Determination of antinuclear antibodies by immunoblotting to clarify the immunological characteristics of patients with systemic lupus erythematosus and Sjogren's syndrome
https://doi.org/10.25789/YMJ.2024.85.09
Abstract
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.
About the Authors
Yu. R. Akhverdyan
FSBI Zborovsky Research Institute of Clinical and Experimental Rheumatology
Russian Federation
Russian Federation
AKHVERDYAN Yuri Rubenovich – PhD in Medicine, Senior Researcher at the Laboratory of Methods for the Treatment and Prevention of Joint Diseases
E. V. Papichev
FSBI Zborovsky Research Institute of Clinical and Experimental Rheumatology
Russian Federation
Russian Federation
PAPICHEV Evgeny Vasilievich – PhD in Medicine, Researcher at the Laboratory for Methods of Treatment and Prevention of Joint Diseases
B. V. Zavodovsky
FSBI Zborovsky Research Institute of Clinical and Experimental Rheumatology
Russian Federation
Russian Federation
ZAVODOVSKY Boris Valerievich Doctor of Medical Sciences, the head of the laboratory of methods of treatment and prevention of joint diseases
Yu. V. Polyakova
FSBI Zborovsky Research Institute of Clinical and Experimental Rheumatology
Russian Federation
Russian Federation
POLYAKOVA Julia Vasilievna – PhD in Medicine, Researcher
L. E. Seewordova
FSBI Zborovsky Research Institute of Clinical and Experimental Rheumatology
Russian Federation
Russian Federation
SEEWORDOVA Larisa Evgenievna – PhD in Medicine, leading researcher at the laboratory of methods for the treatment and prevention of joint diseases
References
1. Aleksandrova E.N., Novikov A.A., Nasonov E.L. Federal`ny`e klinicheskie rekomendacii laboratornaya diagnostika revmaticheskix zabolevanij [Federal clinical guidelines for laboratory diagnosis of rheumatic diseases M.: GEOTAR-Media. 2015: 26 (In Russ.).]
2. Lapin S.V. Klinicheskie rekomendacii po laboratornoj diagnostike autoimmunny`x zabolevanij [Clinical guidelines for laboratory diagnosis of autoimmune diseases. 2014 (In Russ.).]
3. Obshcherossijskaya obshchestvennaya organizaciya «Associaciya revmatologov Rossii». Klinicheskie rekomendacii po diagnostike i lecheniyu bolezni Shegrena [All-Russian public organization 'Association of Rheumatologists of Russia'. Clinical guidelines for the diagnosis and treatment of Sjögren’s disease. 2013, 18 p. (In Russ.).]
4. Kernder A [et al.]. Delayed diagnosis adversely affects outcome in systemic lupus erythematosus: cross sectional analysis of the lula cohort. Lupus 2021;30:431–8.
5. Choi M. Y [et al.]. Different indirect immunofluorescence ANA substrate performance in a diagnostic setting of patients with SLE and related disorders: retrospective review and analysis. Lupus science & medicine. 2020;7(1):e000431.
6. Fanouriakis A [et al.]. EULAR recommendations for the management of systemic lupus erythematosus: 2023 update. Ann Rheum Dis. 2023;0:1–15. doi:10.1136/ard-2023-224762.
7. Aringer M. [et al.]. European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Annals of Rheumatic Diseases, 2019; 78: 1151–1159.
8. Tizaoui K [et al.]. Genetic Polymorphism of PTPN22 in Autoimmune Diseases: A Comprehensive Review. Medicina. 2022;58(8):1034. https://doi.org/10.3390/medicina58081034.
9. Agmon-Levin N [еt al.]. International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti-nuclear antibodies. Ann Rheum Dis. 2014 Jan;73(1):17-23.
10. Naghavi-Behzad M. Diagnostic value of Immunoblotting assay for determination of anti nuclear antibody (ANA) concentration in rheumatologic diseases. Front. Immunol. Conference Abstract: 15th International Congress of Immunology (ICI). 2013doi: 10.3389/conf.fimmu.2013.02.00757.
Review
For citations:
Akhverdyan Yu.R., Papichev E.V., Zavodovsky B.V., Polyakova Yu.V., Seewordova L.E. Determination of antinuclear antibodies by immunoblotting to clarify the immunological characteristics of patients with systemic lupus erythematosus and Sjogren's syndrome. Yakut Medical Journal. 2024;(1):33-36. https://doi.org/10.25789/YMJ.2024.85.09
Views:
32
Email this article 