전신성홍반루프스에서의 항 ENA 항체의 출현빈도 및 임상적 의의

Antinuclear antobodies (ANAs) occur in virtually all patients with systemic lupus erythematosus and in a large portion of patients with other connective tissue diseases. Some ANAs almost surely participate in the generation of tissue injury and were recognized as important parameter for the diagnosis and treatment of patients with various connective tissue diseases. Extractable nuclear antigens (ENAs) contain ribonucleoprotein, Sm, SS-A/Ro, SS-B/La, and other antigens. To determine the diagnostic and clinical usefulness of autoantibodies to these antigens, we studied the frequencies of autoantibodies to these antigens and their correlation with laboratory and clinical features in systemic lupus erythematasus. The results were as follows; 1) The frequency of autoantibody to extractable nuclear antigen using calf thymus extract as antigen source was slightly higher than that using rabbit thymus extract. But this difference was not statistically sipnificant (p>0.05). 2) The frequence of autoantibody to extractable nuclear antigen was 50.0%. The frequencies of autoantibodies to Sm, nRNP, and SS-A/Ro were 26.0%, 46.0%, and 60.8% respectively. But the autoantibody to SS-B/ La was not detected in all patients. 3) The frequence of speckled pattern on fluorescent antinuclear anbtibody test in anti-Sm and/or anti-nRNP antibody positive group was higher than that in negative group (p=0.015). 4) The frequence of skin rash in anti-Sm and /7or anti-nRNP positive group was lower than that in negative group (p=0.035) 5)The presence of autoantibody to SS-A/Ro was no clinical and laboratory difference between anti-SS-A/ Ro antibody positive and negative groups (p>0.05) . 6) ANA-negative lupus using fluorescent antinuclear antibody test represents 15% and frequence of anti-Ro in their sera was approximately 83.3%. These results suggest that autoantibodies to extractable nuclear antigens were useful parameter for the diagnosis and informed some clinical courses in systemic lupus erythematous.