{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:04:47Z","timestamp":1791493487154,"version":"4.3.4"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008386","name":"Marmara University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008386","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Immunol Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Anti-rods and rings (anti-RR) antibodies represent a rare cytoplasmic antinuclear antibody (ANA) pattern typically associated with hepatitis C virus (HCV) infection and interferon-based therapy. However, emerging evidence suggests a broader clinical relevance beyond HCV. This study aimed to investigate the prevalence, immunofluorescence characteristics, autoantibody associations, and clinical contexts of anti-RR antibodies in a large Turkish patient cohort undergoing routine ANA screening. Serum samples were retrospectively analysed for ANA using indirect immunofluorescence (IIF) between January 2022 and October 2024. Samples displaying anti-RR patterns were further evaluated for specific ANA profiles using line immunoassay. Clinical and demographic data were collected from medical records. Among 57,644 patients tested for ANA, 11,752 (20.39%) were ANA-positive, with only 91 cases (0.16%) exhibiting an anti-RR pattern. These cases were predominantly female (60.44%) with a median age of 52 years. Isolated anti-RR patterns were observed in 70.33% of patients, while the remainder showed mixed patterns, most commonly with AC-4,5,31 and AC-1 ANA patterns. Anti-RR positivity showed no significant association with classical ANA-specific autoantibodies. Clinically, anti-RR-positive patients displayed diverse diagnoses, including autoimmune diseases (21.98%), nephropathic conditions (9.89%), hepatic (7.69%) and pulmonary (6.59%) disorders, with the majority (53.85%) categorized under other conditions. Anti-RR antibodies, while rare, occur across a spectrum of diseases and may be associated with heterogeneous clinical conditions beyond hepatitis C infection. Their detection warrants careful interpretation within the appropriate clinical and laboratory context. Prospective studies are needed to explore their pathophysiological roles and diagnostic utility in diverse patient populations.<\/jats:p>","DOI":"10.1007\/s12026-026-09754-6","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T04:38:52Z","timestamp":1771475932000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and clinical associations of anti-rods and rings antibodies in ANA-tested patients"],"prefix":"10.1007","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1966-4240","authenticated-orcid":false,"given":"Baris","family":"Can","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arzu Aksit","family":"Ilki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"issue":"10","key":"9754_CR1","doi-asserted-by":"publisher","first-page":"102643","DOI":"10.1016\/j.autrev.2020.102643","volume":"19","author":"SJ Calise","year":"2020","unstructured":"Calise SJ, Chan EKL. Anti-rods\/rings autoantibody and IMPDH filaments: an update after fifteen years of discovery. Autoimmun Rev. 2020;19(10):102643. https:\/\/doi.org\/10.1016\/j.autrev.2020.102643","journal-title":"Autoimmun Rev"},{"issue":"3","key":"9754_CR2","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1007\/s12026-020-09136-6","volume":"68","author":"AB da Silva Sacerdote","year":"2020","unstructured":"daSilva Sacerdote AB, Filgueira NA, de Barros Barreto S, Batista AD, Lopes EP. Anti-rod and ring antibodies in patients with chronic hepatitis C using direct-acting antivirals. Immunol Res. 2020;68(3):111\u20137. https:\/\/doi.org\/10.1007\/s12026-020-09136-6","journal-title":"Immunol Res"},{"key":"9754_CR3","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/1471-230X-13-50","volume":"13","author":"LM Stinton","year":"2013","unstructured":"Stinton LM, Myers RP, Coffin CS, Fritzler MJ. Clinical associations and potential novel antigenic targets of autoantibodies directed against rods and rings in chronic hepatitis C infection. BMC Gastroenterol. 2013;13:50. https:\/\/doi.org\/10.1186\/1471-230X-13-50","journal-title":"BMC Gastroenterol"},{"issue":"2","key":"9754_CR4","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.gastrohep.2018.08.005","volume":"42","author":"M Alsius","year":"2019","unstructured":"Alsius M, Ferri MJ, Bux\u00f3 M, L\u00f3pez C, Serra I, Queralt X, Acero D. Autoantibodies to cytoplasmic rods and rings in patients with hepatitis C virus infection treated with direct-acting antivirals: the role of prior treatment with interferon plus ribavirin. Gastroenterol Hepatol. 2019;42(2):82\u20139. https:\/\/doi.org\/10.1016\/j.gastrohep.2018.08.005. English, Spanish.","journal-title":"Gastroenterol Hepatol"},{"issue":"6","key":"9754_CR5","doi-asserted-by":"publisher","first-page":"e13254","DOI":"10.1111\/sji.13254","volume":"97","author":"Y Gu","year":"2023","unstructured":"Gu Y, Li S, Wang Z, Yang D. The value of anti-rods and rings antibodies in Chinese population of Dalian city: A retrospective study. Scand J Immunol. 2023;97(6):e13254.","journal-title":"Scand J Immunol"},{"key":"9754_CR6","doi-asserted-by":"publisher","first-page":"1007257","DOI":"10.3389\/fimmu.2022.1007257","volume":"13","author":"J Meng","year":"2022","unstructured":"Meng J, Yang G, Li S, et al. The clinical value of indirect Immunofluorescence for screening anti-rods and rings antibodies: A retrospective study of two centers in China. 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J Cell Physiol. 2019;234(12):21630\u201341. https:\/\/doi.org\/10.1002\/jcp.28821","journal-title":"J Cell Physiol"}],"container-title":["Immunologic Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12026-026-09754-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12026-026-09754-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12026-026-09754-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:27:59Z","timestamp":1781634479000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12026-026-09754-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,19]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["9754"],"URL":"https:\/\/doi.org\/10.1007\/s12026-026-09754-6","relation":{},"ISSN":["1559-0755"],"issn-type":[{"value":"1559-0755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,19]]},"assertion":[{"value":"2 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This retrospective study was conducted in accordance with the Declaration of Helsinki and was approved by the Marmara University Faculty of Medicine, Non-Interventional Clinical Research Ethics Committee (Approval number: 09.2024.561, Date: 22.04.2024). Due to the retrospective design of the study and the use of anonymized patient data, the requirement for written informed consent was waived by the Ethics Committee.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human Ethics"}},{"value":"The research protocol was approved by the Marmara University Faculty of Medicine, Non-Interventional Clinical Research Ethics Committee (Approval number: 09.2024.561, Date: 22.04.2024).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics committee approval"}},{"value":"The Ethics Committee waived the requirement for written informed consent because of the retrospective nature of the study and the use of anonymized data.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Not applicable.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial number"}}],"article-number":"16"}}