IgG, IgM, and IgA antinuclear antibodies in discoid and systemic lupus erythematosus patients.

Sheridan A Jost,Lin-Chiang Tseng,Benjamin F Chong,Song Zhang,Kim B Yancey,Rebecca Vasquez,Loderick A Matthews

doi:10.1155/2014/171028

Sheridan A Jost, Lin-Chiang Tseng + Show 5 more

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https://doi.org/10.1155/2014/171028

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Abstract

IgG antinuclear antibodies (ANAs) are elevated in patients with systemic lupus erythematosus (SLE) compared with patients with discoid lupus erythematosus (DLE). To provide an expanded immunologic view of circulating ANAs in lupus patients, we compared the expressions of IgG, IgM, and IgA ANAs in DLE and SLE patients. In this cross-sectional study, sera from age-, gender-, and ethnic-matched SLE (N = 35), DLE (N = 23), and normal patients (N = 22) were tested for IgG, IgM, and IgA ANAs using enzyme-linked immunosorbent assays (ELISAs) and indirect immunofluorescence (IIF) with monkey esophagus as substrate. ELISAs showed elevated levels of IgG ANA, IgM ANA, and IgG/IgM ANA ratios in SLE patients compared with DLE and normal patients. IgA ANA expression was higher in SLE and DLE patients versus normal patients. IIF studies showed higher percentages of patients positive for IgG, IgM, and IgA ANAs in the SLE group. Higher IgG/IgM ANA ratios in SLE than DLE show enhanced class-switching and a more sustained humoral response in SLE. They also suggest a potential connection of IgM ANAs with disease containment.

Highlights

Discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE) may or may not coexist, with DLE occurring in 20% of SLE patients [1] and 17% progressing to SLE [2]
enzyme-linked immunosorbent assays (ELISAs) Show That SLE Patients Have the Highest IgG, IgM, and IgA Levels and IgG/IgM Ratios versus DLE and Normal Patients
The ELISA and indirect immunofluorescence (IIF) results indicate that IgG and IgM antinuclear antibodies (ANAs) are higher in SLE patients compared with DLE and normal patients

Summary

Introduction

Discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE) may or may not coexist, with DLE occurring in 20% of SLE patients [1] and 17% progressing to SLE [2]. Previous studies have shown that IgG antinuclear antibodies (ANAs) are higher in SLE patients versus DLE patients [3, 4]. It is unknown whether levels of IgM or IgA ANAs can be distinguished between DLE and SLE patients. To better understand immunologic relationships between DLE and SLE, we sought to compare the expressions of IgG, IgM, and IgA ANAs in patients with DLE and SLE by enzyme-linked immunosorbent assays (ELISAs) and indirect immunofluorescence (IIF). We hypothesized that the ANA levels for all three isotypes would be the highest in SLE patients, followed by DLE and normal patients

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