Apheresis enhances the selective removal of antinuclear antibodies in systemic lupus erythematosus

Abstract

Apheresis suppresses clinical manifestations of lupus and reduces levels of antinuclear antibodies implicated in the pathogenesis of systemic lupus erythematosus (SLE). It is not known, however, if reduced levels of antinuclear antibodies are due to nonspecific removal, or specific mechanisms associated with decreased production, or enhanced clearance from the circulation. In order to distinguish between specific and nonspecific effects of apheresis on antinuclear antibodies in SLE, we compared plasma levels of IgG antibodies to DNA and IgG antibodies to microbial antigens in 13 SLE patients before and after apheresis. Although apheresis lowered plasma levels of IgG (21% mean reduction), there was a disproportionate reduction in IgG antibodies to DNA (42% mean reduction, p.