Elghali M, et al. Clin Exp Vaccine Res. 2025 Jul;14:e34. https://doi.org/10.7774/cevr.2025.14.e34

Introduction: The aim of the study was to compare the specific clinical manifestations of systemic lupus erythematosus (SLE) or laboratory findings between patients with and without anti-ribosomal P (anti-P) antibodies and to investigate possible associations between isolated anti-P antibodies and these features.Material and methods: Seventy-five SLE patients were enrolled in this study. They were recruited from the Department of Internal Medicine and Department of Rheumatology at the University Hospital of Monastir, Tunisia (January 2008 – December 2022). All patients met at least four American College of Rheumatology criteria or Systemic Lupus Erythematosus International Collaborating Clinics criteria at the time of disease diagnosis. Antibody typing was performed using a commercial line blot technique. Statistical analysis was performed using the χ2 test, Fisher’s test when appropriate, Student’s t-test, or Mann-Whitney U test according to normality of the data distribution.Results: Thirty patients (40%) were positive for anti-P (anti-P+). The anti-P+ had higher frequency of skin features (26/49 [53.1%] vs. 4/26 [15.4%], p = 0.003) and central nervous system (CNS) involvement (10/15 [66.7%] vs. 20/60 [33.3%], p = 0.018) than patients without anti-P. Interestingly, anti-P+ showed a lower frequency of SLE/rheumatoid arthritis overlap syndrome (1/11 [9.1%] vs. 29/64 [45.3%], p = 0.042). The comparison between groups of patients according to the presence of anti-P, anti-dsDNA, and anti-Sm showed that the group with anti-P lacking anti-dsDNA and anti-Sm had the highest frequency of neuropsychiatric SLE (75%, p = 0.034), and the lowest frequency of lupus nephritis (0%, p = 0.029) and arthritis (12.5%, p = 0.039).Conclusions: This study supports the association of anti-P antibodies with CNS and cutaneous mani­festations. To the best of our knowledge, this is the first study to report a negative association between isolated anti-P antibodies and renal and articular involvement in SLE.

Some studies have described a probable relationship between SARS-CoV-2 infection and autoimmunity. to present a case series of autoimmune manifestations (AIM) following COVID-19 infection. A consecutive series of patients from January 2020 to December 2023 was collected from the various departments of Fattouma Bourguiba University Hospital, Monastir, where all clinical assessments were performed. Anti-nuclear antibody (ANA) screening was performed using indirect immunofluorescence on HEp-2 cells (Euroimmun, Germany) with a positivity titer of ≥1/180. Typing was performed using ELISA (Biosystems, Spain) or line blot (Euroimmun, Germany). The assessment of other autoantibodies was performed using various techniques (indirect immunofluorescence, ELISA, and line blot). Sixteen patients presented with AIM after the COVID-19 infection. Their ages ranged from 12 to 67 years (44.6 ± 15.5 years). The sex ratio was 1 (eight men to eight women). Clinical manifestations began between one week and three months after infection. The clinical presentation was polymorphic (general, cutaneous, neurological, ophthalmic, muscular, articular, and abdominal features). Biological, radiological, and histopathological investigations revealed principal abnormalities in endocrine, articular, muscular, or neurological functions in the presence of ANA and/or specific autoantibodies. Fiveteen patients were diagnosed with autoimmune diseases (AID) and treated with specific treatments. The diagnosis retained for the other case was non-specific autoimmune stimulation with spontaneous recovery. These cases suggest that AID or AIM can be triggered or unmasked by SARS-CoV-2 infection.

Introduction: We sought to compare clinical features among distinct antibody profiles defined by the presence or absence of antinucleosome (anti-NCS) and anti–double-stranded DNA (anti-dsDNA) antibodies in Tunisian patients with systemic lupus erythematosus (SLE). Methods: The study enrolled 131 patients with SLE meeting at least 4 American College of Rheumatology or SLICC criteria. Participants were recruited from the Department of Internal Medicine and Rheumatology at the university teaching hospital of Monastir between January 2000 and December 2022. The patients were divided into 4 groups: Group 1 with neither anti-dsDNA nor anti-NCS; Group 2 with anti-dsDNA and no anti-NCS; Group 3 with anti-NCS lacking anti-dsDNA; and Group 4 with both anti-NCS and anti-dsDNA. Results: The mean (SD) age at the time of diagnosis for the 131 participants with SLE was 38.7 (15.1) years; the ratio of female to male individuals was 7.2. Thirty-four (26%) patients were positive for anti-NCS and anti-dsDNA (group 4: antinuclear antibody pattern AC-1, 72%; pattern AC-5, 16%), and 30 (22.9%) were positive for anti-NCS and negative for anti-dsDNA (group3: pattern AC-1, 53.6%; pattern AC-5, 32.1%). The group 3 patients showed higher peripheral neuropsychiatric SLE (P =.034) and lower rates of disease activity (P =.01). The comparison between the 4 groups showed that group 4 patients had the highest frequency of lupus nephritis (P ≤.001) and the highest rate disease activity (P =.013). Discussion: Patients with both anti-NCS and anti-dsDNA at the time of diagnosis are likely to have severe SLE, while anti-NCS was associated with nonsevere disease in patients with SLE who lack anti-dsDNA.