Summary
The aim of the study was to investigate the prevalence of antinuclear and associated antibodies (anti-dsDNA, anticardiolipin, anti-RNP, anti-Sm, anti-SSA and anti-SSB) and/or combinations thereof in systemic lupus erythematosus (SLE) patients with respect to their diagnostic and pathogenetic significance. The prevalence of anti-dsDNA antibodies was strongly influenced by the selection criteria of the patient; the lowest prevalence was found in SLE patients with central nervous system (CNS) involvement; the highest prevalence in patients with nephritis. The results were also influenced by the different assays. Combinding different assays (Farr/PEG ratio) quantitative as well as qualitative differences could be shown between patients with nephritis (Farr/PEG ratio⩾5) and with CNS involvement (Farr/PEG ratio<5). No difference in anticardiolipin antibody prevalence between the different SLE patient groups could be demonstrated. Regarding antibodies against RNP, Sm, SSA and SSB, the prevalence was found to be strongly influenced by the criteria used for patient selection. Only in CNS patients and association with anti-RNP and anti-SSB antibodies alone or in combination was found. In pleuropericarditis a weak association with RNP antibodies existed. In conclusion: studying the prevalence and possible pathogenetic significance of antibodies one should always consider patient selection criteria and the effect of the different assays used when analysing the results.
Similar content being viewed by others
References
Swaak, A.J.G., Aarden, L.A., Statius van Eps, L.W., Feltkamp, T.E.W. Anti-dsDNA and complement profiles as prognostic guides in systemic lupus erythematosus. Arthritis Rheum 1979, 22, 226–235.
Pincus, T., Schur, P.H., Rose, J.A., Decker, J.L., Talal, N. Measurement of serum DNA binding activity in lupus erythematosus. N Engl J Med 1969, 281, 701–705.
Swaak, A.J.G., Groenwold, J., Aarden, L.A., Feltkamp, T.E.W. Detection of anti-dsDNA as a diagnostic tool. Ann Rheum Dis 1981, 40, 45–49.
Davis, P., Atkins, B., Hughes, G.R.V. Antibodies to native DNA in discoid lupus erythematosus. Br J Dermatol 1974, 91, 175–181.
Harris, E.N., Gharavi, A.E., Asherson, R.A., Boey, M.L., Hughes, G.R.V. Cerebral infarction in systemic lupus: association with anticardiolipin antibodies. Clin Exp Rheumatol 1984, 2, 47–51.
Hughes, G.R.V., Harris, E.N., Garavi, A.E. The anticardiolipin syndrome. J Rheumatol 1986, 13, 486–489.
Harris, E.H., Gharavi, A.E., Boey, M.L., Patel, B.M., Mackworth-Young, C.G. and Hughes, G.R.V. Anti-cardiolipin antibodies: detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus. Lancet 1983, ii 1211–1215.
Smeenk, R.J.T., Lucassen, W.A.M., Swaak, A.J.G. Is anti-cardiolipin activity a cross reaction of anti-DNA of a separate entity. Arthritis Rheum 1987, 30, 607–617.
Bernstein, R.M., Hobbs, R.N., Lea, D.J., Ward, D.J., Hughes, G.R.V. Patterns of antihistone antibody specificity in systemic rheumatic diseases I systemic lupus erythematosus, mixed connective tissue disease, primary sicca syndrome, and rheumatoid arthritis with vasculitis. Arthritis Rheum 1985, 28, 285–293.
Holman, H., Deicher, H.R. The reaction of the lupus erythematosus (LE) cell factor with deoxyribonucleoprotein of the cell nucleus. J Clin Invest 1959, 38, 2059–2072.
Habets, W.J., Berden, J.H.M., Hock, S.D., van Venrooy, W.J. Further characterisation and subcellular localisation of Sm and U1 ribonucleoprotein antigens. Eur J Immunol 1985, 15, 992–997.
Habets, W.J., de Rooy, D.J., Hoet, M.H., van der Putte, L.B., van Venrooy, W.J. Quantitation of anti-RNP and anti-Sm antibodies in MCTD and SLE patients by immunoblotting. Clin Exp Immunol 1985, 59, 457–466.
Maini, R.N., Charles, P.J., Venables, P.J.W. Anti-nuclear antibodies in the immunotaxonomy of connective tissue diseases. Scand J Rheumatol 1985, suppl 56, 49–57.
Winn, D.M., Wolfe, J.F., Lindberg, D.A., Fristoe, F.H., Kingsland, L., Sharp, G.C. Identification of a clinical subset of systemic lupus erythematosus by antibodies in the Sm antigen. Arthritis Rheum 1979, 22, 1334–1337.
Resi, R., Tartarelli, G., d'Ascanio, A. Anti-ENA antibodies in systemic lupus erythematosus: clinical serological correlations. In: Protides of the biological fluids, Editor: Peeters, H., Pergamon Press, Oxford, 1985, 293–296.
Beaufils, M., Konki, F., Mignin, F., Camus, J.P. Morel-Maroga, L., Richet, G. Clinical significance of anti-Sm antibodies in systemic lupus erythematosus. Ann J Med 1983, 74, 201–204.
Miyachi, K., Fritzler, M.J., Tan, E.M. Auto-antibody to a nuclear antigen in proliferating cells. J Immunol 1978, 121, 2228–2234.
Bernstein, R.M., Morgan, S.H., Bunn, C.C., Garney, R.C., Hughes, G.R.V., Mathews, M.B. The SL autoantibody-antigen system: Clinical and biochemical studies. Ann Rheum Dis 1986, 45, 353–358.
Bernstein, R.M., Bunn, C.C., Hughes, G.R.V., Francoeur, A.M., Mathews, M.B. Cellular protein and RNA antigens in autoimmune disease. Mol Biol Med 1984, 2, 105–120.
Treadwell, E.L., Alspaugh, M.A., Sharp, G.C. Characterisation of a new antibody in systemic lupus erythematosus (SLE). Arthritis Rheum 1983, (abstr) 26, 743.
Stetler, D.A., Rose, R.M., Wenger, M.E., Berlin, C.M., Jacob, S.T. Anti-proteinkinase NII antibodies in rheumatic autoimmune disease. J Biochem Chem 1984, 259, 2077–2079.
Swaak, A.J.G., Groenwold, J., Bronsveld, W. Predictive value of complement profiles and anti-dsDNA in systemic lupus erythematosus. Ann Rheum Dis 1986, 45, 359–366.
Swaak, A.J.G., van Rooyen, A., Vogelaar, C., Pillay, M., Hack, C.E. Complement (C3) metabolism in systemic lupus erythematosus in relation to the disease course. Rheumatol Int 1986, 6, 221–226.
Tan, E.M., Cohen, A., Fries, J.F., Masi, A.T., McShane, D.J., Rothfield, N.F., Schuller, J.G., Talal, N., Winchester, R.J. The revised criteria for the classiciation of systemic lupus erythematosus. Arthritis Rheum 1982, 25, 1271–1277.
Lightfoot, R.W., Hughes, G.R.V. Significance of persisting serologic abnormalities in SLE. Arthritis Rheum 1976, 19, 837–843.
Kassan, S.S., Lockskin, M.D. Central nervous system lupus erythematosus: the need for classification. Arthritis Rheum 1979, 22, 1382–1385.
Bonfa, E., Golombek, S.J., Lee, D.K., Skelly, S., Weissback, H., Brot, N., Elkon, K.B. Association between lupus psychosis and anti-ribosomal protein antibodies.
Aarden, L.A., Smeenk, R. Measurement of antibodies specific for DNA. In: Immunological Methods, vol. II, Editor: I. Lefkovitz and B. Pernis, Academic Press, 1981, pp. 75–82.
Smeenk, R., Lely van de, G., Aarden, L.A. Avidity of antibodies to dsDNA. J Immunol 1982, 128, 73–78.
Kurata, N., Tan, E.M. Identification of antibodies to nuclear acidic antigens by counter immunoelectrophoresis. Arthritis Rheum 1976, 19, 574–580.
Kiparsky van, A., Steckemesser, E., Berg, P.A. Auto-anti-körper Profile bei Kollagenerkrankungen. Dtsch Med Wochen 1986, 111, 1234–1241.
Mackworth, C.G., Chan, J.K.H., Bunn, C.C., Hughes, G.R.V. and Gharavi, A.E. Complement fixation by anti-dsDNA antibodies in SLE: measurement by radioimmunoassay and relationship with disease activity. Ann Rheum Dis 1986, 45, 314–318.
Grippenberg, M., Helve, T. Anti-DNA antibodies of IgA class in patients with systemic lupus erythematosus. Rheumatol Int 1986, 6, 53–65.
Isenberg, D.A., Dudeney, C., Williams, W., Addison, I., Charles, S., Clarke, J., Todd-Pokropek, A. Measurement of anti-DNA antibodies: a reappraisal using five different methods. Ann Rheum Dis 1987, 46, 448–456.
Speransky, A.I., Ivanova, M.I., Rjazantceva, T.A., Piven, V.A., Bulanova, T.D. Antinuclear antibodies in lupus erythematosus and Sjögren's syndrome: clinical and immunological investigations. Scand J Rheumatol 1988, suppl 67, 39–43.
Boey, M.L., Peebles, C.L., Tsay, G., Feng, P.H., Tan, E.M. Clinical and auto-antibody correlations in Orientals with systemic lupus erythematosus. Ann Rheum Dis 1988, 47, 918–923.
Harris, E.N., Boey, M.L., Mackworth-Young, C.G. Anti-cardiolipin antibodies: detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus. Lancet 1983, 2, 1211–1214.
Harris, E.N., Gharavi, A.E., Ashreson, R.A., Boey, M.L., Hughes, G.R.V. Cerebral infarction in systemic lupus erythematosus: association with anti-cardiolipin antibodies. Clin Exp Rheumatol 1984, 2, 47–51.
Fort, J.G., Cowchock, F.S., Abruzzo, J.L., Smith, J.B. Anti-cardiolipin antibodies in patients with rheumatic diseases. Arthritis Rheum, 1987, 30, 752–760.
Petri, M., Golbus, M., Anderson, R., Whiting-O'Keefe, P., Corash, L., Hellmann, D. Antinuclear antibody, lupus anticoagulant and anticardiolipin antibody in women with ideopathic habitual abortion. Arthritis Rheum 1987, 30, 601–606.
Petri, M., Rheinschmidt, M., Whiting-O'Keefe, P., Hellmann, D., Corash, L. The frequency of lupus anti-coagulants in systemic lupus erythematosus. Ann Intern Med 1987, 106, 524–531.
Manoussakis, M.N., Gharavi, A.E., Drosos, A.A., Kritridon, R.C., Montsopoulos, H.M. Anticardiolipin antibodies in unselected autoimmune rheumatic disease patients. Clin Immunol Immunopathol 1987, 44, 297–307.
Wasicek, C.A., Reichlin, M. Clinical and serological differences between systemic lupus erythematosus patients with antibodies to Ro versus patients with antibodies in Ro and La. J Clin Invest 1982, 69, 833–843.
Williams, D.G., Stocks, M.R., Charles, P.J., Maini, R.N. Antibodies to La, Jo-1, NRNP and Sm detected by multi-track immunoblotting using a novel filter holder: a comparative study with counter immunoelectrophoresis and immunodiffusion using sera from patients with systemic lupus erythematosus and Sjögren's syndrome. J Immunol Methods 1986, 41, 65–73.
Maddison, P.J., Isenberg, D.A., Goulding, N.J., Leddy, J., Skinner, R.P. Anti La (SSB) identifies a distinctive subgroup of systemic lupus erythematosus. Br J Rheumatol 1988, 27, 27–31.
Arnett, F.C., Hamilton, R.G., Roebber, G., Harvey, J.B., Reichlin, M. Increased frequency of Sm and nRNP auto-antibodies in American blacks compared to whites with systemic lupus erythematosus. J Rheumatol 1988, 15, 1773–1776.
Westgeest, A.A., van den Brink, H.G., de Jong, J., Swaak, A.J.G., Smeenk, R.J.T. Anti-nuclear antibodies in patients with systemic lupus erythematosus: a comparison of counter immunoelectrophoresis and immunoblotting. Rheumatol Int (in press).
Tan, E.M. Autoantibodies to nuclear antigens (ANA): their immunobiology and medicine. Adv Immunol 1982, 33, 167–240.
Koffler, D., Schur, P.H., Kunkel, H.G. Immunological studies concerning the nephritis of systemic lupus erythematosus. J Exp Med 1967, 26, 607–623.
Eilat, D. Cross-reaction of anti-DNA antibodies and the central dogma of lupus nephritis. Immunol Today 1985, 6, 123–127.
Faber, P., Capel, P.J.A., Rijke, G.P.M., Vierwinden, G., Van der Putte, L.B.A., Koene, R.A. Cross-reactivity of anti-DNA antibodies with proteoglycans. Clin Exp Immunol 1984, 55, 502–508.
Dang, H., Harbeck, R.J. The in vivo and in vitro glomerular deposition of isolated anti-double stranded DNA antibodies in NZB/W mice. Clin Immunol Immunopathol 1984, 30, 265–278.
Alascon-Segovia, D., Lorente, L., Fishbein, E., Diaz-Jonanen, E. Abnormalities in the content of nucleic acids of peripheral blood mononuclear cells from patients with systemic lupus erythematosus. Relation to DNA antibodies. Arthritis Rheum 1982, 23, 304–312.
Jacob, L., Tron, F., Bach, J.F., Louvard, D. A monoclonal anti-DNA antibody binds to cell surface protein(s). Proc Natl Acad Sci USA, 1984, 81, 3843–3845.
Houtman, P.M., Kallenberg, C.G.M., Limburg, P.C., Huitema, M.G., van Rijswijk, M.H., The, T.H. Quantitation of antibodies to nucleoribonucleoprotein by ELISA: relation between antibody levels and disease activity in patients with connective tissue disease. Clin Exp Immunol 1985, 62, 696–704.
Nishikai, M., Okano, Y., Mukohda, Y., Sato, A., Ito, M. Serial estimation of anti-RNP antibody titers in systemic lupus erythematosus, mixed connective tissue disease and rheumatoid arthritis. J Clin Lab Immunol 1984, 13, 15–19.
References
Tan, E.M. et al. Arthritis Rheum, 1982, 25, 1271.
Burnham, T.K. et al. J Inv Dermatol, 1963, 41, 451.
Oriente, P. et al. Clin Rheumatol 1989, 8, 50.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Swaak, A.J.G., Huysen, V., Nossent, J.C. et al. Antinuclear antibody profiles in relation to specific disease manifestations of systemic lupus erythematosus. Clin Rheumatol 9 (Suppl 1), 82–95 (1990). https://doi.org/10.1007/BF02205555
Issue Date:
DOI: https://doi.org/10.1007/BF02205555