The Diagnosis Significance Of Serum And Saliva Anti-nuclearsome Antibody In Systemic Lupus Erythmatosus

Objective. To investigate the diagnostic specificity and sensitivity of antinucleosome antibodies (AnuA) and anti-double-strained DNA (dsDNA) antibodies in patients with systemic lupus erythematosus (SLE). And to evaluate the correlation between AnuA and anti-dsDNA antibodies and the correlation between antinucleosome antibodies and disease activity in patients with SLE. We also try to study the saliva level of AnuA in SLE patients and normal group.Method. A sandwish enzyme-linked immunosorbent assay (ELISA) was used to measure the level of AnuA and anti-dsDNA antibodies in serum of SLE patients, patients of other rheumatic diseases ( including rheumatoid arthritis, undifferentiation connective tissue diseases, vasculitis, adult onset Still's disease, ankylosing spondylitis, autoimmune hepatitis, dermatomyositis, Sjogren's syndrome and systemic sclerosis) and healthy controls. Some saliva samples of SLE patients and healthy controls were also detected. We recorded the clinical manifest and laboratory marks of the patients, and analysed the relationship between them.Results.1. The sensitivity and specificity of serum AnuA in SLE were 56.94% and 98.15%.2. The titer of serum AnuA was higher in SLE than in other rheumatic diseases group and healthy group in quantitative analysis ( P < 0.0001). And in qualitative analysis serum AnuA were positive in 56.94% of the SLE patients and 3% of other rheumatic diseases group; none of the healthycontrols was positive.3. The levels of serum AnuA strongly correlated with the levels of serum anti-dsDNA antibodies (r = 0.55, P < 0.0001). The positive rate of serum AnuA in SLE with renal involved was higher than that of without (P = 0.045), while the positive rate of serum anti-dsDNA antibodies in the two groups had no significantly difference (P = 0.627).4. The level of serum AnuA showed positive correlation with serum titer of ANA and CIC (r = 0.32&0.249, P = 0.006&0.035). and showed negative correlation with serum titer of C3 and C4 (r = -0.393 & -0.366, P = 0.001 & 0.002).5. The titer of serum AnuA was associated with SLEDAI (r = 0.639, P < 0.0001).6. The titer of saliva AnuA was associated with serum AnuA (r = 0.380, P = 0.005). The titer of saliva AnuA was higher in the patients of SLE than the healthy controls. (P = 0.049). And the concentration of saliva AnuA was associated with serum IgG and CIC (r = 0.029 & 0.371, P = 0.007 & 0.001).Conclusion.1. Serum AnuA has high sensitivity and specificity in diagnosis of SLE, especially in anti-dsDNA antibody and anti Sm antibody negative SLE patients.2. Our data suggest that the anti-nucleosome antibody showed a close relationship with disease activity, so it may be a useful marker for active assessment of SLE;3. Saliva AnuA level has some diagnosis significance in SLE.