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系统性红斑狼疮中的抗脱氧核糖核酸酶I抗体:诊断价值及在酶抑制中的占比

Anti-DNase I antibodies in systemic lupus erythematosus: diagnostic value and share in the enzyme inhibition.

作者信息

Trofimenko A S, Gontar I P, Zborovsky A B, Paramonova O V

机构信息

FSBSI Research Institute of Clinical and Experimental Rheumatology, 76, Zemlyachki Str., Volgograd, Russia, 400138.

Hospital Therapy Department, Volgograd State Medical University, 1, Pavshikh Bortsov Sq., Volgograd, Russia, 400131.

出版信息

Rheumatol Int. 2016 Apr;36(4):521-9. doi: 10.1007/s00296-016-3437-z. Epub 2016 Feb 15.

Abstract

Diagnostic accuracy of anti-DNase I antibodies measurement in a differentiation between SLE and other autoimmune rheumatic diseases was evaluated. The share of anti-DNase I and actin in the DNase I activity decrease in SLE was established. Serum samples were obtained from 54 patients with verified SLE, 52 control patients with other autoimmune rheumatic diseases, and 44 healthy persons. Anti-DNase I concentrations were measured by ELISA. Free and actin inhibited DNase I activities were evaluated in the fresh serum samples. The appraisal of antibodies and actin effects on DNase I activity was made using multiple regression. Anti-DNase I antibodies were positive in 35 SLE and 8 control patients, without significant difference between the mean antibody concentrations. Sensitivity of this test was 64.81 %, and specificity-84.62 %. Mean free DNase I activity in SLE was somewhat lower than in the control group as a result of augmented frequency of extremely low enzyme activities. On the contrary, after the exclusion of the latter cases we have revealed elevated mean free DNase I activity in the other SLE patients comparing to the similar control subgroup. Unlike the controls, low serum DNase I activity in SLE arose not only from actin and antibody action, but also, in half of the cases, from unidentified factor, related to active SLE. The accuracy of the anti-DNase I antibodies measurement is approximate to the present reference standard of SLE diagnostics. We first demonstrated that neither antibodies nor actin caused DNase I activity decrease in SLE.

摘要

评估了抗DNase I抗体检测在系统性红斑狼疮(SLE)与其他自身免疫性风湿性疾病鉴别诊断中的准确性。确定了SLE患者中抗DNase I和肌动蛋白在DNase I活性降低中的占比。采集了54例确诊SLE患者、52例患有其他自身免疫性风湿性疾病的对照患者以及44例健康人的血清样本。采用酶联免疫吸附测定法(ELISA)检测抗DNase I浓度。在新鲜血清样本中评估游离和肌动蛋白抑制的DNase I活性。使用多元回归评估抗体和肌动蛋白对DNase I活性的影响。35例SLE患者和8例对照患者的抗DNase I抗体呈阳性,平均抗体浓度之间无显著差异。该检测的敏感性为64.81%,特异性为84.62%。由于极低酶活性的频率增加,SLE患者的平均游离DNase I活性略低于对照组。相反,排除这些病例后,我们发现其他SLE患者的平均游离DNase I活性高于类似的对照亚组。与对照组不同,SLE患者血清DNase I活性降低不仅源于肌动蛋白和抗体的作用,在一半的病例中还源于与活动性SLE相关的不明因素。抗DNase I抗体检测的准确性接近目前SLE诊断的参考标准。我们首次证明,在SLE中,抗体和肌动蛋白均未导致DNase I活性降低。

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