抗dfs70在系统性自身免疫性风湿病诊断中的作用

Liudmila Zotova, Victoria Kotova, Zakhar Kuznetsov
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摘要

系统性自身免疫性风湿病(SARD)的诊断或排除要考虑免疫学研究的结果,主要是抗核抗体(ANA)和特异性自身抗体。通常,在细胞和组织底物上通过间接免疫荧光反应进行ANA分析时,可以观察到密集的细斑点70 (DFS70)荧光模式。研究抗dfs70抗体的诊断意义,可以优化SARD的逐步诊断。目前,实验室诊断调查建议采取两步策略:第一步,进行ANA筛查,第二步,结果阳性的患者进行确认试验,以检测针对单个核抗原的特异性抗体。在无临床和/或SARD组中特定疾病特征的其他特异性血清学标志物的ana血清阳性患者中检测到抗dfs70可被视为阴性预后标志物。此外,在临床实践决策过程中,我们应该记住,抗dfs70可以在不同的非sard病理患者的血液中发现,并且大多数显示抗dfs70的人是健康个体。
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The Role of Anti-DFS70 in the Diagnosis of Systemic Autoimmune Rheumatic Diseases
The diagnosis of systemic autoimmune rheumatic disease (SARD) or its exclusion is carried out taking into account the results of immunological studies, primarily antinuclear antibodies (ANA) and specific autoantibodies. Often, during ANA analysis via indirect immunofluorescence reaction on cellular and tissue substrates, a dense fine speckled 70 (DFS70) fluorescence pattern is observed. Studies on the diagnostic significance of antibodies to anti-DFS70 allow for optimizing the stepwise diagnosis of SARD. Currently, a two-step strategy for laboratory diagnostic investigation is recommended: in the first step, ANA screening is performed, and in the second step, patients with positive results undergo confirmatory tests to detect specific antibodies against individual nuclear antigens. The detection of anti-DFS70 in ANA-seropositive patients without clinical and/or other specific serological markers characteristic of a particular disease within the SARD group may be considered a negative prognostic marker. Also, in the process of decision making in clinical practice, we should remember that anti-DFS70 can be found in the blood of patients with a different, non-SARD pathology and that most people showing anti-DFS70 are healthy individuals.
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