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Arthritis Research & Therapy
Published in: Arthritis Research & Therapy 2/2010

Open Access 01-04-2010 | Research article

Automated evaluation of autoantibodies on human epithelial-2 cells as an approach to standardize cell-based immunofluorescence tests

Authors: Karl Egerer, Dirk Roggenbuck, Rico Hiemann, Max-Georg Weyer, Thomas Büttner, Boris Radau, Rosemarie Krause, Barbara Lehmann, Eugen Feist, Gerd-Rüdiger Burmester

Published in: Arthritis Research & Therapy | Issue 2/2010

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Abstract

Introduction

Analysis of autoantibodies (AAB) by indirect immunofluorescence (IIF) is a basic tool for the serological diagnosis of systemic rheumatic disorders. Automation of autoantibody IIF reading including pattern recognition may improve intra- and inter-laboratory variability and meet the demand for cost-effective assessment of large numbers of samples. Comparing automated and visual interpretation, the usefulness for routine laboratory diagnostics was investigated.

Methods

Autoantibody detection by IIF on human epithelial-2 (HEp-2) cells was conducted in a total of 1222 consecutive sera of patients with suspected systemic rheumatic diseases from a university routine laboratory (n = 924) and a private referral laboratory (n = 298). IIF results from routine diagnostics were compared with a novel automated interpretation system.

Results

Both diagnostic procedures showed a very good agreement in detecting AAB (kappa = 0.828) and differentiating respective immunofluorescence patterns. Only 98 (8.0%) of 1222 sera demonstrated discrepant results in the differentiation of positive from negative samples. The contingency coefficients of chi-square statistics were 0.646 for the university laboratory cohort with an agreement of 93.0% and 0.695 for the private laboratory cohort with an agreement of 90.6%, P < 0.0001, respectively. Comparing immunofluorescence patterns, 111 (15.3%) sera yielded differing results.

Conclusions

Automated assessment of AAB by IIF on HEp-2 cells using an automated interpretation system is a reliable and robust method for positive/negative differentiation. Employing novel mathematical algorithms, automated interpretation provides reproducible detection of specific immunofluorescence patterns on HEp-2 cells. Automated interpretation can reduce drawbacks of IIF for AAB detection in routine diagnostics providing more reliable data for clinicians.
Appendix
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Metadata
Title
Automated evaluation of autoantibodies on human epithelial-2 cells as an approach to standardize cell-based immunofluorescence tests
Authors
Karl Egerer
Dirk Roggenbuck
Rico Hiemann
Max-Georg Weyer
Thomas Büttner
Boris Radau
Rosemarie Krause
Barbara Lehmann
Eugen Feist
Gerd-Rüdiger Burmester
Publication date
01-04-2010
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 2/2010
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/ar2949

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