Second generation analysis of antinuclear antibody (ANA) by combination of screening and confirmatory testing
| Autor: | Stefan Rödiger, Kai Grossmann, Ilka Knütter, Dirk Roggenbuck, Karsten Conrad, Nadja Röber, Rico Hiemann, Peter Schierack, Dimitrios P. Bogdanos, Dirk Reinhold, Antonella Radice, Pier Luigi Meroni, Juliane Scholz, Mandy Sowa |
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| Rok vydání: | 2015 |
| Předmět: |
Paraproteinemia
Anti-nuclear antibody Clinical Biochemistry Serology Autoimmune Diseases Rheumatic Diseases medicine Humans skin and connective tissue diseases Fluorescent Antibody Technique Indirect Immunoassay medicine.diagnostic_test biology business.industry Biochemistry (medical) Autoantibody IIf General Medicine Hep G2 Cells medicine.disease Rheumatoid arthritis Antibodies Antinuclear Immunology biology.protein Antibody business |
| Zdroj: | Clinical chemistry and laboratory medicine. 53(12) |
| ISSN: | 1437-4331 |
| Popis: | For the serological diagnosis of systemic autoimmune rheumatic diseases, a two-tier approach starting with sensitive antinuclear antibody (ANA) detection by indirect immunofluorescence (IIF) on HEp-2 cells followed by characterization of positive findings with different immunoassays is recommended. To overcome drawbacks of this approach, we developed a novel technique allowing the combination of screening and simultaneous confirmatory testing. For the first time, this creates the basis for second generation ANA testing.ANA and autoantibodies (autoAbs) to double-stranded DNA (dsDNA), CENP-B, SS-A/Ro52, SS-A/Ro60, SS-B/La, RNP-Sm, Sm, and Scl-70 were determined by IIF and enzyme-linked immunosorbent assay (ELISA), respectively, and compared to simultaneous analysis thereof by second generation ANA analysis in patients with systemic lupus erythematosus (n=174), systemic sclerosis (n=103), Sjögren’s syndrome (n=46), rheumatoid arthritis (n=36), mixed and undetermined connective tissue diseases (n=13), myositis (n=21), infectious disease (n=21), autoimmune liver disease (n=93), inflammatory bowel disease (n=78), paraproteinemia (n=11), and blood donors (n=101).There was very good agreement of second generation ANA testing with classical one by IIF and ELISA regarding testing for ANA and autoAbs to dsDNA, CENP-B, SS-B, RNP-Sm, Scl-70, SS-A/Ro52, and SS-A/Ro60 (Cohen’s κ>0.8). The agreement for anti-Sm autoAb was good (κ=0.77). The differences of both approaches were not significant for autoAbs to SS-B/La, RNP-Sm, Scl-70, SS-A/Ro60, and SS-A/Ro52 (McNemar’s test, p>0.05, respectively).Second generation ANA testing can replace the two-tier analysis by combining IIF screening with multiplex confirmative testing. This addresses shortcomings of classical ANA analysis like false-negative ANA findings and lack of laboratory efficiency and standardization. |
| Databáze: | OpenAIRE |
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