Enzyme-linked immunosorbent assay for anti-histone antibodies and their presence in systemic lupus erythematosus sera

Canine Systemic Lupus Erythematosus. II: Antinuclear Antibodies

The frequency and the specificities of antinuclear antibodies (ANAb) were studied in dogs with systemic lupus erythematosus (SLE) and compared to those found in normal dogs and in dogs with various infectious diseases. Whole ANAb were detected by immunofluorescence. Anti-double-stranded DNA Ab were found in only 2% of SLE dogs, whereas anti-single-stranded DNA Ab were present in 21.4% of SLE dogs and in 26.8% of dogs with infectious disease. Antihistone Ab were frequently observed in SLE dogs (71%) and are essentially directed against trypsin-resistant epitopes of H3, H4 and H2A. The Western blots of nuclear extracts of HeLa cells were recognized mainly by type 1 Ab (30%, reacting with bands of 43, 36, 35, 34, 30 and 27 kDa) and by anti-Sm Ab (12%) associated with anti-RNP Ab. Anti-SSA and anti-SSB Ab were rare.

Sensitivity and specificity of autoantibody tests in the differential diagnosis of lupus nephritis

Several studies have investigated the potential of various autoantibody tests in the diagnosis of systemic lupus erythematosus (SLE). Many lupus patients initially present with glomerulonephritis. In that clinical situation the main differential diagnosis are other forms of glomerulonephritis. In this study the diagnostic value of nine test kits for autoantibody against ANA, dsDNA, circulating immune complexes, C1q, nucleosomes, histones and Sm as well as C3 and C4 levels was evaluated in 39 patients with biopsy-proven lupus nephritis in comparison to 43 patients suffering from other forms of glomerulonephritis. The most useful test was an anti-nucleosome antibody enzyme-linked immunosorbent assay (ELISA) with a sensitivity of 90% and a specificity of 88%. All tests for anti-dsDNA antibodies (Crithidia luciliae Anti-dsDNA, BINDAZYME Anti-dsDNA, FARRZYME high avidity Anti-dsDNA) were of moderate sensitivity and very good specificity. Decreasing the cut-off for the conventional anti-dsDNA ELISA (BINDAZYME) considerably increased its sensitivity (87%) without loss of specificity (90%). Tests for anti-C1q and immune complexes performed worse than the antidsDNA tests. As anti-histone and Sm antibodies are present only in a minority of lupus nephritis patients they are of limited value in diagnosing the disease. In conclusion, testing for anti-nucleosome antibodies and the conventional anti-dsDNA ELISA with lower cut-off provide the best diagnostic aids for differentiation of lupus nephritis from other forms of glomerulonephritis. Lupus (2009) 18, 1276—1280.

Anti-histones antibodies in systemic lupus erythematosus: prevalence and frequency in neuropsychiatric lupus

To investigate the specificity, sensitivity, and concomitant presence of antibodies against histones (H), histone H1 (H1), and histone H3 (H3) in patients with systemic lupus erythematosus (SLE) and analyze their association with SLE. Serum IgG anti-histones antibodies were detected by enzyme-linked immunosorbent assay in 144 SLE patients consisting of 24 neuropsychiatric lupus (NPSLE), 65 lupus nephritis (LN), and 55 SLE, 100 other rheumatic diseases patients, as well as 40 healthy controls. Clinical and biological parameters of the patients were also evaluated. Anti-H, anti-H1, and anti-H3 antibodies yielded a sensitivity of approximately 33% and a specificity of more than 93% for SLE, which was comparable to that found for anti-double-stranded DNA (anti-dsDNa) antibodies. More significantly, anti-histone antibody is found in approximately 50% of patients with NPSLE compared with LN. Moreover, the titers of anti-histones antibodies of NPSLE patients were significantly higher than that of patients with SLE and LN. The sequential analysis revealed a close correlation of anti-H and anti-H1 antibodies with SLE disease activity. There was an approximate 30% positive rate of anti-histones antibodies in 144 SLE patients lacking anti-nucleosome, anti-mDNA, anti-Sm, and anti-dsDNA antibodies. Antibodies to histones H1 and H3 are markers with high specificity of 93.6-96.4% for SLE. The anti-histone antibody markers are prevalent in approximately 50% of NPSLE. Furthermore, there was a strong correlation with SLE disease activity index and levels of antibodies to histones and H1.

Autoantibody Determination in the Diagnosis of Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease that usually develops in young women aged 18-50 years and is characterized by the presence of autoantibodies. Diagnosis is difficult as SLE is a great imitator of other diseases. When SLE is suspected clinically in a patient (involvement of two or more organ systems), an initial laboratory evaluation would be antinuclear antibody (ANA) testing. If ANA is negative, SLE is unlikely and results positive at less than 1:40 strongly argue against SLE. Other explanations for organ system involvement should be pursued. Results positive at greater than 1:40 may merit further evaluation for SLE and at times referral to a rheumatologist for a full SLE evaluation. While the American College of Rheumatology classification criteria for SLE are primarily a tool for research, they may be useful clinically, in that those patients fulfilling four or more criteria are highly likely to have SLE.

The use of laboratory tests in the diagnosis of SLE

ANA IIF is an effective screening assay in patients with clinical features of SLE and will detect most anti-ssDNA, anti-dsDNA, ENAs, and other autoantibodies. False positives are common. The clinical importance cannot be extrapolated from the ANA titre or pattern, although higher titres (> 1/160) are more likely to be important. HEp-2 cells are the most sensitive substrate for ANA detection, but this must be balanced against an increased incidence of insignificant positivity. ANA positive samples should be subjected to more specific assays for the diagnosis of SLE. A combination of ENA (Ro/La/Sm/RNP) and dsDNA assays will detect most patients with SLE as long as the characteristics of the assays used are well understood. ESR and CRP measurements provide useful additional information. Sjogren's syndrome and MCTD will produce overlapping serology with SLE, and anti-dsDNA titres are sometimes seen in autoimmune hepatitis and rheumatoid arthritis. All results should be reported in the light of the clinical details, by an experienced immunologist. A suggested diagnostic protocol is outlined in fig 1. The type of assay used crucially influences the predictive value of the tests. ELISA technology dominates routine laboratory practice, but tends to produce more false positive and true weak positive results, which may reduce the PPV of the test. This can be minimised by using IgG specific conjugates and careful assay validation. The NPV for SLE [figure: see text] is high for most assays but the PPV varies. Where necessary, laboratories should use crithidia or Farr dsDNA assays to confirm dubious ELISA dsDNA results, and ID/IB to confirm dubious ENA results. For monitoring, a precise, quantitative assay is required. It is unclear whether the detection of IgM or low affinity antibodies has a role here. A combination of anti-dsDNA, C3, C4, CRP, and ESR assays provides the most useful clinical information. Anti-ssDNA assays are likely to be useful, and are potentially more robust than anti-dsDNA assays, but require more validation. Local validation of individual assays and EQA participation is essential. Not all assays that apparently measure the same antibody specificities have equal clinical relevance, even within a single technology. Insufficient international or national reference preparations are currently available for many antibody specificities to enable effective standardisation. Quality assurance schemes reveal large differences in units reported by different assays for some analytes, even when calibrated against an IRP or equivalent reference preparation. Serial results can therefore only be compared from the same laboratory at present. Most autoantibodies increase during active disease, but few prospective data are currently available to justify treatment on the basis of rising titres. Further randomised prospective studies are required to examine the importance of antibody isotype and affinity in the monitoring of SLE by individual assay methods. The most important aspect of the appropriate use of laboratory assays is to become familiar with the limitations of the technology currently in use in your local laboratory, and to consult with your clinical immunologist in cases of doubt, preferably before commencing serological screening.

Clinical relevance of autoantibodies in systemic rheumatic diseases

Autoantibodies directed to intracellular antigens are serological hallmarks of systemic rheumatic diseases. Identification of circulating autoantibodies is helpful in establishing the correct diagnosis, indicating the prognosis and providing a guide to treatment and follow-up. Some autoantibodies are included in diagnostic and classification criteria for diseases such as anti-Sm antigen and anti-double-stranded DNA antibodies in systemic lupus erythematosus, anti-U1 nuclear ribonucleoprotein antibodies in mixed connective tissue disease, and anti-SS-A/Ro and anti-SS-B/La antibodies in Sjögren's syndrome. Over the past 30 years, the identification of new autoantibody systems was advanced by the initiation or adaptation of novel techniques such as double immunodiffusion to detect antibodies to saline-soluble nuclear antigens, extraction-reconstitution and ELISA techniques to detect histone and chromatin antibodies, immunoblotting and immunoprecipitation to detect a wide range of antibodies directed against naturally occurring and recombinant proteins. These techniques have been made possible by advances in cellular and molecular biology and in turn, the sera from index patients have been important reagents to identify novel intracellular macromolecules. This paper will focus on the clinical relevance of several autoantibody systems described by Tan and his colleagues over the past 30 years.

Antihistone antibodies in systemic sclerosis. Association with pulmonary fibrosis

OBJECTIVE

To determine the prevalence and clinical significance of antihistone antibodies (AHA) in systemic sclerosis (SSc).

METHODS

Serum samples from patients with limited cutaneous SSc (n = 44), diffuse cutaneous SSc (dcSSc; n = 48), and other SSc-related disorders (n = 22) were examined by enzyme-linked immunosorbent assay and immunoblotting for AHA.

RESULTS

AHA were demonstrated in 29% of the 92 SSc patients and in 44% of those with dcSSc. The presence of AHA correlated with severe pulmonary fibrosis in those with dcSSc. Immunoblotting revealed that the predominant antigen was histone H1.

CONCLUSION

AHA might be a serologic indicator of the severity of pulmonary fibrosis in SSc.

Autoantibodies to histones and their subfractions in chronic liver diseases

Sera of 78 patients with different chronic liver diseases were examined for the presence of anti-histone activity using an enzyme-linked immunosorbent assay. Eighteen patients had primary biliary cirrhosis (PBC), 20 had chronic active hepatitis, and 40 had cirrhosis. Anti-histone antibodies were detected in 34 patients (43.6%), distributed among all liver disease entities studied. When antibodies of specific isotypes (IgG, IgM, and IgA) were measured, even higher frequencies were noted--50% for IgG and 53.8% for IgA. Antibodies to histone subfractions H1, H2a, H2b, H3, and H4 were also observed in all liver disorders investigated (in 22-32% of patients)--H1 and H3 being the prominent fractions involved. Of the various disease entities examined PBC was the one disclosing the highest frequency of anti-histone antibodies.

DNA-anti-DNA complexes account for part of the antihistone activity found in patients with systemic lupus erythematosus

We examined the effect of DNase treatment of sera with antihistone activity. In non-systemic lupus erythematosus (SLE) sera, antihistone levels remained unmodified, but a significant decrease was observed in 7 of 11 SLE sera with anti-DNA antibodies. This was accompanied in some by an increase in anti-DNA levels. We therefore considered that DNA-anti-DNA complexes were being detected, as part of the antihistone activity in SLE patients, by binding of the complexes through their DNA to the histones used in the assay. This was confirmed by demonstrating that DNA-anti-DNA complexes formed in vitro, and by studies performed with monoclonal antibodies with affinity to double-stranded DNA and/or histones.

Antinuclear antibodies detected by indirect immunofluorescence on HEp2 cells and by immunoblotting in patients with systemic sclerosis

The HEp2 cell cultures appeared highly sensitive in detecting the antinuclear antibodies (ANAb) in systemic sclerosis, principally anticentromere antibodies of the CREST syndrome. The immunoblotting used with either complex cellular extracts from HeLa and rabbit thymus or purified nuclear components (high mobility group (HMG) proteins and histones) is able to identify precisely the ANAb targets and to contribute to diagnosis. With nuclear extracts of HeLa cells, the sera from 75.8% of CREST syndrome subjects stained 18 and 22 kD proteins. Corresponding antibodies were also detected in 72.7% of these patients, on HEp2 centromers by indirect immunofluorescence. With the same extracts, 33.3% of sera from diffuse sclerosis/acrosclerosis patients contain antibodies staining 86, 73, 32 and 30kD. These sera also stain 77, 66 and 63kD from thymus extracts. Corresponding antibodies will be the anti-SCL-70 antibodies defined by double immunodiffusion. The anti-HMG antibodies were infrequent in systemic sclerosis, rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) and consequently without interest for diagnosis. The anti-whole histones antibodies which are less frequent in diffuse sclerosis/acrosclerosis (35.7%) than in SLE (41.3%) recognize especially H1 and H2A in the first diseases, H1 and H2B in SLE and H1 and H3 in RA.

Detection of anti-histone activity in sera of patients with monoclonal gammopathies

Sera from 249 patients with monoclonal gammopathies (85 multiple myeloma, 92 benign monoclonal gammopathies, 53 cryoglobulinemia, 19 Waldenström's macroglobulinemia) were examined for the presence of anti-histone activity. Thirty-four sera were found positive. In 12 of these cases the serum monoclonal immunoglobulins were purified and in all, the anti-histone activity appeared to reside in the monoclonal component. None of the patients had symptomatology of lupus despite high titers of anti-histone activity. This study demonstrates an anti-histone activity of monoclonal components of patients with monoclonal gammopathies.

Detection of antibodies to total histones and their subfractions in systemic lupus erythematosus patients and their asymptomatic relatives

Sera drawn from 75 patients with systemic lupus erythematosus, 141 healthy relatives (from the families of 51 patients), and 115 healthy control subjects were examined, by enzyme-linked immunosorbent assay, for IgG and IgM antibodies to total histones and their subfractions. Compared with the controls, statistically significant numbers of patients and their relatives had antihistone antibodies of both isotypes. Among the relatives, the sera from females, notably sisters of the patients, contained the highest levels of anti-total histone antibody. Anti-H2A/H2B and H3 antibodies were most prevalent among the lupus patients, but many of the relatives had IgM anti-H4 antibodies. These findings indicate that antihistone antibodies can serve as a genetic marker in patients with systemic lupus erythematosus.

Specificity of acebutolol-induced antinuclear antibodies

Treatment with the beta blocker acebutolol may trigger antinuclear antibody (ANA) production. We retrospectively studied 97 sera from 47 patients who developed ANA during acebutolol treatment. Anti-histone and anti-denatured (ss) DNA antibodies were found in 53% and 66% respectively of the sera tested. The activities of these two antibodies correlated well with the total ANA titer. Anti-native (ds) DNA were absent or present at low titer. This immunochemical pattern of acebutolol-induced ANA is similar to that reported for other drug-induced ANA. To date, the presence such isolated ANA is not known to expose patients to any particular risk other than exceptional and minor clinical manifestations of lupus which are rapidly reversible following therapy cessation.

IgG antibodies to the histone complex H2A-H2B characterize procainamide-induced lupus

Patients treated with procainamide and other drugs commonly develop antinuclear antibodies and occasionally symptoms of lupus erythematosus. However, the pathological events which lead to clinical symptoms in some patients but only abnormal serology in others have not been established. The present study examines the incidence, amount, immunoglobulin class, and antigen-binding specificity of anti-histone and anti-denatured DNA (anti-dDNA) antibodies in three groups of patients. These comprised a prospective study of patients treated with procainamide, patients with clinical drug-induced lupus symptoms, and a group undergoing therapy for many years without any symptoms. Procainamide elicited IgG and IgM anti-dDNA antibodies concordantly. Anti-histone IgM antibodies also appeared de novo during this period but IgG anti-histone antibodies were detected less frequently. Asymptomatic patients tended to have an antibody profile consisting of highly elevated anti-dDNA, IgM antibodies reactive with all histones and IgG antibodies specific for only one or two histone classes. In contrast symptomatic patients usually had little anti-dDNA or antibodies to individual histones but had pronounced IgG antibodies to the histone complex H2A-H2B. This unique antibody was characteristics of procainamide-induced lupus and was not detected in patients whose disease was induced by hydralazine. Anti-(H2A-H2B) decreased after procainamide was discontinued, concomitant with subsidence of symptoms. The finding that autoantibodies elicited by procainamide in patients with lupus symptoms have a characteristic immunoglobulin class and specificity may be of pathogenic significance and suggests that patients susceptible to procainamide-induced lupus have a unique immune response. In addition, this information could be of diagnostic value in predicting which procainamide-treated patients will develop overt symptoms of lupus.

Patterns of antihistone antibody specificity in systemic rheumatic disease. I Systemic lupus erythematosus, mixed connective tissue disease, primary sicca syndrome, and rheumatoid arthritis with vasculitis

A new fluorimetric assay was used to measure the relative amounts of antibodies to individual nuclear histones in sera from 102 patients with systemic lupus erythematosus (SLE), mixed connective tissue disease, primary sicca syndrome, and rheumatoid arthritis with vasculitis. In SLE sera, the predominant responses were to histones H-1, H-2B, and H-3, with marked elevations of binding to H-1 and H-2B in one-third of the patients, and to H-3 in one-fourth; antibodies of both the IgG and IgM classes were also detected. In a few SLE sera, the pattern of histone response differed or was restricted to 1 immunoglobulin class. In mixed connective tissue disease, only 2 of 9 sera showed elevated histone binding activity, the response being predominantly to H-3 in 1 patient and to H-1 and H-2B in the other. Binding to H-2B was also prominent in 2 of 3 patients with primary sicca syndrome. The highest antihistone reactivity and the most heterogeneous response patterns were observed in patients who had rheumatoid arthritis with vasculitis; 6 of 8 of those sera had elevated histone reactivity. In SLE, the highest histone binding results were found among patients with a history of photosensitivity. Histones are closely associated with DNA in the nucleosome, and we speculate that antihistone antibodies could arise as a result of damage to DNA, induced by drugs or irradiation.

Comparison of nuclear proteins from DMBA-induced mammary tumors and lactating mammary glands by polyacrylamide gel electrophoresis

Nuclear proteins were extracted from purified nuclei of 7,12-dimethylbenz(a)anthracene(DMBA)-induced tumors and normal mammary glands of the rat by enzymatic treatment. Of the 34 bands indicated by one-dimensional polyacrylamide gel electrophoresis of nuclear proteins, 6 appeared in high concentration in tumors but were found as traces or undetectable in normal glands; 6 others were clearly shown in the latter but were not detectable or greatly reduced in the former. Two-dimensional electrophoresis identified about 130 and 92 non-histone proteins in normal mammary and tumor cell nuclei respectively. Marked differences in spot density were noted especially in spots (M.W. X 10(-3)/pI) 100/5.7 and 200/5.5 of tumors and 28/7.1, 32/5.4, 36/5.4, 38/6.9, and 68/6.0 of normal tissue. The relationship between these nuclear proteins and the development of mammary tumors is also discussed.

Non-specific binding of heat-aggregated IgG to histone detected by ELISA

Anti-histone antibodies are currently detected by micro ELISA in systemic lupus erythematosus sera from humans, mice and dogs. Here we show that the control-heated sera may bind non-specifically to the whole histones and histone fractions. The heated immunoglobulins binding to histones are mainly IgG and to a lesser extent IgA, but never IgM. These false positive ELISA reactions occurred only with aggregated IgG which binds to histones via Fc; IgM rheumatoid factor prevented their fixation. Immune complexes do not seem to interfere significantly in the detection of anti-histone antibodies with the ELISA test.

Specificities of antinuclear antibodies detected in dogs with systemic lupus erythematosus

Five hundred and eighty dogs with at least one clinical sign compatible with a systemic lupus erythematosus (SLE) were entered in a prospective study aimed at evaluating the prevalence of antinuclear antibodies (ANAb). SLE was diagnosed in 38 of these dogs (group A) which fulfilled at least four American Rheumatism Association (ARA) criteria; of these, sixteen had ANAb titers greater than or equal to 4096. The 23 dogs which met three or two ARA criteria (group B) had an ANAb geometric mean titer (GMT) of 259. Dogs (group C) with only 1 criterium had an ANAb GMT of 75. Anti-ds-DNA Ab were present in 6 dogs from group A (16%), and 2 dogs from group B (9%). Anti-histone Ab were present among dogs from group A, B and C with frequencies of 81%, 67% and 26%, respectively. Among dogs from group A, the ANAb titers and the levels of anti-histone Ab correlated positively when individual sera were considered. Antibodies against the soluble nuclear antigen (SNA) were detected in 74%, 39% and 13% of the dogs from groups A, B and C, respectively. Antibodies initially described in human SLE also exist in SLE dogs. Anti-Sm Ab were found in 24% of dogs in group A. With anti-RNP Ab the frequency was still lower (10%). However, two other types of anti-SNA Ab against RNAse and trypsin-resistant antigens, not found in human "reference sera", were often detected. The first type (anti-type 1 Ab) was found in 26% and 9% of group A and group B, The first type (anti-type 1 Ab) was found in 26% and 9% of group A and group B, respectively; the second type (anti-type 2 Ab) is less frequent, and was found in 13% and 17% of group A and B, respectively. It appears that testing for anti-Sm, anti-type 1 and anti-histone Ab should be performed in order to improve the diagnosis of SLE in dogs.

Monoclonal autoantibodies to histones from autoimmune NZB/NZW F1 mice

Fusion of spleen cells from autoimmune NZB/NZW female mice with drug-resistant myeloma cells (clones NSI/1, X63-Ag8.653 and NSO/1) produced hybrid clones which secreted antibodies to various nuclear components. Roughly 50% of the anti-nuclear hybridomas produced antibodies reacting with DNA, 20% with RNA and 30% reacted with other nuclear antigens. Two hybridomas of the latter group were cloned and studied in detail. They secreted antibodies which produced bright fluorescence staining of nuclei and metaphase chromosomes. The specificity of the antibodies was determined by testing them in an enzyme-linked immunosorbent assay and a radioimmunoassay against individual acid- and salt-extracted histones, against histones mixed two and three at a time and against histone complexes isolated as such from chromatin. One of the monoclonal antibodies was specific for histone H2B and reacted with the histone free in solution or when present as a H2A-H2B complex. The second monoclonal antibody recognized a specific conformation in the H3-H4 complex that was present only when the complex was obtained from chromatin by salt extraction. The same conformation, however, could be induced by adding histone H2B to a mixture of acid-extracted H3 and H4. Our findings show that the autoimmune syndrome in NZB/NZW mice resembles human systemic lupus erythematosus not only in the incidence of antibodies to DNA and RNA, but also in the production of autoantibodies to histones.

A fluorimetric assay for human antibodies to all the histones

We describe a fluorescence immunoassay for anti-histone antibodies in human sera. Histones are bound to immobilised tyrosine-glutamic acid copolymer on a polystyrene cuvette. With mixed histones as antigen normal sera showed low levels of antibody binding. Much higher values were obtained with some sera from rheumatoid arthritis (RA) patients positive for antinuclear antibodies, and from patients with vasculitic RA, systemic lupus erythematosus (SLE) and drug induced LE. Antibodies to all 5 individual histones were elevated in SLE and vasculitic RA patients. Preliminary results suggest that differences in response patterns may be disease related.

Autoantibodies to nonhistone nuclear antigens and their clinical significance

Identification of the immunologic specificity of antinuclear antibodies (ANAs) in the various systemic rheumatic diseases has become increasingly important. The standard immunofluorescence technique may enable detection of antibodies to nuclear antigens present in abundance in the nucleus, such as DNA, histones, Sm, nuclear ribonucleoprotein (nRNP), and SS-B/La. The nuclear antigens present in low concentrations, such as SS-A, proliferating cell nuclear antigen (PCNA), rheumatoid arthritis nuclear antigen (RANA), and Ku antigens, are unique to cell types, and their detection requires special substrates or reagent systems. Anti-Sm, anti-Scl-70, anticentromere, and anti-PM-1 are characteristic serologic markers for systemic lupus erythematosus, scleroderma, the CREST syndrome of scleroderma, and polymyositis, respectively. Distinct profiles of ANA characterize different rheumatic diseases. A number of ANAs are found in SLE, whereas other diseases are characterized by the presence or absence of a certain ANA or by differences in mean ANA titers. Specific ANAs have been used to isolate and characterize nuclear antigens at molecular and functional levels.

Detection of antibodies to histones in human systemic lupus erythematosus and in murine lupus-like syndromes using micro-ELISA

An enzyme-linked immunosorbent microassay (micro-ELISA) was improved for the detection of anti-histone antibodies. Detection of these antibodies in autoimmune diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and systemic sclerodermitis sclerosis (SCL), showed a positive correlation between the presence of antinuclear antibodies detected by indirect immunofluorescence and the level of anti-histone antibodies (p less than or equal to 0.02) having anti-H1 (p less than or equal to 0.001) and anti-H2B (p less than or equal to 0.01) specificities. These antibodies were more frequently detected, and at a higher level, in human SLE than in RA and SCL. Anti-H1 and anti-H2B (and less frequently anti-H3) antibodies were also found in mice with lupus-like syndrome (MRL/1, PN and Swan). Their level rose with age and they were prevalent in the severe forms, especially in MRL/1 and PN.

Enzyme-linked immunosorbent assay for anti-DNA antibodies using fluorogenic and colorigenic substrates

An enzyme-linked immunosorbent assay is described for the assay of anti-DNA antibodies. The method employs plastic surface for immobilization of the antigen and alkaline phosphatase-linked rabbit anti-human IgG for the detection of immune complex using PNP-P and 4MU-P as substrates. The sensitivity of the assay increased by as much as 16-fold when fluorogenic substrate was used instead of conventional PNP-P and could therefore be employed for the detection of low avidity antibodies. Using PNP-P as substrate 57% of SLE patients were positive for DNA antibody, but if 4MU-P was introduced as substrate, 71% gave a positive response. Moreover, using a fluorogenic substrate, it was possible to minimise the amount of antigen (2 nM bp). The technique is simple, reproducible and of high sensitivity.

Histone antibodies in systemic lupus erythematosus. A possible diagnostic tool

Antibodies to total histones and histone fractions H1, H2a-H4, H2b, and H3 were measured in serum samples from 61 patients with systemic lupus erythematosus (SLE), 33 with rheumatoid arthritis, 17 with systemic sclerosis, and 20 with various other diseases by use of a sensitive immunoenzymatic assay. Histone antibodies were present in 52.4% of the SLE samples whereas only 1 of the samples from other diseases was positive (systemic sclerosis). The presence of these antibodies in SLE patients was not associated with any specific clinical manifestations, but was correlated with activity of the disease: 87% (20 of 23) of patients with active SLE, in particular 9 of 9 not yet treated, showed histone antibody whereas only 18% (4 of 22) of samples from patients with inactive SLE were positive. We believe that the measurement of histone antibodies would be a useful addition to the present laboratory parameters (antinuclear and double-stranded DNA antibodies and circulating immune complexes) for the diagnosis and progression of systemic lupus erythematosus, particularly since they seem to appear during or just before the onset of an active phase and tend to be absent during remission.