评估疾病特异性抗核抗体的流行及其在叙利亚风湿病诊断中的检测

Widad Babelly, Abduljalil Ghrewaty, M. K. Dababo
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摘要

背景:抗核抗体(ANA)检测是诊断全身性自身免疫性疾病的重要实验室检测,通常是自身抗体筛选的第一步。ANA是一种免疫球蛋白,可区分多种核和细胞质成分。ANAs始终存在于各种风湿性疾病患者的血清中。该研究的目的是调查叙利亚一般人群中疾病特异性抗核抗体(ANAs)的种类和扩增情况,以及它们与风湿性疾病的联系。方法:采用免疫荧光法(IIF)检测529例患者血清中ANA的含量。使用免疫印迹法进一步检测IF - ANA阳性个体的疾病特异性ANAs。结果:IF - ANA检测结果显示,样品阳性率为7.9%。分别检测到抗ssa /Ro和抗dsdna抗体7例和6例,检测到抗Scl70、抗核小体、抗u1 - rnp、抗cenp B抗体4例,未检测到抗sm、抗pcna和抗jo -1抗体。在42例IF - ANA阳性个体中,24例发现有疾病特异性ANAs: 9例SLE, 3例硬化症,2例类风湿关节炎。结论无临床指征一般不应检查ANA。在没有临床症状和体征的情况下发现的ANA阳性诊断用处有限,应由风湿病学家根据临床症状和特异性自身抗体的实验室检测结果不断进行解释。
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Assessing the Prevalence of Disease-Specific Antinuclear Antibodies and their Detection in Diagnosis of Rheumatic Disorders in Syria
Background: Antinuclear antibodies (ANA) detection is a crucial laboratory test for diagnosing systemic autoimmune disorders and is commonly the initial step in autoantibodies screening. ANA are immunoglobulins that differentiate a wide range of nuclear and cytoplasmic components. ANAs are consistently present in the sera of patients with a variety of rheumatic disorders. The purpose of the study was to investigate the kinds and the expansion of disease-specific antinuclear antibodies (ANAs) and their link to rheumatic disorders in the general Syrian people.  Method: Immunofluorescence (IIF) was used for testing ANA in serum samples gained from 529 patients. Individualities positive for IF­ ANA were further tested for disease­ specific ANAs using line Immunoblot assay.  Results: Based on the result of the IF­ ANA assay, the rates of positive samples were 7.9%. Anti-SSA/Ro and anti-dsDNA antibodies were detected in 7and 6 individuals, respectively, anti Scl70, anti-Nucleosome, anti-U1-RNP, anti-CENP B were detected in 4 different individuals, but anti-Sm, anti-PCNA, and anti-Jo-1 antibodies were undetectable. Among 42 IF­ ANA­ positive individualities, 24 were found to have disease ­specific ANAs: nine SLE, three Sclerosis, and two rheumatoid arthritis. Conclusions ANA should generally not be examined without a clinical indication. Positive ANA finding in the absence of clinical symptoms and signs has limited diagnostic usefulness and should be interpreted by a rheumatologist constantly, in the context of clinical symptoms and the results of laboratory tests for specific autoantibodies.
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