CLINICAL AND DIAGNOSTIC VALUE OF ANTINUCLEAR ANTIBODIES IN A PEDIATRIC PHYSICIAN’S PRACTICE (PART 2)

Antinuclear antibodies (ANA) are a group of autoantibodies directed against various cell structures such as nucleus, nuclear membrane, mitotic apparatus, components of the cytoplasm and organelles of the cell as well as cell membranes, which has more than 200 varieties. ANA were first discovered in patients with systemic lupus erythematosus (SLE), and ANA-positivity is considered as its diagnostic criterion since then. However, ANA are found highly frequently both in patients with other systemic rheumatic diseases and in healthy people, which determines their relatively low specificity. Determination of the patient's antibody profile is of a greater importance for diagnostic purposes since some ANA are quite highly specific and associated mainly with a single disease e.g., antibodies (abs) to DNA and anti-Sm abs in SLE, abs to topoisomerase I and abs to the centromere with systemic scleroderma and the CREST syndrome. Associations of some types of ANA with variants/subtypes of systemic autoimmune rheumatic diseases (SARDs) with the risk of damage to various organs and systems, the features of the course and prognosis of diseases in this group have been established, which expanded the understanding of the clinical and diagnostic significance of these autoantibodies. The identification of new and further study of the role of already known types of ANA will improve the diagnosis and development of the SARDs’ targeted therapy.