REGULARITIES AND CLINICAL SIGNIFICANCE OF AUTOANTIBODIES IN CHRONIC HCV-INFECTION
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Results of the detection of autoantibodies in patients with chronic HCV-infection are presented. The comparison of importance of autoantibodies both organ specific (to liver specific protein) and organ non-specific (antinuclear and antimitochondrial) is done. The clinical significance of organ specific autoantibodies (to liver specific protein) is high.Keywords:
Clinical Significance
Objective: To analyze chronic urticaria autoantibody expression and significance. Method: In our hospital 78 patients with chronic autoimmune urticaria were selected as the observation group, and 78 healthy people were selected as control group. The detection of anti FceRI antibody, anti thyroid antibodies(anti thyroid peroxidase antibodies and anti thyroglobulin antibody), anti Helicobacter pylori(HP) antibodies, antinuclear antibody(ENA), anti dsDNA antibody and other autoantibodies were compared. Result: Compared with the control group, FceRI antibody, anti thyroid antibodies, HP antibody, dsDNA and other autoantibodies positive rate increased significantly, the difference was statistically significant, but he positive rate of anti nuclear antibodies difference was not statistically significant. Compared with the control group, the expression level of FceRI antibodies, antinuclear antibodies, anti dsDNA antibodies was significantly higher, the differences were statistically significant(P0.05). Conclusion:The incidence of chronic idiopathic urticaria and autoimmune background, its abnormal expression of serum autoantibodies, is worthy of further clinical application study.
Anti-thyroid autoantibodies
Thyroid peroxidase
Thyroglobulin
Clinical Significance
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Objective To compare the specificity and sensitivity of anti-Jo1,anti-SSA,anti-SSB,anti-RNP,anti-dsDNA,anti-Sm and antinuclear antibodies(ANA) and investigate the clinical significance of combined detection of the specific autoantibodies in the diagnosis of children with SLE.Methods Sixty children with SLE(SLE group) and 40 children with other autoimmune diseases(control group) were included in this study.Indirect immunofluorescence was used to measure ANA.Western blot was used to measure anti-Jo1,anti-SSA,anti-SSB,anti-RNP,anti-dsDNA,and anti-Sm antibodies.Results The seropositive rates of ANA,anti-dsDNA,anti-RNP,anti-Sm,anti-SSA and anti-SSB antibodies were 96.7%,48.3%,31.7%,30.0%,20.0% and 18.3% respectively in SLE patients,much higher than those of control group(22.5%,10%,7.5%,5.0%,5.0%,and 5.0%,respectively,P0.01).The sensitivity of ANA was higher,but the specificity of ANA was lower than anti-dsDNA,anti-RNP,and anti-Sm antibodies(P0.05).The specificities of anti-dsDNA,anti-RNP,and anti-Sm antibodies were 95.0%,92.5%,95.0% respectively.The level of anti-dsDNA antibody was not correlated with the levels of anti-RNP and anti-Sm antibodies.Combined detection of autoantibodies increased the sensitivity in the diagnosis of children with SLE.Conclusion Anti-dsDNA,anti-RNP,and anti-Sm-antibodies are specific antibodies in the diagnosis of SLE,but these autoantibodies show different sensitivities with highest sensitivity in the detection of anti-dsDNA antibody.Combined detection of autoantibodies may significantly improve the sensitivity in the diagnosis of SLE.
Clinical Significance
Immunofluorescence
Anti-dsDNA antibodies
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OBJECTIVE--To study the specific autoantibodies against nuclear antigens in patients with primary biliary cirrhosis (PBC). METHODS--Sera from 21 patients with PBC were tested for antinuclear antibody (ANA) by indirect immunofluorescence on human epithelial (HEp)-2 cells, and for antibodies to various nuclear antigens by enzyme linked immunosorbent assay (ELISA) using different purified proteins or recombinant proteins as antigens. RESULTS--ANA detected in 10 of 21 patients (48%) with PBC included five anti-centromere antibody (ACA), two speckled, two homogeneous and one nuclear dot staining. ACA were present in 24% of PBC patients. By ELISA, anti-histone antibodies were detected in 81% of PBC patients, anti-ssDNA antibodies in 71% and anti-dsDNA in 10%, anti-topoisomerase-1 antibodies in 24%, anti-Sm/RNP antibodies in 24%, anti-La-48(SS-A) antibodies in 21%, and anti-Ro-60(SS-A) and anti-Ro-52(SS-A) antibodies in 30% and 25%, respectively. CONCLUSIONS--The high frequencies of various antibodies directed against intracellular proteins and nucleic acids in patients with PBC suggests that PBC is a multisystem autoimmune disease which is similar to other systemic autoimmune diseases.
Primary Biliary Cirrhosis
Extractable nuclear antigens
Anti-dsDNA antibodies
Immunofluorescence
Biliary cirrhosis
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Abstract Despite the progress in the establishment of specific autoantibody assays, screening for antinuclear antibodies (ANA) by indirect immunofluorescence on HEp-2 cells for quality-oriented laboratory diagnosis of ANA associated rheumatic diseases (AARD) remains indispensable. Research results on the relevance of the dense fine speckled (DFS) pattern and DFS70 antibodies disclosed novel possibilities to optimize the serological stepwise diagnostics of AARD. The DFS pattern on HEp-2 cells is well differentiated from the classic “homogeneous” ANA pattern associated with dsDNA antibodies. In DFS pattern positive sera the most important detectable ANA specificity is the DFS70 antibody (synonym LEDGF antibody). This antibody is also the most frequent ANA specificity in ANA positive healthy persons. The prevalence of DFS70 antibodies in AARD patients is significantly lower compared with the prevalence in ANA-positive healthy individuals. There is a negative association between DFS70 antibodies and AARD, especially if no concomitant AARD-specific autoantibodies are found. Isolated DFS70 antibodies are detectable in <1% of AARD, but are detectable in 5%–11% of healthy individuals. In the presence of an isolated DFS70 antibody, the posttest probability for AARD is reduced significantly. DFS70 antibodies are valuable novel biomarkers for the improved interpretation of positive ANA but without detectable AARD associated autoantibodies and should be integrated in modified test algorithms to avoid unnecessary referrals and examinations of ANA-positive subjects.
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Objective To explore the diagnostic value and clinical significance of autoantibody test for SLE patients. Methods Serum samples of 374 SLE patients were analyzed by detecting antinuclear antibody( ANA),anti-ds-DNA antidody and ENA antibody repertoire( anti-Sm,anti-RNP,anti-SS-A,anti-SS-B,antiScl70 and anti-Jo1 antibody) with indirect immunofluorescence assay( IIFA) and gold linked immunodotting percolation and enzyme linked immunodotting respectively. Results ①Among the 374 SLE patients,there were 31 cases of ANA negative of IIFA test,and the positive rate of ANA( IIFA) for SLE patients was91. 7%,and speckled pattern and speckled / homogeneuous pattern were the major immunofluorescence patterns; ②the positive rate of anti-Sm antibody,anti-RNP antibody,anti-SS-A antibody,anti-SS-B antibody,anti-Scl70 antibody,anti-Jo1 antibody and anti-dsDNA were 15. 0%,23. 8%,50. 5%,12. 0%,0%,0. 3%and 43. 8%. Conclusion Co-detection has great clinical significance for diagnosis and evaluation of curative effect of SLE.
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Immunofluorescence
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A group of 255 blood donors was analyzed for the presence of serum autoantibodies, e.g., antinuclear antibodies, smooth muscle antibodies, antimitochondrial antibodies, antiparietal cell antibodies and antireticulin antibodies by indirect immunofluorescence microscopy. The 37 (15%) who had autoantibodies underwent examination and extended laboratory investigation. We found no strong evidence of disease in any of the blood donors with autoantibodies.
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In 1948, Hargraves discovered LE cells in the bone marrow and peripheral blood of a patient with systemic lupus erythematodes (SLE). Since then, the usefulness of the cell in the diagnosis of SLE has not changed. LE factor, a component of LE cell, is an anti-nuclear antibody. To date, many kinds of anti-nuclear antibodies have been discovered. Among others anti-dsDNA, anti-Sm and anti-ribosome antibodies were detected at a high rate and/or specifically in SLE. Therefore, they are used as markers for SLE. Recently, the antigen corresponding to each auto-antibody and the gene coding for it were clarified. In this paper, we describe methods for detecting anti-nuclear antibodies and LE cells, the significance of each auto-antibody in the diagnosis of auto-immune diseases, especially SLE and the relation between autoantibodies and symptoms in patients with the antibodies.
Extractable nuclear antigens
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Objective. Antinuclear antibodies (ANA) occur in up to 95% of patients with systemic sclerosis (SSc). In most, SSc-associated antibodies are detected (i.e., centromere, topoisomerase I, RNA polymerase III, PM/Scl, Ro52/TRIM21, and U1RNP). Ribonuclease P protein subunit p25, (Rpp25) is an autoantigenic component of the Th/To complex. The contribution of anti-Th/To and anti-Rpp25 antibodies to ANA positivity in patients with SSc remains unknown. Methods. Sera from 873 patients with SSc were tested for ANA, and SSc-associated antibodies were measured. Samples without antibodies to extractable nuclear antigens (ENA; n = 53, ANA+/ENA−), were analyzed by immunoprecipitation (IP) and metabolically labeled proteins and for anti-Rpp25 antibodies (n = 50) by a chemiluminescent immunoassay (CLIA) and Rpp25 ELISA. Results. Anti-Th/To antibodies occurred in 19/53 (36%), as determined by IP, and were the most common autoantibody in ANA+/ENA− SSc. Of those samples, 50/53 were available for additional testing by CLIA and ELISA. Anti-Rpp25 antibodies were detected in 12 (24% CLIA) or 10 (20% ELISA) of 50 patients. Receiver-operating characteristic curve analysis showed similar discrimination between Th/To IP-positive (n = 19) and -negative samples (n = 31) by CLIA and ELISA (area under the curve 0.90 vs 0.87; p = 0.6691). The positive percent agreement between IP and CLIA or ELISA was 12/19 (63.2%, 95% CI 38.4–83.7%) or 10/19 (52.6%, 95% CI 73.3–94.2%), respectively. Negative percent agreement was 100% for both assays. Conclusion. Autoantibodies to the Th/To autoantigen are important in patients with SSc who have been considered negative for SSc-specific or SSc-associated antibodies by widely available commercial assays. Rpp25 can be considered a major target of anti-Th/To antibodies. Assays detecting anti-Th/To and anti-Rpp25 antibodies may be important in SSc.
Extractable nuclear antigens
Chemiluminescent immunoassay
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The occurrence of antibodies against the total histone complex and the histone fraction H1, antibodies against denatured (ss) DNA and the synthetic double stranded polynucleotide poly dAT, as well as rheumatoid factors (RF) was determined in patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and Sjögren's syndrome (SS) using enzyme linked immunosorbent assays (ELISA). Antihistone antibodies could be demonstrated at a frequency of about 17% in the patients with systemic rheumatic disease with no differences between the groups, even if there was a tendency for anti-H1 antibodies to occur more often in the SLE and SS patients than in the RA patients. Some of the antihistone antibody activity seen in the RA patients seems to be due to crossreactive RF. All patient groups showed significant IgG anti-ssDNA antibody activity compared to the controls, but the highest antibody levels were seen in the SLE patients. IgG antipoly dAT antibodies occurred significantly more often and at higher levels in the SLE patients than in the other patient groups. Although the individual tests did not readily distinguish the 3 diseases from each other, the antibody profiles were different. Patients with SS had the broadest reactivity, and the SLE patients had antibodies predominantly restricted to polynucleotides.
Polynucleotide
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Neutrophil Extracellular Traps
Clinical Significance
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