Anti-DNA and Anti-Nucleosome Antibodies: An Update

Abstract

Among the large spectrum of autoantibodies (Ab) detected in systemic lupus erythematosus (SLE), anti-dsDNA Ab have been used to diagnose and assess disease activity for more than 60 years. Anti-dsDNA Ab are often associated with anti-nucleosome Ab, and in clinical practice combining both is helpful for diagnosis, prognosis, and as biomarkers to monitor response to treatment, especially when using drugs that target B cells and Ab production. In general, the association of anti-dsDNA Ab plus anti-nucleosome Ab is linked with disease flares and can indicate lupus nephritis. Moreover and since anti-nucleosome Ab have higher sensitivity and specificity than anti-dsDNA Ab, the former is a useful marker in SLE patients negative for anti-dsDNA Ab and in the diagnosis of certain types of drug-induced lupus.

Lupus Nephritis Risk Factors and Biomarkers: An Update

“…Anti-dsDNA Abs tested by ELISA are classically used to monitor disease activity in LN, explaining that anti-dsDNA Ab positivity accounts for two points in the SLE disease activity score (SLEDAI)-2K [72], although the performance is weak in discriminating active LN (AUC = 0.6-0.7) [73]. The presence of anti-dsDNA/chromatin Abs in the follow-up of LN patients represents a risk factor for relapse but its sensitivity and specificity are weak in predicting early relapse, and levels decrease following the introduction of therapy [74,75]. Although not useful for predicting the LN histology class among active patients, anti-dsDNA Ab levels are higher in proliferative LN (class IV/IV) as compared to membranous LN (isolated class V).…”

“…SLE patients with anti-dsDNA Abs but negative for anti-RNPs Abs presented a mild type I IFN response in association with complement consumption, while isolated anti-RNP Abs are characterized by a strong type I IFN response in the absence of complement consumption [62]. The utility of anti-SSA/SSB and anti-Sm/RNP Abs in the follow-up of LN patients is controversial, among them, anti-Sm Abs, which presented an important racial/ethnic bias (30% in black vs. 5% in white) and an overlap with anti-dsDNA Abs, and are described to be imperfectly associated with milder/high renal involvement, renal flares, and Raynaud's phenomenon [76][77][78].…”

Can artificial intelligence help a clinical laboratory to draw useful information from limited data sets ? Application to Mixed Connective Tissue Disease

“…Several sets of diagnostic criteria were suggested with varying sensitivity and specificity [22,23] . An important biological criterion is the presence of high amounts of anti-ribonucleoprotein antibodies with a particular specificity for components of U1 small nuclear ribonucleoprotein [24] . Discrimination between SLE and MCTD is of prognostic and therapeutic interest since MTCD is usually associated with better prognosis and better response to corticosteroid therapy [20] .…”