Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease characterized by antinuclear antibody (ANA) production. ANAs bind to DNA, RNA and complexes of proteins and nucleic acids and are important markers for diagnosis and activity. According to current models, ANAs originate from antigen-driven processes; nevertheless, antibody responses to both DNA and RNA binding proteins display features unexpected in terms of current paradigms for antigenicity. These differences may reflect disturbances in both B and T cells critical for autoreactivity. Clinically, ANA testing has new uses for determining classification as well as assessing eligibility for clinical trials. Studies of patients with established disease show frequent seronegativity. In this setting, seronegativity may indicate a stage of disease called post-autoimmunity in which the natural history of disease or effects of immunosuppressive therapies modifies responses. The new uses of ANA testing highlight the importance of understanding autoantigenicity and developing sensitive and informative assays for clinical assessments.

中文翻译：

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系统性红斑狼疮自身抗体的演变故事。

系统性红斑狼疮（SLE）是一种典型的自身免疫性疾病，其特征是产生抗核抗体（ANA）。ANA 与 DNA、RNA 以及蛋白质和核酸复合物结合，是诊断和活性的重要标记。根据目前的模型，ANA 起源于抗原驱动的过程；然而，抗体对 DNA 和 RNA 结合蛋白的反应显示出当前抗原性范式中意想不到的特征。这些差异可能反映了对自身反应至关重要的 B 细胞和 T 细胞的干扰。在临床上，ANA 测试在确定分类以及评估临床试验资格方面有了新的用途。对已确诊疾病的患者的研究表明，血清反应经常呈阴性。在这种情况下，血清阴性可能表明疾病的一个阶段，称为自身免疫后，其中疾病的自然史或免疫抑制治疗的效果改变了反应。ANA 检测的新用途凸显了了解自身抗原性和开发敏感且信息丰富的临床评估检测方法的重要性。