International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti-nuclear antibodies

International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti-nuclear antibodies

Author Agmon-Levin, Nancy Google Scholar
Damoiseaux, Jan Google Scholar
Kallenberg, Cees Google Scholar
Sack, Ulrich Google Scholar
Witte, Torsten Google Scholar
Herold, Manfred Google Scholar
Bossuyt, Xavier Google Scholar
Musset, Lucille Google Scholar
Cervera, Ricard Google Scholar
Plaza-Lopez, Aresio Google Scholar
Dias, Carlos Google Scholar
Sousa, Maria Jose Google Scholar
Radice, Antonella Google Scholar
Eriksson, Catharina Google Scholar
Hultgren, Olof Google Scholar
Viander, Markku Google Scholar
Khamashta, Munther Google Scholar
Regenass, Stephan Google Scholar
Coelho Andrade, Luis Eduardo Autor UNIFESP Google Scholar
Wiik, Allan Google Scholar
Tincani, Angela Google Scholar
Ronnelid, Johan Google Scholar
Bloch, Donald B. Google Scholar
Fritzler, Marvin J. Google Scholar
Chan, Edward K. L. Google Scholar
Garcia-De la Torre, I. Google Scholar
Konstantinov, Konstantin N. Google Scholar
Lahita, Robert Google Scholar
Wilson, Merlin Google Scholar
Vainio, Olli Google Scholar
Fabien, Nicole Google Scholar
Sinico, Renato Alberto Google Scholar
Meroni, Pierluigi Google Scholar
Shoenfeld, Yehuda Google Scholar
Institution Chaim Sheba Med Ctr
Tel Aviv Univ
Maastricht Univ
Univ Groningen
Univ Leipzig
Sch Med
Med Univ Innsbruck
Univ Hosp Leuven
Katholieke Univ Leuven
GH Pitie Salpetriere
Hosp Clin Barcelona
Hosp Univ Pueta Hierro Majadahonda
S Joao Hosp
Fernando Fonseca Hosp
Azienda Osped Osped San Carlo Borromeo
Umea Univ
Univ Hosp Orebro
Univ Orebro
Univ Turku
Kings Coll London
DIA Univ Spital
Universidade Federal de São Paulo (UNIFESP)
Statens Serum Inst
Spedali Civil Brescia
Univ Brescia
Uppsala Univ
Massachusetts Gen Hosp
Harvard Univ
Univ Calgary
Univ Florida
Hosp Gen Occidente Seguro Social
Univ Guadalajara
Newark Beth Israel Med Ctr UMDNJ
Univ Oulu
NordLab Oulu
CH Lyon Sud
Univ Milan
Abstract Anti-nuclear antibodies (ANA) are fundamental for the diagnosis of autoimmune diseases, and have been determined by indirect immunofluorescence assay (IIFA) for decades. As the demand for ANA testing increased, alternative techniques were developed challenging the classic IIFA. These alternative platforms differ in their antigen profiles, sensitivity and specificity, raising uncertainties regarding standardisation and interpretation of incongruent results. Therefore, an international group of experts has created recommendations for ANA testing by different methods. Two groups of experts participated in this initiative. the European autoimmunity standardization initiative representing 15 European countries and the International Union of Immunologic Societies/World Health Organization/Arthritis Foundation/Centers for Disease Control and Prevention autoantibody standardising committee. A three-step process followed by a Delphi exercise with closed voting was applied. Twenty-five recommendations for determining ANA (1-13), anti-double stranded DNA antibodies (14-18), specific antibodies (19-23) and validation of methods (24-25) were created. Significant differences between experts were observed regarding recommendations 24-25 (p<0.03). Here, we formulated recommendations for the assessment and interpretation of ANA and associated antibodies. Notably, the roles of IIFA as a reference method, and the importance of defining nuclear and cytoplasmic staining, were emphasised, while the need to incorporate alternative automated methods was acknowledged. Various approaches to overcome discrepancies between methods were suggested of which an improved bench-to-bedside communication is of the utmost importance. These recommendations are based on current knowledge and can enable harmonisation of local algorithms for testing and evaluation of ANA and related autoantibodies. Last but not least, new more appropriate terminologies have been suggested.
Keywords Autoantibodies
Autoimmunity
Systemic Lupus Erythematosus
SjOgren's Syndrome
Language English
Date 2014-01-01
Published in Annals of the Rheumatic Diseases. London: Bmj Publishing Group, v. 73, n. 1, p. 17-23, 2014.
ISSN 0003-4967 (Sherpa/Romeo, impact factor)
Publisher Bmj Publishing Group
Extent 17-23
Origin http://dx.doi.org/10.1136/annrheumdis-2013-203863
Access rights Open access Open Access
Type Review
Web of Science ID WOS:000327835100009
URI http://repositorio.unifesp.br/handle/11600/37125

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