Anti-telomere antibodies in systemic lupus erythematosus: a new ELISA testfor anti-DNA with potential pathogenetic implications

Background: Telomeric hexamer repeats (TTAGGG/CCCTAA)(n) are highly repetit ive sequences ut. DNA. They cap the termini of eukaryotic chromosomes and s tabilize them, preventing degradation or fusion. Anti ds-DNA is one of the most specific tests for systemic lupus erythematosus (SLE). Of related impo rtance, a preliminary report has suggested that anti-telomere antibodies ar e also highly specific for the presence of SLE. Methods: 220 patients with SLE, 79 with rheumatoid arthritis (RA), 54 with other rheumatic diseases and 99 healthy controls were tested for anti-telom ere antibody as measured by enzyme immunoassay detecting 30- and 60-mer tel omeric repeats (5-10 hexamers). 48 of the 220 SLE patients charts were abst racted for 90 separate clinical, laboratory and treatment parameters. Compa risons were made between SLE and non-SLE patients, and within the lupus gro up for telomere positivity and among the latter 48 patients for anti-DNA (F arr) levels and SLEDAI scores. Results: Anti-telomere antibody was present in 48.6% of the overall SLE gro up (220), 71% of our cohort (48). 11% with primary Sjogren's (2/18), 7.6% w ith RA (6/79) and 2% of normal controls (2/99) (p < 0.001 comparing SLE to all other groups). In the 48 patient cohort, anti-telomere antibody was mor e sensitive than anti-dsDNA (Farr) (71% vs 500%), but did not correlate wit h other clinical parameters, SLEDAI scores, or other autoantibodies. Conclusions: The detection of anti-telomere antibody appears to be more sen sitive and may be as specific as anti-dsDNA (Farr) in SLE. The detection of telomeric repeats may be as accurate as other anti-DNA assay methodologies and more specific for the presence of SLE. The immunogenic potential of te lomere biology related to the pathogenesis and/or diagnosis of SLE deserves further investigation.