Anti-DNA antibodies - overview of assays and clinical correlations

Abstract

Many authors have studied the links between levels of anti-dsDNA antibodies and disease activity in patients with SLE. Interpretationof these studies must take into account the facts that there are a range of possible assays for anti-dsDNA and a number of indices available for assessing disease activity. A recent study compared levels of various autoantibodies with organ specific disease activity assessed during the British Isles Lupus Assessment Group (BILAG) index. Amti-dsDNA and anti-heparan sulphate levels were more likely to be raised in patients with renal than non-renal disease.

Some anti-DNA antibodies are actually anti-nucleosome antibodies, which lose DNA reactivity when purified under dissociating conditions. Patients with SLE have significantly increased levels of nucleosomes in their sera compared with healthy controls. In patients with SLE, reduced clearance of nucleosomes released from apoptotic cells may induce the formation of antinucleosome antibodies.

Keywords

anti-DNA nucleosome disease activity apoptosis

Get full access to this article

View all access options for this article.

References

Siegert CEH , Daha MR , Tseng CMES , Coremans IEM , van Es LA , Breedveld FC . Predictive value of IgG autoantibodies against Clq for nephritis in systemic lupus erythematosus . Ann Rheum Dis 1993; 52: 851–856 .

Morrow WJW , Isenberg DA , Parry KF et al. Studies on autoantibodies to poly (adenosine diphosphate-ribose) in SLE and other autoimmune diseases . Ann Rheum Dis 1982; 41: 396–402 .

Isenberg DA , Ravirajan CT , Rahman A , Kalsi J . The role of antibodies to DNA in systemic lupus erythematosus . Lupus 1997; 6: 290–304 .

Isenberg DA , Dudeney C , Williams W et al. Measurements of anti-DNA antibodies— a re-appraisal using five different methods . Ann Rheum Dis 1987; 46: 448–456 .

Kadlubowski M , Jackson M , Yap PL , Neill G . Lack of specificity for antibodies to double stranded DNA found in four commercial kits . J Clin Pathol 1991; 44: 246–250 .

Smeenk RJT , van den Brink HG , Brinkman K , Termaat R-M , Berden JHM , Swaak AJG . Anti-dsDNA: choice of assay in relation to clinical value . Rheumatol Int 1991; 11: 101–107 .

Smeenk RJT . Detection of antibodies to dsDNA: current insights in its relevance. Clin Exp Rheumatol 2002 (in press).

Hylkema MN , Huygen H , Kramers C et al. Clinical evaluation of a modified ELISA, using photobiotinylated DNA, for the detection of anti-DNA antibodies . J Immunol Meth 1994; 170: 93–102 .

Isenberg DA , Ramsey-Goldman R . Assessing patients with lupus: towards a drug responder index . Rheumatology 1999; 38: 1046–1049 .

10.

Isenberg DA , Gordon C . From BILAG to BLIPS— disease activity assessment in lupus, past, present and future . Lupus 2000; 9: 651–654 .

11.

Isenberg DA , Garton M , Reichlin MW , Reichlin M . Long term follow up of autoantibody profiles in Black female lupus patients and clinical comparison with Caucasian and Asian patients . Br J Rheum 1997; 36: 229–233 .

12.

Ravirajan CT , Rowse, L , MacGowan JR , Isenberg DA . An analysis of clinical disease activity and nephritis associated serum autoantibody profiles in patients with systemic lupus erythematosus: a cross-sectional study . Rheumatology 2001; 40: 1405–1412 .

13.

Smeenk RJT . Antinuclear antibodies: cause of disease or caused by disease? Rheumatology 2000; 39: 581–584 .

14.

Hylkema MN , van Bruggen MCJ , Hove TT et al. Histone-containing immune complexes are to a large extent responsible for anti-dsDNA reactivity in the Farr assay of active SLE patients . J Autoimmun 2000; 14: 159–168 .