Value of a new automated fluorescence immunoassay (EliA) for PR3 and MPO-ANCA in monitoring disease activity in ANCA-associated systemic vasculitis
| Autor: | Lucafrancesco Di Toma, Renato Alberto Sinico, Antonella Radice, Caterina Corace, Ettore Sabadini |
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| Přispěvatelé: | Sinico, R, Radice, A, Corace, C, Di Toma, L, Sabadini, E |
| Jazyk: | angličtina |
| Rok vydání: | 2005 |
| Předmět: |
Fluoroimmunoassay
Birmingham Vasculitis Activity Score Predictive Value of Test Gastroenterology Birmingham Vasculitis Activity Score (BVAS) immune system diseases ANCA-associated systemic vasculiti Retrospective Studie Medicine Disease activity skin and connective tissue diseases General Neuroscience Titer Evaluation Studies as Topic Predictive value of tests Microscopic poly-angiiti Granulomatosis with polyangiitis Microscopic polyangiitis Vasculitis Case-Control Studie Systemic vasculitis Human Risk medicine.medical_specialty Vasculiti Churg-Strauss syndrome Anti-neutrophil cytoplasmic antibodies (ANCAs) Enzyme-Linked Immunosorbent Assay Sensitivity and Specificity General Biochemistry Genetics and Molecular Biology Antibodies Antineutrophil Cytoplasmic History and Philosophy of Science Predictive Value of Tests Internal medicine Humans cardiovascular diseases Retrospective Studies Peroxidase Biochemistry Genetics and Molecular Biology (all) Receiver operating characteristic business.industry Granulomatosis with Polyangiitis medicine.disease respiratory tract diseases ROC Curve Wegener's granulomatosi Case-Control Studies Immunology Reagent Kits Diagnostic Granulomatosis with Polyangiiti business |
| Popis: | The value of anti-neutrophil cytoplasmic antibody (ANCA) detection for monitoring disease activity in ANCA-associated systemic vasculitis (AASV) remains controversial. The aim of our work was to rate the performance of a new automated fluorescence PR3 and MPO-ANCA immunoassay (EliA) for monitoring disease activity in AASV. We evaluated 100 serum samples from 71 AASV patients (with Wegener's granulomatosis, microscopic polyangiitis, and Churg-Strauss syndrome) as well as sera from 58 pathological and 35 normal controls. In addition to PR3 and MPO-ANCA EliA, we performed indirect immunofluorescence and "homemade" PR3 and MPO-ANCA ELISA tests. In AASV patients, ANCA levels were correlated with disease activity, according to the Birmingham Vasculitis Activity Score (BVAS). We derived cutoff limits from receiver operating characteristic (ROC) curve analysis comparing AASV with pathological controls. Our results showed that EliA and ELISA had comparable sensitivity (76%) and specificity (95%). The analysis of active versus inactive status and correlation with ANCA levels showed a clear difference between BVAS Group I (score ≤ 4) and BVAS Group II (scores > 4) (AUC = 0.86 vs. 0.72; relative risk [RR] = 2.4; P < 0.0001) for PR3-ANCA, but not for MPO-ANCA (AUC = 0.94 vs. 0.87; RR = 1.48; P = 0.46). Serial serum samples from 16 patients were examined in detail. For the majority of patients, for both PR3 and MPO-ANCA, change in titer was strongly associated with change in BVAS score. Our data showed a good correlation between ANCA titer (especially for PR3) and AASV disease activity. We recommend that ANCA titer be used to monitor AASV disease activity with the caveat that a few exceptions, in particular with MPO-ANCA, are possible. © 2005 New York Academy of Sciences |
| Databáze: | OpenAIRE |
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