Department of Autoimmune Disorders, National Institute of Immunohematology, Indian Council of Medical Research, 13th floor, KEM Hospital, Parel, Mumbai, India.
Indian J Dermatol Venereol Leprol. 2010 Mar-Apr;76(2):145-9. doi: 10.4103/0378-6323.60558.
Detection of anti-nucleosome antibodies (anti-nuc) in patients with systemic lupus erythematosus (SLE) has been well established and it is claimed that their presence is associated with disease activity.
The aim of this study is to evaluate the incidence of anti-nuc antibodies and to correlate them with disease activity and its association with other autoantibodies like anti-nuclear antibodies (ANA), anti-double stranded DNA (anti-dsDNA), anti-histone antibodies (AHA), as well as autoantibodies to histone subfractions like H1, (H2A-H4) complex, H2B, and H3.
This cross-sectional study included 100 SLE patients referred from the Rheumatology, Dermatology, and Nephrology Departments. SLE disease activity was evaluated by using SLE-Disease Activity Index (SLEDAI) score. A patient was defined as having active SLE when the SLEDAI score was more than 5.0. Fifty normal controls were also tested as a healthy control group. Anti-nuc antibodies, anti-dsDNA, and AHA were tested by Enzyme-Linked Immunosorbent Assay (ELISA) and ANA was detected by an indirect immunofluorescence test.
All patients studied were in an active stage of disease and were untreated, of which 44 patients had renal biopsy-proven kidney involvement, which was categorized as lupus nephritis (LN) and 56 patients did not show any renal manifestations (SLE without LN). Anti-nuc antibodies were positive in 88%, anti-dsDNA in 80%, and AHA in 38% of the cases. ANA was positive in all SLE patients studied. None of the normal controls was found to be positive for these antibodies. Although a slightly higher incidence of autoantibodies were noted in LN, there was no statistical difference noted between LN and SLE without LN groups for anti-nuc and anti-dsDNA antibodies (p > 0.05). A higher incidence of autoantibodies to ANA specificities were noted in anti-nuc positive cases, but there was no statistical difference between anti-nuc positive and anti-nuc negative cases for ANA specificities among LN and SLE without nephritis groups (p > 0.05).
Anti-nuc antibody detection could be a better tool for the diagnosis of SLE. Although there was no significant difference in LN and SLE without LN groups, this study suggests that anti-nuc detection can be useful as an additional disease activity marker to other laboratory tests.
抗核小体抗体（anti-nuc）在系统性红斑狼疮（SLE）患者中的检测已得到充分证实，据称其存在与疾病活动有关。
本研究旨在评估抗核小体抗体的发生率，并将其与疾病活动相关联，以及与其他自身抗体如抗核抗体（ANA）、抗双链 DNA（anti-dsDNA）、抗组蛋白抗体（AHA）以及组蛋白亚单位如 H1、（H2A-H4）复合物、H2B 和 H3 的自身抗体相关联。
本横断面研究纳入了来自风湿病学、皮肤病学和肾脏病学部门的 100 名 SLE 患者。使用系统性红斑狼疮疾病活动指数（SLEDAI）评分评估 SLE 疾病活动。当 SLEDAI 评分大于 5.0 时，定义患者为处于活动期 SLE。还对 50 名正常对照进行了测试作为健康对照组。通过酶联免疫吸附试验（ELISA）检测抗核小体抗体、抗 dsDNA 和 AHA，通过间接免疫荧光试验检测 ANA。
所有研究的患者均处于疾病的活动期且未接受治疗，其中 44 例患者进行了肾活检证实的肾脏受累，归类为狼疮肾炎（LN），56 例患者未出现任何肾脏表现（无 LN 的 SLE）。抗核小体抗体阳性率为 88%，抗 dsDNA 为 80%，AHA 为 38%。所有 SLE 患者的 ANA 均为阳性。在正常对照组中均未发现这些抗体呈阳性。尽管 LN 中自身抗体的发生率略高，但在 LN 和无 LN 的 SLE 组之间，抗核小体和抗 dsDNA 抗体无统计学差异（p＞0.05）。在抗核小体抗体阳性的病例中，ANA 特异性的自身抗体发生率较高，但在 LN 和无肾炎的 SLE 组中，抗核小体阳性和抗核小体阴性病例之间的 ANA 特异性无统计学差异（p＞0.05）。
抗核小体抗体检测可作为 SLE 的诊断工具。尽管在 LN 和无 LN 的 SLE 组之间无显著差异，但本研究表明，抗核小体检测可作为其他实验室检测的辅助疾病活动标志物。
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