Clinical implication of autoantibodies in patients with systemic rheumatic diseases
Expert Rev Clin Immunol. 2007 Sep;3(5):721-38. doi: 10.1586/1744666X.3.5.721.
Minoru Satoh 1 , Edward Kl Chan, Eric S Sobel, Donald L Kimpel, Yoshioki Yamasaki, Sonali Narain, Rizwan Mansoor, Westley H Reeves
1 University of Florida, Division of Rheumatology and Clinical Immunology, Department of Medicine, Gainesville, FL 32610-0221, USA. satohm@medicine.ufl.edu
Autoantibodies have been used extensively as a useful biomarker in systemic lupus erythematosus and other autoimmune rheumatic diseases. Antinuclear antibodies by immunofluorescence are a standard clinical test to screen for evidence of systemic autoimmunity. Different specific autoantibodies are associated with particular diagnoses, symptoms, unique syndromes, subsets of the disease and clinical activity. They are produced prior to the onset of clinical manifestations and have predictive value. This review focuses on a critical re-evaluation of the clinical significance of autoantibodies. Disease subsets defined by autoantibodies, coexistence of disease marker antibodies, and problems in testing and interpreting results are examined. Clinical approaches in differential diagnosis of antinuclear antibodies and the significance of antinuclear antibodies in healthy individuals are also discussed.