Horák P, Hermanová Z, Faltýnek L, Pospísil Z, Scudla V
III. interní klinika LF UP a FN, Olomouc.
Vnitr Lek. 1997 Oct;43(10):639-44.
Antinuclear antibodies are a group of autoantibodies which are typical for collagenous diseases. By means of the autoantibody profile different sub-groups of systemic lupus erythematosus (SLE) can be identified. This can serve as a certain prognostic factor of the affection. Patients with a negative antibody profile have fewer clinical and laboratory manifestations of SLE. Profile A (anti-dsDNA and/or anti-Sm has, as compared with patients with a negative antibody profile, more frequent organ manifestations. Patients with profile B (anti-RNP) have a higher frequency of Raynaud's phenomenon. Profile C (anti-Ro, anti-La) is characterized in particular by photosensitivity of the skin and secondary Sjögren's syndrome. Profile D (antibodies against centromeres and/or Scl-70) are found in subjects with SLE with traits of scleroderma. Finally profile E (antibodies against histones) are found in SLE induced by drugs. In the submitted study in 28 patients with SLE autoantibodies anti-dsDNA, anti-DNP, extracted nuclear antibodies (ENA-Sm,Ro,La, histones, Sm/RNP, Scl-70) were evaluated and different subgroups of SLE were assessed. Attention was paid to their common characteristics and the activity of the disease. Associations of clinical activity of the disease expressed by the ECLAM index (European Consensus Lupus Activity Measurement) were tested as well as anti-dsDNA levels and also the association of the disease activity with C3 and C4 constituents of complement, CRP and circulating immunocomplexes in serum. Positivity of the antinuclear factor (ANF) was found in 21 patients, while in 7 subjects who were in clinical and laboratory remission, ANF was negative. A negative antibody profile was recorded in 9 patients, profile A was found in 13, 1 patient had profile B, and 4 patients had profile C. Antibody profile D was not found in the group. When using regression analysis and Pearson s correlation coefficient, correlations were found between anti-dsDNA values and the system ECLAM (r = 0.72, p < 0.01), anti-dsDNA and C3 levels (r = -0.59, p < 0.01), C4 (r = -0.50,, p < 0.01), and between the ECLAM system and C3 (r = -0.60, p 0.01) and C4 (r = -0.52, p < 0.01) and also between C3 and C4 mutually (r = 0.72, p < 0.01). From the submitted investigation ensues that investigation of antinuclear antibody levels in SLE is important not only for assessment of the diagnosis of the disease and its activity but also for assessment of the subgroups of the disease and for prediction of its development. As to other indicators of activity, assessment of the C3 and C4 constituents of complement is still important.
抗核抗体是一组自身抗体，是胶原性疾病的典型特征。通过自身抗体谱可以识别系统性红斑狼疮（SLE）的不同亚组。这可作为病情的某种预后因素。抗体谱阴性的患者SLE的临床和实验室表现较少。A谱（抗双链DNA和/或抗Sm）与抗体谱阴性的患者相比，器官表现更频繁。B谱（抗核糖核蛋白）患者雷诺现象的发生率更高。C谱（抗Ro、抗La）的特点尤其在于皮肤光敏性和继发性干燥综合征。D谱（抗着丝粒和/或Scl - 70抗体）见于具有硬皮病特征的SLE患者。最后，E谱（抗组蛋白抗体）见于药物诱发的SLE患者。在提交的这项研究中，对28例SLE患者的抗双链DNA、抗脱氧核糖核蛋白、提取的核抗体（ENA - Sm、Ro、La、组蛋白、Sm/RNP、Scl - 70）进行了评估，并对SLE的不同亚组进行了评估。关注了它们的共同特征和疾病活动情况。测试了由欧洲狼疮活动度共识测量（ECLAM）指数表示的疾病临床活动度的相关性，以及抗双链DNA水平，还测试了疾病活动度与补体C3和C4成分、CRP及血清中循环免疫复合物的相关性。21例患者抗核因子（ANF）呈阳性，而7例处于临床和实验室缓解期的患者ANF为阴性。9例患者抗体谱为阴性，13例为A谱，1例为B谱型，4例为C谱型。该组中未发现D谱型抗体。使用回归分析和皮尔逊相关系数时，发现抗双链DNA值与ECLAM系统之间存在相关性（r = 0.72，p < 0.01），抗双链DNA与C3水平之间（r = -0.59，p < 0.01），C4（r = -0.50，p < 0.01），以及ECLAM系统与C3（r = -0.60，p < 0.01）和C4（r = -0.52，p < 0.01）之间，还有C3和C4之间也存在相关性（r = 0.72，p < 0.01）。从提交的调查结果可知，对SLE患者抗核抗体水平的检测不仅对于评估疾病诊断及其活动度很重要，而且对于评估疾病亚组和预测其发展也很重要。至于其他活动指标，补体C3和C4成分的评估仍然很重要。
