The SLE-key test serological signature: new insights into the course of lupus.

Journal Article (Journal Article)

OBJECTIVE: We previously described the multiplex autoantibody SLE-key Rule-Out test, which detects a signature of autoantibody reactivity that distinguishes healthy subjects from SLE patients with 94% sensitivity, 75% specificity and 93% negative predictive value; thus, an individual manifesting a positive Rule-Out test score is unlikely to have SLE (e.g. lupus is excluded). The objective of this current study was to evaluate the stability of the lupus-associated signature over time. METHODS: We used banked serum samples from healthy subjects (n = 51) and lupus patients (n = 50 individual samples and n = 181 paired samples, for a total of n = 412 serum samples). The samples were drawn at different times after diagnosis to analyse the impact on the SLE-key Rule-Out test of time elapsed since diagnosis and any changes in disease activity (as reflected by the SLEDAI score). RESULTS: The SLE signature remains stable for the first 10 years after diagnosis; in this time frame, <10% of patients manifested a positive Rule-Out score and the SLE-key Rule-Out score was independent of the underlying disease activity as reflected by the SLEDAI score. After ⩾10 years, ∼30% of lupus subjects scored as SLE Ruled-Out; the proportion of patients manifesting this status was even greater in the subset of individuals with a SLEDAI score of 0. CONCLUSION: These findings raise the possibility that a significant number of SLE patients manifest a change in their serological signature over time, and that such a signature change may signify an evolution in the immunological features of their disease relevant to patient management.

Full Text

Duke Authors

Cited Authors

  • Putterman, C; Pisetsky, DS; Petri, M; Caricchio, R; Wu, AHB; Sanz, I; Oates, JC; Wallace, S; Sorek, R; Gerwien, R; Safer, P; Jakobi-Brook, K; Cohen, IR

Published Date

  • September 1, 2018

Published In

Volume / Issue

  • 57 / 9

Start / End Page

  • 1632 - 1640

PubMed ID

  • 29873771

Pubmed Central ID

  • PMC6105919

Electronic International Standard Serial Number (EISSN)

  • 1462-0332

Digital Object Identifier (DOI)

  • 10.1093/rheumatology/key149


  • eng

Conference Location

  • England