Network analysis of associations between serum interferon‐α activity, autoantibodies, and clinical features in systemic lupus erythematosus

TLDR

Interferon‑α is a key pathogenic factor in systemic lupus erythematosus, with high levels linked to specific clinical manifestations that vary by ancestry. The study aimed to identify associations between serum interferon‑α activity, clinical features, and autoantibodies in a large, ancestrally diverse SLE cohort using multivariate and network analyses. Researchers analyzed data from 1,089 SLE patients, applying univariate and multivariate logistic regression models—including ancestry‑specific iterative analyses with Bonferroni correction—to map associations among ACR criteria, autoantibodies, and serum interferon‑α activity. High interferon‑α activity was consistently linked to anti‑Ro, anti‑dsDNA, younger age, non‑European ancestry, and anti‑RNP, but was not independently associated with ACR clinical features; network analysis revealed 14 unique associations, only seven shared across ancestries, suggesting IFNα’s role is more tied to humoral tolerance and early pathogenesis rather than later clinical manifestations.

Abstract

Interferon-α (IFNα) is a primary pathogenic factor in systemic lupus erythematosus (SLE), and high IFNα levels may be associated with particular clinical manifestations. The prevalence of individual clinical and serologic features differs significantly by ancestry. This study was undertaken to detect associations between clinical and serologic disease manifestations and serum IFNα activity in a large diverse SLE cohort, using multivariate and network analyses.We studied 1,089 SLE patients (387 African American, 186 Hispanic American, and 516 European American patients). The presence or absence of individual American College of Rheumatology (ACR) clinical criteria for SLE, autoantibodies, and serum IFNα activity data were analyzed in univariate and multivariate models. Iterative multivariate logistic regression was performed in each ancestral background group separately to establish the network of associations between variables that were independently significant following Bonferroni correction.In all ancestral backgrounds, high IFNα activity was associated with anti-Ro and anti-double-stranded DNA antibodies (P = 4.6 × 10(-18) and P = 2.9 × 10(-16) , respectively). Younger age, non-European ancestry, and anti-RNP were also independently associated with increased serum IFNα activity (P ≤ 6.7 × 10(-4) ). We found 14 unique associations between variables in network analysis, and only 7 of these associations were shared among >1 ancestral background. Associations between clinical criteria were different for different ancestral backgrounds, while autoantibody-IFNα relationships were similar across backgrounds. IFNα activity and autoantibodies were not associated with ACR clinical features in multivariate models.Our findings indicate that serum IFNα activity is strongly and consistently associated with autoantibodies, and not independently associated with clinical features in SLE. IFNα may be more relevant to humoral tolerance and initial pathogenesis than later clinical disease manifestations.