Service de Médecine Interne, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Université de la Méditerranée, 13015 Marseille, France.
Eur J Intern Med. 2010 Apr;21(2):114-7. doi: 10.1016/j.ejim.2010.01.004. Epub 2010 Feb 8.
Anti-RNA polymerase III antibodies (anti-RNAP III) have been reported as potential immune markers of Systemic Sclerosis (SSc). Until now, their clinical use was disregarded because of technical difficulties to perform immunoprecipitation. Recently, ELISA kits became commercially available allowing an easy detection of anti-RNAP III. We intended to clarify the relevance of these antibodies in the diagnosis of SSc by ELISA detection.
The prevalence of anti-RNAP III was analyzed using two ELISA kits in 50 consecutive SSc patients from Marseilles in South of France. Controls included 66 patients with other systemic autoimmune diseases, 34 viral diseases and 50 healthy subjects. Positive results with at least one ELISA kit were controlled by immunoprecipitation which is the reference assay.
In this study, positivity for anti-centromere and/or anti-topoisomerase I antibodies was observed in 84% of SSc patients. The prevalence of anti-RNAP III in SSc patients was 0% to 6% (3/50) depending on the ELISA kit and only 2% by immunoprecipitation. Concerning controls, two rheumatoid arthritis patients were positive using ELISA (6%), including one with immunoprecipitation confirmation. No anti-RNAP III was detected in systemic lupus erythematosus patients. Three blood donors and one viral disease control were positive using ELISA, but all were negative by immunoprecipitation.
Anti-RNAP III was rarely detected in a French population of SSc patients. Their prevalence was even lower than the one observed in rheumatoid arthritis controls. Therefore local immunologic profiles should be established before deciding a change in clinical practice for SSc immune screening.
抗 RNA 聚合酶 III 抗体（抗-RNAP III）已被报道为系统性硬化症（SSc）的潜在免疫标志物。由于进行免疫沉淀的技术困难，其临床应用一直被忽视。最近，ELISA 试剂盒已商业化，使得抗-RNAP III 的检测变得更加容易。我们旨在通过 ELISA 检测来阐明这些抗体在 SSc 诊断中的相关性。
使用两种 ELISA 试剂盒分析了来自法国南部马赛的 50 例连续 SSc 患者的抗-RNAP III 患病率。对照组包括 66 例其他系统性自身免疫性疾病患者、34 例病毒疾病患者和 50 例健康受试者。通过免疫沉淀（即参考检测）控制至少一种 ELISA 试剂盒的阳性结果。
在这项研究中，抗着丝粒和/或抗拓扑异构酶 I 抗体在 84%的 SSc 患者中呈阳性。根据 ELISA 试剂盒的不同，SSc 患者抗-RNAP III 的阳性率为 0%至 6%（3/50），而通过免疫沉淀的阳性率仅为 2%。在对照组中，2 例类风湿关节炎患者的 ELISA 检测结果为阳性（6%），其中 1 例经免疫沉淀证实。系统性红斑狼疮患者中未检测到抗-RNAP III。3 名献血者和 1 名病毒疾病对照者的 ELISA 检测结果为阳性，但免疫沉淀检测结果均为阴性。
在法国 SSc 患者人群中，抗-RNAP III 的检测频率较低。其阳性率甚至低于类风湿关节炎对照组。因此，在决定改变 SSc 免疫筛查的临床实践之前，应建立当地的免疫谱。
