간접면역형광법을 이용한 항핵항체검사에서 Dense Fine Speckled 양상의 임상적 의의
Clinical Significance of Dense Fine Speckled Pattern in Anti-nuclear Antibody Test using Indirect Immunofluorescence Method
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배경 : 최근 간접면역형광법을 이용한 항핵항체(ANA) 검사에 서 특징적인 dense fine speckled (DFS) 양상이 각종 만성염증 성질환 외에도 정상인에서까지 발견되는 것으로 알려졌다. 저자 들은 ANA 검사가 의뢰된 환자들에서 DFS 양상을 보이는 환자 들의 빈도를 조사하고, 임상과별 및 질환별로 DFS 양상을 보인 환자들을 분석하여 특정 질환과의 연관성이 있는지 살펴보고자 하였다. 방법 : 전신자가면역질환의 선별검사 목적으로 ANA 검사가 의뢰된 2,654명의 환자를 대상으로 HEp-2 세포 슬라이드(Kallestad TM; Bio-Rad, Redmond, WA, USA)를 사용한 간접면역 형광법으로 ANA 검사를 시행하였다. ANA 양성 및 DFS 양성 빈도를 성별, 연령별, 임상과별 및 질환별로 분석하였다. 결과 : 2,654명 중 DFS 양성은 101명(3.8%)으로 나타났고 이 는 ANA 양성(352명, 13.3%)의 28.7%인 것으로 나타났다. 임상 과 간 비교에서 DFS 양성 빈도는 류마티스내과 및 신장내과에 서 높았고, ANA 양성자 중 DFS 양성 빈도의 차이는 관찰되지 않았다. 피부과의 경우 지루피부염(14.3%) 및 대상포진(11.1%) 환자에서 DFS 양성 빈도가 높았고, 류마티스내과의 경우 류마 티스관절염(16.9%), 전신홍반루푸스(15.4%) 및 쇼그렌증후군 (14.3%)에서 DFS 양성 빈도가 높았다. 결론 : DFS 양상은 간접면역형광법을 이용한 ANA 검사에서 양성 건수의 약 28%를 차지할 정도로 빈번히 관찰되는 소견으 로 나타났다. DFS 양상과 자가면역질환과의 연관성이 없다는 기존의 보고와 달리 본 연구에서 높은 양성률을 보이므로 특정 질환과의 연관성 유무를 확인하기 anti-DFS70 확인검사를 포 함하는 연구가 뒤따라야 할 것으로 판단된다.
Abstract
Background : Dense fine speckled (DFS) pattern in antinuclear antibody (ANA) test using indirect immunofluorescence method became to be known recently and it is detected in patients with various chronic inflammatory diseases as well as in healthy individuals. We investigated the relation between DFS pattern and various diseases. Methods : ANA tests by indirect immunofluorescence method using HEp-2 cell line slide (Kallestad; Bio-Rad, USA) were performed in 2,654 patients for screening of systemic autoimmune diseases. The frequencies of ANA and DFS positivity were analyzed according to sex, age, clinical department and disease. Results : ANA was positive in 13.3% (352/2,654) of the total patients, and the frequency of DFS pattern was observed in 3.8% (101/2,654) of the total patients and in 28.7% (101/352) of the patients with ANA positivity. Higher frequency of DFS positivity was observed in patients referred from Departments of Rheumatology and Nephrology, but there was no difference in the frequencies of DFS positivity among the patients with ANA positivity. The frequency of DFS pattern was higher in seborrheic dermatitis (14.3%), herpes zoster (11.1%), rheumatoid arthritis (16.9%), systemic lupus erythematosus (15.4%) and Sjogren syndrome (14.3%). Conclusions : The DFS pattern is a frequent finding (about 28% of ANA positivity) in ANA test using indirect immunofluorescence method. Relatively high frequency of DFS pattern was observed in autoimmune diseases, contrary to the previous observations that DFS pattern is not related with autoimmune diseases. Further studies including the confirmation tests of anti-DFS70 are needed for the identification of relation between DFS pattern and particular diseases.
참고문헌 (15)
- Ganapathy V, "Autoimmunity to the nuclear autoantigen DFS70 (LEDGF): what exactly are the autoantibodies trying to tell us?", Arthritis Rheum, 50, pp.684~688 (2004)
- Ochs RL, "Autoantibodies to DFS 70 kd", transcription coactivator p75 in atopic dermatitis and other conditions, 2000, pp.105, 1211~1220
- Ge H, "Isolation of cDNAs encoding novel transcription coactivators p52 and p75 reveals an alternate regulatory mechanism of transcriptional activation", EMBO J, 17, pp.6723~6729 (1998)
- Singh DP, "Lens epithelium-derived growth factor: effects on growth and survival of lens epithelial cells, keratinocytes, and fibroblasts", Biochem Biophys Res Commun, 267, pp.373~381 (2000)
- Sugiura K, "LEDGF", DFS70, a major autoantigen of atopic dermatitis, is a component of keratohyalin granules, 2007, pp.127, 75~80
- Ochs RL, "Tan EM. Autoantibodies in interstitial cystitis", J Urol, 151, pp.587~592 (1994)
- Watanabe A, "Anti-DFS70 antibodies in 597 healthy hospital workers", Arthritis Rheum, 50, pp.892~900 (2004)
- Dellavance A, "The clinical spectrum of antinuclear antibodies associated with the nuclear dense fine speckled immunofluorescence pattern", J Rheumatol, 32, pp.2144~2149 (2005)
- Shinohara T, "LEDGF, a survival factor, activates stress-related genes", Prog Retin Eye Res, 21, pp.341~358 (2002)
- Maertens G, "LEDGF", p75 is essential for nuclear and chromosomal targeting of HIV-1 integrase in human cells, 2003, pp.278, 33528~33539
- Okamoto M, "Autoantibodies to DFS70", LEDGF are increased in alopecia areata patients, 2004, pp.23, 257~266
- Yamada K, "Humoral immune response directed against LEDGF in patients with VKH", Immunol Lett, 78, pp.161~168 (2001)
- Daniels T, "Antinuclear autoantibodies in prostate cancer: immunity to LEDGF", p75, a survival protein highly expressed in prostate tumors and cleaved during apoptosis, 2005, pp.62, 14~26
- Muro Y, "High concomitance of disease marker autoantibodies in anti-DFS70", LEDGF autoantibodypositive patients with autoimmune rheumatic disease, 2008, pp.17, 171~176
- Bizzaro N, "Antibodies to the lens and cornea in anti-DFS70-positive subjects", Ann N Y Acad Sci, 1107, pp.174~183 (2007)