Monospecific anti-DFS70 antibodies are moderately helpful in excluding ANA-associated rheumatic disease in patients presenting with a dense fine speckled pattern – A systematic review and meta-analysis of diagnostic test accuracy

Cheng, Colin C.J.; Lan, Ting-Yuan; Shih, Ming‐Chieh; Li, Ko-Jen

doi:10.1016/j.autrev.2020.102637

Cited by 10 publications

(17 citation statements)

References 27 publications

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“…Both the sensitivity and specificity estimates varied widely; however, heterogeneity was more evident in the sensitivity than the specificity. Compared with a previous meta-analysis focusing on patients with a DFS pattern [15], the τ 2 was smaller for both sensitivity and specificity in the present study (Figure S2). The prediction intervals were also narrower for both sensitivity and specificity in the present study than in the previous meta-analysis [15].…”

Section: Heterogeneitycontrasting

confidence: 99%

“…Compared with a previous meta-analysis focusing on patients with a DFS pattern [15], the τ 2 was smaller for both sensitivity and specificity in the present study (Figure S2). The prediction intervals were also narrower for both sensitivity and specificity in the present study than in the previous meta-analysis [15]. The meta-regression analysis for the exploration of the causes of the heterogeneity showed that the articles limiting the targeted diseases to only AARD had higher specificity than those targeting all types of SARD (Table S1).…”

Section: Heterogeneitycontrasting

confidence: 99%

“…We used a linear mixed model to perform meta-regression analysis for relevant clinical parameters to explore heterogeneity [ 26 ]. In order to compare the difference in heterogeneity in the enrolled studies between this study and previous meta-analysis focusing on patients with a DFS pattern [ 15 ], we used tau-squared (τ 2 ) to estimate the between-studies variance of the sensitivities and specificities in the enrolled studies. A large τ 2 denotes a large between-study variance in the sensitivities or specificities in the enrolled studies.…”

Section: Methodsmentioning

confidence: 99%

“…However, a recent meta-analysis focusing on the diagnostic performance of anti-DFS70 antibodies among patients presenting with a DFS pattern in an ANA test found substantial heterogeneity in both the sensitivity and specificity [ 15 ]. The difficulty in recognizing the DFS pattern [ 16 , 17 , 18 ] and the presence of other autoantibodies that produce a DFS pattern in ANA tests [ 19 , 20 ] may not only contribute to the heterogeneity but also hinder the application of the study results to clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Anti-DFS70 Antibodies for Differentiating Systemic Autoimmune Rheumatic Disease in Patients with Positive ANA Tests: A Systematic Review and Meta-Analysis

et al. 2021

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Anti-DFS70 antibodies have been proposed as a marker to exclude systemic autoimmune rheumatic disease (SARD). We conducted this systematic diagnostic test accuracy review and meta-analysis to determine the performance of anti-DFS70 antibodies in patients with a positive anti-nuclear antibody (ANA) test result to exclude SARD. We searched PubMed, Embase, Web of Science, Scopus and the Cochrane Library up to 22 February 2021, and included studies examining the diagnostic accuracy of anti-DFS70 antibodies in patients with a positive ANA test result. The results were pooled using a hierarchical bivariate model and plotted in summary receiver operating characteristic curves. R software and Stata Statistical Software were used for the statistical analysis. Eight studies with 4168 patients were included. The summary sensitivity was 0.19 (95% confidence interval: 0.12–0.28) and the specificity was 0.93 (95% confidence interval: 0.88–0.96). The area under the curve was 0.69 (95% confidence interval: 0.64–0.72). The meta-regression analysis showed that targeting only ANA-associated rheumatic disease was associated with higher specificity. In addition, the studies with a non-SARD prevalence of <80% and using a chemiluminescence assay were associated with higher specificity. Anti-DFS70 antibodies have high specificity for the exclusion of SARD among patients presenting with a positive ANA test, but the sensitivity is low.

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Section: Heterogeneitycontrasting

confidence: 99%

Section: Heterogeneitycontrasting

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anti-DFS70 Antibodies for Differentiating Systemic Autoimmune Rheumatic Disease in Patients with Positive ANA Tests: A Systematic Review and Meta-Analysis

et al. 2021

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“…It has been shown that the prevalence of anti-DFS70 antibodies in individuals with SLE is significantly lower as compared with healthy individuals, 6 suggesting that anti-DFS70 antibodies in the absence of other autoantibodies specific for SLE could serve as an exclusion criterion for the diagnosis of SLE. 12…”

Section: Discussionmentioning

confidence: 99%

Infusion of anti-DFS70 antibodies prolonged survival of lupus-prone mice

Aljadeff

Shemer

Katz

et al. 2020

Lupus

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Background Systemic-lupus-nephritis is a chronic autoimmune disease characterized by immune complex deposition and a flare of autoantibodies and leading to renal injury. Objectives To expose anti-Dense-Fine-Speckled-70 (DFS70)-antibodies to genetically-prone-lupus-mice. Methods NZBXW/F1 female mice were monitored for the onset of glomerulonephritis by proteinuria upon infusion of anti-DFS70 (40 μg/mouse), commercial-human-IgG (cIgG) or phosphate-buffered-saline (PBS) as controls. The survival time was detected by mice death. Circulating anti-dsDNA were tested by ELISA. Proteinuria, was defined by a standard semi-quantitative-Bayer-Multistix-dipstick. Kidney histology was analyzed by periodic-acid–Schiff-PAS staining. Results A significantly higher percentage of anti-DFS70-infused mice exhibited prolonged survival time as compared with cIgG and PBS-subjected mice (p < 0.022). One mouse out of 10 mice injected with anti-DFS70-antibodies died at week 36, whereas, 6 out of 10 mice subjected with PBS found dead at this time. Eighty percent of anti-DFS70 injected mice did not show severe glomerulonephritis by histology. Conclusions anti-DFS70 attenuated the progression of glomerulonephritis and prolonged the survival time. Circulating anti-DFS70-autoantibodies may confer a protective role against renal injury in murine-lupus-nephritis. Our data may propose a novel therapy approach for lupus patients.

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