Extended reports
Evidence of autoantibodies to cell membrane associated DNA
(cultured lymphocytes): a new specific marker for rapid identification
of systemic lupus erythematosus
a Departments of Immunology, b and Internal Medicine, c Centres Hospitaliers
Universitaires Brugmann-Huderf et St Pierre, Brussels, Belgium
Correspondence to: Dr G Servais, Immunology Department, Centre Hospitalier Universitaire Brugmann-Huderf (ULB), Place Van Gehuchten 4, B-1020 Brussels, Belgium.
Accepted for publication 22 July 1998
OBJECTIVE
Autoantibodies to cell membrane
associated DNA are described in systemic lupus erythematosus (SLE). The
specificity of these antibodies differ from antibodies to nuclear DNA.
METHODSUsing indirect immunofluorescence, a
specific IgG was detected giving a characteristic pattern of continuous
peripheral membrane fluorescence on cultured B-lymphocytes.
RESULTSThis pattern was observed in 53 of 80 serum samples of SLE patients but absent in the serum samples of the
control populations: 15 rheumatoid arthritis, 38 ankylosing
spondylarthritis, 17 non-inflammatory osteopenic patients, and 224 blood donors. In 34 Sjögren syndrome's patients one only showed a
positive test. The cmDNA specificity of these antibodies was confirmed
by pattern extinction with DNAse but not RNase or protease
pre-treatment of the cells. IgG to cmDNA, separated by
absorption/elution from purified cmDNA immobilised on
DEAE-nitrocellulose reproduced the immunofluorescence pattern pictures.
Extensive serum depletion of anti-double strand or single strand DNA
antibodies by absorption to cellulose bound ds- or ss-DNA affected
marginally the pericellular fluorescence revealing some minor cross
reactivity with nuclear DNA. Moreover, in SLE patients without
detectable antibody to ds-DNA, pericellular fluorescence could be visible.
CONCLUSIONThis novel rapid immunofluorescence
method may serve as an identification test of SLE patients. Given its
positive (97.1%) and negative (92.9%) predictive value, sensitivity
(66%) and specificity (99.5%), it improves on other diagnostic tests
such as the detection of antibodies to Sm.
© 1998 by Annals of the Rheumatic Diseases
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