| Objective:To investigate the clinical utility of the quantitative determination of Systemic lupus erythematosus(SLE)related autoantibodies with magnetic nanoparticle chemiluminescent immunoassay(NM-CLIA).Methods:108 sera samples from patients who suffered from Systemic Lupus Erythematosus(SLE)and 60 from healthy subjects were collected and tested with chemiluminescent immunoassay(NM-CLIA)and line immunoassay(LIA)for SLE related autoantibodies,including anti-nucleosome antibodies(anti-Nuc),anti-dsDNA antibody(anti-dsDNA),anti-sm antibody(anti-Sm),anti-RNP antibody(anti-nRNP),anti-Ro52 antibody(anti-Ro52),anti-Ro60 antibody(anti-Ro60),anti-SSB antibody(anti-SSB)and anti-histone antibody(anti-His).Antinuclear antibody(ANA)was tested with chemiluminescent immunoassay(NM-CLIA)and indirect immunofluorescence(IIF),.The positive rate,the quantitative level and the ability to identify SLE from healthy subjects of these SLE related antibodies were evaluated.The consistency between NM-CLIA and IIF?LI A for these SLE related autoantibodies were compared.The agreement between the antibody level and SLEDAI?rate differences of each antibody in important clinical characteristics and different disease activities of SLE were analyzed.We used SPSS 21.0 statistics software to analyse related data.Result:1.Among all these antibodies,ANA showed the highest antibody level in SLE cohort(more than 50%SLE samples>400 RU/mL),while anti-Sm antibody demonstrated the lowest antibody level(more than 50%SLE samples<2RU/mL).2.The positive rate of SLE related antibody tested by NM-CLIA in SLE group were 32.4%(anti-Nuc)?54.6%(anti-dsDNA)?14.0%(anti-Sm)?38.0%(anti-nRNP)?19.4%(anti-PO)?61.1%(anti-Ro52)?76.9%(anti-Ro60)?25.0%(anti-SSB)?96.3%(ANA)?29.6%(anti-His).3.The positive rate of SLE related antibody were tested by NM-CLIA in healthy group all lower than 5%.4.Anti-Nuc and anti-His had slightly worse agreement between NM-CLIA and LIA(Kappa=0.262?0.314);anti-dsDNA?anti-Sm had general agreement(Kappa=0.546?0.694);anti-nRNP?anti-PO?anti-Ro52?anti-Ro60?anti-SSB had best agreement(Kappa=0.752?0.940?0.796?0.901?0.800).For ANA determination,NM-CLIA also had good agreement with IIF(P>0.05).5.Anti-nRNP,anti-Ro60 detected by NM-CLIA had high accuracy in identifying SLE from healthy subjects(AUC=0.952?0.941);Anti-dsDNA,anti-Nuc?anti-SSB and anti-His had certain accuracy(AUC=0.771?0.833?0.881?0.823);The accuracy of anti-Sm is general(AUC=0.619).6.The level of anti-dsDNA?anti-His?anti-Nuc?anti-Sm determined by NM-CLIA were correlated positively with SLED AI(r=0.334,P<0.05;r=0.362,P<0.05;r=0.323,P<0.05;1=0.201,P<0.05).7.Anti-dsDNA,anti-Nuc and anti-His had statistically significant difference in different activity levels(P<0.05).8.Anti-Sm had different rate in the group of rash;anti-Nuc in the group of fever?low complement,hematuria and proteinuria,;Anti-His in the group of rash,fever,reduced platelet and leukocyte,low complement,hematuria and proteinuria;Anti-dsDNA in low complement,hematuria and proteinuria;anti-P0 in rash and pleurisy;Anti-SSB in rash and fever(P<0.05).Conclusion:The correlation analysis suggested that the level of anti-dsDNA?anti-His and anti-Nuc determined by NM-CLIA was related to the SLE activity.NM-CLIA as an experimental technique to quantitatively detect autoantibodies can provide better help for clinical SLE disease assessment. |
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