{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:42:20Z","timestamp":1760060540426,"version":"build-2065373602"},"reference-count":34,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T00:00:00Z","timestamp":1757116800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving multiple organs and the production of anti-double-stranded DNA (anti-dsDNA) antibodies. This study evaluated the associations between anti-dsDNA levels and smoking, oral corticosteroid (OCS) use, and immunosuppressive therapy in SLE patients. A retrospective monocentric analysis was performed on 119 SLE patients. Data on smoking history, OCS dosage, and immunosuppressive treatments were collected. Anti-dsDNA levels were assessed using fluorescent enzyme immunoassays and confirmed via indirect immunofluorescence. Smoking was significantly associated with higher anti-dsDNA levels (Spearman\u2019s \u03c1 = 0.292, p = 0.0014). Logistic regression identified pack-years (PPY) as a predictor of high anti-dsDNA levels (\u226575 U\/mL), with a 50% probability at 12.51 PPY and a 75% probability at 17.65 PPY (p &lt; 0.001). OCSs were used by 58.82% of patients, with a median prednisone-equivalent dose of 5.0 mg; higher OCS doses correlated weakly but significantly with anti-dsDNA levels (R2 = 0.066, p &lt; 0.001). Anti-dsDNA levels differed across treatments (p = 0.027): MTX vs. AZA\/MMF, and belimumab vs. AZA\/MTX. Smoking, OCS use, and immunosuppressants influence anti-dsDNA levels. Belimumab showed greater reduction compared to conventional therapies. Personalized treatment strategies are needed, considering the effects of smoking and cortico-steroids.<\/jats:p>","DOI":"10.3390\/ijms26178705","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T10:27:12Z","timestamp":1757500032000},"page":"8705","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Smoking, Steroid Use and Immunosuppression on Anti-dsDNA Antibodies in Systemic Lupus Erythematosus"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2478-1900","authenticated-orcid":false,"given":"Richard","family":"Borrelli","sequence":"first","affiliation":[{"name":"Allergy and Immunology Unit, Department of Medical Science, University of Turin, Mauriziano Hospital, 10128 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Nicola","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Unit, Department of Medical Science, University of Turin, Mauriziano Hospital, 10128 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Corradi","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Unit, Department of Medical Science, University of Turin, Mauriziano Hospital, 10128 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4201-3456","authenticated-orcid":false,"given":"Luca","family":"Lo Sardo","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Unit, Department of Medical Science, University of Turin, Mauriziano Hospital, 10128 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iuliana","family":"Badiu","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Unit, Department of Medical Science, University of Turin, Mauriziano Hospital, 10128 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7679-2372","authenticated-orcid":false,"given":"Anna","family":"Quinternetto","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Unit, Department of Medical Science, University of Turin, Mauriziano Hospital, 10128 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilaria","family":"Vitali","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Unit, Department of Medical Science, University of Turin, Mauriziano Hospital, 10128 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1267-4320","authenticated-orcid":false,"given":"Simone","family":"Negrini","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Unit, Department of Medical Science, University of Turin, Mauriziano Hospital, 10128 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7249-7616","authenticated-orcid":false,"given":"Luisa","family":"Brussino","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Unit, Department of Medical Science, University of Turin, Mauriziano Hospital, 10128 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Nandakumar, K.S., and N\u00fcndel, K. 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