1068: Anti-vinculin Antibodies in Systemic Sclerosis: Associations with Slow Gastric Transit and Extra-Intestinal Clinical Phenotype

Maria Herran¹, Brit Adler², Jamie Perin³, Walter Morales⁴, Mark Pimentel⁵ and Zsuzsanna McMahan⁶, ¹School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia, ²Johns Hopkins University, Division of Rheumatology, Baltimore, MD, ³John Hopkins University, Baltimore, MD, ⁴Medically Associated Science and Technology (MAST) Program, Cedars-Sinai, Los Angeles, CA, ⁵Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai, Los Angeles, CA, ⁶Johns Hopkins Rheumatology, Baltimore, MD

Background/Purpose: The gastrointestinal tract is commonly affected in systemic sclerosis (SSc). Prior studies have reported an association between higher levels of anti-vinculin antibodies and gastrointestinal symptom severity in SSc. Our aim was to determine whether anti-vinculin antibodies associate with objective measures of gastrointestinal dysmotility in SSc, and to determine the clinical phenotype associated with these antibodies.

Methods: Sera from 88 well-characterized patients who fulfilled the criteria 2013 ACR/EULAR criteria and the 1980 American College of Rheumatology (ACR) criteria for SSc in our cohort were assayed for anti-vinculin antibodies by enzyme-linked immunosorbent assay (ELISA). Whole gut scintigraphy, gastrointestinal symptom scores, and clinical features of SSc were compared with and without second generation anti-vinculin antibodies.

Results: Twenty-two out of 88 (25%) patients in our cohort had anti-vinculin antibodies. Anti-vinculin antibodies were more prevalent in patients with slow gastric transit than in patients without (37% vs. 21%). In the univariate analyses, higher levels of anti-vinculin autoantibodies were associated with a reduction of gastric emptying (β coefficient -3.41, 95% CI -6.72, -0.09), more limited cutaneous disease (OR 5.0, 95% CI 1.04, 23.9) and more thyroid disease (OR 3.2, 95% CI 1.02, 10.01). Patients were less likely to have lung involvement based on the Medsger Severity Score ³2 (OR 0.19, 95% CI 0.05, 0.68) and had a higher percent predicted diffusion capacity for carbon monoxide (DLCO) (β coefficient 15.3, 95% CI 0.12, 30.5). The association between anti-vinculin antibodies levels and slow gastric transit (β coefficient -3.64, 95% CI -7.05, -0.23) remained statistically significant in our multivariable model.

Conclusion: Anti-vinculin antibodies associate with gastric transit delays and other clinical features of SSc and may provide insight into slow gastric transit and an associated phenotype in SSc.
Table 1. Evaluation of associations between SSc clinical characteristics and anti-vinculin antibodies

Table 2. Linear regression analyses evaluating the association between anti-vinculin antibody levels and gastrointestinal transit

Table 3. Multivariable modeling with clinical and demographic features
Disclosures: M. Herran, None; B. Adler, None; J. Perin, None; W. Morales, None; M. Pimentel, Bausch Health, Synthetic Biologics, Gemelli Biotech, Ardelyx, Progenity, 9 meters; Z. McMahan, None.