►在健康人群或非系统性自身免疫性风湿疾病的患者中可出现高滴度的HEp-2 荧光核型阳性（9）
►其自身反应性与系统性自身免疫性风湿疾病呈负相关，只有确认检测出DFS70（也称为LEDGF / p75）阳性并且未检测到其他常见ENA时才有效（20，21）
►在健康人群以及非系统性自身免疫性风湿疾病的患者中，AC-2核型可能是由DFS70以外的其他靶抗原的自身抗体引起的（22） 注：抗DFS70抗体的确认仅可在专业临床实验室中进行。
| 简体中文 | English | |
| 同义词 | 无 | None |
| 描述 | 间期细胞核呈现大小不一、荧光强度不同、分布不均的颗粒，且这些颗粒在某些区域排列密集，而在其他的区域则较为稀疏 (典型的特征)。分裂中期板区呈现强颗粒荧光，并有明显的粗颗粒核型。 | Speckled pattern distributed throughout the interphase nucleus with characteristic heterogeneity in the size, brightness and distribution of the speckles. Throughout the interphase nucleus, there are some denser and looser areas of speckles (very characteristic feature). The metaphase plate depicts strong speckled pattern with some coarse speckles standing out. |
| 抗原相关性 | DFS70/LEDGF | DFS70/LEDGF |
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► Commonly found as high titer HEp-2 IIFA-positive in apparently healthy individuals or in patients who do not have a systemic autoimmune rheumatic disease (SARD) (9)
► The negative association with SARD is only valid if the autoreactivity is confirmed as being directed to DFS70 (also known as LEDGF/p75) and if no other common ENA is recognized (20, 21)
► Both in apparently healthy individuals as well as patients who do not have a SARD the AC-2 pattern may be caused by autoantibodies to other antigens than DFS70 (22)
Note: Confirmatory assays for anti-DFS70 antibodies may be available only in specialty clinical laboratories.
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一级信息参考文献First level information references
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9. Mariz HA, Sato EI, Barbosa SH, et al. Pattern on the antinuclear antibody-HEp-2 test is a critical parameter for discriminating antinuclear antibody-positive healthy individuals and patients with autoimmune rheumatic diseases. Arthritis & Rheumatism 2011;63:191–200.
20. Watanabe A, Kodera M, Sugiura K, et al. Anti-DFS70 antibodies in 597 healthy hospital workers. Arthritis Rheum 2004;50:892–900.
21. Mahler M, Parker T, Peebles CL, et al. Anti-DFS70/LEDGF antibodies are more prevalent in healthy individuals compared to patients with systemic autoimmune rheumatic diseases. J Rheumatol 2012;39:2104–10.
22. Ochs RL, Mahler M, Basu A, et al. The significance of autoantibodies to DFS70/LEDGFp75 in health and disease: integrating basic science with clinical understanding. Clin Exp Med 2016;16:273–93.
9. Mariz HA, Sato EI, Barbosa SH, et al. Pattern on the antinuclear antibody-HEp-2 test is a critical parameter for discriminating antinuclear antibody-positive healthy individuals and patients with autoimmune rheumatic diseases. Arthritis & Rheumatism 2011;63:191–200.
20. Watanabe A, Kodera M, Sugiura K, et al. Anti-DFS70 antibodies in 597 healthy hospital workers. Arthritis Rheum 2004;50:892–900.
21. Mahler M, Parker T, Peebles CL, et al. Anti-DFS70/LEDGF antibodies are more prevalent in healthy individuals compared to patients with systemic autoimmune rheumatic diseases. J Rheumatol 2012;39:2104–10.
22. Ochs RL, Mahler M, Basu A, et al. The significance of autoantibodies to DFS70/LEDGFp75 in health and disease: integrating basic science with clinical understanding. Clin Exp Med 2016;16:273–93.
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二级信息Second level information
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无None
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二级信息参考文献Second level information references
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无None
FAQ
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类DFS荧光核型？有些样本在有丝分裂中期和后期的染色体中，会呈现一种与AC-2（核致密细颗粒型）非常相似的核颗粒荧光核型，但特异性抗DFS70抗体检测阴性。这类既不能完全是AC-2荧光核型，又没有抗DFS70抗体反应性的荧光核型该如何报告？ICAP对这类荧光核型有定义吗？
这是个有趣的问题，也反映出了ANA实验室常遇到的一个难题。目前，“类DFS”这一命名尚未得到ICAP认可，也未包含在ICAP分类中。但有证据表明，并非所有具有核“致密”细颗粒荧光核型或类似染色质染色荧光核型血清中都可检测到抗DFS70自身抗体。虽然分裂间期细胞核与分裂期染色体中呈现颗粒结构染色，但其颗粒结构与真正的AC-2荧光核型略有不同，可能反应的是一种有别于抗DFS70阳性的AC-2荧光核型[1, 2]。抗DFS70阳性的AC-2荧光核型在细胞核中呈现不均匀的颗粒结构，较致密的颗粒区域与较稀疏的区域相邻、较大较亮颗粒区域与较小较暗颗粒区域相穿插，分裂期染色体中也有同样表现。因此一些研究人员建议使用“类DFS”一词来指代不具有明确AC-2染色特征的血清荧光核型[1, 2]。自身抗体标准化委员会可免费提供具有不同HEp-2 IFA荧光核型及抗体特异性的参考血清(http://www.autoab.org/)，其中包括AC-2荧光核型（DFS70有反应性）的参考血清[3]，有助于准确识别AC-2荧光核型。此外需要注意，抗DFS70阴性的类DFS荧光核型与对应的特异性自身抗体靶抗原间的临床相关性仍有待研究。
1. Mahler M, Andrade LE, Casiano CA, Malyavantham K, Fritzler MJ. Anti-DFS70 antibodies: an update on our current understanding and their clinical usefulness. Expert Rev Clin Immunol. 2019;15:241-250.
2. Infantino M, Bizzaro N, Grossi V, Manfredi M. The long-awaited 'pseudo-DFS pattern'. Expert Rev Clin Immunol. 2019 15(5):445.
3. Dellavance A, Baldo DC, Zheng B, Mora RA, Fritzler MJ, Hiepe F, Ronnelid J, Satoh M, Garcia-De La Torre I, Wener MH, Chan EKL, Andrade LEC. Establishment of an international autoantibody reference standard for human anti-DFS70 antibodies: proof-of-concept study for a novel Megapool strategy by pooling individual specific sera. Clin Chem Lab Med. 2019;57:1754-63.
日期：2019年11月26日