From the Guidelines
Double-stranded DNA (dsDNA) antibodies in AB serum testing are important markers for autoimmune diseases, particularly systemic lupus erythematosus (SLE), and a positive result indicates the presence of antibodies targeting double-stranded DNA, which is highly specific for SLE diagnosis. If you've received a positive result, consult with a rheumatologist promptly for proper evaluation. The test is typically performed using enzyme-linked immunosorbent assay (ELISA) or immunofluorescence techniques, with results reported as positive/negative or as a titer.
Key Points to Consider
- Treatment depends on the underlying condition but often includes hydroxychloroquine (200-400mg daily), corticosteroids like prednisone (5-60mg daily depending on severity), or immunosuppressants such as azathioprine (50-150mg daily) or mycophenolate mofetil (1-3g daily) 1.
- Regular monitoring of dsDNA antibody levels helps track disease activity and treatment response, as these antibodies form immune complexes that deposit in tissues, particularly kidneys, causing inflammation and organ damage, which explains their association with more severe disease manifestations like lupus nephritis 1.
- The use of anti-dsDNA antibodies in SLE diagnosis and monitoring is supported by recent guidelines, including those from the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) 1.
Important Considerations for Diagnosis and Monitoring
- A double-screening strategy using a last-generation SPA in the first place, and subsequently, the CLIFT as the confirmation test, is recommended for anti-dsDNA testing 1.
- In the event of a negative anti-dsDNA SPA result, a confirmatory CLIFT should be done only when other signs of clinical suspicion are present, and without clinical suspicion, the result should be reported directly as negative anti-dsDNA 1.
- The laboratory should include the method used in their reports, and if several methods are used, the results obtained with each method should be reported 1.
Treatment and Management
- Treatment should be individualized based on the patient's specific condition, disease activity, and response to therapy, and may involve a combination of medications, including hydroxychloroquine, corticosteroids, and immunosuppressants 1.
- Regular monitoring of disease activity, organ damage, and treatment response is crucial to optimize patient outcomes and minimize the risk of complications 1.
From the Research
Dsdna AB Serum
- Dsdna AB serum is related to Systemic Lupus Erythematosus (SLE), a chronic autoimmune disease characterized by inflammation and immune-mediated injury to multiple organ systems 2.
- Anti-dsDNA antibodies are part of the classification criteria and recommended for monitoring SLE with regards to lupus flares and therapy responses 3.
- The autoimmune response to chromatin or one of the nucleosome components (double stranded (ds)DNA and histones) is typically associated with the development of SLE 3.
- Coupling anti-dsDNA with anti-Chr Ab can be proposed to define endotypes, which is useful to follow disease activity, predict lupus nephritis/serositis, and anticipate therapeutic response in the DP+ group 3.
Treatment and Management
- Hydroxychloroquine should be administered to every lupus patient irrespective of organ involvement 4.
- Conventional immunosuppressive therapy includes corticosteroids, methotrexate, cyclophosphamide, mycophenolate mofetil, azathioprine, cyclosporine, and tacrolimus 4.
- Biologic agents targeting various pathogenetic paths have been applied, including belimumab, rituximab, and anifrolumab 4, 2.
- The primary goal of treatment is to achieve disease remission or quiescence, defined by minimal symptoms, low levels of autoimmune inflammatory markers, and minimal systemic glucocorticoid requirement 2.
Anti-dsDNA Antibodies
- Anti-dsDNA antibodies have been suggested to contribute to multiple end-organ injuries, especially to lupus nephritis, in patients with SLE 5.
- Serum levels of anti-DNA antibodies fluctuate with disease activity in patients with SLE 5.
- Anti-dsDNA antibodies can accumulate in the glomerular and tubular basement membrane, trigger the complement cascade, penetrate into living cells, modulate gene expression, and even induce profibrotic phenotypes of renal cells 5.