Abstract:
The detection of antinuclear antibodies is central to the diagnosis and prognosis of systemic lupus erythematosus (SLE), primary Sjögren\'s syndrome (pSS) and mixed connective tissue disease (MCTD). Anti-U1-RNP and anti-RNP70 antibodies were assayed in the sera of patients with SLE (n = 114), pSS (n = 54) and MCTD (n = 12). In the SLE group, 34/114 (30%) were anti-U1-RNP positive, and 21/114 (18%) were both anti-RNP70 positive and anti-U1-RNP positive. In the MCTD group, 10/12 (83%) were anti-U1-RNP positive, and 9/12 (75%) were anti-RNP70 positive. Only one individual with pSS was antibody positive (for both anti-U1-RNP and anti-RNP70). All anti-RNP70-positive samples were also anti-U1-RNP positive. Anti-U1-RNP-positive subjects with SLE were younger (p < 0.0001); showed lower concentrations of complement protein 3 (p = 0.03); had lower eosinophil (p = 0.0005), lymphocyte (p = 0.006) and monocyte (p = 0.03) counts; and had accrued less organ damage (p = 0.006) than the anti-U1-RNP-negative SLE patients. However, we observed no significant clinical or laboratory parameter differences between the anti-U1-RNP-positive individuals with/without anti-RNP70 in the SLE group. In conclusion, anti-RNP70 antibodies are not exclusive to MCTD but are rarely detected in pSS and healthy individuals. In SLE, anti-U1-RNP antibodies are associated with a clinical phenotype that resembles MCTD, with hematologic involvement and less damage accrual. Based on our results, the clinical value of subtyping anti-RNP70 in anti-U1-RNP-positive sera appears to be of limited value.
摘要:
抗核抗体的检测对于系统性红斑狼疮(SLE)的诊断和预后至关重要。原发性干燥综合征(PSS)和混合性结缔组织病(MCTD)。在SLE患者(n=114)的血清中测定了抗U1-RNP和抗RNP70抗体,PSS(n=54)和MCTD(n=12)。在SLE组中,34/114(30%)抗U1-RNP阳性,21/114(18%)的抗RNP70阳性和抗U1-RNP阳性。在MCTD组中,10/12(83%)抗U1-RNP阳性,9/12(75%)为抗RNP70阳性。只有一个具有pSS的个体是抗体阳性的(对于抗U1-RNP和抗RNP70)。所有抗RNP70阳性样品也是抗U1-RNP阳性的。患有SLE的抗U1-RNP阳性受试者较年轻(p<0.0001);显示较低浓度的补体蛋白3(p=0.03);嗜酸性粒细胞较低(p=0.0005),淋巴细胞(p=0.006)和单核细胞(p=0.03)计数;与抗U1-RNP阴性SLE患者相比,器官损伤较少(p=0.006)。然而,我们观察到SLE组中有/没有抗RNP70的抗U1-RNP阳性个体之间没有显著的临床或实验室参数差异.总之,抗RNP70抗体并非MCTD独有,但在pSS和健康个体中很少检测到.在SLE中,抗U1-RNP抗体与类似MCTD的临床表型相关,血液学受累,损害减少。根据我们的结果,抗U1-RNP阳性血清中抗RNP70亚型分型的临床价值似乎有限.