anticentromères

Anticentromere antibodies (ACA) are autoantibodies directed against centromere-associated proteins, most commonly CENP-B, and also others such as CENP-A and CENP-C. They are detected in the serum of some individuals with autoimmune diseases. In laboratory testing, ACA typically produce a distinct centromeric staining pattern on indirect immunofluorescence, and more specific assays like ELISA or line immunoassays can identify antibodies against CENP-B or related centromere proteins.

ACA have the strongest association with limited cutaneous systemic sclerosis (lcSSc), including the CREST variant of the disease. Their presence is considered a serologic hallmark of this subset and supports the clinical impression when lcSSc is suspected. Clinically, ACA-positive individuals tend to have a higher likelihood of limited skin involvement and a different profile of organ involvement compared with other systemic sclerosis subsets. They are associated with a relatively lower risk of interstitial lung disease but with a greater concern for pulmonary arterial hypertension in some patients. However, the course of disease varies, and ACA positivity does not by itself determine prognosis.

In clinical practice, ACA results are used to support the diagnosis of lcSSc in the appropriate clinical context and to help differentiate it from diffuse cutaneous sclerosis and other autoimmune diseases. ACA can occasionally be detected in other autoimmune conditions and, at low frequency, in healthy individuals. Interpretation of a positive test should consider the overall clinical picture and other laboratory findings.