Determination of specific autoantibodies in patients with systemic lupus erythematosus by Line immunoassay, ELISA and CLIF

Wongjarit, Kanphai; Thammacharoenrach, Niramol; Dityen, Kanthaporn; Kaewopas, Yadah; Kositpesat, Naravadee; Ukritchon, Sittichai; Osiri, Manathip; Wongpiyabovorn, Jongkonnee

doi:10.12932/ap-301019-0681

Cited by 2 publications

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“…Accordingly, most published data available for the ELiA dsDNA is compromised by the fact it was collected in retrospective studies ( 37 – 40 ). After the initial technology validation study ( 27 ), the commercially available version of the anti-dsDNA-NcX ELISA was rarely investigated in clinical studies and most of its limited available published data was collected in China ( 41 ) and Thailand ( 42 ) and solely considered SLE patients of Asian ethnicity.…”

Section: Discussionmentioning

confidence: 99%

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Comparative analysis of contemporary anti-double stranded DNA antibody assays for systemic lupus erythematosus

Bauer,

Karakostas,

Weber

et al. 2023

Front. Immunol.

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ObjectiveElevated double-stranded DNA (dsDNA) antibody levels in blood serum are considered a disease-specific marker in systemic lupus erythematosus (SLE), correlate with disease activity and the incidence of lupus nephritis, and can be detected in up to 86% of all SLE cases. Despite the high clinical relevance, the variety of dsDNA antibody testing methods with heterogenous performance in clinical use remains challenging. This study is the first to prospectively investigate the performance of two of today’s most commonly applied anti-dsDNA testing methods head-to-head under real-world conditions, as well as their correlation with other clinical and serological disease parameters in SLE patients.MethodsIn this prospective study, all SLE patients undergoing treatment at the Department of Rheumatology at the University Hospital Bonn within a 13-months period (n=41) and control patients without connective-tissue disease (n=51) were consecutively enrolled and examined. For all study participants’ serum samples both anti-dsDNA-NcX enzyme-linked immunoassay testing EUROIMMUN, Luebeck, Germany) and the fluorescence immunoassay ELiA dsDNA (Thermo Fisher Scientific, Waltham, USA) were performed. In addition, demographic data, further laboratory values and disease activity parameters were recorded. Clinical disease activity was assessed by SLEDAI-2K.ResultsBoth assays showed high specificity (anti-dsDNA-NcX ELISA: 0.9, ELiA dsDNA: 0.959), but there were notable differences in sensitivity (anti-dsDNA-NcX ELISA: 0.51, ELiA dsDNA: 0.38). Pearsons’s correlation yielded a positive correlation between anti-dsDNA concentrations and CRP concentrations for the anti-dsDNA-NcX ELISA (R=0.22; p=0.038) and a mild-to-moderate inverse correlation between concentrations of anti-dsDNA and complement C4 for the ELiA dsDNA test (R=-0.22; p=0.045) when SLE and control patients were considered together. Other than, no significant correlation between anti-dsDNA concentrations and clinical or laboratory findings was found for either test procedure.ConclusionBoth anti-dsDNA antibody assays represent reliable examination methods with high specificity for the diagnosis of SLE that fulfill EULAR/ACR requirements. However, the anti-dsDNA-NcX ELISA showed superior sensitivity and significant correlation with disease activity (as measured by CRP concentrations).

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Section: Discussionmentioning

confidence: 99%

“…Despite all standardization efforts, notable confounders for anti-dsDNA testing in general remain and so far have only been taken into account in approximately half of the discussed studies ( 38 , 40 , 42 , 47 ). Known external factors that can lead to elevated anti-dsDNA titers include drugs, such as selected antiarrhythmics (e.g.…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of contemporary anti-double stranded DNA antibody assays for systemic lupus erythematosus

Bauer,

Karakostas,

Weber

et al. 2023

Front. Immunol.

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Diagnostic Performance of Anti-dsDNA Tests by Indirect Immunofluorescence and Enzyme-linked Immunosorbent Assay in Patients with Systemic Lupus Erythematosus

Nieto-Aristizábal

España

Ortega

et al. 2023

The Journal of Applied Laboratory Medicine

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Background Several laboratory techniques for anti double-stranded (ds) DNA detection in systemic lupus erythematosus (SLE) are available, with variable diagnostic performance. We aimed to evaluate anti-dsDNA’s diagnostic performance by indirect immunofluorescence (IIF) and enzyme-linked immunosorbent assay (EIA). Methods We conducted a single-center retrospective (2015 to 2020) study. Patients with anti-dsDNA tests by IIF and EIA were included. We evaluated the indications, applications, concordance, positive predictive value (PPV) of anti-dsDNA to confirm SLE diagnosis or flares, and associations of disease manifestations with positivity with each technique. Results A total of 1368 reports of anti-dsDNA tests by IIF and EIA and the corresponding medical records of the patients were analyzed. The main indication for anti-dsDNA testing was to help in the diagnosis of SLE in 890 (65%) of the samples, and the main application after obtaining the results was SLE exclusion in 782 (57.2%) cases. The combination with the highest frequency was the negativity result by both techniques in 801 (58.5%) cases (Cohen kappa 0.57). Both methods were positive in 300 patients with SLE (Cohen kappa 0.42). The PPVs of anti-dsDNA tests to confirm diagnosis/flare was 79.64% (95% CI, 75.35–83.35) by EIA, 78.75% (95% CI, 74.27–82.62) by IIF, and 82% (95% CI, 77.26–85.93) when both were positive. Conclusions Anti-dsDNA detection by IIF and EIA are complementary and may indicate different clinical patterns in patients with SLE. The detection of anti-dsDNA antibodies by both techniques has a higher PPV than either separately for confirming SLE diagnosis or flares. These results highlight the need for evaluating both methods in clinical practice.

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Determination of specific autoantibodies in patients with systemic lupus erythematosus by Line immunoassay, ELISA and CLIF

Cited by 2 publications

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Comparative analysis of contemporary anti-double stranded DNA antibody assays for systemic lupus erythematosus

Comparative analysis of contemporary anti-double stranded DNA antibody assays for systemic lupus erythematosus

Diagnostic Performance of Anti-dsDNA Tests by Indirect Immunofluorescence and Enzyme-linked Immunosorbent Assay in Patients with Systemic Lupus Erythematosus

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