Antinuclear autoantibodies in systemic lupus erythematosus

The production of autoantibodies against nuclear antigens is the hallmark of systemic lupus erythematosus. Among the large number of autoantibodies known, only a limited number appear to be clinically important. The various autoantibodies have different clinical significance in lupus patients. In this review, we will discuss the various antinuclear autoantibodies detected in lupus patients, their potential pathogenic role, and their usefulness in clinical practice.

Recent advances include the clear demonstration of autoantibody transport into living cells, a process that clearly includes interactions with a number of cellular components that may play a role in cellular dysfunction and disease. Also, the anti-Sm B/B' response originates from a single antigenic epitope that appears to be the same structure in different patients, before spreading to other epitopes and becoming the typically mature, complex humoral autoimmune anti-Sm autoantibody response.

The existing data strongly support a central role of autoantibodies in the pathogenesis of lupus. Better characterization of autoantibodies, their mechanisms of production, and their interactions with various cellular constituents will clarify the pathogenesis of this disease.