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Autoimmune diseases and their antibodies

Published on 3/12/2019
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Autoimmune diseases are diseases caused by the body's immune response to its own antigen and causing damage to its own tissues. Since Donath and Landsteiner proposed this concept, many diseases have been listed as autoimmune diseases. It is worth mentioning that the existence of autoantibodies is not the same concept as autoimmune diseases. Autoantibodies can exist in no autoimmune Normal people with diseases, especially the elderly, such as anti-thyroglobulin, thyroid epithelial cells, gastric parietal cells, nuclear DNA antibodies, and the like. Sometimes, tissues with altered or antigenic changes can trigger the production of autoantibodies. For example, when myocardial ischemia, necrotic myocardium can lead to the formation of anti-myocardial autoantibodies, but this antibody has no pathogenic effect and is a secondary immune response. Therefore, to determine the existence of autoimmune diseases generally need to be based on: 1 the existence of autoimmune reactions, 2 the possibility of eliminating secondary immune responses, 3 excluding the existence of other causes.

Type of autoimmune disease:

  1. Organ-specific autoimmune disease

The pathological damage and dysfunction of tissues and organs is limited to an organ to which an antibody or sensitized lymphocyte is directed. Mainly chronic lymphocytic thyroiditis, hyperthyroidism, insulin-dependent diabetes mellitus, myasthenia gravis, ulcerative colitis, pernicious anemia with chronic atrophic gastritis, pulmonary hemorrhagic nephritis syndrome, pemphigus vulgaris, pemphigoid , primary biliary cirrhosis, multiple cerebrospinal sclerosing, acute idiopathic polyneuritis, etc., which are common in each systemic disease.

  1. Systemic autoimmune disease

Systemic autoimmune diseases are called systemic autoimmune diseases due to extensive deposition of antigen-antibody complexes on the blood vessel wall and other causes of systemic multi-organ damage. It is also known as collagen disease or connective tissue disease, which is caused by immunological damage leading to cellulose-like necrotic inflammation of the blood vessel wall and interstitium and subsequent proliferation of collagen fibers of multiple organs. In fact, no matter from the ultrastructural and biochemical metabolism, most of the collagen fibers have no primary changes. The common autoimmune diseases are as follows:

(1) systemic lupus erythematosus: the disease is more common in women of childbearing age, can include all the clinical features of connective tissue disease, manifested as multiple organ system involvement, may have fever, facial erythema, joint pain, hair loss, mouth ulcers, etc., can be involved Kidney, blood system, cardiovascular and nervous system.

(2) Rheumatoid arthritis: It occurs in middle-aged and elderly women and is a systemic disease. The lesion mainly affects the joints. Joint symptoms are usually recurrent, and as the number of episodes increases, joint damage becomes more and more serious, eventually leading to dysfunction and deformity of varying degrees. In addition to joints, skin rheumatoid nodules, arteritis, pericarditis, scleritis, lymphadenitis, hepatosplenomegaly, neuropathy, etc. are not uncommon.

(3) Systemic vasculitis: includes a series of lesions characterized by damage to the vessel wall caused by chronic inflammation of the vessel wall. More common is nodular polyarteritis. The patients are mostly male. The lesion mainly invades the arteries and small arteries in the muscles, resulting in narrowing of the lumen. Kidney and heart are the most frequently violated organs. Lesions can also invade the digestive tract, peripheral nerves, skin, lungs, brain, liver, spleen, testicles, etc. The initial symptoms are often symptoms of fever, fatigue, weight loss, and affected organs.

(4) Scleroderma: characterized by excessive hyperplasia of skin fibrous tissue, which occurs in women. As the skin thickens and hardens, the appearance is tight and waxy, and the patient's face is dull and lacks expression. There are two types of scleroderma, one is limited, the skin lesions are limited to the skin; the other is systemic, which can have joints, gastrointestinal, kidney, cardiovascular, lung and other diseases. Joint movement disorders and dysphagia are common symptoms. Antinuclear antibodies and rheumatoid factors can be found in serum.

(5) Pemphigus: A type of skin disease characterized by a bullous lesion on the surface of the skin. Autoantibodies against skin antigens can be found in the blood of patients. There are different types of pemphigus, some lesions are self-limiting and can be relieved by themselves; some combined with visceral lesions can be quickly fatal.

(6) Dermatomyositis: an autoimmune disease characterized by skin involvement and muscle weakness. Due to muscle atrophy, the patient feels extremely weak. Another feature is often associated with malignant lesions, especially in elderly patients.

(7) mixed connective tissue disease: clinical manifestations of rheumatoid arthritis, systemic lupus erythematosus, scleroderma, dermatomyositis and other diseases cross-symptoms. There are high titers of anti-nuclear antibodies and anti-U1RNP antibodies in the blood, while Sm antibodies are negative. Most patients respond well to corticosteroid treatment, and this disease has a tendency to develop systemic scleroderma.

(8) Autoimmune hemolytic anemia: The patient's serum contains antibodies against his own red blood cells. Some of these antibodies can agglutinate red blood cells, and some can dissolve red blood cells together with complement. According to the appropriate temperature of autoantibody action, such antibodies can be divided into two categories: hot antibodies, cold antibodies, so-called hot antibodies, the most suitable temperature for the action is 37 ° C, the degree of anemia in patients is not the same, the light clinical symptoms are not Obvious, heavy can be associated with jaundice and acute blood loss symptoms.

(9) Thyroid autoimmune disease: thyroid autoimmune disease is a local autoimmune disease. Such as Hashimoto's thyroiditis, primary mucinous edema (can also measure anti-thyroid antibodies, but the titer is low. Ultimately lead to thyroid atrophy, may be the final stage of the development of Hashimoto's thyroiditis), hyperthyroidism (Clinical manifestations are goiter, tremor, exophthalmos, and increased basal metabolic rate).

(10) Ulcerative colitis: more common in women. Mainly involving the rectum and sigmoid colon, showing shallow ulcers. Repeated illness

Work, causing intestinal connective tissue hyperplasia.

Autoimmune and anti-nuclear antibodies:


Each autoimmune disease has different antibodies, autoimmune encephalitis antibodies, autoimmune myositis antibodies, and autoimmune nuclear antibodies. The antibodies to each autoimmune disease are also different. For example, an anti-nuclear antibody, also known as an anti-nucleic acid antigen antibody, is a group of autoantibodies produced by DNA, RNA, proteins or molecular complexes of these substances in the nucleus. Each ANA can be distinguished according to the performance of each molecule in the nucleus, such as: 1. anti-DNA antibody; 2. anti-histone antibody; 3. anti-histone antibody; 4. anti-nucleoside antibody. Each category is       subdivided into many categories due to different antigenic properties. Therefore, ANA is broadly a group of autoantibodies with different clinical significance, and the more precise name should be the antinuclear antibody spectrum. ANA is mainly found in IgG and is also found in IgM, IgA, and even IgD and IgE. Antinuclear antibodies can recognize various nuclear components, and can be characteristically found in many autoimmune diseases, especially rheumatic diseases, which can judge the activity and prognosis of the disease, observe the therapeutic response, and guide clinical treatment.

Clinical significance of antinuclear antibody (ANA) in autoimmune diseases (AID): 2055 patients who met the diagnostic criteria of AID were selected, and ANA was detected by indirect immunofluorescence. The positive rate and karyotype of ANA were analyzed. And changes in titer.


The ANA titer AID patients were mainly 1:160, and the control group was mainly 1:80. Among the patients with AID, the ANA positive rate was 80%, which was significantly different from the control group (P<0.01), and the ANA positive rate of systemic lupus erythematosus was the highest. ANA fluorescence model results in systemic lupus erythematosus, dry syndrome, rheumatoid arthritis patients with spot type, autoimmune hepatitis patients with nuclear homogeneity and nuclear speckle.


The ANA positive rate and titer of different AID patients are different. The value of ANA titer should be emphasized. There are many types of ANA fluorescence models. Different fluorescence models indicate different target antigens, especially some special fluorescence models, which have great clinical significance for the diagnosis of AID.

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