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Antinuclear and Anti-Single-Stranded DNA Antibodies in Morphea and Generalized Morphea

Antinuclear and Anti-Single-Stranded DNA Antibodies in Morphea and Generalized Morphea Abstract • The clinical features of localized scleroderma have allowed investigators to distinguish three morphologic variants: morphea, generalized morphea, and linear scleroderma. The latter has been reported to have a higher frequency of antinuclear antibodies and has been associated with antibodies to single-stranded DNA (ssDNA). In this study we determined the frequency of antinuclear antibodies and anti-ssDNA antibodies in 22 patients with morphea or generalized morphea. None had Raynaud's phenomenon or evidence of a systemic connective-tissue disease. Antinuclear antibodies were present in 18% of patients when serum samples were tested on mouse kidney substrate but were found in 50% of HEp-2 cells. The serum samples contained anti-ssDNA antibodies in 59% of the patients, with the highest levels of ssDNA binding observed in patients with generalized morphea. The frequency of antibodies to ssDNA was higher in patients with clinical evidence of active compared with inactive disease. Discordance in immune reactivity indicates that at least three distinctive serum autoantibodies exist in morphea and generalized morphea: anti-ssDNA antibodies and antinuclear antibodies with either homogeneous or speckled immunofluorescence patterns. These findings are similar to those recently described in linear scleroderma and suggest that comparable serum autoantibody abnormalities are present in all the variants of localized scleroderma. (Arch Dermatol 1987;123:350-353) References 1. Rodnan GP: When is scleroderma not scleroderma? Bull Rheum Dis 1981;31:7-10. 2. LeRoy EC: Systemic sclerosis , in Kelly WN, Harris ED Jr, Ruddy S, et al (eds): Textbook of Rheumatology . Philadelphia, WB Saunders Co, 1981, pp 1211-1230. 3. Tuffanelli DL, Winkelmann RK: Systemic scleroderma . Arch Dermatol 1955;84:359-371.Crossref 4. Christianson HB, Dorsey CS, O'Leary PA, et al: Localized scleroderma: A clinical study of 235 cases . Arch Dermatol 1956; 74:629-639.Crossref 5. Mackel SE, Kozin F, Ryan LM, et al: Concurrent linear scleroderma and systemic lupus erythematosus: A report of two cases . J Invest Dermatol 1979;73:368-372.Crossref 6. Dubois EL, Chandoz S, Friou GJ, et al: Progressive systemic sclerosis (PSS) and localized scleroderma (morphea) with positive LE cell test and unusual systemic manifestations compatible with systemic lupus erythematosus (SLE) . Medicine 1971;50:199-222.Crossref 7. Curtis AC, Jansen TG: The prognosis of localized scleroderma . Arch Dermatol 1958;78:749-756.Crossref 8. Rowell NR, Beck JS: The diagnostic value of an antinuclear antibody test in clinical dermatology . Arch Dermatol 1967;96:290-295.Crossref 9. Barthelmes H: Das Verhalten der antinuklearen Faktoren bei Sklerodermie . Dermatol Monatsschr 1975;161:536-544. 10. Takehara K, Morol Y, Nakabayashi Y, et al: Antinuclear antibodies in localized scleroderma . Arthritis Rheum 1983;26:612-616.Crossref 11. Falanga V, Medsger TA Jr, Reichlin M: The prognostic value of blood eosinophilia and anti-ssDNA antibodies in linear scleroderma , abstracted. Arthritis Rheum 1985;28:185. 12. Falanga V, Medsger TA Jr, Reichlin M, et al: Linear scleroderma: Clinical spectrum, prognosis and laboratory abnormalities . Ann Intern Med 1986;104:849-857.Crossref 13. Falanga V, Medsger TA Jr, Reichlin M: High titers of antibodies to single-stranded DNA in linear scleroderma . Arch Dermatol 1985;121:345-347.Crossref 14. Mattioli M, Reichlin M: Characterization of a soluble ribonucleoprotein antigen active with SLE sera . J Immunol 1971; 107:1281-1290. 15. Commerford SL: Iodination of nucleic acids in vitro . Biochemistry 1971;11:1993-1999.Crossref 16. Wold RT, Young FE, Tan EM, et al: Deoxyribonucleic acid antibody: A method to detect its primary interaction with deoxyribonucleic acid . Science 1968;161:806-807.Crossref 17. Woo TY, Rasmussen JE: Childhood linear scleroderma associated with serologic abnormalities . Arch Dermatol 1985; 121:1403-1405.Crossref 18. Bourgeois-Droin C, Touraine R: Sclerodermie en plaques: Perturbations immunologiques et viscerales . Ann Med Interne 1978;129:107-112. 19. Burnham TK, Neblett TR, Fine G, et al: The immunofluorescent tumor imprint technique: IV. The significance of `thready' nuclear immunofluorescence . Arch Dermatol 1969;99:611-616.Crossref 20. Rodnan GP, Lipinski E, Rabin BS, et al: Eosinophilia and serologic abnormalities in linear localized scleroderma , abstracted. Arthritis Rheum 1977;20:133.Crossref 21. Sontheimer RD, Deng JS, Gilliam JN: Antinuclear and anticytoplasmic antibodies . J Am Acad Dermatol 1983;9:335-343.Crossref 22. Arana R, Seligmann M: Antibodies to native and denatured deoxyribonucleic acid in systemic lupus erythematosus . J Clin Invest 1967;46:1867-1870.Crossref 23. Wasicek CA, Maddison PJ, Reichlin M: Occurrence of antibodies to ssDNA in ANA negative patients . Clin Exp Immunol 1979;37:190-195. 24. Lange A: Evaluation of the simultaneous estimation of anti-ssDNA and anti-dsDNA antibodies for clinical purposes . Clin Exp Immunol 1978;31:472-481. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Antinuclear and Anti-Single-Stranded DNA Antibodies in Morphea and Generalized Morphea

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1987.01660270088021
Publisher site
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Abstract

Abstract • The clinical features of localized scleroderma have allowed investigators to distinguish three morphologic variants: morphea, generalized morphea, and linear scleroderma. The latter has been reported to have a higher frequency of antinuclear antibodies and has been associated with antibodies to single-stranded DNA (ssDNA). In this study we determined the frequency of antinuclear antibodies and anti-ssDNA antibodies in 22 patients with morphea or generalized morphea. None had Raynaud's phenomenon or evidence of a systemic connective-tissue disease. Antinuclear antibodies were present in 18% of patients when serum samples were tested on mouse kidney substrate but were found in 50% of HEp-2 cells. The serum samples contained anti-ssDNA antibodies in 59% of the patients, with the highest levels of ssDNA binding observed in patients with generalized morphea. The frequency of antibodies to ssDNA was higher in patients with clinical evidence of active compared with inactive disease. Discordance in immune reactivity indicates that at least three distinctive serum autoantibodies exist in morphea and generalized morphea: anti-ssDNA antibodies and antinuclear antibodies with either homogeneous or speckled immunofluorescence patterns. These findings are similar to those recently described in linear scleroderma and suggest that comparable serum autoantibody abnormalities are present in all the variants of localized scleroderma. (Arch Dermatol 1987;123:350-353) References 1. Rodnan GP: When is scleroderma not scleroderma? Bull Rheum Dis 1981;31:7-10. 2. LeRoy EC: Systemic sclerosis , in Kelly WN, Harris ED Jr, Ruddy S, et al (eds): Textbook of Rheumatology . Philadelphia, WB Saunders Co, 1981, pp 1211-1230. 3. Tuffanelli DL, Winkelmann RK: Systemic scleroderma . Arch Dermatol 1955;84:359-371.Crossref 4. Christianson HB, Dorsey CS, O'Leary PA, et al: Localized scleroderma: A clinical study of 235 cases . Arch Dermatol 1956; 74:629-639.Crossref 5. Mackel SE, Kozin F, Ryan LM, et al: Concurrent linear scleroderma and systemic lupus erythematosus: A report of two cases . J Invest Dermatol 1979;73:368-372.Crossref 6. Dubois EL, Chandoz S, Friou GJ, et al: Progressive systemic sclerosis (PSS) and localized scleroderma (morphea) with positive LE cell test and unusual systemic manifestations compatible with systemic lupus erythematosus (SLE) . Medicine 1971;50:199-222.Crossref 7. Curtis AC, Jansen TG: The prognosis of localized scleroderma . Arch Dermatol 1958;78:749-756.Crossref 8. Rowell NR, Beck JS: The diagnostic value of an antinuclear antibody test in clinical dermatology . Arch Dermatol 1967;96:290-295.Crossref 9. Barthelmes H: Das Verhalten der antinuklearen Faktoren bei Sklerodermie . Dermatol Monatsschr 1975;161:536-544. 10. Takehara K, Morol Y, Nakabayashi Y, et al: Antinuclear antibodies in localized scleroderma . Arthritis Rheum 1983;26:612-616.Crossref 11. Falanga V, Medsger TA Jr, Reichlin M: The prognostic value of blood eosinophilia and anti-ssDNA antibodies in linear scleroderma , abstracted. Arthritis Rheum 1985;28:185. 12. Falanga V, Medsger TA Jr, Reichlin M, et al: Linear scleroderma: Clinical spectrum, prognosis and laboratory abnormalities . Ann Intern Med 1986;104:849-857.Crossref 13. Falanga V, Medsger TA Jr, Reichlin M: High titers of antibodies to single-stranded DNA in linear scleroderma . Arch Dermatol 1985;121:345-347.Crossref 14. Mattioli M, Reichlin M: Characterization of a soluble ribonucleoprotein antigen active with SLE sera . J Immunol 1971; 107:1281-1290. 15. Commerford SL: Iodination of nucleic acids in vitro . Biochemistry 1971;11:1993-1999.Crossref 16. Wold RT, Young FE, Tan EM, et al: Deoxyribonucleic acid antibody: A method to detect its primary interaction with deoxyribonucleic acid . Science 1968;161:806-807.Crossref 17. Woo TY, Rasmussen JE: Childhood linear scleroderma associated with serologic abnormalities . Arch Dermatol 1985; 121:1403-1405.Crossref 18. Bourgeois-Droin C, Touraine R: Sclerodermie en plaques: Perturbations immunologiques et viscerales . Ann Med Interne 1978;129:107-112. 19. Burnham TK, Neblett TR, Fine G, et al: The immunofluorescent tumor imprint technique: IV. The significance of `thready' nuclear immunofluorescence . Arch Dermatol 1969;99:611-616.Crossref 20. Rodnan GP, Lipinski E, Rabin BS, et al: Eosinophilia and serologic abnormalities in linear localized scleroderma , abstracted. Arthritis Rheum 1977;20:133.Crossref 21. Sontheimer RD, Deng JS, Gilliam JN: Antinuclear and anticytoplasmic antibodies . J Am Acad Dermatol 1983;9:335-343.Crossref 22. Arana R, Seligmann M: Antibodies to native and denatured deoxyribonucleic acid in systemic lupus erythematosus . J Clin Invest 1967;46:1867-1870.Crossref 23. Wasicek CA, Maddison PJ, Reichlin M: Occurrence of antibodies to ssDNA in ANA negative patients . Clin Exp Immunol 1979;37:190-195. 24. Lange A: Evaluation of the simultaneous estimation of anti-ssDNA and anti-dsDNA antibodies for clinical purposes . Clin Exp Immunol 1978;31:472-481.

Journal

Archives of DermatologyAmerican Medical Association

Published: Mar 1, 1987

References