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The antinuclear antibody dense fine speckled pattern and possible clinical associations: An indication of a proinflammatory microenvironment.
J Immunol Methods. 2021 01; 488:112904.JI

Abstract

BACKGROUND

Indirect immunofluorescence (IIF) is the most prevalent screening antinuclear antibody test for systemic autoimmune rheumatic disease (SARD). Certain IIF patterns have known antibody and disease associations, but the dense fine speckled (ANA-DFS) pattern has no confirmed clinical associations. Our objective was to determine the prevalence of SARD among a group of ANA-DFS positive individuals and to identify final diagnoses among non-SARD individuals in order to determine possible clinical associations with the ANA-DFS pattern.

METHODS

A retrospective study of 425 patients from a university health care system with a positive ANA-DFS pattern consecutively between August 2017 and September 2018. Sera samples underwent ANA testing by IIF on HEp-2 cell substrates (Euroimmun, Germany). Clinical information was retrieved from electronic health records and stored in a de-identified database.

RESULTS

The prevalence of SARD was 24%. Undetermined diagnosis (17%), skin disorders (12.1%), and fibromyalgia/chronic pain syndrome/chronic fatigue syndrome (11.8%) were the most common non-SARD diagnoses. Taking into account past medical history, the most common non-SARD were atopic disorders (21.2%), fibromyalgia/chronic pain syndrome/chronic fatigue syndrome (17.6%), and skin disorders (16.7%).

CONCLUSIONS

The ANA-DFS pattern may be indicative of an underlying antigen-antibody interaction that plays a role in either the initiation or propagation of immunologic reactions. DFS70/LEDGF is a transcription factor involved in cell survival and stress protection, and autoantibodies may inhibit its function. It is likely that there are other antibodies producing the ANA-DFS pattern besides anti-DFS70/LEDGF, and more research is necessary to identify additional antibody specificities. The ANA-DFS pattern may be an indicator of a proinflammatory microenvironment given the high frequency of symptomatic patients and disease processes with an immunologic basis (including SARD).

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Lundgren MC
University of Minnesota Medical School, Laboratory Medicine and Pathology, 420 Delaware Street SE, Minneapolis, MN 55455, USA. Electronic address: Lund1111@umn.edu.
Sapkota S
University of Minnesota Medical Center, Dept of Medicine, Division of General Internal Medicine, MMC 741 Mayo Building 420 Delaware Street SE, Minneapolis, MN 55455, USA. Electronic address: sapko010@umn.edu.
Peterson DJ
University of Minnesota Medical Center, Special Chemistry Laboratory, L270 Mayo Building 420 Delaware Street SE, Minneapolis, MN 55455, USA. Electronic address: dpeters7@fairview.org.
Crosson JT
University of Minnesota Medical School, Laboratory Medicine and Pathology, MMC 609 Mayo Building 420 Delaware Street SE, Minneapolis, MN 55455, USA. Electronic address: cross008@umn.edu.

MeSH

Adaptor Proteins, Signal TransducingAdolescentAdultAgedAged, 80 and overAntibodies, AntinuclearAutoimmune DiseasesBiomarkersCellular MicroenvironmentChildChild, PreschoolFemaleFluorescent Antibody Technique, IndirectHumansMaleMiddle AgedPredictive Value of TestsPrevalenceReproducibility of ResultsRetrospective StudiesRheumatic DiseasesSeroepidemiologic StudiesSerologic TestsTranscription FactorsYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33121975

Citation

Lundgren, Mia C., et al. "The Antinuclear Antibody Dense Fine Speckled Pattern and Possible Clinical Associations: an Indication of a Proinflammatory Microenvironment." Journal of Immunological Methods, vol. 488, 2021, p. 112904.
Lundgren MC, Sapkota S, Peterson DJ, et al. The antinuclear antibody dense fine speckled pattern and possible clinical associations: An indication of a proinflammatory microenvironment. J Immunol Methods. 2021;488:112904.
Lundgren, M. C., Sapkota, S., Peterson, D. J., & Crosson, J. T. (2021). The antinuclear antibody dense fine speckled pattern and possible clinical associations: An indication of a proinflammatory microenvironment. Journal of Immunological Methods, 488, 112904. https://doi.org/10.1016/j.jim.2020.112904
Lundgren MC, et al. The Antinuclear Antibody Dense Fine Speckled Pattern and Possible Clinical Associations: an Indication of a Proinflammatory Microenvironment. J Immunol Methods. 2021;488:112904. PubMed PMID: 33121975.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The antinuclear antibody dense fine speckled pattern and possible clinical associations: An indication of a proinflammatory microenvironment. AU - Lundgren,Mia C, AU - Sapkota,Smarika, AU - Peterson,Daniel J, AU - Crosson,John T, Y1 - 2020/10/27/ PY - 2020/04/28/received PY - 2020/08/30/revised PY - 2020/10/21/accepted PY - 2020/10/31/pubmed PY - 2021/7/13/medline PY - 2020/10/30/entrez KW - Antinuclear antibodies KW - DFS70 KW - Dense fine speckled KW - Lens epithelium-derived growth factor KW - Systemic autoimmune rheumatic disease SP - 112904 EP - 112904 JF - Journal of immunological methods JO - J Immunol Methods VL - 488 N2 - BACKGROUND: Indirect immunofluorescence (IIF) is the most prevalent screening antinuclear antibody test for systemic autoimmune rheumatic disease (SARD). Certain IIF patterns have known antibody and disease associations, but the dense fine speckled (ANA-DFS) pattern has no confirmed clinical associations. Our objective was to determine the prevalence of SARD among a group of ANA-DFS positive individuals and to identify final diagnoses among non-SARD individuals in order to determine possible clinical associations with the ANA-DFS pattern. METHODS: A retrospective study of 425 patients from a university health care system with a positive ANA-DFS pattern consecutively between August 2017 and September 2018. Sera samples underwent ANA testing by IIF on HEp-2 cell substrates (Euroimmun, Germany). Clinical information was retrieved from electronic health records and stored in a de-identified database. RESULTS: The prevalence of SARD was 24%. Undetermined diagnosis (17%), skin disorders (12.1%), and fibromyalgia/chronic pain syndrome/chronic fatigue syndrome (11.8%) were the most common non-SARD diagnoses. Taking into account past medical history, the most common non-SARD were atopic disorders (21.2%), fibromyalgia/chronic pain syndrome/chronic fatigue syndrome (17.6%), and skin disorders (16.7%). CONCLUSIONS: The ANA-DFS pattern may be indicative of an underlying antigen-antibody interaction that plays a role in either the initiation or propagation of immunologic reactions. DFS70/LEDGF is a transcription factor involved in cell survival and stress protection, and autoantibodies may inhibit its function. It is likely that there are other antibodies producing the ANA-DFS pattern besides anti-DFS70/LEDGF, and more research is necessary to identify additional antibody specificities. The ANA-DFS pattern may be an indicator of a proinflammatory microenvironment given the high frequency of symptomatic patients and disease processes with an immunologic basis (including SARD). SN - 1872-7905 UR - https://www.unboundmedicine.com/medline/citation/33121975/The_antinuclear_antibody_dense_fine_speckled_pattern_and_possible_clinical_associations:_An_indication_of_a_proinflammatory_microenvironment_ DB - PRIME DP - Unbound Medicine ER -