Skip to main content
Top
Published in: Immunologic Research 1-2/2015

01-02-2015 | DIAGNOSTICS AND ENVIRONMENTAL FACTORS

A fully automated IIF system for the detection of antinuclear antibodies and antineutrophil cytoplasmic antibodies

Authors: O. Shovman, N. Agmon-Levin, B. Gilburd, T. Martins, A. Petzold, T. Matthias, Y. Shoenfeld

Published in: Immunologic Research | Issue 1-2/2015

Login to get access

Abstract

Indirect immunofluorescence (IIF) is the main technique for the detection of antinuclear antibodies (ANA) and antineutrophil cytoplasmic antibodies (ANCA). The fully automated IIF processor HELIOS® is the first IIF processor that is able to automatically prepare slides and perform automatic reading. The objective of the present study was to determine the diagnostic performance of this system for ANA and ANCA IIF interpretation, in comparison with visual IIF. ANA detection by visual IIF or HELIOS® was performed on 425 sera samples including: 218 consecutive samples submitted to a reference laboratory for routine ANA testing, 137 samples from healthy subjects and 70 ANA/ENA positive samples. For ANCA determination, 170 sera samples were collected: 40 samples for routine testing, 90 samples from healthy blood donors and 40 anti-PR3/anti-MPO positive subjects. Good correlation was found for the visual and automated ANA IIF approach regarding positive/negative discrimination of these samples (kappa = 0.633 for ANA positive samples and kappa = 0.657 for ANA negative samples, respectively). Positive/negative IIF ANCA discrimination by HELIOS® and visual IIF revealed a complete agreement of 100 % in sera from healthy patients and PR3/MPO positive samples (kappa = 1.00). There was 95 % agreement between the ANCA IIF performed by automated and visual IIF on the investigation of routine samples. Based on these results, HELIOS® demonstrated a high diagnostic performance for the automated ANA and ANCA IIF interpretation that was similar to a visual reading in all groups of samples.
Literature
1.
go back to reference Agmon-Levin N, Damoiseaux J, Shoenfeld Y. Response to: ‘detection of antinuclear antibodies—added-value of solid phase assay?’ by Bossuyt and Fieuws. Ann Rheum Dis. 2014;73:e11.PubMedCrossRef Agmon-Levin N, Damoiseaux J, Shoenfeld Y. Response to: ‘detection of antinuclear antibodies—added-value of solid phase assay?’ by Bossuyt and Fieuws. Ann Rheum Dis. 2014;73:e11.PubMedCrossRef
2.
go back to reference Fritzler MJ. Challenges to the use of autoantibodies as predictors of disease onset, diagnosis and outcomes. Autoimmun Rev. 2008;7:616–20.PubMedCrossRef Fritzler MJ. Challenges to the use of autoantibodies as predictors of disease onset, diagnosis and outcomes. Autoimmun Rev. 2008;7:616–20.PubMedCrossRef
3.
go back to reference Tozzoli R, Bizzaro N, Tonutti E, et al. Guidelines for the laboratory use of autoantibody tests in the diagnosis and monitoring of autoimmune rheumatic diseases. Am J Clin Pathol. 2002;117:316–24.PubMedCrossRef Tozzoli R, Bizzaro N, Tonutti E, et al. Guidelines for the laboratory use of autoantibody tests in the diagnosis and monitoring of autoimmune rheumatic diseases. Am J Clin Pathol. 2002;117:316–24.PubMedCrossRef
4.
go back to reference Meroni PL, Schur PH. ANA screening: an old test with new recommendations”. Ann Rheum Dis. 2010;69:1420–2.PubMedCrossRef Meroni PL, Schur PH. ANA screening: an old test with new recommendations”. Ann Rheum Dis. 2010;69:1420–2.PubMedCrossRef
5.
go back to reference Nifli AP, Notas G, Mamoulaki M, et al. Comparison of a multiplex, bead-based fluorescent assay and immunofluorescence methods for the detection of ANA and ANCA autoantibodies in human serum. J Immunol Methods. 2006;311:189–97.PubMedCrossRef Nifli AP, Notas G, Mamoulaki M, et al. Comparison of a multiplex, bead-based fluorescent assay and immunofluorescence methods for the detection of ANA and ANCA autoantibodies in human serum. J Immunol Methods. 2006;311:189–97.PubMedCrossRef
6.
go back to reference Smith J, Onley D, Garey C, et al. Determination of ANA specificity using the UltraPlex platform. Ann NY Acad Sci. 2005;1050:286–94.PubMedCrossRef Smith J, Onley D, Garey C, et al. Determination of ANA specificity using the UltraPlex platform. Ann NY Acad Sci. 2005;1050:286–94.PubMedCrossRef
7.
go back to reference Invernizzi P. PBC screen: an IgG/IgA dual isotype ELISA detecting multiple mitochondrial and nuclear autoantibodies specific for primary biliary cirrhosis. J Autoimmun. 2010;35:436–42.PubMedCrossRef Invernizzi P. PBC screen: an IgG/IgA dual isotype ELISA detecting multiple mitochondrial and nuclear autoantibodies specific for primary biliary cirrhosis. J Autoimmun. 2010;35:436–42.PubMedCrossRef
8.
go back to reference American College of Rheumatology, “American College of Rheumatology position statement: methodology of testing for antinuclear antibodies.” 2009. pp. 1–3. American College of Rheumatology, “American College of Rheumatology position statement: methodology of testing for antinuclear antibodies.” 2009. pp. 1–3.
9.
go back to reference Bosch X, Font J, Mirapeix E, et al. Anti-neutrophil cytoplasmic autoantibodies (ANCA): antigenic specificities and clinical associations. Adv Exp Med Biol. 1993;14:281–6.CrossRef Bosch X, Font J, Mirapeix E, et al. Anti-neutrophil cytoplasmic autoantibodies (ANCA): antigenic specificities and clinical associations. Adv Exp Med Biol. 1993;14:281–6.CrossRef
10.
go back to reference Savige JF, Gillis DF, Benson E, et al. International consensus statement on testing and reporting of antineutrophil cytoplasmic antibodies (ANCA). Am J Clin Pathol. 1999;14:507–13. Savige JF, Gillis DF, Benson E, et al. International consensus statement on testing and reporting of antineutrophil cytoplasmic antibodies (ANCA). Am J Clin Pathol. 1999;14:507–13.
11.
go back to reference Craig WY, Ledue TB, Collins MF, et al. Serologic associations of anti-cytoplasmic antibodies identified during anti-nuclear antibody testing. Clin Chem Lab Med. 2006;14:1283–6. Craig WY, Ledue TB, Collins MF, et al. Serologic associations of anti-cytoplasmic antibodies identified during anti-nuclear antibody testing. Clin Chem Lab Med. 2006;14:1283–6.
12.
go back to reference Csernok E, Ahlquist D, Ullrich S, et al. A critical evaluation of commercial immunoassays for antineutrophil cytoplasmic antibodies directed against proteinase 3 and myeloperoxidase in Wegener’s granulomatosis and microscopic polyangiitis. Rheumatology (Oxford). 2002;14:1313–7.CrossRef Csernok E, Ahlquist D, Ullrich S, et al. A critical evaluation of commercial immunoassays for antineutrophil cytoplasmic antibodies directed against proteinase 3 and myeloperoxidase in Wegener’s granulomatosis and microscopic polyangiitis. Rheumatology (Oxford). 2002;14:1313–7.CrossRef
13.
go back to reference Egerer K, Roggenbuck D, Hiemann R et al. Automated evaluation of autoantibodies on human epithelial-2 cells as an approach to standardize cell-based immunofluorescence tests. Arthritis Res Ther. 2010;12:R40. Egerer K, Roggenbuck D, Hiemann R et al. Automated evaluation of autoantibodies on human epithelial-2 cells as an approach to standardize cell-based immunofluorescence tests. Arthritis Res Ther. 2010;12:R40.
14.
go back to reference Hiemann R, Hilger N, Michel J, et al. Automatic analysis of immunofluorescencepatterns of HEp-2 cells. Ann NY Acad Sci. 2007;1109:358–71.PubMedCrossRef Hiemann R, Hilger N, Michel J, et al. Automatic analysis of immunofluorescencepatterns of HEp-2 cells. Ann NY Acad Sci. 2007;1109:358–71.PubMedCrossRef
15.
go back to reference Bonroy C, Verfaillie C, Smith V, et al. Automated indirect immunofluorescence antinuclear antibody analysis is a standardized alternative for visual microscope interpretation. Clin Chem Lab Med. 2013;51(9):1771–9.PubMedCrossRef Bonroy C, Verfaillie C, Smith V, et al. Automated indirect immunofluorescence antinuclear antibody analysis is a standardized alternative for visual microscope interpretation. Clin Chem Lab Med. 2013;51(9):1771–9.PubMedCrossRef
16.
go back to reference Voigt J, Krause C, Rohwäder E, et al. Automated indirect immunofluorescence evaluation of antinuclear autoantibodies on HEp-2 cells. Clin Dev Immunol. 2012;2012:651058.PubMedCentralPubMedCrossRef Voigt J, Krause C, Rohwäder E, et al. Automated indirect immunofluorescence evaluation of antinuclear autoantibodies on HEp-2 cells. Clin Dev Immunol. 2012;2012:651058.PubMedCentralPubMedCrossRef
17.
go back to reference Knütter I, Hiemann R, Brumma T, et al. Automated interpretation of ANCA patterns: a new approach in the serology of ANCA-associated vasculitis. Arthritis Res Ther. 2012;14(14):R271.PubMedCentralPubMedCrossRef Knütter I, Hiemann R, Brumma T, et al. Automated interpretation of ANCA patterns: a new approach in the serology of ANCA-associated vasculitis. Arthritis Res Ther. 2012;14(14):R271.PubMedCentralPubMedCrossRef
18.
go back to reference Kivity S, Gilburd B, Agmon-Levin N, et al. A novel automated indirect immunofluorescence autoantibody evaluation. Clin Rheumatol. 2011;14:503–9. Kivity S, Gilburd B, Agmon-Levin N, et al. A novel automated indirect immunofluorescence autoantibody evaluation. Clin Rheumatol. 2011;14:503–9.
19.
go back to reference Willitzki A, Hiemann R, Peters V, et al. New platform technology for comprehensive serological diagnostics of autoimmune diseases. Clin Dev Immunol. 2012;2012:284740.PubMedCentralPubMedCrossRef Willitzki A, Hiemann R, Peters V, et al. New platform technology for comprehensive serological diagnostics of autoimmune diseases. Clin Dev Immunol. 2012;2012:284740.PubMedCentralPubMedCrossRef
20.
go back to reference Melegari A, Bonaguri C, Russo A, et al. A comparative study on the reliability of an automated system for the evaluation of cell-based indirect immunofluorescence. Autoimmun Rev. 2012;11:713–6.PubMedCrossRef Melegari A, Bonaguri C, Russo A, et al. A comparative study on the reliability of an automated system for the evaluation of cell-based indirect immunofluorescence. Autoimmun Rev. 2012;11:713–6.PubMedCrossRef
21.
go back to reference Tozzoli R, Bonaguri C, Melegari A, et al. Current state of diagnostic technologies in the autoimmunology laboratory. Clin Chem Lab Med. 2013;51:129–38.PubMedCrossRef Tozzoli R, Bonaguri C, Melegari A, et al. Current state of diagnostic technologies in the autoimmunology laboratory. Clin Chem Lab Med. 2013;51:129–38.PubMedCrossRef
22.
go back to reference Tozzoli R, Antico A, Porcelli B, et al. Automation in indirect immunofluorescence testing: a new step in the evolution of the autoimmunology laboratory. Autoimmun Highlight. 2012;2012(3):59–65.CrossRef Tozzoli R, Antico A, Porcelli B, et al. Automation in indirect immunofluorescence testing: a new step in the evolution of the autoimmunology laboratory. Autoimmun Highlight. 2012;2012(3):59–65.CrossRef
23.
go back to reference Bizzaro N, Antico A, Platzgummer S, et al. Automated antinuclear immunofluorescence antibody screening: a comparative study of six computer-aided diagnostic systems. Autoimmun Rev. 2014;13(3):292–8.PubMedCrossRef Bizzaro N, Antico A, Platzgummer S, et al. Automated antinuclear immunofluorescence antibody screening: a comparative study of six computer-aided diagnostic systems. Autoimmun Rev. 2014;13(3):292–8.PubMedCrossRef
24.
go back to reference Damoiseaux J, Mallet K, Vaessen M, et al. Automatic reading of ANCA-slides: evaluation of the AKLIDES system. In: Conrad K, Chan EKL, Fritzler MJ, Humbel RL, Meroni PL, Shoenfeld Y, editors. From prediction to prevention of autoimmune disease. Lengerich, Germany: Pabst Science Publishers; 2011. p. 683–4. Damoiseaux J, Mallet K, Vaessen M, et al. Automatic reading of ANCA-slides: evaluation of the AKLIDES system. In: Conrad K, Chan EKL, Fritzler MJ, Humbel RL, Meroni PL, Shoenfeld Y, editors. From prediction to prevention of autoimmune disease. Lengerich, Germany: Pabst Science Publishers; 2011. p. 683–4.
26.
go back to reference Altman D. Practical statistics for medical research. London, UK: Chapman & Hall; 1991. Altman D. Practical statistics for medical research. London, UK: Chapman & Hall; 1991.
Metadata
Title
A fully automated IIF system for the detection of antinuclear antibodies and antineutrophil cytoplasmic antibodies
Authors
O. Shovman
N. Agmon-Levin
B. Gilburd
T. Martins
A. Petzold
T. Matthias
Y. Shoenfeld
Publication date
01-02-2015
Publisher
Springer US
Published in
Immunologic Research / Issue 1-2/2015
Print ISSN: 0257-277X
Electronic ISSN: 1559-0755
DOI
https://doi.org/10.1007/s12026-014-8588-y

Other articles of this Issue 1-2/2015

Immunologic Research 1-2/2015 Go to the issue