Systemic lupus erythematosus (SLE)
Systemic lupus erythematosus (SLE) — is an autoimmune disease of the groups of systemic connective tissue disease (connective tissue), unknown etiology, characterized by hyperproduction of a wide spectrum of organ and immune complexes of autoantibodies to various components of the nucleus.
Systemic lupus erythematosus (SLE) includes:
- cutaneous form with a benign course and favorable prognosis
- systemic failure of the connective tissue and blood vessels, thrilling many internal organs
The resulting set of autoantibodies to nucleic acids and histones settles everywhere on the walls of small vessels and renal glomeruli, which results in the presence of complement to inflammatory processes, particularly dangerous in cases where the complex is localized in the kidney or brain.
Antinuclear antibodies — is a heterogeneous group of autoantibodies that react with various components of the nucleus.
To date, more than 100 described species AYAA directed against structures of cytoplasm and nucleus (against nucleic acids, histones, nuclear membrane proteins, spliceosome components, ribonucleoproteins, nucleolar and centromere proteins).
Nuclear antigens can be divided into 3 groups:
- true nuclear antigens - double-helical DNA odnospiralnaya DNA, histones, nuclear RNA
- extractable nuclear antigens - Sm, n-RNP, Scl-70
- cytoplasmic antigens - SS-A (Ro), SS-B (La), Jo-1
The difference between the test systems for screening is that in the studied serum antibodies to a mixture of antigens - nuclear extract (ENA). A positive result indicates the presence of the patient one or a combination of several varieties AYAA.
In patients with positive results determine AYAA recommended conducting confirmatory tests for specific AYAA to separate nuclear and cytoplasmic antigens.
Antibodies to double-helical DNA
Antibodies to dsDNK are highly specific marker for SLE are found in the active phase of the disease and are positively correlated with the severity of the disease. With an effective and successful treatment of their concentration is greatly reduced.
Antibody titers to dsDNK closely correlated with the concentration of IgG-containing circulating immune complexes (CIC) in serum of patients with systemic lupus erythematosus (SLE).
Antibodies to alpha-helical DNA
Antibodies to alpha-helical DNA occur in approximately 70% of SLE patients, but these antibodies are not specific for systemic lupus erythematosus (SLE) and present in the body in a variety of connective tissue diseases.
Detection of antibodies to alpha-helical DNA of IgM is important for the diagnosis of discoid lupus erythematosus, as well as the drug of systemic lupus erythematosus (SLE), in which the level of antibodies to osDNK rises to more than 50% of cases. These antibodies are also found in the serum of patients with mononucleosis, hepatitis, and various forms of leukemia.
Antibodies to histones
Histones - the main protein components of the cell nucleus, subdivided into 5 classes.
About 80% of patients with systemic lupus erythematosus (SLE) have antibodies to histones. In addition, these antibodies can be detected in patients with multidrug systemic lupus erythematosus (SLE), occurring after ingestion of hydralazine and procainamide, patients with primary biliary cirrhosis, rheumatoid arthritis and scleroderma.
Antibodies to nucleosomes
Antibodies to nucleosomes appear much earlier than antibodies to dsDNK and found 85% of patients with systemic lupus erythematosus (SLE). Antinukleosomnye IgG-antibodies are found almost exclusively in systemic lupus erythematosus (SLE), scleroderma and mixed connective tissue disease.
Antibodies to Sm component
Sm-antigen forms about 9 proteins associated with RNA, which are part of the spliceosome - a protein complex, the ongoing restructuring of the mRNA. Antibodies to Sm component have been reported in 20-30% of patients with systemic lupus erythematosus (SLE), and they are absolutely specific for the disease and their concentration is not affected by treatment of systemic lupus erythematosus (SLE). Clinical signs associated with the presence of Sm-antibodies are first and foremost a more aggressive course of disease, central nervous system lupus psychosis and the relative preservation of renal function.
Antibodies to ribosomal protein P
These antibodies interact with the ribosomal phosphoprotein and occur mainly in patients with systemic lupus erythematosus (SLE) with central nervous system (CNS).