Novel Clinical and Diagnostic Aspects of Antineutrophil Cytoplasmic Antibodies

Abstract

Antineutrophil cytoplasmic antibodies (ANCA) are the serological hallmark of some idiopathic systemic vasculitides. Besides the investigation of ANCA-associated vasculitis (AAV) and constant effort for a standardized nomenclature and classification of the AAV, a main focus of research during the last few years has been to constantly improve the performance of enzyme immunoassays. With the latest so called third generation ELISA, this goal seemed to be fulfilled. The International Consensus Statement on Testing and Reporting of ANCA gave recommendations for standardized strategies for the serological diagnosis of ANCA. New developments now target the system immanent drawbacks of the respective diagnostic methods, be it the need for batching and the long time to result for ELISA, or the high likelihood of error and subjectivity of indirect immunofluorescence (IIF). Random access technology and multiplexing for solid phase assays as well as digital imaging for IIF are tools which may help to expedite and simplify routine diagnostics in the lab and in emergency settings. Recent findings indicate that PR3-ANCA have clinical utility beyond the diagnosis of AAV. PR3-ANCA can also serve as an aid for the differentiation between ulcerative colitis (UC) and Crohn's disease (CrD) and the stratification of UC patients. This review provides a detailed review of what is known about ANCA and highlights the latest research and state-of-the-art developments in this area.

Autoantibodies to asialoglycoprotein receptor (ASGPR) in patients with autoimmune liver diseases

“…There seems to be an autoimmune component in the pathophysiology of PSC and related intestinal disorders as it has been suggested for proteinase 3 recently. [42][43][44] The appearance of ASGPR Ab in patients with viral liver infections such as with HCV has been shown in earlier reports and the prevalence of 12.0% obtained in this study is in line with these data. [45] A viral infection can be associated with liver autoimmunity and, over and above, exclusion of a viral cause of disease is mandatory in the diagnostic criteria of AIH.…”

Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Diagnosis and Assessment of Takayasu Arteritis and Ulcerative Colitis

“…At the time of diagnosis, the patient in this case was revealed to have positive P-ANCA. This result can be associated with UC [10,11]. High prevalence of P-ANCA about 40 to 60% in UC has been reported [11].…”

“…This result can be associated with UC [10,11]. High prevalence of P-ANCA about 40 to 60% in UC has been reported [11]. The cases about coexistence of TA and UC are rarely reported over the world and most of them are Japanese.…”

The CytoBead assay – a novel approach of multiparametric autoantibody analysis in the diagnostics of systemic autoimmune diseases

“…(e) The screening results distinguish possible false-positive findings in the specific immunoassays (e.g., positive dsDNA antibodies with Brought to you by | Kungliga Tekniska Högskolan Authenticated Download Date | 8/25/15 9:11 PM negative ANA) and thus increase diagnostic confidence. Thus, the quality of medical diagnostics is improved by the combination of highly sensitive screening and highly specific confirmatory testing [30,31] . Essentially, a negative result obtained with a highly sensitive screening assay potentially exclude patients under suspicion of AARD due to its high negative predictive value [32,33] .…”