The British Journal of Rheumatology, Vol 37, 15-20, Copyright © 1998 by British Society for Rheumatology
CC Bunn, CP Denton, X Shi-Wen, C Knight and CM Black
Sera from 735 patients with systemic sclerosis were classified according to
antinuclear antibody (ANA) pattern as follows: centromere (25%),
homogeneous (26%), fine speckled (21%), fine speckled with nucleolar (14%),
coarse speckled (7%), nucleolar only (3%) and cytoplasmic only (3%).
Immunoprecipitations using 35S-labelled HeLa cell antigen extract were
performed using sera from 374 of these patients to detect the systemic
sclerosis-specific antibodies to RNA polymerases I and III. The sera were
selected to represent each ANA group, but focused on those giving fine
speckled nucleoplasmic staining (with or without nucleolar staining) where
all 86 sera positive for these antibodies were concentrated.
Immunoprecipitates from a further 93 sera from patients with ANA-positive
autoimmune diseases other than systemic sclerosis did not precipitate RNA
polymerases. In addition, all sera were tested for antibodies to the
extractable nuclear antigens topoisomerase I, nRNP, Ro, La and PM-Scl. Sera
positive for antibodies to these antigens gave clear correlations with ANA
patterns but, of the examples tested, none contained antibodies
precipitating RNA polymerase I or III. Thus, sera containing antibodies to
RNA polymerases I and III were exclusive of both anticentromere and
anti-topoisomerase I, and formed a major serological subgroup (11.7%).
Clinically, 77% were patients with diffuse cutaneous disease reflected by
higher skin scores and a significantly higher incidence of renal
involvement (33%) than patients with antibodies to topoisomerase I (3%).
ORIGINAL PAPERS
Anti-RNA polymerases and other autoantibody specificities in systemic sclerosis
Department of Clinical Immunology, Royal Free Hospital, London.
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