From the Guidelines
Anti-dsDNA antibodies are a crucial diagnostic and monitoring tool for systemic lupus erythematosus (SLE), and their measurement is recommended at baseline and for re-evaluation in previously negative patients, particularly for assessing disease activity and predicting flares, as suggested by the most recent expert panel recommendations 1.
Importance of Anti-dsDNA Antibodies in SLE
Anti-dsDNA antibodies are highly specific for SLE, with approximately 70-80% of SLE patients testing positive for them. The presence of these antibodies is one of the diagnostic criteria for SLE and is included in both the American College of Rheumatology and Systemic Lupus International Collaborating Clinics classification criteria.
Diagnostic and Monitoring Value
These antibodies are particularly associated with lupus nephritis, and rising titers often correlate with disease activity or flares. Testing for anti-dsDNA antibodies is typically done using enzyme-linked immunosorbent assay (ELISA), Crithidia luciliae immunofluorescence test (CLIFT), or radioimmunoassay methods.
Clinical Recommendations
According to recent guidelines, monitoring of anti-dsDNA antibodies, along with other autoantibodies and complement levels, is recommended at baseline and for re-evaluation in previously negative patients, especially for assessing disease activity and predicting flares 1. This approach is supported by expert recommendations for the management of SLE patients, emphasizing the importance of regular assessments and monitoring to improve patient outcomes 1.
Key Points for Clinical Practice
- Anti-dsDNA antibodies are a valuable tool in the diagnosis and management of SLE.
- Monitoring anti-dsDNA levels can help assess treatment response and predict disease flares.
- Regular assessments, including the measurement of anti-dsDNA antibodies, are crucial for improving patient outcomes in SLE.
From the Research
Anti-dsDNA Antibodies
- Anti-dsDNA antibodies are a type of autoantibody associated with systemic lupus erythematosus (SLE) 2, 3, 4, 5, 6
- They are part of the classification criteria for SLE and are recommended for monitoring SLE with regards to lupus flares and therapy responses 2, 4, 5
- However, the performance of anti-dsDNA antibodies as a biomarker is weak, and coupling them with anti-chromatin antibodies can be proposed to improve monitoring 2
Clinical Significance
- Anti-dsDNA antibodies are correlated with disease activity, lupus nephritis, and serositis in SLE patients 2, 3, 6
- The levels of anti-dsDNA antibodies can be used to predict flares and monitor therapeutic response in SLE patients 2, 3, 6
- The presence of anti-dsDNA antibodies is not specific to SLE and can be found in other autoimmune diseases 3, 5
Measurement and Monitoring
- Anti-dsDNA antibodies can be measured using various assays, including enzyme-linked immunosorbent assay (ELISA) and automated immunofluorescence assay 4, 6
- The choice of assay can affect the results, and some assays may be more useful for monitoring SLE activity than others 6
- Regular monitoring of anti-dsDNA antibodies can help identify changes in disease activity and guide treatment decisions 2, 3, 6