Automated indirect immunofluorescence antinuclear antibody analysis is a standardized alternative for visual microscope interpretation

Bonroy, Carolien; Verfaillie, Charlotte; Smith, Vanessa; Persijn, Lies; Witte, Evy De; Keyser, Filip De; Devreese, Katrien

doi:10.1515/cclm-2014-5002

Cited by 7 publications

(12 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Automated systems for ANA analysis are currently being introduced in laboratories [7][8][9][10][11][12][13][14][15]. Such systems can overcome some of the disadvantages of manual IIF.…”

Section: Introductionmentioning

confidence: 99%

Value-added reporting of antinuclear antibody testing by automated indirect immunofluorescence analysis

Schouwers

Bonnet²,

Verschueren

et al. 2014

Clinical Chemistry and Laboratory Medicine

View full text Add to dashboard Cite

show abstract

“…Automated systems for ANA analysis are currently being introduced in laboratories [7][8][9][10][11][12][13][14][15]. Such systems can overcome some of the disadvantages of manual IIF.…”

Section: Introductionmentioning

confidence: 99%

Value-added reporting of antinuclear antibody testing by automated indirect immunofluorescence analysis

Schouwers

Bonnet²,

Verschueren

et al. 2014

Clinical Chemistry and Laboratory Medicine

View full text Add to dashboard Cite

show abstract

“…

We noticed with great interest the study by Bonroy et al reporting the evaluation of antinuclear antibody (ANA) detection by an automated interpretation system for indirect immunofluorescence (IIF) images [1]. We would like to comment on their intriguing data regarding the quantification of ANA titer levels based on our experience with the first commercially available automated IIF system AKLIDES ® .

…”

mentioning

confidence: 99%

“…This decreases the hands-on time for an autoantibody-positive sample dramatically avoiding further dilution steps. Bonroy et al demonstrated the usefulness of this new approach with a novel commercially available interpretation system for the detection of a probability index (PI) [1]. The authors report a significant correlation of the PI with the classical endpoint titer.…”

mentioning

confidence: 99%

Digital immunofluorescence enables automated detection of antinuclear antibody endpoint titers avoiding serial dilution

Roggenbuck¹,

Hiemann

Schierack

et al. 2014

Clinical Chemistry and Laboratory Medicine (CCLM)

View full text Add to dashboard Cite

We noticed with great interest the study by Bonroy et al. reporting the evaluation of antinuclear antibody (ANA) detection by an automated interpretation system for indirect immunofluorescence (IIF) images [1]. We would like to comment on their intriguing data regarding the quantification of ANA titer levels based on our experience with the first commercially available automated IIF system AKLIDES ® . We have a long lasting interest in the development of quantification methods for autoantibody assessment by cell-based IIF tests and we generated a software module for the determination of ANA endpoint titers [2,3].With the development of digital IIF reading and novel pattern recognition algorithms, a new era in autoantibody diagnostics by IIF has been ushered in, overcoming such shortcomings like human bias in IIF reading and laborious data management [2,4]. Quantification of fluorescence signals equals IIF testing with other quantitative methods used in autoimmune diagnostics such as enzyme immunoassays. Thus, automated interpretation of cellbased fluorescence tests has become available addressing the rising demand for the standardized assessment of autoantibodies by IIF in routine laboratories [5][6][7][8]. Indirect IIF on human epidermoid laryngeal carcinoma (HEp-2) cells is the preferred method for the screening of ANA within the reco mmended two-stage diagnostic strategy for systemic autoimmune rheumatic diseases (SARD) [9]. Due to the unsurpassed sensitivity of ANA IIF, this method is the ideal diagnostic tool for the screening stage followed by confirmatory testing with different immunological assay technologies [10].Despite the controversial discussion on the need of quantitative ANA results in clinical practice, the determination of endpoint titers is offered by the majority of routine autoimmune laboratories for the serological diagnosis of SARD. In general, endpoint titers higher than 160 are scored positive and respective sera are recommended to be further diluted for their endpoint titer quantification. Endpoint titers should not to be reported higher than 5120 [9].For the first time in ANA IIF reading, digital IIF offers the opportunity to quantify ANA titers by using just one sample dilution. This decreases the hands-on time for an autoantibody-positive sample dramatically avoiding further dilution steps. Bonroy et al. demonstrated the usefulness of this new approach with a novel commercially available interpretation system for the detection of a probability index (PI) [1]. The authors report a significant correlation of the PI with the classical endpoint titer. However, there appears to be no statistical difference between the PI of positive samples with a classical titer of 320 and those with 640. The same phenomenon was reported for samples with classical titers of 1280 compared to samples with titers higher than 1280 hinting to a non-linear dependency.We fully concur with the author's view that quantification of ANA testing can be achieved with automated IIF reading. According to our experience, ...

show abstract

“…Recently, several studies have established the efficiency of different automated IIF systems for objective ANA detection providing the basis for the employment of IIF as gold standard for ANA testing according to recommendations of ACR [13][14][15][16][17][18][19][20][21][22][23][24]. Advanced stages of research were performed on six commercial systems: EUROPattern, AKLIDES, Nova View, HELIOS Ò , Zenit G Sight and Image Navigator.…”

Section: Discussionmentioning

confidence: 99%

“…In order to automate and standardize ANA and ANCA screening by IIF, different commercially available platforms were developed [13][14][15][16][17][18][19][20][21][22][23][24][25]. These systems are based on the automation of all of the steps of IIF procedure, including the preparation of substrates and the microscope reading.…”

Section: Introductionmentioning

confidence: 99%

A fully automated IIF system for the detection of antinuclear antibodies and antineutrophil cytoplasmic antibodies

et al. 2014

View full text Add to dashboard Cite

Indirect immunofluorescence (IIF) is the main technique for the detection of antinuclear antibodies (ANA) and antineutrophil cytoplasmic antibodies (ANCA). The fully automated IIF processor HELIOS(®) is the first IIF processor that is able to automatically prepare slides and perform automatic reading. The objective of the present study was to determine the diagnostic performance of this system for ANA and ANCA IIF interpretation, in comparison with visual IIF. ANA detection by visual IIF or HELIOS(®) was performed on 425 sera samples including: 218 consecutive samples submitted to a reference laboratory for routine ANA testing, 137 samples from healthy subjects and 70 ANA/ENA positive samples. For ANCA determination, 170 sera samples were collected: 40 samples for routine testing, 90 samples from healthy blood donors and 40 anti-PR3/anti-MPO positive subjects. Good correlation was found for the visual and automated ANA IIF approach regarding positive/negative discrimination of these samples (kappa = 0.633 for ANA positive samples and kappa = 0.657 for ANA negative samples, respectively). Positive/negative IIF ANCA discrimination by HELIOS(®) and visual IIF revealed a complete agreement of 100% in sera from healthy patients and PR3/MPO positive samples (kappa = 1.00). There was 95% agreement between the ANCA IIF performed by automated and visual IIF on the investigation of routine samples. Based on these results, HELIOS(®) demonstrated a high diagnostic performance for the automated ANA and ANCA IIF interpretation that was similar to a visual reading in all groups of samples.

show abstract

Automated indirect immunofluorescence antinuclear antibody analysis is a standardized alternative for visual microscope interpretation

Cited by 7 publications

References 0 publications

Value-added reporting of antinuclear antibody testing by automated indirect immunofluorescence analysis

Value-added reporting of antinuclear antibody testing by automated indirect immunofluorescence analysis

Digital immunofluorescence enables automated detection of antinuclear antibody endpoint titers avoiding serial dilution

A fully automated IIF system for the detection of antinuclear antibodies and antineutrophil cytoplasmic antibodies

Contact Info

Product

Resources

About