Autoantibodies in the autoimmune rheumatic diseases

The detection of autoantibodies to a variety of antigenic targets plays an important role in the diagnosis of autoimmune rheumatic disease. Rheumatoid factor and antinuclear antibodies have been key in the diagnosis of rheumatoid arthritis and systemic lupus erythematosus for many years. There have been several developments over the past 5 years. Antibodies against cyclic citrullinated peptides (CCP) have been shown to be specific for rheumatoid arthritis and may predict the development of erosive disease. This assay will probably become widely used over the next few years. There is increasing interest in the use of anti-C1q antibodies for the detection and monitoring of renal nephritis as this assay appears to be more sensitive than anti-DNA antibodies. ELISA based assays are being increasingly used in place of both radioimmunoassay and immunofluorescence because they readily automated and less dependent on the use of experienced technicians.