抗核抗体在儿科临床诊断中的价值(二)

Q4 Medicine

Pediatriya - Zhurnal im G.N. Speranskogo Pub Date : 2023-04-21 DOI:10.24110/0031-403x-2023-102-2-78-89

N. S. Podchernyaeva, M. Osminina, E. Frolkova, M. Kudryashova, M. Gripp, N. Golovanova

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引用次数: 0

摘要

抗核抗体(anti - nuclear antibodies, ANA)是一组针对细胞核、核膜、有丝分裂器、细胞质成分和细胞器以及细胞膜等各种细胞结构的自身抗体，有200多个品种。ANA最早在系统性红斑狼疮(SLE)患者中发现，ANA阳性被认为是其诊断标准。然而，ANA在其他系统性风湿病患者和健康人群中都非常常见，这决定了其特异性相对较低。确定患者的抗体谱对于诊断目的具有更重要的意义，因为一些ANA具有相当高的特异性，主要与单一疾病相关，例如SLE的DNA抗体和抗sm抗体，拓扑异构酶I抗体和系统性硬皮病和CREST综合征的着丝粒抗体。一些类型的ANA与系统性自身免疫性风湿性疾病(SARDs)的变体/亚型之间的关联以及对各器官和系统的损害风险，以及该组疾病的病程和预后的特点已经被确立，这扩大了对这些自身抗体的临床和诊断意义的认识。发现新的和进一步研究已知类型的ANA的作用将改善SARDs的诊断和靶向治疗的发展。

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CLINICAL AND DIAGNOSTIC VALUE OF ANTINUCLEAR ANTIBODIES IN A PEDIATRIC PHYSICIAN’S PRACTICE (PART 2)

Antinuclear antibodies (ANA) are a group of autoantibodies directed against various cell structures such as nucleus, nuclear membrane, mitotic apparatus, components of the cytoplasm and organelles of the cell as well as cell membranes, which has more than 200 varieties. ANA were first discovered in patients with systemic lupus erythematosus (SLE), and ANA-positivity is considered as its diagnostic criterion since then. However, ANA are found highly frequently both in patients with other systemic rheumatic diseases and in healthy people, which determines their relatively low specificity. Determination of the patient's antibody profile is of a greater importance for diagnostic purposes since some ANA are quite highly specific and associated mainly with a single disease e.g., antibodies (abs) to DNA and anti-Sm abs in SLE, abs to topoisomerase I and abs to the centromere with systemic scleroderma and the CREST syndrome. Associations of some types of ANA with variants/subtypes of systemic autoimmune rheumatic diseases (SARDs) with the risk of damage to various organs and systems, the features of the course and prognosis of diseases in this group have been established, which expanded the understanding of the clinical and diagnostic significance of these autoantibodies. The identification of new and further study of the role of already known types of ANA will improve the diagnosis and development of the SARDs’ targeted therapy.

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来源期刊

Pediatriya - Zhurnal im G.N. Speranskogo Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.60

自引率

0.00%

发文量

150

期刊介绍： Journal “Pediatria” named after G.N. Speransky (the official short names of the Journal are “Journal «Pediatria»,” “Pediatria,” and “«Pediatria,» the Journal”) is the oldest Soviet-and-Russian (in the Russian Federation, the CIS and former Soviet Union) scientific and practical medical periodical assigned for pediatricians that is published continuously since May, 1922, and distributed worldwide. Our mission statement specifies that we aim to the ‘raising the level of skills and education of pediatricians, organizers of children’s health protection services, medicine scientists, lecturers and students of medical institutes for higher education, universities and colleges worldwide with an emphasis on Russian-speaking audience and specific, topical problems of children’s healthcare in Russia, the CIS, Baltic States and former Soviet Union Countries and their determination with the use of the World’s best practices in pediatrics.’ As part of this objective, the Editorial of the Journal «Pediatria» named after G.N. Speransky itself adopts a neutral position on issues treated within the Journal. The Journal serves to further academic discussions of topics, irrespective of their nature - whether religious, racial-, gender-based, environmental, ethical, political or other potentially or topically contentious subjects. The Journal is registered with the ISSN, - the international identifier for serials and other continuing resources, in the electronic and print world: ISSN 0031-403X (Print), and ISSN 1990-2182 (Online). The Journal was founded by the Academician, Dr. Georgiy Nestorovich SPERANSKY, in May, 1922. Now (since 1973) the Journal bears his honorary name.