Balboni Imelda M

Limb Cindy

Sandborg Christy I

Utz Paul J

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Pediatric Rheumatology

Evaluation of autoantibody profiles in a cohort of new-onset pediatric systemic lupus erythematosus patients using autoantigen microarray technology

Imelda M Balboni

Cindy Limb

Christy I Sandborg

Paul J Utz

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ORAL PRESENTATION Open Access
Evaluation of autoantibody profiles in a cohort of
new-onset pediatric systemic lupus
erythematosus patients using autoantigen
microarray technology
Imelda M Balboni2*, Cindy Limb2, Christy I Sandborg1, Paul J Utz3
From 2011 Pediatric Rheumatology Symposium sponsored by the American College of Rheumatology
Miami, FL, USA. 2-5 June 2011
Purpose
Systemic lupus erythematosus (SLE) is characterized by
the production of autoantibodies directed against many
highly-conserved nuclear antigens. 15% of SLE patients
develop disease in childhood or adolescence, and pedia-
tric (pSLE) patients often have more severe disease
onset and organ system involvement. Antigen microar-
ray technology allows the comprehensive analysis of
autoantibodies directed against hundreds of antigens
with minimal amounts of sera. The purpose of this
study was to characterize autoantibody profiles in a pro-
spective cohort of new-onset pSLE patients at onset and
within 6-9 months of disease onset and to determine if
autoantibody profiles differentiate patients with distinct
clinical manifestations such as nephritis.
Methods
New-onset pediatric rheumatology patients meeting the
revised ACR diagnostic criteria for SLE were eligible for
this study. The study was approved by the Stanford Uni-
versity Institutional Review Board and informed consent
was obtained prior to participation in the study. Sera from
51 pSLE patients and 17 healthy age- and sex-matched
controls were evaluated using an 1128-feature antigen
microarray manufactured with approximately 130 anti-
gens. Demographic and clinical data from corresponding
clinic visits were collected. Microarrays were probed with
1:200 dilutions of serum and a Cy5-conjugated goat-anti-
human IgG secondary antibody, scanned with a GenePix
4000 scanner, and analyzed using GenePix 6.1 software to
determine median fluorescence intensity minus back-
ground for each antigen. Significance Analysis of Microar-
rays (SAM) software was used to determine differences in
autoantibody expression between pSLE patients and con-
trols, within the pSLE group over time, and between pSLE
patients with and without nephritis.
Results
SAM identified increased reactivity against more than 50
autoantigens in new-onset pSLE patients compared to
controls, with a false discovery rate (FDR) of less than 1%.
Reactivity against many of these antigens decreased signifi-
cantly by 6-9 months from disease onset. Subgroup analy-
sis comparing patients with class III or IV Iupus nephritis
to patients without significant nephritis demonstrated
increased reactivity against several autoantigens including
double stranded DNA, C1q and several types of collagen
in patients with nephritis. Conversely, patients without sig-
nificant nephritis had increased reactivity against other
antigens including heat shock proteins and desmoglein.
Conclusion
New-onset pSLE patients have a broad spectrum of anti-
bodies directed against many autoantigens, including
those not classically associated with SLE. In addition, preli-
minary subgroup analysis of pSLE patients with and with-
out nephritis revealed distinct autoantibody profiles
between the two groups. Further studies are currently
underway to validate these findings and evaluate additional
subgroups of patients with various clinical manifestations.
Ultimately, autoantibody profiles may identify important
biomarkers for more accurate diagnosis, prognostication,
and treatment of pSLE patients.
2Stanford University, Stanford, CA, USA
Full list of author information is available at the end of the article
Balboni et al. Pediatric Rheumatology 2012, 10(Suppl 1):A3
http://www.ped-rheum.com/content/10/S1/A3
© 2012 Balboni et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
Disclosure
Imelda M. Balboni: None; Cindy Limb: None; Christy I.
Sandborg: None; Paul J. Utz: None.
Author details
1Stanford Medical Center, Stanford, CA, USA. 2Stanford University, Stanford,
CA, USA. 3Stanford University School of Medicine, Stanford, CA, USA.
Published: 13 July 2012
doi:10.1186/1546-0096-10-S1-A3
Cite this article as: Balboni et al.: Evaluation of autoantibody profiles in
a cohort of new-onset pediatric systemic lupus erythematosus patients
using autoantigen microarray technology. Pediatric Rheumatology 2012
10(Suppl 1):A3.
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Balboni et al. Pediatric Rheumatology 2012, 10(Suppl 1):A3
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Evaluation of autoantibody profiles in a cohort of new-onset pediatric systemic lupus erythematosus patients using autoantigen microarray technology

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