학술논문
Comparison of ANA testing by indirect immunofluorescence or solid-phase assays in a low pre-test probability population for systemic autoimmune disease: the Camargo Cohort.
Document Type
Academic Journal
Author
Martinez-Revuelta D; Family Medicine, Healthcare Center Astillero, Santander, Spain.; Irure-Ventura J; Immunology Department, University Hospital Marqués de Valdecilla, Santander, Spain.; Research Institute 'Marqués de Valdecilla' (IDIVAL) Santander, Spain.; López-Hoyos M; Immunology Department, University Hospital Marqués de Valdecilla, Santander, Spain.; Research Institute 'Marqués de Valdecilla' (IDIVAL) Santander, Spain.; University of Cantabria Santander, Spain.; Olmos JM; Internal Medicine Department, University Hospital Marqués de Valdecilla, Santander, Spain.; Research Institute 'Marqués de Valdecilla' (IDIVAL) Santander, Spain.; University of Cantabria Santander, Spain.; Pariente E; Family Medicine, Healthcare Center Camargo, Santander, Spain.; Martín-Millán M; Internal Medicine Department, University Hospital Marqués de Valdecilla, Santander, Spain.; Research Institute 'Marqués de Valdecilla' (IDIVAL) Santander, Spain.; University of Cantabria Santander, Spain.; Nan D; Internal Medicine Department, University Hospital Marqués de Valdecilla, Santander, Spain.; Research Institute 'Marqués de Valdecilla' (IDIVAL) Santander, Spain.; University of Cantabria Santander, Spain.; Comins-Boo A; Immunology Department, University Hospital Marqués de Valdecilla, Santander, Spain.; Research Institute 'Marqués de Valdecilla' (IDIVAL) Santander, Spain.; Martínez-Taboada VM; Rheumatology Division, University Hospital Marqués de Valdecilla Santander, Spain.; Research Institute 'Marqués de Valdecilla' (IDIVAL) Santander, Spain.; University of Cantabria Santander, Spain.; Hernández JL; Internal Medicine Department, University Hospital Marqués de Valdecilla, Santander, Spain.; Research Institute 'Marqués de Valdecilla' (IDIVAL) Santander, Spain.; University of Cantabria Santander, Spain.
Source
Publisher: Walter De Gruyter Country of Publication: Germany NLM ID: 9806306 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 1437-4331 (Electronic) Linking ISSN: 14346621 NLM ISO Abbreviation: Clin Chem Lab Med Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: Autoantibodies and, specifically antinuclear antibodies (ANA), are the hallmark of systemic autoimmune diseases (AID). In the last decades, there has been great technical development to detect these autoantibodies along with an increased request for this test by clinicians, while the overall pre-test probability has decreased. In this study, we compare the diagnostic performance of three different methods for ANA screening (indirect immunofluorescence [IIF], addressable laser bead immunoassay [ALBIA], and fluorescence enzyme immunoassay [FEIA]).
Methods: Serum samples at baseline visit from 2,997 participants from the Camargo Cohort, a population with an overall low pre-test probability for systemic AID, were analyzed with the three methods. Participants have a minimum follow-up of 10 years and the development of autoimmune diseases was collected from clinical records.
Results: The highest frequency of positive ANA was observed by IIF assay. However, ALBIA showed high sensitivity for AID. Likewise, solid phase assays (SPA) presented higher specificity than IIF for AID. ANA prevalence with any method was significantly higher in females and overall increased with age. Triple positivity for ANA was significantly related to the presence of anti-dsDNA-SSA/Ro60, Ro52, SSB/La, RNP, Scl-70, and centromere-specificities. No association was found for anti-Sm - RNP68, or ribosomal P - specificities. Noteworthy, triple positivity for ANA screening was associated with diagnosis of systemic AID both at baseline visit and follow-up.
Conclusions: ANA detection by IIF may be better when the pre-test probability is high, whereas SPA techniques are more useful in populations with an overall low pre-test probability for systemic AID.
(© 2023 Walter de Gruyter GmbH, Berlin/Boston.)
Methods: Serum samples at baseline visit from 2,997 participants from the Camargo Cohort, a population with an overall low pre-test probability for systemic AID, were analyzed with the three methods. Participants have a minimum follow-up of 10 years and the development of autoimmune diseases was collected from clinical records.
Results: The highest frequency of positive ANA was observed by IIF assay. However, ALBIA showed high sensitivity for AID. Likewise, solid phase assays (SPA) presented higher specificity than IIF for AID. ANA prevalence with any method was significantly higher in females and overall increased with age. Triple positivity for ANA was significantly related to the presence of anti-dsDNA-SSA/Ro60, Ro52, SSB/La, RNP, Scl-70, and centromere-specificities. No association was found for anti-Sm - RNP68, or ribosomal P - specificities. Noteworthy, triple positivity for ANA screening was associated with diagnosis of systemic AID both at baseline visit and follow-up.
Conclusions: ANA detection by IIF may be better when the pre-test probability is high, whereas SPA techniques are more useful in populations with an overall low pre-test probability for systemic AID.
(© 2023 Walter de Gruyter GmbH, Berlin/Boston.)