A prospective, observational study published in Annals of the Rheumatic Diseases, showed that patients at risk of autoimmune connective tissue disease who evolved to definite disease had high interferon levels and a family history of autoimmune rheumatic disease, foreseeing a link between the interferon scores and disease progression.

Md Yuzaiful Md Yusof, MBChB, of the Institute of Rheumatic and Musculoskeletal Medicine at the University of Leeds (England) and his colleagues assessed long-term data from musculoskeletal ultrasounds and blood and skin biopsy samples of 118 patients who had a possibility of developing autoimmune connective tissue disease (AI-CTD). They contrasted exams and samples from baseline as well as 12 months, 24 months, and 36 months against data from 49 healthy patients and 114 patients with systemic lupus erythematosus (SLE).

They found that patients who had one or lesser symptoms of clinical SLE, exhibited symptoms for less than 12 months, were antinuclear antibody (ANA) positive, and had not been treated formerly for AI-CTD stood a chance of developing AI-CTD. Blood and biopsy results for two continuous interferon (IFN) expression scores, IFN-Score-A and IFN-Score-B were analyzed.

“Referrals of ANA-positive individuals to rheumatologists has increased over the last decade. Concerns are that these at-risk individuals may be discharged prematurely or be observed in an inefficient ‘watch and wait’ fashion until the diagnosis is clear, by which time the potential to prevent disease and confer the most benefit may be lost,” Dr. Yusof and his colleagues wrote in their study.

 “Although we could not confirm which IFN pathways predominate, our findings suggest that progression to AI-CTD may not be exclusively driven by IFN-I [type I interferon] but by a synergistic activation of [interferon-stimulated genes] induced by a range of IFNs and IFN-Score-B [that] could act as a biomarker for more diverse immune activation,” Dr. Yusof added.