Guffroy Aurélien, Dima Alina, Nespola Benoit, Poindron Vincent, Sibilia Jean, Herbrecht Raoul, De Sèze Jerome, Habersetzer François, Andres Emmanuel, Quoix Elisabeth, Ohlmann Patrick, Cribier Bernard, Langer Bruno, Martin Thierry, Pasquali Jean-Louis, Goetz Joëlle, Korganow Anne-Sophie
Department of Clinical Immunology and Internal Medicine, National Reference Center for Autoimmune Diseases, Strasbourg Hospital and University, 1, place de l'Hôpital, 67091 Strasbourg, France; Department of Rheumatology, National Reference Center for Autoimmune Diseases, Strasbourg Hospital and University, 67000 Strasbourg, France.
Department of Internal Medicine, Colentina Clinical Hospital, 72202 Bucharest, Romania.
Joint Bone Spine. 2016 May;83(3):330-4. doi: 10.1016/j.jbspin.2015.07.002. Epub 2015 Oct 1.
Describe the clinical significance of anti-SG2NA antibodies also called anti-pseudo-PCNA type 1 (proliferating cell nuclear antigen auto-antibodies) which are rare antinuclear antibodies (ANAs) staining distinctly S/G2 proliferative HEp-2 cells by indirect immunofluorescence. By analogy with anti-PCNA antibodies, they have been suspected to be associated with systemic lupus erythematosus (SLE), cancers or viral diseases.
From May 2006 to February 2013, 16,827 patients were tested positive for ANAs in the Laboratory of Immunology, Strasbourg, France. We retrospectively analyzed clinical and biological data from 126 patients with anti-pseudo-PCNA type 1 antibodies.
There was a 0.75% prevalence of anti-pseudo-PCNA type 1 Abs among ANAs(+) patients. Median age was 56.9 years (standard deviation [SD] 13.4 years) with a sex ratio female/male of 1.9. Compared to ANAs(+) patients, many more patients have been hospitalized in the Oncology and Hematology Department (23% vs. 6.3%, P < 0.05). Indeed, anti-pseudo-PCNA type 1 Abs were detected in 33 patients suffering from solid and hematological cancers (26%). Another group of patients presented various auto-immune diseases but surprisingly none of our patients was affected with SLE when 5 out of 8 patients in anti-PCNAs(+) Abs group (P < 5.10(-6)) were. Finally, the presence of anti-pseudo-PCNA type 1 Abs was associated in 30 cases with other auto-Abs reflecting a more general breakdown of B cell tolerance against other self-antigens.
Considering our results, explorations for tumors should be at least recommended for patients with anti-pseudo-PCNA type 1 Abs. Lupus disease is not associated with these autoAbs.
描述抗SG2NA抗体（也称为抗1型假增殖细胞核抗原抗体，即增殖细胞核抗原自身抗体）的临床意义，该抗体是一种罕见的抗核抗体（ANA），通过间接免疫荧光法可清晰地对S/G2期增殖的人喉表皮样癌细胞（HEp-2细胞）进行染色。与抗增殖细胞核抗原（PCNA）抗体类似，它们被怀疑与系统性红斑狼疮（SLE）、癌症或病毒性疾病有关。
2006年5月至2013年2月，法国斯特拉斯堡免疫学实验室对16827例患者进行了ANA检测，结果呈阳性。我们回顾性分析了126例抗1型假增殖细胞核抗原抗体患者的临床和生物学数据。
在ANA阳性患者中，抗1型假增殖细胞核抗原抗体的患病率为0.75%。中位年龄为56.9岁（标准差[SD]13.4岁），女性/男性性别比为1.9。与ANA阳性患者相比，更多抗1型假增殖细胞核抗原抗体患者入住肿瘤科和血液科（23%对6.3%，P<0.05）。实际上，在33例实体癌和血液系统癌症患者中检测到抗1型假增殖细胞核抗原抗体（26%）。另一组患者患有各种自身免疫性疾病，但令人惊讶的是，我们的患者中无一例患有SLE，而抗PCNA抗体阳性组的8例患者中有5例患有SLE（P<5×10⁻⁶）。最后，在30例患者中，抗1型假增殖细胞核抗原抗体的存在与其他自身抗体相关，这反映出B细胞对其他自身抗原的耐受性出现了更普遍的破坏。
根据我们的研究结果，至少应建议对抗1型假增殖细胞核抗原抗体阳性的患者进行肿瘤筛查。狼疮疾病与这些自身抗体无关。
