Clinical disease activity and titers of anti-dsDNA antibodies measured by an automated immunofluorescence assay in patients with systemic lupus erythematosus

Abstract

Autoantibodies specific for double stranded DNA (anti-dsDNA Abs) are a serological biomarker of systemic lupus erythematosus (SLE) and constitute useful tools for monitoring many SLE patients. A new automated immunofluorescence and quantitative assay (EliA dsDNA) has recently become available. Its performance has been demonstrated to be equivalent to the Farr and Crithidia luciliae fluorescence (CLIFT) tests. The aim of the present work was to assess the utility of this new assay to monitor clinical activity in a large cohort of SLE patients. To this end, 1020 sera from 181 SLE patients were evaluated by the two methods. Results showed a higher frequency of positive results of anti-dsDNA Abs during lupus flares measured by EliA dsDNA than by CLIFT. Likewise, titers of those Abs were significantly increased in active SLE in comparison with inactive SLE when measured by EliA dsDNA but not by CLIFT. Serum titers of anti-dsDNA Abs by both assays showed a significant negative association with concentrations of C3 and C4. In summary, this retrospective study on a large cohort of patients demonstrated that EliA dsDNA was at least as useful as CLIFT as monitoring tool in the follow-up of SLE patients, but with the advantages of being automated, quick and quantitative.

Keywords

anti-dsDNA antibodies immunofluorescence nephritis SLEDAI

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References

Hahn BH. Antibodies to DNA . N Engl J Med 1998; 338: 1359-1368 .

Isenberg D , Smeenk R. Clinical laboratory assays for measuring anti-dsDNA antibodies. Where are we now ? Lupus 2002; 11: 797-800 .

Brinkman K , Termaat R , van den Brink H , Berden J , Smeenk R. The specificity of the anti-dsDNA ELISA. A closer look . J Immunol Methods 1991; 139: 91-100 .

Hernando M , Gonzalez C , Sanchez A et al. Clinical evaluation of a new automated anti-dsDNA fluorescent immunoassay . Clin Chem Lab Med 2002; 40: 1056-1060 .

Villalta D , Bizzaro N , Corazza D , Tozzoli R , Tonutti E. Evaluation of a new automated enzyme fluoroimmunoassay using recombinant plasmid dsDNA for the detection of anti-dsDNA antibodies in SLE . J Clin Lab Anal 2002; 16: 227-232 .

Lopez-Hoyos M , Ayerbe I , Martinez-Taboada VM et al. Clinical utility of antibodies to double-stranded DNA by a new immunofluorescence test . Lupus 2004; 13: 144-147 .

Tan EM , Cohen AS , Fries JF et al. The 1982 revised criteria for the classification of systemic lupus erythematosus . Arthritis Rheum 1982; 25: 1271-1277 .

Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus . Arthritis Rheum 1997; 40: 1725-1725 .

Bombardier C , Gladman DD , Urowitz MB , Caron D , Chang CH , and the Committee on prognosis studies in SLE. Deviation of the SLEDAI . A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE . Arthritis Rheum 1992; 35: 630-640 .

10.

Ho A , Magder LS , Barr SG , Petri M. Decreases in anti-double-stranded DNA levels are associated with concurrent flares in patients with systemic lupus erythematosus . Arthritis Rheum 2001; 44: 2342-2349 .

11.

Gladman DD , Ibanez D , Urowitz MB. Systemic lupus erythematosus disease activity index 2000 . J Rheumatol 2002; 29: 288-291 .

12.

Chen CY , Tseng HM , Chen LC et al. Use of a new fluorescence immunoassay to detect anti-dsDNA antibodies is more correlated with disease activity and complement than the ELISA method in SLE patients . Lupus 2003; 12: 266-273 .

13.

Petri M , Genovese M , Engle E , Hochberg M. Definition, incidence, and clinical description of flare in systemic lupus erythematosus. A prospective cohort study . Arthritis Rheum 1991; 34: 937-944 .

14.

Zonana-Nacach A , Salas M , Sanchez ML , Camargo-Coronel A , Bravo-Gatica C , Mintz G. Measurement of clinical activity of systemic lupus erythematosus and laboratory abnormalities: a 12-month prospective study . J Rheumatol 1995; 22: 45-49 .

15.

Xie C , Liang Z , Chang S , Mohan C. Use of a novel elution regimen reveals the dominance of polyreactive antinuclear autoantibodies in lupus kidneys . Arthritis Rheum 2003; 48: 2343-2352 .

16.

Zuniga R , Markowitz GS , Arkachaisri T , Imperatore EA , D’Agati VD , Salmon JE. Identification of IgG subclasses and C-reactive protein in lupus nephritis: the relationship between the composition of immune deposits and FCgamma receptor type IIA alleles . Arthritis Rheum 2003; 48: 460-470 .

17.

Kramers C , Hylkema MN , van Bruggen MC et al. Anti-nucleosome antibodies complexed to nucleosomal antigens show anti-DNA reactivity and bind to rat glomerular basement membrane in vivo . J Clin Invest 1994; 94: 568-577 .