Anti-Ro52/TRIM21 autoantibodies predict Sjögren's syndrome in patients with primary biliary cholangitis

Marie Louise Næstholt Dahl; Trine Line Korsholm; Jakob Hauge Mikkelsen; Malene Hvid; Ayad Babaee; Matias Hauge Böttcher; Jesper Bach Hansen; Peter Holland-Fischer; Christian Brix Folsted Andersen; Henning Grønbæk; Bent Deleuran

doi:10.1111/hepr.14213

Anti-Ro52/TRIM21 autoantibodies predict Sjögren's syndrome in patients with primary biliary cholangitis

Marie Louise Næstholt Dahl^*
, Trine Line Korsholm
, Jakob Hauge Mikkelsen
, Malene Hvid
, Ayad Babaee
, Matias Hauge Böttcher
, Jesper Bach Hansen
, Peter Holland-Fischer
, Christian Brix Folsted Andersen
, Henning Grønbæk
, Bent Deleuran

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Background and aims: Sjögren's syndrome is a common comorbidity in patients with primary biliary cholangitis (PBC). Anti-Ro52 autoantibodies against the protein TRIM21 are often seen in Sjögren's syndrome. TRIM21 consists of four domains (PRY/SPRY, Coiled-Coil, B-box, and RING domain), each with a specific function. We hypothesized that patients with PBC and concomitant autoantibodies against TRIM21 had a higher risk of developing Sjögren's syndrome. Methods: Using ELISA, we analyzed plasma from 236 Danish patients with PBC. Binomial regression assessed the risk rates between demographics, serologic variables, PBC-40 results, and autoantibody positivity. Results: Forty patients (16.9%) tested positive for anti-Ro52 autoantibodies, with 23 (9.7%) samples positive against Coiled-Coil, 12 against PRY/SPRY (5.1%), and 10 against RING (4.2%). Increased IgG plasma levels, reports of dry mouth, and a diagnosis of Sjögren's syndrome increased the risk of both anti-Ro52 and all domain autoantibodies. In the anti-Ro52 positive subgroup, no less than 14 undiagnosed patients met the criteria for Sjögren's syndrome. Conclusions: We observed a 16.9% positivity of anti-Ro52 autoantibodies and an association between having these autoantibodies and elevated IgG, the symptom dry mouth, and having Sjögren's syndrome. Furthermore, we found a sizable undiagnosed group of Sjögren's patients in the anti-Ro52 positive subgroup. Our results suggest that Sjögren's patients are underdiagnosed in patients with PBC. We propose that patients with PBC be tested for anti-Ro52 autoantibodies and, if positive, referred for rheumatological examination.

Original language	English
Journal	Hepatology Research
Volume	55
Issue	8
Pages (from-to)	1128-1138
Number of pages	11
ISSN	1386-6346
DOIs	https://doi.org/10.1111/hepr.14213
Publication status	Published - Aug 2025

Keywords

autoantibodies
autoimmune disease
primary biliary cholangitis
Sjögren's syndrome
TRIM21

Access to Document

10.1111/hepr.14213

Library access?

Check availability with the Royal Danish Library

Cite this

@article{08c7d088f7e4419490fdea6ed6287845,

title = "Anti-Ro52/TRIM21 autoantibodies predict Sj{\"o}gren's syndrome in patients with primary biliary cholangitis",

abstract = "Background and aims: Sj{\"o}gren's syndrome is a common comorbidity in patients with primary biliary cholangitis (PBC). Anti-Ro52 autoantibodies against the protein TRIM21 are often seen in Sj{\"o}gren's syndrome. TRIM21 consists of four domains (PRY/SPRY, Coiled-Coil, B-box, and RING domain), each with a specific function. We hypothesized that patients with PBC and concomitant autoantibodies against TRIM21 had a higher risk of developing Sj{\"o}gren's syndrome. Methods: Using ELISA, we analyzed plasma from 236 Danish patients with PBC. Binomial regression assessed the risk rates between demographics, serologic variables, PBC-40 results, and autoantibody positivity. Results: Forty patients (16.9\%) tested positive for anti-Ro52 autoantibodies, with 23 (9.7\%) samples positive against Coiled-Coil, 12 against PRY/SPRY (5.1\%), and 10 against RING (4.2\%). Increased IgG plasma levels, reports of dry mouth, and a diagnosis of Sj{\"o}gren's syndrome increased the risk of both anti-Ro52 and all domain autoantibodies. In the anti-Ro52 positive subgroup, no less than 14 undiagnosed patients met the criteria for Sj{\"o}gren's syndrome. Conclusions: We observed a 16.9\% positivity of anti-Ro52 autoantibodies and an association between having these autoantibodies and elevated IgG, the symptom dry mouth, and having Sj{\"o}gren's syndrome. Furthermore, we found a sizable undiagnosed group of Sj{\"o}gren's patients in the anti-Ro52 positive subgroup. Our results suggest that Sj{\"o}gren's patients are underdiagnosed in patients with PBC. We propose that patients with PBC be tested for anti-Ro52 autoantibodies and, if positive, referred for rheumatological examination.",

keywords = "autoantibodies, autoimmune disease, primary biliary cholangitis, Sj{\"o}gren's syndrome, TRIM21",

author = "Dahl, \{Marie Louise N{\ae}stholt\} and Korsholm, \{Trine Line\} and Mikkelsen, \{Jakob Hauge\} and Malene Hvid and Ayad Babaee and B{\"o}ttcher, \{Matias Hauge\} and Hansen, \{Jesper Bach\} and Peter Holland-Fischer and \{Folsted Andersen\}, \{Christian Brix\} and Henning Gr{\o}nb{\ae}k and Bent Deleuran",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s). Hepatology Research published by John Wiley \& Sons Australia, Ltd on behalf of Japan Society of Hepatology.",

year = "2025",

month = aug,

doi = "10.1111/hepr.14213",

language = "English",

volume = "55",

pages = "1128--1138",

journal = "Hepatology Research",

issn = "1386-6346",

publisher = "John Wiley \& Sons Inc.",

number = "8",

}

Anti-Ro52/TRIM21 autoantibodies predict Sjögren's syndrome in patients with primary biliary cholangitis. / Dahl, Marie Louise Næstholt; Korsholm, Trine Line; Mikkelsen, Jakob Hauge et al.
In: Hepatology Research, Vol. 55, No. 8, 08.2025, p. 1128-1138.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Anti-Ro52/TRIM21 autoantibodies predict Sjögren's syndrome in patients with primary biliary cholangitis

AU - Dahl, Marie Louise Næstholt

AU - Korsholm, Trine Line

AU - Mikkelsen, Jakob Hauge

AU - Hvid, Malene

AU - Babaee, Ayad

AU - Böttcher, Matias Hauge

AU - Hansen, Jesper Bach

AU - Holland-Fischer, Peter

AU - Folsted Andersen, Christian Brix

AU - Grønbæk, Henning

AU - Deleuran, Bent

PY - 2025/8

Y1 - 2025/8

N2 - Background and aims: Sjögren's syndrome is a common comorbidity in patients with primary biliary cholangitis (PBC). Anti-Ro52 autoantibodies against the protein TRIM21 are often seen in Sjögren's syndrome. TRIM21 consists of four domains (PRY/SPRY, Coiled-Coil, B-box, and RING domain), each with a specific function. We hypothesized that patients with PBC and concomitant autoantibodies against TRIM21 had a higher risk of developing Sjögren's syndrome. Methods: Using ELISA, we analyzed plasma from 236 Danish patients with PBC. Binomial regression assessed the risk rates between demographics, serologic variables, PBC-40 results, and autoantibody positivity. Results: Forty patients (16.9%) tested positive for anti-Ro52 autoantibodies, with 23 (9.7%) samples positive against Coiled-Coil, 12 against PRY/SPRY (5.1%), and 10 against RING (4.2%). Increased IgG plasma levels, reports of dry mouth, and a diagnosis of Sjögren's syndrome increased the risk of both anti-Ro52 and all domain autoantibodies. In the anti-Ro52 positive subgroup, no less than 14 undiagnosed patients met the criteria for Sjögren's syndrome. Conclusions: We observed a 16.9% positivity of anti-Ro52 autoantibodies and an association between having these autoantibodies and elevated IgG, the symptom dry mouth, and having Sjögren's syndrome. Furthermore, we found a sizable undiagnosed group of Sjögren's patients in the anti-Ro52 positive subgroup. Our results suggest that Sjögren's patients are underdiagnosed in patients with PBC. We propose that patients with PBC be tested for anti-Ro52 autoantibodies and, if positive, referred for rheumatological examination.

AB - Background and aims: Sjögren's syndrome is a common comorbidity in patients with primary biliary cholangitis (PBC). Anti-Ro52 autoantibodies against the protein TRIM21 are often seen in Sjögren's syndrome. TRIM21 consists of four domains (PRY/SPRY, Coiled-Coil, B-box, and RING domain), each with a specific function. We hypothesized that patients with PBC and concomitant autoantibodies against TRIM21 had a higher risk of developing Sjögren's syndrome. Methods: Using ELISA, we analyzed plasma from 236 Danish patients with PBC. Binomial regression assessed the risk rates between demographics, serologic variables, PBC-40 results, and autoantibody positivity. Results: Forty patients (16.9%) tested positive for anti-Ro52 autoantibodies, with 23 (9.7%) samples positive against Coiled-Coil, 12 against PRY/SPRY (5.1%), and 10 against RING (4.2%). Increased IgG plasma levels, reports of dry mouth, and a diagnosis of Sjögren's syndrome increased the risk of both anti-Ro52 and all domain autoantibodies. In the anti-Ro52 positive subgroup, no less than 14 undiagnosed patients met the criteria for Sjögren's syndrome. Conclusions: We observed a 16.9% positivity of anti-Ro52 autoantibodies and an association between having these autoantibodies and elevated IgG, the symptom dry mouth, and having Sjögren's syndrome. Furthermore, we found a sizable undiagnosed group of Sjögren's patients in the anti-Ro52 positive subgroup. Our results suggest that Sjögren's patients are underdiagnosed in patients with PBC. We propose that patients with PBC be tested for anti-Ro52 autoantibodies and, if positive, referred for rheumatological examination.

KW - autoantibodies

KW - autoimmune disease

KW - primary biliary cholangitis

KW - Sjögren's syndrome

KW - TRIM21

UR - https://www.scopus.com/pages/publications/105006453824

U2 - 10.1111/hepr.14213

DO - 10.1111/hepr.14213

M3 - Journal article

C2 - 40418171

AN - SCOPUS:105006453824

SN - 1386-6346

VL - 55

SP - 1128

EP - 1138

JO - Hepatology Research

JF - Hepatology Research

IS - 8

ER -

Anti-Ro52/TRIM21 autoantibodies predict Sjögren's syndrome in patients with primary biliary cholangitis

Abstract

Keywords

Access to Document

Library access?

Other files and links

Fingerprint

Cite this