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Antibodies to carbonic anhydrase in patients with connective tissue diseases: relationship with lung involvement

D Caccavo1, A Afeltra, A Rigon

  • 1Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari, Bari, Italy. caccavo@midim.uniba.it

International Journal of Immunopathology and Pharmacology
|October 4, 2008
PubMed

Insights

Antibodies to carbonic anhydrase (ACAI and ACAII) are present in over 30% of patients with connective tissue diseases. Higher ACAI levels correlate with lung involvement, suggesting a potential role in disease pathogenesis.

Area of Science:

  • Immunology
  • Rheumatology
  • Pulmonology

Background:

  • Connective tissue diseases (CTD) encompass a range of autoimmune disorders.
  • Lung involvement is a significant complication in CTD patients.
  • Antibodies to carbonic anhydrase I and II (ACAI and ACAII) are implicated in autoimmune conditions.

Purpose of the Study:

  • To evaluate the prevalence of ACAI and ACAII in CTD patients.
  • To investigate the association between ACAI/ACAII and lung involvement assessed by High-Resolution CT (HRCT).

Main Methods:

  • ELISA was used to detect ACAI and ACAII in 96 CTD patients (RA, PA, AS, SLE, SS, SSc).
  • Lung involvement was quantified using a validated HRCT score.
  • Patients were categorized based on HRCT scores predictive of interstitial lung disease.

Main Results:

  • ACAI and/or ACAII were detected in 31.2% of CTD patients, significantly higher than controls.
  • Prevalence was notably elevated in Rheumatoid Arthritis, Psoriatic Arthritis, Systemic Lupus Erythematosus, and Systemic Sclerosis.
  • Positive correlations were observed between HRCT scores and C-reactive protein (CRP) or ACAI levels.
  • Patients with significant lung involvement (HRCT score ≥ 10) exhibited higher CRP and ACAI levels.
  • Inverse correlations were found between HRCT scores and C3/C4 complement fractions, with lower levels in patients with lung involvement.

Conclusions:

  • ACAI and/or ACAII are prevalent in CTD patients, particularly those with RA, PA, SLE, and SSc.
  • Elevated ACAI levels are associated with lung involvement in CTD.
  • Lower complement levels (C3, C4) in patients with lung involvement suggest a potential immune-complex-mediated mechanism contributing to pulmonary complications.

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