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Infantino M, Carbone T, Brusca I, Alessio MG, Previtali G, Platzgummer S, Paura G, Castiglione C, Fabris M, Pesce G, Porcelli B, Terzuoli L, Bacarelli MR, Tampoia M, Cinquanta L, Villalta D, Buzzolini F, Palterer B, Pancani S, Benucci M, Manfredi M, Bizzaro N. Current technologies for anti-ENA antibody detection: State-of-the-art of diagnostic immunoassays. J Immunol Methods 2022; 507:113297. [PMID: 35690095 DOI: 10.1016/j.jim.2022.113297] [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: 10/26/2021] [Revised: 06/03/2022] [Accepted: 06/03/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Autoantibodies against extractable nuclear antigens (ENA) play a pivotal role in the diagnosis and classification of systemic autoimmune rheumatic diseases (SARD). In recent years, newly developed methods have enabled the simultaneous and quantitative detection of multiple anti-ENA reactivities. However, data regarding the comparability of results obtained using different technologies across different platforms are scarce. In this study we compared eight different immunoassays, commonly used in current laboratory practice for detection of anti-ENA antibodies. METHODS Sixty patients suffering from different SARD, 10 inflammatory arthritis patients (disease controls) and 10 healthy blood donors were included in this comparative study. Sera were collected in 15 centers belonging to the Study Group on Autoimmune Diseases of the Italian Society of Clinical Pathology and Laboratory Medicine. We evaluated the analytical sensitivity, specificity and diagnostic accuracy of each method for antibodies to Sm, RNP, Ro60, Ro52, Scl70, CENP-B and Jo1. Cohen's kappa was used to analyze the agreement among methods. RESULTS Average agreement among methods was 0.82, ranging from substantial (k = 0.72) to almost perfect (k = 0.92). However, while the specificity was very good for all methods, some differences emerged regarding the analytical sensitivity. CONCLUSIONS Diagnostic performance of current technologies for anti-ENA antibody detection showed good comparability. However, as some differences exist among methods, laboratory scientists and clinicians must be aware of the diagnostic accuracy of the testing method in use.
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Affiliation(s)
- Maria Infantino
- Laboratorio di Immunologia e Allergologia, Ospedale S. Giovanni di Dio, Firenze, Italy.
| | - Teresa Carbone
- UOC Patologia Clinica Microbiologia e Medicina di Laboratorio, Azienda Sanitaria Locale di Matera (ASM), Matera, Italy
| | - Ignazio Brusca
- Patologia Clinica, Ospedale Buccheri La Ferla FBF, Palermo, Italy
| | | | - Giulia Previtali
- Laboratorio Analisi Chimico Cliniche, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Giusi Paura
- Laboratorio Analisi, Ospedale Civile, Voghera, Italy
| | | | - Martina Fabris
- SOC Istituto di Patologia Clinica, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - Giampaola Pesce
- Laboratorio Diagnostico di Autoimmunologia, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Dipartimento di Medicina Interna e Specialità Mediche (DIMI), Università di Genova, Genova, Italy
| | - Brunetta Porcelli
- UOC Laboratorio Patologia Clinica, Policlinico S. Maria alle Scotte, AOU Senese, Siena, Italy; Dipartimento Biotecnologie Mediche, Università degli Studi di Siena, Siena, Italy
| | - Lucia Terzuoli
- UOC Laboratorio Patologia Clinica, Policlinico S. Maria alle Scotte, AOU Senese, Siena, Italy; Dipartimento Biotecnologie Mediche, Università degli Studi di Siena, Siena, Italy
| | - Maria-Romana Bacarelli
- UOC Laboratorio Patologia Clinica, Policlinico S. Maria alle Scotte, AOU Senese, Siena, Italy; Dipartimento Scienze Mediche Chirurgiche e Neuroscienze, Università degli Studi di Siena, Siena, Italy
| | - Marilina Tampoia
- Patologia Clinica, Microbiologia e Genetica Medica, ASL TA, Taranto, Italy
| | - Luigi Cinquanta
- Laboratorio centralizzato (HUB) SDN Spa, Gruppo SYNLAB, Pagani (SA), Italy
| | - Danilo Villalta
- SSD di Allergologia e Immunologia clinica, Presidio Ospedaliero S. Maria degli Angeli, Pordenone, Italy
| | - Francesca Buzzolini
- SSD di Allergologia e Immunologia clinica, Presidio Ospedaliero S. Maria degli Angeli, Pordenone, Italy
| | - Boaz Palterer
- Università degli studi di Firenze, Dipartimento di Medicina Sperimentale e Clinica, Firenze, Italy
| | - Silvia Pancani
- Laboratorio di Immunologia e Allergologia, Ospedale S. Giovanni di Dio, Firenze, Italy
| | | | - Mariangela Manfredi
- Laboratorio di Immunologia e Allergologia, Ospedale S. Giovanni di Dio, Firenze, Italy
| | - Nicola Bizzaro
- Laboratorio di Patologia Clinica, Ospedale San Antonio, Azienda Sanitaria Universitaria Integrata, Udine, Italy
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Anti-Sm antibodies in the classification criteria of systemic lupus erythematosus. J Transl Autoimmun 2022; 5:100155. [PMID: 35464346 PMCID: PMC9026971 DOI: 10.1016/j.jtauto.2022.100155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 04/10/2022] [Indexed: 11/23/2022] Open
Abstract
Systemic lupus erythematosus is characterized by autoantibodies and immune complex deposition. Several autoantibodies against mainly nuclear autoantigens have been described. One of these nuclear autoantigens is the Smith antigen. In this review, we focus on the position of autoantibodies against the Smith antigen in the classification criteria, the characteristics of the antigen, the production of anti-Smith antibodies in SLE and we discuss the different test methods available, together with their pitfalls, to detect these autoantibodies. Patients having anti-Sm antibodies already fulfil sixty percent of the criteria required for SLE classification. Correct interpretation of anti-Smith antibody test results is strongly related to the choice of the test used for detection. Anti-Sm antibodies are very specific for SLE.
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