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Antinuclear antibodies in healthy people and non-rheumatic diseases – diagnostic and clinical implications
 
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Submission date: 2018-05-25
 
 
Final revision date: 2018-07-26
 
 
Acceptance date: 2018-08-02
 
 
Online publication date: 2018-08-31
 
 
Publication date: 2018-08-31
 
 
Reumatologia 2018;56(4):243-248
 
KEYWORDS
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ABSTRACT
The presence of antinuclear antibodies (ANA) is mainly associated with connective tissue diseases (CTD). In addition, their presence is found in healthy people. These antibodies are more common in women and the elderly. Some drugs and xenobiotics are also important for the development of autoimmunity and ANA synthesis. Moreover, the deficiency of vitamin D in the body of patients correlates with occurrence of these antibodies. Unlike the healthy group, a positive ANA count was observed in patients with atopic dermatitis (AD) and in people with immune disorders. Antinuclear antibodies in low counts are also found in the course of chronic bacterial or viral infection and in patients with hematological malignancies. Also the possibility of false positive results, which may be caused by the choice of method used to determine antibodies, should be borne in mind. Taking into account all these factors, it is concluded that the ANA result itself has no diagnostic value.
REFERENCES (57)
1.
Rai E, Wakeland EK. Genetic predisposition to autoimmunity – what have we learned? Semin Immunol 2011; 23: 67-83.
 
2.
Wandstrat A, Carr-Johnson F, Branch V, et al. Autoantibody profiling to identify individuals at risk for systemic lupus erythematosus. J Autoimmun 2006; 27: 153-160.
 
3.
Agmon-Levin N, Damoiseaux J, Kallenberg C, et al. International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti-nuclear antibodies. Ann Rheum Dis 2014; 73: 17-23.
 
4.
Marin GG, Cardiel MH, Cornejo H, et al. Prevalence of Antinuclear Antibodies in 3 Groups of Healthy Individuals. J Clin Rheumatol 2009; 15: 325-329.
 
5.
Petri M, Orbai AM, Alarcón GS, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 2012; 64: 2677-2686.
 
6.
New Lupus Classification Criteria Presented at ACR/ARHP Annual Meeting. Susan Bernstein. the-rheumatologist.org/article/new-lupus-classification-criteria-presented-acrarhp-annual-meeting.
 
7.
Tan EM. Antinuclear antibodies: diagnostic markers for autoimmune diseases and probes for cell biology. Adv Immunol 1989; 44: 93-151.
 
8.
O’Sullivan M, McLean-Tooke A, Loh R. Antinulcear antibody test. Aust Fam Physician 2013; 42: 718-721.
 
9.
Karamehic J, Subasic D, Gavrankapetanovic F, et al. The incidence of antinuclear antibodies (ANA) detected by indirect immunofluorescence assay (IFA) method. Med Arh 2007; 61: 16-19.
 
10.
Pisetsky DS, Lipsky PE. The Role of ANA Determinations in Classification Criteria for SLE. Arthritis Care Res (Hoboken) 2018 Mar 26. doi: 10.1002/acr.23559.
 
11.
Davidson A, Diamond B. Autoimmune diseases. N Engl J Med 2001; 345: 340-350.
 
12.
Chakravarty E, Bush T, Manzi S, et al. Prevalence of adult systemic lupus erythematosus in California and Pennsylvania in 2000: estimates obtained using hospitalization data. Arthritis Rheum 2007; 56: 2092-2094.
 
13.
Heinlen LD, McClain MT, Merrill J, et al. Clinicalcriteria for systemic lupus erythematosus precede diagnosis, and associated autoantibodies are present before clinical symptoms. Arthritis Rheum 2007; 56: 2344-2351.
 
14.
Arbuckle MR, McClain MT, Rubertone MV, et al. Development of autoantibodies before the clinical onset of systemic lupus erythematosus. N Engl J Med 2003; 349: 1526-1533.
 
15.
Li QZ, Karp DR, Quan J, et al. Risk factors for ANA positivity in healthy persons. Arthritis Res Ther 2011; 13: R38.
 
16.
Puszczewicz M, Białkowska-Puszczewicz G, Majewski D. Znaczenie autoprzeciwciał w rozpoznaniu chorób reumatycznych. Post Nauk Med 2012; 2: 156-163.
 
17.
Kątnik-Prastowska I. Immunochemia w biologii medycznej. PWN, Warszawa 2009.
 
18.
MarizHA, Sato EI, Barbosa SH, et al. Pattern on the antinuclear antibody-HEp-2 test is a critical parameter for discriminating antinuclear antibody-positive healthy individuals and patients with autoimmune rheumatic diseases. Arthritis Rheum 2011; 63: 191-200.
 
19.
Satoh M, Chan EK, Ho LA, et al. Prevalence and sociodemographic correlates of antinuclear antibodies in the United States. Arthritis Rheum 2012; 64: 2319-2327.
 
20.
Candore G, Grimaldi MP, Listi F, et al. Prevalence of nonorgan-specific autoantibodies in healthy centenarians. Arch Gerontol Geriatr Suppl 2002; 35: 75-80.
 
21.
Nilsson BO, Skogh T, Ernerudh J, et al. Antinuclear antibodies in the oldest-old women and men. J Autoimmun 2006; 27: 281-288.
 
22.
van der Geest KS, Lorencetti PG, Abdulahad WH, et al. Aging-dependent decline of IL-10 producing B cells coincides with production of antinuclear antibodies but not rheumatoid factors. Exp Gerontol 2016; 75: 24-29.
 
23.
Watanabe A, Kodera M, Sugiura K, et al. Anti-DFS70 antibodies in 597 healthy hospital workers. Arthritis Rheum 2004; 50: 892-900.
 
24.
Hayashi N, Koshiba M, Nishimura K, et al. Prevalence of disease-specific antinuclear antibodies in general population: estimates from annual physical examinations of residents of a small town over a 5-year period. Mod Rheumatol 2008; 18: 153-160.
 
25.
Shah AA, Hummers LK, Casciola-Rosen L, et al. Examination of autoantibody status and clinical features associated with cancer risk and cancer-associated scleroderma. Arthritis Rheumatol 2015; 67: 1053-1061.
 
26.
Ząbek J. Wsparcie diagnostyczne w rozpoznaniu schorzeń z autoimmunizacją. Medyk, Warszawa 2013.
 
27.
Odrowąż-Sypniewska G. Diagnostyka laboratoryjna wybranych chorób reumatycznych. Med Pharm Polska, Wrocław 2011.
 
28.
Tozzoli R, Bonaguri Ch, Melegari A, et al. Current state of diagnostics technologies in the autoimmunology laboratory. Clin Chem Lab Med 2013; 51: 129-138.
 
29.
Copple SS, Martins TB, Masterson C, et al. Comparison of three multiplex immunoassays for detection of antibodies to extractable nuclear antibodies using clinically defined sera. Ann NY Acad Sci 2007; 1109: 464-472.
 
30.
Meroni PL, Schur PH. ANA screening: an old test with new recommendations. Ann Rheum Dis 2010; 69: 1420-1422.
 
31.
Wiik AS, Bizzaro N. Missing links in high quality diagnostics of inflammatory systemic rheumatic diseases. It is all about the patient! Autoimmun Highlights 2010; 3: 35-49.
 
32.
Gołąb J, Jakóbisiak M, Lasek W, et al. Immunologia. PWN, Warszawa 2014.
 
33.
Quintero O, Amador-Patarroyo M, Montoya-Ortiz G, et al. Auto-immune disease and gender: plausible mechanisms for the female predominance of autoimmunity. J Autoimmun 2012; 38: 109-119.
 
34.
Cutolo M, Straub R. Insights into endocrine-immunological disturbances in autoimmunity and their impact on treatment. Arthritis Res Ther 2009; 11: 218.
 
35.
Sacks GP, Studena K, Sargent IL, Redman CWG. Normal pregnancy and preeclampsia both produce inflammatory changes in peripheral blood leukocytes akin to those of sepsis. Am J Obstet Gynecol 1998; 179: 80-86.
 
36.
Bianchi DW, Wataganara T, Lapaire O, et al. Fetal nucleicacids in maternal body fluids. Ann NY Acad Sci 2006; 1075: 63-73.
 
37.
Li Q-Z, Karp DR, Quan J, et al. Risk factors for ANA positivity in healthy persons. Arthritis Res Ther 2011; 13: R38.
 
38.
Mahler M, Hanly JG, Fritzler MJ. Importance of the dense fine speckled pattern onHEp-2 cells and anti-DFS70 antibodies for the diagnosis of systemic autoimmune diseases. Autoimmun Rev 2012; 11: 642-645.
 
39.
Ochs RL, Muro Y, Si Y, et al. Autoantibodies to DFS 70 kd/transcription coactivator p75 in atopic dermatitis and other conditions. J Allergy Clin Immunol 2000; 105: 1211-1220.
 
40.
Singh DP, Ohguro N, Kikuchi T, et al. Lens epithelium-derive growth factor: effects on growth and survival of lens epithelial cells, keratinocytes, and fibroblasts. Biochem Biophys Res Commun 2000; 267: 373-381.
 
41.
Miller FW. Environmental agents and auto-immune diseases. Adv Exp Med Biol 2011; 711: 61-81.
 
42.
Langer P, Kocan A, Tajtáková M, et al. Increased thyroid volume, prevalence of thyroid antibodies and impaired fasting glucose in young adults from organochlorine cocktail polluted area: outcome of trans generational transmission? Chemosphere 2008; 73: 1145-1150.
 
43.
Daniel V, Huber W, Bauer K, et al. Associations of blood levels of PCB, HCHs, and HCB with numbers of lymphocyte subpopulations, in vitro lymphocyte response, plasmacytokine levels, and immunoglobulin auto-antibodies. Environ Health Perspect 2001; 109: 173-178.
 
44.
Cooper GS, Dooley MA, Treadwell EL, et al. Hormonal, environmental, and infectious disease risk factors for the development of systemic lupus erythematosus. Arthritis Rheum 2004; 41: 1714-1724.
 
45.
Cooper GS, Martin SA, Longnecker MP, et al. Associations between plasma DDE levels and immunologic measures in African- American farmers in North Carolina. Environ Health Perspect 2004; 112: 1080-1084.
 
46.
Pfau JC, Sentissi JJ, Weller G, et al. Assessment of autoimmune responses associated with asbestos exposure in Libby, Montana, USA. Enviro Health Perspect 2005; 113: 25-30.
 
47.
Bernhoft RA. Mercury toxicity and treatment: a review of the literature. J Environ Public Health 2012: ID 460508.
 
48.
Dinse GE, Jusko TA, Whitt IZ, et al. Associations between selected xenobiotics and antinuclear antibodies in the national health and nutrition examination survey, 1999–2004. Environ Health Perspect 2016; 124: 426-436.
 
49.
Fang JL, Stingley RL, Beland FA, et al. Occurrence, efficacy, metabolism, and toxicity of triclosan. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev 2010; 28: 147-171.
 
50.
Selmi C, Leung PS, Sherr DH, et al. Mechanisms of environmental influence on human autoimmunity: a National Institute of Environmental Health Sciences expert panel workshop. J Autoimmun 2012; 39: 272-284.
 
51.
Somers EC, Ganser MA, Warren JS, et al. Mercury exposure and antinuclear antibodies among females of reproductive age in the United States: NHANES. Environ Health Perspect 2015; 123: 792-798.
 
52.
Slight-Webb S, Ritterhouse LL, Munroe ME, et al. Autoantibody-Positive Healthy Individuals Display Unique Immune Profiles That May Regulate Autoimmunity. Arthritis Rheumatol 2016; 68: 2492-2502.
 
53.
Nagpal S, Na S, Rathnachalam R. Non calcemic actions of vitamin D receptor ligands. Endocr Rev 2005; 26: 662-687.
 
54.
Kamen DL, Cooper GS, Bouali H, et al. Vitamin D deficiency in systemic lupus erythematosus. Autoimmun Rev 2006; 5: 114-117.
 
55.
Crow MK, Kirou KA. Interferon-alpha in systemic lupus erythematosus. Curr Opin Rheumatol 2004; 16: 541-547.
 
56.
Kamen DL, Tangpricha V. Vitamin D and molecular actions on the immune system: modulation of innate and autoimmunity. J Mol Med 2010; 88: 441-450.
 
57.
Ritterhouse LL, Crowel SR, Niewold TB, et al. Vitamin D deficiency is associated with an increased autoimmune response in healthy individuals and in patients with systemic lupus erythematosus. Ann Rheum Dis 2011; 70: 1569-1574.
 
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