Efficiency of different strategies to detect autoantibodies to extractable nuclear antigens
| Autor: | Buenaventura Brito Díaz, Antonio Cabrera de León, Armando Aguirre Jaime, Ana González Hernández, Diego García García, María del Cristo Rodríguez Pérez, Carmen Vázquez Moncholi, Delia Almeida González |
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| Rok vydání: | 2010 |
| Předmět: |
Immunodiffusion
Anti-nuclear antibody Cost effectiveness Extractable nuclear antigens Cost-Benefit Analysis Immunology Enzyme-Linked Immunosorbent Assay Epitopes Antigen Seroepidemiologic Studies Cell Line Tumor Humans Immunology and Allergy Medicine Line immunoassay Fluorescent Antibody Technique Indirect business.industry Autoantibody Antigens Nuclear Multiphasic Screening IIf Molecular biology Titer Antibodies Antinuclear business Algorithms |
| Zdroj: | Journal of Immunological Methods. 360:89-95 |
| ISSN: | 0022-1759 |
| DOI: | 10.1016/j.jim.2010.06.013 |
| Popis: | Autoantibodies to extractable nuclear antigens (anti-ENA) are identified mainly in samples positive for antinuclear antibodies (ANA). Although the method of choice for ANA screening is indirect immunofluorescence (IIF), several techniques are available to detect anti-ENA. The aim of this study was to compare the efficiency of five different strategies to determine anti-ENA. During a 2-year period we screened ANA in 30375 samples with IIF, and the 4475 samples ANA positive were tested for anti-ENA by double immune diffusion screening or fluoroenzymeimmunoassay (Screening FI); anti-ENA specificities were then determined by line immunoassay (LIA) or fluoroenzymeimmunoassay (FI). We compared five strategies that involved FI or LIA identification of anti-ENA with or without prior screening, or an algorithm that combined fluorescence pattern, number of anti-ENA specificities requested by the clinician and ANA dilution titer. One cost unit (CU) was defined as the cost of 1 test of ANA determination. We detected 553 anti-ENA positive samples. The most efficient strategy was the algorithm, at a cost of 3.3 CU per sample processed, the second most efficient strategy was screening plus FI identification (cost=3.8 CU), and the third most efficient strategy was screening plus LIA identification (cost=3.9 CU). The fourth most efficient strategy was FI identification without prior screening (13.3 CU per sample) and the least efficient was LIA identification without prior screening (13.6 CU per sample). In conclusion, an algorithm that combined techniques for detection, ANA titer, fluorescence pattern and number of specificities requested was the most efficient strategy for determining anti-ENA. |
| Databáze: | OpenAIRE |
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