International consensus on ANA patterns (ICAP): the bumpy road towards a consensus on reporting ANA results

Damoiseaux, Jan; Mühlen, Carlos Alberto von; Torre, Ignacio García-De La; Carballo, Orlando Gabriel; Cruvinel, Wilson de Melo; Francescantônio, Paulo Luiz Carvalho; Fritzler, Marvin J.; Herold, Manfred; Mimori, Tsuneyo; Satoh, Minoru; Andrade, Luís Eduardo Coelho; Chan, Edward K. L.; Conrad, Karsten

doi:10.1007/s13317-016-0075-0

Cited by 128 publications

(136 citation statements)

References 34 publications

Supporting

Mentioning

131

Contrasting

Unclassified

Order By: Relevance

“…The provision of the ANA pattern and titer is considered to be of added clinical value, especially with respect to other methods for ANA detection (1-3, 15, 21-29). As mentioned above, the patterns most commonly recognized and reported by clinical laboratories are those staining the nuclear region, referred to as homogeneous, speckled, centromere, and nucleolar (1,2,(15)(16)(17). With the use of HEp-2 cells as the substrate, there is increasing awareness that additional nuclear staining patterns, as well as reactivity with cell compartments outside the nucleus (cytoplasmic patterns) and features associated with different stages of mitosis (mitotic patterns), may be of diagnostic relevance in SARDs (1-3, 15-17).…”

Section: Contemporary Issues On Antinuclear Antibody Nomenclaturementioning

confidence: 98%

“…While the immunological mechanisms underlying these interactions are poorly understood, the presence of ANAs generally represents abnormal responses to self-antigens, a key feature of autoimmunity. In routine clinical laboratory evaluations, ANAs are generally categorized based on the recognition of homogeneous, speckled, centromere, and nucleolar patterns (1,2,(15)(16)(17). While ANAs are used as part of diagnoses for some SARDs (e.g., SLE, MCTD, and SjS), their presence may serve as an important diagnostic support for others (SSc, IIMs, secondary SjS, and juvenile arthritis).…”

Section: Indications For Antinuclear Antibody Testingmentioning

confidence: 99%

“…The use of HEp-2 cells, of human larynx epithelioma origin, provided increased sensitivities for detecting ANAs, probably due to their ability to divide rapidly in vitro as well as the presence of large nuclei, which allowed optimal detection of patterns associated with specific autoantibodies in SARDs (4,9,10). Although the ANA IFA method continued to be plagued by a number of analytical and diagnostic challenges, increasing recognition of the use of autoantibodies to diagnose and to further stratify SARDs, as well as efforts to harmonize the nomenclatures for testing and reporting, makes this a powerful screening tool (1,(11)(12)(13)(14)(15)(16)(17). Thus, testing for ANAs or ANA-specific autoantibodies has been incorporated in a few guidelines on diagnostic criteria.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Recent Approaches To Optimize Laboratory Assessment of Antinuclear Antibodies

Tebo

2017

Clin Vaccine Immunol

View full text Add to dashboard Cite

The presence of antinuclear antibodies (ANAs) is a hallmark of a number of systemic autoimmune rheumatic diseases, and testing is usually performed as part of the initial diagnostic workup when suspicion of an underlying autoimmune disorder is high. The indirect immunofluorescence antibody (IFA) technique is the preferred method for detecting ANAs, as it demonstrates binding to specific intracellular structures within the cells, resulting in a number of staining patterns that are usually categorized based on the cellular components recognized and the degree of binding, as reflected by the fluorescence intensity or titer. As a screening tool, the ANA patterns can guide confirmatory testing useful in elucidating a specific clinical diagnosis or prognosis. However, routine use of ANA IFA testing as a global screening test is hampered by its labor-intensiveness, subjectivity, and limited diagnostic specificity, among other factors. This review focuses on current efforts to standardize the nomenclature of ANA patterns and on alternative methods for ANA determination, as well as on recent advances in image-based computer algorithms to automate IFA testing in clinical laboratories.

show abstract

Section: Contemporary Issues On Antinuclear Antibody Nomenclaturementioning

confidence: 98%

Section: Indications For Antinuclear Antibody Testingmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Recent Approaches To Optimize Laboratory Assessment of Antinuclear Antibodies

Tebo

2017

Clin Vaccine Immunol

View full text Add to dashboard Cite

show abstract

“…Thus, the term "anti-cellular antibodies" has been suggested to describe the wider spectrum of these autoantibodies. However, because the use of the ANA acronym is firmly established and universally used, the ANA term is maintained for historical reasons and for laboratory coding and invoicing 20 .…”

Section: Ana Testing-iif On Hep-2mentioning

confidence: 99%

The history and recent advancements in antinuclear antibody testing

Moschou¹,

Pipi²,

Tsirogianni³

2017

JRPMS

View full text Add to dashboard Cite

In 1948, Malcolm Hargraves, Helen Richmond, and Robert Morton during evaluation of bone marrow examinations at the Mayo Clinic (Minnesota, USA) observed exclusively in patients with systemic lupus erythematosus (SLE) the presence of abnormal cells with specific morphology (the nucleus is phagocytosed by mature leucocytes) and introduced the term "LE cell" 1 . Although LE cells are usually found in the bone borrow of these patients, it has been shown that after a period of incubation they can be formed in buffy coats of peripheral blood 2 indicating that the LE phenomenon is rather a secondary response to a blood circulating factor and not a developmental cellular defect.One year later, two research laboratories independently confirmed the inducible nature of LE phenomenon 3 . Incubation of bone marrow cells from healthy subject with plasma from SLE patients lead to the formation of LE cells. It took almost a decade and a series of ingenious research to discover that the phenomenon LE cells are autoantibodies that bind to nuclear elements. The molecular nature of the LE factor was determined when it was discovered that this factor lies in the gamma globulin fraction 4 . The nuclear specificity has been shown later by at least two different research groups at the same time. Holborow et al, showed that in all tissues examined (skin, heart muscle, kidney, thyroid and spleen) exposure of the section to LE cells positive sera resulted in marked specific fluorescence of the nuclei on subsequent staining with the anti-globulin conjugate 5 .In the same year, Holman and Kunkel published a seminal work in Science where they show that the LE serum factor possesses affinity for cell nuclei and nucleoproteins 6 . One year later, Friou and colleagues introduced an indirect immunofluorescence (IIF) assay with end-point titres for the detection of anti-nuclear antibodies 7,8 (ANA). Subsequently, three distinct classic patterns (homogeneous, speckled and nucleolar) of ANA fluorescence were described by Swanson Beck during the staining of rat liver sections with patients' serum 9 , introducing the importance of ANA pattern in clinical practice. Since then significant progress has been made on the identification of ANA specificity in SLE and other systemic autoimmune rheumatic diseases, including Rheumatoid Arthritis (RA), Sjögren's Syndrome (SjS), Systemic Sclerosis (SSc), Mixed Connective Tissue Disease (MCTD), and Idiopathic Inflammatory Myopathies (IIM). AbstractThe antinuclear antibody (ANA) testing is an indispensable diagnostic tool for the management of systemic autoimmune rheumatic diseases (SARD). From the initial discovery of ANA identification until today there has been considerable technical progress in ANA testing and standardisation which has allow the development of commercial ANA assay kits that are widespread used in clinical and research practice. In this mini-review we explore the history and recent advancements in ANA testing and provide guidelines to the laboratory interpretation and clinical assessment of ANA...

show abstract

“…Our study simply focused on the potential recognition of antisynthetase antibody (anti-SynAb)-positive patients using the results of the screening ANA on HEp-2 cells. Our definition of positive anti-CytAb is cytoplasmic staining related to Jo1 and non-Jo1 antisynthetase autoantibodies, which includes the cytoplasmic dense fine speckled pattern, the cytoplasmic fine speckled pattern, and the cytoplasmic diffuse pattern 4,5 . We recognize that many sophisticated immunology laboratories can differentiate specific cytoplasmic patterns.…”

Section: To the Editormentioning

confidence: 99%