RNP (also called nRNP and U1RNP) is a small nuclear ribonucleoprotein that contains 3 protein autoantigens (called A, C, and 68 kD). Sera that contain RNP antibodies react predominately with the A and 68-kD autoantigens. Antibodies to RNP occur in approximately 50% of patients with lupus erythematosus (LE) and in patients with other connective tissue diseases, notably mixed connective tissue disease (MCTD). MCTD is characterized by high levels of RNP antibodies without detectable Sm or double-stranded DNA (dsDNA) antibodies. MCTD resembles LE but is not accompanied by renal involvement.(1,2)
RNP is 1 of 4 autoantigens commonly referred to as extractable nuclear antigens (ENA). The other ENAs are SS-A/Ro, SS-B/La, and Sm. Each ENA is composed of 1 or more proteins associated with small nuclear RNA species (snRNP) ranging in size from 80 to approximately 350 nucleotides. Antibodies to ENAs are common in patients with connective tissue diseases (systemic rheumatic diseases) including LE, MCTD, Sjogren syndrome, scleroderma (systemic sclerosis), and polymyositis/dermatomyositis.
See Connective Tissue Disease Cascade (CTDC) in Special Instructions.
A positive result for RNP antibodies is consistent with a connective tissue disease. Although strongly associated with connective tissue diseases, RNP antibodies are not considered a "marker" for any particular disease except in the following situation: when found in isolation (ie, dsDNA antibodies and Sm antibodies are not detectable), a positive result for RNP antibodies is consistent with the diagnosis of mixed connective tissue disease.
1. Homburger H, Larsen S: Detection of specific antibodies. In Clinical Immunology: Principles and Practice. First edition. Edited by R Rich, T Fleisher, B Schwartz, et al. St. Louis, Mosby-Year Book, 1996, pp 2096-2109
2. Kotzin B, West S: Systemic lupus erythematosus. In Clinical Immunology Principles and Practice. Second edition. Edited by R Rich, T Fleisher, W Shearer, et al. St. Louis, Mosby-Year Book, 2001, pp 60.1-60.24
