Turk J Immunol. 2022; 10(3): 155-161 | DOI: 10.4274/tji.galenos.2022.25238

Could SARS-CoV-2 Trigger the Formation of Antinuclear Antibodies?

Melek Bilgin¹, Ese Basbulut¹, Hatice Sule Baklacioglu², Adem Keskin³, Recai Aci^4
1University of Health Sciences Turkey, Samsun Training and Research Hospital, Clinic of Medical Microbiology, Samsun, Turkey
²University of Health Sciences Turkey, Samsun Training and Research Hospital, Clinic of Rheumatology, Samsun, Turkey
³Aydin Adnan Menderes University, Institute of Health Sciences, Department of Medicine Biochemistry, Aydýn, Turkey
⁴University of Health Sciences Turkey, Samsun Training and Research Hospital, Clinic of Biochemistry, Samsun, Turkey

Objective: The effect of severe acute respiratory syndrome-coronavirus-2 (SARS‑CoV‑2) infection on autoimmunity in both disease and post-disease stages has not been fully explained. There is not enough information about the evaluation of autoimmune antibodies in convalescent SARS-CoV-2 patients. This study aimed to investigate the presence and types of autoantibodies in post-illness coronavirus disease-2019 (COVID-19) patients and to compare them with indirect immunofluorescence assay (IIF)-antinuclear antibody (ANA) results before SARS-CoV-2 infection.
Materials and Methods: Twenty-four COVID-19 patients with known and reported ANA test results prior to SARS-CoV-2 infection were included in this study. Patients’ IIF-ANA, extractable nuclear antigen blot and anti-dsDNA tests were studied three and nine months after SARS-CoV-2 infection.
Results: Three months after SARS-CoV-2 infection, 41.66% of patients had a positive IIF-ANA test. When we compared these results with pre-infection ANA results, 3 patients (12.5%) were variable. The first case was chromosomal granular positive before infection and was found to be homogeneous, and cytoplasm was speckled positive after infection. Additionally, Scl-70, DFS70, and anti-dsDNA were found to be positive. We think that lupus symptoms were triggered after COVID-19. The second case had negative ANA before infection, while the ANA was antinuclear membrane positive (2+) three months after infection. Also, anti-RNP/Sm was detected as positive. The third case had negative ANA before infection, and was detected to have speckled weakly positive ANA three months after infection. However, autoantibody positivity was not detected.
Conclusion: As a result, these data support the idea that SARS-CoV-2 infection may trigger autoimmunity and be associated with the development of autoantibodies.

Keywords: SARS-CoV-2, COVID-19, antinuclear antibodies, autoimmunity

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SARS-CoV-2, Antinükleer Antikorlarýn Oluþumunu Tetikleyebilir mi?

Melek Bilgin¹, Ese Basbulut¹, Hatice Sule Baklacioglu², Adem Keskin³, Recai Aci^4
1Samsun Eðitim ve Araþtýrma Hastanesi, Týbbi Mikrobiyoloji Anabilim Dalý, Ýlkadým, Samsun, Türkiye
²Samsun Eðitim ve Araþtýrma Hastanesi, Romatoloji Bölümü, Ýlkadým, Samsun, Türkiye
³Aydýn Adnan Menderes Üniversitesi, Saðlýk Bilimleri Enstitüsü, Týp Biyokimya Anabilim Dalý, Efeler, Aydýn, Türkiye
⁴Samsun Eðitim ve Araþtýrma Hastanesi, Biyokimya Anabilim Dalý, Ýlkadým, Samsun, Türkiye

Amaç: Þiddetli akut solunum yolu sendromu-koronavirüsü-2 (SARS-CoV-2) enfeksiyonunun hem hastalýk hem de hastalýk sonrasý evrelerde otoimmünite üzerindeki etkisi tam olarak açýklanamamýþtýr. Nekahet dönemindeki SARS-CoV-2 hastalarýnda otoimmün antikorlarýn deðerlendirilmesi hakkýnda yeterli bilgi bulunmamaktadýr. Bu çalýþmada, hastalýk sonrasý koronavirüs hastalýðý-2019 (COVID-19) hastalarýnda otoantikorlarýn varlýðýný ve tiplerini araþtýrmak ve bunlarý SARS-CoV-2 enfeksiyonu öncesi dolaylý immünofloresan (IIF)-antinükleer antikor (ANA) sonuçlarýyla karþýlaþtýrmak amaçlanmýþtýr.
Gereç ve Yöntem: Bu çalýþmaya SARS-CoV-2 enfeksiyonu öncesi bilinen ve bildirilen ANA test sonuçlarý olan 24 COVID-19 hastasý dahil edilmiþtir. Hastalarýn IIF-ANA, ekstrakte edilebilir nükleer antijen blot ve anti-dsDNA testleri, SARS-CoV-2 enfeksiyonundan üç ve dokuz ay sonra çalýþýlmýþtýr.
Bulgular: SARS-CoV-2 enfeksiyonundan üç ay sonra hastalarýn %41.66’sýnda pozitif IIF-ANA testi saptanmýþtýr. Bu sonuçlar enfeksiyon öncesi ANA sonuçlarýyla karþýlaþtýrýldýðýnda üç hastada (%12.5) deðiþkenlik gözlenmiþtir. Ýlk olgu enfeksiyondan önce kromozomal granüler pozitif ve homojen, enfeksiyondan sonra sitoplazma benekli pozitif saptanmýþtýr. Ek olarak, Scl-70, DFS70, anti-dsDNA pozitif bulunmuþtur. Lupus semptomlarýnýn COVID-19 sonrasý tetiklendiði düþünülmektedir. Ýkinci olguda, enfeksiyondan önce ANA negatif iken, enfeksiyondan üç ay sonra ANA antinükleer membran pozitif (2+) saptanmýþtýr. Ayrýca, anti-RNP/Sm pozitif tespit edilmiþtir. Üçüncü olgu da enfeksiyondan önce ANA negatif, enfeksiyondan üç ay sonra benekli zayýf pozitif ANA olarak tespit edilmiþ, ancak otoantikor pozitifliði tespit edilmemiþtir.
Sonuç: Sonuç olarak bu veriler SARS-CoV-2 enfeksiyonunun otoimmüniteyi tetikleyebileceði ve otoantikor geliþimi ile iliþkili olabileceði fikrini desteklemektedir.

Anahtar Kelimeler: SARS-CoV-2, COVID-19, antinükleer antikorlar, otoimmünite

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