Anti-nucleosome atibodies in systemic lupus erythematosus as a diagnostic tool and useful marker for lupus nephropathy

Abstract EN

Objective : To investigate the clinical utility of anti-nucleosome antibodies (anti-NCS) for the diagnosis of SLE and as a marker of disease activity.

Also, to explore their role in biopsy-proven lupus nephritis.

Methodology : The study was conducted on 83 SLE patients diagnosed according to the revised ACR criteria.

Serum IgG anti-NCS antibodies were detected with ELISA for the patients and 100 matched apparently healthy subjects as a control group.

Renal biopsies were performed for 44 patients with renal involvement and classified according to the WHO classification criteria.

Results : Serum anti-NCS antibodies levels were significantly higher in patients with renal affection, arthritis (p < 0.001), molar rash and with hematological disorders (p < 0.05).

Anti-NCS antibodies showed a higher diagnostic sensitivity (74.7%) and specificity (97%) than anti-dsDNA.

The incidence of anti-NCS antibodies in SLE patients with renal affection was significantly higher (p < 0.05) than anti-dsDNA (86% versus 68%).

Serum anti-NCS antibody levels correlated significantly with laboratory markers of disease activity, total SLEDAI score, SLICC/ACR damage index score of all patients and histopathological activity score for a group of patients with renal affection.

Conclusions : Anti-NCS antibodies showed a high sensitivity and specificity in SLE patients.

Their levels were significantly higher in patients with active renal affection, arthritis, malar rash and hematological disorders and correlated significantly with SLEDAI and worse SLICC / ACR damage scores.

Therefore, serum anti-NCS antibody levels could be a useful parameter in the diagnosis, activity assessment especially active renal disease and may have a role in predicting disease outcome.