We characterized serum from a patient with polymyositis, and found that it produced a peripheral (rim) fluorescent antinuclear antibody pattern on rat liver substrate. Indirect immunofluorescence analysis revealed a punctate pattern at the nuclear surface of PtK2, BHK-21, and HEp-2 cells. This pattern was still present after sequential extraction in situ with non-ionic detergent, DNase, RNase, and high ionic strength buffer (2M NaCI). Immunogold electron microscopic localization was specific for nuclear pore complexes. By immunoblot analysis, the antigens were polypeptides of 200 kd and 130 kd that were enriched in the nuclear fraction.Antinuclear antibodies (ANA) in human sera are routinely detected with indirect immunofluorescence microscopy on substrates such as rat liver sections (1). Among the patterns identified by this method, the peripheral (rim) pattern is of diagnostic importance because of its association with systemic lupus erythematosus (SLE) (1,2). Studies of the antigenic specificity of autoantibodies from sera causing a peripheral ANA pattern have shown a strong association with anti-DNA antibodies (2,3). In addition, autoantibodies to nuclear lamins, observed in sera from 1 patient with linear scleroderma (4) and 5 patients with SLE (5,6), were shown to cause a peripheral ANA pattern because of continuous labeling of the nuclear envelope.Nuclear pore complexes are structures localized at the points of fusion of the double nuclear membranes (7) and are thought to allow molecular exchanges across the nuclear envelope. We report the identification, in serum from a patient with polymyositis, of a novel autoantibody that causes a peripheral ANA pattern on rat liver sections and stains the nuclear envelope of various cell lines. This autoantibody reacts with nuclear pore complexes.
PATIENTS AND METHODSPatient LL. The index serum was obtained from a 35-year-old white woman who, in December 1985, developed polymyositis, which was characterized by progressive proximal muscle weakness, elevated levels of serum creatine kinase (4,836 units/liter, normal 24-1 70), myopathic changes evident on electromyogram, and abnormal findings on quadriceps muscle biopsy. ANA were detected by indirect immunofluorescence on cryostat rat liver sections, at a titer of 1: 1,280 and with a peripheral pattern. Esophageal manometry revealed decreased peristaltic pressure in the distal two-thirds of the esophagus.Normal or negative results were noted on the following tests: hemoglobin, leukocyte and platelet