Clinical significance of the detection of anti-nucleosome antibodies in patients with systemic lupus erythematosus

Objective To explore the role of anti-nucleosome antibodies(ANuA) in the pathogenesis and diagnosis of patients with systemic lupus erythematosus(SLE).Methods Serum ANuA was measured with immuno-spot assay in 101 SLE patients and 260 patients with other rheumatic diseases including 96 rheumatoid arthritis patients,61 osteoarthritis patients and 30 ankylosing spondylitis patients.At the same time,anti-nuclear antibodies(ANA),anti-ds-DNA antibodies,anti-ENA antibodies were examined and the clinical manifestations were recorded.Clinical significance of ANuA was then analyzed accordingly.Results The sensitivity and specificity of ANuA in SLE were 40.6% and 99.2% respectively.The incidence of ANuA in active SLE patients was higher(58.1%) than in non-active SLE patients(26.3%).ESR,ANA titer,anti-ds-DNA,SLE Disease Activity Index(SLEDAI) score,incidence of lupus nephritis and Raynaud phenomenon were higher in ANuA positive SLE than in ANuA negative SLE(P0.05);however,levels of C3 and C4 were on the contrary.ANuA was related to anti-ds-DNA and anti-histone antibodies,but not related to other auto-antibodies such as anti-Sm and anti-SSA.Conclusion ANuA is to some extent sensitive and very specific to the diagnosis of SLE and it is useful to evaluate lupus activity and lupus nephritis.