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ORIGINAL RESEARCH article

Front. Immunol.

Sec. Primary Immunodeficiencies

Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1657670

This article is part of the Research TopicDiseases with Immune Dysregulation in AfricaView all 3 articles

Prevalence and Clinical Implications of Major and Minor ANCAs in Tunisian (North African) Patients with Systemic Lupus Erythematosus

Provisionally accepted
Zeineb  MeddebZeineb Meddeb1,2,3*Houssem  AbidaHoussem Abida1,3Dhouha  KrirDhouha Krir1,4Ahlem  Ben HmidAhlem Ben Hmid1,4,5Raja  AouaidiaRaja Aouaidia1,6Cherifa  AbdelkéfiCherifa Abdelkéfi1,3Yosra  NasriYosra Nasri4Ines  Ben SghaierInes Ben Sghaier4Hayet  KebaierHayet Kebaier4Samar  SamoudSamar Samoud4,5Rim  GouchaRim Goucha1,6Saloua  B'chir HamzaouiSaloua B'chir Hamzaoui1,3Mélika  Ben AhmedMélika Ben Ahmed1,4,5Thara  LarbiThara Larbi1Imen  ZamaliImen Zamali1*Yousr  GalaiYousr Galai4,7
  • 1Faculty of Medicine of Tunis, University of Tunis El Manar, 1068, Tunis, Tunisia
  • 2Laboratory of Genetics, Immunology, and Human Pathology, Faculty of Sciences of Tunis, University of Tunis El Manar,, Tunis, Tunisia
  • 3Internal medicine department, Mongi Slim University Hospital, Tunis, Tunisia
  • 4Clinical immunology department, Pasteur Institute of Tunis, Tunis, Tunisia
  • 5Laboratory of Transmission, Control and Immunobiology of Infection, Pasteur Institute of Tunis, 1002, Tunis, Tunisia
  • 6Nephrology Department, Mongi Slim University Hospital, Tunis, Tunisia
  • 7Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia

The final, formatted version of the article will be published soon.

This study explores the prevalence, antigenic specificity, and clinical significance of anti-neutrophil cytoplasmic antibodies (ANCAs) in systemic lupus erythematosus (SLE) within a North African (Tunisian) population. While ANCAs have been previously reported in SLE, their relevance remains poorly understood, particularly in African cohorts. Through a case-control study combining indirect immunofluorescence and antigenspecific ELISA, we identify a high prevalence of ANCAs-particularly anti-lactoferrin antibodies-and establish their association with lupus nephritis, cutaneous manifestations, and higher disease activity. Our findings highlight potential ethnic and environmental influences on autoantibody profiles in SLE and suggest that ANCAs, specifically anti-lactoferrin, could serve as biomarkers of disease severity in this population.

Keywords: Ahlem Ben Hmid: Investigation, Writingreview & editing. Cherifa Abdelkéfi: Writingreview & editing. Dhouha Krir: Data curation, Formal analysis, Writingoriginal draft. Hayet Kebaier: Writingreview & editing. Houssem Abida: Data curation, Writing original draft. Imen Zamali: Conceptualization, investigation, supervision, Validation

Received: 01 Jul 2025; Accepted: 30 Jul 2025.

Copyright: © 2025 Meddeb, Abida, Krir, Ben Hmid, Aouaidia, Abdelkéfi, Nasri, Sghaier, Kebaier, Samoud, Goucha, B'chir Hamzaoui, Ben Ahmed, Larbi, Zamali and Galai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Zeineb Meddeb, Faculty of Medicine of Tunis, University of Tunis El Manar, 1068, Tunis, Tunisia
Imen Zamali, Faculty of Medicine of Tunis, University of Tunis El Manar, 1068, Tunis, Tunisia

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