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Panafidina TA, Verizhnikova ZG, Avdeeva AS, Popkova TV, Nasonov EL. Clinical Significance of Antibodies to DFS70 in Immunoinflammatory Rheumatic Diseases. DOKL BIOCHEM BIOPHYS 2024; 517:207-213. [PMID: 38861147 DOI: 10.1134/s1607672924700911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 06/12/2024]
Abstract
The relevance of the problem of immunoinflammatory rheumatic diseases (IIRD) for modern medicine is determined by their high prevalence in the population, the difficulty of early diagnosis, the rapid development of disability and poor life prognosis. Recent data on the significance of anti-DFS70 have opened up new possibilities for optimizing the step-by-step diagnosis of IIRD. The detection of these antibodies can help in the interpretation of a positive result for antinuclear antibodies (ANA) by indirect immunofluorescence assay on HEp-2 cells (IIFA-HEp-2) in the absence of autoantibodies specific for IIRD. Detection of anti-DFS70 in antinuclear factor (ANF) seropositive patients without clinical and/or serological markers characteristic of a certain disease from the IIRD group can be considered as a potential marker that excludes this group of diseases.
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Affiliation(s)
- T A Panafidina
- Nasonova Research Institute of Rheumatology, Moscow, Russia.
| | | | - A S Avdeeva
- Nasonova Research Institute of Rheumatology, Moscow, Russia
| | - T V Popkova
- Nasonova Research Institute of Rheumatology, Moscow, Russia
| | - E L Nasonov
- Nasonova Research Institute of Rheumatology, Moscow, Russia
- Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
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Park MJ, Jang HM, Kim D, Won DI, Baek HS, Cho MH. Differences in the Clinical Significance of Antinuclear Antibodies According to Titers and Patterns in Children. Clin Pediatr (Phila) 2023; 62:1254-1260. [PMID: 36829288 DOI: 10.1177/00099228231154948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
This study aimed to evaluate the differences in the clinical significance of antinuclear antibody (ANA) according to their titers and patterns in the diagnosis of systemic autoimmune diseases (AiD) in pediatric patients. Of the 2442 children who had undergone an ANA test, 473 (19.4%) were positive for ANA, of whom 33 (7.0%) were diagnosed with significant AiD. The positive predictive value (PPV) for significant AiD was considerably high on application of an ANA titer of ≥1:640, and the PPV of a dense fine speckled (DFS) pattern was significantly lower compared with those of speckled and homogenous patterns. The diagnostic value of ANA positivity for AiD is limited, and the clinical significance of the DFS pattern is relatively lower compared with that of other patterns, such as homogenous and speckled patterns, in children. It is necessary to approach the significance of ANA in children individually depending on titers and patterns.
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Affiliation(s)
- Min Ji Park
- Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, Republic of Korea
| | - Hae Min Jang
- Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, Republic of Korea
| | - Dongsub Kim
- Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, Republic of Korea
| | - Dong Il Won
- Department of Clinical Pathology, Kyungpook National University, School of Medicine, Daegu, Republic of Korea
| | - Hee Sun Baek
- Department of Pediatrics, Yeungnam University, College of Medicine, Daegu, Republic of Korea
| | - Min Hyun Cho
- Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, Republic of Korea
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Sanchez-Hernandez ES, Ortiz-Hernandez GL, Ochoa PT, Reeves M, Bizzaro N, Andrade LEC, Mahler M, Casiano CA. The Nuclear Dense Fine Speckled (DFS) Immunofluorescence Pattern: Not All Roads Lead to DFS70/LEDGFp75. Diagnostics (Basel) 2023; 13:diagnostics13020222. [PMID: 36673033 PMCID: PMC9858485 DOI: 10.3390/diagnostics13020222] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
The monospecific dense fine speckled (DFS) immunofluorescence assay (IFA) pattern is considered a potential marker to aid in exclusion of antinuclear antibody (ANA)-associated rheumatic diseases (AARD). This pattern is typically produced by autoantibodies against transcription co-activator DFS70/LEDGFp75, which are frequently found in healthy individuals and patients with miscellaneous inflammatory conditions. In AARD patients, these antibodies usually co-exist with disease-associated ANAs. Previous studies reported the occurrence of monospecific autoantibodies that generate a DFS-like or pseudo-DFS IFA pattern but do not react with DFS70/LEDGFp75. We characterized this pattern using confocal microscopy and immunoblotting. The target antigen associated with this pattern partially co-localized with DFS70/LEDGFp75 and its interacting partners H3K36me2, an active chromatin marker, and MLL, a transcription factor, in HEp-2 cells, suggesting a role in transcription. Immunoblotting did not reveal a common protein band immunoreactive with antibodies producing the pseudo-DFS pattern, suggesting they may recognize diverse proteins or conformational epitopes. Given the subjectivity of the HEp-2 IFA test, the awareness of pseudo-DFS autoantibodies reinforces recommendations for confirmatory testing when reporting patient antibodies producing a putative DFS pattern in a clinical setting. Future studies should focus on defining the potential diagnostic utility of the pseudo-DFS pattern and its associated antigen(s).
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Affiliation(s)
- Evelyn S. Sanchez-Hernandez
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Greisha L. Ortiz-Hernandez
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Pedro T. Ochoa
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Michael Reeves
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Nicola Bizzaro
- Laboratorio di Patologia Clinica, Ospedale San Antonio, Azienda Sanitaria Universitaria Integrata, 33100 Udine, Italy
| | - Luis E. C. Andrade
- Rheumatology Division, Department of Medicine, Federal University of Sao Paulo, São Paulo 04021-001, Brazil
- Immunology Division, Fleury Medicine and Health Laboratory, São Paulo 04023-062, Brazil
| | | | - Carlos A. Casiano
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
- Rheumatology Division, Department of Medicine, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
- Correspondence: ; Tel.: +909-558-1000 (ext. 42759); Fax: +909-558-0196
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Autoantibodies to dense-fine-speckled 70 (DFS70) do not necessarily rule out connective tissue diseases. Semin Arthritis Rheum 2021; 52:151936. [PMID: 35027246 DOI: 10.1016/j.semarthrit.2021.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/04/2021] [Accepted: 12/21/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVES In some patients with antinuclear antibodies (ANA), a pattern called anti-dense-fine-speckled-70 antibody (anti-DFS70) can be detected. Presence of anti-DFS70 is less frequently observed in patients with connective tissue diseases (CTD) and is therefore used as an exclusion criterion by some rheumatologists. To date, however, it is unclear as to what extent the presence of an anti-DFS70 can reliably rule out CTDs. METHODS Data of 460 patients who were tested for the presence of anti-DFS70 at University Hospital Bonn, Germany, were analyzed. Patients were examined with regard to clinical symptoms and signs, type of disease, type of CTD, fulfillment of the classification criteria, presence of anti-DFS70, other systemic autoantibodies and ANA titers by indirect immunofluorescence (IIF) assays and line immunoassays. Differences in DFS70 antibody status between patients with CTD were examined. In addition, specificity, sensitivity, and positive predictive values for different ANA titers were calculated. RESULTS In 182 of the 460 patients (of whom 79.8% were female), CTD was diagnosed. 354 patients (77.0%) tested negative, 81 (17.6%) positive and 25 (5.4%) borderline for anti-DFS70. Twenty-one patients (25.9%) with a positive result had CTD. No significant differences were observed between anti-DFS70 positive and anti-DFS70 negative patients with CTD concerning age, gender, symptoms, clinical signs, and other disease-specific antibodies. However, of these 21 patients, only one patient showed the monospecific appearance of anti-DFS70. Anti-DFS70 had a sensitivity and a specificity of 26.9% and 86.8%, respectively, with a positive predictive value of 68.2% at an ANA titer of ≥1:160 with respect to the absence of CTD. CONCLUSIONS Autoantibodies to DFS70 seem to be prevalent in CTD patients and are thus not a good exclusion criterion. The monospecific occurrence of anti-DFS70 can, however, be helpful in ambiguous situations.
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Romero-Álvarez V, Acero-Molina DA, Beltrán-Ostos A, Bello-Gualteros JM, Romero-Sánchez C. Frequency of ANA/DFS70 in relatives of patients with rheumatoid arthritis compared to patients with rheumatoid arthritis and a healthy population, and its association with health status. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.reumae.2019.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Romero-Álvarez V, Acero-Molina DA, Beltrán-Ostos A, Bello-Gualteros JM, Romero-Sánchez C. Frequency of ANA/DFS70 in Relatives of Patients with Rheumatoid Arthritis Compared to Patients with Rheumatoid Arthritis and a Healthy Population, and its Association with Health Status. REUMATOLOGIA CLINICA 2021; 17:67-73. [PMID: 31104879 DOI: 10.1016/j.reuma.2019.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 02/12/2019] [Accepted: 02/14/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION DFS70 ANAs have attracted interest due to their frequency in individuals with no clinical evidence of systemic autoimmune rheumatic disease, groups with genetic risk for rheumatoid arthritis (RA) were not assessed. OBJECTIVE To determine the frequency of ANA and DFS70 ANA in blood relatives (BR) of people with RA compared to patients with early RA (ERA), and control individuals, and its association with health status. METHODOLOGY A cross-sectional study with an analytical component. Sixty ERA patients, 60 BR and 120 control individuals paired by age and sex were studied. Hep2-ANA and DFS70 ANA were studied. The absolute and relative frequencies and associations were established using logistic regression models, with a significance level of 95%. RESULTS 43% ANA in ERA, 30% in BR, and 25.8% in control individuals 1:80. The fine dense granular pattern based on conventional Hep2 was found in 12.9% of the positive samples, and 1.66% of the total samples. There was no detection of DFS70 ANAs in patients with ERA. In ERA there was an association between the presence of ANA and inflamed joints (p=.02), CRP (p=.01), DAS28CRP (p=.03) and HAQ (p=.04). There was an association between ANA and elevated CRP (p=.05) in the BR. In the control individuals, there was an association between ANA and painful joints (p=02). In DFS70 ANA individuals we observed an association between a normal ESR p=.032, BR (-), p=.044 and absence of painful joints, p=.039. CONCLUSIONS The frequency of DFS70 ANA in the groups studied was low, none of the patients with ERA was positive. The presence of DFS70 ANA was only confirmed in systemically healthy individuals.
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Affiliation(s)
- Verónica Romero-Álvarez
- Grupo de Inmunología Clínica, Servicio de Reumatología e Inmunología, Hospital Militar-Universidad Militar Nueva Granada, Bogotá, Colombia.
| | | | - Adriana Beltrán-Ostos
- Unidad de Investigación Científica, Subdirección de Docencia e Investigación Científica, Hospital Militar Central, Bogotá, Colombia
| | - Juan Manuel Bello-Gualteros
- Grupo de Inmunología Clínica, Servicio de Reumatología e Inmunología, Hospital Militar-Universidad Militar Nueva Granada, Bogotá, Colombia
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Van Hoovels L, Broeders S, Chan EKL, Andrade L, de Melo Cruvinel W, Damoiseaux J, Viander M, Herold M, Coucke W, Heijnen I, Bogdanos D, Calvo-Alén J, Eriksson C, Kozmar A, Kuhi L, Bonroy C, Lauwerys B, Schouwers S, Lutteri L, Vercammen M, Mayer M, Patel D, Egner W, Puolakka K, Tesija-Kuna A, Shoenfeld Y, de Sousa MJR, Hoyos ML, Radice A, Bossuyt X. Current laboratory and clinical practices in reporting and interpreting anti-nuclear antibody indirect immunofluorescence (ANA IIF) patterns: results of an international survey. AUTOIMMUNITY HIGHLIGHTS 2020; 11:17. [PMID: 33228811 PMCID: PMC7684889 DOI: 10.1186/s13317-020-00139-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/29/2020] [Indexed: 12/15/2022]
Abstract
Background The 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. Methods Two 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. Results 438 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. Conclusion This 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.
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Affiliation(s)
- Lieve Van Hoovels
- Department of Laboratory Medicine, OLV Hospital, Aalst, Belgium. .,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
| | - Sylvia Broeders
- Sciensano (Formerly Scientific Institute of Public Health), Brussels, Belgium
| | - Edward K L Chan
- Department of Oral Biology, University of Florida, Gainesville, FL, USA
| | - Luis Andrade
- Rheumatology Division, Universidade Federal de São Paulo, Escola Paulista de Medicina, Sao Paulo, Brazil
| | | | - Jan Damoiseaux
- Centraal Diagnostisch Laboratorium, MUMC, Maastricht, The Netherlands
| | - Markku Viander
- Department of Medical Microbiology and Immunology, University of Turku, Turku, Finland
| | - Manfred Herold
- Rheumatology Laboratory, Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Wim Coucke
- Sciensano (Formerly Scientific Institute of Public Health), Brussels, Belgium
| | - Ingmar Heijnen
- Medical Immunology, Laboratory Medicine, University Hospital Basel, Basel, Switzerland
| | - Dimitrios Bogdanos
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Jaime Calvo-Alén
- Servicio de Reumatología, Hospital Universitario Araba, Vitoria, Spain
| | | | - Ana Kozmar
- Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Liisa Kuhi
- Central Laboratory, East Tallin Central Hospital, Tallin, Estonia
| | - Carolien Bonroy
- Department of Internal Medicine, Ghent University, Ghent, Belgium.,Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
| | - Bernard Lauwerys
- Pôle de Pathologies Rhumatismales Et systémiques, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.,Department of Rheumatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Sofie Schouwers
- Department of Laboratory Medicine, GZA Hospitals, Antwerp, Belgium
| | - Laurence Lutteri
- Department of Clinical Chemistry, University Hospital Liège, Liège, Belgium
| | - Martine Vercammen
- Department of Laboratory Medicine, AZ Sint-Jan Hospital Bruges-Ostend, Bruges, Belgium.,Research Group Reproductive Immunology and Implantation (REIM), Vrije Universiteit Brussel, Brussels, Belgium
| | - Miroslav Mayer
- Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Dina Patel
- UK NEQAS Immunology, Northern General Hospital, Immunochemistry & Allergy, Sheffield, UK
| | - William Egner
- UK NEQAS Immunology, Northern General Hospital, Immunochemistry & Allergy, Sheffield, UK
| | - Kari Puolakka
- Department of Medicine, South Karelia Central Hospital, Lappeenranta, Finland
| | - Andrea Tesija-Kuna
- Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Yehuda Shoenfeld
- Laboratory of the Mosaic of Autoimmunity, Saint Petersburg State University, Saint-Petersburg, Russian Federation.,Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Affiliated to Tel-Aviv University School of Medicine, Tel-Hashomer, Tel Aviv, Israel
| | | | - Marcos Lopez Hoyos
- Servicio de Inmunología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Antonella Radice
- UOC Microbiologia e Virologia, Presidio Ospedaliero San Carlo Borromeo, Milan, Italy
| | - Xavier Bossuyt
- Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.,Department of Laboratory Medicine, University Hospital Leuven, Leuven, Belgium
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The antinuclear antibody dense fine speckled pattern and possible clinical associations: An indication of a proinflammatory microenvironment. J Immunol Methods 2020; 488:112904. [PMID: 33121975 DOI: 10.1016/j.jim.2020.112904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/30/2020] [Accepted: 10/21/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Indirect immunofluorescence (IIF) is the most prevalent screening antinuclear antibody test for systemic autoimmune rheumatic disease (SARD). Certain IIF patterns have known antibody and disease associations, but the dense fine speckled (ANA-DFS) pattern has no confirmed clinical associations. Our objective was to determine the prevalence of SARD among a group of ANA-DFS positive individuals and to identify final diagnoses among non-SARD individuals in order to determine possible clinical associations with the ANA-DFS pattern. METHODS A retrospective study of 425 patients from a university health care system with a positive ANA-DFS pattern consecutively between August 2017 and September 2018. Sera samples underwent ANA testing by IIF on HEp-2 cell substrates (Euroimmun, Germany). Clinical information was retrieved from electronic health records and stored in a de-identified database. RESULTS The prevalence of SARD was 24%. Undetermined diagnosis (17%), skin disorders (12.1%), and fibromyalgia/chronic pain syndrome/chronic fatigue syndrome (11.8%) were the most common non-SARD diagnoses. Taking into account past medical history, the most common non-SARD were atopic disorders (21.2%), fibromyalgia/chronic pain syndrome/chronic fatigue syndrome (17.6%), and skin disorders (16.7%). CONCLUSIONS The ANA-DFS pattern may be indicative of an underlying antigen-antibody interaction that plays a role in either the initiation or propagation of immunologic reactions. DFS70/LEDGF is a transcription factor involved in cell survival and stress protection, and autoantibodies may inhibit its function. It is likely that there are other antibodies producing the ANA-DFS pattern besides anti-DFS70/LEDGF, and more research is necessary to identify additional antibody specificities. The ANA-DFS pattern may be an indicator of a proinflammatory microenvironment given the high frequency of symptomatic patients and disease processes with an immunologic basis (including SARD).
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Anti-DFS70 antibodies detected by specific methods in patients with thrombosis or recurrent pregnancy loss: no evidence of an association. Sci Rep 2020; 10:7748. [PMID: 32385308 PMCID: PMC7210276 DOI: 10.1038/s41598-020-64550-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 04/17/2020] [Indexed: 11/08/2022] Open
Abstract
A dense fine speckled pattern (DFS) caused by antibodies to the DFS70 kDa nuclear protein is a relatively common finding while testing for anti-nuclear antibodies (ANA) by indirect immunofluorescence (IIF) on HEp-2 cells. However, despite many efforts and numerous studies, the clinical significance of anti-DFS70 antibodies is still unknown as they can be found in patients with various disorders and even in healthy subjects. In this study we aimed at verifying whether these antibodies are associated with thrombotic events or with unexplained recurrent pregnancy loss (RPL). We studied 443 patients with venous or arterial thrombosis or RPL and 244 controls by IIF on HEp-2 cells and by a DFS70-specific chemiluminescent immunoassay (CIA). The DFS pattern was observed in IIF in 31/443 (7.0%) patients and in 6/244 (2.5%) controls (p = 0.01) while anti-DFS70 specific antibodies were detected by CIA in 11 (2.5%) patients and in one (0.4%) control (p = 0.06). Positive samples, either by IIF or by CIA, were then assayed by a second DFS70-specific line-immunoassay (LIA) method: 83.3% of the CIA positive samples were confirmed DFS70 positive versus only 29.7% of the IIF positive samples. These findings show that IIF overestimates anti-DFS70 antibody frequency and that results obtained by specific CIA and LIA assays do not indicate that venous or arterial thrombosis or RPL are linked to a higher prevalence of anti-DFS70 antibodies.
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Carbone T, Pafundi V, Bizzaro N, Infantino M, Padula MC, Padula AA, D'Angelo S. Assessing vitamin D levels in an anti-DFS70 positive population: New insights emerging. Autoimmunity 2020; 53:231-236. [PMID: 32164458 DOI: 10.1080/08916934.2020.1736048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Anti-dense fine speckled 70 (DFS70) autoantibodies have more often been described in apparently healthy individuals than in patients with systemic autoimmune rheumatic diseases (SARD). The aim of this study was to explore the link between anti-DFS70 autoantibodies and vitamin D (25(OH)D) levels in an Italian adult cohort.Methods: Serum samples from 34 (five males and 29 females) anti-DFS70 positive patients (index cases), 34 ANA-negative healthy controls, 34 ANA-positive anti-DFS70 negative SLE patients, both groups age- and gender-matched with the index cases, 23 ANA-positive anti-DFS70 negative healthy blood donors and six female SARD patients showing mixed DFS positive pattern were collected and tested for 25(OH)D levels. Relevant demographics and lifestyle practices, body mass index (BMI), comorbidities, and use of medication were recorded for patients and healthy controls.Results: Mean serum levels of 25(OH)D were significantly higher in anti-DFS70 positive subjects (mean ± SD: 22.1 ± 9.8 ng/ml) than in ANA-negative healthy controls (mean ± SD: 17.3 ± 6.7 ng/ml; p = .03), ANA-positive healthy controls (mean ± SD: 15.2 ± 6.8 ng/ml; p = .01), SLE patients (16.6 ± 11.0 ng/ml; p = .01) and in patients with SARD (15.0 ± 5.6 ng/ml; p = .01). No statistically relevant differences in BMI, clinical, or demographic parameters were found.Conclusions: Our findings showed higher levels of vitamin D in anti-DFS70 positive subjects than in the controls, which is compatible with the hypothesis of the "benign" nature of anti-DFS70 antibodies.
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Affiliation(s)
- Teresa Carbone
- IReL - Rheumatology Institute of Lucania, San Carlo Hospital, Potenza, Italy.,Immunopathology Laboratory, San Carlo Hospital, Potenza, Italy
| | - Vito Pafundi
- Immunopathology Laboratory, San Carlo Hospital, Potenza, Italy
| | - Nicola Bizzaro
- Laboratory of Clinical Pathology, San Antonio Hospital, Tolmezzo, Italy
| | - Maria Infantino
- Laboratory of Immunology-Allergology, San Giovanni di Dio Hospital, Firenze, Italy
| | | | - Angela Anna Padula
- IReL - Rheumatology Institute of Lucania, San Carlo Hospital, Potenza, Italy
| | - Salvatore D'Angelo
- IReL - Rheumatology Institute of Lucania, San Carlo Hospital, Potenza, Italy
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Ortiz-Hernandez GL, Sanchez-Hernandez ES, Casiano CA. Twenty years of research on the DFS70/LEDGF autoantibody-autoantigen system: many lessons learned but still many questions. AUTOIMMUNITY HIGHLIGHTS 2020; 11:3. [PMID: 32127038 PMCID: PMC7065333 DOI: 10.1186/s13317-020-0126-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 01/14/2020] [Indexed: 12/24/2022]
Abstract
The discovery and initial characterization 20 years ago of antinuclear autoantibodies (ANAs) presenting a dense fine speckled (DFS) nuclear pattern with strong staining of mitotic chromosomes, detected by indirect immunofluorescence assay in HEp-2 cells (HEp-2 IIFA test), has transformed our view on ANAs. Traditionally, ANAs have been considered as reporters of abnormal immunological events associated with the onset and progression of systemic autoimmune rheumatic diseases (SARD), also called ANA-associated rheumatic diseases (AARD), as well as clinical biomarkers for the differential diagnosis of these diseases. However, based on our current knowledge, it is not apparent that autoantibodies presenting the DFS IIF pattern fall into these categories. These antibodies invariably target a chromatin-associated protein designated as dense fine speckled protein of 70 kD (DFS70), also known as lens epithelium-derived growth factor protein of 75 kD (LEDGF/p75) and PC4 and SFRS1 Interacting protein 1 (PSIP1). This multi-functional protein, hereafter referred to as DFS70/LEDGF, plays important roles in the formation of transcription complexes in active chromatin, transcriptional activation of specific genes, regulation of mRNA splicing, DNA repair, and cellular survival against stress. Due to its multiple functions, it has emerged as a key protein contributing to several human pathologies, including acquired immunodeficiency syndrome (AIDS), leukemia, cancer, ocular diseases, and Rett syndrome. Unlike other ANAs, "monospecific" anti-DFS70/LEDGF autoantibodies (only detectable ANA in serum) are not associated with SARD and have been detected in healthy individuals and some patients with non-SARD inflammatory conditions. These observations have led to the hypotheses that these antibodies could be considered as negative biomarkers of SARD and might even play a protective or beneficial role. In spite of 20 years of research on this autoantibody-autoantigen system, its biological and clinical significance still remains enigmatic. Here we review the current state of knowledge of this system, focusing on the lessons learned and posing emerging questions that await further scrutiny as we continue our quest to unravel its significance and potential clinical and therapeutic utility.
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Affiliation(s)
- Greisha L Ortiz-Hernandez
- Center for Health Disparities and Molecular Medicine, Loma Linda University School of Medicine, Loma Linda, CA, 92350, USA.,Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, USA
| | - Evelyn S Sanchez-Hernandez
- Center for Health Disparities and Molecular Medicine, Loma Linda University School of Medicine, Loma Linda, CA, 92350, USA.,Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, USA
| | - Carlos A Casiano
- Center for Health Disparities and Molecular Medicine, Loma Linda University School of Medicine, Loma Linda, CA, 92350, USA. .,Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, USA. .,Department of Medicine/Division of Rheumatology, Loma Linda University School of Medicine, Loma Linda, USA.
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12
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Kiefer D, von Brunn M, Baraliakos X, Andreica I, Braun J. [Clinical significance of determination of DFS70 antibodies to rule out connective tissue diseases]. Z Rheumatol 2020; 79:749-754. [PMID: 31889213 DOI: 10.1007/s00393-019-00741-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Connective tissue diseases (CTD) are autoimmune diseases highly associated with the presence of antinuclear antibodies (ANA). Since ANA and musculoskeletal symptoms are not uncommon in the general population, differential diagnostic challenges frequently occur for the treating physician. Dense fine speckled antibodies (DFS70) were recently discovered but their presence appeared to be rare in CTD. METHODS In this cross-sectional study a total of 270 patients treated in the Rheumatism Center of the Ruhr Area (Rheumazentrum Ruhrgebiet) were preferentially included, when they were ANA+ (≥1:80). Other autoantibodies and DFS70 antibodies were also investigated. The diagnosis of CTD was confirmed by rheumatologists. The sensitivity, specificity and the positive predictive value of DFS70 antibodies were differentially evaluated for various ANA titers. RESULTS In 91 (33.7%) of the ANA+ patients (33.7%) the diagnosis of CTD was confirmed and in 84 (92.3%) the ANA titer was ≥1:160. The DFS70 antibodies were detected in 17 out of 130 ANA+ patients without CTD (13.1%) versus 2 ANA+ patients (2.2%) with CTD (p = 0.027). None of the patients with ANA 1:80 had DFS70 antibodies. The specificity of DFS70 antibodies to detect the absence of CTD was 97.6%, the sensitivity was 13.1% and the positive predictive value was 89.5%. There was almost no effect of the strength of the different ANA titers. CONCLUSION It was found that DFS70 antibodies are rarely present in ANA+ patients with CTD but the diagnosis of CTD cannot be reliably ruled out solely by the presence of DFS70 antibodies; however, the high specificity of DFS70 antibodies can be of clinical importance in unclear situations and in cases of anxious patients.
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Affiliation(s)
- D Kiefer
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland.
| | - M von Brunn
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
| | - X Baraliakos
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
| | - I Andreica
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
| | - J Braun
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
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Abstract
The presence of antinuclear antibodies (ANAs), which include autoantibodies to extractable nuclear antigens (ENAs), in the sera of patients with connective tissue diseases provides useful immunologic and pathophysiologic insight into the nature of their disease. This article discusses the most commonly used diagnostic modalities for detecting and quantitating the presence of ANA: indirect immunofluorescence assay, enzyme-linked immunosorbent assay, and multiplex bead technology, which serve as useful screening tests. We also review testing for autoantibodies to ENAs, which are often helpful to confirm the diagnosis of a specific connective tissue disease.
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Affiliation(s)
- Morris Ling
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Cox 201, Boston, MA 02114, USA; Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, 55 Fruit Street, Cox 201, Boston, MA 02114, USA; Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, Cox 201, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, 55 Fruit Street, Cox 201, Boston, MA 02114, USA.
| | - Mandakolathur Murali
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Cox 201, Boston, MA 02114, USA; Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, Cox 201, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, 55 Fruit Street, Cox 201, Boston, MA 02114, USA
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14
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Peker BO, Şener AG, Tarhan EF, Kaya S. Investigation of anti-DFS70 antibody in patients with systemic autoimmune rheumatic diseases. Clin Rheumatol 2019; 38:3627-3633. [PMID: 31396837 DOI: 10.1007/s10067-019-04730-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/05/2019] [Accepted: 07/30/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Dense fine-speckled 70 (DFS70) antibody is defined as an antinuclear antibody (ANA) pattern in indirect immunofluorescence (IIF). The presence of anti-DFS70 antibody has been shown as a potential marker for the exclusion of systemic autoimmune rheumatic diseases (SARD) (without any other SARD-associated autoantibodies). We aimed to investigate the frequency of anti-DFS70 antibodies in patients with SARD and in the blood bank donors (BD). MATERIALS AND METHODS The study group consists of 418 rheumatoid arthritis (RA), 101 systemic lupus erythematosus (SLE), 71 Sjogren's syndrome (SS), 43 ankylosing spondylitis (AS), 36 systemic sclerosis-scleroderma (SSc), 2555 undifferentiated connective tissue disease (UCTD), and 507 BD. All samples were tested on the HEp-2 IIF-ANA assay. Samples that showed DFS70 pattern in IIF were confirmed by a specific DFS70 antibody enzyme-linked immunosorbent assay (ELISA). RESULTS The DFS70 pattern was detected in 43 (1.33%) in SARD and four (0.78%) in BD. The anti-DFS70 antibody was detected in three (0.59%) in BD, six (1.43%) in RA, three (2.97%) in SLE, one (1.40%) in SS, and 25 (0.97%) in UCTD, however, it was not detected in AS and SSc by ELISA. There was no significant difference between BD and SARD (p = 0.28). Distinctly, the frequency of anti-DFS70 was significantly different for SLE in SARD (p = 0.02). CONCLUSION Anti-DFS70 antibody was more prevalent in the subsets of SARD than BD. This result may be related to the demographic formation of study groups and individual immunological status. More comprehensive studies are needed to investigate the importance of the anti-DFS70 antibody for SARD.Key Points• This study draws attention to the importance of anti-DFS70 antibodies in the diagnostic algorithm in systemic autoimmune rheumatic diseases.• This study emphasizes the further investigation of anti-DFS70 antibodies in undifferentiated connective tissue diseases.• This study emphasizes the need to verify the DFS70 pattern detected in IIF-ANA test for definitive diagnosis with additional confirmation methods.
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Affiliation(s)
- Bilal Olcay Peker
- Department of Medical Microbiology, Izmir Katip Çelebi University Atatürk Training and Research Hospital, Karabağlar, 35360, Izmir, Turkey.
| | - Aslı Gamze Şener
- Department of Medical Microbiology, Izmir Katip Çelebi University Atatürk Training and Research Hospital, Karabağlar, 35360, Izmir, Turkey
| | - Emine Figen Tarhan
- Department of Rheumatology, Muğla Sıtkı Koçman University Research and Training Hospital, Muğla, Turkey
| | - Selçuk Kaya
- Department of Medical Microbiology, Izmir Katip Çelebi University Medical Faculty, Izmir, Turkey
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15
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Infantino M, Pregnolato F, Bentow C, Mahler M, Benucci M, Li Gobbi F, Damiani A, Grossi V, Franceschini F, Bodio C, Borghi MO, Manfredi M. Only monospecific anti-DFS70 antibodies aid in the exclusion of antinuclear antibody associated rheumatic diseases: an Italian experience. ACTA ACUST UNITED AC 2019; 57:1764-1769. [DOI: 10.1515/cclm-2019-0454] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 06/18/2019] [Indexed: 01/27/2023]
Abstract
Abstract
Background
The dense fine speckled (DFS) is one of the most common patterns that can be observed as a result of the anti-nuclear antibodies (ANA) test on HEp-2 cells and is mostly caused by antibodies to DFS70 as the main antigenic target. As was recently demonstrated, isolated anti-DFS70 positivity can be used as an aid in the exclusion of ANA associated rheumatic diseases (AARD) due to the opportunity to better interpret unexplained positive IIF ANA results.
Methods
Our study included 333 subjects with AARD, 51 undifferentiated connective tissue disease (UCTD) patients, 235 disease controls and 149 healthy blood donors from an Italian cohort. All samples were tested for anti-DFS70 and anti-ENA antibodies using QUANTA Flash assays (Inova Diagnostics, San Diego, CA, USA).
Results
No differences in the prevalence of anti-DFS70 antibodies were seen among AARD, non-AARD and UCTD (2.1% [7/333] vs. 2.3% [9/384] vs. 5.9% [3/51], respectively; p-value = 0.188). AARD patients positive for anti-DFS70 antibodies showed in all cases an accompanying anti-ENA specificity. In contrast, monospecific anti-DFS70 antibodies showed a significantly different distribution with a clear trend across the main groups (AARD vs. non-AARD vs. UCTD: 0% [0/7] vs. 22% [2/9] vs. 100% [3/3], p = 0.007). Anti-DFS70 antibody levels among AARD, non-AARD and UCTD patients were not significantly different (p = 0.094). Within the anti-DFS70 antibody positive cases, AARD cohort showed a higher variability (median [min–max]: 3.2 [3.2–450.8] CU) compared to non-AARD (median [min–max]: 3.2 [3.2–75.7] CU) and UCTD patients (median [min–max]: 3.2 [3.2–59.0] CU).
Conclusions
Our preliminary data showed a similar frequency of anti-DFS70 antibodies in AARD, UCTD and non-AARD cohorts. Monospecificity of anti-DFS70 antibodies but not their mere presence is the key element in the diagnostic algorithm. Mono-specific anti-DFS70 antibodies might be a helpful biomarker to discriminate individuals with AARD from non-AARD presenting with a positive ANA.
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Affiliation(s)
- Maria Infantino
- SOS Laboratorio Immunologia e Allegologia Ospedale S. Giovanni di Dio Firenze , Florence , Italy
| | - Francesca Pregnolato
- Istituto Auxologico Italiano, IRCCS , Experimental Laboratory of Immunorheumatology , Cusano Milanino, Milan , Italy
| | | | | | - Maurizio Benucci
- SOS Reumatologia Ospedale S. Giovanni di Dio Firenze , Florence , Italy
| | | | - Arianna Damiani
- SOS Reumatologia Ospedale S. Giovanni di Dio Firenze , Florence , Italy
| | - Valentina Grossi
- SOS Laboratorio Immunologia e Allegologia Ospedale S. Giovanni di Dio Firenze , Florence , Italy
| | - Franco Franceschini
- UOC Reumatologia e Immunologia Clinica – ASST Spedali Civili Brescia , Brescia , Italy
| | - Caterina Bodio
- Istituto Auxologico Italiano, IRCCS , Experimental Laboratory of Immunorheumatology , Cusano Milanino, Milan , Italy
| | - Maria Orietta Borghi
- Istituto Auxologico Italiano, IRCCS , Experimental Laboratory of Immunorheumatology , Cusano Milanino, Milan , Italy
- Department of Clinical Sciences and Community Health , University of Milan , Milan , Italy
| | - Mariangela Manfredi
- SOS Laboratorio Immunologia e Allegologia Ospedale S. Giovanni di Dio Firenze , Florence , Italy
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16
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Albesa R, Sachs U, Infantino M, Manfredi M, Benucci M, Baus Y, Lutterbeck S, Andrade L, Morris K, Friedenberg A, Casas S, Bossuyt X, Mahler M. Increased prevalence of anti-DFS70 antibodies in young females: experience from a large international multi-center study on blood donors. Clin Chem Lab Med 2019; 57:999-1005. [PMID: 30739097 DOI: 10.1515/cclm-2018-1233] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 12/27/2018] [Indexed: 08/02/2024]
Abstract
Background Isolated antibodies to DFS70 have been described in healthy individuals and are rarely found in patients with antinuclear antibody-associated autoimmune rheumatic diseases (AARD). However, no data is available on geographic differences in the prevalence of anti-DFS70 antibodies. We aimed to study the prevalence of anti-DFS70 antibodies in blood donor samples from several countries representing various ethnical backgrounds and geographic regions in the world. Methods Sera from apparently healthy blood donors (n≥300 per site) were collected in seven countries (USA, Italy, Spain, Germany, UK, Belgium and Brazil). All samples (n=2628) were tested for anti-DFS70 antibodies by QUANTA Flash DFS70 (Inova Diagnostics, Inc., San Diego, CA, USA). Results The prevalence of anti-DFS70 antibodies varied from 4/321 (1.2%, Italy) to 42/497 (8.5%, USA). Consequently, the prevalence of the antibodies was significantly higher in USA compared to all other countries (p<0.05). In addition, the prevalence in the combined cohort (all sites) was higher in young blood donors (<35 years; 5.0% vs. 2.7%; p=0.0017) and among females (4.5% vs. 3.0%; p=0.0446). However, when cohorts from different countries were corrected for age and gender, no significant difference between the countries were found. Conclusions This is the first study to analyze the prevalence of anti-DFS70 antibodies in different geographic areas using a standardized assay. Our findings show that the antibodies are most prevalent in young females.
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Affiliation(s)
| | - Ulrich Sachs
- Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen, Germany
| | - Maria Infantino
- Immunology and Allergology Laboratory Unit, S. Giovanni di Dio Hospital, Laboratory Medicine, Florence, Italy
| | - Mariangela Manfredi
- Immunology and Allergology Laboratory Unit, S. Giovanni di Dio Hospital, Laboratory Medicine, Florence, Italy
| | - Maurizio Benucci
- Rheumatology Unit, S. Giovanni di Dio Hospital, Medicine Department, Florence, Italy
| | | | | | - Luis Andrade
- Rheumatology Division, Universidade Federal de Sao Paulo, São Paulo, Brazil
| | - Kieran Morris
- Northern Ireland Blood Transfusion Service, BCH Complex, Belfast, UK
| | | | | | - Xavier Bossuyt
- KU Leuven Department of Microbiology and Immunology, Leuven, Belgium
- University Hospitals Leuven, Department of Laboratory Medicine, Leuven, Belgium
| | - Michael Mahler
- Inova Diagnostics, INC, 9900 Old Grove Road, San Diego, CA 32131-1638, USA, Phone/Fax: +858 586 9900/858 586 9911
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17
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Clinical use of anti-DFS70 autoantibodies. Rheumatol Int 2019; 39:1423-1429. [DOI: 10.1007/s00296-019-04299-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 04/02/2019] [Indexed: 12/12/2022]
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18
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Lyu Y, Boerner E, Theegarten D, Guzman J, Kreuter M, Costabel U, Bonella F. Utility of Anti-DSF70 Antibodies to Predict Connective Tissue Disease in Patients Originally Presenting with Idiopathic Interstitial Pneumonia. Respiration 2019; 98:29-37. [DOI: 10.1159/000496483] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 12/29/2018] [Indexed: 11/19/2022] Open
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Jeong J, Kim DH, Park G, Park S, Kim HS. Clinical significance of anti-dense fine speckled 70 antibody in patients with fibromyalgia. Korean J Intern Med 2019; 34:426-433. [PMID: 29166758 PMCID: PMC6406084 DOI: 10.3904/kjim.2016.276] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 12/29/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND/AIMS Fibromyalgia (FM) is a common rheumatologic disease characterized by chronic widespread pain, along with various clinical manifestations including atypical autoimmune characteristics. Despite its high prevalence, there remain no approved laboratory tests to identify specific manifestations of FM, or to rule out FM from other rheumatic diseases. Anti-dense fine speckled 70 (anti-DFS70) antibodies were initially identified as a form of anti-nuclear antibodies in a patient with interstitial cystitis. Anti-DFS70 antibodies are found in ≤ 10% of healthy individuals, but have suggestive negative association with autoimmune diseases; however, the clinical significance of these autoantibodies in FM patients remains poorly understood. METHODS We examined 39 patients with FM, along with 17 patients with systemic lupus erythematosus (SLE), and 19 healthy individuals (HI). Patients were compared based on physical measurements, disease duration, tender point counts, FM Impact Questionnaire (FIQ) scores, visual analog scale (VAS) for pain, somatic symptoms, and anti-DFS70 antibodies. RESULTS Levels of anti-DFS70 antibodies were significantly higher in the FM and HI groups than in those with SLE. Both anti-DFS70 antibodies and VAS scores were positively correlated with FM. Within the FM group, patients with arthralgia had higher anti-DFS70 antibody values compared to those without arthralgia (p = 0.024); antibody levels were also higher in patients with sleep disturbances relative to those without sleep issues (p = 0.024). In contrast, there were no correlations between anti-DFS70 antibodies and age, body mass index, disease duration, tender point counts, FIQ, short-form health survey results, or other clinical manifestations. CONCLUSION Anti-DFS70 antibodies may represent a useful biomarker for differentiating between FM and other autoimmune diseases. The levels of anti-DFS70 antibodies were also significantly higher among patients with arthralgia and sleep disturbances. Further investigations are necessary to evaluate the relationships between anti-DFS70 antibodies and other cytokines as a predictive marker for pain.
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Affiliation(s)
- Jisoo Jeong
- Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Seoul, Korea
| | - Dong Hyun Kim
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Gun Park
- Department of Laboratory Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Suyeon Park
- Department of Biostatistics, Soon Chun Hyang University College of Medicine, Seoul, Korea
| | - Hyun-Sook Kim
- Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Seoul, Korea
- Correspondence to Hyun-Sook Kim, M.D. Division of Rheumatology, Department of Internal Medicine, Soon Chun Hyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu. Seoul 04414, Korea Tel: +82-2-710-3060 Fax: +82-2-709-9554 E-mail:
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20
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Prevalence and serological profile of anti-DFS70 positive subjects from a routine ANA cohort. Sci Rep 2019; 9:2177. [PMID: 30778125 PMCID: PMC6379419 DOI: 10.1038/s41598-019-38686-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 12/27/2018] [Indexed: 11/17/2022] Open
Abstract
Anti-Dense Fine Speckled 70 (DFS70) antibodies are a common finding in clinical laboratory referrals. High prevalence of DFS70 autoantibodies in healthy population and usual negative association with Antinuclear Antibody (ANA)-associated autoimmune rheumatic diseases (AARD) were reported. The aim of this study was to evaluate the prevalence of DFS70 autoantibodies and their association with other autoantibodies in the context of a routine ANA referral cohort. Consecutive sera submitted for ANA screening were analyzed for anti-DFS70 antibodies by indirect immunofluorescence (IIF) (n = 3175, 1030 men and 2145 women) then confirmed by immunoblotting. Anti-DFS70 positive samples were also assayed for a large spectrum of other circulating autoantibodies. The prevalence of anti-DFS70 antibodies was 1.7% in the whole population and 4.6% in the ANA-positive samples. Comparison between DFS70 IIF and immunoblotting showed an excellent correlation between the two methods. The prevalence of anti-DFS70 positive was significantly higher in females (2.1%, 45/2145) than in males (1.0%, 10/1030). Of note, no concomitant autoantibodies were found in the DFS70-positive male group compared with DFS70-positive females group that showed other serum autoantibodies in the 51% of cases. Anti-DFS70 reactivity in male population may represent an useful biomarker predicting the absence of other autoantibodies. On the contrary, the serological profile of DFS70-positive females required further investigations in order to define the presence of concomitant disease-marker autoantibodies.
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21
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Mahler M, Andrade LE, Casiano CA, Malyavantham K, Fritzler MJ. Anti-DFS70 antibodies: an update on our current understanding and their clinical usefulness. Expert Rev Clin Immunol 2019; 15:241-250. [DOI: 10.1080/1744666x.2019.1562903] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Michael Mahler
- Research & Development, Inova Diagnostics, San Diego, CA, USA
| | - Luis E. Andrade
- Rheumatology Division, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
- Immunology Division, Fleury Laboratories, São Paulo, Brazil
| | - Carlos A. Casiano
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Department of Medicine, Division of Rheumatology, Loma Linda University School of Medicine, Loma Linda, CA, USA
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22
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Infantino M, Shovman O, Pérez D, Grossi V, Manfredi M, Benucci M, Damiani A, Gilburd B, Azoulay D, Serrano A, Shoenfeld Y. A better definition of the anti-DFS70 antibody screening by IIF methods. J Immunol Methods 2018; 461:110-116. [DOI: 10.1016/j.jim.2018.07.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 07/05/2018] [Accepted: 07/05/2018] [Indexed: 11/15/2022]
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23
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Bizzaro N, Fabris M. New genetically engineered DFS70 knock-out HEp-2 cells enable rapid and specific recognition of anti-DFS70 antibodies. Autoimmunity 2018; 51:152-156. [PMID: 29732925 DOI: 10.1080/08916934.2018.1469013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The correct identification of anti-dense fine speckled-70 (DFS70) antibodies represents an important issue in the detection of anti-nuclear antibodies (ANAs) as performed by the indirect immunofluorescence (IIF) test on HEp-2 substrates. In this study, we have evaluated a new method for anti-DFS70 antibody detection employing HEp-2 cells knocked-out for the DFS70 antigen. METHODS We studied 148 sera with a DFS70-like pattern (91 positive and 57 negative when tested for anti-DFS70 antibodies by a specific chemoluminescence [CLIA] method); 116 sera with infectious disease; 100 healthy donors (HDs), 139 samples from patients with a defined diagnosis of autoimmune rheumatic disease (ARD), and 242 consecutive unselected samples screened for ANA during the routine work-up. RESULTS The HEp2 DFS70-Ko substrate recognized anti-DFS70 antibodies in 86/91 (94.5%) of the DFS70 CLIA-positive sera and in 9/57 (15.8%) of the DFS70 CLIA-negative samples. None of the 116 infectious diseases were positive for DFS70 using the engineered IIF substrate. Two samples (2%) were positive among HDs and were then confirmed by CLIA. The 139 ANA-positive sera from patients with ARD displaying a defined antibody specificity showed their expected patterns also on DFS70-Ko HEp-2 substrate. Five of the 242 (2.1%) consecutive samples tested in the routine ANA-screening were identified as DFS70-positive using the HEp2 Ko-substrate and were then confirmed by CLIA. CONCLUSIONS The use of DFS70 HEp-2 Ko cells may offer the unique possibility of simultaneously identifying and confirming the presence of anti-DFS70 antibodies during the standard ANA evaluation, while keeping the expression of other autoantibody markers intact.
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Affiliation(s)
- Nicola Bizzaro
- a Laboratory of Clinical Pathology , San Antonio Hospital , Tolmezzo , Italy.,b Azienda Sanitaria Universitaria Integrata , Udine , Italy
| | - Martina Fabris
- b Azienda Sanitaria Universitaria Integrata , Udine , Italy.,c Institute of Clinical Pathology , University Hospital S. Maria Misericordia , Udine , Italy
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24
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Carter JB, Carter S, Saschenbrecker S, Goeckeritz BE. Recognition and Relevance of Anti-DFS70 Autoantibodies in Routine Antinuclear Autoantibodies Testing at a Community Hospital. Front Med (Lausanne) 2018; 5:88. [PMID: 29686987 PMCID: PMC5900435 DOI: 10.3389/fmed.2018.00088] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 03/21/2018] [Indexed: 01/08/2023] Open
Abstract
Antinuclear autoantibodies (ANA) displaying a dense fine speckled pattern (DFS, ICAP AC-2) on HEp-2 cells are frequently observed in clinical laboratory referrals, often associated with anti-DFS70 specificity. Anti-DFS70 positive patients rarely develop systemic autoimmune rheumatic disease (SARD), especially in the absence of clinical evidence or additional anti-extractable nuclear antigen (ENA) antibodies, prompting suggestions that an isolated DFS70-specific ENA may be an exclusionary finding for SARD. In this study, the frequency and diagnostic significance of anti-DFS70 autoantibodies was investigated in a community hospital cohort of patients undergoing routine ANA testing. ANA screening was performed by HEp-20-10-based indirect immunofluorescence, followed by ENA profiling using a multiparametric line immunoassay (LIA). Of 6,511 patient samples tested for ANA in 2016, the DFS pattern was identified in 1,758 (27.0%), 720 (41.0%) of which were anti-DFS70 positive by LIA. Of these, 526 (73.1%) revealed isolated anti-DFS70 reactivity, while 194 (26.9%) showed additional ENA specificities. Among 1,038 anti-DFS70 negative or borderline samples, 778 (75.0%) were ENA profile negative, while the remaining 260 (25.0%) showed a varied presence of other ENA specificities. Chart reviews of patients with an isolated anti-DFS70 ANA affirmed that ANA-related SARD is rare in the absence of clinical evidence or other ENA specificities, there being no case thus far identified. Rheumatoid arthritis patients occasionally had an isolated anti-DFS70 ANA and were positive for rheumatoid factor and anti-cyclic citrullinated peptide antibodies. In conclusion, the recognition of a DFS ANA pattern using a mitotic-rich HEp-2 substrate, followed by confirmation of anti-DFS70 specificity should be a routine ANA testing service. Use of an expanded ENA profile and clinical correlation is necessary to affirm the "isolation" of anti-DFS70 as the cause of an ANA. Recognition of isolated anti-DFS70 ANA enables reassurance of patients that SARD is unlikely, thus avoiding referral for more extensive testing. The presence of significant elevations of other ENAs may reflect SARD and warrants close clinical correlation and follow-up.
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Affiliation(s)
- John B. Carter
- Lexington Medical Center, West Columbia, SC, United States
| | - Sara Carter
- Lexington Medical Center, West Columbia, SC, United States
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25
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Infantino M, Shovman O, Pérez D, Manfredi M, Grossi V, Benucci M, Gobbi FL, Bandinelli F, Damiani A, Moscato P, Azoulay D, Gilburd B, Shoenfeld Y. Anti-DFS70 autoantibodies in undifferentiated connective tissue diseases subjects: what’s on the horizon? Rheumatology (Oxford) 2018; 57:1293-1298. [DOI: 10.1093/rheumatology/key012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 01/12/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Maria Infantino
- Laboratory of Immunology and Allergology, S. Giovanni di Dio Hospital, Florence, Italy
| | - Ora Shovman
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Aviv, Israel
| | - Dolores Pérez
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Aviv, Israel
| | - Mariangela Manfredi
- Laboratory of Immunology and Allergology, S. Giovanni di Dio Hospital, Florence, Italy
| | - Valentina Grossi
- Laboratory of Immunology and Allergology, S. Giovanni di Dio Hospital, Florence, Italy
| | | | | | | | | | - Paolo Moscato
- Internal Medicine and Rheumatology Unit, University of Salerno, Salerno, Italy
| | - Danielle Azoulay
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Aviv, Israel
| | - Boris Gilburd
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Aviv, Israel
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Aviv, Israel
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Malyavantham KS, Suresh L. Simultaneous Distinction of Monospecific and Mixed DFS70 Patterns During ANA Screening with a Novel HEp-2 ELITE/DFS70 Knockout Substrate. J Vis Exp 2018:56722. [PMID: 29364249 PMCID: PMC5908655 DOI: 10.3791/56722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Systemic autoimmune connective tissue disorders are characterized by circulating antinuclear antibodies (ANA). Although there are several technologies available for ANA screening, indirect immunofluorescence (IIF) using Human epithelial cells-2 (HEp-2) substrate remains the primary and recommended method because of its superior sensitivity. HEp-2 substrates can detect a multitude of patterns resulting from autoantibody binding to various protein and nucleic acid autoantigens distributed throughout the nucleus and cytoplasm of the cells. The great diversity of monospecific and mixed patterns resulting from positive reactions on HEp-2 substrate also complicate the interpretation and accuracy of reporting. One specific example which received utmost attention recently is the dense fine speckled 70 (DFS70) pattern resulting from autoantibodies that specifically bind to a protein called lens epithelium derived growth factor (LEDGF). Lack of clear association with a specific systemic autoimmune disease and high prevalence in healthy populations have made accurate interpretation of DFS70 pattern important. Accurate distinction of DFS70 pattern from disease-associated patterns using conventional HEp-2 substrate is challenging. Moreover, frequent co-occurrence of DFS70 pattern along with disease-associated patterns such as homogeneous, speckled, and mixed homogeneous-speckled patterns complicate the IIF interpretation. The goal of this paper is to demonstrate the utility of a novel engineered HEp-2 IIF substrate that retains all advantages of conventional HEp-2 substrate while simultaneously providing the ability to distinguish DFS70 pattern with high confidence in both monospecific and mixed ANA positive examples. The new substrate is further able to unmask disease-associated ANA patterns previously concealed by DFS70 pattern.
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Affiliation(s)
| | - Lakshmanan Suresh
- Research & Development, Immco Diagnostics, A Trinity Biotech Company
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Antinuclear antibodies in autoimmune and allergic diseases. Reumatologia 2017; 55:298-304. [PMID: 29491538 PMCID: PMC5825968 DOI: 10.5114/reum.2017.72627] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 12/14/2017] [Indexed: 01/25/2023] Open
Abstract
Antinuclear antibodies (ANA) are primarily significant in the diagnosis of systemic connective tissue diseases. The relationship between their occurrence in allergic diseases is poorly documented. However, the mechanism of allergic and autoimmune diseases has a common thread. In both cases, an increased production of IgE antibodies and presence of ANA in selected disease entities is observed. Equally important is the activation of basophils secreting proinflammatory factors and affecting the differentiation of TH17 lymphocytes. Both autoimmune and allergic diseases have complex multi-pathogenesis and often occur in genetically predisposed individuals. The presence of antinuclear antibodies was confirmed in many systemic connective tissue diseases and some allergic diseases. Examples include atopic dermatitis, non-allergic asthma, and pollen allergy. Co-occurring allergic and autoimmune disorders induce further search for mechanisms involved in the aetiopathogenesis of both groups of diseases.
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Analysis of DFS70 pattern and impact on ANA screening using a novel HEp-2 ELITE/DFS70 knockout substrate. AUTOIMMUNITY HIGHLIGHTS 2017; 8:3. [PMID: 28315185 PMCID: PMC5357240 DOI: 10.1007/s13317-017-0091-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 03/07/2017] [Indexed: 12/11/2022]
Abstract
Indirect immunofluorescence (IIF) using human epithelial cell (HEp-2) substrate is a widely used and the recommended method for screening of antinuclear antibodies (ANA). Dense fine speckled (DFS70) pattern on HEp-2 has been widely reported in various healthy and disease groups. Interpretation of DFS70 pattern can be challenging on a conventional HEp-2 substrate due to its similarity to some of the disease associated patterns. The high prevalence of DFS70 autoantibodies in normal population, lack of association with a particular disease group and a general negative association with systemic and ANA associated autoimmune rheumatic diseases (SARD/AARD) necessitates the confirmation of DFS70 pattern. Results using available commercial assays for confirmation of DFS70 autoantibodies do not always agree with IIF screening results further complicating the lab work flow and ANA algorithms. In this review, we discuss the prevalence of DFS70 antibodies and factors affecting the performance of IIF and DFS70 specific confirmatory assays. Factors that contribute to disagreement between DFS70 suspicion by IIF and confirmatory assays will also be discussed. In addition, we also describe a novel IIF HEp-2 substrate, and its positive impact on DFS70 reporting and ANA screening-confirmation algorithm.
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Yoo IY, Oh JW, Cha HS, Koh EM, Kang ES. Performance of an Automated Fluorescence Antinuclear Antibody Image Analyzer. Ann Lab Med 2017; 37:240-247. [PMID: 28224770 PMCID: PMC5339096 DOI: 10.3343/alm.2017.37.3.240] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 11/08/2016] [Accepted: 01/26/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The gold standard for antinuclear antibody (ANA) screening is the indirect immunofluorescence (IIF) assay with human epithelial cells (HEp-2). However, a number of substantial disadvantages of manual IIF assays have highlighted the need for the automation and standardization of fluorescent ANA (FANA) testing. We evaluated the performance of EUROPattern Suite (Euroimmun AG, Germany), an automated FANA image analyzer, with regard to ANA detection and pattern recognition compared with conventional manual interpretation using the fluorescence microscopic IIF assay. METHODS A total of 104 samples including 70 ANA-positive sera and 34 ANA-negative sera collected from September to October 2015 were included. The sensitivity, specificity, and pattern recognition function were evaluated to determine the performance of EUROPattern Suite compared with the manual IIF assay results. RESULTS The sensitivity and specificity of EUROPattern Suite for ANA detection were 94.3% and 94.1%, respectively. The concordance rate between the two methods was 94.2%. For pattern recognition, 45.7% of the samples were assigned identical ANA patterns including simple and mixed. When major pattern matching was considered, 83.7% (41/49) and 95.2% (20/21) of the samples with simple and mixed patterns, respectively, showed concordant results between the two methods. CONCLUSIONS EUROPattern Suite, an automated FANA image analyzer, provides a viable option for distinguishing between positive and negative results, although the ability to assign specific patterns is insufficient to replace manual microscopic interpretation. This automated system may increase efficiency in laboratories, in which a large number of samples need to be processed.
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Affiliation(s)
- In Young Yoo
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Won Oh
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hoon Suk Cha
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Mi Koh
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Suk Kang
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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The prevalence and determinants of anti-DFS70 autoantibodies in an international inception cohort of systemic lupus erythematosus patients. Lupus 2017; 26:1051-1059. [DOI: 10.1177/0961203317692437] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Autoantibodies to dense fine speckles 70 (DFS70) are purported to rule out the diagnosis of SLE when they occur in the absence of other SLE-related autoantibodies. This study is the first to report the prevalence of anti-DFS70 in an early, multinational inception SLE cohort and examine demographic, clinical, and autoantibody associations. Patients were enrolled in the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort within 15 months of diagnosis. The association between anti-DFS70 and multiple parameters in 1137 patients was assessed using univariate and multivariate logistic regression. The frequency of anti-DFS70 was 7.1% (95% CI: 5.7–8.8%), while only 1.1% (95% CI: 0.6–1.9%) were monospecific for anti-DFS70. In multivariate analysis, patients with musculoskeletal activity (Odds Ratio (OR) 1.24 [95% CI: 1.10, 1.41]) or with anti-β2 glycoprotein 1 (OR 2.17 [95% CI: 1.22, 3.87]) were more likely and patients with anti-dsDNA (OR 0.53 [95% CI: 0.31, 0.92]) or anti-SSB/La (OR 0.25 [95% CI: 0.08, 0.81]) were less likely to have anti-DFS70. In this study, the prevalence of anti-DFS70 was higher than the range previously published for adult SLE (7.1 versus 0–2.8%) and was associated with musculoskeletal activity and anti-β2 glycoprotein 1 autoantibodies. However, ‘monospecific’ anti-DFS70 autoantibodies were rare (1.1%) and therefore may be helpful to discriminate between ANA-positive healthy individuals and SLE.
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Glerup M, Herlin T, Twilt M. Remission rate is not dependent on the presence of antinuclear antibodies in juvenile idiopathic arthritis. Clin Rheumatol 2017; 36:671-676. [PMID: 28097448 DOI: 10.1007/s10067-017-3540-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/10/2017] [Accepted: 01/10/2017] [Indexed: 01/17/2023]
Abstract
Recently, it has been hypothesized that the subcategories of the ILAR classification of juvenile idiopathic arthritis (JIA) are not homogeneous, and that the presence of antinuclear antibodies (ANA) should lead to a separate entity. Therefore, the aim of this study was to evaluate ANA positivity as a predictor of achieving remission. A retrospective single-center cohort study including all JIA patients diagnosed between January 2000 and May 2014. A minimum follow-up of 1 year was required plus the ANA status. ANA positivity was defined as at least two positive results with a titer ≥1:160. Demographic and clinical features were collected. Remission at last follow-up was defined by the Wallace criteria. A total of 625 patients met the inclusion criteria and 230 (37%) were found ANA positive. Analysis showed no difference in remission rate between ANA-positive and ANA-negative patients. Additionally, joint count at diagnosis and at last follow-up were comparable in both groups. ANA positivity was correlated to a female predominance and young age at diagnosis (p < 0.001). Remission rates are not different in ANA-positive patients than in ANA-negative patients. This does not support the hypothesis to possibly divide JIA patients based on their ANA status.
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Affiliation(s)
- M Glerup
- Department of Paediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
| | - T Herlin
- Department of Paediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - M Twilt
- Department of Paediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
- Department of Paediatrics, division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada
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The clinical impact of Anti-DFS70 antibodies in undifferentiated connective tissue disease: case reports and a review of the literature. Immunol Res 2016; 65:293-295. [DOI: 10.1007/s12026-016-8836-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bizzaro N, Pesente F, Cucchiaro F, Infantino M, Tampoia M, Villalta D, Fabris M, Tonutti E. Anti-DFS70 antibodies detected by immunoblot methods: A reliable tool to confirm the dense fine speckles ANA pattern. J Immunol Methods 2016; 436:50-3. [PMID: 27374867 DOI: 10.1016/j.jim.2016.06.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 06/28/2016] [Accepted: 06/28/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Autoantibodies to the DFS70 (dense fine speckles 70) protein have been identified among the antinuclear antibodies (ANA) in patients with various disorders. However, the ANA test in indirect immunofluorescence (IIF) is not a reliable method to identify anti-DFS70 antibodies. We undertook this study to evaluate the diagnostic performance of two new immunoblot methods for the detection of anti-DFS70 antibodies and to investigate whether their different DFS70 antigen composition could affect diagnostic accuracy in detecting anti-DFS70 antibodies. METHODS 62 samples showing a DFS70 staining pattern by IIF were tested by dot blot (Alphadia) and line blot (Euroimmun) methods. The dot blot method employs a truncated sequence of the DFS70 antigen (residues 349-435), while the line blot uses the full-length protein (aa 1-530). The 62 samples were previously assayed by a chemoluminescent (CLIA) method also using a truncated antigen (aa 349-435): 27 were CLIA positive and 35 were CLIA negative. 120 sera from subjects with infectious diseases were used as controls. RESULT Both immunoblot methods were positive in the 27 IIF/CLIA positive samples; in addition, the Alphadia dot blot identified another seven DFS70 samples and the Euroimmun line blot was positive in five samples that were negative by CLIA. Among the 120 control samples, two false positives were recorded for the CLIA method, six for the Alphadia method and four for the Euroimmun method. Therefore, in this selected series of samples, sensitivity and specificity were 43.5% and 98.3% for the CLIA method, 54.8% and 95% for the dot blot and 51.6% and 96.6% for the line blot, respectively. CONCLUSIONS Because of great inconsistency in assessing the DFS70 pattern using the ANA-IIF test, specific assays should be used to confirm anti-DFS70 antibodies. The results of this study show that there is no difference in the overall diagnostic accuracy among methods that use the truncated or the full-length DFS70 antigenic sequence and that it is likely that antibodies directed against antigens other than DFS70 may be responsible for producing a DFS70-like ANA-IIF pattern.
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Affiliation(s)
- Nicola Bizzaro
- Laboratorio di Patologia Clinica, Ospedale San Antonio, Tolmezzo, Italy.
| | - Fiorenza Pesente
- Laboratorio di Patologia Clinica, Ospedale San Antonio, Tolmezzo, Italy
| | | | - Maria Infantino
- Laboratorio di Immunologia e Allergologia, Ospedale S. Giovanni di Dio, Firenze, Italy
| | - Marilina Tampoia
- Laboratorio di Patologia Clinica, Policlinico Universitario, Bari, Italy
| | - Danilo Villalta
- Allergologia e Immunologia Clinica, Azienda Ospedaliera S. Maria degli Angeli, Pordenone, Italy
| | - Martina Fabris
- Istituto di Patologia Clinica, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine, Italy
| | - Elio Tonutti
- Immunopatologia e Allergologia, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine, Italy
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Menor Almagro R, Rodríguez Gutiérrez JF, Martín-Martínez MA, Rodríguez Valls MJ, Aranda Valera C, de la Iglesia Salgado JL. Association between antinuclear antibody titers and connective tissue diseases in a Rheumatology Department. ACTA ACUST UNITED AC 2016; 13:150-155. [PMID: 27221374 DOI: 10.1016/j.reuma.2016.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 03/23/2016] [Accepted: 03/30/2016] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To determine the dilution titles at antinuclear antibodies (ANA) by indirect immunofluorescence observed in cell substrate HEp-2 and its association with the diagnosis of systemic connective tissue disease in ANA test requested by a Rheumatology Unit. METHOD Samples of patients attended for the first time in the rheumatology unit, without prior ANA test, between January 2010 and December 2012 were selected. The dilution titers, immunofluorescence patterns and antigen specificity were recorded. In January 2015 the diagnosis of the patients were evaluated and classified in systemic disease connective tissue (systemic lupus erythematosus, Sjögren's syndrome, systemic sclerosis, undifferentiated connective, antiphospholipid syndrome, mixed connective tissue and inflammatory myophaty) or not systemic disease connective tissue. RESULT A total of 1282 ANA tests requested by the Rheumatology Unit in subjects without previous study, 293 were positive, predominance of women (81.9%). Patients with systemic connective tissue disease were recorded 105, and 188 without systemic connective tissue disease. For 1/640 dilutions the positive predictive value in the connective was 73.3% compared to 26.6% of non-connective, and for values ≥1/1,280 85% versus 15% respectively. When performing the multivariate analysis we observed a positive association between 1/320 dilution OR 3.069 (95% CI: 1.237-7.614; P=.016), 1/640 OR 12.570 (95% CI: 3.659-43.187; P=.000) and ≥1/1,280 OR 42.136 (95% CI: 8.604-206.345; P=.000). CONCLUSION These results show association titles dilution ≥1/320 in ANA's first test requested by a Rheumatology Unit with patients with systemic connective tissue disease. The VPP in these patients was higher than previous studies requested by other medical specialties. This may indicate the importance of application of the test in a targeted way.
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Affiliation(s)
- Raúl Menor Almagro
- Sección de Reumatología, Hospital General de Jerez, Jerez de la Frontera, España.
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35
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Broadfoot A, Sivertsen T, Baumgart K. Dense fine speckled indirect immunofluorescence pattern in an Australian population. Pathology 2016; 48:247-50. [DOI: 10.1016/j.pathol.2016.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 11/20/2015] [Accepted: 11/26/2015] [Indexed: 11/29/2022]
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Confirmation of anti-DFS70 antibodies is needed in routine clinical samples with DFS staining pattern. Cent Eur J Immunol 2016; 41:6-11. [PMID: 27095916 PMCID: PMC4829817 DOI: 10.5114/ceji.2016.58812] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 02/23/2016] [Indexed: 11/17/2022] Open
Abstract
Background Recognition of nuclear dense fine speckled (DFS) pattern by indirect immunofluorescence (IIF) is not easy. Thus, confirming the presence of these antibodies might be needed. In this study, we aimed to determine the frequency of DFS pattern in our diagnostic laboratory and to investigate the presence of anti-DFS70 antibodies in samples showing DFS pattern by two commercially available research kits retrospectively. Material and methods Seventy-four sequential serum samples with DFS pattern on HEp2010 cell substrates by IIF were included in this study. The semiquantitative DFS70 ELISA Kit (MBL International Corporation, Woburn, UK) was used for detection of anti-DFS70 antibodies in these samples. Twenty selected samples were tested for the presence of anti-DFS70 antibodies using ANA Line Immunoassay (LIA) (Immco Diagnostics, New York, USA). Results Sixty-two (83.8%) of 74 serum samples were found positive with ELISA, when 15 U/ml was taken as a reference value. Among 18 samples that were found positive by ELISA, five were negative for anti-DFS70 antibodies by LIA, while 13 were found positive. The lowest ELISA result of the sample that was positive by LIA was found to be 45.3 U/ml. When 45.3 U/ml was considered as a reference value, 45 (60.8%) of 74 serum samples were positive by ELISA. Nineteen of 20 patients had no SARD, while one had systemic lupus erythematosus (SLE). Conclusions DFS pattern should be confirmed with an objective method such as ELISA, LIA, or IB. We think that confirmation tests for detection of anti-DFS70 antibodies should be included in diagnostic algorithms.
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Choosing wisely: Review and commentary on anti-nuclear antibody (ANA) testing. Autoimmun Rev 2016; 15:272-80. [DOI: 10.1016/j.autrev.2015.12.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 12/08/2015] [Indexed: 12/22/2022]
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Damoiseaux J, von Mühlen CA, Garcia-De La Torre I, Carballo OG, de Melo Cruvinel W, Francescantonio PLC, Fritzler MJ, Herold M, Mimori T, Satoh M, Andrade LEC, Chan EKL, Conrad K. International consensus on ANA patterns (ICAP): the bumpy road towards a consensus on reporting ANA results. AUTOIMMUNITY HIGHLIGHTS 2016; 7:1. [PMID: 26831867 PMCID: PMC4733811 DOI: 10.1007/s13317-016-0075-0] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 12/25/2015] [Indexed: 12/20/2022]
Abstract
The International Consensus on ANA Patterns (ICAP) was initiated as a workshop aiming to thoroughly discuss and achieve consensus regarding the morphological patterns observed in the indirect immunofluorescence assay on HEp-2 cells. One of the topics discussed at the second ICAP workshop, and addressed in this paper, was the harmonization of reporting ANA test results. This discussion centered on the issue if cytoplasmic and mitotic patterns should be reported as positive or negative. This report outlines the issues that impact on two major different reporting methods. Although it was appreciated by all participants that cytoplasmic and mitotic patterns are clinically relevant, implications for existing diagnostic/classification criteria for ANA-associated diseases in particular hampered a final consensus on this topic. Evidently, a more concerted action of all relevant stakeholders is required. Future ICAP workshops may help to facilitate this action.
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Affiliation(s)
- Jan Damoiseaux
- Central Diagnostic Laboratory, Maastricht University Medical Center, Maastricht, P. Debyelaan 25, 6229 HX, Maastricht, Netherlands.
| | | | - Ignacio Garcia-De La Torre
- Department of Immunology and Rheumatology, Hospital General de Occidente, University of Guadalajara, Guadalajara, Mexico
| | - Orlando Gabriel Carballo
- Laboratory of Immunology, Hospital Carlos G. Durand, Buenos Aires, Argentina
- Department of Immunology, Instituto Universitario del Hospital Italiano, Buenos Aires, Argentina
| | | | | | - Marvin J Fritzler
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Manfred Herold
- Department of Internal Medicine VI, Medical University of Innsbruck, Innsbruck, Austria
| | - Tsuneyo Mimori
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Minoru Satoh
- Department of Clinical Nursing, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Luis E C Andrade
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
- Fleury Medicine and Health Laboratories, Immunology Division, São Paulo, Brazil
| | - Edward K L Chan
- Department of Oral Biology, University of Florida, Gainesville, FL, USA
| | - Karsten Conrad
- Institute of Immunology, Technical University of Dresden, Dresden, Germany
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Lee H, Kim Y, Han K, Oh EJ. Application of anti-DFS70 antibody and specific autoantibody test algorithms to patients with the dense fine speckled pattern on HEp-2 cells. Scand J Rheumatol 2015; 45:122-8. [PMID: 26643611 DOI: 10.3109/03009742.2015.1060260] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Whereas antinuclear antibodies (ANAs) detected by indirect immunofluorescence (IIF) have diagnostic significance, the dense fine speckled (DFS) pattern on HEp-2 cells may be an exclusionary marker for ANA-associated rheumatic disease (AARD). The aim of this study was to evaluate a new algorithm considering anti-DFS70 antibodies for routine ANA testing. METHOD From ANA requested sequential 10 528 sera, 181 sera samples showing the DFS pattern were additionally tested for anti-DFS70 antibodies by an enzyme-linked immunosorbent assay (ELISA-DFS70) and for specific-ANAs. Specific-ANAs(+)/IIF-DFS(-) control sera samples (n = 50) were also tested. RESULTS Of the 181 IIF-DFS-positive sera samples, 82.9% (n = 150) were from non-AARD patients and 112 (61.9%) patients had non-rheumatic diseases (NRD), including the most common clinical feature of dermatitis (18.2%). The ELISA-DFS70 was positive in 109 (60.2%) sera and was negative in all control sera. Specific-ANAs were similarly detected as 25.7% (28/109) and 22.2% (16/72) of ELISA-DFS70(+) and ELISA-DFS70(+) patients, respectively (p > 0.05). The prevalence of non-AARD was 95.1% and 25.1% in the ELISA-DFS70(+)/specific-ANAs(-) and ELISA-DFS70(-)/specific-ANAs (+) groups, respectively. CONCLUSIONS In patients with a HEp-2 DFS pattern, the additional ELISA-DFS70 and specific-ANAs test could improve the efficiency of diagnosing AARD. The detection of anti-DFS70 antibodies should be included in test algorithms for ANA testing.
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Affiliation(s)
- H Lee
- a Department of Laboratory Medicine , College of Medicine, Seoul St. Mary's Hospital, the Catholic University of Korea , Seoul , South Korea
| | - Y Kim
- a Department of Laboratory Medicine , College of Medicine, Seoul St. Mary's Hospital, the Catholic University of Korea , Seoul , South Korea
| | - K Han
- a Department of Laboratory Medicine , College of Medicine, Seoul St. Mary's Hospital, the Catholic University of Korea , Seoul , South Korea
| | - E-J Oh
- a Department of Laboratory Medicine , College of Medicine, Seoul St. Mary's Hospital, the Catholic University of Korea , Seoul , South Korea
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Basu A, Woods-Burnham L, Ortiz G, Rios-Colon L, Figueroa J, Albesa R, Andrade LE, Mahler M, Casiano CA. Specificity of antinuclear autoantibodies recognizing the dense fine speckled nuclear pattern: Preferential targeting of DFS70/LEDGFp75 over its interacting partner MeCP2. Clin Immunol 2015; 161:241-50. [PMID: 26235378 PMCID: PMC4712632 DOI: 10.1016/j.clim.2015.07.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 07/28/2015] [Accepted: 07/29/2015] [Indexed: 11/26/2022]
Abstract
Human antinuclear autoantibodies (ANAs) targeting the dense fine speckled (DFS) nuclear protein DFS70, commonly known as lens epithelium derived growth factor p75 (LEDGFp75), present a clinical puzzle since their significance remains elusive. While their frequencies are low in ANA-positive autoimmune rheumatic diseases, they are relatively elevated in clinical laboratory referrals, diverse inflammatory conditions, and 'apparently' healthy individuals. We reported previously that DFS70/LEDGFp75 is an autoantigen in prostate cancer that closely interacts with another 70kD DFS nuclear protein, methyl CpG binding protein 2 (MeCP2). This led us to investigate if anti-DFS sera exclusively target DFS70/LEDGFp75 or also recognize MeCP2. Using several complementary autoantibody detection platforms and cellular/molecular approaches we evaluated 65 human sera producing anti-DFS autoantibodies. Our results show that these antibodies are highly specific for DFS70/LEDGFp75 and do not target MeCP2. Establishing the specificity of anti-DFS autoantibodies has implications for increasing our understanding of their biological significance and clinical utility.
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Affiliation(s)
- Anamika Basu
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Leanne Woods-Burnham
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Greisha Ortiz
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Leslimar Rios-Colon
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Johnny Figueroa
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Roger Albesa
- Department of Research, Inova Diagnostics, Inc., San Diego, CA, USA
| | - Luis E Andrade
- Rheumatology Division, Universidade Federal de Sao Paulo, Immunology Division, Fleury Medicine and Health Laboratories, Sao Paulo, Brazil
| | - Michael Mahler
- Department of Research, Inova Diagnostics, Inc., San Diego, CA, USA
| | - Carlos A Casiano
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA; Department of Medicine, Division of Rheumatology, Loma Linda University School of Medicine, Loma Linda, CA, USA.
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Clinical performance evaluation of a novel, automated chemiluminescent immunoassay, QUANTA Flash CTD Screen Plus. Immunol Res 2015; 61:110-6. [PMID: 25420962 DOI: 10.1007/s12026-014-8601-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The QUANTA Flash(®) CTD Screen Plus is a chemiluminescent immunoassay (CIA) for the detection of the major antinuclear antibodies (ANA) on the BIO-FLASH(®) platform. NOVA View(®) is an automated fluorescence microscope that acquires digital images of indirect immunofluorescent assay (IFA) slides. Our goal was to evaluate the clinical performance of the two automated systems and compare their performance to that of traditional IFA. Sera from patients with systemic autoimmune rheumatic diseases (SARD, n = 178), along with disease and healthy controls (n = 204), were tested with the CTD CIA and with NOVA Lite(®) HEp-2 ANA, using both the manual method of reading the IFA slides and the NOVA View instrument. The CTD CIA showed 78.1% sensitivity for SARD, coupled with 94.1% specificity. Manual IFA and NOVA View showed somewhat higher sensitivity (81.5 and 84.8% in SARD, respectively), but significantly lower specificity (79.4 and 64.7%, respectively). Both automated systems displayed somewhat different performance, due to the different principals of ANA detection: IFA with NOVA View digital image interpretation had higher sensitivity, while the CTD CIA showed higher specificity. With the added benefits of full automation, the new CTD CIA is an attractive alternative to traditional ANA screening.
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Bizzaro N, Tonutti E, Tampoia M, Infantino M, Cucchiaro F, Pesente F, Morozzi G, Fabris M, Villalta D. Specific chemoluminescence and immunoasdorption tests for anti-DFS70 antibodies avoid false positive results by indirect immunofluorescence. Clin Chim Acta 2015; 451:271-7. [PMID: 26471835 DOI: 10.1016/j.cca.2015.10.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 10/08/2015] [Accepted: 10/09/2015] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To evaluate two new diagnostic methods for the identification of anti-DFS70 antibodies in samples showing a DFS70-staining pattern by indirect immunofluorescence (IIF). METHODS We studied 731 patients: 576 were collected consecutively among those that in the ANA test on HEp-2 cells had produced a DFS70 fluorescence pattern and 155 were a consecutive series of patients sent by referring physicians for routine ANA testing. As controls we studied 50 patients with autoimmune diseases and 120 patients with active infectious disease. All 731 sera were assayed for anti-DFS70 antibodies by a specific chemoluminescence assay (CLIA); 70 randomly selected IIF-positive sera and 35 samples from patients with autoimmune diseases were studied by inhibition tests using the HEp-2 Select method. RESULTS Assays performed with the CLIA-DFS70 method were positive in 30.4% of the samples presenting a DFS70 pattern by IIF, in 1.3% of the routine ANA sera, in 1.6% of the infectious sera and in none of the 50 autoimmune controls. However, as the IIF-DFS70 positive group included 106 patients with systemic autoimmune rheumatic diseases (SARD), 11 of which were DFS70 positive by CLIA, the prevalence of DFS70 antibodies in SARD was 7.5%. The ANA test performed after the use of HEp-2 Select showed an inhibition in 95.7% of the sera. No change in fluorescence intensity and pattern morphology between the native sera and the same sera tested with the solution containing the DFS70 antigen was observed in the 35 samples from patients with autoimmune diseases. CONCLUSIONS To avoid misinterpretation of ANA pattern and consequent diagnostic errors, confirmation of the DFS70-IIF pattern by CLIA or other specific methods is mandatory before reporting the presence of anti-DFS70 antibodies. The HEp-2 Select test in most cases eliminates the interference by anti-DFS70 antibodies and avoids the possible reporting of false positive results.
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Affiliation(s)
- Nicola Bizzaro
- Laboratorio di Patologia Clinica, Ospedale San Antonio, Tolmezzo, Italy.
| | - Elio Tonutti
- Immunopatologia e Allergologia, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine, Italy
| | - Marilina Tampoia
- Laboratorio di Patologia Clinica, Policlinico Universitario, Bari, Italy
| | - Maria Infantino
- Laboratorio di Immunologia e Allergologia, Ospedale S. Giovanni di Dio, Firenze, Italy
| | | | - Fiorenza Pesente
- Laboratorio di Patologia Clinica, Ospedale San Antonio, Tolmezzo, Italy
| | - Gabriella Morozzi
- Dipartimento di Medicina Clinica e Scienze Immunologiche, Sezione di Reumatologia, Policlinico Universitario Le Scotte, Siena, Italy
| | - Martina Fabris
- Istituto di Patologia Clinica, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine, Italy
| | - Danilo Villalta
- Allergologia e Immunologia Clinica, Azienda Ospedaliera S. Maria degli Angeli, Pordenone, Italy
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Schmeling H, Mahler M, Levy DM, Moore K, Stevens AM, Wick J, McMillan JD, Horneff G, Assassi S, Charles J, Salazar G, Mayes MD, Silverman ED, Klien-Gitelman M, Lee T, Brunner HI, Reed AM, Fritzler MJ. Autoantibodies to Dense Fine Speckles in Pediatric Diseases and Controls. J Rheumatol 2015; 42:2419-26. [PMID: 26472409 DOI: 10.3899/jrheum.150567] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Autoantibodies to the dense fine speckled 70 kDa antigen (DFS70) are reported to be more common in individuals who do not have an antinuclear antibody (ANA)-associated rheumatic disease (AARD) than in patients with AARD. The frequency of anti-DFS70 antibodies has been thoroughly studied in adult but not in pediatric populations. The primary objective of this observational study was to determine the frequency of anti-DFS70 in pediatric AARD and reference cohorts. METHODS Sera from 743 children with AARD and related conditions, and 345 samples from reference cohorts (healthy children and those being investigated for AARD) were studied for anti-DFS70 autoantibodies as measured by a chemiluminescence immunoassay. A de-identified administrative database was used to retrieve demographic, serologic, and clinical data. RESULTS Anti-DFS70 antibodies were seen in 2.1% of healthy children and in 4.5% of sera from pediatric individuals referred for ANA testing. The frequency of anti-DFS70 was highest in juvenile localized scleroderma (LS; 4/29, 13.8%), juvenile dermatomyositis (JDM; 2/11, 18.2%), childhood systemic lupus erythematosus (cSLE; 19/331, 5.7%), diffuse cutaneous systemic sclerosis (1/22, 4.5%), celiac disease (2/49, 4.1%), and juvenile idiopathic arthritis (JIA; 5/202, 2.5%). Of note, anti-DFS70 antibodies were observed in 3/26 children (11.5%) with uveitis and JIA-associated uveitis. CONCLUSION The frequency of anti-DFS70 autoantibodies in healthy pediatric subjects is within the lower range of that reported in adults. Anti-DFS70 antibodies can be found in childhood SSc and cSLE, but has a remarkably high frequency in children with LS, JDM, and uveitis.
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Affiliation(s)
- Heinrike Schmeling
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Michael Mahler
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Deborah M Levy
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Katharine Moore
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Anne M Stevens
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - James Wick
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Jacob D McMillan
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Gerd Horneff
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Shervin Assassi
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Julio Charles
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Gloria Salazar
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Maureen D Mayes
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Earl D Silverman
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Marissa Klien-Gitelman
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Tzelan Lee
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Hermine I Brunner
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Ann M Reed
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
| | - Marvin J Fritzler
- From the Department of Paediatrics, Alberta Children's Hospital, and McCaig Institute for Bone and Joint Health, and Faculty of Medicine, University of Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta; Hospital for Sick Children; University of Toronto, Toronto, Ontario, Canada; Inova Diagnostics Inc., San Diego, California; Stanford University/Lucile Packard Children's Hospital, Stanford, California; Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, Washington; Division of Rheumatology, University of Texas Houston Medical School, Houston, Texas; Northwestern University/Lurie Children's Hospital, Chicago, Illinois; University of Cincinnati; Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, Duke University, Durham, North Carolina, USA; Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics, Sankt Augustin, Germany.H. Schmeling, MD, Department of Paediatrics, Alberta Children's Hospital, University of Calgary, and Alberta Children's Hospital Research Institute, and McCaig Institute for Bone and Joint Health; M. Mahler, PhD, Inova Diagnostics Inc.; D.M. Levy, PhD, Hospital for Sick Children, and University of Toronto; K. Moore, MD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; A.M. Stevens, MD, PhD, Seattle Children's Research Institute, Department of Pediatrics, University of Washington; J. Wick, BSc, Faculty of Medicine, University of Calgary; J.D. McMillan, Faculty of Medicine, University of Calgary; G. Horneff, MD, Department of General Paediatrics, Centre of Paediatrics and Neonatology, Asklepios Clinics; S. Assassi, MD, Division of Rheumatology, University of Texas Houston Medical School; J. Charles, BSc, MSc, Division of Rheumatology, University of Texas Houston Medical School; G. Salazar, MD, Division of Rheumatology, University of Texas Houston Medical School; M
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Chan EKL, Damoiseaux J, Carballo OG, Conrad K, de Melo Cruvinel W, Francescantonio PLC, Fritzler MJ, Garcia-De La Torre I, Herold M, Mimori T, Satoh M, von Mühlen CA, Andrade LEC. Report of the First International Consensus on Standardized Nomenclature of Antinuclear Antibody HEp-2 Cell Patterns 2014-2015. Front Immunol 2015; 6:412. [PMID: 26347739 DOI: 10.3389/fimmu.2015.00412/bibtex] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 07/27/2015] [Indexed: 05/26/2023] Open
Abstract
During the 12th International Workshop on Autoantibodies and Autoimmunity held in Sao Paulo, Brazil, on August 28, 2014, a full day session was devoted to establishing a consensus on the nomenclature of staining patterns observed in the antinuclear antibody (ANA) indirect immunofluorescence test on HEp-2 cells. The current report summarizes the collective agreements with input from the host Brazilian and international communities that represented research, clinical, and diagnostic service laboratories. Patterns are categorized in three major groups (nuclear, cytoplasmic, and mitotic patterns) and each pattern has been defined and described in detail. The consensus nomenclature and representative patterns are made available online at the international consensus on antinuclear antibody pattern (ICAP) website (www.ANApatterns.org). To facilitate continuous improvement and input, specific comments on ICAP are encouraged and these will be discussed in subsequent ICAP meetings. The ultimate goal with the establishment of the ICAP is to promote harmonization and understanding of autoantibody test nomenclature, as well as interpretation guidelines for ANA testing, thereby optimizing usage in patient care.
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Affiliation(s)
- Edward K L Chan
- Department of Oral Biology, University of Florida , Gainesville, FL , USA
| | - Jan Damoiseaux
- Central Diagnostic Laboratory, Maastricht University Medical Center , Maastricht , Netherlands
| | - Orlando Gabriel Carballo
- Laboratory of Immunology, Hospital Carlos G. Durand , Buenos Aires , Argentina ; Department of Immunology, Instituto Universitario del Hospital Italiano , Buenos Aires , Argentina
| | - Karsten Conrad
- Institute of Immunology, Technical University of Dresden , Dresden , Germany
| | | | | | - Marvin J Fritzler
- Department of Medicine, Cumming School of Medicine, University of Calgary , Calgary, AB , Canada
| | - Ignacio Garcia-De La Torre
- Department of Immunology and Rheumatology, Hospital General de Occidente, University of Guadalajara , Guadalajara , Mexico
| | - Manfred Herold
- Department of Internal Medicine VI, Medical University of Innsbruck , Innsbruck , Austria
| | - Tsuneyo Mimori
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University , Kyoto , Japan ; Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University , Kyoto , Japan
| | - Minoru Satoh
- Department of Clinical Nursing, University of Occupational and Environmental Health , Kitakyushu , Japan
| | | | - Luis E C Andrade
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo , Brazil ; Immunology Division, Fleury Medicine and Health Laboratories , São Paulo , Brazil
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Chan EKL, Damoiseaux J, Carballo OG, Conrad K, de Melo Cruvinel W, Francescantonio PLC, Fritzler MJ, Garcia-De La Torre I, Herold M, Mimori T, Satoh M, von Mühlen CA, Andrade LEC. Report of the First International Consensus on Standardized Nomenclature of Antinuclear Antibody HEp-2 Cell Patterns 2014-2015. Front Immunol 2015; 6:412. [PMID: 26347739 PMCID: PMC4542633 DOI: 10.3389/fimmu.2015.00412] [Citation(s) in RCA: 216] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 07/27/2015] [Indexed: 12/30/2022] Open
Abstract
During the 12th International Workshop on Autoantibodies and Autoimmunity held in Sao Paulo, Brazil, on August 28, 2014, a full day session was devoted to establishing a consensus on the nomenclature of staining patterns observed in the antinuclear antibody (ANA) indirect immunofluorescence test on HEp-2 cells. The current report summarizes the collective agreements with input from the host Brazilian and international communities that represented research, clinical, and diagnostic service laboratories. Patterns are categorized in three major groups (nuclear, cytoplasmic, and mitotic patterns) and each pattern has been defined and described in detail. The consensus nomenclature and representative patterns are made available online at the international consensus on antinuclear antibody pattern (ICAP) website (www.ANApatterns.org). To facilitate continuous improvement and input, specific comments on ICAP are encouraged and these will be discussed in subsequent ICAP meetings. The ultimate goal with the establishment of the ICAP is to promote harmonization and understanding of autoantibody test nomenclature, as well as interpretation guidelines for ANA testing, thereby optimizing usage in patient care.
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Affiliation(s)
- Edward K. L. Chan
- Department of Oral Biology, University of Florida, Gainesville, FL, USA
| | - Jan Damoiseaux
- Central Diagnostic Laboratory, Maastricht University Medical Center, Maastricht, Netherlands
| | - Orlando Gabriel Carballo
- Laboratory of Immunology, Hospital Carlos G. Durand, Buenos Aires, Argentina
- Department of Immunology, Instituto Universitario del Hospital Italiano, Buenos Aires, Argentina
| | - Karsten Conrad
- Institute of Immunology, Technical University of Dresden, Dresden, Germany
| | | | | | - Marvin J. Fritzler
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ignacio Garcia-De La Torre
- Department of Immunology and Rheumatology, Hospital General de Occidente, University of Guadalajara, Guadalajara, Mexico
| | - Manfred Herold
- Department of Internal Medicine VI, Medical University of Innsbruck, Innsbruck, Austria
| | - Tsuneyo Mimori
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Minoru Satoh
- Department of Clinical Nursing, University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | - Luis E. C. Andrade
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
- Immunology Division, Fleury Medicine and Health Laboratories, São Paulo, Brazil
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Ochs RL, Mahler M, Basu A, Rios-Colon L, Sanchez TW, Andrade LE, Fritzler MJ, Casiano CA. The significance of autoantibodies to DFS70/LEDGFp75 in health and disease: integrating basic science with clinical understanding. Clin Exp Med 2015; 16:273-93. [PMID: 26088181 PMCID: PMC4684813 DOI: 10.1007/s10238-015-0367-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 06/03/2015] [Indexed: 12/16/2022]
Abstract
Antinuclear autoantibodies (ANAs) displaying the nuclear dense fine speckled immunofluorescence (DFS-IIF) pattern in HEp-2 substrates are commonly observed in clinical laboratory referrals. They target the dense fine speckled autoantigen of 70 kD (DFS70), most commonly known as lens epithelium-derived growth factor p75 (LEDGFp75). Interesting features of these ANAs include their low frequency in patients with systemic autoimmune rheumatic diseases (SARD), elevated prevalence in apparently healthy individuals, IgG isotype, strong trend to occur as the only ANA specificity in serum, and occurrence in moderate to high titers. These autoantibodies have also been detected at varied frequencies in patients with diverse non-SARD inflammatory and malignant conditions such as atopic diseases, asthma, eye diseases, and prostate cancer. These observations have recently stimulated vigorous research on their clinical and biological significance. Some studies have suggested that they are natural, protective antibodies that could serve as biomarkers to exclude a SARD diagnosis. Other studies suggest that they might be pathogenic in certain contexts. The emerging role of DFS70/LEDGFp75 as a stress protein relevant to human acquired immunodeficiency syndrome, cancer, and inflammation also points to the possibility that these autoantibodies could be sensors of cellular stress and inflammation associated with environmental factors. In this comprehensive review, we integrate our current knowledge of the biology of DFS70/LEDGFp75 with the clinical understanding of its autoantibodies in the contexts of health and disease.
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Affiliation(s)
- Robert L Ochs
- Ventana Medical, Roche Tissue Diagnostics, Tucson, AZ, USA
| | - Michael Mahler
- Department of Research, Inova Diagnostics, Inc., San Diego, CA, USA
| | - Anamika Basu
- Department of Basic Sciences, Center for Health Disparities and Molecular Medicine, Loma Linda University School of Medicine, Mortensen Hall 142, 11085 Campus St, Loma Linda, CA, 92350, USA
| | - Leslimar Rios-Colon
- Department of Basic Sciences, Center for Health Disparities and Molecular Medicine, Loma Linda University School of Medicine, Mortensen Hall 142, 11085 Campus St, Loma Linda, CA, 92350, USA
| | - Tino W Sanchez
- Department of Basic Sciences, Center for Health Disparities and Molecular Medicine, Loma Linda University School of Medicine, Mortensen Hall 142, 11085 Campus St, Loma Linda, CA, 92350, USA
| | - Luis E Andrade
- Rheumatology Division, Universidade Federal de Sao Paulo, and Immunology Division, Fleury Medicine and Health Laboratories, São Paulo, Brazil
| | | | - Carlos A Casiano
- Department of Basic Sciences, Center for Health Disparities and Molecular Medicine, Loma Linda University School of Medicine, Mortensen Hall 142, 11085 Campus St, Loma Linda, CA, 92350, USA.
- Department of Medicine, Division of Rheumatology, Loma Linda University School of Medicine, Loma Linda, CA, USA.
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López Sañudo S, Fernández Alonso I, López Hoyos M. [Importance of the dense fine speckled pattern and anti-DFS70 antibodies for the diagnosis of systemic autoimmune rheumatic diseases]. Med Clin (Barc) 2015; 145:218-23. [PMID: 26021571 DOI: 10.1016/j.medcli.2015.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 03/20/2015] [Accepted: 03/27/2015] [Indexed: 01/31/2023]
Affiliation(s)
- Susana López Sañudo
- Werfen, Diagnostic Solutions for Life, Línea de Autoinmunidad, L'Hospitalet de Llobregat, Barcelona, España.
| | - Irene Fernández Alonso
- Werfen, Diagnostic Solutions for Life, Línea de Autoinmunidad, L'Hospitalet de Llobregat, Barcelona, España
| | - Marcos López Hoyos
- Servicio de Inmunología, Hospital Universitario Marqués de Valdecilla, Santander, España
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Şener AG, Afşar İ. Frequency of dense fine speckled pattern in immunofluorescence screening test. Eur J Rheumatol 2015; 2:103-105. [PMID: 27708940 DOI: 10.5152/eurjrheum.2015.0003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 03/02/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The presence of antinuclear antibodies (ANA), directed against intracellular antigens, is a distinctive feature of systemic autoimmune rheumatic diseases (SARDs). The standard test for antinuclear antibody screening is the indirect immunofluorescence (IIF). Anti-dense fine speckled 70 (anti-DFS70) antibodies were initially identified as an ANA IIF pattern from a patient with interstitial cystitis, but they were later associated with various other conditions. The objective of the study was to determine the frequency of anti-DFS70 antibodies in a cohort of patients undergoing routine ANA testing. MATERIAL AND METHODS From January 2011 to January 2012, a total of 5800 serum samples were screened for ANA by IIF (Euroimmune AG, Lübeck, Germany). DFS pattern was searched. RESULTS ANA were present in 1302 (22.4%) of all patients. There were 16 (1.2%) anti-DFS70 antibody-positive patients. The number of females and males who have anti-DFS70 antibody was eleven and five, respectively. All of the samples presented a titer of ≥1/320. There was one patient with SARD from the rheumatology department. Another 15 patients were from gastroenterology, endocrinology, and general internal medicine. CONCLUSION Although a distinctive clinical association has not been reported, anti-DFS70 have been proposed as a significant biomarker for the exclusion of SARD. The present study is a preliminary study. There is a need for a reliable assay to ensure reactivity to DFS70 and screening large populations.
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Affiliation(s)
- Aslı Gamze Şener
- Department of Medical Microbiology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - İlhan Afşar
- Department of Medical Microbiology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
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Basu A, Sanchez TW, Casiano CA. DFS70/LEDGFp75: An Enigmatic Autoantigen at the Interface between Autoimmunity, AIDS, and Cancer. Front Immunol 2015; 6:116. [PMID: 25852687 PMCID: PMC4367441 DOI: 10.3389/fimmu.2015.00116] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 03/02/2015] [Indexed: 11/25/2022] Open
Abstract
Clinical and diagnostic laboratories often encounter patient sera containing antinuclear antibodies (ANAs) that produce a nuclear dense fine speckled immunofluorescence pattern on HEp-2 cells. These autoantibodies usually target the dense fine speckled protein of 70 kDa (DFS70), commonly known as lens epithelium-derived growth factor p75 (LEDGFp75). Anti-DFS70/LEDGFp75 autoantibodies have recently attracted much interest because of their relatively common occurrence in sera from patients with positive ANA tests with no clinical evidence of systemic autoimmune rheumatic disease (SARD). Their presence has been documented primarily in patients with diverse non-SARD inflammatory conditions and “apparently healthy” individuals. While there is circumstantial evidence that depending on the context these autoantibodies could play protective, pathogenic, or sensor roles, their significance remains elusive. DFS70/LEDGFp75 has emerged during the past decade as a stress transcription co-activator relevant to HIV integration, cancer, and inflammation. It is not clear, however, what makes this protein the target of such a common autoantibody response. We suggest that a better understanding of DFS70/LEDGFp75 biology is key to elucidating the significance of its associated autoantibodies. Here, we discuss briefly our current understanding of this enigmatic autoantigen and potential scenarios leading to its targeting by the immune system.
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Affiliation(s)
- Anamika Basu
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine , Loma Linda, CA , USA
| | - Tino W Sanchez
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine , Loma Linda, CA , USA
| | - Carlos A Casiano
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine , Loma Linda, CA , USA ; Department of Medicine, Loma Linda University School of Medicine , Loma Linda, CA , USA
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50
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Mahler M, Fritzler MJ, Satoh M. Autoantibodies to the mitochondrial RNA processing (MRP) complex also known as Th/To autoantigen. Autoimmun Rev 2015; 14:254-7. [DOI: 10.1016/j.autrev.2014.11.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 11/11/2014] [Indexed: 02/06/2023]
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