AUTHOR=Al-Mughales Jamil A. 

TITLE=Anti-Nuclear Antibodies Patterns in Patients With Systemic Lupus Erythematosus and Their Correlation With Other Diagnostic Immunological Parameters

JOURNAL=Frontiers in Immunology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.850759

DOI=10.3389/fimmu.2022.850759

ISSN=1664-3224

ABSTRACT=Abstract
Background
Antinuclear antibodies (ANA) are major immunodiagnostic tools in systemic lupus erythematosus (SLE); however, their clinical and pathogenic role is not yet elucidated and is a subject of controversy.
Objectives
To explore the pathogenic significance of ANA patterns among SLE patients, by analyzing their association with ANA titers, complement levels and other pathogenic immune markers including anti double-stranded DNA (anti-dsDNA), complements C3 and C4, rheumatoid factor (RF), anticardiolipin antibodies IgG (ACL IgG) and IgM (ACL IgM), Beta-2 Glycoprotein 1 Antibodies (β2-GP) IgG (β2-IgM) and IgM (β2-IgM), and lupus anticoagulant (LA). 
Method
A comparative cross-sectional study was conducted among 495 SLE patients, who were diagnosed and classified by consultant rheumatologists according to the new European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) 2019 criteria. SLE immunodiagnostic profiles were analyzed including the following parameters: ANA antibody titers and staining patterns; anti-dsDNA; C3 and C4 levels; aCL; anti- β2-GP and LA.
Result
The most frequently observed ANA patterns were the speckled (52.1%) and homogenous (35.2%) patterns; while other patterns were rare representing less than 7% of the patients each. ANA titers were highest in patients with mixed pattern followed by speckled pattern. Of all the investigated patterns, the peripheral pattern showed the most pathogenic immune profile including highest levels of anti-dsDNA, lowest levels of C4, and highest levels of aCL and β2-GP IgG and IgM. 
Conclusion
This retrospective study showed that speckled followed by homogenous ANA patterns were predominant accounting for 52.1% and 35.2% of the patients. The ANA pattern showed several associations with other immune markers that are documented to have significant clinical implications in SLE. Peripheral, mixed, and speckled patterns were associated with higher profiles of immune markers indicative of a potential prognostic value of these patterns in SLE.