 4742709. Fax: 049 1212-6 466266866. E-mail: m.mahler.job{at}web.de.

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Clinical and Vaccine Immunology, January 2006, p. 77-83, Vol. 13, No. 1
1071-412X/06/$08.00+0     doi:10.1128/CVI.13.1.77-83.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

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