Autoantibodies in Autoimmune Diseases

Abstract

The occurrence of autoantibodies is a common feature of autoimmune diseases. This review is intended to give an overview of the most important autoantibodies and their role in diagnosis, disease activity and prognosis in rheumatoid arthritis (RA), systemic lupus erythematodes (SLE) and multiple sclerosis (MS). Whereas in RA and SLE these antibodies are meaningful for diagnosis and partially for the prognosis of the disease, the situation is quite different in the case of MS. Up to date, no specific antibody is known to be exclusively present in the serum or cerebrospinal fluid (CSF) of MS-patients compared to the respective fluids of healthy individuals. Nevertheless, there are some antigens that are reported to be bound significantly more often by MS-patients' serum or CSF than by comparable samples of healthy volunteers. In addition to the importance of several autoantibodies for diagnosis of the respective disease, the serum concentration of certain antibodies in RA and SLE is associated with therapy response. Since therapy with biologicals (e. g. TNF-alpha blockade, B-cell depletion) is expensive, monitoring these autoantibodies seems to be an additional useful tool for early identification of therapy responders or non-responders.

Activation-induced cytidine deaminase deficiency accelerates autoimmune diabetes in NOD mice

“…Autoantibodies contribute to the pathology of the targeted tissues via activation of complement system, formation and deposition of immune complexes, stimulation of phagocytes, and induction of inflammation (29,30). Although the role of the autoantibodies in T1D is not completely understood, autoantibodies against GAD, IA2, and insulin are important biomarkers for diagnosis and prediction of T1D development (31-33).…”

Do we need broad immunological work-up in all patients with CIS?

“…Many autoantibodies have been identified in both, serum and CSF, of MS patient but unfortunately, there is no autoantibody described being exclusively expressed in MS patients compared to the respective fluids of healthy individuals [3]. Recent proteomic studies on the other hand demonstrated that autoantibody in sera or CSF of MS patients are reactive to a panel of proteins, rather than a single protein, suggesting a MS-specific pattern of autoantibodies [4].…”

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“…76 Current treatments for such autoimmune disease include immune suppression via cytotoxic drugs, administration of other types of antibodies, and systemic glucocorticoids. 77 There are side effects to such broad immune suppression therapies, but the treatments are still clinically used as the underlying cause of many autoimmune diseases remains unknown.…”