İndirekt immünofloresan testi ile değerlendirilen otoantikor pozitifliklerine Şiddetli Akut Solunum Yolu Sendromu Koronavirüsü 2 pandemisinin etkisinin araştırılması

Yıl 2025, Cilt: 30 Sayı: 1, 71 - 77, 29.01.2025

Zeynep Dilara Karamurat , Emel Çalışkan , Emel Akbaş , Şükrü Öksüz , İdris Şahin

https://doi.org/10.21673/anadoluklin.1490524

Öz

Amaç: Bu çalışmanın amacı Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) enfeksiyonu ile sistemik veya organa özgü otoimmün hastalıklar arasındaki olası ilişkiyi belirlemektir.

Yöntemler: Çalışmamıza Mart 2018 ile Mart 2022 tarihleri arasında çeşitli kliniklerden, otoimmün hastalık ön tanısı olan hastalardan Tıbbi Mikrobiyoloji Laboratuvarı’na gönderilen serum örnekleri dâhil edildi. Bu dönemde laboratuvarımızda çalışılan indirekt immünofloresan antikor test sonuçları hastanemiz otomasyon sisteminden elde edilerek retrospektif olarak değerlendirildi.

Bulgular: Coronavirus Disease 2019 (COVİD 19) pandemisinden önceki iki yılda ve pandemi dönemindeki iki yılda indirect immunofluorescence assay (IIAF) değerlendirmesi yapılan 8325 hastanın 2256’sında anti-nükleer antikor (ANA) pozitifliği saptandı [2038 hastada tekli patern (1363’ü benekli), 218 hastada çoklu patern]. Otoantikor pozitifliğinin zaman içindeki değişimi incelendiğinde, pandeminin ilk iki yıllık döneminde önceki iki yıla göre ANA, anti-double-stranded DNA antibody (anti-dsDNA), antigliadin,anti-islet cell antibody (anti -ICA) ve anti-Gliadin otoantikorlarının pozitiflik oranlarında istatistiksel olarak anlamlı bir artış olduğu tespit edildi. anti-mitochondrial antibody (AMA),, anti-smooth muscle antibody (ASMA), anti-Endomysium, anti-neutrophil cytoplasmic antibody (ANCA), otoantikorlarının ise pozitiflik oranlarında COVID-19 pandemi döneminde ve öncesinde farklılık gözlenmedi.

Sonuç: Pandemi döneminde ANA, anti-dsDNA, anti-ICA, anti-Gliadin otoantikorlarının pozitiflik oranlarının artması, COVID-19 sürecinin bazı otoimmün hastalıkları etkileyebileceğini düşündürdü.

Anahtar Kelimeler

İndirek immunfloresan ölçüm, otoantikorlar, otoimmün hastalıklar, SARS-CoV-2

Investigation of the effect of Severe Acute Respiratory Syndrome Coronavirus 2 pandemic on autoantibody

Öz

Aim: The aim of this study is to determine the possible relationship between Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) infection and systemic or organ-specific autoimmune diseases.

Methods: Serum samples sent to a Medical Microbiology Laboratory from patients in various clinics with preliminary diagnoses of autoimmune disease between March 2018 and March 2022 were included in our study. During this period, the indirect immunofluorescent antibody test results studied in our laboratory were obtained from the automation system of our hospital and evaluated retrospectively.

Results: In the two years before the Coronavirus Disease 2019 (COVİD 19) pandemic and the two years during the pandemic anti-nuclear antibody (ANA) positivity was detected in 2256 of 8325 patients who underwent indirect immunofluorescence assay (IIAF) evaluation [single pattern in 2038 patients (1363 speckled), multiple pattern in 218 patients]. When the change in autoantibody positivity over time was examined, it was determined that there was a statistically significant increase in the positivity rates of ANA, anti-double-stranded DNA antibody (anti-dsDNA), antigliadin,anti-islet cell antibody (anti -ICA) and anti-Gliadin autoantibodies in the first two years of the pandemic compared to the previous two years. No difference was observed in the positivity rates of anti-mitochondrial antibodies (AMA), anti-smooth muscle antibodies (ASMA), anti-endomysium, Antineutrophil cytoplasmic antibody (ANCA) autoantibodies before and during the COVID-19 pandemic.

Conclusion: The increase in the positivity rates of ANA, anti-dsDNA, anti-ICA, anti-Gliadin autoantibodies during the pandemic period suggested that the COVID-19 process may affect some autoimmune diseases.

Anahtar Kelimeler

Autoantibodies, autoimmune diseases, indirect immunofluorescence assay, SARS-CoV-2

Kaynakça

• Gur Vural D, Tanriverdi Cayci Y, Bıyık I, Bilgin K, Birinci A,. Evaluation of immunoblotting test results in patients with positive antinuclear antibodies. Turk Hij ve Deney Biyol Derg. 2021;78(4):443-50.
• Yuluğ N, Bahar IH, Ergon MC, Karaman M, Yılmaz Ö. The importance of antinuclear (ANA) and anti-double stranded DNA (Anti-dsDNA) antibodies in the diagnosis of connective tissue diseases. Acta Parasitologica Turcica. 2005;29(4):287-90.
• Salle V. Coronavirus-induced autoimmunity. Clin Immunol. 2021;226:108694.
• Sacchi MC, Tamiazzo S, Stobbione P, et al. SARS-CoV-2 infection as a trigger of autoimmune response. Clin Transl Sci. 2021;14(3):898-907.
• Gracia-Ramos AE, Martin-Nares E, Hernández-Molina G. New onset of autoimmune diseases following COVID-19 diagnosis. Cells. 2021;10(12):3592.
• Sung YK, Yoshida K, Prince FHM, et al. Prevalence and predictors for sustained remission in rheumatoid arthritis. PLoS One. 2019;14(4):e0214981.
• Nevreste Çelikbilek, Birsen Özdem, Ziya Cibali Açıkgöz. Evaluation of Anti-Nuclear antibody test results in clinical practice. J Microbiol Infect Dis. 2015;5(2):63-8.
• Wang L, Wang F-S, Gershwin ME. Human autoimmune diseases: a comprehensive update. J Intern Med. 2015;278(4):369-95.
• Barut BÖ, Ufuk E, Demir AS, Ünal A, Tekin İ. The importance of examining antinuclear antibody (ANA) in neurological diseases. Nobel Med. 2013;9(2):74-8.
• Yanik K, Unal N, Birinci A, Gunaydin M. Distribution of the patterns in patients with positive antinuclear antibody and anti-extractable nuclear antigen. J Immunol Clin Microbiol 2016; 1(2).
• Mariz HA, Sato EI, Barbosa SH, Rodrigues SH, Dellavance A, Andrade LEC. Pattern on the antinuclear antibody-HEp-2 test is a critical parameter for discriminating antinuclear antibody-positive healthy individuals and patients with autoimmune rheumatic diseases. Arthritis Rheum. 2011;63(1):191-200.
• Peker BO, Şener AG, Kaptan Aydoğmuş F. Antinuclear antibodies (ANAs) detected by indirect immunofluorescence (IIF) method in acute COVID-19 infection; future roadmap for laboratory diagnosis. J Immunol Methods. 2021;499:113174.
• Pascolini S, Vannini A, Deleonardi G, Ciordinik M, Sensoli A, Carletti I, et al. COVID-19 and immunological dysregulation: can autoantibodies be useful? Clin Transl Sci. 2021;14(2):502–8.
• Chang SH, Minn D, Kim YK. Autoantibodies in moderate and critical cases of COVID-19. Clin Transl Sci. 2021;14(5):1625-6.
• Singh B, Kaur P, Maroules M. Autoimmune hepatitis-primary biliary cholangitis overlap syndrome triggered by COVID-19. Eur J case reports Intern Med. 2021;8(3):2264.
• Hollstein T, Schulte DM, Schulz J, Glück A, Ziegler AG, Bonifacio E, et al. Autoantibody-negative insulin-dependent diabetes mellitus after SARS-CoV-2 infection: a case report. Nat Metab. 2020;2(10):1021-4.
• Cakir M, Guven B, Issi F, Ozkaya E. New-onset celiac disease in children during COVID-19 pandemic. Acta Paediatr. 2022;111(2):383-8.
• Izci Duran T, Turkmen E, Dilek M, Sayarlioglu H, Arik N. ANCA-associated vasculitis after COVID-19. Rheumatol Int. 2021;41(8):1523-9.
• Gelzo M, Cacciapuoti S, Pinchera B, et al. A Transient ıncrease in the serum ANCAs in patients with SARS-CoV-2 infection: a signal of subclinical vasculitis or an epiphenomenon with no clinical manifestations? a pilot study. Viruses. 2021;13(9):1718.