Autoantibodies, cutaneous subset and immunosuppressants contribute to the cancer risk in systemic sclerosis

Objective Systemic sclerosis (SSc) is associated with an increased risk of cancer. We aimed to assess the prevalence of cancer in our cohort and to explore possible associations with clinical, immunological and treatment characteristics.Methods Our retrospective monocentric cohort study of patients...

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Main Authors: Maria De Santis, Carlo Selmi, Angela Ceribelli, Stefanos Bonovas, Francesca Motta, Antonio Tonutti, Natasa Isailovic, Rita Ragusa, Emanuele Nappi
Format: Article
Language:English
Published: BMJ Publishing Group 2024-09-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/10/3/e004492.full
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author Maria De Santis
Carlo Selmi
Angela Ceribelli
Stefanos Bonovas
Francesca Motta
Antonio Tonutti
Natasa Isailovic
Rita Ragusa
Emanuele Nappi
author_facet Maria De Santis
Carlo Selmi
Angela Ceribelli
Stefanos Bonovas
Francesca Motta
Antonio Tonutti
Natasa Isailovic
Rita Ragusa
Emanuele Nappi
author_sort Maria De Santis
collection DOAJ
description Objective Systemic sclerosis (SSc) is associated with an increased risk of cancer. We aimed to assess the prevalence of cancer in our cohort and to explore possible associations with clinical, immunological and treatment characteristics.Methods Our retrospective monocentric cohort study of patients with SSc recorded prevalent and incident cases of malignancy, including those diagnosed within 3 years of the SSc onset (defined as cancer-associated scleroderma) and sought associations with the clinical characteristics and the serum autoantibody profiling performed using RNA and protein immunoprecipitation, Western-blot, immunoblot and ELISA at the time of SSc diagnosis, prior to any specific treatment.Results Among 290 patients with SSc, the overall prevalence of cancer was 20%, with 8% of cases being cancer-associated scleroderma. Both conditions were more frequent in elderly patients and in patients with positive anti-Ro52 or anti-U3-RNP. Cancer-associated scleroderma was significantly more prevalent among patients negative for both anti-centromere (ACA) and anti-topoisomerase-1 (TOPO1) antibodies, especially in the case of diffuse SSc. Immunosuppressants were not significantly associated with cancer. Patients triple negative for ACA, TOPO1 and anti-RNA polymerase III antibodies had a significantly higher risk of breast cancer.Conclusions Cancer surveillance should be particularly careful in patients with diffuse SSc, increased age at disease onset and without classical SSc-related autoantibodies.
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spelling doaj-art-6ebc8d8768d04041b9fac8a561e4652e2025-08-20T01:55:38ZengBMJ Publishing GroupRMD Open2056-59332024-09-0110310.1136/rmdopen-2024-004492Autoantibodies, cutaneous subset and immunosuppressants contribute to the cancer risk in systemic sclerosisMaria De Santis0Carlo Selmi1Angela Ceribelli2Stefanos Bonovas3Francesca Motta4Antonio Tonutti5Natasa Isailovic6Rita Ragusa7Emanuele Nappi8Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalyIRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalyRheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, ItalyRheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalyObjective Systemic sclerosis (SSc) is associated with an increased risk of cancer. We aimed to assess the prevalence of cancer in our cohort and to explore possible associations with clinical, immunological and treatment characteristics.Methods Our retrospective monocentric cohort study of patients with SSc recorded prevalent and incident cases of malignancy, including those diagnosed within 3 years of the SSc onset (defined as cancer-associated scleroderma) and sought associations with the clinical characteristics and the serum autoantibody profiling performed using RNA and protein immunoprecipitation, Western-blot, immunoblot and ELISA at the time of SSc diagnosis, prior to any specific treatment.Results Among 290 patients with SSc, the overall prevalence of cancer was 20%, with 8% of cases being cancer-associated scleroderma. Both conditions were more frequent in elderly patients and in patients with positive anti-Ro52 or anti-U3-RNP. Cancer-associated scleroderma was significantly more prevalent among patients negative for both anti-centromere (ACA) and anti-topoisomerase-1 (TOPO1) antibodies, especially in the case of diffuse SSc. Immunosuppressants were not significantly associated with cancer. Patients triple negative for ACA, TOPO1 and anti-RNA polymerase III antibodies had a significantly higher risk of breast cancer.Conclusions Cancer surveillance should be particularly careful in patients with diffuse SSc, increased age at disease onset and without classical SSc-related autoantibodies.https://rmdopen.bmj.com/content/10/3/e004492.full
spellingShingle Maria De Santis
Carlo Selmi
Angela Ceribelli
Stefanos Bonovas
Francesca Motta
Antonio Tonutti
Natasa Isailovic
Rita Ragusa
Emanuele Nappi
Autoantibodies, cutaneous subset and immunosuppressants contribute to the cancer risk in systemic sclerosis
RMD Open
title Autoantibodies, cutaneous subset and immunosuppressants contribute to the cancer risk in systemic sclerosis
title_full Autoantibodies, cutaneous subset and immunosuppressants contribute to the cancer risk in systemic sclerosis
title_fullStr Autoantibodies, cutaneous subset and immunosuppressants contribute to the cancer risk in systemic sclerosis
title_full_unstemmed Autoantibodies, cutaneous subset and immunosuppressants contribute to the cancer risk in systemic sclerosis
title_short Autoantibodies, cutaneous subset and immunosuppressants contribute to the cancer risk in systemic sclerosis
title_sort autoantibodies cutaneous subset and immunosuppressants contribute to the cancer risk in systemic sclerosis
url https://rmdopen.bmj.com/content/10/3/e004492.full
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