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autoantibodies in systemic lupus erythmatosus (SLE)

Autoantigen frequency autoantigen (frequency) 1) antinuclear antibody (99%) 2) double-stranded DNA (40%) 3) single stranded DNA (70%) 4) histones (70%) 5) Sm protein (30%) 6) U1 snRNP (32%) 7) SSA/Ro (35%) 8) SSB/La (15%) 9) Ku antigen (10%) 10) Ki antigen (31%) 11) proliferating cell nuclear antigen [PCNA] ( 3%) 12) ribosomal ribonucleoprotein (10%) - anti-ribosomal protein P (15%) 13) heat shock protein Hsp-90 (50%) 14) ALu RNA protein (rare) 15) ribosomal protein S10 (11%) 16) cardiolipin (20-40%) Autoantigen characteristics 1) antinuclear antibody a) multiple nuclear antigens b) sensitive, not specific 2) anti-dsDNA Ab a) spefific for SLE with high titer b) titer fluctuates with disease activity c) titer fluctuates with lupus nephritis 3) anti-ssDNA Ab: not specific 4) anti-histone Ab: high fequency with drug-induces lupus 5) anti-Sm Ab a) Ab against small nuclear RNP associated with spliceosome b) specific for SLE c) activity does not fluctuate with disease activity 6) anti-U1 snRNP Ab - associated with mixed connective tissue disease when sole autoantibody present 7) anti-SSA/Ro Ab - associated with Sjogren's syndrome, neonatal lupus, & subacute cutaneous lupus 8) anti-SSB/La Ab - associated with Sjogren's syndrome & neonatal lupus 9) antiphospholipid antibody - associated with thrombosis & miscarriage 10) antiribosomal protein P - 15% sensitivity for SLE - associated with CNS lupus & lupus hepatitis 11) direct antiglobulin test: + anti-IgG & anti-C3d

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systemic lupus erythematosus

General

autoantibodies in rheumatologic disease

References

  1. Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 1015
  2. Medical Knowledge Self Assessment Program (MKSAP) 16 American College of Physicians, Philadelphia 2012