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Ann Rheum Dis 1998;57:606-613 ( October )

Extended reports

Evidence of autoantibodies to cell membrane associated DNA (cultured lymphocytes): a new specific marker for rapid identification of systemic lupus erythematosus Geneviève Servais,a Marie-Paule Guillaume,b Nicolas Dumarey,b Jean Duchateaua

a Departments of Immunology, b and Internal Medicine, c Centres Hospitaliers Universitaires Brugmann-Huderf et St Pierre, Brussels, Belgium

Correspondence to: Dr G Servais, Immunology Department, Centre Hospitalier Universitaire Brugmann-Huderf (ULB), Place Van Gehuchten 4, B-1020 Brussels, Belgium.

Accepted for publication 22 July 1998

OBJECTIVE---Autoantibodies to cell membrane associated DNA are described in systemic lupus erythematosus (SLE). The specificity of these antibodies differ from antibodies to nuclear DNA.
METHODS---Using indirect immunofluorescence, a specific IgG was detected giving a characteristic pattern of continuous peripheral membrane fluorescence on cultured B-lymphocytes.
RESULTS---This pattern was observed in 53 of 80 serum samples of SLE patients but absent in the serum samples of the control populations: 15 rheumatoid arthritis, 38 ankylosing spondylarthritis, 17 non-inflammatory osteopenic patients, and 224 blood donors. In 34 Sjögren syndrome's patients one only showed a positive test. The cmDNA specificity of these antibodies was confirmed by pattern extinction with DNAse but not RNase or protease pre-treatment of the cells. IgG to cmDNA, separated by absorption/elution from purified cmDNA immobilised on DEAE-nitrocellulose reproduced the immunofluorescence pattern pictures. Extensive serum depletion of anti-double strand or single strand DNA antibodies by absorption to cellulose bound ds- or ss-DNA affected marginally the pericellular fluorescence revealing some minor cross reactivity with nuclear DNA. Moreover, in SLE patients without detectable antibody to ds-DNA, pericellular fluorescence could be visible.
CONCLUSION---This novel rapid immunofluorescence method may serve as an identification test of SLE patients. Given its positive (97.1%) and negative (92.9%) predictive value, sensitivity (66%) and specificity (99.5%), it improves on other diagnostic tests such as the detection of antibodies to Sm.

Keywords: anti-nuclear antibodies; systemic lupus erythematosus, immunofluorescence, cytoplasmic membrane associated DNA


© 1998 by Annals of the Rheumatic Diseases



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