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The following is a summary of “Clinical features of patients with connective tissue disease with anti–human upstream binding factor antibodies: A single-center retrospective study,” published in the February 2024 issue of Dermatology by Fushida, et al.

Anti-human upstream-binding factor (anti-hUBF) antibodies have been observed primarily in patients with connective tissue diseases (CTDs) and those without CTDs, such as hepatocellular carcinoma. Due to their low frequency and limited case reports, the clinical significance of these antibodies remains to be determined. For a study, researchers sought to examine the clinical features of patients with anti–hUBF antibodies among those with clinically suspected CTDs. They sought to investigate the clinical features and significance of anti–hUBF antibodies in patients with suspected CTDs.

A cohort of 1,042 patients with clinically suspected CTDs was analyzed. The presence of anti–hUBF antibodies was determined using immunoprecipitation assays.

Out of the 1,042 patients, 19 (1.82%) tested positive for anti–hUBF antibodies. Among these, 10 (56%) were diagnosed with undifferentiated CTD (UCTD), six with systemic sclerosis (SSc), and three with other diseases. Five of the 10 patients with UCTD were referred with suspected SSc; however, none met the 2013 American College of Rheumatology/European League Against Rheumatism classification criteria, although three had relatively high scores (seven points). In the six patients with anti–hUBF-positive SSc, the modified Rodnan skin score (mRSS) was significantly lower compared to patients with anti–hUBF-positive SSc (2 [0–2] vs. 7 [0–49], P < 0.01). Additionally, compared to patients with anti–topoisomerase I-positive, patients with anti–hUBF-positive SSc had a significantly lower mRSS (2 [0–2] vs. 13 [0–42], P< 0.01) and a lower incidence of scleroderma renal crisis (0 of 6 vs. 8 of 184, P < 0.01). While patients with anti–hUBF–positive had a higher incidence of interstitial lung disease (ILD) than patients with anti–centromere–positive, this difference was not statistically significant (4 of 6 vs. 19 of 239).

Anti–hUBF antibodies were predominantly detected in patients with CTDs and UCTD. Among patients with CTD, those with SSc had a lower mRSS and a higher incidence of ILD. Patients with UCTD should be closely monitored as they may develop CTDs in the future.

Reference: onlinelibrary.wiley.com/doi/10.1111/1346-8138.17156