Abstract

KOKUINA, Elena et al. Anti-nucleosome antibodies against conventional Immunological markers in the diagnosis of SLE activity. Rev cubana med [online]. 2014, vol.53, n.4, pp.430-444. ISSN 0034-7523.

Objectives: to examine the profile of antibodies in patients with systemic lupus erythematosus and establish the correlation between antibody levels and disease activity, and lupus nephritis. Methods: anti-double stranded DNA (dsDNA), antinucleosoma (Nu), anti-Sm, anti-RNP, anti-Ro, anti-La, and anti-Scl-70 antibodies by enzyme-linked immunosorbent assay (ELISA) as well as C3 and C4 were determined in 213 patients with systemic lupus erythematosus who were treated consecutively. Disease activity was assessed by the SLEDAI 2K-index, without the contribution of anti-dsDNA, C3 or C4. The levels of antibodies, complement and activity of systemic lupus erythematosus were correlated. Results: the levels of antibodies turned out to be remarkably higher in patients in the active phase of the disease compared to those who were in the inactive phase. The higher Spearman correlation coefficients with SLEDAI-2K score corresponded to the anti-Nu and anti-dsDNA (p = 0.856 and p = 0.616, respectively, p <0.001 for both). The areas under the ROC curve analysis of the activity of systemic lupus erythematosus were in descending order as follows: anti-Nu = 0.948; anti-dsDNA = 0.810; anti-RNP = 0.705; C4 = 0.704; anti-Sm = 0.703; C3 = 0.688; anti-Scl-70 = 0.611; = 0.601 anti-La. Anti-Ro = 0.593; and renal activity for anti-Nu = 0.845; anti-dsDNA = 0.755; C4= 0.694; C3 = 0.670; anti-Sm = 0.641; anti-RNP = 0.630; anti-Scl-70 = 0.611; anti-Ro = 0.593 and anti-La = 0.567. Conclusion: the anti-Un exhibit excellent activity discriminating capacity of SLE lupus and renal activity, higher than the anti-dsDNA and other markers.

Keywords : autoantibody; antinucleosoma; anti-dsDNA; C3; C4; activity of systemic lupus erythematosus; SLEDAI-2K; lupus nephritis.

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