What are the implications of double-stranded DNA (dsDNA) antibodies (AB) in serum?

From the Guidelines

Anti-dsDNA antibodies are a crucial diagnostic and monitoring tool for systemic lupus erythematosus (SLE), and their detection in serum is essential for diagnosing and managing the disease. Testing for these antibodies is primarily used to help diagnose SLE and monitor disease activity, as they are a hallmark of the autoimmune process in lupus [ 1 ]. The level of anti-dsDNA antibodies often correlates with disease activity, making it useful for monitoring treatment response.

Key Points to Consider

• Anti-dsDNA antibodies are specific autoantibodies found in patients with SLE, and their detection is essential for diagnosing and managing the disease [ 1 ].
• The test measures antibodies that target double-stranded DNA, which can deposit in tissues, particularly the kidneys, leading to inflammation and organ damage.
• The level of anti-dsDNA antibodies often correlates with disease activity, making it useful for monitoring treatment response [ 1 ].
• However, not all lupus patients will have positive anti-dsDNA results, and the test should be interpreted alongside other clinical and laboratory parameters.

Recommendations for Clinical Practice

• If anti-dsDNA antibodies are detected, further evaluation by a rheumatologist is recommended for proper diagnosis and management of potential SLE [ 1 ].
• The European League Against Rheumatism recommends monitoring anti-dsDNA antibodies, as well as other autoantibodies and complement levels, to assess disease activity and guide treatment decisions [ 1 ].
• Regular assessments, including laboratory tests and clinical evaluations, are essential for monitoring disease activity and preventing complications in patients with SLE [ 1 ].

Conclusion is not allowed, so the answer ends here.

From the Research

Dsdna AB Serum

• Dsdna AB serum is associated with systemic lupus erythematosus (SLE), a chronic autoimmune disease characterized by inflammation and immune-mediated injury to multiple organ systems 2.
• The presence of anti-dsDNA antibodies is one of the classification criteria for SLE and is recommended for monitoring SLE with regards to lupus flares and therapy responses 3.
• However, anti-dsDNA antibody biomarker performances are weak, and coupling anti-dsDNA with anti-Chr Ab can be proposed to improve monitoring of SLE patients 3.
• Studies have shown that patients with positive anti-dsDNA antibodies are at risk of developing lupus nephritis and serositis, and that disease activity is correlated with both anti-dsDNA and anti-Chr Ab levels 3.
• Hydroxychloroquine is a standard treatment for SLE and has been associated with a significant reduction in mortality, and may also reduce the risk of flares and allow the reduction of the dosage of steroids 2, 4.
• Other diseases, such as rheumatological disorders, infections, and malignancy, can also be associated with positive anti-dsDNA antibodies, and a statistically significant association between highly positive anti-dsDNA testing and rheumatological disorders has been found 5.

Associated Diseases

• SLE is the most common disease associated with positive anti-dsDNA antibodies, but other diseases such as:
  • Rheumatological disorders (e.g. antiphospholipid antibody syndrome, autoimmune hepatitis) 5
  • Infections (e.g. tuberculosis, osteomylitis) 5
  • Malignancy (e.g. thymoma, lymphoma, sarcoidosis) 5 can also be associated with positive anti-dsDNA antibodies.

Monitoring and Treatment

• Monitoring of SLE patients with anti-dsDNA antibodies can be improved by coupling anti-dsDNA with anti-Chr Ab 3.
• Hydroxychloroquine is a standard treatment for SLE and may also reduce the risk of flares and allow the reduction of the dosage of steroids 2, 4.
• Other treatments, such as azathioprine and mycophenolate mofetil, can be used in addition to hydroxychloroquine to treat moderate to severe SLE 2, 6.