Massardo L, Martínez M E, Pérez R, Ramírez V, Foradori A, González A, Radrigán F, Gutiérrez F, Jacobelli S
Departamento de Inmunología Clínica y Reumatología, Facultad de Medicina, Pontificia Universidad Católica de Chile.
Rev Med Chil. 1999 Apr;127(4):411-20.
Patients with inactive systemic lupus erythematosus (SLE) and elevated high affinity double-stranded anti-DNA antibodies (anti-dsDNA), measured using Farr technique, would have a risk of relapse that fluctuates between 40 to 80% according to different series.
To study the association between anti-dsDNA levels measured using Farr technique and disease activity and their predictive capacity for relapses.
Anti-dsDNA antibodies were measured according to Farr method in 60 healthy subjects, 69 patients with other connective tissue diseases and in 120 patients with SLE. Farr positive were considered those individuals with anti-dsDNA levels over 10.4 IU/ml. Disease activity, assessed using MEX-SLEDAI score was related with anti-dsDNA levels in 101 patients. Forty seven patients with inactive disease were followed for 17 +/- 14 months.
Anti-dsDNA levels were 3 +/- 2.5 IU/ml (range 1-26) in subjects without LED, and 127 +/- 500 IU/ml (range 1-5280) in patients with LED. Sixty subjects had an active SLE and 43 (72%) were Farr positive; in 41 the disease was inactive and 13 (32%) were Farr positive (p < 0.001), OR 5.45. Twelve of the 47 followed patients had a relapse and 10 (83%) were Farr positive. Of those that did not have a relapse, 13 (37%) were Farr positive (p < 0.02, RR 5.22). Six of 15 patients that were followed for more than on year (40%), were Farr positive.
Elevated anti-dsDNA antibodies measured using Farr technique in patients with inactive generalised lupus erythematosus, predicted the risk of relapse. However less than half of patients with inactive disease and elevated Farr relapsed in a period of one year. The need to treat patients with inactive SLE and positive Farr should therefore be considered debatable.
使用Farr技术检测发现，非活动期系统性红斑狼疮（SLE）患者且高亲和力双链抗DNA抗体（抗dsDNA）升高，根据不同系列研究，其复发风险在40%至80%之间波动。
研究使用Farr技术检测的抗dsDNA水平与疾病活动度之间的关联及其对复发的预测能力。
采用Farr方法检测60名健康受试者、69名其他结缔组织病患者和120名SLE患者的抗dsDNA抗体。抗dsDNA水平超过10.4 IU/ml的个体被视为Farr阳性。使用MEX-SLEDAI评分评估疾病活动度，并将其与101例患者的抗dsDNA水平相关联。对47例非活动期疾病患者进行了17±14个月的随访。
无狼疮性肾炎（LED）的受试者抗dsDNA水平为3±2.5 IU/ml（范围1 - 26），有LED的患者抗dsDNA水平为127±500 IU/ml（范围1 - 5280）。60例患者患有活动期SLE，其中43例（72%）Farr阳性；41例疾病为非活动期，13例（32%）Farr阳性（p < 0.001），比值比为5.45。47例随访患者中有12例复发，10例（83%）Farr阳性。未复发的患者中，13例（37%）Farr阳性（p < 0.02，相对危险度为5.22）。15例随访超过一年的患者中有6例（40%）Farr阳性。
使用Farr技术检测发现，非活动期全身性红斑狼疮患者抗dsDNA抗体升高可预测复发风险。然而，在一年时间内，非活动期疾病且Farr检测结果升高的患者中复发的不到一半。因此，是否需要治疗非活动期SLE且Farr检测结果为阳性的患者存在争议。
