Assessing the Prevalence of Disease-Specific Antinuclear Antibodies and their Detection in Diagnosis of Rheumatic Disorders in Syria
DOI:
https://doi.org/10.37285/ijpsn.2022.15.2.4Abstract
Background: Antinuclear antibodies (ANA) detection is a crucial laboratory test for diagnosing systemic autoimmune disorders and is commonly the initial step in autoantibodies screening. ANA are immunoglobulins that differentiate a wide range of nuclear and cytoplasmic components. ANAs are consistently present in the sera of patients with a variety of rheumatic disorders. The purpose of the study was to investigate the kinds and the expansion of disease-specific antinuclear antibodies (ANAs) and their link to rheumatic disorders in the general Syrian people.
Method: Immunofluorescence (IIF) was used for testing ANA in serum samples gained from 529 patients. Individualities positive for IF ANA were further tested for disease specific ANAs using line Immunoblot assay.
Results: Based on the result of the IF ANA assay, the rates of positive samples were 7.9%. Anti-SSA/Ro and anti-dsDNA antibodies were detected in 7and 6 individuals, respectively, anti Scl70, anti-Nucleosome, anti-U1-RNP, anti-CENP B were detected in 4 different individuals, but anti-Sm, anti-PCNA, and anti-Jo-1 antibodies were undetectable. Among 42 IF ANA positive individualities, 24 were found to have disease specific ANAs: nine SLE, three Sclerosis, and two rheumatoid arthritis.
Conclusions ANA should generally not be examined without a clinical indication. Positive ANA finding in the absence of clinical symptoms and signs has limited diagnostic usefulness and should be interpreted by a rheumatologist constantly, in the context of clinical symptoms and the results of laboratory tests for specific autoantibodies.
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Keywords:
Antinuclear antibodies, rheumatologist, iindirect immunofluorescence, Line immunoassay, Connective tissue diseases, systemic lupus erythematosusDownloads
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Abeles, A. M., & Abeles, M. (2013). The clinical utility of a positive antinuclear antibody test result. The American journal of medicine, 126(4), 342-348.
Alspaugh, M. A., & Tan, E. M. (1975). Antibodies to cellular antigens in Sjögren's syndrome. The Journal of clinical investigation, 55(5), 1067-1073.
American College of Rheumatology. American College of Rheumatology position statement: methodology of testing for antinuclear antibodies (2009)
Buchner, C., Bryant, C., Eslami, A., & Lakos, G. (2014). Anti-nuclear antibody screening using HEp-2 cells. Journal of visualized experiments: JoVE, (88).
Grygiel-Górniak, B., Rogacka, N., & Puszczewicz, M. (2018). Antinuclear antibodies in healthy people and non-rheumatic diseases–diagnostic and clinical implications. Reumatologia, 56(4), 243.
Hayashi, N., Koshiba, M., Nishimura, K., Sugiyama, D., Nakamura, T., Morinobu, S., ... & Kumagai, S. (2008). Prevalence of disease-specific antinuclear antibodies in the general population: estimates from annual physical examinations of residents of a small town over 5 years. Modern Rheumatology, 18(2), 153-160.
Holborow, E. J., Weir, D. M., & Johnson, G. D. (1957). A serum factor in lupus erythematosus with an affinity for tissue nuclei. British medical journal, 2(5047), 732.
Kumar, Y., Bhatia, A., & Minz, R. W. (2009). Antinuclear antibodies and their detection methods in diagnosis of connective tissue diseases: a journey revisited. Diagnostic pathology, 4(1), 1-10.
Marin, G. G., Cardiel, M. H., Cornejo, H., & Viveros, M. E. (2009). Prevalence of antinuclear antibodies in 3 groups of healthy individuals: blood donors, hospital personnel, and relatives of patients with autoimmune diseases. JCR: Journal of Clinical Rheumatology, 15(7), 325-329.
Meroni, P. L., & Schur, P. H. (2010). ANA screening: an old test with new recommendations. Annals of the rheumatic diseases, 69(8), 1420-1422.
Murakami, A., Kojima, K., Ohya, K., Imamura, K., & Takasaki, Y. (2002). A new conformational epitope generated by the binding of recombinant 70‐kd protein and U1 RNA to anti–U1 RNP autoantibodies in sera from patients with mixed connective tissue disease. Arthritis & Rheumatism, 46(12), 3273-3282.
Narain, S., Richards, H. B., Satoh, M., Sarmiento, M., Davidson, R., Shuster, J., ... & Reeves, W. H. (2004). Diagnostic accuracy for lupus and other systemic autoimmune diseases in the community setting. Archives of internal medicine, 164(22), 2435-2441.
Peene, I., Meheus, L., Veys, E. M., & De Keyser, F. (2001). Detection and identification of antinuclear antibodies (ANA) in a large and consecutive cohort of serum samples referred for ANA testing. Annals of the rheumatic diseases, 60(12), 1131-1136.
Raj, P., Li, Q. Z., Karp, D., Olsen, N., Sivils, K., James, J., ... & Wakeland, E. (2013). Antinuclear antibodies in general population: what does that mean?(P4535).
Robbins, W. C., Holman, H. R., Deicher, H., & Kunkel, H. G. (1957). Complement fixation with cell nuclei and DNA in lupus erythematosus. Proceedings of the Society for Experimental Biology and Medicine, 96(3), 575-579.
Slater, C. A., Davis, R. B., & Shmerling, R. H. (1996). Antinuclear antibody testing: a study of clinical utility. Archives of Internal Medicine, 156(13), 1421-1425.
Tan, E. M., Feltkamp, T. E. W., Smolen, J. S., Butcher, B., Dawkins, R., Fritzler, M. J., ... & Koziol, J. A. (1997). Range of antinuclear antibodies in “healthy” individuals. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 40(9), 1601-1611.
Volkmann, E. R., Taylor, M., & Ben-Artzi, A. (2012). Using the antinuclear antibody test to diagnose rheumatic diseases: when does a positive test warrant further investigation?. Southern medical journal, 105(2), 100-104.
Walravens, M. (1987). Systemic diseases and the detection of antinuclear and anticytoplasmic antibodies. An hystorical review. Clinical rheumatology, 6(1), 9-17.
