Background
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease characterized by abnormal activity of the immune system with a wide range of clinical manifestations including renal, cutaneous, neuropsychiatric and cardiovascular symptoms. Biomarkers play a crucial role in the diagnosis of SLE, classification of SLE complications, assessment of SLE disease activity, and reflection of the efficacy of SLE interventional therapy. The diagnosis and classification of SLE is based on the patient's clinical symptoms, signs and laboratory biomarkers reflecting immune reactivity and inflammation in various organs. However, because SLE can cause multi-organ damage, complex pathogenesis, and heterogeneity of clinical manifestations, a particular biomarker may reflect only a specific aspect of SLE, but not the overall state of the disease.
Figure 1. Common biomarkers for SLE and their measurement sites in patients with SLE
(Source: Yu H, et al. 2021)
Defective clearance of apoptotic and necrotic cells as well as defective degradation of NETosis (neutrophil extracellular traps) may play a crucial role in SLE, where autoantigens contain nuclear material released from the dead cells described above, which are exposed to antigen-presenting cells (APCs), processed by the APCs, and then presented to the autoreactive T cells or B cells. In this process, dysregulation of multiple immune pathways, secretion of pro-inflammatory cytokines, autoantibody production and activation of the complement system ultimately lead to loss of autoimmune tolerance. Anti-dsDNA antibody is one of the most widely used SLE biomarkers and an organ-specific SLE biomarker that assesses, monitors, or predicts organ-specific damage in SLE patients, especially with strong correlation to lupus nephritis, which contributes to organ-specific precision medicine in SLE patients. Anti-DNA antibody binds directly to DNA antigen or cross-reactive antigen in renal cells and indirectly forms an immune complex containing anti-dsDNA antibody in the renal parenchyma, which triggers a complement cascade reaction accompanied by infiltration of immune cells and release of cytokines, thereby inducing renal inflammatory and fibrotic processes.
Anti-dsDNA antibodies are associated with SLE disease activity, so their levels fluctuate over time. Anti-dsDNA antibodies may disappear during treatment but reappear during flares, especially in active nephritis. Anti-dsDNA antibodies are highly specific for SLE (96%) but have low diagnostic sensitivity (52%-70%) due to the brief time of presentation. The reasons for changes in anti-dsDNA antibody levels in vivo may be due to the following reasons: first, antibody concentrations vary with the timing of pathological changes in SLE, or non-nephropathic episodes are not always accompanied by anti-dsDNA antibodies; second, the antibodies may be deposited in renal tissues and undetectable in serum, or the detection techniques may not be sufficiently sensitive and specific; third, not all subclasses of anti-dsDNA antibodies are pathogenic and are associated with disease activity and nephropathy.
Alternative Names
double-stranded DNA IgG ELISA Kit
References
- 1. Yu H, et al. Clinical and Immunological Biomarkers for Systemic Lupus Erythematosus. Biomolecules. 2021 Jun 22;11(7):928.
- 2. Wang Y, et al. The Therapeutic Strategies for SLE by Targeting Anti-dsDNA Antibodies. Clin Rev Allergy Immunol. 2022 Oct;63(2):152-165.