Anti dsDNA Antibodies Ellen O’Reilly

What are Anti dsDNA Antibodies? Anti dsDNA antibodies are a part of a group of antibodies against self called autoantibodies. They attack the double stranded DNA in the nucleus. They arise in patients with conditions such as lupus erythematosus. Figure 1: Rekvig O P (2015) The anti-DNA antibody: Origin and impact, dogmas and controversies , doi:10.1038/nrrheum.2015.69 , Nature reviews Rheumatology [accessed 13th February 2016]

Lupus Erythematosus Lupus can cause organ and muscle damage. Symptoms: Weight loss, Chest Pain, Fatigue, Fever, Nausea, Anaemia, and kidney disorders. The condition can affect any sex and age but is most common in women of childbearing age and can affect newborn babies. Two main types: Discoid Lupus Erythematosus and Systematic Lupus Erythematosus. Figure 2: Lupus Connection (2001) Types of Lupus [online] Available: http://lupusconnection.net/types-of-lupus/

Discoid Lupus Erythematous Chronic skin condition Red, inflamed sores, scaling and crusty appearance. Common on face, ears and scalp. If sores develop on an area with hair, baldness may occur. Can develop further and cause organ damage and serious illness (systematic lupus) Figure 3: American Osteopathic College of Dermatology, Discoid Lupus Erythematosus [online] Available: http://www.aocd.org/?page=DiscoidLupusErythe

Systematic Lupus Erythematosus Can develop from discoid form. Pain / loss of function in area affected. The brain and nervous system when affected can cause seizures and a behaviour change in the patient When the heart is affected it causes an irregular heartbeat Figure 4: RegenCenter (2015) Lupus [online] Available : http://www.regen-center.com/lupus.html

Rheumatic Arthritis Arthritis is the most common rheumatic disease. The term “rheumatism” is avoided by doctors as it is a broad term. Rheumatic arthritis most commonly affects the elderly. Figure 5: BelirtileriNelerdir (2015) Romatizma Belirtileri Nelerdir? [online] Available: http://belirtilerinelerdir.com/romatizma-belirtileri-nelerdir/ (translated by Google Chrome from Turkish)

Detection Urinalysis used as an initial detection method - determines requirement of further testing. Patient tests positive for anti- nuclear antibodies. Test for anti dsDNA antibodies is carried out. Anti dsDNA antibodies are detected in ~95% of systematic lupus cases. Anti-dsDNA tests often carried out alongside tests for other anti-nuclear antibodies. ELISA immunosorbent assay for arthritis. Figure 6: AACC (2016) ANA [online] Available: https://labtestsonline.org/understanding/analytes/ana/tab/glance/

Treatment Treatment of autoimmune disease is limited: either supress immune response or replace function of the damaged organ. Systemic Lupus Erythematosus can be treated with a number of drugs: Hydralazine, procainamide, D- Penicillamide, Minocycline (for acne). Hormone treatment may also be executed to treat Lupus.

References AACC (2016) ANA [online] Available: https://labtestsonline.org/understanding/analytes/ana/tab/glance/ Irish Lupus Support Group (2006) What is LUPUS? [online] Available: http://www.lupus.ie/what-is.htm American Osteopathic College of Dermatology, Discoid Lupus Erythematosus [online] Available: http://www.aocd.org/?page=DiscoidLupusErythe MedLine Plus (2016) Systemic Lupus erythematosus [online] Available: https://www.nlm.nih.gov/medlineplus/ency/article/000435.htm “Essentials of Clinical Immunology” fourth edition. Chapel, Haeney, Misbah, Snowden. 1999, Oxford, London. Cat. No. 0-632-04972-3 pages 95-107. American College of Rheumatology (2016) Managing Your Rheumatic Disease [online] Available: http://www.rheumatology.org/I-Am-A/Patient- Caregiver/Diseases-Conditions/Living-Well-with-Rheumatic-Disease/Managing- Your-Rheumatic-Disease Lupus Connection (2001) Types of Lupus [online] Available: http://lupusconnection.net/types-of-lupus/