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Scleroderma pp 209–225Cite as

The Clinical Aspects of Autoantibodies

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Abstract

Disease classification in systemic sclerosis (SSc) is based primarily on the extent of skin involvement due to the recognition of its capacity to predict organ-specific manifestations. However, as shall be discussed in this chapter, antibody specificity, despite certain limitations, may prove of greater importance in predicting disease course and prognosis. (Walker UA, Tyndall A, Czirjak L, Denton C, Farge-Bancel D, Kowal-Bielecka O, et al. Clinical risk assessment of organ manifestations in systemic sclerosis: a report from the EULAR Scleroderma Trials And Research group database. Ann Rheum Dis. 2007;66(6):754–63. doi:ard.2006.062901 [pii]10.1136/ard.2006.062901.) Circulating autoantibodies are attractive as biomarkers in SSc owing to their high specificity, the mutual exclusivity of the major SSc-autoantibody subtypes, their persistence for the duration of illness and most importantly, the characteristic constellation of clinical features associated with individual autoantibody groups. (Okano Y. Antinuclear antibody in systemic sclerosis (scleroderma). Rheum Dis Clin North Am. 1996;22(4):709–35; Hamaguchi Y. Autoantibody profiles in systemic sclerosis: predictive value for clinical evaluation and prognosis. J Dermatol. 2010;37(1):42–53. doi:JDE762 [pii]10.1111/j.1346-8138.2009.00762.x.) It is important to note, however, that the major clinical associations with SSc specific autoantibody reactivities, whilst of major prognostic value, are not absolute and organ-specific manifestations can occur in the presence of any autoantibody reactivity. (Arnett FC. Is scleroderma an autoantibody mediated disease? Curr Opin Rheumatol. 2006;18(6):579–81. doi:10.1097/01.bor.0000245726.33006.c300002281-200611000-00002 [pii].)

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  1. Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, Barnes, UK

    John D. Pauling BMBS, MRCP & Neil McHugh MB, ChB, MD, FRCP, FRCPath

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  1. John D. Pauling BMBS, MRCP
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  2. Neil McHugh MB, ChB, MD, FRCP, FRCPath
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Correspondence to John D. Pauling BMBS, MRCP .

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  1. Feinberg School of Medicine, Northwestern University, E. Huron Street 240, Chicago, 60611-2909, Illinois, USA

    John Varga

  2. Royal Free and University College, Medical School, University College London, Rowland Street, London, NW3 2PF, United Kingdom

    Christopher P. Denton

  3. School of Medicine, Div. Rheumatology, Johns Hopkins University, Eastern Avenue 5200, Baltimore, 21224, Maryland, USA

    Fredrick M. Wigley

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Pauling, J.D., McHugh, N. (2012). The Clinical Aspects of Autoantibodies. In: Varga, J., Denton, C., Wigley, F. (eds) Scleroderma. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-5774-0_18

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