АХВЕРДЯН Юрий Рубенович – к.м.н., с.н.с.
AKHVERDYAN Yuri Rubenovich – PhD in Medicine, Senior Researcher at the Laboratory of Methods for the Treatment and Prevention of Joint Diseases
ПАПИЧЕВ Евгений Васильевич – к.м.н., н.с.
PAPICHEV Evgeny Vasilievich – PhD in Medicine, Researcher at the Laboratory for Methods of Treatment and Prevention of Joint Diseases
ЗАВОДОВСКИЙ Борис Валерьевич д.м.н., зам. директора
ZAVODOVSKY Boris Valerievich Doctor of Medical Sciences, the head of the laboratory of methods of treatment and prevention of joint diseases
ПОЛЯКОВА Юлия Васильевна – к.м.н., н.с.
POLYAKOVA Julia Vasilievna – PhD in Medicine, Researcher
СИВОРДОВА Лариса Евгеньевна – к.м.н., в.н.с.
SEEWORDOVA Larisa Evgenievna – PhD in Medicine, leading researcher at the laboratory of methods for the treatment and prevention of joint diseases
Целью исследования было изучение иммунологической характеристики пациентов с системной красной волчанкой (СКВ) и синдромом Шегрена (СШ) путем определения антинуклеарных антител методом иммуноблоттинга. В группах пациентов с СКВ и СШ достоверно чаще наблюдались анти-SS-A native, антитела к гистонам достоверно чаще выявлялись в группе пациентов с СКВ. Наиболее специфичными тестами для диагностики СКВ являются антитела к антигенам RNP/Sm, SS-A native, антитела к гистонам, для СШ - анти-SS-A native, анти- Ro-52 recombinant, анти-RIB. С помощью дополнительных методов статистического анализа подтверждены рассчитанные чувствительность и специфичность определения анти-SS-A native для диагностики СКВ и анти-Ro-52 – для СШ.
Objective: to study the immunological characteristics of patients with systemic lupus erythe- matosus and Sjogren's syndrome by determining antinuclear antibodies using immunoblotting.
Materials and methods. We observed 69 patients whose average age was 38.9 years [23.2- 62.9], of which 63 (91.30%) were women and 6 (8.69%) men. BMI was 27.3 kg/m2 [21.8-49.2]. Inclusion criteria: age from 18 to 70 years, presence of a reliable diagnosis. To study the di- agnostic value of determining the ANA profile, patients were divided into 3 groups: 1st group 15 patients with systemic lupus erythematosus (SLE), 2nd – 21 patients with the disease and Sjögren’s syndrome (SS), 3rd (control) group – 33 patients with osteoarthritis. The control group was comparable to the study groups by gender and age.
Results. The determination of anti-SS-A in SLE has good quality (area under the ROC curve - 0.66). A cut-off value was determined with 79.6% specificity and 53.3% sensitivity. Anti-RNP/SM, anti-Sm, anti-dsDNA and anti-HI were somewhat less sensitive (30%), with a specificity level of 91% for anti-dsDNA and anti-Sm and 100% for anti-RNP/Sm and anti -HI. The most informative diagnostic tests for the disease and Sjogren's syndrome are anti-Ro-52 recombinant (sensitivity 57.1%, specificity 96%), anti-SS-Anative (sensitivity 52.4%, specificity 86%). The determination of anti-Ro-52 in SS is of good quality, which confirms the value of the area under the ROC curve (>0.7). The optimal cut-off value corresponded to 99.6% specificity and 57.1% sensitivity. Some- what less sensitive (28.6%) were anti-Sm (specificity - 92%), anti-dsDNA (specificity - 92%) and anti-RIB (specificity 100.0%).
Findings. The laboratory tests studied, as a rule, had high specificity, but rather low sensitivity. The most specific tests for diagnosing SLE are antibodies to the antigens RNP/Sm, SS-Ana- tive, antibodies to histones, for SS - anti-SS-Anative, anti-Ro-52 recombinant, anti-RIB.
The authors declare that there are no conflicts of interest present.