Performance of two strategies for urgent ANCA and anti-GBM analysis in vasculitis

Joode, Anoek A. E. de; Roozendaal, Caroline; Leij, Marcel J. van der; Bungener, Laura; Sanders, Jan-Stephan; Stegeman, Coen A.

doi:10.1016/j.ejim.2013.11.011

Cited by 15 publications

(13 citation statements)

References 23 publications

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“…The Phadia ELiA test for antiPR3s or anti-MPOs produced positive results for 57 of 62 AAV patients (sensitivity 92%, NPV 97%), with five falsepositive results (specificity 97%, PPV 88%). The routine ELISA yielded similar results (sensitivity 94%, specificity 97%, PPV 88%, NPV 98%) [16].…”

Section: Criteria Subcriteria Pointssupporting

confidence: 56%

“…This can cause a significant delay in arriving at a diagnosis particularly for critical patients. One study, therefore, involving 260 consecutive patients suspected of AAV, looked at the accuracy of rapid tests (dot blot method, with results within two hours) when it comes to analyzing anti-PR3 ab, anti-MPO ab and anti-GBM ab by means of standard diagnostic procedures (IFA and ELISA) [16]. For a total of 74 patients in this study, the diagnosis was AAV (n = 62) or anti-GBM disease (n = 12).…”

Section: Criteria Subcriteria Pointsmentioning

confidence: 99%

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Laboratory testing for systemic autoimmune diseases

Diller

2016

LaboratoriumsMedizin

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The detection of autoantibodies is well established in daily clinical practice for evaluation of systemic autoimmune diseases like rheumatoid arthritis (RA), connective tissue diseases and vasculitides. Rheumatoid factor (RF) or the anti-citrullinated protein antibody (ACPA) is only observed in approximately 80% of patients suffering from rheumatoid arthritis. Anti-CarP autoantibodies might serve as a novel marker, filling this gap. The detection of anti-nuclear antibody (ANA) facilitates the diagnosis of connective tissue diseases. Elevated levels of anti-centromer antibodies, anti-topoisomerase I [anti-Scl-70] antibodies and the anti-RNA polymerase III antibodies, which belong to the group of ANA, are frequently present in the serum of patients suffering from systemic sclerosis and are therefore incorporated into the new classification criteria. To establish the diagnosis of an antiphospholipid syndrome, the detection of the lupus anticoagulant and the aCL-/anti-β2GPI-antibodies of IgG, IgM and IgA isotypes plays a pivotal role. The antineutrophil cytoplasmic antibodies (ANCAs) are associated with vasculitides of small vessels. Screening with immunofluorescence testing (IFT) is established as the first step followed by additional immunoassays specific for proteinase 3 (PR3) and myeloperoxidase (MPO) autoantibodies. Novel bedside test procedures for these antibodies allow an early diagnosis in critically ill patients. New biomarkers for polymyalgia rheumatic and for spondyloarthritides are also described, but their clinical relevance remains uncertain and necessitates further studies.

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Section: Criteria Subcriteria Pointssupporting

confidence: 56%

Section: Criteria Subcriteria Pointsmentioning

confidence: 99%

Laboratory testing for systemic autoimmune diseases

Diller

2016

LaboratoriumsMedizin

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“…cytoplasmic, perinuclear or atypical ANCA) and ANCA titers. ANCA specificity for anti-proteinase 3 (anti-PR3) and anti-myeloperoxidase (anti-MPO) antibodies was confirmed by an in-house capture enzyme-linked immunosorbent assay (ELISA) as described earlier [17]. …”

Section: Methodsmentioning

confidence: 99%

M2 macrophage is the predominant phenotype in airways inflammatory lesions in patients with granulomatosis with polyangiitis

et al. 2017

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BackgroundMacrophages may present two distinct phenotypes indicated as M1 and M2 under different stimuli. M1 and M2 macrophages have divergent functions that range from enhancement of inflammation for M1 to tissue repair and remodeling for M2 macrophages. The objective of this study was to evaluate the distribution of M1 and M2 macrophage phenotypes in biopsies from the airways of patients with active granulomatosis with polyangiitis (GPA) and to analyze their associations with T and B cells in those biopsies, and with nasal carriage of Staphylococcus aureus, disease parameters and therapy.MethodsConsecutive GPA patients (n = 35) with active airway disease, who underwent respiratory tract biopsy were included. Immunohistochemical evaluation was performed to assess the distribution of macrophages and T and B cells using the markers CD68, CD3 and CD20, respectively. CD86 was used as the M1 marker and CD163 as the M2 marker while Tbet and GATA-3 were used as Th1 and Th2 markers, respectively. At the time of the biopsy patients were assessed for nasal carriage of Staphylococcus aureus and treatment.ResultsPercentages of macrophages and T cells were significantly higher than those of B cells in lesional tissue from the respiratory tract in GPA. M2 macrophages and Th2 cells were more frequent than M1 macrophages (p = 0.0007) and Th1 cells (p < 0.0001), respectively. Percentages of T cells were higher in nose biopsies than in biopsies from other sites (p = 0.021); macrophages and CD163+ macrophages were more predominant in biopsy sites other than the nose (p = 0.039 and p = 0.012, respectively). Carriage of Staphylococcus aureus was associated with higher T cell scores (p = 0.014). The frequency of macrophages, especially M2 macrophages, was higher in GPA patients treated with immunosuppressive agents (p = 0.010); daily prednisolone dose was positively correlated with all macrophage markers. However, in multivariate analysis no independent associations were found between disease parameters and therapy with macrophage markers or T cells.ConclusionIn GPA, M2 is the predominant macrophage phenotype in the respiratory tract. Although some associations were observed between macrophages and T cells with therapy and nasal carriage of Staphylococcus aureus, they were not independently significant in multivariate analysis.Electronic supplementary materialThe online version of this article (doi:10.1186/s13075-017-1310-4) contains supplementary material, which is available to authorized users.

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“…This is the case, for example, with ANCA-associated small-vessel vasculitis, particularly Goodpasture syndrome with its characteristic circulating anti-glomerular basement membrane antibodies [41], and with Graves–Basedow disease, which is induced by anti-TSH receptor antibodies, in which thyroid crisis is the initial presentation [42, 43]. …”

Section: Turnaround Time and Effectiveness Of Responsementioning

confidence: 99%

Chemiluminescent immunoassay technology: what does it change in autoantibody detection?

Cinquanta

Fontana

Bizzaro³

2017

Autoimmun Highlights

193

122

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Diagnostic technology is rapidly evolving, and over the last decade, substantial progress has been made even for the identification of antibodies, increasingly approaching this type of diagnostic to that of automated clinical chemistry laboratory. In this review, we describe the analytical and diagnostic characteristics of chemiluminescence technology in its strength and in its applicability for a more rapid and accurate diagnosis of autoimmune diseases. The wide dynamic range, greater than that of immunoenzymatic methods, the high sensitivity and specificity of the results expressed in quantitative form, the high degree of automation and the clinical implications related to the reduction in the turnaround time, and the ability to run a large number of antibody tests (even of different isotypes), directed towards large antigenic panels in random access mode, make this technology the most advanced in the clinical laboratory, with enormous repercussions on the workflow and on the autoimmunology laboratory organisation. Further improvements are expected in the coming years with the development of new analytical platforms such as the flow-injection chemiluminescent immunoassay, the two-dimensional resolution for chemiluminescence multiplex immunoassay and the magnetic nanoparticles chemiluminescence immunoassay, which will likely result in additional increases in the clinical efficacy of antibody tests.

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Performance of two strategies for urgent ANCA and anti-GBM analysis in vasculitis

Cited by 15 publications

References 23 publications

Laboratory testing for systemic autoimmune diseases

Laboratory testing for systemic autoimmune diseases

M2 macrophage is the predominant phenotype in airways inflammatory lesions in patients with granulomatosis with polyangiitis

Chemiluminescent immunoassay technology: what does it change in autoantibody detection?

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