The clinical value of indirect immunofluorescence for screening anti-rods and rings antibodies: A retrospective study of two centers in China

Meng, Jingjing; Yang, Guoxiang; Li, Siting; Luo, Yueming; Bai, Yina; Deng, Chuiwen; Song, Ning; Li, Mengtao; Zeng, Xiaofeng; Hu, Chaofan

doi:10.3389/fimmu.2022.1007257

Cited by 1 publication

(2 citation statements)

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“…also reported higher presence of RR in patients with autoimmune diseases and concluded that autoantibodies were much more common in connective tissue diseases than that in other diseases. They interestingly noted the highest prevalence in patients with AIH and primary biliary cholangitis (PBC) ( 15 ). RR structures were also defined by Assandri in 2019 in a case with PBC ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

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Retrospective evaluation of “Rods and Rings” pattern detected in the anti-nuclear antibody (ANA) indirect immunofluorescence (IIF) test

İnal,

Kurumanastırlı,

Taşkınoğlu

et al. 2024

Front. Immunol.

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IntroductionAnti-rods and rings (anti-RR) antibodies have recently been described as a cytoplasmic pattern in IIF-based screening of autoantibodies on HEp-2 cells and ICAP has named it as AC-23. It is most frequently related to drug-induced antibody generation. This study aimed to investigate the clinical significance of AC-23 positivity and its relevance to the diagnosis and/or follow-up of the associated diseases and/or drug use.MethodsA multicenter retrospective study was conducted among 10 hospitals from six different provinces in Türkiye from January 2017 to December 2021. The laboratory data and clinical information of 600 patients with positive anti-RR antibodies out of 547.558 HEp-2 IIF ANA samples were analyzed.ResultsThe distribution of AC-23 positive patients by year indicated a steady increase between 2017-2021. Anti-RR prevalence in post-COVID-19 period was significantly higher than that of pre-COVID-19 period (p=0.00). Concomitant ANA positivity was detected in 56.5% of patients, the most common patterns being AC-4 and AC-5 (41.1%). The most frequent pathology among the anti-RR positive patients was an autoimmune disease (19.83%); 28.57% of which had rheumatoid arthritis and 17.65% autoimmune liver disease. Among the 600 patients, 65 (10.83%) were diagnosed as hepatitis C virus (HCV) infection. Available data for 38 of the HCV patients revealed that 71.05% of them had a history of interferon alfa+ribavirin and 28.95% of them had a history of NS3/4/5A/5B polymerase inhibitor or protease inhibitor drug use. Significant increase in the rate of anti-RR positivity was observed in the post-COVID-19 period when compared to pre-COVID-19 period (p:0.00).DiscussionThis is the first multicenter study in Türkiye about the clinical association of anti-RR antibodies which may be ignored during routine HEp-2 IIF testing. Pathologies other than HCV should be taken into consideration in terms of the possible role of anti-RR in autoimmune diseases and other pathologies. The preliminary data obtained in this study suggest that anti-RR antibody development might also be associated to COVID-19, supporting the several previous data related to the potential of viruses triggering the formation of autoantibodies. Large-scale prospective studies should elucidate the clinical significance of RR pattern and determine its role in patient diagnosis and follow-up.

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Section: Discussionmentioning

confidence: 99%

“…Zhang reported anti-RR prevalence as 0.10% in western China in 2016-2018 period (2). However, Meng et al reported anti-RR frequencies of 0.16% and 0.23% in two different large hospitals in China between 2018 and 2020 (15). Considering these results, there is a wide variety in the prevalence of RR positive patients in different locations.…”

Section: Discussionmentioning

confidence: 99%