Core Facilities

Animal Models Core Facility

BIACORE

Clinical Immunology
Laboratory

Crystallography

Myositis Testing

DNA Sequencing

Flow Cytometry

Imaging Core Facility

Microarray Research
Facility

Nuclear Magnetic Resonance Core Facility

Signal Transduction
Core Facility

Shared Facilities

Laboratory Animal
Resource Center (LARC)

Institutional Animal
Care and Use
Committee (IACUC)

In a normal, healthy human, the immune system produces antibodies that protect the body from harmful microbes. In some instances; however, the immune system can malfunction, attacking the body's own tissues, resulting in a condition called autoimmunity.

Systemic lupus erythematosus (SLE), commonly known as lupus, is a chronic inflammatory autoimmune disease in which the body's immune system attacks healthy tissues and organs. Patients can display a whole spectrum of symptoms and signs such as skin rashes, joint pain, pleurisy, pericarditis, strokes, seizures, coma, visual problems, anemia, low platelets, and kidney inflammation, any of which can be slight to serious. Individual patients tend to consistently have one or more of these manifestations at any time, and they tend to follow the same pattern in recurrent flare-ups of the disease.

Lupus affects approximately one person in 1,000, which means an estimated 400,000 people in the United States have the disease. Ninety percent of those who develop lupus are women between the ages of 18 and 40. Black women have the highest risk of developing the disease, approaching a prevalence of 1 in 250.

The OMRF Clinical Immunology Laboratory, under the direction of Dr. Morris Reichlin, performs a variety of tests to identify these autoantibodies for diagnostic and treatment purposes. The Reichlin Profile, also known as the Lupus Profile, is the definitive diagnostic test for these autoimmune diseases.

The following three tests comprise the Reichlin Profile:

• ANA - Antinuclear antibodies are present in many rheumatic diseases, and often are not specific for any single disease. They are present in over 95% of SLE patients, 86% of scleroderma patients, and in lower frequencies in rheumatoid arthritis (RA), Sjogren's syndrome, and polymyositis.

• dsDNA - Anti-double strand DNA at a titer of 1:10 or more strongly suggests SLE.

• ENA - Extractable nuclear antibodies (precipitating antibodies) have definitive diagnostic information. Precipitating antibodies to soluble tissue antigens are present in diverse rheumatic diseases: anti-Sm is highly specific for SLE; anti-nRNP (nuclear ribonucleo- protein) is present in SLE and overlap syndromes with scleroderma and polymyositis; anti-Scl-70 is highly specific for scleroderma; anti-Ro and anti-La are associated with SLE and Sjogren's syndrome; Anti-P (Ribosomal P) is a new specificity related to psychosis in SLE patients and may be enriched in patients with nephritis and unexplained hepatitis; anti-Jo-1, anti-PM-Scl and anti-Mi-2 may be seen in polymyositis patients. Precipitating antibodies are detected by the formation of precipitin lines in agar gel against calf thymus extract (CTE); or rabbit thymus extract (RTE) for anti-Scl70. When a line does not show identity with known antibodies against tissue extracts, the precipitin is called UIL (unidentified line), which is associated with "rheumatic disease," but their specificities are unknown. When polymyositis is suspected a more sensitive and definitive method, immunoprecipitation, is indicated for the detection of myositis-specific antibodies that may be present at levels to low to be detected by ENA.

Other Testing

• ANCA (anti-neutrophil cytoplasm antibody) detects autoantibodies against neutrophil specific antigens. cANCA (cytoplasmic) is highly specific for necrotizing vasculitis and is present in more than 90% of biopsy proven Wegener's granulomatosis but also in classical polyarteritis nodosa and Churg-Strauss' syndrome. pANCA (perinuclear) is less specific than C-ANCA but is present in a high proportion of cases of crescentic glomerulonephritis and microscopic polyarteritis nodosa. There are numerous antigens associated with both cANCA and pANCA. PR3 (serine protease3) and MPO (myeloperoxidase) are available to help further define autoimmune vasculitis disorders.

• aPL (antibodies to phospholipid) - are associated with recurrent fetal loss and recurrent thromboses and strokes. aPL can be found in SLE as well as non-SLE patients and conditions with positivity include migraines, peripheral vascular disease, and some autoimmune cases of myocardial infarction and post-bypass graft thromboses.

• CCP (cyclic citrullinated peptides) - is a new test for the early detection of RA. These antibodies predict erosive disease, and are present in 30-40% of seronegative RA.

• CH-50 and CRYOGLOBULINS - these results must be interpreted in the context of the individual clinical case, but they may indicate or be used to monitor disease activity.

Requisition Form - Word format

Specimen Handling - Word format

Price List - Word format

For more information regarding the OMRF Clinical Laboratory please call Mary Jones at (405) 271-7395, or the laboratory staff at (405) 271-7771.