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ANA (antinuclear antibody): The first of the serologic tests to evaluate is the ANA. Tests for ANA are the most widely used screening tests for serodiagnosis in SLE. Positive ANA tests are obtained to a variable extent in all the connective tissue diseases. Positive ANA are found in scleroderma, RA, Sjogren's syndrome, polymyositis, juvenile RA, chronic active hepatisit, infectious mononucleosis, subacute bacterial endocarditis, vasculitis and in normal, especially in order individuals.
Anti-ds-DNA (anti-double strained- DNA): antibodies to DNA contain two types, anti-ss-DNA (single-strained DNA) and anti-ds-DNA. A nti-ds-DNA has highest specificity for diagnosis of SLE.
Anti-Sm : Antibodies to Sm are said to be specific for SLE patients, but there have been numerous patients with anti-Sm described with limited clinical findings in which the clinical diagnosis is obscure. It is likely, but not certain, that many of these patients are part of the SLE spectrum.
Antihistone : Autoantibodies to histones have been detected in a high percentage of patients with idiopathic and drug-induced lupus. The specificities of antihistone autoantibodies differ in lupus induced by different drugs. Procainamide and quinidine induce IgG antibodies reactive, while hydralazine and chlorpromazine induce IgM antibodies.
Anti-Ro (SSA) and anti-La (SSB) : The most thoroughly characterized Ro proteins are Ro 60 and Ro 52. Although most anti- Ro/La positive patients with either SLE or Sjogren's syndrome have antibodies that bind to both Ro 60 and Ro 52, approximately 40% of Sjogren's syndrome anti-Rosera recognize only Ro 52 and 20% of SLE sera bind to Ro 60, but not to Ro 52.
Antiphospholipid antibodies : These antibodies bind to the acidic phospholipids cardiolipin, phosphatidylserine, phosphatidylinositol and phosphatidic acid. Since the acidic phospholipids are located on the inner surface of the cell membrane, these antigens are inaccessible on normal intact cell. Phospholipids arealso present in serum bound to proteins (lipoproteins) and play important roles in the coagulation, and possibly other, cascades. Their clinical importance lies in their association with thrombosis, fetal loss, and thrombocytopenia.
Anti-mDNA : mDNA is a kind of DNA molecule expressed on the surface of human B lymphocyte, monocyte and peripheral blood mononuclear cell. Autoantibodies to mDNA are kind of SLE serology markers with both high specificity and sensitivity.
Anti-nucleosome : Nucleosome is the main component of chromatin, comprising DNA and histone. It is one of the pathogenic materials in SLE and has important clinical significance in early diagnosis of SLE.
RF : rheumatoid factor is a subset of antiglobulin antibodies directed against the Fc region of IgG. RF is detected in75-80%of RA patients. However serum RF is also found in other condition s of B cell hyperactivity, e.g. infectious and autoimmune diseases, hyperglobulinemias, B ell lymphoproliferative disorders and also in the aged.
AKA (anti-keratinized epithelium antibody): AKA produces a smooth lamellar staining of stratum corneum in the rat mid-esophagus. Although the assay sensitivity is low, specificity for RA is high (95-100%).
APF (anti-perinuclear factor): the antigen source for the APF assay remains human buccal mucosa epithelial cells. APF occurs at titers from 1:5 in healthy individuals to 1:800 in autoimmune patients. The sensitivity of the APF assay, using 1:5 diluted serum, is 86% in RA and its specificity is 96%.
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