Connective Tissue Diseases

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Article No.

No. of tests

Varelisa ReCombi ANA Profile

184 96

10 Profiles

Varelisa ANA Profile

183 96

10 Profiles

Antigens

Antinuclear antibodies bind intracellular antigens and are serological hallmarks of systemic rheumatic diseases. In 1961 it was shown, that different immunofluorescence patterns correspond to different antibody specificities and thus sometimes to special diseases. In the ELISA, nuclear antigens can be used for the detection of those ANA specificities, which are of special interest for the diagnosis of rheumatic diseases.

Antigens in the Varelisa ReCombi ANA Profile:

dsDNA (recombinant plasmid double-stranded DNA)
U1RNP (human recombinant 70 kDa, A and C)
Sm

(synthetic SmD peptide)

SS-A/Ro (human recombinant 52 kD and 60 kD)
SS-B/La

(human recombinant)

Scl-70 (human recombinant topoisomerase 1)
CENP (human recombinant CENP-B)
Jo-1 (human recombinant histidylt RNA synthetase)


Antigens in the Varelisa ANA Profile:

RNP70 (human recombinant U1 snRNP 70 kD)
U1RNP (human recombinant U1 snRNP 70 kD, A, C)
Sm

(synthetic Sm D peptide)

SS-A/Ro (human recombinant 52 kD and 60 kD)
SS-B/La

(human recombinant )

Scl-70 (human recombinant topoisomerase 1)
CENP (human recombinant CENP-B)
Jo-1 (human recombinant histidyl tRNA synthetase)


Disease association, antibody prevalence and specificity

Autoantigen

Disease and Prevalence

Clinical Significance

Ref.
dsDNA

Active SLE with renal involvement: >95 %
without renal involvement: 50-70%
Inactive SLE: <40%

Specific marker in SLE; correlates with disease activity (monitoring), marker for tissue damage
dsDNA antibodies are associated with an increased risk of nephritis.
1
RNP
(70 kDa, A, C)
SLE: 30 - 40 %
MCTD: 100 %
U1 snRNP antibodies indicate a good prognosis concerning the development of renal involvement, also when they are found in combination with Sm.
MCTD is defined through high levels of anti-U1 snRNP.
2
Sm D SLE: 10 - 30 % Hihly specific marker for SLE 2
SS-A/Ro
(52 kD, 60 kD)
SLE: 40 - 50 %
SS: 60 - 70 %
Mother of child with neonatal lupus
High risk of neonatal lupus if mother has SS-A/Ro (especially when directed to 52 kD) and SS-B/La antibodies 3
SS-B/La SLE: 5 - 10 %
SS: 25 - 50 %
Mother of child with neonatal lupus: 60%
SS-B/La antibodies are found almost always in combination with anti-SSA antibodies; more specific for Sjögren's syndrome than Anti-SS-A/Ro 3
Scl-70 Scleroderma:
20 - 60 %
Highly specific marker for scleroderma 3
Centromere
(CENP-B)
CREST: 20-35 % Present in patients with scleroderma, in most cases the limited form. Also found in patients with primary biliary cirrhosis 3
Jo-1 Poly-/Dermatomyositis: 30 % Patients often have lung involvement. Jo-1 antibodies positive patients tend to have a severe disease with poor response to therapy 2

 

Disease activity

Single antigens in the profile have good correlation with the disease activity, others not. For monitoring the measurement of single specificities is recommended.

When is the measurement recommended?

Suspicion of connective tissue disease.

Antibody isotypes

IgG

References

Conrad K, Schössler W, Hiepe F (2002)  |  Peter JB, Shoenfeld Y (1996)  |  Shoenfeld Y, Gershwin ME, Meroni PL (2007)  |  Venrooij WJ, Maini RN (1996)  |  Peene I, Meheus L, Veys EM, De Keyser F (2001)  |  Peng SL, Hardin JA, Craft J (1997)  

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As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.