Association of autoantibodies to different nuclear antigens with clinical patterns of rheumatic disease and responsiveness to therapy

Abstract

A B S T R A C T Using a hemagglutination test which can detect antibodies to (a) native and denatured deoxyribonucleic acid (DNA) and (b) an extractable nuclear antigen (ENA), a comparative study of patterns of autoantibody formation has been done in systemic lupus erythematosus (SLE) and related rheumatic diseases. Antibody to native DNA was present in the serum in 96% of patients with active SLE and disappeared during remissions. Antibody to ENA was found in 86% of those patients with SLE nephritis who responded to treatment but in only 8% of those who did not. The highest titers of antibody to ENA were found in patients having a mixed connective tissue disease syndrome with features of SLE, scleroderma, and myositis. The latter syndrome was notable for the absence of renal disease and for a striking responsiveness to corticosteroid therapy. Hemagglutination testing of 277 sera from normal persons and patients with a wide variety of acute diseases other than SLE revealed the presence of antibody to native DNA in only 1.4% and antibody to ENA in only 0.4%.These results yield significant correlations among the pattern of autoimmune reactivity, the clinical form of the rheumatic disease, and responsiveness to treatment. They implicate the qualitative nature of the patient's immune response as a conditioning factor in the type of disease. Together with other correlations they may allow classification of rheumatic diseases into more biologically meaningful groups and lead to more selective methods of therapy.

Association of myositis and myocarditis in progressive systemic sclerosis

“…Antibodies to extractable nuclear antigens (ENA) were measured by the method of Sharp (17). Rheumatoid factor (RF) was measured by commercial slide latex agglutination test.…”

Anti‐DNA antibody in procainmide‐induced lupus erythematosus. Determination using DNA fractionated by methylated albumin‐kieselguhr chromatography

“…Fractions eluting with a molarity of 0.9 M or less were considered to be nDNA (16,30,31,17), although with KB DNA at least some dDNA was still present (vide infra). The fraction eluting at high pH has been shown to be dDNA (5,17,31). To increase the proportion of this fraction, several chromatographic runs were carried out with DNA which had been heated for 12 minutes in a boiling water bath and cooled immediately.…”

Survivorship in systemic lupus erythematosus. effect of antibody to extractable nuclear antigen

“…These data are comparable to the findings of Fries and Holman who noted no significant difference in cumulative adjusted mortality at either 1, 6, or 30 months after first visit when comparing SLE patients with and without antibody to ENA (10). In contrast are the findings of others (16)(17)(18)(19)(22)(23)(24)(25)(26) who have suggested that antiRNP antibody is associated with a good prognosis; these studies have either excluded SLE patients with antibody to DNA (18) or their study group has been defined by the presence of antiRNP antibody as the "sine qua non" and not by the clinical diagnosis of SLE (17,19,22,23,25,26). Furthermore, a long-term observation of these latter laboratory-defined groups is not available.…”