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TOPLINE:

Anti–transcription factor A, mitochondrial (anti-TFAM) antibodies in patients with systemic lupus erythematosus (SLE) were associated with a threefold increased risk for thrombotic events. 

METHODOLOGY:

• Researchers discovered the autoantibody in an exploratory sample of 22 patients with SLE and nine healthy controls.
• The findings were validated using a sample of 158 patients with SLE and 98 healthy control individuals from the “Study of biological Pathways, Disease Activity and Response markers in patients with Systemic Lupus Erythematosus” (SPARE) cohort.
• Researchers used comprehensive clinical, serological, and gene expression data collected from the SPARE cohort to identify clinical features associated with anti-TFAM antibodies.

TAKEAWAY:

• Anti-TFAM antibodies were detected in 30.3% of patients with SLE (48 of 158) and 4% of healthy controls (four of 98).
• Patients with SLE who were positive for anti-TFAM antibodies showed significantly higher risk for thrombosis (odds ratio [OR], 2.9) and antiphospholipid syndrome (APS; OR, 5.4), independent of traditional APS-associated antibodies.
• The presence of both anti-TFAM antibodies and lupus anticoagulant demonstrated an additive effect, increasing thrombosis risk substantially (OR, 8.71).

IN PRACTICE:

“Anti-TFAM antibodies are potential biomarkers for identifying SLE patients at risk of thrombosis, independent of traditional APS-associated antibodies. These novel autoantibodies may aid in disease evaluation and treatment strategies for SLE, as well as provide novel insights into disease mechanisms, particularly those related to thrombotic events and APS,” study authors wrote.

SOURCE:

The study was led by Eduardo Gómez-Bañuelos, MD, PhD, Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore. It was published online in Annals of the Rheumatic Diseases on May 10, 2025.

LIMITATIONS:

Due to the cross-sectional nature of the sample collection, the researchers could not determine whether anti-TFAM seroconversion occurs simultaneously or sequentially with vascular events in SLE. The significance of anti-TFAM antibodies with thrombotic events in other patient groups without SLE or primary APS requires further investigation.

DISCLOSURES:

The study was funded by the Jerome L. Greene Foundation, the National Institute of Allergy and Infectious Diseases, and the National Institute of Arthritis and Musculoskeletal and Skin Diseases. One author disclosed receiving consulting fees and/or royalties from Celgene, Inova, Advise Connect Inspire, and Hillstar Bio Inc.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.