This study aims to evaluate the prognostic value of quantitative anti-Ro52 antibody levels in patients with primary Sjögren's Syndrome. Anti-Ro52 antibodies are frequently detected in this autoimmune disease, but their specific role in disease stratification, systemic involvement, and long-term outcomes remains unclear. Through a prospective cohort analysis, the investigators will investigate the association between anti-Ro52 titers and clinical phenotypes, including extraglandular manifestations, immunological profiles, and disease progression. The objective is to determine whether quantitative assessment of anti-Ro52 antibodies can serve as a biomarker to refine risk stratification and guide personalized management in primary Sjögren's Syndrome.
Primary Sjögren's Syndrome (pSS) is a systemic autoimmune disorder characterized by lymphocytic infiltration of exocrine glands, leading to dryness symptoms, and by a wide spectrum of systemic manifestations. Autoantibodies, particularly anti-Ro/SSA antibodies, are hallmark features of the disease and play a central role in diagnosis and classification. Among these, anti-Ro52 antibodies have been increasingly recognized as a distinct immunological marker, often co-occurring with or without anti-Ro60 and anti-La antibodies. While qualitative detection of anti-Ro52 is widely used in routine clinical practice, the clinical significance of their quantitative levels remains underexplored. Recent studies suggest that high titers of anti-Ro52 may be associated with more severe systemic disease, including pulmonary, muscular, and neurological involvement, as well as with increased interferon signature activity. However, no consensus currently exists regarding their utility as a prognostic or stratification biomarker in pSS. This retrospective cohort study aims to assess whether quantitative anti-Ro52 antibody levels correlate with specific clinical phenotypes, immunological patterns, and long-term outcomes in patients with primary Sjögren's Syndrome. Clinical data, including organ involvement, biological markers, disease activity scores (e.g., ESSDAI), and treatment response, will be collected and analyzed in relation to anti-Ro52 titers measured by standardized quantitative assays. The objectives are: * To determine whether high anti-Ro52 titers are predictive of systemic involvement at baseline or during follow-up; * To identify clusters of patients based on anti-Ro52 levels and associated clinical/immunological profiles; * To evaluate the potential of quantitative anti-Ro52 testing as a tool for risk stratification and personalized therapeutic strategies. This study will provide insights into the prognostic implications of anti-Ro52 in pSS and contribute to refining clinical management and follow-up of affected patients.
Study Type
OBSERVATIONAL
Enrollment
150
Université de Nancy
Vandœuvre-lès-Nancy, France
Occurrence of a severe clinical event during follow-up
Occurrence of a severe clinical event during follow-up, defined as the first occurrence of any of the following: Death (any cause), Histologically confirmed lymphoma, Severe organ involvement (e.g., glomerulonephritis, interstitial lung disease requiring immunosuppression, autoimmune CNS/PNS involvement, systemic vasculitis), Persistently high disease activity, defined as an ESSDAI (EULAR Sjögren's Syndrome Disease Activity Index) score ≥ 5 for ≥12 consecutive months. ESSDAI ranges from 0 to 123; higher scores indicate worse disease activity.
Time frame: 2 years
Frequency of anti-Ro52 positiviy
Frequency of anti-Ro52 antibodies (presence vs absence) and quantitative distribution within the study cohort.
Time frame: 2 years
Association between anti-Ro52 antibody levels and disease activity
Association between anti-Ro52 antibody levels and disease activity, using the ESSDAI score and, where applicable, biomarkers such as gammaglobulins and complement levels (C3/C4).
Time frame: 2 years
Correlation between quantitative anti-Ro52 antibody levels and clinical/immunological features at baseline.
Correlation between anti-Ro52 levels (IU/mL, ELISA) and baseline clinico-biological features: Glandular vs extraglandular involvement (binary phenotype from clinical chart), Presence of cryoglobulinemia (% of patients, assessed by immunofixation), Autoimmune cytopenias (% of patients with diagnosis from CRF), Hypergammaglobulinemia (serum IgG, g/L, measured by nephelometry), Immunoglobulin deficiency (IgG/A/M, g/L). Statistical correlations will be assessed using Spearman or logistic regression as appropriate.
Time frame: 2 years
Classification of patients into subgroups (clusters) based on anti-Ro52 levels.
Cluster-based classification of patients using anti-Ro52 levels (IU/mL, ELISA) and associated variables (clinical phenotype, immunological markers, disease course). A data-driven clustering approach (e.g., hierarchical or k-means) will be applied to group patients. For each cluster, the following aggregated characteristics will be described: type of organ involvement (% of patients), presence of immunological markers (e.g., cryoglobulinemia, cytopenias), and indicators of disease progression (e.g., number of flares, treatment escalation).
Time frame: 2 years
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