The mosaic of autoimmunity: prediction, autoantibodies, and therapy in autoimmune diseases--2008.

Abstract

For more than two decades, the detection of serum autoanti-bodies has been used for the diagnosis and classification of autoimmune diseases. In addition, some autoantibodies have a prognostic significance or are used as markers for disease activity. In recent years a new piece in the mosaic of autoimmunity has clearly emerged – namely, the predictive value of autoantibodies. Indeed, many autoantibodies can be detected in the preclinical phase of autoimmune diseases many years before the disease becomes apparent; furthermore, they have a high diagnostic positive predictive value [1].Among autoimmune rheumatic diseases, antibodies to RNP, Sm, dsDNA, cardiolipin, Ro and La have a PPV for systemic lupus erythematosus of 94–100%. According to the type of antibody, the appearance can precede clinical diagnosis by 7–10 years with a frequency that varies from 32% to 78% at the moment of