Automation, consolidation, and integration in autoimmune diagnostics

Abstract

Over the past two decades, we have witnessed an extraordinary change in autoimmune diagnostics, characterized by the progressive evolution of analytical technologies, the availability of new tests, and the explosive growth of molecular biology and proteomics. Aside from these huge improvements, organizational changes have also occurred which brought about a more modern vision of the autoimmune laboratory. The introduction of automation (for harmonization of testing, reduction of human error, reduction of handling steps, increase of productivity, decrease of turnaround time, improvement of safety), consolidation (combining different analytical technologies or strategies on one instrument or on one group of connected instruments) and integration (linking analytical instruments or group of instruments with pre- and post-analytical devices) opened a new era in immunodiagnostics. In this article, we review the most important changes that have occurred in autoimmune diagnostics and present some models related to the introduction of automation in the autoimmunology laboratory, such as automated indirect immunofluorescence and changes in the two-step strategy for detection of autoantibodies; automated monoplex immunoassays and reduction of turnaround time; and automated multiplex immunoassays for autoantibody profiling.

Clinical consequences of polymerase chain reaction‐based diagnosis of intestinal parasitic infections

“…Naturally, these costs are dependent on the amount of stool samples processed, cost of labor, and current technology in place. As an additional benefit of automation of PCR procedures, the influence of human errors on test results can be minimized . For this reason, the amount of cases in which human errors can occur is already smaller for PCR detection compared with microscopy detection.…”

Multiplex Technology for Biomarker Immunoassays

“…which are characterised by the presence of autoantibodies of different isotypes. Nowadays, multiplex technology has achieved high analytical accuracy and provides results comparable or superior to the manual and automated monoplex technology [29]. Multiplex autoantibody assays can detect many specific autoantibodies in a single run, whereas the traditional ELISA uses a single antigen to detect only a single autoantibody.…”

The clinical and the laboratory autoimmunologist: Where do we stand?

“…In Italy as well as in other countries this phenomenon has materialized in parallel with the progressive transfer of autoimmune diagnostics from small-medium size hospital laboratories spread throughout the territory to big laboratories at the provincial/regional level. This epochal change to a model of consolidated analytical activity was made both for reasons of economies of scale and in order to concentrate professional expertise [ 10 ]. It also involved small but highly specialized university laboratories in moving towards a model of laboratory medicine less oriented to the academy and more to patient’s care [ 20 ].…”

“…At the same time, the technological progress and the activity of the biomedical industry in the sector has produced new analytical methods and new automated instrumental platforms allowing a faster and more precise and accurate execution of autoantibody tests, configuring a profound revolution in autoimmune diagnostics. Therefore, the organizational structure of clinical laboratories has progressively changed to respond more and more efficiently to clinical needs through the consolidation of autoantibody tests in larger laboratories with higher operational capacity and the transition of production lines from academic laboratories to general laboratories [ 10 ].…”