Solid phase assays versus automated indirect immunofluorescence for detection of antinuclear antibodies

Claessens, Jolien; Belmondo, Thibaut; Langhe, Ellen De; Westhovens, René; Poesen, Koen; Hüe, Sophie; Blockmans, Daniel Engelbert; Mähler, Michael; Fritzler, Marvin J.; Bossuyt, Xavier

doi:10.1016/j.autrev.2018.03.002

Cited by 59 publications

(54 citation statements)

References 22 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is in line with recent studies that showed that combining an immunoassay with ANA IIF adds value if the results of both tests are correctly judged in the context of the clinical manifestations of the patient (42,43). Furthermore, combining IIF with a solid-phase assay can assist in patient strati cation, especially in case of a low-positive ANA IIF titer (42,44,45). ICAP promotes to integrate the ANA IIF titer and pattern with advice for follow-up testing, taking into account the clinical presentation of the patient (10,46).…”

Section: Discussionsupporting

confidence: 85%

Current laboratory and clinical practices in reporting and interpreting anti-nuclear antibody indirect immunofluorescence (ANA IIF) patterns: results of an international survey. 

Hoovels

Broeders

Chan

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

BackgroundThe International Consensus on Antinuclear Antibody (ANA) Patterns (ICAP) has recently proposed nomenclature in order to harmonize ANA indirect immunofluorescence (IIF) pattern reporting. ICAP distinguishes competent-level from expert-level patterns. A survey was organized to evaluate reporting, familiarity, and considered clinical value of ANA IIF patterns. MethodsTwo surveys were distributed by European Autoimmunity Standardization Initiative (EASI) working groups, the International Consensus on ANA Patterns (ICAP) and UK NEQAS to laboratory professionals and clinicians. Results438 laboratory professionals and 248 clinicians from 67 countries responded. Except for dense fine speckled (DFS), the nuclear competent patterns were reported by >85% of the laboratories. Except for rods and rings, the cytoplasmic competent patterns were reported by >72% of laboratories. Cytoplasmic IIF staining was considered ANA positive by 55% of clinicians and 62% of laboratory professionals, with geographical and expertise-related differences. Quantification of fluorescence intensity was considered clinically relevant for nuclear patterns, but less so for cytoplasmic and mitotic patterns. Combining IIF with specific extractable nuclear antigens (ENA)/dsDNA antibody testing was considered most informative. Of the nuclear competent patterns, the centromere and homogeneous pattern obtained the highest scores for clinical relevance and the DFS pattern the lowest. Of the cytoplasmic patterns, the reticular/mitochondria-like pattern obtained the highest scores for clinical relevance and the polar/Golgi-like and rods and rings patterns the lowest. ConclusionThis survey confirms that the major nuclear and cytoplasmic ANA IIF patterns are considered clinically important. There is no unanimity on classifying DFS, rods and rings and polar/Golgi-like as a competent pattern and on reporting cytoplasmic patterns as ANA IIF positive.

show abstract

Section: Discussionsupporting

confidence: 85%

Current laboratory and clinical practices in reporting and interpreting anti-nuclear antibody indirect immunofluorescence (ANA IIF) patterns: results of an international survey. 

Hoovels

Broeders

Chan

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Different weights could be assigned to an IIF result depending on the level of positivity. Furthermore, combining IIF with solid-phase assay can help to better stratify patients, especially in case of low-positive IIF titre 9–11…”

mentioning

confidence: 99%

Antinuclear antibody as entry criterion for classification of systemic lupus erythematosus: pitfalls and opportunities

Willems

Langhe²,

Westhovens

et al. 2018

Ann Rheum Dis

Self Cite

View full text Add to dashboard Cite

Acknowledgements We thank Laura Hendrickx, Marie-Christine Clukkers and Silke Willebrords for expert technical assistance. Contributors PW reviewed all the medical records of the patients included and performed the analysis. EDL, RW, SV and DB took care of the patients and helped with clinical classification of the patients. XB wrote a draft of the manuscript. All authors reviewed the draft and approved the submission of the manuscript.

show abstract

“…In addition, the harmonization of ANA IFA testing is challenging because other variables such as laboratory equipment (i.e., microscope optics and light sources), serum screening dilutions, and other factors have yet to be standardized [33,34]. There is evidence that the recent introduction of automated microscopic testing provides more harmonized ANA IFA results [35][36][37]. However, this technology requires a quality assurance program that addresses the total ANA IFA process.…”

Section: Important Considerations In Interpretation Of Ana Test Resulmentioning

confidence: 99%

“…For the most part, SPMAAs are widely available and are currently used either as an approach to the diagnosis of specific SARDs (i.e., separate SLE, scleroderma (SSc), Sjögren's syndrome (SjS), autoimmune inflammatory myopathy (AIM) profiles), and/or the most common targets seen in SARDs included in a SARD screen as an alternative to the ANA IFA. However, there is some evidence that while SPMAA are a significant move forward, combining ANA IFA with SPMAA has higher clinical impact than either of the tests alone [3,20,36,42,43]. SLE serum samples that have negative SPMAA test results should ideally be tested by ANA IFA to determine if antibodies to targets not included in the SPMAA are detected.…”

Section: Important Considerations In Interpretation Of Ana Test Resulmentioning

confidence: 99%

Challenges and Advances in SLE Autoantibody Detection and Interpretation

Choi

Fritzler

2019

Curr Treat Options in Rheum

Self Cite

View full text Add to dashboard Cite

Purpose of review This review is an overview of key autoantibodies used in the diagnosis and management of SLE. Questions addressed are the advantages to but limitations of ANA testing and what are the key considerations in ordering ANA tests and then interpreting the ANA results. Recent findings There is a progressive move towards • Solid-phase multi-analyte arrays with algorithmic analysis (SPMAAA) • Closing the seronegative gap in SLE • Harmonization of ANA testing Summary As an approach to limiting morbidity and rising health care costs associated with SLE, the future of ANA testing should focus on making an accurate and actionable diagnosis of very early SLE. To achieve this goal, harmonization of autoantibody testing will be important. Autoantibodies in SLE Choi and Fritzler

show abstract

Solid phase assays versus automated indirect immunofluorescence for detection of antinuclear antibodies

Cited by 59 publications

References 22 publications

Current laboratory and clinical practices in reporting and interpreting anti-nuclear antibody indirect immunofluorescence (ANA IIF) patterns: results of an international survey.

Current laboratory and clinical practices in reporting and interpreting anti-nuclear antibody indirect immunofluorescence (ANA IIF) patterns: results of an international survey.

Antinuclear antibody as entry criterion for classification of systemic lupus erythematosus: pitfalls and opportunities

Challenges and Advances in SLE Autoantibody Detection and Interpretation

Contact Info

Product

Resources

About

Solid phase assays versus automated indirect immunofluorescence for detection of antinuclear antibodies

Cited by 59 publications

References 22 publications

Current laboratory and clinical practices in reporting and interpreting anti-nuclear antibody indirect immunofluorescence (ANA IIF) patterns: results of an international survey.&nbsp;

Current laboratory and clinical practices in reporting and interpreting anti-nuclear antibody indirect immunofluorescence (ANA IIF) patterns: results of an international survey.&nbsp;

Antinuclear antibody as entry criterion for classification of systemic lupus erythematosus: pitfalls and opportunities

Challenges and Advances in SLE Autoantibody Detection and Interpretation

Contact Info

Product

Resources

About

Current laboratory and clinical practices in reporting and interpreting anti-nuclear antibody indirect immunofluorescence (ANA IIF) patterns: results of an international survey.

Current laboratory and clinical practices in reporting and interpreting anti-nuclear antibody indirect immunofluorescence (ANA IIF) patterns: results of an international survey.