Special Precautions/Comments:

Method: Enzyme Linked Enzyme ImmunoSorbent Assay (ELISA). Calibration:Calibrated by manufacturer to human anti-nuclear factor MRC 66/233. EQA Scheme: Participate in a sample exchange scheme. IQC: In house preparation and kit controls

Interferences: None known

Interpretation: Results are reported in U/mL as follows: NEGATIVE Result is < 40 U/mL. POSITIVE Result is > 40 U/mL. It should be noted that the assay does not measure antibody concentration, but is a measure of the activity of antibody present in the sample. The activity is affected by a number of parameters, such as antibody avidity (hence the use of “units” per mL rather than a unit of concentration such as milli moles per mL).

Additional Information:

Indication: Systemic lupus erythematosus (SLE), drug induced SLE (DIL).

Background Information: Histones are basic proteins which bind to DNA within the nuclei of cells. Anti-histone antibodies are found in patients with SLE and patients with DIL. In SLE, anti-histone antibodies do not provide any better diagnostic information than DNA and anti-nuclear antibodies but in drug induced lupus, a typical antibody profile consists of anti-nuclear antibodies, anti-histone antibodies but rarely dsDNA antibodies and extractable nuclear antibodies [1]. Drugs implicated in DIL include hydralazine, procainamide and isoniazid [1]. Histone antibodies can be positive in active lupus nephritis [2]. Anti-histone antibodies have also been reported in selected cases of rheumatoid arthritis. Anti-histone antibody levels are reportedly higher in neuropsychiatric lupus [3].

References: Vedove CD, et al. Drug induced lupus erythematosus. Archives of Dermatological Research. 2009. 301(1):99-105. [Ref 1] Sun XY, et al. Anti-histone antibodies in systemic lupus erythematosus: prevalence and frequency in neuropsychiatric lupus. J Clin Lab Anal. 2008. 22(4):271-277. [Ref 3] Vasoo S. Drug induced lupus: an update. Lupus. 2006. 15(11):757-761. Cohen MG, Pollard KM, Webb J. Antibodies to histones in systemic lupus erythematosus: prevalence, specificity and relationship to clinical and laboratory features. Annals of the rheumatic diseases. 1992. 51(1):61-66. Suenaga R, Abdou NI. Ani-(DNA-histone) antibodies in active lupus nephritis. Journal of Rheumatology. 1996. 23(2):279-284. [Ref 2] Shoenfeld, Y, Segol, O. Anti-Histone antibodies in SLE and other autoimmune diseases. Clin Exp Rheum. 1989. 7(3):265 – 271.

See Also: ANA; DNA

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