Skip to main content
Top
Published in: Autoimmunity Highlights 1/2020

Open Access 01-12-2020 | Editorial

The clinical and the laboratory autoimmunologist: Where do we stand?

Authors: Renato Tozzoli, Nicola Bizzaro

Published in: Autoimmunity Highlights | Issue 1/2020

Login to get access

Excerpt

As highlighted in many medical reports from industrialized countries, autoimmune diseases (AIDs) are increasing in number (almost 100 distinct AIDs have been classified to date) and in epidemiology (5–10% of individuals worldwide are affected by an AID) [1, 2]. In the United States, AIDs are collectively estimated to affect from 5 to 8% of the population or 15 to 20 million individuals [3] and are cumulatively the third cause of illness and mortality in humans [2, 4]. Consequently, many efforts are produced by health systems for prevention, early diagnosis and treatment of autoimmune diseases. …
Literature
1.
go back to reference Hoyter SM, Cook MC. Uptated assessment of the prevalence, spectrum and case definition of autoimmune disease. Autoimmun Rev. 2012;11:754–65. Hoyter SM, Cook MC. Uptated assessment of the prevalence, spectrum and case definition of autoimmune disease. Autoimmun Rev. 2012;11:754–65.
2.
go back to reference Wang L, Wang F-S, Gershwin ME. Human autoimmune diseases: a comprehensive update. J Intern Med. 2015;278:369–95.PubMed Wang L, Wang F-S, Gershwin ME. Human autoimmune diseases: a comprehensive update. J Intern Med. 2015;278:369–95.PubMed
3.
go back to reference Roberts MH, Erdei E. Comparative United States autoimmune diseases rates for 2010–2016 by sex, geographic region, and race. Autoimmun Rev. 2020;19:102423.PubMed Roberts MH, Erdei E. Comparative United States autoimmune diseases rates for 2010–2016 by sex, geographic region, and race. Autoimmun Rev. 2020;19:102423.PubMed
4.
go back to reference Thomas SL, Griffiths C, Smeeth L, Rooney C, Hall AJ. Burden of mortality associated with autoimmune diseases among females in the United Kingdom. Am J Public Health. 2010;100:2279–87.PubMedPubMedCentral Thomas SL, Griffiths C, Smeeth L, Rooney C, Hall AJ. Burden of mortality associated with autoimmune diseases among females in the United Kingdom. Am J Public Health. 2010;100:2279–87.PubMedPubMedCentral
5.
go back to reference Shoenfeld Y, Selmi C, Zimlichman F, Gershwin ME. The autoimmunologist: geoepidemiology, a new center of gravity, and prime time of autoimmunity. J Autoimmun. 2008;31:325–30.PubMed Shoenfeld Y, Selmi C, Zimlichman F, Gershwin ME. The autoimmunologist: geoepidemiology, a new center of gravity, and prime time of autoimmunity. J Autoimmun. 2008;31:325–30.PubMed
6.
go back to reference Shoenfeld Y. The autoimmunologist: a profession being created. Harefuah. 2009;148:796–7. Shoenfeld Y. The autoimmunologist: a profession being created. Harefuah. 2009;148:796–7.
7.
go back to reference Selmi C, Gershwin ME. The long-term marriage between autoimmunity and internal medicine: a homage to Manuel Carlos Dias. Clin Rev Allerg Immunol. 2012;43:207–10. Selmi C, Gershwin ME. The long-term marriage between autoimmunity and internal medicine: a homage to Manuel Carlos Dias. Clin Rev Allerg Immunol. 2012;43:207–10.
8.
go back to reference Watad A, Bragazzi NL, Adawi M, Amital H, Kivity S, Mahroum N, et al. Is autoimmunology a discipline of its own? A big data-based bibliometric and scientometric analyses. Autoimmunity. 2017;50:269–74.PubMed Watad A, Bragazzi NL, Adawi M, Amital H, Kivity S, Mahroum N, et al. Is autoimmunology a discipline of its own? A big data-based bibliometric and scientometric analyses. Autoimmunity. 2017;50:269–74.PubMed
9.
go back to reference Rose NR. Prediction and prevention of autoimmune disease in the 21st century: a review and preview. Am J Epidemiol. 2016;183:403–6.PubMed Rose NR. Prediction and prevention of autoimmune disease in the 21st century: a review and preview. Am J Epidemiol. 2016;183:403–6.PubMed
10.
go back to reference Tozzoli R, D’Aurizio F, Villalta D, Bizzaro N. Automation, consolidation, and integration in autoimmune diagnostics. Auto Immun Highlights. 2015;6:1–6.PubMedPubMedCentral Tozzoli R, D’Aurizio F, Villalta D, Bizzaro N. Automation, consolidation, and integration in autoimmune diagnostics. Auto Immun Highlights. 2015;6:1–6.PubMedPubMedCentral
11.
go back to reference Barabas AZ, Cole CD, Graeff RM, Lafreniere R, Weir DM. The role of autoimmunologists in investigating and treating autoimmune disorders. Autoimmun Rev. 2011;10:166–70.PubMed Barabas AZ, Cole CD, Graeff RM, Lafreniere R, Weir DM. The role of autoimmunologists in investigating and treating autoimmune disorders. Autoimmun Rev. 2011;10:166–70.PubMed
12.
go back to reference Tozzoli R, Bizzaro N. The clinical autoimmunologist and the laboratory autoimmunologist: the two sides of the coin. Autoimmun Rev. 2012;11:766–70.PubMed Tozzoli R, Bizzaro N. The clinical autoimmunologist and the laboratory autoimmunologist: the two sides of the coin. Autoimmun Rev. 2012;11:766–70.PubMed
13.
go back to reference Vasconcelos C. Do we need autoimmune disease units in hospitals? Ann N Y Acad Sci. 2009;1173:4–9.PubMed Vasconcelos C. Do we need autoimmune disease units in hospitals? Ann N Y Acad Sci. 2009;1173:4–9.PubMed
14.
go back to reference Damoiseaux J, Olschowka N, Shoenfeld Y. EASI—European Autoimmunity Standardisation Initiative: facing the challenges of diagnostics in autoimmunity. Clin Chem Lab Med. 2018;56:1620–3.PubMed Damoiseaux J, Olschowka N, Shoenfeld Y. EASI—European Autoimmunity Standardisation Initiative: facing the challenges of diagnostics in autoimmunity. Clin Chem Lab Med. 2018;56:1620–3.PubMed
15.
go back to reference Damoiseaux J. The perspective on standardisation and harmonisation: the viewpoint of the EASI president. Auto Immun Highlights. 2020;11:4.PubMedPubMedCentral Damoiseaux J. The perspective on standardisation and harmonisation: the viewpoint of the EASI president. Auto Immun Highlights. 2020;11:4.PubMedPubMedCentral
16.
go back to reference Baker KF, Isaacs JD. Novel therapies for immune-mediated inflammatory diseases: what can we learn from their use in rheumatoid arthritis, spondyloarthritis, systemic lupus erythematosus, psoriasis, Crohn’s disease and ulcerative colitis? Ann Rheum Dis. 2018;77:175–87.PubMed Baker KF, Isaacs JD. Novel therapies for immune-mediated inflammatory diseases: what can we learn from their use in rheumatoid arthritis, spondyloarthritis, systemic lupus erythematosus, psoriasis, Crohn’s disease and ulcerative colitis? Ann Rheum Dis. 2018;77:175–87.PubMed
17.
go back to reference De Luca F, Shoenfeld Y. The microbiome in autoimmune diseases. Clin Exp Immunol. 2019;195:74–85.PubMed De Luca F, Shoenfeld Y. The microbiome in autoimmune diseases. Clin Exp Immunol. 2019;195:74–85.PubMed
18.
19.
go back to reference Tozzoli R, Sorrentino MC, Bizzaro N. Detecting multiple autoantibodies to diagnose autoimmune comorbidity (multiple autoimmune syndromes and overlap syndromes): a challenge for the autoimmunologist. Immunol Res. 2013;56:425–31.PubMed Tozzoli R, Sorrentino MC, Bizzaro N. Detecting multiple autoantibodies to diagnose autoimmune comorbidity (multiple autoimmune syndromes and overlap syndromes): a challenge for the autoimmunologist. Immunol Res. 2013;56:425–31.PubMed
20.
go back to reference Scott MG, Rifai N, Smith B, Oellerich M, Panteghini M, Apple F, et al. The changing face of laboratory medicine: a more service and less academically oriented profession? Clin Chem. 2015;6:322–9. Scott MG, Rifai N, Smith B, Oellerich M, Panteghini M, Apple F, et al. The changing face of laboratory medicine: a more service and less academically oriented profession? Clin Chem. 2015;6:322–9.
21.
go back to reference Bizzaro N, Tozzoli R, Villalta D. Autoimmune diagnostics: the technology, the strategy and the clinical governance. Immunol Res. 2015;61:126–34.PubMed Bizzaro N, Tozzoli R, Villalta D. Autoimmune diagnostics: the technology, the strategy and the clinical governance. Immunol Res. 2015;61:126–34.PubMed
22.
go back to reference Boursier G, Vukasovic I, Brguljan PM, Lohmander M, Ghita I, Bernabeu Andreu FA, et al. Accreditation process in European countries—an EFLM survey. Clin Chem Lab Med. 2016;54:545–51.PubMed Boursier G, Vukasovic I, Brguljan PM, Lohmander M, Ghita I, Bernabeu Andreu FA, et al. Accreditation process in European countries—an EFLM survey. Clin Chem Lab Med. 2016;54:545–51.PubMed
23.
go back to reference Bizzaro N, Bossuyt X, Haapala A-M, Shoenfeld Y, Sack U. Accreditation in autoimmune diagnostic laboratories. A position paper of the European Autoimmunity Standardisation Initiative (EASI). Autoimmun Rev. 2017;16:81–6.PubMed Bizzaro N, Bossuyt X, Haapala A-M, Shoenfeld Y, Sack U. Accreditation in autoimmune diagnostic laboratories. A position paper of the European Autoimmunity Standardisation Initiative (EASI). Autoimmun Rev. 2017;16:81–6.PubMed
24.
go back to reference Sack U, Bossuyt X, Andreeva H, Antal-Szalmás P, Bizzaro N, Bogdanos D, et al. Quality and best practice in medical laboratories—specific requests for autoimmunity testing. Auto Immun Highlights 2020. Sack U, Bossuyt X, Andreeva H, Antal-Szalmás P, Bizzaro N, Bogdanos D, et al. Quality and best practice in medical laboratories—specific requests for autoimmunity testing. Auto Immun Highlights 2020.
25.
go back to reference Bizzaro N, Morozzi G. A proposed model for effective collaboration between rheumatologists and clinical pathologists for the diagnosis of autoimmune rheumatic diseases. Rheumatol Int. 2009;29:849–51.PubMed Bizzaro N, Morozzi G. A proposed model for effective collaboration between rheumatologists and clinical pathologists for the diagnosis of autoimmune rheumatic diseases. Rheumatol Int. 2009;29:849–51.PubMed
26.
go back to reference Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, Ramsey-Goldman R, et al. 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheumatol. 2019;71:1400–12.PubMedPubMedCentral Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, Ramsey-Goldman R, et al. 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheumatol. 2019;71:1400–12.PubMedPubMedCentral
27.
go back to reference Bizzaro N, Brusca I, Previtali G, Alessio MG, Daves M, Platzgummer S, et al. The association of solid-phase assays to immunofluorescence increases the diagnostic accuracy for ANA screening in patients with autoimmune rheumatic diseases. Autoimmun Rev. 2018;17:541–7.PubMed Bizzaro N, Brusca I, Previtali G, Alessio MG, Daves M, Platzgummer S, et al. The association of solid-phase assays to immunofluorescence increases the diagnostic accuracy for ANA screening in patients with autoimmune rheumatic diseases. Autoimmun Rev. 2018;17:541–7.PubMed
28.
go back to reference Mariampillai K, Granger B, Amelin D, Guiguet M, Hachulla E, Maurier F, et al. Development of a new classification system for idiopathic inflammatory myopathies based on clinical manifestations and myositis-specific autoantibodies. JAMA Neurol. 2018;75:1528–37.PubMedPubMedCentral Mariampillai K, Granger B, Amelin D, Guiguet M, Hachulla E, Maurier F, et al. Development of a new classification system for idiopathic inflammatory myopathies based on clinical manifestations and myositis-specific autoantibodies. JAMA Neurol. 2018;75:1528–37.PubMedPubMedCentral
29.
go back to reference Bidoli E, Villalta D. Epidemiological and ethical aspects of multiplex autoantibody testing. Autoimmun Rev. 2007;6:354–8.PubMed Bidoli E, Villalta D. Epidemiological and ethical aspects of multiplex autoantibody testing. Autoimmun Rev. 2007;6:354–8.PubMed
31.
go back to reference Chan EL, Damoiseaux J, Carballo OG, Conrad K, de Melo Cruvinel W, Francescantonio PLC, et al. Report of the first international consensus on standardized nomenclature of antinuclear antibody HEp-2 cell patterns 2014–2015. Front Immunol. 2015;6:412.PubMedPubMedCentral Chan EL, Damoiseaux J, Carballo OG, Conrad K, de Melo Cruvinel W, Francescantonio PLC, et al. Report of the first international consensus on standardized nomenclature of antinuclear antibody HEp-2 cell patterns 2014–2015. Front Immunol. 2015;6:412.PubMedPubMedCentral
32.
go back to reference Damoiseaux J, von Mühlen CA, De La Garcia Torre I, Carballo OG, de Melo Cruvinel W, Francescantonio PL, et al. International consensus on ANA patterns (ICAP): the bumpy road towards a consensus on reporting ANA results. Auto Immun Highlights. 2016;7:1.PubMedPubMedCentral Damoiseaux J, von Mühlen CA, De La Garcia Torre I, Carballo OG, de Melo Cruvinel W, Francescantonio PL, et al. International consensus on ANA patterns (ICAP): the bumpy road towards a consensus on reporting ANA results. Auto Immun Highlights. 2016;7:1.PubMedPubMedCentral
33.
go back to reference Damoiseaux J, Andrade JEC, Carballo OG, Conrad K, Francescantonio PLC, Fritzler MJ, et al. Clinical relevance of HEp-2 indirect immunofluorescent patterns: the International Consensus on ANA patterns (ICAP) perspective. Ann Rheum Dis. 2019;78:879–89.PubMed Damoiseaux J, Andrade JEC, Carballo OG, Conrad K, Francescantonio PLC, Fritzler MJ, et al. Clinical relevance of HEp-2 indirect immunofluorescent patterns: the International Consensus on ANA patterns (ICAP) perspective. Ann Rheum Dis. 2019;78:879–89.PubMed
34.
go back to reference Bossuyt X. Clinical performance characteristics of a laboratory test. A practical approach in the autoimmune laboratory. Autoimmun Rev. 2009;8:5438. Bossuyt X. Clinical performance characteristics of a laboratory test. A practical approach in the autoimmune laboratory. Autoimmun Rev. 2009;8:5438.
35.
go back to reference Bossuyt X, Claessens J, Belmondo T, De Langhe E, Westhovens R, Poesen K, et al. Harmonization of clinical interpretation of antinuclear antibody test results by solid phase assay and by indirect immunofluorescence through likelihood ratios. Autoimmun Rev. 2019;18:102386.PubMed Bossuyt X, Claessens J, Belmondo T, De Langhe E, Westhovens R, Poesen K, et al. Harmonization of clinical interpretation of antinuclear antibody test results by solid phase assay and by indirect immunofluorescence through likelihood ratios. Autoimmun Rev. 2019;18:102386.PubMed
36.
go back to reference Tozzoli R, Villalta D, Bizzaro N. Challenges in the standardization of autoantibody testing: a comprehensive review. Clin Rev Allergy Immunol. 2017;53:68–77.PubMed Tozzoli R, Villalta D, Bizzaro N. Challenges in the standardization of autoantibody testing: a comprehensive review. Clin Rev Allergy Immunol. 2017;53:68–77.PubMed
37.
go back to reference Oliver JE, Silman AJ. Why are women predisposed to autoimmune rheumatic diseases? Arthr Res Ther. 2009;11:252. Oliver JE, Silman AJ. Why are women predisposed to autoimmune rheumatic diseases? Arthr Res Ther. 2009;11:252.
38.
go back to reference Ørstavik KH. Why are autoimmune diseases more prevalent in women? Tidsskr Nor Laegeforen. 2017;137:866–8.PubMed Ørstavik KH. Why are autoimmune diseases more prevalent in women? Tidsskr Nor Laegeforen. 2017;137:866–8.PubMed
39.
go back to reference Tozzoli R, Giavarina D, Villalta D, Soffiati G, Bizzaro N. Definition of reference limits for autoantibodies to thyroid peroxidase and thyroglobulin in a large population of outpatients using an indirect method based on current data. Arch Pathol Lab Med. 2008;132:1924–8.PubMed Tozzoli R, Giavarina D, Villalta D, Soffiati G, Bizzaro N. Definition of reference limits for autoantibodies to thyroid peroxidase and thyroglobulin in a large population of outpatients using an indirect method based on current data. Arch Pathol Lab Med. 2008;132:1924–8.PubMed
40.
go back to reference Bizzaro N, Wiik A. Appropriateness in anti-nuclear antibody testing: from clinical request to strategic laboratory practice. Clin Exp Rheumatol. 2004;22:349–55.PubMed Bizzaro N, Wiik A. Appropriateness in anti-nuclear antibody testing: from clinical request to strategic laboratory practice. Clin Exp Rheumatol. 2004;22:349–55.PubMed
41.
go back to reference Sinclair D, Duncan H. What happens to patients with positive tissue transglutaminase and endomysium antibody results in general practice? J Clin Pathol. 2004;57:943–5.PubMedPubMedCentral Sinclair D, Duncan H. What happens to patients with positive tissue transglutaminase and endomysium antibody results in general practice? J Clin Pathol. 2004;57:943–5.PubMedPubMedCentral
42.
go back to reference Hickner J, Thompson PJ, Wilkinson T, Epner P, Sheehan M, Pollock AM, et al. Primary care physicians’ challenges in ordering clinical laboratory tests and interpreting results. J Am Board Fam Med. 2014;27:268–74.PubMed Hickner J, Thompson PJ, Wilkinson T, Epner P, Sheehan M, Pollock AM, et al. Primary care physicians’ challenges in ordering clinical laboratory tests and interpreting results. J Am Board Fam Med. 2014;27:268–74.PubMed
43.
go back to reference Betterle C, Presotto E. Update on autoimmune polyglandular syndromes (APS). Acta Bio Med. 2003;74:9–33. Betterle C, Presotto E. Update on autoimmune polyglandular syndromes (APS). Acta Bio Med. 2003;74:9–33.
44.
go back to reference Bagnasco M, Grassia L, Pesce G. The management of the patient with unexpected autoantibody positivity. Autoimmun Rev. 2007;6:347–53.PubMed Bagnasco M, Grassia L, Pesce G. The management of the patient with unexpected autoantibody positivity. Autoimmun Rev. 2007;6:347–53.PubMed
45.
go back to reference Molano-González N, Rojas M, Monsalve DM, Pacheco Y, Acosta-Ampudia Y, Rodríguez Y, et al. Cluster analysis of autoimmune rheumatic diseases based on autoantibodies. New insights for polyautoimmunity. J Autoimmun. 2019;98:24–32.PubMed Molano-González N, Rojas M, Monsalve DM, Pacheco Y, Acosta-Ampudia Y, Rodríguez Y, et al. Cluster analysis of autoimmune rheumatic diseases based on autoantibodies. New insights for polyautoimmunity. J Autoimmun. 2019;98:24–32.PubMed
46.
go back to reference Tozzoli R, Kodermaz G, Perosa AR, Tampoia M, Zucano A, Antico A, et al. Autoantibodies to parietal cells as predictors of atrophic body gastritis: a five-year prospective study in patients with autoimmune thyroid diseases. Autoimmun Rev. 2010;10:80–3.PubMed Tozzoli R, Kodermaz G, Perosa AR, Tampoia M, Zucano A, Antico A, et al. Autoantibodies to parietal cells as predictors of atrophic body gastritis: a five-year prospective study in patients with autoimmune thyroid diseases. Autoimmun Rev. 2010;10:80–3.PubMed
47.
go back to reference Zaninotto M, Plebani M. Understanding and managing interferences in clinical laboratory assays: the role of laboratory professionals. Clin Chem Lab Med. 2020;58:350–6.PubMed Zaninotto M, Plebani M. Understanding and managing interferences in clinical laboratory assays: the role of laboratory professionals. Clin Chem Lab Med. 2020;58:350–6.PubMed
48.
go back to reference Censi S, Cavedon E, Fernando SW, Barollo S, Bertazza L, Zambonin L, et al. Calcitonin measurement and immunoassay interference: a case report and literature review. Clin Chem Lab Med. 2016;54:1861–70.PubMed Censi S, Cavedon E, Fernando SW, Barollo S, Bertazza L, Zambonin L, et al. Calcitonin measurement and immunoassay interference: a case report and literature review. Clin Chem Lab Med. 2016;54:1861–70.PubMed
49.
go back to reference Warda G, Simpson A, Boscatoc L, Hickman PE. The investigation of interferences in immunoassay. Clin Biochem. 2017;50:1306–11. Warda G, Simpson A, Boscatoc L, Hickman PE. The investigation of interferences in immunoassay. Clin Biochem. 2017;50:1306–11.
50.
go back to reference Luong JH, Male KB, Glennon JD. Biotin interference in immunoassays based on biotin-strept(avidin) chemistry: an emerging threat. Biotechnol Adv. 2019;37:634–41.PubMed Luong JH, Male KB, Glennon JD. Biotin interference in immunoassays based on biotin-strept(avidin) chemistry: an emerging threat. Biotechnol Adv. 2019;37:634–41.PubMed
51.
go back to reference Sciacovelli L, Aita A, Padoan A, Pelloso M, Antonelli G, Piva E, et al. Performance criteria and quality indicators for the post-analytical phase. Clin Chem Lab Med. 2016;54:1169–76.PubMed Sciacovelli L, Aita A, Padoan A, Pelloso M, Antonelli G, Piva E, et al. Performance criteria and quality indicators for the post-analytical phase. Clin Chem Lab Med. 2016;54:1169–76.PubMed
Metadata
Title
The clinical and the laboratory autoimmunologist: Where do we stand?
Authors
Renato Tozzoli
Nicola Bizzaro
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Autoimmunity Highlights / Issue 1/2020
Print ISSN: 2038-0305
Electronic ISSN: 2038-3274
DOI
https://doi.org/10.1186/s13317-020-00133-1

Other articles of this Issue 1/2020

Autoimmunity Highlights 1/2020 Go to the issue