title: Clinical applications of the indirect immunofluorescence assay for detection of anticell membrane-associated DNA antibodies in juvenile systemic lupus erythematosus.
abstract: BACKGROUND
  Juvenile-onset systemic lupus erythematosus (JSLE) has a higher mortality risk compared to adult-onset SLE. We compared the diagnostic value of anti-cmDNA antibodies with that of antinucleosome antibodies (AnuA), anti-Sm antibodies, and anti-dsDNA antibodies and human B lymphocyte Raji cells with that of human promyelocytic leukemia HL60 cells as substrates in an indirect immunofluorescence assay to detect anti-cmDNA antibodies in JSLE patients.
  
  
  METHODS
  We recruited 92 JSLE patients and 71 patients with other juvenile-onset rheumatic diseases. Anti-cmDNA antibodies and antinuclear antibodies (ANA) were detected in patient sera using indirect immunofluorescence assays. Anti-dsDNA antibodies were detected by combining ELISA and indirect immunofluorescence. Anti-Sm antibodies were detected by double immunodiffusion assay and immunoblotting, while AnuA were detected by ELISA.
  
  
  RESULTS
  The JSLE group had a significantly higher percentage of patients positive for anti-cmDNA compared to patients with other rheumatoid diseases. Using one antibody for diagnosis, anti-cm DNA antibodies had the highest accuracy at 84.0%; using two antibodies, the combination of anti-cm DNA and anti-dsDNA antibodies had 90.8% accuracy. Raji cells used as substrate demonstrated a stronger intensity of fluorescent patterns compared to HL60 cells.
  
  
  CONCLUSIONS
  The high sensitivity, specificity, and accuracy of detection of anti-cmDNA antibodies make it a valuable diagnostic tool for JSLE.
authors.affiliation: Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China.
authors.forename: Jin-li
authors.initials: JL
authors.lastname: Ru
authors.affiliation: Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China.
authors.forename: Xiao-xiang
authors.initials: XX
authors.lastname: Xie
authors.affiliation: Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China.
authors.forename: Guo-zhu
authors.initials: GZ
authors.lastname: Che
authors.affiliation: Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China.
authors.forename: Chuan-fang
authors.initials: CF
authors.lastname: Cheng
authors.affiliation: Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China.
authors.forename: Hua-ming
authors.initials: HM
authors.lastname: Zhao
authors.affiliation: Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China.
authors.forename: Zhi-yong
authors.initials: ZY
authors.lastname: Jin
authors.affiliation: Department of Rheumatology and Immunology, The 264th Hospital of Chinese People's Liberation Army, Taiyuan, China.
authors.forename: Hui-ping
authors.initials: HP
authors.lastname: Sun
authors.affiliation: Department of Rheumatology and Immunology, The Second Hospital of Shanxi Medical University, Taiyuan, China.
authors.forename: Xiao-feng
authors.initials: XF
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000974:Antibodies, Antinuclear / Q000097:blood; D001402:B-Lymphocytes; D002462:Cell Membrane / Q000276:immunology; D002648:Child; D002681:China; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect / Q000379:methods*; D018922:HL-60 Cells; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000276:immunology*; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
chemical_list: D000974:Antibodies, Antinuclear