Anti-Sitoplazmik ve Anti-Mitotik Otoantikorlar; Bu Antikorların Hastalıklarla İlişkisi Var Mı?

Yıl 2022, Cilt: 44 Sayı: 6, 851 - 861, 28.11.2022

Nilgün Kaşifoğlu Nazife Şule Yaşar Bilge Timuçin Kaşifoğlu

https://doi.org/10.20515/otd.1142942

Öz

Sistemik otoimmün hastalıkların tanısında antinükleer antikor (ANA) incelemesi yapılır ve HEp-2 hücrelerini kullanan indirekt immünfloresan (IIF) test altın standart yöntemdir. HEp-2, çok sayıda hedef antijene yönelmiş otoantikorların saptanmasına imkân verir. “Antinükleer Antikor (ANA) Paterninde Uluslararası Uzlaşı” rehberi, paternleri üç gruba ayırır: nükleer, sitoplazmik ve mitotik. Bunların çoğu otoimmün hastalıklarla ilişkilidir, ancak bazıları otoimmün hastalıklarda nadiren görülür veya otoimmün hastalık dışındaki durumlarla ilişkili olabilir. Sitoplazmik ve mitotik paternlerin nasıl raporlanacağı konusunda- negatif veya pozitif- bir fikir birliği yoktur. IIF ile ANA değerlendirmesinde sitoplazmik veya mitotik boyanma olan hastaların özelliklerini incelemeyi amaçladık. Tıbbi Mikrobiyoloji Laboratuvarımızda 01.01.2015-31.12.2019 tarihleri arasında 16940 hastaya ait 18985 ANA testi çalışılmıştır. 385 hastaya ait 393 (%2.07) testte sitoplazmik veya mitotik patern tespit edildi. Anti-mitokondriyal antikor (AMA), anti-düz kas antikoru (ASMA), anti-Jo-1 ve anti-ribozomal P-proteini düşündüren sitoplazmik paternler çalışmaya dahil edilmedi. En sık görülen paternler anti-midbody (hücreler arası köprü), anti-spindle fibers (iğsi iplikçikler) ve anti-vimentin paternleriydi. Altmış altı romatoloji hastasında ANA negatifti ancak sitoplazmik veya mitotik boyanma saptandı. Bu hastaların tanı ve paternleri arasında istatistiksel olarak anlamlı bir fark bulunamadı. Anti-hücre antikoru terimi kullanılmadıkça, sitoplazmik veya mitotik patern olması durumunda ANA'nın “negatif” olarak rapor edilmesini öneriyoruz. Bu boyanma, önemli sitoplazmik paternleri ayırt etmek ve bazı spesifik durumlar hakkında fikir vermek için raporun açıklama kısmında belirtilmelidir

Anahtar Kelimeler

Anti-nükleer antikor, anti-sitoplazmik patern, anti-mitotik patern, otoantikor, indirekt immünfloresan test

The Anti-Cytoplasmic and Anti-Mitotic Autoantibodies; Are These Antibodies Associated with Diseases?

Öz

Examination of antinuclear antibody (ANA) is used in diagnosis of systemic autoimmune diseases, and the indirect immunofluorescence (IIF) assay using HEp-2 cells is the gold standard method. HEp-2 allows the detection of multiple target antigen-directed autoantibodies. The guide “The International Consensus on ANA Patterns (ICAP)”, characterizes the patterns into three groups: nuclear, cytoplasmic, and mitotic. The majority of these are associated with autoimmune diseases, but some are rarely seen in autoimmune diseases or may be associated with conditions other than autoimmune disease. There is no consensus on how to report cytoplasmic and mitotic patterns-negative or positive. We aimed to examine the characteristics of patients that had cytoplasmic or mitotic staining in ANA evaluation by IIF. In our Medical Microbiology Laboratory, 18985 ANA tests of 16940 patients were studied between 01.01.2015-31.12.2019. Cytoplasmic or mitotic pattern was detected in 393 (2.07%) tests belonging to 385 patients. Cytoplasmic patterns suggestive of anti-mitochondrial antibody (AMA), anti-smooth muscle antibody (ASMA), anti-Jo-1 and anti-ribosomal P-protein were not included. The most common patterns were anti-midbody, anti-spindle fibers, and anti-vimentin patterns. There were 66 rheumatology patients that were negative for ANA but had cytoplasmic or mitotic staining. There was no statistically significant difference between the diagnosis and patterns of these patients. We suggest that the ANA should be reported as “negative” in case of cytoplasmic or mitotic pattern unless the term anti-cell antibody is used. It should be noted in the description part of the report in order to distinguish significant cytoplasmic patterns and give an idea for some specific conditions.

Anahtar Kelimeler

Anti-nuclear antibody, anti-cytoplasmic pattern, anti-mitotic pattern, autoantibody, indirect immunofluorescence assay

Kaynakça

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