Autoantibodies: the table to know !
- Topic
Autoantibodies are antibodies against the body's own parts. Each disease tends to have its own, which helps doctors name it.
Updated 2026-11-01
See it in 3D: Thyroid gland · Pancreas · Stomach · Jejunum
What it is
Autoantibodies are made when B-cell tolerance fails, usually with help from self-reactive CD4 T cells. Some cause the damage directly (anti-TSH receptor, anti-acetylcholine receptor, anti-GBM); others are markers that point to a diagnosis without being the cause. A positive result is read together with the clinical picture: low titres of ANA or rheumatoid factor are common in healthy people, especially older ones. The table lists the pairs most asked about in exams and on the wards.
Key facts
- Anti-smooth muscle antibodies point to autoimmune hepatitis type 1.
- Anti-desmoglein antibodies cause pemphigus vulgaris; antibodies against hemidesmosome proteins cause bullous pemphigoid.
- ANA is screened by indirect immunofluorescence on HEp-2 cells; the specific antibody is then identified with targeted tests.
Autoantibody → disease pairs
| Antibody | Target | Disease | Pearl |
|---|---|---|---|
| ANA (antinuclear) | Nuclear antigens | Systemic lupus erythematosus | Very sensitive, not specific; lupus without ANA is rare |
| Anti-dsDNA | Double-stranded DNA | Systemic lupus erythematosus | Specific; tracks activity and lupus nephritis |
| Anti-Sm | Smith ribonucleoprotein | Systemic lupus erythematosus | Very specific but less sensitive |
| Anti-histone | Histones | Drug-induced lupus | Kidney and brain usually spared |
| Anti-Ro (SSA) and anti-La (SSB) | Ribonucleoproteins | Sjögren syndrome, lupus | Maternal anti-Ro crosses the placenta: neonatal lupus and congenital heart block |
| Anti-U1 RNP | U1 ribonucleoprotein | Mixed connective tissue disease | High titre is its defining marker |
| Anti-CCP (ACPA) | Citrullinated proteins | Rheumatoid arthritis | More specific than RF; can precede the disease; linked to smoking and HLA-DR4 |
| Rheumatoid factor | Fc portion of IgG | Rheumatoid arthritis | Not specific (also in Sjögren, hepatitis C, healthy elderly) |
| Anti-centromere | Centromere proteins | Limited systemic sclerosis (CREST) | Raynaud, calcinosis, telangiectasia |
| Anti-Scl-70 | Topoisomerase I | Diffuse systemic sclerosis | Linked to lung fibrosis |
| Anti-TSH receptor (TRAb) | TSH receptor | Graves disease | Stimulating; present in over 95% |
| Anti-TPO and anti-thyroglobulin | Thyroid peroxidase, thyroglobulin | Hashimoto thyroiditis | Anti-TPO positive in over 90% |
| Anti-acetylcholine receptor | Nicotinic receptor at the motor end plate | Myasthenia gravis | Blocking; anti-MuSK in some seronegative cases |
| Anti-GAD65, anti-insulin, anti-IA-2, anti-ZnT8 | Islet beta-cell proteins | Type 1 diabetes | The more antibodies positive, the higher the risk |
| Anti-tissue transglutaminase IgA, anti-endomysium | Tissue transglutaminase 2 | Celiac disease | Check total IgA: IgA deficiency gives false negatives; needs gluten in the diet |
| Anti-intrinsic factor, anti-parietal cell | Intrinsic factor, gastric proton pump | Pernicious anemia | Anti-intrinsic factor is the more specific |
| Anti-GBM | Type IV collagen | Goodpasture (anti-GBM) disease | Lung bleeding plus nephritis; linear deposits |
| c-ANCA (anti-PR3) | Proteinase 3 | Granulomatosis with polyangiitis | Sinuses, lungs and kidneys |
| p-ANCA (anti-MPO) | Myeloperoxidase | Microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis | Also seen in ulcerative colitis |
| Antiphospholipid (lupus anticoagulant, anticardiolipin, anti-β2-glycoprotein I) | Phospholipid-binding proteins | Antiphospholipid syndrome | Clots and pregnancy loss; may prolong the PTT |
| Anti-mitochondrial | Pyruvate dehydrogenase E2 | Primary biliary cholangitis | Middle-aged women, itching, high alkaline phosphatase |
Test yourself
Think of the answer, then tap the question to see it.
Which antibody is most specific for lupus and also follows kidney activity?
Anti-dsDNA. Anti-Sm is also very specific but does not track activity; ANA is sensitive but not specific.
Why is total IgA measured together with IgA anti-tissue transglutaminase?
Selective IgA deficiency is more common in celiac disease and makes IgA-based tests falsely negative; IgG-based tests are then used.
A newborn has complete heart block and the mother has dry eyes and mouth. Which maternal antibody is responsible?
Anti-Ro (SSA). It crosses the placenta and can damage the fetal conduction system (neonatal lupus).
Which antibody is more useful to confirm rheumatoid arthritis, RF or anti-CCP, and why?
Anti-CCP, because it is much more specific; rheumatoid factor also appears in other diseases and in healthy older adults.
Which antibody pattern suggests granulomatosis with polyangiitis?
c-ANCA directed against proteinase 3 (anti-PR3).
See it in 3D
The structures of Durgical's 3D anatomy where it is found.
Related
- Immunofluorescence and the ANA test
- ELISA, western blot and rapid tests
- Immune tolerance and how autoimmunity begins
- HLA associations with disease
- Type II hypersensitivity (antibody against cells)
- Type III hypersensitivity (immune complexes)
- B cell and plasma cell
Related conditions
- Systemic lupus erythematosus
- Rheumatoid arthritis
- Graves disease (hyperthyroidism)
- Hypothyroidism
- Type 1 diabetes mellitus
- Coeliac disease
- Pernicious anaemia
Educational content on the immune system; not a treatment or individual vaccination guide and no substitute for a health professional's advice. No doses are given.
Sources: Systemic lupus erythematosus (El Rosario University Press (NCBI Bookshelf), 2013); Rheumatoid arthritis (El Rosario University Press (NCBI Bookshelf), 2013); Thyroid disease and autoimmune diseases (El Rosario University Press (NCBI Bookshelf), 2013); Celiac disease (El Rosario University Press (NCBI Bookshelf), 2013).
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Representative model, for educational purposes only.