Antinuclear Antibodies

RJT Smeenk, Central Laboratory of the Netherlands Red Cross, Amsterdam, The Netherlands TEW Feltkamp, Research Center for Rheumatic Diseases, Amsterdam, The Netherlands

Copyright © 1998 Elsevier Ltd. All Rights Reserved.

Antibodies against antigens of cell nuclei probably occur in the blood of all human beings. Since such antibodies generally react with all kinds of nuclei, whatever their origin, they are also directed against antigens in the nuclei of the host, and are therefore considered to be 'autoantibodies'. If the anti-nuclear antibodies (ANAs) occur in titers elevated significantly above the normal serum level, the employed test is considered 'positive'. Such high titered autoantibodies are especially associated with the autoimmune disease systemic lupus erythematosus (SLE), although they also occur in high frequencies in patients with rheumatoid arthritis (RA), Sjögrens syndrome, scleroderma, polymyositis, mixed connective tissue disease (MCTD), myasthenia gravis and chronic active hepatitis.

ANA were first demonstrated in 1957 by Holborow and by Friou, using the indirect immunofluorescence technique (IFT) as developed by Coons. This method is still the method of choice as a screening technique, before more specific methods are used. The distinct ANAs and the assays used to demonstrate their presence are listed in Table 1.

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