ArticleRheumatology (Oxford, England)2025
Anti-cytolethal distending toxin antibodies in systemic sclerosis: associations with gastrointestinal disease and immune dysregulation.
Article in Rheumatology (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Gastrointestinal Disorders in Scleroderma.Gastroenterology · 2026Review
- Gastrointestinal involvement in systemic sclerosis: A spotlight on small bowel involvement, complications and management.Best practice & research. Clinical rheumatology · 2026Review
- Cellular Players in Gastrointestinal Involvement of Systemic Sclerosis: Insights into Pathogenesis.Cells · 2025Review
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Authors and funding
10 authors.
Funding
Abstract
objectivesAnti-cytolethal distending toxin (CDT) antibodies may serve as biomarkers for post-infectious autoimmunity and aid clinical risk stratification. We aimed to determine the prevalence of anti-CDT antibodies in a large, well-characterized cohort of systemic sclerosis (SSc) patients and examine associations with gastrointestinal (GI) and extraintestinal clinical features and SSc-related antibodies.
methodsSera from 130 SSc patients enriched for GI disease were screened for anti-CDT antibodies by ELISA. Clinical features, UCLA GIT 2.0-assessed symptoms and autoantibody profiles were compared between patients with and without anti-CDT antibodies. Linear mixed-effects models evaluated whether anti-CDT titres changed over time and correlated with longitudinal UCLA GIT 2.0 scores.
resultsAnti-CDT antibodies were detected in 18% (23/130) of SSc patients. Patients with anti-CDT antibodies more frequently had significant GI disease (87% vs 71%; P = 0.19) and were significantly more likely to have antibodies to U11/U12 (RNPC3) (35% vs 4%; P < 0.001), U1RNP (26% vs 8%; P = 0.018) and topoisomerase-1 (30% vs 12%; P = 0.044). UCLA GIT Soilage scores were significantly higher among anti-CDT positive patients [median (interquartile range) 1 (1-2) vs 0 (0-2); P = 0.037]. In multivariable analyses, anti-CDT antibodies remained significantly associated with anti-U11/U12 (RNPC3) [odds ratio (OR) 19.0 (95% CI: 4.3, 83.4); P ≤ 0.001], anti-U1RNP antibodies [OR 7.2 (95% CI: 1.9, 27.9); P = 0.004] and anti-topoisomerase-1 antibodies [OR 4.7 (95% CI: 1.3, 16.8); P = 0.019], even after adjusting for confounders. Anti-CDT titres did not change significantly over time.
conclusionsAnti-CDT antibodies may serve as markers of post-infectious autoimmunity and strongly associate with SSc-autoantibodies linked to severe, progressive GI disease. Understanding the connection between anti-CDT antibodies and SSc-specific autoimmunity may provide insight into disease pathogenesis.
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