Association between antinuclear antibodies (ANA) patterns and extractable nuclear antigens (ENA) in patients with autoimmune diseases

Abstract Background Antinuclear antibodies (ANA) and extractable nuclear antigens (ENA) are crucial biomarkers for the diagnosis of autoimmune diseases (AID) such as systemic lupus erythematosus (SLE), Sjogren’s syndrome, systemic sclerosis, and polymyositis. In the present study, we assessed the most frequent ANA patterns associated with the most detectable ENA antigen (Ag) that could be used as a diagnostic and efficient prognostic marker of AID. Materials and Methods The primary objective of this study was to investigate the association between immunofluorescence (IF) ANA and ENA in patients with AIDs. This was a retrospective cross-sectional study. The study was performed at the Immunology Department of the Armed Forces Institute of Pathology, Rawalpindi. Retrospective data from 76 patients were tested for ANA and ENA from June 2020 to Nov 2020. Results A total of 76 patients comprising 14 (18.4%) males and 62(81.6%) females were tested for AIDs. The most frequent pattern among AID patients was coarse speckled, followed by the peripheral ANA pattern. The most frequent ENA Ags were Sjogren’s syndrome A (SSA) and B (SSB). SSA was significantly associated with coarse speckled and peripheral ANA patterns, whereas SSB was associated with coarse speckled ANA patterns. These associations are relevant for accurate diagnosis of autoimmune diseases. Conclusion SSA was associated with coarse speckled and peripheral ANA patterns, whereas SSB was associated with coarse speckled ANA patterns. The ANA patterns were significantly associated with ENA antigens.