1Clinical Chemistry Laboratory.
Lupus. 2013 Oct;22(11):1169-73. doi: 10.1177/0961203313500368. Epub 2013 Aug 8.
Measuring anti-dsDNA levels could support treatment adjustment during follow-up of patients with systemic lupus erythematosus (SLE). We investigated whether patients with exacerbations of SLE showed changes in anti-double-stranded DNA (anti-dsDNA) levels prior to the exacerbation using the Farr and EliA assay and examined which assay showed highest specificity and predictive value for exacerbations. Changes in anti-dsDNA of ≥ 25% prior to exacerbation were considered of clinical significance. Exacerbations were retrospectively abstracted from medical records. Eighteen of 48 patients showed one or more exacerbations. We found 22 exacerbations with complete lab work-up, all accompanied by ≥ 25% change in anti-dsDNA in one or both assays. Only 10 exacerbations showed concordant changes in anti-dsDNA in both assays. Changes in anti-dsDNA had a low predictive value for exacerbations of SLE, but the specificity of anti-dsDNA changes for patients with exacerbations was higher for EliA than Farr. We conclude that despite the limited relation between anti-dsDNA changes and exacerbations of SLE, anti-dsDNA testing could still support clinical decision making when used in the correct setting. We conclude that EliA is preferable over Farr for assaying anti-dsDNA during follow-up of patients with SLE because of higher specificity, less "hands-on" time and absence of radioactivity.
检测抗双链 DNA（anti-dsDNA）水平可能有助于在系统性红斑狼疮（SLE）患者的随访中调整治疗方案。我们通过 Farr 和 EliA 检测法调查了 SLE 恶化的患者在恶化前的抗双链 DNA（anti-dsDNA）水平是否发生变化，并研究了哪种检测方法对恶化具有最高的特异性和预测价值。恶化前抗 dsDNA 水平变化≥25%被认为具有临床意义。我们从病历中回顾性地提取了恶化事件。48 名患者中有 18 名出现了一次或多次恶化。我们发现 22 次恶化伴有完整的实验室检查结果，所有恶化均伴有一项或两项检测中的抗 dsDNA 水平变化≥25%。只有 10 次恶化在两项检测中显示出抗 dsDNA 的一致性变化。抗 dsDNA 变化对 SLE 恶化的预测价值较低，但对于出现恶化的患者，EliA 检测法比 Farr 检测法的抗 dsDNA 变化的特异性更高。我们得出的结论是，尽管抗 dsDNA 变化与 SLE 恶化之间的相关性有限，但在正确的情况下，抗 dsDNA 检测仍可以支持临床决策。我们得出的结论是，由于特异性更高、操作时间更短且无放射性，在 SLE 患者的随访中，EliA 检测法优于 Farr 检测法，适用于抗 dsDNA 检测。
