The Clinical Relevance of Anti-DFS70 Autoantibodies.

Abstract

Despite all the progress in the establishment of specific autoantibody assays, screening for antinuclear antibodies (ANA) by indirect immunofluorescence on HEp-2 cells for quality-oriented laboratory diagnosis of ANA associated rheumatic diseases (AARD) remains indispensable but is not without limitations. Recent data on the relevance of the dense fine speckled (DFS) pattern and anti-DFS70 antibodies disclosed novel possibilities to optimize the serological stepwise diagnostics of AARD. The DFS pattern on HEp-2 cells is well differentiated from the classic "homogeneous" ANA pattern associated with dsDNA antibodies. This is the most frequent pattern in high titer ANA-positive healthy persons. The most characteristic ANA specificity associated with DFS pattern is the anti-DFS70 antibody (synonym LEDGF antibody). The prevalence of anti-DFS70 antibodies in AARD patients is significantly lower compared with the prevalence in ANA-positive healthy persons. There is a negative association between anti-DFS70 antibodies and AARD, especially if no concomitant AARD-specific autoantibodies are found. Isolated anti-DFS70 antibodies are detectable in less than 1 % of AARD but are detectable in 2-22 % of healthy persons. In the presence of an isolated anti-DFS70 antibody, the posttest probability for AARD is reduced significantly. The significance of anti-DFS70 antibodies as a criterion that helps to exclude AARD is also confirmed by follow-up studies on anti-DFS70 antibodies of positive, healthy individuals, who did not develop any AARD during a 4 year observation period. Consequently, anti-DFS70 antibodies are valuable novel biomarkers for better interpretation of positive ANA in cases of negative AARD-associated autoantibodies and should be integrated in modified test algorithms to avoid unnecessary referrals and examinations of ANA-positive persons.

• Authors: Karsten Conrad, Nadja Röber, Luis E C Andrade, Michael Mahler
• Journal: Clinical reviews in allergy & immunology (Clin Rev Allergy Immunol) Vol. 52 Issue 2 Pg. 202-216 (Apr 2017) ISSN: 1559-0267 [Electronic] United States
• PMID: 27350273 (Publication Type: Journal Article, Review)

Chemical References

• Adaptor Proteins, Signal Transducing
• Antibodies, Antinuclear
• Autoantibodies
• Autoantigens
• Biomarkers
• PSIP1 protein, human
• Transcription Factors

Topics

• Adaptor Proteins, Signal Transducing (immunology)
• Antibodies, Antinuclear (immunology)
• Autoantibodies (immunology)
• Autoantigens (immunology)
• Autoimmune Diseases (diagnosis, immunology)
• Biomarkers (analysis)
• Humans
• Transcription Factors (immunology)