González D Almeida, Rodríguez C Casañas, Armas L Magdalena, Varela A Roces, Rodríguez I Marcelino, Duarte M Troche, de León A Cabrera
Immunology Unit, Nuestra Señora de Candelaria University Hospital, Santa Cruz de Tenerife, Spain; Research Unit, Nuestra Señora de Candelaria University Hospital, Santa Cruz de Tenerife, Spain.
Immunology Unit, Nuestra Señora de Candelaria University Hospital, Santa Cruz de Tenerife, Spain.
Immunol Lett. 2014 Sep;161(1):6-12. doi: 10.1016/j.imlet.2014.04.009. Epub 2014 Apr 23.
Anti-Ro52 (Ro52) and anti-Ro60 (Ro60) antibodies are associated with different clinical entities. We investigated their relationship with the presence of anti-SS-B/La (SSB) antibody, the pattern and titer of antinuclear antibody (ANA), and the variations in antibody profiles related with anti-SS-A/Ro (SSA) positivity. Our aim was to develop a strategy to increase the efficiency of anti-extractable nuclear antigen (ENA) determinations. Statistical analyses were based on the Chi-squared test for categorical variables, the Mann-Whitney U test to compare profiles, and the odds ratio (OR) and 95% confidence interval (95% CI) to estimate the risk of variability. We analyzed 800 SSA-positive samples with Ro52 or Ro60 reactivity. The most frequent profiles were Ro52+Ro60+SSB (n=349, 43.6%); Ro52+Ro60 (n=126, 15.8%); Ro52 (n=121, 15.1%) and Ro60 (n=71, 8.9%). In samples positive only for SSA and an ANA titer ≤1:640, the most likely profile was positivity for either Ro52 or Ro60, whereas when the ANA titer was >1:640, positivity for both Ro52 and Ro60 simultaneously was more likely (p<0.001). In samples positive for both SSA and SSB, the most likely profile was Ro52+Ro60+SSB regardless of the ANA titer (p=0.001). When only SSA was positive and the ANA staining pattern was nucleolar, centromeric or cytoplasmic, Ro52 positivity was most likely (p<0.001). When both SSA and SSB were positive, both Ro52 and Ro60 were likely to be positive regardless of the ANA staining pattern. In 28.7% of the patients the profile was variable. Variability was significantly greater in those with the SSA profile (23/67) than with the SSA+SSB profile (15/105; OR=1.9, 95% CI=1.1-3.3; p=0.025), and the difference in variability was greatest between the Ro52+Ro60 profile (8/23) and the Ro52+Ro60+SSB profile (8/68; OR=4.2, 95% CI=1.9-9.5; p<0.001). We conclude that to increase efficiency in the immunology laboratory, positivity for Ro52 and Ro60 individually or simultaneously can be deduced from SSB status and the ANA pattern and titer. In general, for the most frequent anti-ENA findings, priority should be given to retesting autoantibodies not detected in the initial analysis.
抗Ro52（Ro52）抗体和抗Ro60（Ro60）抗体与不同的临床实体相关。我们研究了它们与抗SS - B/La（SSB）抗体的存在、抗核抗体（ANA）的模式和滴度以及与抗SS - A/Ro（SSA）阳性相关的抗体谱变化之间的关系。我们的目的是制定一种策略来提高抗可提取核抗原（ENA）检测的效率。统计分析基于分类变量的卡方检验、比较谱的曼 - 惠特尼U检验以及比值比（OR）和95%置信区间（95%CI）来估计变异性风险。我们分析了800份具有Ro52或Ro60反应性的SSA阳性样本。最常见的谱型为Ro52 + Ro60 + SSB（n = 349，43.6%）；Ro52 + Ro60（n = 126，15.8%）；Ro52（n = 121，15.1%）和Ro60（n = 71，8.9%）。在仅SSA阳性且ANA滴度≤1:640的样本中，最可能的谱型是Ro52或Ro60阳性；而当ANA滴度>1:640时，Ro52和Ro60同时阳性的可能性更大（p<0.001）。在SSA和SSB均阳性的样本中，无论ANA滴度如何，最可能的谱型是Ro52 + Ro60 + SSB（p = 0.001）。当仅SSA阳性且ANA染色模式为核仁型、着丝粒型或胞质型时，Ro52阳性的可能性最大（p<0.001）。当SSA和SSB均阳性时，则Ro52和Ro60均可能阳性，与ANA染色模式无关。28.7%的患者谱型可变。具有SSA谱型的患者变异性（23/67）显著高于具有SSA + SSB谱型的患者（15/105；OR = 1.9, 95%CI = 1.1 - 3.3；p = 0.025），且Ro52 + Ro60谱型（8/23）和Ro52 + Ro60 + SSB谱型（8/68）之间的变异性差异最大（OR = 4.2, 95%CI = 1.9 - 9.5；p<0.001）。我们得出结论，为提高免疫实验室的效率，可根据SSB状态以及ANA模式和滴度推断Ro52和Ro60单独或同时阳性的情况。一般来说，对于最常见的抗ENA检测结果，应优先重新检测初始分析中未检测到的自身抗体。
