Zandman-Goddard Gisele, Gilburd Boris, Shovman Ora, Blank Miri, Berdichevski Svetlana, Langevitz Pnina, Shoenfeld Yehuda
The Center for Autoimmune Diseases and the Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel.
Clin Dev Immunol. 2005 Jun;12(2):107-11. doi: 10.1080/17402520500116723.
Systemic lupus erythematosus (SLE) is a multi-systemic autoimmune disease leading to immunological aberrations and excessive multiple autoantibody production. The aim of this study was to investigate the prevalence of multiple autoantibodies in SLE patients utilizing the multiplex system method. We analyzed the presence of elevated titers of anti-Ro, anti-La, anti-RNP, anti-Sm, anti-Jo1, anti-centromere, anti-Scl-70, anti-histone, and anti-dsDNA antibodies in 199 serum samples (113 SLE patients, 86 healthy donors). We compared the type, level and number of autoantibodies and the correlation between the autoantibody profile and disease severity utilizing the SLEDAI score. Elevated titers of at least one autoantibody were detected in 48% of 42 SLE patients. Elevated titers of anti-Ro antibodies were most commonly detected. The distribution of specific autoantibodies was: anti-Ro- 23.8%, anti-dsDNA- 19%, antihistone- 19%, anti-RNP- 14.2%, anti-La antibodies- 11.9%, anti-Sm- 7.1%, anti-Scl 70-4.7%, and anti-centromere- 2.4%. Utilizing ROC analysis, the sensitivity and specificity of anti-DNA antibodies at a cutoff value of 34 IU/ml were 87.1% and 79.4% respectively. Elevated titers of anti-Jo1 antibody were not detected. There was a correlation with the titer of anti-Ro antibodies and disease activity by the SLEDAI score. Seven patients harbored one autoantibody only, 15 patients harbored 2-3 autoantibodies, 3 patients harbored 4-5 autoantibodies, and one patient harbored 6 autoantibodies. A correlation between the number of autoantibodies per patient and disease severity was found. One patient with a multitude of autoantibodies had severe lupus and a myriad of clinical manifestations. In conclusion, the multiplex system is specific and sensitive, provides an autoantibody profile in a single test, and may be useful as a diagnostic test for SLE. Elevated anti-Ro antibodies are associated with severe disease. An autoantibody load may be indicative of more severe disease.
系统性红斑狼疮（SLE）是一种多系统自身免疫性疾病，可导致免疫异常和多种自身抗体过度产生。本研究旨在利用多重检测系统方法调查SLE患者中多种自身抗体的患病率。我们分析了199份血清样本（113例SLE患者和86例健康供体）中抗Ro、抗La、抗RNP、抗Sm、抗Jo1、抗着丝点、抗Scl-70、抗组蛋白和抗双链DNA（dsDNA）抗体滴度升高的情况。我们比较了自身抗体的类型、水平和数量，以及利用SLE疾病活动指数（SLEDAI）评分得出的自身抗体谱与疾病严重程度之间的相关性。在42例SLE患者中，48%检测到至少一种自身抗体滴度升高。抗Ro抗体滴度升高最为常见。特异性自身抗体的分布情况为：抗Ro-23.8%，抗dsDNA-19%，抗组蛋白-19%，抗RNP-14.2%，抗La抗体-11.9%，抗Sm-7.1%，抗Scl 70-4.7%，抗着丝点-2.4%。利用ROC分析，抗DNA抗体在临界值为34 IU/ml时的敏感性和特异性分别为87.1%和79.4%。未检测到抗Jo1抗体滴度升高。抗Ro抗体滴度与SLEDAI评分所反映的疾病活动度存在相关性。7例患者仅有一种自身抗体，15例患者有2至3种自身抗体，3例患者有4至5种自身抗体，1例患者有6种自身抗体。发现每位患者的自身抗体数量与疾病严重程度之间存在相关性。一名有多种自身抗体的患者患有严重狼疮且有众多临床表现。总之，多重检测系统具有特异性和敏感性，可在一次检测中提供自身抗体谱，可能作为SLE的诊断检测方法。抗Ro抗体升高与严重疾病相关。自身抗体负荷可能表明疾病更严重。
