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Medicine (Baltimore). 2016 Aug;95(35):e4713. doi: 10.1097/MD.0000000000004713.

Single-specificity anti-Ku antibodies in an international cohort of 2140 systemic sclerosis subjects: clinical associations.

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  • 1aDepartment of Medicine, McGill University, Montreal, Quebec, Canada bLady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada cDivision of Rheumatology, Jewish General Hospital, Montreal, Quebec, Canada dDivision of Rheumatology, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada eDepartment of Medicine, Université de Montréal, Montreal, Quebec, Canada fRheumatology Unit, Royal Adelaide Hospital, Adelaide, Australia gDiscipline of Medicine, University of Adelaide, Bedford Park, Australia hDepartment of Allergy and Immunology, Flinders Medical Centre, Bedford Park, Australia iDepartment of Rheumatology, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia jDepartment of Medicine, The University of Melbourne at St. Vincent's Hospital, Melbourne, Victoria, Australia kDivision of Rheumatology and Immunogenetics, University of Texas Health Science Centre at Houston, Houston, TX lFaculty of Medicine, University of Calgary, Calgary, Alberta, Canada.


Autoantibodies directed against the Ku autoantigen are present in systemic sclerosis (SSc) and have been associated with myositis overlap and interstitial lung disease (ILD). However, there is a paucity of data on the clinical correlates of anti-Ku antibodies in the absence of other SSc-specific antibodies. The aim of this study was to assess the clinical correlates of single-specificity anti-Ku in SSc.An international (Canada, Australia, USA, Mexico) cohort of 2140 SSc subjects was formed, demographic and clinical variables were harmonized, and sera were tested for anti-Ku using a line immunoassay. Associations between single-specificity anti-Ku antibodies (i.e., in isolation of other SSc-specific antibodies) and outcomes of interest, including myositis, ILD, and survival, were investigated.Twenty-four (1.1%) subjects had antibodies against Ku, and 13 (0.6%) had single-specificity anti-Ku antibodies. Subjects with single-specificity anti-Ku antibodies were more likely to have ILD (58% vs 34%), and to have increased creatine kinase levels (>3× normal) at baseline (11% vs 1%) and during follow-up (10% vs 2%). No difference in survival was noted in subjects with and without single-specificity anti-Ku antibodies.This is the largest cohort to date focusing on the prevalence and disease characteristics of single-specificity anti-Ku antibodies in subjects with SSc. These results need to be interpreted with caution in light of the small sample. International collaboration is key to understanding the clinical correlates of uncommon serological profiles in SSc.

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