Relation between antinuclear antibodies and the autoimmune rheumatic diseases and disease type and activity in systemic lupus erythematosus using a variety of cultured cell lines

Article Abstract:

In many of the rheumatic diseases, such as systemic lupus erythematosus (SLE), blood levels of autoantibodies (antibodies that recognize and attack the body's own tissues) are elevated, a finding thought to be related to disease processes. In SLE, high levels of antinuclear antibodies (ANAs), which are specific to molecules from the cell nucleus, are characteristic of the disease, which is often detected and evaluated by measuring ANA levels. A previous study found that modification of the usual test for ANAs, which uses evaluation of antibodies that bind to cell nuclei, results in greater sensitivity to any ANAs present. The modification involves the use of cultured (laboratory-grown) human cells, rather than mouse kidney cells, to which antibodies from patients' blood are allowed to bind. To continue evaluation of the cultured cells, blood samples from 40 SLE patients who had different symptoms (kidney, joint, or nervous system involvement, for example) were studied, as were samples from 20 healthy subjects and samples from 10 patients each with rheumatoid arthritis, Sjogren's syndrome, scleroderma, and myositis. Results from several types of cultured cells were assessed, and the effects on the tests of ultraviolet radiation, which can trigger skin symptoms in SLE, were studied. Antinuclear staining in SLE patients varied from 80 to 100 percent with different cell lines, while patients with Sjogren's syndrome were 50 to 70 percent positive and those with myositis were 70 percent positive for ANA. Few differences in tests existed among SLE patients with different organ involvement, although only 50 percent of patients with deep vein thrombosis (clot formation) were positive for ANA. Patients with pleuropericarditis (inflammation of heart and lung membranes) or deep venous thrombosis had stronger staining of cells during inactive phases of SLE. Ultraviolet radiation appeared to increase the exposure of particular molecules to the samples' antibodies. The study suggests that all the cultured cell types tested provided sensitive detection of ANAs, but no correlation between ANAs and disease activity or pattern was found. (Consumer Summary produced by Reliance Medical Information, Inc.)

Rheumatic diseases

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Correlation between clinical features of systemic lupus erythematosus and levels of antihistone antibodies of the IgG, IgA, and IgM isotypes

Article Abstract:

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of connective tissue that affects the skin, joints, kidneys, nervous system, and mucous membranes. The disease is characterized by the development of a butterfly rash (redness across the cheeks and nose) fever, joint pain, and discomfort, although symptoms involving any organ system may develop. Antinuclear antibodies are abnormal immune proteins that attack components of the nucleus, and are detected in patients with SLE. Antihistone antibodies are antinuclear antibodies and may be classified into IgG, IgA, and IgM isotypes. The relation between the clinical features of SLE and levels of various isotypes of antihistone antibodies was assessed. The blood levels of antibodies in 25 patients were measured using an immunological technique called the enzyme linked immunosorbent assay (ELISA). The patients were divided into groups based on their disease or condition including kidney disease; central nervous system disorders; skin and joint disease; inflammation of the serous membrane that lines the lung, abdominal, and heart cavities; and blood clot formation (deep vein thrombosis) with or without miscarriage. The levels of antihistone antibodies of each isotype varied widely among different patients, but were closely related within single patients. The levels of IgA and IgG antihistone antibodies were closely related to each other, but not to IgM antihistone antibodies. The levels of IgG and IgA isotypes were higher in patients with more active disease. However, no simple relation between the levels of antihistone antibodies and disease activity was established. (Consumer Summary produced by Reliance Medical Information, Inc.)

Identification and classification, Immunoglobulins, Antibodies

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Antinuclear antibodies and the diagnosis of systemic lupus erythematosus in patients with acute intermittent porphyria

Article Abstract:

Systemic lupus erythematosus (SLE, or simply lupus) is a long-term inflammatory disease of connective tissue that affects the skin, joints, kidneys, nervous system, and mucous membranes. SLE can occur with porphyria, a condition resulting from abnormalities in the metabolism of porphyrin, a nitrogen-containing compound involved in formation of oxygen-carrying pigments such as hemoglobin. Studies suggest that there may be a genetic or environmental relation between SLE and porphyria, although a link between the two diseases has not been established. The presence of connective tissue disease was assessed in 38 patients with various forms of porphyria. Antinuclear antibodies, or abnormal immune system proteins that specifically bind to components of the cell nucleus, were detected in 8 of 15 patients with acute intermittent porphyria. This form of porphyria is characterized by the excessive excretion of porphyrins, abdominal pain, nerve disorders, and sensitivity to light. Although sudden attacks of porphyria occurred more often in these patients, only one patient had clinical evidence of SLE. Antinuclear antibodies were not detected in other forms of porphyria. These findings suggest that antinuclear antibodies may serve as a link to explain the co-occurrence of SLE and porphyria. Because clinical symptoms of these two disorders are similar, selective criteria for diagnosing SLE and porphyria are needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Porphyria

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