Antinuclear autoantibodies: discordance among four different assays

Abstract

Due to the huge heterogeneity in the results, further efforts to standardise autoantibodies detection techniques need to be performed, emphasising in homogenisation of the antigens preparation allowing reproducibility of both population of patients and at individual patient level.

Response to ‘Antinuclear antibodies by indirect immunofluorescence and solid phase assays’ by Bossuytet al

“…We would like to thank Dr Bossuyt and colleagues1 for their comments on our article on variability in testing for antinuclear antibodies (ANA) 2. This letter, along with previous correspondence,3–9 highlights the many issues about ANA testing and the results obtained with different assay platforms. We agree that a combination of different assays can be a valuable approach to assess more completely the serological profile of patients with autoantibody-associated rheumatic disease (AARD).…”

Role of ANA testing in the classification of patients with systemic lupus erythematosus

“…The recent publication1 2 of the European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) criteria for the classification for systemic lupus erythematosus (SLE) provides an important reason to continue the dialogue on testing for antinuclear antibodies (ANA) that has appeared in Annals of the Rheumatic Diseases ( ARD ). Following our article on the variability of immunofluorescence assays (IFA) for testing ANA in SLE,3 the journal published a series of very interesting and informative letters addressing our findings and reporting on other experience in ANA testing 4–12. These letters have been important in alerting the field to the challenges in ANA testing and the variety of assay approaches, including solid phase assays (SPA), that are currently available for determining the serological status of patients.…”

Response to: ‘Can solid-phase assays replace immunofluorescence for ANA screening?’ by Bizzaro

“…We would like to thank Dr Bizzaro for his commentary1 on our article2 on the variability of testing for antinuclear antibodies (ANA) by indirect immunofluorescence (IIF). Along with other letters that have been published in response to our article,3–9 Dr Bizzaro’s letter highlights the concerns about the IIF, its status as the ‘gold standard’ and the availability of other technologies (eg, solid phase assays) that alone or together can provide testing with comparable or better sensitivity and specificity than the IIF. As Dr Bizzaro indicates, the utilisation of these technologies may have advantages in terms of overall costs of patient care.…”