HEP 2 Antigen Blot (SS-A, SS-B, Sm, RNP, SCL-70, JO-1, PM-SCL, CENT B, CENT C, AMA-M2, RIB-P, RO52)

Immunology

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Description

The Hep 2 blot can be used as a confirmatory mechanism for the presence of the antigens if the primary method of detection ( lineblot or immunofluorescence ) does not give a definitive answer. The blot can also be used to investigate the presence of Centromere B and C, Anti-mitochondrial antibody-M2 and Ribosomal-P which may have been observed by immunofluorescence. � SS-A ( Ro ) can be associated with Sjogrens syndrome, SLE, cutaneous LE and C2-deficient lupus. Positive Ro antibodies in pregnancy may lead to congenital heart block. Ro52 may be seen in patients with systemic sclerosis along with Ro60 and La, or myositis patients, but is of limited clinical significance [1]. � SS-B ( La ) can be associated with primary Sjogrens syndrome, often along with Ro antibodies. Approximately 15% of SLE patients will have La antibodies [3]. � SCL-70 is found in 20-40% of patients with progressive systemic sclerosis and 20% of patients with limited scleroderma [3]. � RNP can be observed in SLE and MCTD. In SLE patients, RNP may be seen along with Sm antibodies. The presence of Sm antibodies is specific for SLE [3]. � JO-1 antibodies are found in 25% of patients with autoimmune myositis, they can also be found in myositis, Raynauds disease and interstitial lung disease [2,3]. � PM-SCL may be seen in the polymyosis-scleroderma overlap syndrome where the presence of the antibodies may indicate an increased risk of renal disease, or in dermatomyositis/polymyositis or in systemic sclerosis alone. � CENT B and C are associated with CREST syndrome. � AMA-M2 with PBC although this antibody can usually be confirmed by immunofluorescence or by using the liver blot rather than the Hep 2 blot. � Ribosomal P may be seen in SLE. It can also be associated with neuropsychiatric lupus and rheumatoid arthritis.

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Indications

May be used to support other assay results in the investigation of Mixed connective tissue disease ( MCTD ), systemic lupus erythematosus ( SLE ), Sjogren's syndrome ( SS ), Progressive Systemic Sclerosis ( PSS ), Poly-/Dermatomyositis and Primary Biliary liver Cirrhosis ( PBC ).

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Sample Type

2mL Serum ( Gel 5mL Yellow tube ) or 2mL Plasma ( EDTA, heparin or citrate ). Requests from outside Sheffield: Transport at ambient temperature via Royal Mail or Courier.

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Reference Range

Normal result is Negative.

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Turnaround Time

Within 10 days

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Testing Frequency

Weekly

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References

Parker JC, Burlingame RW, Bunn CC. Prevalence of antibodies to Ro52 in a serologically defined population of patients with systemic sclerosis. J Autoimmun Dis. 2009. 6( 2 ):1-6. [Ref 1PRU Handbook of Autoimmunity. 4th Edition. 2007. [Ref 2]Spickett G. Oxford handbook of Clinical Immunology and Allergy. 2nd Edition. 2006. [Ref 3]

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See Also

Hep 2; ENA; ENA types; FATS; Liver blot

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