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Abstract：
BACKGROUND: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease. Detection of antinuclear antibodies (ANAs) aids in the diagnosis of SLE. The indirect immunofluorescence (IIF) assay is often used a routine screening test for the detection of ANA. The pathogenic role and significance of various patterns produced in IIF is yet to be explored.
OBJECTIVE: This study aimed to detect ANA patterns generated by IIF and correlate these patterns with specific antibodies detected by line immunoassay. We also investigated the significance of each ANA pattern and its association with specific serological SLE markers, such as complement molecules, anti-dsDNA, antiphospholipid antibody, and C-reactive protein (CRP), along with associations with direct Coombs test (DCT).
METHODS: We conducted a retrospective study that included 204 patients newly diagnosed with SLE according to the European Alliance of Associations for Rheumatology/American College of Rheumatology (EULAR/ACR) criteria. The detection and pattern determination of ANA was performed by IIF using HEp-20-10. Furthermore, line immunoassay was performed, and the antibody profile of each sample was obtained. Other immunodiagnostic markers were analyzed, including C3, C4, anti-dsDNA, antiphospholipid antibodies (anti-cardiolipin antibodies, anti-beta-2-glycoprotein I, and lupus anticoagulant), CRP, and DCT.
RESULTS: Of the 204 samples, the most frequent ANA pattern observed was nucleus speckled (52.9%), followed by nucleus homogenous (27.5%), mixed (13.7%), and cytoplasm speckled (5.9%). The nucleus homogenous pattern showed the most pathogenic immune profile due to its close association with markers of disease activity, namely, high anti-dsDNA titer, low C3 level, and DCT positivity. Conclusion: This study showed that the most common pattern associated with SLE is nucleus speckled, followed by the nucleus homogenous pattern. Based on associations with specific serological markers, the nucleus homogenous pattern may be linked to a high disease activity in SLE.
OBJECTIVE: This study aimed to detect ANA patterns generated by IIF and correlate these patterns with specific antibodies detected by line immunoassay. We also investigated the significance of each ANA pattern and its association with specific serological SLE markers, such as complement molecules, anti-dsDNA, antiphospholipid antibody, and C-reactive protein (CRP), along with associations with direct Coombs test (DCT).
METHODS: We conducted a retrospective study that included 204 patients newly diagnosed with SLE according to the European Alliance of Associations for Rheumatology/American College of Rheumatology (EULAR/ACR) criteria. The detection and pattern determination of ANA was performed by IIF using HEp-20-10. Furthermore, line immunoassay was performed, and the antibody profile of each sample was obtained. Other immunodiagnostic markers were analyzed, including C3, C4, anti-dsDNA, antiphospholipid antibodies (anti-cardiolipin antibodies, anti-beta-2-glycoprotein I, and lupus anticoagulant), CRP, and DCT.
RESULTS: Of the 204 samples, the most frequent ANA pattern observed was nucleus speckled (52.9%), followed by nucleus homogenous (27.5%), mixed (13.7%), and cytoplasm speckled (5.9%). The nucleus homogenous pattern showed the most pathogenic immune profile due to its close association with markers of disease activity, namely, high anti-dsDNA titer, low C3 level, and DCT positivity. Conclusion: This study showed that the most common pattern associated with SLE is nucleus speckled, followed by the nucleus homogenous pattern. Based on associations with specific serological markers, the nucleus homogenous pattern may be linked to a high disease activity in SLE.
摘要：
背景：系统性红斑狼疮（SLE）是一种多系统自身免疫性疾病。检测抗核抗体（ANA）有助于SLE的诊断。间接免疫荧光（IIF）测定通常用于检测ANA的常规筛选测试。IIF中产生的各种模式的致病作用和意义尚待探索。
目的：本研究旨在检测IIF产生的ANA模式，并将这些模式与通过线免疫测定检测到的特异性抗体相关联。我们还调查了每种ANA模式的意义及其与特定血清学SLE标记的关联，比如补体分子，抗dsDNA，抗磷脂抗体，和C反应蛋白（CRP），以及与直接库姆斯测试(DCT)的关联。
方法：我们进行了一项回顾性研究，纳入了符合欧洲风湿病学协会联盟/美国风湿病学会(EULAR/ACR)标准的204例新诊断为SLE的患者。使用HEp-20-10通过IIF进行ANA的检测和模式测定。此外，行免疫测定，并获得每个样品的抗体谱。分析了其他免疫诊断标志物，包括C3，C4，抗dsDNA，抗磷脂抗体（抗心磷脂抗体，抗β-2-糖蛋白I,和狼疮抗凝药)，CRP,DCT。
结果：在204个样本中，观察到的最常见的ANA模式是核斑点(52.9%)，其次是细胞核同质(27.5%)，混合（13.7%），和细胞质斑点（5.9％）。由于与疾病活动标志物密切相关，细胞核同质模式显示出最致病的免疫谱，即,高抗dsDNA滴度，低C3水平，和DCT积极性。结论：这项研究表明，与SLE相关的最常见模式是核斑点，其次是核同质模式。基于与特定血清学标志物的关联，细胞核同质模式可能与SLE的高疾病活动性有关。
目的：本研究旨在检测IIF产生的ANA模式，并将这些模式与通过线免疫测定检测到的特异性抗体相关联。我们还调查了每种ANA模式的意义及其与特定血清学SLE标记的关联，比如补体分子，抗dsDNA，抗磷脂抗体，和C反应蛋白（CRP），以及与直接库姆斯测试(DCT)的关联。
方法：我们进行了一项回顾性研究，纳入了符合欧洲风湿病学协会联盟/美国风湿病学会(EULAR/ACR)标准的204例新诊断为SLE的患者。使用HEp-20-10通过IIF进行ANA的检测和模式测定。此外，行免疫测定，并获得每个样品的抗体谱。分析了其他免疫诊断标志物，包括C3，C4，抗dsDNA，抗磷脂抗体（抗心磷脂抗体，抗β-2-糖蛋白I,和狼疮抗凝药)，CRP,DCT。
结果：在204个样本中，观察到的最常见的ANA模式是核斑点(52.9%)，其次是细胞核同质(27.5%)，混合（13.7%），和细胞质斑点（5.9％）。由于与疾病活动标志物密切相关，细胞核同质模式显示出最致病的免疫谱，即,高抗dsDNA滴度，低C3水平，和DCT积极性。结论：这项研究表明，与SLE相关的最常见模式是核斑点，其次是核同质模式。基于与特定血清学标志物的关联，细胞核同质模式可能与SLE的高疾病活动性有关。
