Comparison of ANA testing by indirect immunofluorescence or solid-phase assays in a low pre-test probability population for systemic autoimmune disease: the Camargo Cohort
Author:
Martinez-Revuelta Daniel1, Irure-Ventura Juan23ORCID, López-Hoyos Marcos234, Olmos José Manuel534, Pariente Emilio6, Martín-Millán Marta534, Nan Daniel534, Comins-Boo Alejandra23, Martínez-Taboada Víctor Manuel734, Hernández José Luis534
Affiliation:
1. Family Medicine , Healthcare Center Astillero , Santander , Spain 2. Immunology Department , University Hospital Marqués de Valdecilla , Santander , Spain 3. Research Institute “Marqués de Valdecilla” (IDIVAL) Santander , Spain 4. University of Cantabria Santander , Spain 5. Internal Medicine Department , University Hospital Marqués de Valdecilla , Santander , Spain 6. Family Medicine , Healthcare Center Camargo , Santander , Spain 7. Rheumatology Division , University Hospital Marqués de Valdecilla Santander , Spain
Abstract
Abstract
Objectives
Autoantibodies and, specifically antinuclear antibodies (ANA), are the hallmark of systemic autoimmune diseases (AID). In the last decades, there has been great technical development to detect these autoantibodies along with an increased request for this test by clinicians, while the overall pre-test probability has decreased. In this study, we compare the diagnostic performance of three different methods for ANA screening (indirect immunofluorescence [IIF], addressable laser bead immunoassay [ALBIA], and fluorescence enzyme immunoassay [FEIA]).
Methods
Serum samples at baseline visit from 2,997 participants from the Camargo Cohort, a population with an overall low pre-test probability for systemic AID, were analyzed with the three methods. Participants have a minimum follow-up of 10 years and the development of autoimmune diseases was collected from clinical records.
Results
The highest frequency of positive ANA was observed by IIF assay. However, ALBIA showed high sensitivity for AID. Likewise, solid phase assays (SPA) presented higher specificity than IIF for AID. ANA prevalence with any method was significantly higher in females and overall increased with age. Triple positivity for ANA was significantly related to the presence of anti-dsDNA–SSA/Ro60, Ro52, SSB/La, RNP, Scl-70, and centromere–specificities. No association was found for anti-Sm – RNP68, or ribosomal P – specificities. Noteworthy, triple positivity for ANA screening was associated with diagnosis of systemic AID both at baseline visit and follow-up.
Conclusions
ANA detection by IIF may be better when the pre-test probability is high, whereas SPA techniques are more useful in populations with an overall low pre-test probability for systemic AID.
Funder
Instituto de Salud Carlos III
Publisher
Walter de Gruyter GmbH
Subject
Biochemistry (medical),Clinical Biochemistry,General Medicine
Reference52 articles.
1. Aringer, M, Costenbader, K, Daikh, D, Brinks, R, Mosca, M, Ramsey-Goldman, R, et al.. European League against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis 2019;78:1151–9. https://doi.org/10.1136/annrheumdis-2018-214819. 2. Irure-Ventura, J, López-Hoyos, M. The past, present, and future in antinuclear antibodies (ANA). Diagnostics 2022;12:647. https://doi.org/10.3390/diagnostics12030647. 3. Pashnina, IA, Krivolapova, IM, Fedotkina, Tv., Ryabkova, VA, Chereshneva, Mv., Churilov, LP, et al.. Antinuclear autoantibodies in health: autoimmunity is not a synonym of autoimmune disease. Antibodies 2021;10:1–26. https://doi.org/10.3390/antib10010009. 4. Tan, EM, Feltkamp, TEW, Smolen, JS, Butcher, B, Dawkins, R, Fritzler, MJ, et al.. Range of antinuclear antibodies in “healthy” individuals. Arthritis Rheum 1997;40:1601–11. https://doi.org/10.1002/art.1780400909. 5. Xavier, RM, Yamauchi, Y, Nakamura, M, Tanigawa, Y, Ishikura, H, Tsunematsu, T, et al.. Antinuclear antibodies in healthy aging people: a prospective study. Mech Ageing Dev 1995;78:145–54. https://doi.org/10.1016/0047-6374(94)01532-q.
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