A simple micro-ELISA method for the assay of antithyroglobulin autoantibodies in human serum

Immunoassay of anti-thyroid autoantibodies: high analytical variability in second generation methods

The use of highly sensitive immunometric methods in clinical laboratories to assay anti-thyroid antibodies has progressively expanded in recent years but it is not known whether the new techniques have improved the analytical variability connected with the preceding methodologies. The Italian Society of Laboratory Medicine Study Group on Autoimmune Diseases conducted a collaborative study with the biomedical industry to evaluate the degree of standardization of the new analytical procedures. Twelve companies agreed to participate in the study on the search for anti-thyroglobulin (anti-Tg) and anti-thyroperoxidase (anti-TPO) antibodies in nine sera from patients with autoimmune thyroiditis, and in six sera from patients with non-autoimmune thyroid disease; ten immunometric and three immunofluorescence methods were employed. Agreement of qualitative results was close to 90% for anti-Tg and 97% for anti-TPO, with no important differences between the methods; variability of the quantitative results, expressed as CV% of absolute (in lU/ml) and relative (in cut-off concentration multiples) values was 93.9% and 102.3%, respectively, for anti-Tg, and 75.5% and 62.9%, respectively, for anti-TPO. These findings show that despite the progressive improvement in the analytical techniques, the variability between methods for the assay of anti-Tg and anti-TPO is still unexpectedly high, and probably due to several factors such as uncertainty in defining the positive cutoff concentration, absence of adequate international reference preparations, modality of autoantigen purification, and analytical variability in the assay procedures.

Spontaneous IgM autoantibody production in vitro by B lymphocytes of normal human neonates

Human neonate B lymphocytes display unique phenotypic and functional characteristics: in addition to CD1c antigens, CD5+ and CD5- subsets both express activation markers such as CD23 and Bac-1. They proliferate strongly in the presence of various lymphokines (rIL-2, rIL-4, low molecular weight BCGF), but differentiate poorly in the presence of the same lymphokines, pokeweed mitogen and Epstein-Barr virus. It has also been reported that human neonate B lymphocytes produce polyreactive autoantibodies after in vitro activation by Staphylococcus aureus Cowan I and transformation by Epstein-Barr virus. We now show that, in the absence of in vitro stimulation, human neonate B lymphocytes produce polyreactive antibodies of the IgM isotype against several autoantigens. The B lymphocytes involved expressed membrane IgD, IgM, CD23 and CD11b molecules; CD5 expression was variable. This phenotype was consistently found on a minority of B lymphocytes and is similar to that of polyreactive autoantibody-producing B cells in mice. We also found that autoantibody production in vitro could occur in the absence of any T helper effect. The function of these autoantibodies is not clearly established, but their occurrence in a large proportion of human neonates strongly suggests that they play an important role in the development of the immune system.

Autoantibodies and circulating immune complexes in sera from patients with hepatitis B virus-related chronic liver disease

Sera from 56 patients with hepatitis B virus-related chronic liver disease (CLD) and 30 normal individuals as controls were examined by enzyme immunoassay (EIA) for the presence of autoantibodies directed against actin, tubulin, myosin, double-stranded (ds) DNA, polymerized human albumin, thyroglobulin, and trinitrophenyl coupled to bovine serum albumin (TNP-BSA). Patients with CLD had consistently elevated levels of IgG, IgA, and IgM antibodies directed against all the panel antigens. The percentage of patients with autoantibodies of the IgA class was particularly high: respectively, 88 and 78% of the patients had strikingly high levels of anti-actin and anti-TNP-BSA IgA autoantibodies. High amounts of IgA and IgG antibodies to polymerized albumin as well as IgG to thyroglobulin were also detected. Circulating immune complexes (CIC) were isolated from patients' sera and their autoantibody activities were tested on the same antigen panel. The autoantibodies thus detected were of the same class and possessed the same activities, although at higher values than those present in the homologous sera. These results indicate that, regardless of their origin, autoantibodies are present in high amounts in the sera of these patients. Moreover, autoantibodies participating in the formation of CIC might play a pathological role.

Quantitative clonal analysis of the B cell repertoire in human lupus

To gain further insight into the origin of autoantibody hyperproduction in human lupus, we quantitated the B cell repertoire toward exogenous and self-antigens. Using the Spot-ELISA method and two panels of nine exogenous and 10 self-antigens, we found that the normal human immune repertoire comprises a high frequency of B cell precursors secreting IgM antibodies to self- and exogenous determinants. This repertoire was markedly deficient in precursors producing IgG able to bind self-antigens. In lupus patients, the absolute numbers of clone precursors of the immune repertoire expressing IgM receptors whose paratopes impart affinity to self- and exogenous determinants were higher than in control individuals. Additionally, IgG antibody-forming cell precursors with binding specificity for lupus-associated antigens were detectable in the repertoire of these patients. Based on these results, we propose that hyperproduction of human lupus-associated autoantibodies arises in a two-stage mechanism whereby a general activation of the multireactive immune B cell repertoire precedes an oligospecific expansion of selected B cell clonotypes.

Enzyme immunoassay analysis of antibody specificities present in the circulating immune complexes of selected pathological sera

Using immobilized anti-C3 antibody and an enzyme immunoassay, sera from 26 patients (eight with systemic lupus erythematosus (SLE), four with Hashimoto's thyroiditis, eight haemophiliacs and six with post-hepatitis cirrhosis) containing high levels of circulating immune complexes (IC) were selected. The IC were precipitated with 2.5% polyethylene glycol, washed, treated with acid buffer, neutralized and tested using an enzyme immunoassay in parallel with the original sera for antibody activity against a panel of antigens: human myosin and thyroglobulin, mouse actin and tubulin, calf thymus DNA and trinitrophenyl coupled to bovine serum albumin (TNP/BSA). It was found that all the isolated IC may contain IgG, IgA and IgM antibodies reacting with actin tubulin and TNP/BSA and also, depending upon the disease, antibodies reacting with some of the other antigens of the panel. By comparison to the antibodies present in the original sera, higher titers of antibodies were found in the isolated IC while some antibody specificities not detected in a given serum were occasionally noted in the isolated IC. The antibodies present in the IC seem to possess characteristics similar to those of polyreactive human natural autoantibodies. It is concluded that natural autoantibodies participate actively in the formation of IC found in pathological sera.

Enzyme-linked immunosorbent assay for determination of thyroglobulin autoantibodies. Comparison with RIA and haemagglutination

An enzyme immunoassay (ELISA) has been developed for the detection of human autoantibodies to thyroglobulin (TgAb). The ELISA assay was compared to the previous routine method, the tanned red cell (TRC) method and a radioimmunoassay (RIA) technique for thyroglobulin autoantibodies. Sera from 163 healthy non-hospitalized persons, 31 patients with Hashimoto's thyroiditis, 13 patients with Graves disease, 136 patients with thyroid cancer and 365 sera consecutively received for thyroid autoantibody screening were examined for TgAb in the three methods. The nosological sensitivity for ELISA methods was comparable to that of RIA and higher than that of TRC. The ELISA method was accurate, precise, objective, inexpensive and well suited for quantitative routine determination of TgAb.

Development of an enzyme-linked immunosorbent assay for the detection of autoantibodies against thyroglobulin in chickens

This paper describes the development of an enzyme immunoassay (EIA) for the detection of autoantibodies against thyroglobulin in an avian system. In this system EIA offers an efficient and alternative approach to already established methods such as double diffusion in gel, passive haemagglutination, indirect immunofluorescence and radioimmunoassay. The optimization of the different incubation steps is described and the expression of results of observed antibody activity is discussed.

Enzyme-linked immunoassay of monoclonal and serum microsomal autoantibodies

An automated enzyme-linked immunoassay for the detection of antibodies to human thyroid microsomes has been assessed. This assay correlated closely with the established commercial passive haemagglutination method. Variations in the purity of crude microsome preparations and the degree of thyroglobulin contamination make careful comparison of different preparations essential for meaningful interpretation of results, and attempts to circumvent these problems by further purification of microsome preparations using gel filtration are discussed. The application of this method for routine screening of serum samples is demonstrated using populations of normal subjects and patients with rheumatoid arthritis and anti-glomerular basement membrane disease. This assay has also permitted the establishment of murine hybrid myelomas secreting monoclonal antibodies to human thyroid microsomes.

Enzyme-linked immunosorbent assay for anti-DNA antibodies using fluorogenic and colorigenic substrates

An enzyme-linked immunosorbent assay is described for the assay of anti-DNA antibodies. The method employs plastic surface for immobilization of the antigen and alkaline phosphatase-linked rabbit anti-human IgG for the detection of immune complex using PNP-P and 4MU-P as substrates. The sensitivity of the assay increased by as much as 16-fold when fluorogenic substrate was used instead of conventional PNP-P and could therefore be employed for the detection of low avidity antibodies. Using PNP-P as substrate 57% of SLE patients were positive for DNA antibody, but if 4MU-P was introduced as substrate, 71% gave a positive response. Moreover, using a fluorogenic substrate, it was possible to minimise the amount of antigen (2 nM bp). The technique is simple, reproducible and of high sensitivity.

A rapid standardized enzyme immunoassay for autoantibodies to thyroglobulin

A rapid, specific, standardized, objective and sensitive quantitative enzyme immunoassay (ELISA) procedure has been developed for the detection of human autoantibodies to thyroglobulin. It involves three ten minute incubations, with the positive control serum adjusted to yield an absorbance of approximately 1.00. The results are reported as 'percentage of positive control' absorbance. The specificity of the reactions for thyroglobulin autoantibodies was supported by the good correlation found between the ELISA values obtained and the passive hemagglutination (PHA) titers of 348 sera from 333 patients suspected of having thyroid disturbances, as well as by antigen absorption experiments. Rheumatoid factor did not interfere with the assay. An appreciable proportion of passive hemagglutination-negative sera were confirmably positive for thyroglobulin autoantibodies by the ELISA method.

An enzyme-linked immunoassay for thyroid microsomal antibodies

An enzyme-linked immunoassay (ELISA) for microsomal antibody is described. The method was found to be rapid, sensitive and precise and analysis of 115 serum samples showed good correlation between the ELISA and the conventional tanned red cell haemagglutination test. The presence of thyroglobulin antibody, rheumatoid factor, antinuclear factor or gastric parietal cell antibodies did not interfere in the microsomal antibody ELISA but some sera with mitochondrial antibody activity appeared to cause a non-specific effect. The ELISA was particularly useful for analysing microsomal antibody production by Hashimoto lymphocyte cultures and in some cases antibody synthesis could be studied in the absence of mitogen. The high capacity of the ELISA combined with its sensitivity suggest that it will be a valuable technique for studying microsomal autoantibody activity both in serum and in lymphocyte cultures.

The preparation of thyroid microsomal antigen for use in the indirect micro-ELISA method for the detection of anti-thyroid microsomal autoantibody

Thyroid microsomes for use in assay systems for anti-thyroid-microsomal antibodies are normally prepared by ultracentrifugation. By means of gel filtration studies we show that preparations made in this way are invariably contaminated with thyroglobulin. A further purification by gel filtration is described which enables the preparation of thyroid microsomes of sufficient purity for use in a micro-ELISA method for the measurement of anti-thyroid-microsomal antibodies. Microsomes prepared in this way would also be suitable for haemagglutination and radioassays, which are also affected by thyroglobulin contamination.