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ANA was determined by parallel enzyme-linked immunosorbent assays of crude nuclear protein antigen extracted from HEp-2 cells either grown under optimal conditions (providing nonstress ANA antigen) or exposed to stress (providing stress ANA antigen). The stress stimuli used were gamma radiation (causing DNA damage) and a hypertonic environment (causing apoptosis). Signs of stress-related ANA reactivity were seen among connective tissue disease (CTD) patients (including patients with systemic lupus erythematosus; mixed CTD; calcinosis, Reynaud's phenomenon, esophageal motility disorders, sclerodactyly, and telangiectasia; scleroderma; and Sjo\u0308gren's syndrome): 11% showed stress-positive ANA (i.e., a significantly stronger ANA reactivity with the extract from stressed cells), whereas 21% showed a markedly weaker reaction with the stress antigen. In contrast, among ANA screening patient sera, with no diagnosis of CTD, the fraction showing stress-positive ANA was higher (7 to 8%, depending on the type of stress) than among those showing a lower reactivity with stress antigen (1.5 to 2.5%). Only one serum among 89 (1%) tested sera from healthy individuals showed a stress-related ANA reaction. This demonstration of stress-related ANA suggests a means to improve the performance of clinical ANA testing.<\/jats:p>","DOI":"10.1128\/cdli.9.2.287-294.2002","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T09:58:35Z","timestamp":1027763915000},"page":"287-294","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":4,"title":["Exposure of HEp-2 Cells to Stress Conditions Influences Antinuclear Antibody Reactivity"],"prefix":"10.1128","volume":"9","author":[{"given":"Liping","family":"Du","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachiko","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annahita","family":"Sallmyr","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Manthorpe","sequence":"additional","affiliation":[{"name":"Sjo\u0308gren's Syndrome Research Centre, Department of Rheumatology, Lund University, Malmo University Hospital, S-205 02 Malmo, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Bredberg","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"99","DOI":"10.3109\/08916939109006745","volume":"9","year":"1991","unstructured":"Bachmann, M., S. 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