Working Paper Review Version 2 This version is not peer-reviewed

Antinuclear Autoantibodies in Health: Autoimmunity Is Not a Synonym of Autoimmune Disease

Version 1 : Received: 27 October 2020 / Approved: 28 October 2020 / Online: 28 October 2020 (12:17:13 CET)
Version 2 : Received: 6 January 2021 / Approved: 8 January 2021 / Online: 8 January 2021 (14:01:32 CET)

How to cite: Pashnina, I.A.; Krivolapova, I.M.; Fedotkina, T.V.; Ryabkova, V.A.; Chereshneva, M.V.; Churilov, L.P.; Chereshnev, V.A. Antinuclear Autoantibodies in Health: Autoimmunity Is Not a Synonym of Autoimmune Disease. Preprints 2020, 2020100591 Pashnina, I.A.; Krivolapova, I.M.; Fedotkina, T.V.; Ryabkova, V.A.; Chereshneva, M.V.; Churilov, L.P.; Chereshnev, V.A. Antinuclear Autoantibodies in Health: Autoimmunity Is Not a Synonym of Autoimmune Disease. Preprints 2020, 2020100591

Abstract

Incidence of autoimmune diseases increases. Antinuclear antibodies (ANA) testing is a critical tool for their diagnosis. However, ANA prevalence in health increased over last decades, especially among young people. ANA in health occur in low concentrations, with prevalence up to 50% in some populations, which demands a cutoff revision. The review deals with origin and probable physiological or compensatory function of ANA in health, according to the concept of immunological clearance, theory of autoimmune regulation of cell functions and the concept of functional autoantibodies. Considering ANA titers ≤1:320 as a serological marker of autoimmune diseases seems inappropriate. The role of anti-DFS70/LEDGFp75 autoantibodies is highlighted as possible anti-risk biomarker for autoimmune rheumatic disorders. ANA prevalence in health is different in various regions due to several underlying causes discussed in the review, all influencing in additive combinations according to the concept of the mosaic of autoimmunity. Not only titer, but the HEp-2 IFA staining patterns, like AC-2, is also important. Accepting autoantibodies as a kind of bioregulators, not only upper, but also lower borders of their normal range should be determined. Not only their excess, but also lack of them or “autoimmunodeficiency” could be a reason of disorders.

Subject Areas

autoimmune diseases; antinuclear antibodies; antinuclear factor; functional autoantibodies; natural autoantibodies; physiological autoimmunity

Comments (1)

Comment 1
Received: 8 January 2021
Commenter: Yehuda Shoenfeld
Commenter's Conflict of Interests: Author
Comment: This is a new version of the manuscript, revised according to the Reviewers' comments
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