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Chapter 87 : Antinuclear Antibody Tests

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Antinuclear Antibody Tests, Page 1 of 2

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Abstract:

Autoantibodies are historical hallmarks in the establishment of the concept of autoimmunity and in the definition of the clinical limits of several autoimmune diseases. On a day-to-day basis, autoantibodies are helpful elements not only in the diagnosis of autoimmune diseases, but also frequently in the establishment of prognosis and in the monitoring of disease activity.

Citation: Dellavance A, Cruvinel W, Francescantonio P, Andrade L. 2016. Antinuclear Antibody Tests, p 843-858. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch87
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Figures

Image of FIGURE 1
FIGURE 1

LE cell phenomenon. Viable neutrophils have their nucleus (thin arrow) displaced to the periphery of the cell due to the phagocytosis of a large piece of opsonized chromatin (wide arrow) from dead cells.

Citation: Dellavance A, Cruvinel W, Francescantonio P, Andrade L. 2016. Antinuclear Antibody Tests, p 843-858. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch87
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Image of FIGURE 2
FIGURE 2

Influence of cell substrate on the ANA pattern. (A and B) Sample with anti-U1 RNP antibodies processed on slides from two different suppliers. The expected nuclear coarse speckled pattern is observed with the slide brand shown in panel A, whereas a nonspecific nuclear fine speckled pattern is observed the slide brand depicted in panel B. (C and D) Sample with anti-PCNA (proliferating cell nuclear antigen) antibody processed on slides from two different suppliers. The expected pleomorphic PCNA pattern is observed in the slide brand shown in panel C, whereas a nonspecific pattern is observed in the slide brand shown in panel D. Indirect immunofluorescence on HEp-2 cells; magnification, ×400.

Citation: Dellavance A, Cruvinel W, Francescantonio P, Andrade L. 2016. Antinuclear Antibody Tests, p 843-858. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch87
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Image of FIGURE 3
FIGURE 3

Checkerboard titration of the conjugate. A sample with known ANA titer is used to gauge the dilution of the conjugate that will reproduce the expected titer for that sample.

Citation: Dellavance A, Cruvinel W, Francescantonio P, Andrade L. 2016. Antinuclear Antibody Tests, p 843-858. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch87
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Image of FIGURE 4
FIGURE 4

Example of report of the IIF-ANA test.

Citation: Dellavance A, Cruvinel W, Francescantonio P, Andrade L. 2016. Antinuclear Antibody Tests, p 843-858. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch87
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Image of FIGURE 5
FIGURE 5

Panel of relevant IIF-ANA patterns. (A) Nuclear homogeneous pattern; (B) nuclear dense fine speckled pattern; (C) nuclear coarse speckled pattern; (D) nuclear SS-A/Ro pattern; (E) nuclear fine speckled pattern; (F) centromere pattern; (G) nuclear pleomorphic pattern; (H) ribosomal-P cytoplasmic pattern. Double arrows, cells in interphase; single arrow, cells in metaphase; arrowheads, cell nuclei with pleomorphic pattern and variable intensity. Indirect immunofluorescence using HEp-2 cells.

Citation: Dellavance A, Cruvinel W, Francescantonio P, Andrade L. 2016. Antinuclear Antibody Tests, p 843-858. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch87
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Image of FIGURE 6
FIGURE 6

Pretest probability influences the diagnostic performance of tests. Anti-X antibody is a biomarker for the rare hypothetical disease Z and occurs in 1% of the general population. Indiscriminate testing for anti-X yields poor positive predictive value. Enrichment of the population sample to be tested according to clinical judgment restores the good performance of the anti-X antibody test.

Citation: Dellavance A, Cruvinel W, Francescantonio P, Andrade L. 2016. Antinuclear Antibody Tests, p 843-858. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch87
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Image of FIGURE 7
FIGURE 7

Decision-tree algorithm for classification of IIF-ANA patterns proposed by the IV Brazilian Consensus on ANA. MCP, metaphase chromatin plate.

Citation: Dellavance A, Cruvinel W, Francescantonio P, Andrade L. 2016. Antinuclear Antibody Tests, p 843-858. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch87
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References

/content/book/10.1128/9781555818722.ch87
1. Hargraves M, Richmond H, Morton R. 1948. Presentation of two bone marrow components; the tart cell and the L.E. cell. Proc Staff Meet Mayo Clin 27:2528.
2. Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, Schaller JG, Talal N, Winchester RJ. 1982. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:12711277.[PubMed].[CrossRef]
3. Holborow EJ, Weir DM, Johnson GD. 1957. A serum factor in lupus erythematosus with affinity for tissue nuclei. BMJ 2:732734.[PubMed].[CrossRef]
4. Friou GJ, Finch SC, Detre KD. 1958. Interaction of nuclei and globulin from lupus erythematosis serum demonstrated with fluorescent antibody. J Immunol 80:324329.[PubMed]
5. Fritzler MJ. 1986. Autoantibody testing: procedures and significance in systemic rheumatic diseases. Methods Achiev Exp Pathol 12:224260.[PubMed]
6. Nelson-Rees WA, Daniels DW, Flandermeyer RR. 1981. Cross-contamination of cells in culture. Science 212:446452.[PubMed].[CrossRef]
7. Meroni PL, Schur PH. 2010. ANA screening: an old test with new recommendations. Ann Rheum Dis 69:14201422.[CrossRef].[PubMed]
8. Satoh M, Chan EK, Sobel ES, Kimpel DL, Yamasaki Y, Narain S, Mansoor R, Reeves WH. 2007. Clinical implication of autoantibodies in patients with systemic rheumatic diseases. Expert Rev Clin Immunol 3:721738.[CrossRef].[PubMed]
9. Fritzler MJ, Pauls JD, Kinsella TD, Bowen TJ. 1985. Antinuclear, anticytoplasmic, and anti-Sjogren's syndrome antigen A (SS-A/Ro) antibodies in female blood donors. Clin Immunol Immunopathol 36:120128.[PubMed].[CrossRef]
10. de Vlam K, De Keyser F, Verbruggen G, Vandenbossche M, Vanneuville B, D'Haese D, Veys EM. 1993. Detection and identification of antinuclear autoantibodies in the serum of normal blood donors. Clin Exp Rheumatol 11:393397.[PubMed]
11. Tan EM, Feltkamp TE, Smolen JS, Butcher B, Dawkins R, Fritzler MJ, Gordon T, Hardin JA, Kalden JR, Lahita RG, Maini RN, McDougal JS, Rothfield NF, Smeenk RJ, Takasaki Y, Wiik A, Wilson MR, Koziol JA. 1997. Range of antinuclear antibodies in “healthy” individuals. Arthritis Rheum 40:16011611.[CrossRef].[PubMed]
12. Mariz HA, Sato EI, Barbosa SH, Rodrigues SH, Dellavance A, Andrade LE. 2011. Pattern on the antinuclear antibody-HEp-2 test is a critical parameter for discriminating antinuclear antibody-positive healthy individuals and patients with autoimmune rheumatic diseases. Arthritis Rheum 63:191200.[CrossRef].[PubMed]
13. Dellavance A, Gabriel A, Cintra AFU, Ximenes AC, Nuccitelli B, Taliberti BH, Moreira C, von Mühlen CA, Bichara CD, Santos CHR, Yano CM, Mangueira CLP, Carvalho DC, Bonfá ESDO, Doi EM, Guimarães FNC, Araújo FI, Mundim HM, Rego J, Vieira LEA, Poli L, Andrade LEC, Callado MR, Mesquita MM, Sugiyama M, Slhessarenko N, Silva NA, Carballo OG, Leser PG, Francescantonio PLC, Jarach R, Xavier RM, Levy RA, Neves SPF, Cruvinel WM, Santos WS. 2003. II Brazilian consensus on antinuclear antibodies on HEp-2 cells. Rev Bras Reumatol 43:129140. (In Portuguese.)
14. Sack U, Conrad K, Csernok E, Frank I, Hiepe F, Krieger T, Kromminga A, von Landenberg P, Messer G, Witte T, Mierau R German EASI (European Autoimmunity Standardization Initiative). 2009. Autoantibody detection using indirect immunofluorescence on HEp-2 cells. Ann N Y Acad Sci 1173:166173.[CrossRef].[PubMed]
15. Wiik AS, Hoier-Madsen M, Forslid J, Charles P, Mayerowitsch. 2010. Antinuclear antibodies: a contemporary nomenclature using HEp-2 cells. J Autoimmun 35:276290.[CrossRef].[PubMed]
16. Melegari A, Bonaguri C, Russo A, Luisita B, Trenti T, Lippi G. 2012. A comparative study on the reliability of an automated system for the evaluation of cell-based indirect immunofluorescence. Autoimmun Rev 11:713716.[CrossRef].[PubMed]
17. Voigt J, Krause C, Rohwäder E, Saschenbrecker S, Hahn M, Danckwardt M, Feirer C, Ens K, Fechner K, Barth E, Martinetz T, Stöcker W. 2012. Automated indirect immunofluorescence evaluation of antinuclear autoantibodies on HEp-2 cells. Clin Dev Immunol 2012:651058.[CrossRef].[PubMed]
18. Copple SS, Jaskowski TD, Giles R, Hill HR. 2014. Interpretation of ANA indirect immunofluorescence test outside the darkroom using NOVA view compared to manual microscopy. J Immunol Res 2014:149316.[CrossRef].[PubMed]
19. Bizzaro N, Antico A, Platzgummer S, Tonutti E, Bassetti D, Pesente F, Tozzoli R, Tampoia M, Villalta D Study Group on Autoimmune Diseases of the Italian Society of Laboratory Medicine, Italy. 2014. Automated antinuclear immunofluorescence antibody screening: a comparative study of six computer-aided diagnostic systems. Autoimmun Rev 13:292298.[CrossRef].[PubMed]
20. Fenger M, Wiik A, Høier-Madsen M, Lykkegaard JJ, Rozenfeld T, Hansen MS, Samsoe BD, Jacobsen S. 2004. Detection of antinuclear antibodies by solid-phase immunoassays and immunofluorescence analysis. Clin Chem 50:21412147.[CrossRef].[PubMed]
21. Op De Beeck K, Vermeersch P, Verschueren P, Westhovens R, Mariën G, Blockmans D, Bossuyt X. 2011. Detection of antinuclear antibodies by indirect immunofluorescence and by solid phase assay. Autoimmun Rev 10:801808.[CrossRef].[PubMed]
22. Bonilla E, Francis L, Allam F, Ogrinc M, Neupane H, Phillips PE, Perl A. 2007. Immunofluorescence microscopy is superior to fluorescent beads for detection of antinuclear antibody reactivity in systemic lupus erythematosus patients. Clin Immunol 124:1821.[CrossRef].[PubMed]
23. Chan EKL, Fritzler MJ, Wiik A, Andrade LE, Reeves WH, Tincani A, Meroni PL IUIS/WHO/AF/CDC Committee for the Standardization of Autoantibodies in Rheumatic and Related Diseases. 2007. AutoAbSC.Org—Autoantibody Standardization Committee in 2006. Autoimmun Rev 6:577580.[CrossRef].[PubMed]
24. Dellavance A, Gallindo C, Soares MG, da Silva NP, Mortara RA, Andrade LEC. 2009. Redefining the Scl-70 indirect immunofluorescence pattern: autoantibodies to DNA topoisomerase I yield a specific compound immunofluorescence pattern. Rheumatology (Oxford) 48:632637.[CrossRef].[PubMed]
25. Dellavance A, Viana VST, Leon EP, Bonfa ESDO, Andrade LEC, Leser PG. 2005. The clinical spectrum of antinuclear antibodies associated with the nuclear dense fine speckled immunofluorescence pattern. J Rheumatol 32:21442149.[PubMed]
26. Dellavance A, Alvarenga RR, Rodrigues SH, Barbosa SH, Camilo AC, Shiguedomi HS, Rodrigues SS, Silva CG, Andrade LE. 2013. Autoantibodies to 60kDa SS-A/Ro yield a specific nuclear myriad discrete fine speckled immunofluorescence pattern. J Immunol Methods 390:3540.[CrossRef].[PubMed]
27. Peene I, Meheus L, Veys EM, De Keyser F. 2001. Detection and identification of antinuclear antibodies (ANA) in a large and consecutive cohort of serum samples referred for ANA testing. Ann Rheum Dis 60:11311136.[PubMed].[CrossRef]
28. Hoffman IEA, Peene I, Veys EM, De Keyser F. 2002. Detection of specific antinuclear reactivities in patients with negative anti-nuclear antibody immunofluorescence screening tests. Clin Chem 48:21712176.[PubMed]
29. Satoh M, Vázquez-Del Mercado M, Chan EK. 2009. Clinical interpretation of antinuclear antibody tests in systemic rheumatic diseases. Mod Rheumatol 19:219228.[CrossRef].[PubMed]
30. Ochs RL, Muro Y, Si Y, Ge H, Chan EK, Tan EM. 2000. Autoantibodies to DFS 70 kd/transcription coactivator p75 in atopic dermatitis and other conditions. J Allergy Clin Immunol 105:12111220.[PubMed].[CrossRef]
31. Mahler M, Parker T, Peebles CL, Andrade LE, Swart A, Carbone Y, Ferguson DJ, Villalta D, Bizzaro N, Hanly JG, Fritzler MJ. 2012. Anti-DFS70/LEDGF antibodies are more prevalent in healthy individuals compared to patients with systemic autoimmune rheumatic diseases. J Rheumatol 39:21042110.[CrossRef].[PubMed]
32. Francescantonio PL, Cruvinel WM, Dellavance A, Andrade LE, Taliberti BH, von Mühlen CA, Bichara CD, Bueno C, Mangueira CL, Carvalho DG, Bonfá ES, Brito FA, Araújo FI, Rêgo J, Pereira KM, dos Anjos LM, Bissoli MF, Santiago MB, Maluf NZ, Alvarenga RR, Neves SP, Valim V, dos Santos WS. 2014. IV Brazilian guidelines for autoantibodies on HEp-2 cells. Rev Bras Reumatol 54:4450.[PubMed]

Tables

Generic image for table
TABLE 1

Advantages of the ANA assay on HEp-2 cells

Citation: Dellavance A, Cruvinel W, Francescantonio P, Andrade L. 2016. Antinuclear Antibody Tests, p 843-858. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch87
Generic image for table
TABLE 2

Ability of the ANA-HEp-2 test to detect clinically relevant autoantibodies

Citation: Dellavance A, Cruvinel W, Francescantonio P, Andrade L. 2016. Antinuclear Antibody Tests, p 843-858. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch87
Generic image for table
TABLE 3

Specific composite IIF-ANA patterns

Citation: Dellavance A, Cruvinel W, Francescantonio P, Andrade L. 2016. Antinuclear Antibody Tests, p 843-858. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch87
Generic image for table
TABLE 4

IIF-ANA patterns, targeted autoantigen, and disease associations

Citation: Dellavance A, Cruvinel W, Francescantonio P, Andrade L. 2016. Antinuclear Antibody Tests, p 843-858. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch87

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