Clinical evaluation of a capture ELISA for detection of proteinase-3 antineutrophil cytoplasmic antibody: Technical Note

Westman, Kerstin; Selga, Daina; Bygren, Per; Segelmark, Mårten; Baslund, Bo; Wiik, Allan; Wieslander, Jörgen

doi:10.1046/j.1523-1755.1998.00873.x

Cited by 85 publications

(50 citation statements)

References 31 publications

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“…Also MPOhas been expressed in an enzymatically active form which can be used as an antigen for MPO-ANCA determination (35). Recent studies have suggested that it may be advantageous to capture PR3 using a monoclonal antibody, which does not cover up any important epitope on the PR3 molecule (29,30). There maybe two advantages with this approach: 1) the conformation of the molecule may be better preserved, and 2) all epitopes on the PR3 molecule may be available for reaction with PR3-ANCAin human sera.…”

Section: If-anca Testingmentioning

confidence: 99%

“…There maybe two advantages with this approach: 1) the conformation of the molecule may be better preserved, and 2) all epitopes on the PR3 molecule may be available for reaction with PR3-ANCAin human sera. Using capture PR3-ANCA technique it seems possible to see better correlations between PR3-ANCAlevels and disease activity than by use of direct EIA (29,30). There are no indications that capture MPO-ANCA detection is advantageous over the direct EIA technique.…”

Section: If-anca Testingmentioning

confidence: 99%

“…Most recent publications on the use of direct EIA for following PR3-ANCA have shown that only around 50%of patients have a rise of ANCA in relation to exacerbation and a decrease following remission (36). Capture PR3-ANCAEIA may be better suited for monitoring patients (29,30), and high levels of PR3-ANCA by capture EIA are associated with diminished renal survival (30). Also recombinant PR3maybe used in a capture EIA setting (37).…”

Section: If-anca Testingmentioning

confidence: 99%

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Anti-neutrophil Cytoplasmic Antibodies Tests: Which Tests Should be Used in Practice?

Wiik

2001

Intern. Med.

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Serological testing for anti-neutrophil cytoplasmic antibodies (ANCA)has become an important tool for supporting a diagnosis of systemic necrotizing small vessel vasculitis: Wegener's granulomatosis, microscopic polyangiitis, Churg-Strauss syndromeand oligo-symptomatic forms of these. These so-called ANCA-associated vasculitides most often necessitate the institution of therapies with cytotoxic as well as anti-inflammatory agents, and hence, a firmly established diagnosis is mandatory to avoid unnecessary and risky treatment. In the laboratory of today the most appropriate way to detect the presence of vasculitis-associated ANCAis by using both indirect immunofluorescence and direct enzyme immuno-assay for antibodies to proteinase 3 and myeloperoxidase. The diagnostic specificity of these latter assays towards systemic vasculitis can only be secured by setting a suitably high cut-off value, chosen in collaboration with clinicians after testing carefully selected disease control sera. Whenclassical cytoplasmic ANCA as well as a significant level of proteinase 3-ANCAare found in a given serum this combined result strongly indicates vasculitis. Similarly, the combination of perinuclear ANCA and a significant level of myeloperoxidase-ANCA is close to 100%specific for vasculitis. (Internal Medicine 40: 466-470, 2001)

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Section: If-anca Testingmentioning

confidence: 99%

Section: If-anca Testingmentioning

confidence: 99%

Section: If-anca Testingmentioning

confidence: 99%

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Anti-neutrophil Cytoplasmic Antibodies Tests: Which Tests Should be Used in Practice?

Wiik

2001

Intern. Med.

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“…2b). In these ELISA-based tests a monoclonal antibody, specific for either PR3 or MPO, is coated to the carrier and, next, the antigen preparation, either as a crude neutrophil extract (Cohen Tervaert et al, 1990) or as purified antigens (Westman et al, 1998;Boomsma et al, 2001) is added. The antigen is now captured by the monoclonal antibody, hence the name, and the assay is continued with subsequent incubations with patient serum, anti-human IgG conjugate, and, finally, the substrate, similar as in the direct ELISA described above.…”

Section: Methods For Anca Detectionmentioning

confidence: 99%

ANCA Diagnostics in Clinical Practice: New Developments

Damoiseaux¹,

Austen²,

Tervaert³

2011

Advances in the Diagnosis and Treatment of Vasculitis

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“…One such assay was almost equivalent in terms of speci¢city and sensitivity to a direct ELISA and IIF assay and another group report that the sensitivity for WG was increased by 50% without compromising speci¢-city. 34,35 Their performance in di¡erent routine laboratory settings is yet to be evaluated fully and such ¢ndings are not universal. 36 It is not only IF tests that may be di⁄cult to interpret in that some SLEs have 'true' P-ANCA on IIF.…”

Section: Laboratory Investigation Of Small Vessel Systemic Vasculitismentioning

confidence: 99%

Role of antineutrophil cytoplasmic antibodies and glomerular basement membrane antibodies in the diagnosis and monitoring of systemic vasculitides

Sinclair

Stevens

2007

Ann Clin Biochem

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This article was prepared at the invitation of the Clinical Sciences Reviews Committee of the Association for Clinical Biochemistry Systemic vasculitis, although rare, is often diagnosed late and long after the onset of symptoms. The small vessel vasculitides are recognized clinically by their multisystem presentation, markers of inflammation and evidence for an acute glomerulonephritis (GN), with the most apparent organ involved directing referral to secondary care. Routine laboratory tests are usually non-specific in systemic vasculitis but the use of anti-neutrophil cytoplasmic antibodies (ANCAs) and glomerular basement membrane (GBM) antibodies can aid diagnosis, treatment and monitoring decisions. These antibodies are detected and quantified by indirect immunofluorescence (IIF) and antigen-specific enzyme-linked immunosorbent assay (ELISA), usually in combination for ANCA, and ELISA systems (or direct IIF on kidney biopsy) for GBM antibodies. The presence or absence of ANCA does not confirm or exclude the diagnosis of systemic vasculitis but negative and positive predictive values will be strongly influenced by clinical presentation. Various large studies have been unable to conclude that following serial ANCA titres has great clinical utility in each case but each patient must be considered on its own merits; for example the reappearance of ANCA in a patient who was rendered ANCA negative following treatment is more likely to indicate relapse. The adoption of consensus guidelines that direct testing towards patients with rapidly progressive GN, pulmonary haemorrhage, persistent and destructive ear, nose and upper airways problems, such as subglottic tracheal stenosis, a retro-orbital mass and cutaneous vasculitis with systemic features or peripheral neuropathy, will greatly increase the clinical utility and positive predictive value of these tests.

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Clinical evaluation of a capture ELISA for detection of proteinase-3 antineutrophil cytoplasmic antibody: Technical Note

Cited by 85 publications

References 31 publications

Anti-neutrophil Cytoplasmic Antibodies Tests: Which Tests Should be Used in Practice?

Anti-neutrophil Cytoplasmic Antibodies Tests: Which Tests Should be Used in Practice?

ANCA Diagnostics in Clinical Practice: New Developments

Role of antineutrophil cytoplasmic antibodies and glomerular basement membrane antibodies in the diagnosis and monitoring of systemic vasculitides

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