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Clinical usefulness of anti-RNA polymerase III antibody measurement by enzyme-linked immunosorbent assay
Rheumatology, 10/08/09

Satoh T et al. – The measurement of anti-RNAP III antibody by ELISA is useful in routine clinical practice, because it helps diagnose SSc and identify a disease subset with severe skin and renal involvement.

Methods

Multicentre study involved 354 patients with SSc, 245 with non-SSc CTDs and 102 healthy controls
ELISAs used to detect anti-RNAP III antibody, anti-topo I antibody and ACA
The presence of anti-RNAP III antibody in selected serum samples was confirmed by immunoprecipitation (IP) assay

Results

By ELISA, anti-RNAP III antibody detected in 38 (10.7%) patients with SSc, 3 (1.2%) with non-SSc CTD and no healthy controls
Clinical specificity for SSc was excellent (98.8%), although small number of false positives occurred
Sensitivity of anti-topo I and ACA ELISAs for SSc was 59.9%, which increased to 68.2% without reduction in specificity when anti-RNAP III measurement added
Clinical features associated with positivity for anti-RNAP III antibody include dcSSc, high total skin score and trend towards high prevalence of renal crisis, consistent with previous studies that used an IP assay
On clinical severity scales, SSc patients with anti-RNAP III antibody scored highest for skin and renal involvement among patients subgrouped by presence of individual SSc-related antibodies

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