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Clinical Investigations: DIFFUSE LUNG DISEASE |

Is Anti-Topoisomerase I a Serum Marker of Pulmonary Involvement in Systemic Sclerosis?*

Elisabeth Diot, MD; Bruno Giraudeau, PhD; Patrice Diot, MD, PhD; Danielle Degenne, PharmD; Laurence Ritz, MD; Jean-Louis Guilmot, MD; Etienne Lemarié, MD
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*From the Groupe de Recherche Epithélium Respiratoire et Inflammation (Drs. E. Diot, Ritz, and Guilmot), Services de Médecine Interne B, Immunologie (Dr. Degenne), et Pneumologie (Drs. P. Diot and Lemarié), CHU Bretonneau, Tours, France; and Centre de Recherche Clinique (Dr. Giraudeau), Faculté de Médecine, Tours, France.

Correspondence to: Patrice Diot, MD, PhD, Service de Pneumologie, CHU Bretonneau, 2 bis Boulevard Tonnellé, 37044 Tours Cedex, France; e-mail: diot@med.univ-tours.fr



Chest. 1999;116(3):715-720. doi:10.1378/chest.116.3.715
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Study objective: To determine the value of the level of anti-topoisomerase I (anti-topo I) to evaluate lung involvement defined by abnormal high-resolution computed tomography (HRCT) score and pulmonary function tests (PFTs) in systemic sclerosis (SS).

Patients: Forty-eight patients with SS, 20 with lung involvement and 28 with no lung involvement.

Design: PFT measurement, HRCT scoring of lung involvement, and anti-topo I assay by enzyme-linked immunosorbent assay. Normal anti-topo I level was defined as < 30.

Results: There was a significant association between cutaneous extent and anti-topo I level (6.5% of patients with limited cutaneous scleroderma had abnormal anti-topo I levels vs 70.6% of patients with diffuse cutaneous scleroderma, p = 0.0001). In patients with diffuse cutaneous scleroderma, pulmonary involvement was associated with a higher percentage of abnormal anti-topo I level: 91.7% vs 20% (p = 0.010). In patients with diffuse cutaneous scleroderma, a significant association was found between the class of anti-topo I level and total lung capacity (median, 69 in patients with abnormal anti-topo I level vs 87 in patients with normal anti-topo I level, p = 0.010), between the class of anti-topo I level and HRCT score (median, 12 in patients with abnormal anti-topo I level vs 5 in patients with normal anti-topo I level, p = 0.05).

Conclusion: Anti-topo I can be considered as a marker of lung involvement in patients with diffuse cutaneous scleroderma.

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