DOI

The incidence of autoimmune diseases is increasing. Antinuclear antibody (ANA) testing is a critical tool for their diagnosis. However, ANA prevalence in healthy persons has increased over the last decades, especially among young people. ANA in health occurs in low concentrations, with a prevalence up to 50% in some populations, which demands a cutoff revision. This review deals with the 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 a 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 additive combinations according to the concept of the mosaic of autoimmunity. Not only are titers, but also HEp-2 IFA) staining patterns, such as AC-2, important. Accepting autoantibodies as a kind of bioregulator, not only the upper, but also the lower borders of their normal range should be determined; not only their excess, but also a lack of them or "autoimmunodeficiency" could be the reason for disorders.

Original languageEnglish
Article number9
Pages (from-to)1-26
Number of pages26
JournalAntibodies (Basel, Switzerland)
Volume10
Issue number1
DOIs
StatePublished - Mar 2021

    Scopus subject areas

  • Drug Discovery
  • Immunology and Allergy
  • Immunology

    Research areas

  • Antinuclear antibodies, Antinuclear factor, Autoimmune diseases, Functional autoantibodies, Natural autoantibodies, Physiological autoimmunity, autoimmune diseases, NATURAL AUTOANTIBODIES, SYSTEMIC-LUPUS-ERYTHEMATOSUS, NATURALLY-OCCURRING ANTIBODIES, antinuclear antibodies, 9 COMMON ANTIGENS, antinuclear factor, ANTI-DSDNA ANTIBODIES, FUNCTIONAL AUTOANTIBODIES, HEP-2 CELLS, functional autoantibodies, INTERNATIONAL CONSENSUS, physiological autoimmunity, CONNECTIVE-TISSUE DISEASES, natural autoantibodies, B-CELL TOLERANCE

ID: 74885857