The significance of cytoplasmic antinuclear antibody patterns in autoimmune liver disease

Abstract

We aimed to determine the significance of cytoplasmic antinuclear antibody (ANA) patterns using computer-aided immunofluorescence microscopy in patients with autoimmune liver diseases (AILD). ANA staining pattern was identified by treating cultured human epithelial type 2 (HEp-2) cells with the sera of the patients. Medical records of patients with suspected AILD who had positive cytoplasmic ANA patterns between February 2017 and November 2019 were retrospectively reviewed for clinical, laboratory, and immunological data. Cytoplasmic ANA patterns of AILD and non-AILD groups were compared. Further subgroup analysis of patients with AILD who had reticular or speckled cytoplasmic ANA patterns was conducted. We found that among the 196 patients with positive cytoplasmic ANA patterns, 113 (57.6%) were diagnosed with AILD. The percentage of reticular cytoplasmic pattern was higher in the AILD group than that in the non-AILD group (64.0% vs. 21.9%, p < 0.001). Furthermore, patients with AILD who exhibited a reticular ANA pattern demonstrated a higher positive rate for anti-mitochondrial antibodies (66.7% vs. 2.6%, p < 0.001) than those who exhibited the speckled ANA pattern. Moreover, AILD patients with the reticular ANA pattern displayed a lower positive rate for anti-smooth muscle antibodies (0% vs. 45%, p < 0.001) and nuclear ANA pattern (73.2% vs. 97.5%, p = 0.003) than those with the speckled ANA pattern. Therefore, cytoplasmic ANA patterns could be used to guide AILD characterization in suspected AILD cases, especially as the reticular ANA pattern is strongly associated with AILD. Thus, it is important to check cytoplasmic ANA patterns for AILD evaluation, even when nuclear ANA patterns are negative.

Clinical Significance of Uncommon, Non-Clinical, and Novel Autoantibodies

“…Patients with a reticular cytoplasmic staining showed a higher positive frequency for mitochondrial autoantibodies and a lower positive frequency for smooth muscle autoantibodies and nuclear ANA staining than people who exhibited the speckled cytoplasmic pattern. 69 Therefore, they concluded that positive cytoplasmic reticular staining patterns should be employed to manage autoimmune liver disease description in presumed clinical cases.…”

The Contemporary Role of Antinuclear Antibodies in Early Diagnosis of Autoimmune Rheumatic Diseases

“…Autoimmune liver diseases are detectable using the peripheral homogeneous and filamentous subtypes of cytoplasmic fluorescence [18]. The mitochondrial subtype of cytoplasmic fluorescence is highly specific and indicative of autoimmune liver disease [19]. Fine speckled fluorescence has very low specificity and may indicate the presence of systemic rheumatic diseases, atopic dermatitis, psoriasis, or an oncological process [20].…”

Clinical value of chemiluminescence method for detection of antinuclear antibody profiles

“…Antinuclear antibodies (ANA) are a general term for organ-specific autoantibodies that essentially use various cellular components of eukaryotic cells as target antigens, and the spectrum of specific antibodies against the multiple substances in the nucleus is regarded as ANA spectrum[ 1 , 2 ]. It is irreplaceable and essential for the clinical diagnosis, disease assessment, and efficacy evaluation of different autoimmune diseases[ 3 ]. The main techniques commonly used for ANA detection involve indirect fluorescent assay (IFA), enzyme-linked immune sorbent assay (ELISA), and LIA.…”