Analysis of antinuclear antibody titers and patterns by using HEp‐2 and primate liver tissue substrate indirect immunofluorescence assay in patients with systemic autoimmune rheumatic diseases

Wei, Qiujing; Jiang, Yutong; Xie, Junqiu; Lv, Qing; Xie, Ya; Tu, Liudan; Xiao, Min; Wu, Zhongming; J, Gu

doi:10.1002/jcla.23546

Cited by 16 publications

(13 citation statements)

References 32 publications

(47 reference statements)

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“…To the best of our knowledge, the cytoplasmic pattern of ANA indicates the existence of AMA, thus favoring the diagnosis of PBC [30,31]. It has been reported that 59% of patients with SS display cytoplasmic pattern positivity, and patients with autoimmune disease and cytoplasmic pattern positivity exhibit hepatic involvement [32]. Our study found that 85.4% of patients with SS ± PBC had a cytoplasmic pattern, which was similar to the 62.2-85.7% of patients with PBC reported in the literature [31,33] but higher than the 57.14% (4/13) of patients with SS ± PBC in the literature [33].…”

Section: Discussionmentioning

confidence: 92%

Laboratory risk factors for coexistent primary biliary cholangitis in patients with Sjögren’s syndrome: a retrospective study

Gao

Xiao

Yang

et al. 2023

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Background There is limited research on the laboratory characteristics of coexistent primary biliary cholangitis (PBC) and Sjögren's syndrome (SS). This study aimed to investigate the laboratory risk factors for the coexistence of PBC in patients with SS. Methods Eighty-two patients with coexistent SS and PBC (median age 52.50 years) and 82 age- and sex-matched SS controls were retrospectively enrolled between July 2015 and July 2021. The clinical and laboratory characteristics of the two groups were compared. Laboratory risk factors for the coexistence of PBC in patients with SS were analyzed using logistic regression analysis. Results Both groups had a similar prevalence of hypertension, diabetes, thyroid disease, and interstitial lung disease. Compared with the SS group, patients in the SS + PBC group had higher levels of liver enzymes, immunoglobulins M (IgM), G2, and G3 (P < 0.05). The percentage of patients with an antinuclear antibody (ANA) titer > 1:10000 in the SS + PBC group was 56.1%, higher than that in the SS group (19.5%, P < 0.05). In addition, cytoplasmic, centromeric, and nuclear membranous patterns of ANA and positive anti-centromere antibody (ACA) were observed more frequently in the SS + PBC group (P < 0.05). Logistic regression analysis showed that elevated IgM levels, high ANA titer, cytoplasmic pattern, and ACA were independent risk factors for PBC coexistence in SS. Conclusion In addition to established risk factors, elevated IgM levels, positive ACA, and high ANA titer with cytoplasmic pattern also provide clues to clinicians for the early screening and diagnosis of PBC in patients with SS.

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Section: Discussionmentioning

confidence: 92%

Laboratory risk factors for coexistent primary biliary cholangitis in patients with Sjögren’s syndrome: a retrospective study

Gao

Xiao

Yang

et al. 2023

Preprint

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“…Some population-based studies published in recent years do not specify ANA-HEp-2 patterns or use automated or semiautomated ANA reading systems, with limited fluorescent patterns, making comparisons with our findings difficult [6][7][8]22]. Wei et al [20], in a patient-based study with 4583 individuals (3510 with SARD and 1073 HI), found AC-4, AC-1, AC-5, AC-8-9, and mixed patterns to be the most frequent results in the SARD group (HEp-2 test positivity = 78.7%). In the HI group, 12.2% of HEp-2 tests were positive, and AC-2, AC-4, AC-1, and AC-8-9 were more frequently observed [20].…”

Section: Discussionmentioning

confidence: 97%

“…Wei et al [20], in a patient-based study with 4583 individuals (3510 with SARD and 1073 HI), found AC-4, AC-1, AC-5, AC-8-9, and mixed patterns to be the most frequent results in the SARD group (HEp-2 test positivity = 78.7%). In the HI group, 12.2% of HEp-2 tests were positive, and AC-2, AC-4, AC-1, and AC-8-9 were more frequently observed [20]. Augustinelli et al [11], in a study involving 1969 Brazilian individuals divided into three groups (HI; nonautoimmune disease -NAD; and SARD), found HEp-2 IIF positivity equal to 21.4%.…”

Section: Discussionmentioning

confidence: 99%

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The influence of demography and referral medical specialty on the detection of autoantibodies to HEP-2 cells in a large sample of patients

et al. 2022

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Background The prevalence of anti-cell autoantibodies detected by indirect immunofluorescence assay on HEp-2 cells (HEp-2-IIFA) increases with age and is higher in female sex. The number of medical specialties that use HEp-2-IIFA in the investigation of autoimmune diseases has increased lately. This study aimed to determine the prevalence and patterns of autoantibodies on HEp-2-IIFA according to demographics variables and referring medical specialties. Methods A retrospective analysis of the HEp-2-IIFA carried out between January and June of 2017 was performed. The International Consensus on Antinuclear Antibodies Patterns (ICAP) and the Brazilian Consensus on Autoantibodies were used for patterns definition on visual reading of the slides. Anti-cell (AC) codes from ICAP and Brazilian AC codes (BAC) were used for patterns classification. Results From 54,990 samples referred for HEp-2-IIF testing, 20.9% were positive at titer ≥ 1/80. HEp-2-IIFA positivity in females and males was 24% and 12%, respectively (p < 0.0001). The proportion of positive results in the 4 age groups analyzed: 0–19, 20–39, 40–59, and ≥ 60 years was 23.3, 20.2, 20.1, and 22.8%, respectively (p < 0.0001). Considering all positive sera (n = 11,478), AC-4 nuclear fine speckled (37.7%), AC-2 nuclear dense fine speckled (21.3%), BAC-3 nuclear quasi-homogeneous (10%) and mixed/composite patterns (8.8%) were the most prevalent patterns. The specialties that most requested HEp-2-IIFA were general practitioner (20.1%), dermatology (15%), gynecology (9.9%), rheumatology (8.5%), and cardiology (5.8%). HEp-2-IIFA positivity was higher in patients referred by rheumatologists (35.7% vs. 19.6%) (p < 0.0001). Moderate (46.4%) and high (10.8%) titers were more observed in patients referred by rheumatologists (p < 0.0001). We observed a high proportion of mixed and cytoplasmic patterns in samples referred by oncologists and a high proportion of BAC-3 (nuclear quasi-homogeneous) pattern in samples referred by pneumologists. Conclusions One-fifth of the patients studied were HEp-2-IIFA-positive. The age groups with more positive results were 0–19 and ≥ 60 years. AC-4, AC-2, BAC-3 and mixed/composite patterns were the most frequent patterns observed. Rheumatologists requested only 8.5% of HEp-2-IIFA. Positive results and moderate to high titers of autoantibodies were more frequent in patients referred by rheumatologists.

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“…The mixed patterns in our study referred to the existence of two or more patterns. The mixed patterns could provide a hint for SSc (43.4%) and SLE (27.8%) 13 . Though, in this study, ANA pattern and titer were found irrelevant with the severe course of infection.…”

Section: Discussionmentioning

confidence: 99%

Antinuclear antibodies (ANA) in COVID-19 infection

Yumuk

Okumuş

2021

Preprint

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We examined correlates of antinuclear antibody (ANA) positivity in individuals with COVID-19 infection. Sera from 156 patients were evaluated by indirect immunofluorescence on Hep-2 cells for ANA pattern and semi-quantitative titer. There was a significant difference in the prevalence of ANA (1:100) by gender (P = 0.0294). Male gender was correlated with ANA positivity and association persisted in multivariable analyses (OR = 0.354; CI: 0.139–0.816; P = 0.0200). Age (OR = 1.932; CI: 0.929–4.121; P = 0.0814), warm weather (OR = 1.307; CI: 0.611–2.921; p = 0.4989), geographic location (or = 0.886; CI:0.353–2.442; P = 0.8042), and diabetes mellitus (OR = 1.765; CI:0.513–5.477; P = 0.3369) were not correlated with ANA positivity. In this analysis, hospitalization was used as indicator for a more severe course. Of the 156 COVID-19 patients, 18 (11.5%) were hospitalized. Among 18 hospitalized patients, 4 (22.2%) were ANA positive (Table 2), although this did not reach statistical significance (OR = 0.841; CI: 0.227–2.527; p = 0.7725). In conclusion, although males were more prone to produce ANA during COVID-19 infection, this was not correlated with severe course.

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Analysis of antinuclear antibody titers and patterns by using HEp‐2 and primate liver tissue substrate indirect immunofluorescence assay in patients with systemic autoimmune rheumatic diseases

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 16 publications

References 32 publications

Laboratory risk factors for coexistent primary biliary cholangitis in patients with Sjögren’s syndrome: a retrospective study

Laboratory risk factors for coexistent primary biliary cholangitis in patients with Sjögren’s syndrome: a retrospective study

The influence of demography and referral medical specialty on the detection of autoantibodies to HEP-2 cells in a large sample of patients

Antinuclear antibodies (ANA) in COVID-19 infection

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