Antinuclear antibodies: presence and specificity in autoimmune connective tissue disease in the dog

A scoping review of autoantibodies as biomarkers for canine autoimmune disease

Background

Autoantibody biomarkers are valuable tools used to diagnose and manage autoimmune diseases in dogs. However, prior publications have raised concerns over a lack of standardization and sufficient validation for the use of biomarkers in veterinary medicine.

Objectives

Systematically compile primary research on autoantibody biomarkers for autoimmune disease in dogs, summarize their methodological features, and evaluate their quality; synthesize data supporting their use into a resource for veterinarians and researchers.

Animals

Not used.

Methods

Five indices were searched to identify studies for evaluation: PubMed, CAB Abstracts, Web of Science, Agricola, and SCOPUS. Two independent reviewers (AET and ELC) screened titles and abstracts for exclusion criteria followed by full‐text review of remaining articles. Relevant studies were classified based on study objectives (biomarker, epitope, technique). Data on study characteristics and outcomes were synthesized in independent data tables for each classification.

Results

Ninety‐two studies qualified for final analysis (n = 49 biomarker, n = 9 epitope, and n = 34 technique studies). A high degree of heterogeneity in study characteristics and outcomes reporting was observed. Opportunities to strengthen future studies could include: (1) routine use of negative controls, (2) power analyses to inform sample sizes, (3) statistical analyses when appropriate, and (4) multiple detection techniques to confirm results.

Conclusions

These findings provide a resource that will allow veterinary clinicians to efficiently evaluate the evidence supporting the use of autoantibody biomarkers, along with the varied methodological approaches used in their development.

Development and evaluation of a flow cytometry microsphere assay to detect anti-histone antibody in dogs

Anti-nuclear antibody (ANA) is one of the diagnostic parameters that support a diagnosis of autoimmune disorders in humans, dogs, and horses, particularly the condition systemic lupus erythematosus (SLE). The most commonly used method for detecting ANA in canine serum is the indirect immunofluorescence antibody assay (IFA) that detects dog IgG with reactivity towards mammalian cell nuclei. Interpretation of the IFA results is very subjective and dependent on the source of tissue/cellular substrate. We have developed a flow cytometry based assay to detect canine serum antibodies specific to histones. Histones were chosen as the target antigen because these nuclear proteins are the most common nuclear substrate for ANA in dogs with SLE. Microsphere beads were coated with histones and incubated with canine sera. Bound anti-histone antibodies were detected by FITC-conjugated rabbit F(ab')2 anti-dog IgG. Sera from four groups of dogs (47 dogs total) were tested for anti-histone antibodies and compared with the traditional IFA assay. The groups included 15 healthy dogs, 15 dogs with noninflammatory diseases, 9 dogs with polyarthritis and positive ANA, and 8 German shepherds with perianal fistulas. The microsphere assay results indicated that only one dog in the noninflammatory group and four out of nine dogs in the polyarthritis group had mean fluorescent intensity values above our established cut-off (defined as 2 S.D. above the mean of healthy controls). There was moderate agreement between the anti-histone assay and the traditional ANA (kappa statistic=0.54). Absorption of ANA positive serum with total histones dramatically diminished the fluorescent signal detected by flow cytometry and the speckled nuclear pattern observed by IFA, whereas preabsorption did not change the diffuse nuclear staining pattern. These findings indicate that the anti-histone assay will not replace the ANA test and that other nuclear proteins, such as ribonucleoproteins may contribute to the diffuse ANA patterns.

Generation of therapeutic antibody responses against IgE in dogs, an animal species with exceptionally high plasma IgE levels

Allergic diseases are common in dogs and the involvement of IgE in the pathogenesis of canine atopic dermatitis (CAD) and flea allergy dermatitis (FAD) is documented. However, many dogs do not achieve sufficient control of their allergic disease, and there is a great need for new treatment strategies. In order to address this issue we first needed to obtain a better picture of IgE-levels in dogs and how plasma IgE-levels are affected by breed, age and health status. IgE is normally present at diminutive concentrations in sera and detection by diagnostic methods has been a technical challenge. Here, we present a new in vitro assay for determining absolute levels of total IgE in sera from dogs. In a panel of 76 adult dogs diagnosed either as healthy or suffering from atopic dermatitis, autoimmunity or infection by skin parasites, we show that levels of IgE range from 1 to 41 microg/ml. This is almost 100 times the level observed in non-atopic humans. However, these exceptionally high IgE-levels in the dogs could not be correlated to either breed or health status. To address the issue of novel treatment strategies, the possibility of reducing the IgE-levels in nine Beagle dogs by immunization with a new therapeutic vaccine was investigated. High levels of anti-IgE antibodies were induced in all dogs, and the IgE-levels were subsequently decreased by a mean of 65%. This shows that the allergy vaccine is potent enough to break the tolerance against IgE, even when the initial IgE-levels are as high as those observed in dogs. Thus, the vaccination treatment may have the potential to serve as a future therapy for dogs with atopic diseases.