Antinuclear antibodies

Cabiedes, Javier; Núñez-Álvarez, Carlos A.

doi:10.1016/S2173-5743(10)70049-6

array:23 ["pii" => "S2173574310700496" "issn" => "21735743" "doi" => "10.1016/S2173-5743(10)70049-6" "estado" => "S300" "fechaPublicacion" => "2010-07-01" "aid" => "70049" "copyright" => "Sociedad Española de Reumatología and Colegio Mexicano de Reumatología" "copyrightAnyo" => "2010" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Reumatol Clin. 2010;6:224-30" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5927 "formatos" => array:3 [ "EPUB" => 61 "HTML" => 3404 "PDF" => 2462 ] ] "itemSiguiente" => array:18 [ "pii" => "S2173574310700502" "issn" => "21735743" "doi" => "10.1016/S2173-5743(10)70050-2" "estado" => "S300" "fechaPublicacion" => "2010-07-01" "aid" => "70050" "copyright" => "Sociedad Española de Reumatología and Colegio Mexicano de Reumatología" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Reumatol Clin. 2010;6:231-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1685 "formatos" => array:3 [ "EPUB" => 41 "HTML" => 1174 "PDF" => 470 ] ] "en" => array:7 [ "idiomaDefecto" => true "titulo" => "Schönlein-Henoch purpura: a case observation" "tienePdf" => "en" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "231" "paginaFinal" => "232" ] ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Inmaculada Macías Fernández" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Inmaculada" "apellidos" => "Macías Fernández" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574310700502?idApp=UINPBA00004M" "url" => "/21735743/0000000600000004/v1_201305061610/S2173574310700502/v1_201305061610/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2173574310700484" "issn" => "21735743" "doi" => "10.1016/S2173-5743(10)70048-4" "estado" => "S300" "fechaPublicacion" => "2010-07-01" "aid" => "70048" "copyright" => "Sociedad Española de Reumatología and Colegio Mexicano de Reumatología" "documento" => "article" "crossmark" => 0 "subdocumento" => "rev" "cita" => "Reumatol Clin. 2010;6:217-23" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2801 "formatos" => array:3 [ "EPUB" => 51 "HTML" => 1834 "PDF" => 916 ] ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Osteoporosis in young individuals" "tienePdf" => "en" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "217" "paginaFinal" => "223" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Osteoporosis en individuos jóvenes" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pilar Peris Bernal" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Pilar" "apellidos" => "Peris Bernal" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574310700484?idApp=UINPBA00004M" "url" => "/21735743/0000000600000004/v1_201305061610/S2173574310700484/v1_201305061610/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "titulo" => "Antinuclear antibodies" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "224" "paginaFinal" => "230" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Javier Cabiedes, Carlos A. Núñez-Álvarez" "autores" => array:2 [ 0 => array:3 [ "nombre" => "Javier" "apellidos" => "Cabiedes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "◊" "identificador" => "fn0005" ] ] ] 1 => array:4 [ "nombre" => "Carlos A." "apellidos" => "Núñez-Álvarez" "email" => array:1 [ 0 => "nuac80df@yahoo.com.mx" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "¿" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Laboratorio de Inmunología, Departamento de Inmunología y Reumatología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Anticuerpos antinucleares" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-07-24" "fechaAceptado" => "2009-10-01" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec112507" "palabras" => array:3 [ 0 => "Antinuclear antibodies" 1 => "Indirect immunofluorescence" 2 => "Autoimmune diseases" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec112506" "palabras" => array:3 [ 0 => "Anticuerpos antinucleares" 1 => "Inmunofluorescencia indirecta" 2 => "Enfermedades autoinmunes" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "Anti-nuclear antibodies (ANA) are immunoglobulin directed against autologous cell nuclear and cytoplasmic components. Besides the autoimmune ANA there are other ANA that can be detected in circulation, like natural and infectious ANA.Because of its high sensibility, detection of the ANA must be done by indirect immunofluorescence (IIF) as screening test and all of those positive samples are convenient to confirm its specificity by ELISA, western blot or other techniques.Positive ANA detected by IIF must be evaluated taking in to account the pattern and titer. The following recommended step is the specificity characterization (reactivity against extractable nuclear antigens [ENA], dsDNA, etc.) which is useful for the diagnosis and follow up of patients with autoimmune diseases, and by such reasoning, its detection must be performed in an orderly and reasonable way using guides or strategies focused to the good use and interpretation of the autoantibodies. The objective of this review is to present a compilation of the literature and our experience in the detection and study of the ANA." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "Los anticuerpos antinucleares son inmunoglobulinas que reconocen componentes celulares autólogos (nucleares y citoplasmáticos). Además de los ANA autoinmunes, pueden estar en circulación ANA infecciosos y naturales.La detección de ANA debe realizarse mediante inmunofluorescencia indirecta (IFI) en líneas celulares como prueba de tamizado inicial debido a su alta sensibilidad. Una muestra positiva para ANA, detectados mediante IFI, debe confirmarse mediante técnicas más sensibles y específicas, como ELISA, electroinmunotransferencia (Western blot) u otras.Los ANA detectados por IFI deben ser evaluados según el patrón y el título. La detección específica de diversos autoanticuerpos (anti-ENA, ADNcd, etc.) resulta útil en el diagnóstico y seguimiento de pacientes con enfermedades autoinmunes. Por tal motivo, su detección debe realizarse de manera ordenada y razonable, empleando las guías o estrategias enfocadas al buen uso e interpretación de la presencia de autoanticuerpos. El objetivo de la revisión es presentar una recopilación de la literatura y nuestra experiencia en la detección y estudio de los ANA." ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Note: Section credited by SEAFORMEC with 1.7 credits. Please consult questions for each article at URL: http://www.reumatologiaclinica.org" ] 1 => array:2 [ "etiqueta" => "◊" "nota" => "In memoriam to our teacher and friend" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Presentation of two bone marrow elements; “tart” cell and LE cell" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.M. Hargraves" 1 => "H. Richmond" 2 => "R. Morton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Proc Mayo Clin" "fecha" => "1948" "volumen" => "23" "paginaInicial" => "25" "paginaFinal" => "28" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The reaction of the lupus erythematosus (L.E.) cell factor with deoxyribonucleoprotein of the cell nucleus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H. Holman" 1 => "H.R. Deicher" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1172/JCI103984" "Revista" => array:6 [ "tituloSerie" => "J Clin Invest" "fecha" => "1959" "volumen" => "38" "paginaInicial" => "2059" "paginaFinal" => "2072" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14402750" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Localization of antigen in tissue cells II: improvements in a method for the detection of antigen by means of fluorescent antibody" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.H. Coons" 1 => "M.H. Kaplan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Exp Med" "fecha" => "1950" "volumen" => "91" "paginaInicial" => "1" "paginaFinal" => "13" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15395569" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Characteristics of a soluble nuclear antigen precipitating with sera of patients with systemic lupus erythematosus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E.M. Tan" 1 => "H.G. Kunkel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Immunol" "fecha" => "1966" "volumen" => "96" "paginaInicial" => "464" "paginaFinal" => "471" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5932578" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antitissue antibodies in rheumatic disease. Standardization and nomenclature" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.M. Tan" 1 => "C. Christian" 2 => "H.R. Holman" 3 => "M. Homma" 4 => "H.G. Kunkel" 5 => "M. Reichlin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arthritis Rheu" "fecha" => "1977" "volumen" => "20" "paginaInicial" => "1419" "paginaFinal" => "1420" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Autoantibodies to nuclear antigens (ANA): their immunobiology and medicine, in: advances in immunology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "E.M. Tan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Pub Academic Press Inc" "fecha" => "1982" "volumen" => "33" "paginaInicial" => "167" "paginaFinal" => "240" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Autoantibodies in systemic autoimmune disease. A diagnostic reference. Autoantigens, autoantibodies, autoimmunity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. Conrad" 1 => "W. SchöBler" 2 => "F. Hiepe" 3 => "M. Fritzler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Edi. PABST" "fecha" => "2002" "volumen" => "2" "paginaInicial" => "21" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Range of antinuclear antibodies in “healthy” individuals" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.M. Tan" 1 => "T.E.W. Feltkamp" 2 => "J.S. Smolen" 3 => "B. Butcher" 4 => "R. Dawkins" 5 => "M.J. Fritzler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arthritis Rheu" "fecha" => "1997" "volumen" => "40" "paginaInicial" => "1601" "paginaFinal" => "1611" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalencia de anticuerpos antinucleares (ANA) en donadores sanos del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I. Rosas" 1 => "E.I. Gómez" 2 => "C.A. Núñez Álvarez" 3 => "M.T. Huerta" 4 => "A. Alvarado" 5 => "J. Cabiedes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Rev Mex Reumatol" "fecha" => "2005" "volumen" => "20" "paginaInicial" => "72" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Autoantibodies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y. Shoenfeld" 1 => "M.E. Gershwin" 2 => "P.L. Meroni" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Elsevier" "fecha" => "2007" "volumen" => "2" "paginaInicial" => "3" "paginaFinal" => "6" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "From ANA to ENA: how to proceed?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.G.M.C. Damoiseaux" 1 => "J.W. Cohen Tervaert" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Autoimmunty Rev" "fecha" => "2006" "volumen" => "5" "paginaInicial" => "10" "paginaFinal" => "17" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Autoantibodies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y. Shoenfeld" 1 => "M.E. Gershwin" 2 => "P.L. Meroni" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Elsevier" "fecha" => "2007" "volumen" => "2" "paginaInicial" => "37" "paginaFinal" => "46" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Torrico R. Prevalencia de autoanticuerpos en pacientes con diagnóstico de Esclerodermia. Tesina de Especialidad en Bioquímica Clínica. 2009. UNAMINCMNSZ." ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Caracterización inmunoquímica de los patrones de inmunofluorescencia (IFI) moteado fino y moteado grueso en pacientes con enfermedades autoinmunes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Pagola Santander" 1 => "C.A. Núñez Álvarez" 2 => "A. Martínez Castillo" 3 => "D.F. Hernández-Ramírez" 4 => "A.R. Cabral" 5 => "J.L. García Hernández" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.reuma.2008.07.001" "Revista" => array:5 [ "tituloSerie" => "Reumatol Clin" "fecha" => "2009" "volumen" => "5" "paginaInicial" => "55" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21794578" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Atlas of HEp-2 patterns" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.R. Bradwell" 1 => "R.G. Hugues" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2007" "editorial" => "The Binding Site" "editorialLocalizacion" => "Third Ed" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Mimori T. Atlas of antinuclear antibodies. Medical & Biological Laboratories CO, LTD. RhiGene Inc. 2nd Ed. 1999." ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Laboratory testing in autoimmune rheumatic diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Sheldon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1146/annurev-publhealth-031914-122855" "Revista" => array:6 [ "tituloSerie" => "Best Practice & and Research Clinical Rheumatology" "fecha" => "2004" "volumen" => "18" "paginaInicial" => "249" "paginaFinal" => "269" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25785892" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antinuclear antibody testing" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D.F. Keren" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Lab Med" "fecha" => "2002" "volumen" => "22" "paginaInicial" => "447" "paginaFinal" => "474" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12134471" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines for the laboratory use of autoantibody test in the diagnosis and monitoring of autoimmune rheumatic diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Tozzoli" 1 => "N. Bizarro" 2 => "E. Tonutti" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1309/Y5VF-C3DM-L8XV-U053" "Revista" => array:6 [ "tituloSerie" => "Am J Clin Pathol" "fecha" => "2002" "volumen" => "117" "paginaInicial" => "316" "paginaFinal" => "324" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11863229" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Martínez Bezies V. Asociación ente las características de las metafases con la actividad de los anticuerpos anticromatina en pacientes con enfermedades autoinmunes. Tesina de Especialidad en Bioquímica Clínica. 2007. UNAM-INCMNSZ." ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Atlas of autoantibody patterns on Tissues" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.G. Hugues" 1 => "M.J. Surmacz" 2 => "A.R. Karim" 3 => "A.R. Bradwell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2008" "editorial" => "Third Ed" "editorialLocalizacion" => "The Binding Site" ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalencia de ANA en tres grupos de población mestizo-mexicana sana: donadores de sangre, personal médicosanitario y familiares de pacientes con enfermedad autoinmune" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G.G. Marin" 1 => "M.H. Cardiel" 2 => "H. Cornejo" 3 => "M.E. Viveros" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1699-258X(08)71800-X" "Revista" => array:5 [ "tituloSerie" => "Reumatol Clin" "fecha" => "2008" "volumen" => "4" "paginaInicial" => "55" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21794498" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Alvarado Hernández A, Cachafeiro Vilar A, Pascual Ramos V, Gabilondo Navarro F, Núñez Álvarez CA, Cabral AR, et al. Detección de anti-DNA de cadena doble por cuatro. Validación del ELISA caotrópico. Sent." ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines for clinical use of the antionuclear antibody test and test for specific autoantibodies to nuclear antigens" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Kavanaugh" 1 => "R. Tomar" 2 => "J. Reveille" 3 => "D.H. Solomon" 4 => "H.A. Homburger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1043/0003-9985(2000)124<0071:GFCUOT>2.0.CO;2" "Revista" => array:6 [ "tituloSerie" => "Arch Pathol Lab Med" "fecha" => "2000" "volumen" => "124" "paginaInicial" => "71" "paginaFinal" => "81" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10629135" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evidence-based guidelines for the use of immunologic test: antinuclear antibody testing" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.H. Solomon" 1 => "A. Kavanaugh" 2 => "P.H. Schur" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arthritis Rheu" "fecha" => "2002" "volumen" => "47" "paginaInicial" => "434" "paginaFinal" => "444" ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Application of a diagnostic algorithm in autoantibody testing: assessment of clinical effectiveness and economic efficiency" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Tampoia" 1 => "A. Fontana" 2 => "F. Di Serio" 3 => "P. Maggiolini" 4 => "N. Pansini" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clinic Chimica Acta" "fecha" => "2003" "volumen" => "333" "paginaInicial" => "181" "paginaFinal" => "183" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Application of a combined protocol for rational request and utilization of antibody assays improve clinical diagnostic efficacy in autoimmune rheumatic disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Tampoia" 1 => "V. Brescia" 2 => "A. Fontana" 3 => "A. Zucano" 4 => "L.F. Morrone" 5 => "N. Pansini" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1043/1543-2165(2007)131[112:AOACPF]2.0.CO;2" "Revista" => array:6 [ "tituloSerie" => "Arch Pathol Lab Med" "fecha" => "2007" "volumen" => "131" "paginaInicial" => "112" "paginaFinal" => "116" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17227110" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000000600000004/v1_201305061610/S2173574310700496/v1_201305061610/en/main.assets" "Apartado" => array:4 [ "identificador" => "8414" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Continuing Medical Education" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000000600000004/v1_201305061610/S2173574310700496/v1_201305061610/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574310700496?idApp=UINPBA00004M"]

Article information

Abstract

Bibliography

Download PDF

Statistics

Abstract

Anti-nuclear antibodies (ANA) are immunoglobulin directed against autologous cell nuclear and cytoplasmic components. Besides the autoimmune ANA there are other ANA that can be detected in circulation, like natural and infectious ANA.

Because of its high sensibility, detection of the ANA must be done by indirect immunofluorescence (IIF) as screening test and all of those positive samples are convenient to confirm its specificity by ELISA, western blot or other techniques.

Positive ANA detected by IIF must be evaluated taking in to account the pattern and titer. The following recommended step is the specificity characterization (reactivity against extractable nuclear antigens [ENA], dsDNA, etc.) which is useful for the diagnosis and follow up of patients with autoimmune diseases, and by such reasoning, its detection must be performed in an orderly and reasonable way using guides or strategies focused to the good use and interpretation of the autoantibodies. The objective of this review is to present a compilation of the literature and our experience in the detection and study of the ANA.

Keywords:

Antinuclear antibodies

Indirect immunofluorescence

Autoimmune diseases

Resumen

Los anticuerpos antinucleares son inmunoglobulinas que reconocen componentes celulares autólogos (nucleares y citoplasmáticos). Además de los ANA autoinmunes, pueden estar en circulación ANA infecciosos y naturales.

La detección de ANA debe realizarse mediante inmunofluorescencia indirecta (IFI) en líneas celulares como prueba de tamizado inicial debido a su alta sensibilidad. Una muestra positiva para ANA, detectados mediante IFI, debe confirmarse mediante técnicas más sensibles y específicas, como ELISA, electroinmunotransferencia (Western blot) u otras.

Los ANA detectados por IFI deben ser evaluados según el patrón y el título. La detección específica de diversos autoanticuerpos (anti-ENA, ADNcd, etc.) resulta útil en el diagnóstico y seguimiento de pacientes con enfermedades autoinmunes. Por tal motivo, su detección debe realizarse de manera ordenada y razonable, empleando las guías o estrategias enfocadas al buen uso e interpretación de la presencia de autoanticuerpos. El objetivo de la revisión es presentar una recopilación de la literatura y nuestra experiencia en la detección y estudio de los ANA.

Palabras clave:

Anticuerpos antinucleares

Inmunofluorescencia indirecta

Enfermedades autoinmunes

Full text is only aviable in PDF

References

[1.]

M.M. Hargraves, H. Richmond, R. Morton.

Presentation of two bone marrow elements; “tart” cell and LE cell.

Proc Mayo Clin, 23 (1948), pp. 25-28

[2.]

H. Holman, H.R. Deicher.

The reaction of the lupus erythematosus (L.E.) cell factor with deoxyribonucleoprotein of the cell nucleus.

J Clin Invest, 38 (1959), pp. 2059-2072

http://dx.doi.org/10.1172/JCI103984 | Medline

[3.]

A.H. Coons, M.H. Kaplan.

Localization of antigen in tissue cells II: improvements in a method for the detection of antigen by means of fluorescent antibody.

J Exp Med, 91 (1950), pp. 1-13

Medline

[4.]

E.M. Tan, H.G. Kunkel.

Characteristics of a soluble nuclear antigen precipitating with sera of patients with systemic lupus erythematosus.

J Immunol, 96 (1966), pp. 464-471

Medline

[5.]

E.M. Tan, C. Christian, H.R. Holman, M. Homma, H.G. Kunkel, M. Reichlin, et al.

Antitissue antibodies in rheumatic disease. Standardization and nomenclature.

Arthritis Rheu, 20 (1977), pp. 1419-1420

[6.]

E.M. Tan.

Autoantibodies to nuclear antigens (ANA): their immunobiology and medicine, in: advances in immunology.

Pub Academic Press Inc, 33 (1982), pp. 167-240

[7.]

K. Conrad, W. SchöBler, F. Hiepe, M. Fritzler.

Autoantibodies in systemic autoimmune disease. A diagnostic reference. Autoantigens, autoantibodies, autoimmunity.

Edi. PABST, 2 (2002), pp. 21

[8.]

E.M. Tan, T.E.W. Feltkamp, J.S. Smolen, B. Butcher, R. Dawkins, M.J. Fritzler, et al.

Range of antinuclear antibodies in “healthy” individuals.

Arthritis Rheu, 40 (1997), pp. 1601-1611

[9.]

I. Rosas, E.I. Gómez, C.A. Núñez Álvarez, M.T. Huerta, A. Alvarado, J. Cabiedes.

Prevalencia de anticuerpos antinucleares (ANA) en donadores sanos del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.

Rev Mex Reumatol, 20 (2005), pp. 72

[10.]

Y. Shoenfeld, M.E. Gershwin, P.L. Meroni.

Autoantibodies.

Elsevier, 2 (2007), pp. 3-6

[11.]

J.G.M.C. Damoiseaux, J.W. Cohen Tervaert.

From ANA to ENA: how to proceed?.

Autoimmunty Rev, 5 (2006), pp. 10-17

[12.]

Y. Shoenfeld, M.E. Gershwin, P.L. Meroni.

Autoantibodies.

Elsevier, 2 (2007), pp. 37-46

[13.]

Torrico R. Prevalencia de autoanticuerpos en pacientes con diagnóstico de Esclerodermia. Tesina de Especialidad en Bioquímica Clínica. 2009. UNAMINCMNSZ.

[14.]

L. Pagola Santander, C.A. Núñez Álvarez, A. Martínez Castillo, D.F. Hernández-Ramírez, A.R. Cabral, J.L. García Hernández, et al.

Caracterización inmunoquímica de los patrones de inmunofluorescencia (IFI) moteado fino y moteado grueso en pacientes con enfermedades autoinmunes.

Reumatol Clin, 5 (2009), pp. 55

http://dx.doi.org/10.1016/j.reuma.2008.07.001 | Medline

[15.]

A.R. Bradwell, R.G. Hugues.

Atlas of HEp-2 patterns.

The Binding Site, (2007),

[16.]

Mimori T. Atlas of antinuclear antibodies. Medical & Biological Laboratories CO, LTD. RhiGene Inc. 2nd Ed. 1999.

[17.]

J. Sheldon.

Laboratory testing in autoimmune rheumatic diseases.

Best Practice & and Research Clinical Rheumatology, 18 (2004), pp. 249-269

http://dx.doi.org/10.1146/annurev-publhealth-031914-122855 | Medline

[18.]

D.F. Keren.

Antinuclear antibody testing.

Clin Lab Med, 22 (2002), pp. 447-474

Medline

[19.]

R. Tozzoli, N. Bizarro, E. Tonutti.

Guidelines for the laboratory use of autoantibody test in the diagnosis and monitoring of autoimmune rheumatic diseases.

Am J Clin Pathol, 117 (2002), pp. 316-324

http://dx.doi.org/10.1309/Y5VF-C3DM-L8XV-U053 | Medline

[20.]

Martínez Bezies V. Asociación ente las características de las metafases con la actividad de los anticuerpos anticromatina en pacientes con enfermedades autoinmunes. Tesina de Especialidad en Bioquímica Clínica. 2007. UNAM-INCMNSZ.

[21.]

R.G. Hugues, M.J. Surmacz, A.R. Karim, A.R. Bradwell.

Atlas of autoantibody patterns on Tissues.

Third Ed, (2008),

[22.]

G.G. Marin, M.H. Cardiel, H. Cornejo, M.E. Viveros.

Prevalencia de ANA en tres grupos de población mestizo-mexicana sana: donadores de sangre, personal médicosanitario y familiares de pacientes con enfermedad autoinmune.

Reumatol Clin, 4 (2008), pp. 55

http://dx.doi.org/10.1016/S1699-258X(08)71800-X | Medline

[23.]

Alvarado Hernández A, Cachafeiro Vilar A, Pascual Ramos V, Gabilondo Navarro F, Núñez Álvarez CA, Cabral AR, et al. Detección de anti-DNA de cadena doble por cuatro. Validación del ELISA caotrópico. Sent.

[24.]

A. Kavanaugh, R. Tomar, J. Reveille, D.H. Solomon, H.A. Homburger.

Guidelines for clinical use of the antionuclear antibody test and test for specific autoantibodies to nuclear antigens.

Arch Pathol Lab Med, 124 (2000), pp. 71-81

http://dx.doi.org/10.1043/0003-9985(2000)124<0071:GFCUOT>2.0.CO;2 | Medline

[25.]

D.H. Solomon, A. Kavanaugh, P.H. Schur.

Evidence-based guidelines for the use of immunologic test: antinuclear antibody testing.

Arthritis Rheu, 47 (2002), pp. 434-444

[26.]

M. Tampoia, A. Fontana, F. Di Serio, P. Maggiolini, N. Pansini.

Application of a diagnostic algorithm in autoantibody testing: assessment of clinical effectiveness and economic efficiency.

Clinic Chimica Acta, 333 (2003), pp. 181-183

[27.]

M. Tampoia, V. Brescia, A. Fontana, A. Zucano, L.F. Morrone, N. Pansini.

Application of a combined protocol for rational request and utilization of antibody assays improve clinical diagnostic efficacy in autoimmune rheumatic disease.

Arch Pathol Lab Med, 131 (2007), pp. 112-116

http://dx.doi.org/10.1043/1543-2165(2007)131[112:AOACPF]2.0.CO;2 | Medline

☆

Note: Section credited by SEAFORMEC with 1.7 credits. Please consult questions for each article at URL: http://www.reumatologiaclinica.org

◊

In memoriam to our teacher and friend

Indexed in:

Follow us:

Subscribe:

Indexed in:

Follow us:

Subscribe:

Subscribe to our newsletter