engleski

The predictive and diagnostic value of antibodies against topoisomerase I (Scl-70) in systemic sclerosis

Aim of this study was to evaluate the predictive and diagnostic value of antibodies against topoisomerase I (Scl-70) in systemic sclerosis by investigating the possible correlation between titre of Scl-70 and appearance of certain clinical abnormalities. DNA topoisomerase I, an enzyme contributing to relaxation of DNA is a major autoantigen recognized in systemic sclerosis. Esophageal dysfunction is present in approximately 85% of patients ; motility disturbances and lowered gastroesophageal spinchter pressure may result in gastroesophageal reflux, esophagitis and stricture. Clinically apparent pulmonary hypertension with evidence of right sided heart failure occurs in 5-10% ; once pulmonary hypertension is clinically evident patients rarely survive more than one year. Heart disease (in 30-50%) is probably due to myocardial ischemia, caused by disturbances of the coronary microcirculation. These clinical abnormalities were tested by cineradiography with repeated boluses of barium fluid, echocardiography, tallium scintigraphy of the myocardium. Scl-70 antibodies were determined in all patients. Twenty patients who fulfilled the American College of Rheumatology criteria for the classification of systemic sclerosis were included. Significantly high titre of Scl-70 was recognized in 5 patients with serious esophageal disturbances. In 4 patients with pulmonary hypertension we found mild elevation of Scl-70. Similar titres were found in 3 patients with coronary disease. High titre of Scl-70 could suggest esophageal abnormality but we have not found correlation with other clinical manifestations. The question remains whether the high titre of Scl-70 occurs coincidentally with organ damage or does it appear earlier and could serve as predictor of characteristic involvement in systemic sclerosis.

Systemic sclerosis ; Scl-70 ; Clinical abnormalities

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