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Giornale Italiano di Dermatologia e Venereologia 2004 June;139(3):239-49

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: English, Italian

Serology of Lupus erythematosus

Parodi A., Cozzani E., Drosera M.

Dermatology Unit Department of Endocrinologic and Metabolic Sciences University of Genoa, Genoa, Italy

Lupus erythematosus (LE), expecially its systemic form (SLE), is serologically characterized by the presence of autoantibodies directed to nuclear, cytoplasmic and cellular membrane antigens. Some of them are specific of the disease, others characterize only particular substes. Antinuclear antibodies (ANA) can be detected by various assays: indirect immunofluorescence (IIF), immunodiffusion (ID), counterimmunoelectrophoresis (CIE), enzyme linked immunosorbent assay (ELISA), radioimmunoassay (RIA) and immunoblotting (IB). IIF and ELISA are the most used. ELISA is very sensitive, IIF is sensitive, easy to perform and cheap. In IIF monolayers of cultured cells particularly Hep-2 are the best substrate to use. Antibodies to ds-DNA are high specific of SLE and can be used to monitor the clinical course of the disease. Anti-nucleosome antibodies are now considered the major autoantibodies in SLE and they probably play an important pathogenetic role. Anti-histone antibodies are the marker of drug-induced SLE but they are found also in other diseases. Antibodies to Sm are a highly specific marker for SLE but their sensitivity is low. They are correlated to renal and central nervous system involvements. Anti RNP antibodies are the marker of Sharp’s sydrome but can be found in patients with SLE as well. Anti SB/La and anti SSA/Ro antibodies are found in Sjogren’syndrome but they characterize also neonatal lupus erythematosus (NLE) with congenital heart block and, anti SSA/Ro, also subacute cutaneous lupus erythematosus (SCLE) with photosensitivity. Anti proliferating-cell-nuclear- antigen antibodies are found in 5-10% of SLE patients with arthritis and hypocomplementemia. Anti Ki antibodies and anti ASE-1 antibodies have been recently described, the letter are correlated with renal involvement. Anti ribosomal antibodies are usually associated with LE psychosis and anti phospholipid antibodies with thrombosis, recurrent pregnancy loss, thrombocytopenia, hemolytic anemia, livedo reticularis and skin ulcers. Anti phospholipid antibodies can be found also in patients without LE. Anti C1q antibodies can be found in SLE patients with nephritis.