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

被引：468

作者：

Agmon-Levin, Nancy ^{[1
,2
]}

Damoiseaux, Jan ^{[3
]}

Kallenberg, Cees ^{[4
]}

Sack, Ulrich ^{[5
]}

Witte, Torsten ^{[6
]}

Herold, Manfred ^{[7
,8
]}

Bossuyt, Xavier ^{[9
]}

Musset, Lucille ^{[10
]}

Cervera, Ricard ^{[11
]}

Plaza-Lopez, Aresio ^{[12
]}

Dias, Carlos ^{[13
]}

Sousa, Maria Jose ^{[14
]}

Radice, Antonella ^{[15
]}

Eriksson, Catharina ^{[16
]}

Hultgren, Olof ^{[17
,18
]}

Viander, Markku ^{[19
]}

Khamashta, Munther ^{[20
]}

Regenass, Stephan ^{[21
]}

Coelho Andrade, Luis Eduardo ^{[22
]}

Wiik, Allan ^{[23
]}

Tincani, Angela ^{[24
,25
]}

Ronnelid, Johan ^{[26
]}

Bloch, Donald B. ^{[27
,28
]}

Fritzler, Marvin J. ^{[29
]}

Chan, Edward K. L. ^{[30
]}

Garcia-De la Torre, I. ^{[31
,32
]}

Konstantinov, Konstantin N.

Lahita, Robert ^{[33
,34
]}

Wilson, Merlin

Vainio, Olli ^{[35
,36
]}

Fabien, Nicole ^{[37
]}

Sinico, Renato Alberto ^{[38
,39
]}

Meroni, Pierluigi ^{[40
]}

Shoenfeld, Yehuda ^{[1
,2
,41
]}

机构：

[1] Chaim Sheba Med Ctr, Zabludowicz Ctr Autoimmune Dis, Tel Aviv, Israel

[2] Tel Aviv Univ, Sackler Fac Med, IL-69978 Tel Aviv, Israel

[3] Maastricht Univ, Med Ctr, Cent Diagnost Lab, Maastricht, Netherlands

[4] Univ Groningen, Univ Med Ctr Groningen, Dept Rheumatol & Clin Immunol, Groningen, Netherlands

[5] Univ Leipzig, Inst Clin Immunol & Transfus Med, D-04109 Leipzig, Germany

[6] Sch Med, Dept Clin Immunol & Rheumatol, Hannover, Germany

[7] Med Univ Innsbruck, Rheumatol Unit, Dept Internal Med 1, A-6020 Innsbruck, Austria

[8] Univ Hosp Leuven, Louvain, Belgium

[9] Katholieke Univ Leuven, Dept Microbiol & Immunol, Louvain, Belgium

[10] GH Pitie Salpetriere, Dept Immunol, Paris, France

[11] Hosp Clin Barcelona, Dept Autoimmune Dis, Catalonia, Spain

[12] Hosp Univ Pueta Hierro Majadahonda, Serv Inmunol, Madrid, Spain

[13] S Joao Hosp, Dept Med, Autoimmune Dis Unit, Oporto, Portugal

[14] Fernando Fonseca Hosp, Autoimmun & PreNatal Diagnost Lab Unit, Oporto, Portugal

[15] Azienda Osped Osped San Carlo Borromeo, Inst Microbiol, Milan, Italy

[16] Umea Univ, Dept Clin Microbiol, Umea, Sweden

[17] Univ Hosp Orebro, Dept Lab Med, Orebro, Sweden

[18] Univ Orebro, SE-70182 Orebro, Sweden

[19] Univ Turku, Dept Med Microbiol & Immunol, Turku, Finland

[20] Kings Coll London, Div Womens Hlth, Lupus Res Lab, London WC2R 2LS, England

[21] DIA Univ Spital, Klin Immunol, Zurich, Switzerland

[22] Univ Fed Sao Paulo, Div Rheumatol, Sao Paulo, Brazil

[23] Statens Serum Inst, Dept Clin Chem & Immunol, DK-2300 Copenhagen S, Denmark

[24] Spedali Civil Brescia, Rheumatol & Clin Immunol Unit, Dept Clin & Expt Sci, I-25125 Brescia, Italy

[25] Univ Brescia, Brescia, Italy

[26] Uppsala Univ, Dept Immunol Genet & Pathol, Uppsala, Sweden

[27] Massachusetts Gen Hosp, Div Rheumatol Allergy & Immunol, Harvard, MA USA

[28] Harvard Univ, Sch Med, Harvard, MA USA

[29] Univ Calgary, Fac Med, Calgary, AB, Canada

[30] Univ Florida, Dept Oral Biol, Gainesville, FL 32610 USA

[31] Hosp Gen Occidente Seguro Social, Dept Immunol & Rheumatol, Guadalajara, Jalisco, Mexico

[32] Univ Guadalajara, Guadalajara 44430, Jalisco, Mexico

[33] Newark Beth Israel Med Ctr UMDNJ, Newark, NJ USA

[34] Newark Beth Israel Med Ctr UMDNJ, VP, Newark, NJ USA

[35] Univ Oulu, Inst Diagnost, Dept Med Microbiol & Immunol, Oulu, Finland

[36] NordLab Oulu, Oulu, Finland

[37] CH Lyon Sud, Dept Immunol, Pierre Benite, France

[38] Azienda Osped Osped San Carlo Borromeo, Clin Immunol Unit, Milan, Italy

[39] Azienda Osped Osped San Carlo Borromeo, Renal Unit, Milan, Italy

[40] Univ Milan, Div Rheumatol, Ist G Pini, Ist Auxol Italiano, Milan, Italy

[41] Tel Aviv Univ, Sackler Fac Med, Laura Schwarz Kip Chair Res Autoimmune Dis, IL-69978 Tel Aviv, Israel

来源：

ANNALS OF THE RHEUMATIC DISEASES | 2014年 / 73卷 / 01期

关键词：

Autoantibodies; Autoimmunity; Systemic Lupus Erythematosus; SjOgren's Syndrome; SYSTEMIC-LUPUS-ERYTHEMATOSUS; EXTRACTABLE NUCLEAR ANTIGENS; INDIRECT IMMUNOFLUORESCENCE; RHEUMATIC-DISEASES; HEALTHY-INDIVIDUALS; DIAGNOSTIC-ACCURACY; AUTOIMMUNE-DISEASES; COMMERCIAL KITS; ANA; GUIDELINES;

D O I：

10.1136/annrheumdis-2013-203863

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：17 / 23

页数：7

共 48 条

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