medigraphic.com
ISSN 1561-302X (Impreso)

2014, Número 4

<< Anterior Siguiente >>

Rev cubana med 2014; 53 (4)


Anticuerpos antinucleosoma frente a marcadores inmunológicos convencionales en el diagnóstico de la actividad del lupus eritematoso sistémico

Kokuina E, Estévez TM, Gutiérrez RÁ, Ortiz LA, Sánchez BY, Pérez CD, Argüelles ZA, Casas FN, Chico CA

Idioma: Español
Referencias bibliográficas: 33
Paginas: 430-444
Archivo PDF: 320.24 Kb.


RESUMEN

Objetivos: examinar el perfil de anticuerpos en pacientes con lupus eritematoso sistémico y establecer la correlación entre los niveles de anticuerpos y la actividad de la enfermedad y de la nefritis lúpica.
Métodos: en 213 pacientes con lupus eritematoso sistémico, atendidos de forma consecutiva, se determinaron los anticuerpos anti-DNA de doble cadena (DNAdc), antinucleosoma (Nu), anti-Sm, anti-RNP, anti-Ro, anti-La y anti-Scl-70 por ensayo inmunoadsorbente ligado a enzima (ELISA), el C3 y el C4. La actividad de la enfermedad fue evaluada por el índice SLEDAI-2K, sin la contribución de anti- DNAdc, C3 ni C4. Los niveles de anticuerpos, el complemento y la actividad del lupus eritematoso sistémico fueron correlacionados.
Resultados: los niveles de todos los anticuerpos resultaron superiores significativamente en los pacientes en fase activa de la enfermedad con respecto a los que se hallaban en la fase inactiva. Los coeficientes de correlación de Spearman más altos con la puntuación de SLEDAI-2K correspondieron a los anti-Nu y anti- DNAdc (p= 0,856 y p= 0,616, respectivamente, p ‹ 0,001 para ambos). Las áreas bajo de la curva (AUC) del análisis COR de la actividad del LES fueron en orden decreciente para los anti-Nu= 0,948, anti-DNAdc= 0,810, anti-RNP= 0,705, C4= 0,704, anti-Sm= 0,703, C3= 0,688, anti-Scl-70= 0,611, anti-La= 0,601 y anti-Ro= 0,593; y de la actividad renal para los anti-Nu= 0,845, anti-DNAdc= 0,755, C4= 0,694, C3= 0,670, anti-Sm= 0,641, anti-RNP= 0,630, anti-Scl-70= 0,611, anti-Ro= 0,593 y anti-La= 0,567.
Conclusión: los anticuerpos anti-Nu mostraron una capacidad discriminatoria excelente para la actividad del LES y de la actividad renal lúpica, superior a la de los anti-DNAdc y el resto de los marcadores.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rithfield NF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982;25:1271-7.

  2. Gladman DD, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002;29:288-91.

  3. Esdaile JM, Abrahamowicz M, Joseph L, MacKenzie T, Li Y, Danoff D. Laboratory tests as predictors of disease exacerbations in systemic lupus erythematosus. Why some tests fail. Arthritis Rheum. 1996;39:370-8.

  4. Gladman DD, Hirani N, Ibanez D, Urowitz MB. Clinically active serologically quiescent systemic lupus erythematosus. J Rheumatol. 2003;30:1960-2.

  5. Mohan C, Adams S, Stanik V, Datta SK. Nucleosome: a major immunogen for pathogenic autoantibody-inducing T cells of lupus. J Exp Med. 1993;177:1367-81.

  6. Simon JA, Cabiedes J, Ortiz E, Alcocer-Varela J, Sanchez-Guerrero J. Antinucleosome antibodies in patients with systemic lupus erythematosus of recent onset. Potential utility as a diagnostic tool and disease activity marker. Rheumatology. 2004;43:220-4.

  7. Gómez-Puerta JA, Burlingame RW, Cervera R. Antichromatin (anti-nucleosome) antibodies: diagnostic and clinical value. Autoimmun Rev. 2008;7:606-11.

  8. Agarwal S, Harper J, Kiely PDW. Concentration of antibodies to extractable nuclear antigens and disease activity in systemic lupus erythematosus. Lupus. 2009;18:407-412.

  9. Liu CC, Kao AH, Manzi S, Ahearn JM. Biomarkers in systemic lupus erythematosus: challenges and prospects for the future. Ther Adv Musculoskel Dis. 2013;5:210-33.

  10. Villegas-Zambrano N, Martínez-Taboada VM, Bolívar A, San Martin M, Álvarez L, Marín MJ, et al. Correlation between clinical activity and serological markers in a wide cohort of patients with systemic lupus erythematosus: an eight-year prospective study. Ann NY Acad Sci. 2009;1173:60-6.

  11. Andrejevic S, Jeremic I, Sefik-Bukilica M, Nikolic M, Stojimirovic B, Bonaci- Nikolic B. Immunoserological parameters in SLE: high-avidity anti-dsDNA detected by ELISA are the most closely associated with the disease activity Clin Rheumatol. 2013,32:1619-26.

  12. Brunner HI, Bennett MR, Mina R, Suzuki M, Petri M, Kiani AN, et al. Noninvasive renal protein biomarkers are associated with histological features of lupus nephritis. Arthritis Rheum. 2012;64:2687-97.

  13. Amoura Z, Koutouzov S, Chabre H, Cacoub P, Amoura I, Musset L, et al. Presence of antinucleosome autoantibodies in a restricted set of connective tissue diseases. Antinucleosome antibodies of the IgG3 subclass are markers of renal pathogenicity in systemic lupus erythematosus. Arthritis Rheum. 2000;43:76-84.

  14. Benucci M, Saviola G, Baiardi P, Cammelli E, Manfredi M. Antinucleosome antibodies as prediction factor of development of autoantibodies during therapy with three different TNF alpha blocking agents in rheumatoid arthritis. Clin Rheumatol. 2008;27:91-5.

  15. Ferreira FGM, Skare TL, Nisihara RM, Utiyama SR. Antinucleosome antibodies in scleroderma patients. Indian J Med Res. 2011;133:341-2.

  16. Quattrocchi P, Barrile A, Bonanno D, Giannetto L, Patafi M, Tigano V, et al. The role of anti-nucleosome antibodies in systemic lupus erythematosus. Results of a study of patients with systemic lupus erythematosus and other connective tissue diseases. Reumatismo. 2005;57:109-13.

  17. Souza A, da Silva LM, Oliveira FR, Roselino AMF, Louzada-Junior P. Antinucleosome and anti-chromatin antibodies are present in active systemic lupus erythematosus but not in the cutaneous form of the disease. Lupus. 2009;18:223-9.

  18. Suleiman S, Kamaliah D, Nadeem A, Naing NN, Che Maraina CH. Antinucleosome antibodies as a disease activity marker in patients with systemic lupus erythematosus. Intern J Rheum Dis. 2009;12:100-6.

  19. Saisoong S, Eiam-Ong S, Hanvivatvong O. Correlations between antinucleosome antibodies and ant-double-stranded DNA antibodies, C3, C4, and clinical activity in lupus patients. Clin Exp Rheumatol. 2006;24:51-8.

  20. Tikly M, Gould T, Wadee AA, van der Westhuizen E, Mokgethwa BB. Clinical and serological correlates of antinucleosome antibodies in South Africans with systemic lupus erythematosus. Clin Rheumatol. 2007;26:2121-5.

  21. Hung WT, Chen YM, Lan JL, Chen HH, Chen YH, Chen DY, et al. Antinucleosome antibodies as a potential biomarker for the evaluation of renal pathological activity in patients with proliferative lupus nephritis. Lupus. 2011;20:1404-10.

  22. Kiss E, Lakos G, Szegedi G, Poor G, Szodoray P. Anti-nucleosome antibody, a reliable indicator for lupus nephritis. Autoimmunity. 2009;42:393-8.

  23. Düzgün N, Sahin M, Genç Y, Tutkak H. Antinucleosome antibodies and systemic lupus erythematosus. Ann N Y Acad Sci. 2007;1109:421-8.

  24. Kim HA, Jeon JY, Choi GS, Sung JM, Kim MJ, Yun JM, et al. The antichromatin antibodies can be useful as a diagnostic tool and disease activity marker of systemic lupus erythematosus in Koreans. Clin Immunol. 2008;128:277-83.

  25. Manson JJ, Ma A, Rogers P, Mason LJ, Berden JH, van der Vlag J, et al. Relationship between anti-dsDNA, anti-nucleosome and anti-alpha-actinin antibodies and markers of renal disease in patients with lupus nephritis: a prospective longitudinal study. Arthritis Res Ther. 2009;11:R154.

  26. Mok CC, Ho LY, Leung HW, Wong LG. Performance of anti-C1q, antinucleosome and anti-dsDNA antibodies for detecting concurrent disease activity of systemic lupus erythematosus. Trans Res. 2010;156:320-5.

  27. Dorner T, Heimbacher C, Farner NL, Lipsky PE. Enhanced mutational activity of Vkappa gene rearrangements in systemic lupus erythematosus. Clin Immunol. 1999;92:188-96.

  28. Furtado J, Isenberg DA. B cell elimination in systemic lupus erythematosus. Clin Immunol. 2013;146:90-103.

  29. Agmon-Levin N, Mosca M, Petri M, Shoenfeld Y. Systemic lupus erythematosus one disease or many? Autoimmun Rev. 2012;11:593-595

  30. Su Y, Jia RL, Han L, Li ZG. Role of anti-nucleosome antibody in the diagnosis of systemic lupus erythematosus. Clin Immunol. 2007;122:115-20.

  31. Grootscholten C, Dieker JW, McGrath FD, Roos A, Derksen RH, van der Vlag J, et al. A prospective study of anti-chromatin and anti-C1q autoantibodies in patients with proliferative lupus nephritis treated with cyclophosphamide pulses or azathioprine/methylprednisolone. Ann Rheum Dis. 2007;66:693-6.

  32. Shabana AA, El-Ghawet AE, Machaly SA, Abu Hashim EM, El-Kady BA, Shaat R. Anti-chromatin and anti-histone antibodies in Egyptian patients with systemic lupus erythematosus. Clin Rheumatol. 2009;28:673-8.

  33. Bose N, Wang X, Gupta M, Yao Q. The clinical utility of anti-chromatin antibodies as measured by BioPlex 2200 in the diagnosis of systemic lupus erythematosus versus other rheumatic diseases. Int J Clin Exp Med. 2012;5:316-20.




2020     |     www.medigraphic.com