Title:
Significance of Anti-Centromere Antibodies

Authors:
Vanesa Alende-Castro, Caritina Vázquez-Triñanes, Sergio Rodríguez-Fernández, Pablo Eiras, Arturo González-Quintela, Bernardo Sopeña, Spain

Abstract:

Anti centromere antibodies (ACA) are a specific pattern of antinuclear antibodies (ANA). There are many autoimmune and systemic diseases associated with anticentromere antibodies (ACA). In fact, ACA are part of the denominated systemic sclerosis (SSc)-specific autoantibody. However, some studies and clinical practice have reported the existence of positive ACA in the general population without associated autoimmune disease associated. Also, it has been described an increased risk of malignancy has been described among patients diagnosed with systemic sclerosis (SSc). Different authors have demonstrated that ANAs are presented, not only in autoimmune diseases, but also in the serum of patients with different types of cancer. Thus, this fact has been previously studied in patients with LES focused on a subset of lupus autoantibodies that penetrate cells. The autoantibodies can inhibit DNA repair or directly damage DNA, leading to the accumulation of DNA damage which increases the risk of cancer in these patients. The present study is performed in a teaching hospital in Santiago de Compostela. Demographic, clinical, capillaroscopic and immunological characteristics and complementary tests were analysed. A total of 236 patients were involved. Overall, 90.3 % were female with a mean age of 64.0 years old (range = 22-92 years).  We detected autoimmune diseases in 140 patients (59.3%). The most frequent was Systemic Sclerosis (55.9%), followed by primary biliary cirrhosis (9.3%), primary Sjögren's syndrome (7.2%) and autoimmune hepatitis (4.7%). Thirty-one patients reported having cancer at some point (13.1%), with three of them reporting two types of cancer. The variables associated with mortality were age, diabetes mellitus, dysphagia, anemia and the presence of pulmonary arterial hypertension. The variables associated with the diagnosis of cancer were age, alcohol consumption, monoclonal peak, chronic gastritis, interstitial lung disease, anti-DNA antibodies and anti-Jo-1 antibodies. The mortality in our cohort was 6.4%. In this review, we are going to describe all of the reported data regarding the diagnosis of autoimmune diseases and the presence of cancer in samples from patients with positive ACA as well as the potential factors associated with mortality in these patients. These results provide new insights into the prognosis and outcomes of these patients, but further investigations into factors that determine the risk of cancer in patients with positive ACA may be warranted.