临床相关性
一级信息 关于临床相关性和缩写列表 |
Clinical Relevance
First level information About Clinical Relevance & List of Abbreviations |
►在不同的系统性自身免疫性风湿疾病中有不同程度的表现,特别是系统性红斑狼疮、系统性硬化症、混合性结缔组织病、系统性硬化症-自身免疫性肌病重叠综合征和未分化结缔组织病(例如,具有风湿症状但未明确诊断为系统性自身免疫性风湿病的患者)(29) ►对于临床疑似系统性红斑狼疮的患者,建议后续检测抗Sm和U1RNP抗体;这些抗原通常包含在常规的抗可溶性抗原谱检测中;系统性红斑狼疮的分类标准包含抗Sm抗体(16,30,31) ►对于临床疑似系统性硬化症的患者,建议后续检测抗RNApol III抗体(例如,系统性硬化症谱*);抗RNApol III抗体包含于系统性硬化症的分类标准中(8) ►对于临床疑似混合性结缔组织病的患者,建议后续检测抗U1RNP抗体。U1RNP抗原通常包含在常规的ENA谱检测中;抗U1RNP抗体包含于混合性结缔组织病的诊断标准中(32) ►对于临床疑似系统性硬化症-自身免疫性肌病重叠综合征的患者,建议后续检测抗U1RNP抗体和抗Ku抗体;U1RNP抗原包含在常规的抗可溶性抗原谱检测中,抗Ku抗体则包含于疾病特异性免疫检测中(例如,炎症性肌病谱*和系统性硬化症谱*)(26,33) ►对于一般人群中的非系统性自身免疫性风湿疾病个体,AC-5核型的存在与上述自身抗原无关,且通常抗体滴度低。 *炎症性肌病谱、系统性硬化症谱和(扩展的)肝病谱的应用可能仅限于专业的临床实验室。 |
► Present to a varying degree in distinct SARD, in particular SLE, SSc, MCTD, SSc-AIM overlap syndrome, and UCTD (i.e, patients with rheumatic symptoms without a definite SARD diagnosis) (29) ► If SLE is clinically suspected, it is recommended to perform follow-up tests for anti-Sm and anti-U1RNP antibodies; these antigens are commonly included in the routine ENA profile; anti-Sm antibodies are included in the classification criteria for SLE (16, 30, 31) ► If SSc is clinically suspected, it is recommended to perform a follow-up test for anti-RNApol III antibodies (e.g., SSc profile*); the anti-RNApol III antibodies are included in the classification criteria for SSc (8) ► If MCTD is clinically suspected, it is recommended to perform a follow-up test for anti-U1RNP antibodies; the antigen is commonly included in the routine ENA profile; anti-U1RNP antibodies are included in the diagnostic criteria for MCTD (32) ► If the SSc-AIM overlap syndrome is clinically suspected, it is recommended to perform follow-up tests for anti-U1RNP and anti-Ku antibodies; these antigens are included in the routine ENA profile (U1RNP), or in disease specific immunoassays (Ku, i.e., inflammatory myopathy profile* and SSc profile*) (26, 33) ► In non-SARD individuals in the general population, the presence of the AC-5 pattern is not associated with the autoantigens mentioned above and most often concerns low antibody titers *Availability of the inflammatory myopathy profile, the SSc profile and the (extended) liver profile may be limited to specialty clinical laboratories. |
一级信息参考文献 | First level information references |
8. van den Hoogen F, Khanna D, Fransen J, et al. 2013 classification criteria for systemic sclerosis: an American College of rheumatology/European League against rheumatism collaborative initiative. Ann Rheum Dis 2013;72:1747–55. 16. Petri M, Orbai AM, Alarcón GS, et al. Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 2012;64:2677–86. 26. Betteridge Z, McHugh N. Myositis-specific autoantibodies: an important tool to support diagnosis of myositis. J Intern Med 2016;280:8–23. 29. Northway JD, Tan EM. Differentiation of antinuclear antibodies giving Speckled staining patterns in immunofluorescence. Clin Immunol Immunopathol 1972;1:140–54. 30, Satoh M, Fritzler MJ, Chan EKL. Antihistone and antispliceosomal antibodies. In: Lahita RG, Tsokos G, Buyon JP, et al, eds. Systemic lupus erythematosus. San Diego: Academic Press, 2011: 275–92. 31. Satoh M, Vázquez-Del Mercado M, Chan EK. Clinical interpretation of antinuclear antibody tests in systemic rheumatic diseases. Mod Rheumatol 2009;19:219–28. 32. Sharp GC, Irvin WS, Tan EM, et al. Mixed connective tissue disease--an apparently distinct rheumatic disease syndrome associated with a specific antibody to an extractable nuclear antigen (ENA). Am J Med 1972;52:148–59. |
8. van den Hoogen F, Khanna D, Fransen J, et al. 2013 classification criteria for systemic sclerosis: an American College of rheumatology/European League against rheumatism collaborative initiative. Ann Rheum Dis 2013;72:1747–55. 16. Petri M, Orbai AM, Alarcón GS, et al. Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 2012;64:2677–86. 26. Betteridge Z, McHugh N. Myositis-specific autoantibodies: an important tool to support diagnosis of myositis. J Intern Med 2016;280:8–23. 29. Northway JD, Tan EM. Differentiation of antinuclear antibodies giving Speckled staining patterns in immunofluorescence. Clin Immunol Immunopathol 1972;1:140–54. 30, Satoh M, Fritzler MJ, Chan EKL. Antihistone and antispliceosomal antibodies. In: Lahita RG, Tsokos G, Buyon JP, et al, eds. Systemic lupus erythematosus. San Diego: Academic Press, 2011: 275–92. 31. Satoh M, Vázquez-Del Mercado M, Chan EK. Clinical interpretation of antinuclear antibody tests in systemic rheumatic diseases. Mod Rheumatol 2009;19:219–28. 32. Sharp GC, Irvin WS, Tan EM, et al. Mixed connective tissue disease--an apparently distinct rheumatic disease syndrome associated with a specific antibody to an extractable nuclear antigen (ENA). Am J Med 1972;52:148–59. |
二级信息 | Second level information |
►少数情况下,AC-5核型相关的自身抗体可能为非U1RNP的RNP,例如U2RNP(与系统性硬化症-自身免疫性肌病重叠综合征相关)或U11/U12RNP(与系统性硬化症相关);这些自身抗体可以通过免疫沉淀反应进行检测(13,14) 注:这些自身抗体的特异性免疫检测目前尚未商品化。 |
► Occasionally, autoantibodies revealing the AC‐5 pattern are reactive with RNP other than U1RNP, for instance U2RNP (associated with SSc‐AIM overlap syndrome) or U11/U12RNP (associated with SSc); these autoantibodies can be detected by immunoprecipitation (13, 14) Note: Specific immunoassays for these autoantibodies are currently not commercially available. |
二级信息参考文献 | Second level information references |
13. Mimori T, Hinterberger M, Pettersson I, et al. Autoantibodies to the U2 small nuclear ribonucleoprotein in a patient with scleroderma‐polymyositis overlap syndrome. J Biol Chem 1984;259:560‐5. 14. Fretig N, Domsic RT, Rodriguez‐Reyna T, et al. Anti‐U11/U12 RNP antibodies in systemic sclerosis: a new serologic marker associated with pulmonary fibrosis. Arthritis Rheum 2009;61:958‐65. |
13. Mimori T, Hinterberger M, Pettersson I, et al. Autoantibodies to the U2 small nuclear ribonucleoprotein in a patient with scleroderma‐polymyositis overlap syndrome. J Biol Chem 1984;259:560‐5. 14. Fretig N, Domsic RT, Rodriguez‐Reyna T, et al. Anti‐U11/U12 RNP antibodies in systemic sclerosis: a new serologic marker associated with pulmonary fibrosis. Arthritis Rheum 2009;61:958‐65. |
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