Anti-nucleosome, anti-chromatin, anti-dsDNA and anti-histone antibody reactivity in systemic lupus erythematosus

Abstract

Anti-nucleosome (anti-chromatin) antibodies play a key role in the pathogenesis of systemic lupus erythematosus (SLE). The objective of the present study was to determine the clinical significance of anti-nucleosome (anti-chromatin) antibodies, anti-dsDNA antibodies and anti-histone antibodies in patients with SLE in relation to patients with positive nuclear antibodies and healthy controls. We measured anti-nucleosome (anti-chromatin) antibodies, anti-dsDNA antibodies and anti-histone antibodies in 70 patients with SLE, 35 antinuclear antibody (ANA)-positive subjects without autoimmune disease and 35 blood donors. All antibodies were determined by enzyme-linked immunosorbent assay (ELISA). We obtained the receiver operating characteristic (ROC) curve and the area under the curve (AUC) for each autoantibody. Likewise, we obtained the sensitivity, specificity and positive and negative likelihood ratios for each autoantibody. The highest AUC was obtained for anti-nucleosome (0.898) and the lowest AUC for a kit for anti-dsDNA (0.725). Stratification of the control group (ANA-positive subjects without autoimmune disease and blood donors) produced significant changes in the AUCs; all AUCs decreased when ANA-positive patients without autoimmune disease were considered as controls and all AUCs increased when blood donors were considered as controls. These effects were less marked in anti-dsDNA antibodies. We observed discrepancies between kits (anti-nucleosome and anti-chromatin and two for anti-dsDNA). The highest sensitivity for SLE was obtained for anti-nucleosome antibodies (86%) and the highest specificity was obtained for anti-dsDNA antibodies (90%). In conclusion, anti-nucleosome and anti-chromatin kits show different degrees of clinical accuracy due to the cut-off selected by the manufacturer. Once the kits with the best performance and the optimal cut-offs have been selected, anti-nucleosome antibodies and anti-dsDNA antibodies provide similar information in established SLE.

Antinucleosome antibodies correlate with the disease severity in children with systemic lupus erythematosus

“…Although anti-NCS Ab have been detected both in active and inactive SLEs [12,24], a close relationship between anti-NCS Ab and SLE disease activity evaluated by SLEDAI score [15,23,24,35] or the European Community Lupus Activity Measure (ECLAM) score [16,30] has been summarized. Benucci et al [16], also demonstrated the significantly lower levels of C3 and C4 in patients with positive anti-NCS Ab.…”

Como interpretar e valorizar adequadamente o teste de anticorpos antinúcleo

“…LES, LES induzido por drogas, artrite juvenil idiopática, síndrome de Felty, esclerose sistêmica, CBP, hepatite auto-imune (18) Homogêneo DNA nativo LES, LES induzido por drogas, artrite juvenil idiopática, síndrome de Felty, esclerose sistêmica, cirrose biliar primária, hepatite auto-imune…”

Desempenho diagnóstico e associações clínicas dos anticorpos contra componentes da cromatina no lúpus eritematoso sistêmico juvenil

“…The sensitivity of the various tests for the different autoantibodies against chromatin components was relatively low (11%-40%) when compared to the literature data on adult SLE. 11,[36][37][38][39][40][41][42][43][44][45] This may be related to specifi c features of JSLE and to the ethnic makeup of the studied sample or to the fact that most JSLE patients were under immunosuppressive therapy at the moment of serum harvest. In the present study 22 of 23 (96%) anti-dsDNA ELISA positive samples were also anti-CHR-20 positive.…”