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Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (6): 1099-1105. doi: 10.19723/j.issn.1671-167X.2022.06.007

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Relationship between anti-ENO1 antibody and systemic lupus erythematosus patients with retinopathy

Lin-qi ZHANG1,Jing ZHAO2,Hong-yan WANG2,Zong-yi WANG1,Ying-ni LI2,Ji-yang TANG1,Si-ying LI1,Jin-feng QU1,*(),Ming-wei ZHAO1   

  1. 1. Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Disease, College of Optometry, Peking University Health and Science Center, Beijing, 100044
    2. Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, 100044
  • Received:2022-08-19 Online:2022-12-18 Published:2022-12-19
  • Contact: Jin-feng QU E-mail:drbari@163.com
  • Supported by:
    the National Key Research and Development Program of China(2020YFC20820);the Capital Clinical Diagnosis and Treatment Technology Research and Demonstration Application Project of China(Z191100006619029)

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Abstract:

Objective: To build bridges between anti-α enolase antibody (anti-enolase 1 antibody, anti-ENO1 antibody) and common clinical and laboratory characteristics of systemic lupus erythematosus (SLE) and to analyze the role of anti-ENO1 antibody in the evaluation of SLE disease activity. Methods: The SLE patients with retinopathy and without retinopathy were enrolled in the study, as well as healthy individuals whose gender and age matched with those of the SLE patients. Serum anti-ENO1 antibodies were measured using enzyme-linked immunosorbent assay (ELISA), presenting as intra-group positive rate and arbitrary units (AU) value. Clinical and laboratory data were obtained from medical records. Results: The SLE retinopathy patients represented various fundus abnormalities. Ranked by percentage, the top three retinopathies were retinal hemorrhage (14/32, 43.75%), cotton-wool spots (8/32, 25.00%) and retinal vein occlusion (3/32, 9.38%). Among the 32 SLE retinopathy patients, 13 (40.63%) suffered from two or more fundus abnormalities. The positive rate and AU value of the SLE patients were higher than of the SLE patients without retinopathy (68.75% vs. 46.00%, P=0.043; 16.11%±10.35% vs. 12.06%±6.47%, P=0.045). Besides, the positive rate and AU value of the two SLE groups were both significantly higher than those of the healthy control group (P < 0.001). Compared with the SLE-without-retinopathy group, the systemic lupus erythematosus disease activity index (SLEDAI)-2000 of the SLE retinopathy patients were significantly higher than those of the SLE patients without retinopathy (17.41±4.25 vs. 9.48±5.35, P < 0.001). Dividing all the SLE patients into an anti-ENO1-positive group and an anti-ENO1-negative group, we found that anti-ENO1-positive was more likely to be correlated to developing fever and positive result of urine occult blood (P=0.011, P=0.042). Comparing with the patients with negative anti-ENO1 antibodies, the patients with positive anti-ENO1 antibodies had significantly higher erythrocyte sedimentation rate (ESR) [the median (range) was 29.50 (1.52-110.00) mg/L vs. 12.00 (4.00-101.00) mg/L, P=0.001], higher immunoglobulin G (IgG) [the median (range) was 14.30 (4.02-37.80) g/L vs. 10.46 (2.50-25.73) g/L, P=0.000 3], and higher blood platelet count (PLT) [(205.87×109±67.98×109) /L vs. (164.57×109±69.57×109) /L, P=0.008], as well as higher immunoglobulin A (IgA) [the median (range) was 2.85 (0.07-27.00) g/L vs. 2.05 (0.42-4.36) g/L, P=0.014]. Conclusion: The positive rate and AU value of anti-ENO1 antibody suggested higher SLE disease activity and they were elevated in SLE and SLE retinopathy.

Key words: Systemic lupus erythematosus, Retinopathy, Autoantibody, α-enolase, Anti-ENO1 antibody

CLC Number: 

  • R593.24

Table 1

Demographic data of all the three groups"

Items SLE retinopathy SLE without retinopathy Healthy control P value
Age/years, ${\bar x}$±s 43.40±17.31 35.58±14.87 39.03±19.39 0.335
Range of age/years 18－73 17－70 19－74 -
Sample size, n 32 50 50 -
Gender, n (%)
  Male 7 (21.87) 7 (14.00) 6 (12.00) 0.458
  Female 25 (78.13) 43 (86.00) 44 (88.00)
Disease duration
  Median/years 10.5 6 - 0.156
  Range 20 days to 50 years 6 months to 42 years - -

Table 2

Clinical and laboratory characteristics of the two SLE groups"

Items SLE retinopathy, n=32 SLE without retinopathy, n=50 P value
SLEDAI-2000, ${\bar x}$±s 17.41±4.25 9.48±5.35 < 0.001#
Clinical Features
  Fever, n (%) 22 (68.75) 35 (70.00) 0.905
  Tmax/℃, ${\bar x}$±s 38.92±0.76 38.93±0.76 0.980
  Rash, n (%) 13 (40.62) 23 (46.00) 0.632
  Malar erythema, n (%) 15 (46.88) 20 (40.00) 0.539
  Arthralgia, n (%) 20 (62.50) 32 (64.00) 0.891
  Hair loss, n (%) 17 (53.12) 18 (36.00) 0.126
  Mucosal ulcer, n (%) 11 (34.38) 10 (20.00) 0.146
  Photosensitivity, n (%) 5 (15.62) 9 (18.00) 0.780
  Raynaud’s phenomenon, n (%) 5 (15.62) 11 (22.00) 0.477
  Urine occult blood, n (%) 13 (40.62) 11 (22.00) 0.071
  Urine protein, n (%) 19 (59.38) 25 (50.00) 0.406
  Pleurisy, n (%) 13 (40.62) 11 (22.00) 0.071
  Pericarditis, n (%) 9 (28.12) 10 (20.00) 0.395
Antibodies
  anti-dsDNA (+), n (%) 12 (37.50) 21 (42.00) 0.770
  ANA (+), n (%) 28 (87.50) 48 (96.00) 0.314
  anti-Sm (+), n (%) 3 (9.38) 12 (24.00) 0.095
  anti-U1 RNP (+), n (%) 10 (31.25) 19 (38.00) 0.533
  anti-SSA (+), n (%) 12 (37.50) 26 (52.00) 0.199
  anti-SSB (+), n (%) 2 (6.25) 4 (8.00) >0.999

Table 3

Prevalence of symptoms and laboratory abnormalities of SLE patients"

Items Anti-ENO1(+), n=45 Anti-ENO1(-), n=37 P value
SLEDAI-2000, ${\bar x}$±s 13.56±6.23 11.38±6.20 0.119
Fever, n (%) 26 (57.78) 31 (83.78) 0.011*
Tmax/℃, ${\bar x}$±s 38.88±0.69 38.96±0.79 0.705
Rash, n (%) 19 (42.22) 17 (45.95) 0.735
Malar erythema, n (%) 21 (46.67) 14 (37.84) 0.421
Arthralgia, n (%) 31 (68.89) 21 (56.76) 0.256
Hair loss, n (%) 20 (44.44) 15 (40.54) 0.722
Mucosal ulcer, n (%) 9 (20.00) 12 (32.43) 0.199
Photosensitivity, n (%) 6 (13.33) 8 (21.62) 0.301
Raynaud’s phenomenon, n (%) 9 (20.00) 7 (18.92) 0.902
Urine occult blood, n (%) 9 (20.00) 15 (40.54) 0.042*
Urine protein, n (%) 12 (46.67) 23 (62.16) 0.161
Pleurisy, n (%) 14 (31.11) 10 (27.03) 0.686
Pericarditis, n (%) 11 (24.44) 8 (21.62) 0.763
Anti-dsDNA (+), n (%) 21 (47.73) 12 (32.43) 0.163
ANA (+), n (%) 44 (97.78) 32 (86.49) 0.127
anti-Sm (+), n (%) 11 (24.44) 4 (10.81) 0.112
anti-U1 RNP (+), n (%) 19 (42.22) 10 (27.03) 0.152
anti-SSA (+), n (%) 21 (46.67) 17 (45.95) 0.948
anti-SSB (+), n (%) 6 (13.33) 0 0.060
ESR/(mm/h), M (range) 29.50 (1.52－110.00) 12.00 (4.00－101.00) 0.001#
CRP/(mg/L), M (range) 1.30 (0.30－52.40) 1.55 (0.39－101.71) 0.922
IgA/(g/L), M (range) 2.85 (0.07－27.00) 2.05 (0.42－4.36) 0.014*
IgG/(g/L), M (range) 14.30 (4.02－37.80) 10.46 (2.50－25.73) 0.0003#
IgM/(g/L), M (range) 0.90 (0.22－3.18) 0.69 (0.17－2.24) 0.148
C3/(g/L), ${\bar x}$±s 0.63±0.31 0.73±0.29 0.157
C4/(g/L), M (range) 0.14 (0.02－0.47) 0.16 (0.02－0.49) 0.245
WBC/(×109 /L), M (range) 6.40 (1.89－12.20) 5.00 (1.50－17.60) 0.132
HB/(g/L), ${\bar x}$±s 107.98±19.09 111.32±23.76 0.481
PLT/(×109 /L), ${\bar x}$±s 205.87±67.98 164.57±69.57 0.008#
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