Autoimmune Antibodies Overview
According to the Autoimmune Association, in recent years, the NIH has identified autoimmune conditions as a major women’s health issue, affecting females in a 3:1 ratio versus males. As anyone who has experience with them will tell you, these disorders can be both dangerous and debilitating, and they are all caused by similar mechanisms involving autoimmune antibodies, where the body mistakenly directs its immune defenses at normal tissues. Here, we discuss the basics of autoimmune antibodies, and their effects on the body.
What are autoimmune antibodies?
Labtestsonline.org defines autoimmune antibodies as “antibodies (immune proteins) that mistakenly target and damage specific tissues or organs of the body.” There are many different autoimmune antibodies that have been discovered, and likely more will be discovered in the future. Scientists are still not sure what exactly causes or triggers these reactions and their related diseases, but in many cases, an initial viral or bacterial infection has been linked to the onset of disease.
Regardless of the cause, these autoimmune antibodies proceed to identify one’s own tissues as foreign and therefore pathological, which results in an inflammatory reaction against the involved organs, as the immune system attempts to combat the perceived invader. As a result, patients suffer from a host of symptoms and complications, based on which organs and organ systems are affected, which is in turn based on the specific autoimmune antibodies actively attacking the body. Think of it as the same type of reaction you might experience when your body correctly identifies a flu virus and mounts a defense, producing fever, pain, etc. The only difference is – and it’s a big one – that this process is normal and serves a restorative purpose, whereas this is not the case with autoimmune conditions, where the immune system is out of control and damaging various tissues and organs.
What are the top antibodies I would have and in which conditions are they implicated?
Since the list of possible autoimmune antibodies is quite extensive, we will look to answer the above question as it relates to the most commonly involved systems and diseases. We will not delve into the mechanisms of each, as most can be quite complex, and it should be noted that many conditions will overlap with regard to which autoimmune antibodies are involved. Also, only the most common autoimmune antibodies will be covered here. To that end, below is a brief list of some of the more prevalent autoimmune antibodies, along with the medical disease(s) they impact:
- Antinuclear Antibody (ANA): systemic lupus erythematosus (SLE) or “lupus”, polymyositis, and others
- Antineutrophil Cytoplasmic Antibodies (ANCA): Wegener’s granulomatosis (WG), microscopic polyangitis (MPA), others
- Anti-double-stranded DNA Antibodies (Anti-dsDNA): systemic lupus erythematosus (SLE) or lupus
- Rheumatoid Factor (RF): Rheumatoid Arthritis (RA) and Sjögren syndrome
- Extractable Nuclear Antigen Antibodies (ENAA): Sjögren syndrome and scleroderma
- Anti-Thyroid Antibodies (ATA): Hashimoto’s thyroiditis and Grave’s disease (this antibody panel includes thyroid stimulating immunoglobulin and thyroid peroxidase antibody)
- Intrinsic Factor Antibody (IFA): certain anemias (B12/pernicious/macrocytic) and neurological conditions
- Anti-tissue Transglutaminase Antibodies (tTGA) and Anti-Gliadin Antibodies (AGA): Celiac disease/gluten sensitivity
- Smooth Muscle Antibody (SMA): chronic active autoimmune hepatitis
- Antimitochondrial Antibody (AMA): primary billiary cirrhosis and other metabolic conditions
- Anti-Glomerular Basement Membrane Antibody (AGBMA): autoimmune kidney disease
- Anticardiolipin Antibodies (ACLA): autoimmune clotting disorders
- Anti-ribonulcear protein (anti-RNP): Mixed Connective Tissue Disease
- Anti-ganglioside antibodies (AGLA): various neurological conditions
This list is far from all-inclusive, and there are many other autoimmune antibodies that impact various diseases, both common and rare. There are many excellent references, including Wikipedia, that provide more extensive listings. Still, the above should serve as a good primer and reference for some of the most common clinically used lab evaluations and their associated conditions.
If I don’t have these antibodies, but I have other signs or symptoms of an autoimmune condition, could I still have that condition without the antibodies present?
The first thing to remember is that many diseases, autoimmune and otherwise, have heavily overlapping signs and symptoms, so the presence or absence of these indicators does not, on its own, rule in or out specific disorders. Having said that, yes, you can certainly still have the condition without a positive lab test, though the question of whether the antibodies are absent or just undetected cannot be answered definitively.
It is unlikely that an autoimmune disease is causing your symptoms if there are no pertinent antibodies circulating, but this is difficult to distinguish from low levels that are below the threshold of the lab test being used. Conversely, you may have positive antibody tests and still be suffering from more than one condition, not all of which are necessarily autoimmune in nature. This is why it’s important to do an extensive lab workup on any patient who displays possible autoimmune manifestations.
Questions for your doctor:
- Who should manage my autoimmune disease if it involves several organ systems and/or medical specialties?
- Is it possible to have positive antibody results and still be completely free of clinical disease?
- Are there any medications that will affect my upcoming laboratory tests? Should I stop them? When and for how long?
- Do I need follow-up testing for my condition(s)? If so, how often and for which tests?
- Are there other ways to combat autoimmune antibodies besides immunosuppressants?
About the Author
Dr. Rothbard is a professional medical writer and consultant based in New York City, specializing in medical education articles targeted at a variety of audiences, from children through clinicians. After leaving medicine, he worked as a biology and medical science educator for several years, before deciding to pursue writing full-time. He may be reached at email@example.com.
This blog post was originally published by AutoimmuneMom.com, written by Dr. Rothbard, and first published on May 2, 2012.
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