Vincent Christian, Nogueira Leonor, Sebbag Mireille, Chapuy-Regaud Sabine, Arnaud Michel, Letourneur Odile, Rolland Dominique, Fournié Bernard, Cantagrel Alain, Jolivet Michel, Serre Guy
Institut National de la Santé et de la Recherche Médicale (CJF 96-02, IFR30), Purpan School of Medicine, University of Toulouse III, Toulouse, France.
Arthritis Rheum. 2002 Aug;46(8):2051-8. doi: 10.1002/art.10436.
To assay antifilaggrin autoantibodies, we developed an enzyme-linked immunosorbent assay (ELISA) using a "citrullinated" recombinant rat filaggrin. Our objectives were to assess its value for diagnosing rheumatoid arthritis (RA) and to compare the results with those obtained using 4 other reference methods for detection of antifilaggrin autoantibodies, including the commercially available ELISA that uses a modified "citrullinated" synthetic peptide derived from the sequence of human filaggrin (CCP-ELISA).
We analyzed 711 sera from patients with well-characterized rheumatic diseases, including 240 patients with RA. Antifilaggrin autoantibodies were detected by an ELISA using a recombinant rat filaggrin deiminated in vitro as immunosorbent (ArFA-ELISA). The results considered were the differences between the optical densities obtained on deiminated and nondeiminated proteins. Antibodies to rat esophagus epithelium were detected by indirect immunofluorescence, while antibodies to human filaggrin were detected by immunoblotting and by a recently described ELISA using a deiminated recombinant human filaggrin. Finally, CCP-ELISA was performed according to the manufacturer's recommendations.
At the titer thresholds allowing diagnostic specificities of 0.95, 0.985, and 0.99 to be reached, the diagnostic sensitivities of the ArFA-ELISA were 0.76, 0.67, and 0.65, respectively. At these 3 thresholds, the sensitivities were significantly higher than those of the 4 other tests. Despite incomplete overlapping of the 5 tests, the high diagnostic performance of the ArFA-ELISA allows us to propose this test to replace all the other methods for antifilaggrin autoantibody detection.
ArFA-ELISA appears to be the most efficient test among those available for the detection of antifilaggrin autoantibodies, in terms of diagnostic accuracy for RA. Its diagnostic performance in early RA and its prognostic value are currently under evaluation.
为检测抗丝聚蛋白自身抗体，我们研发了一种酶联免疫吸附测定法（ELISA），使用一种“瓜氨酸化”的重组大鼠丝聚蛋白。我们的目标是评估其在诊断类风湿关节炎（RA）方面的价值，并将结果与使用其他4种检测抗丝聚蛋白自身抗体的参考方法所获得的结果进行比较，其中包括使用源自人丝聚蛋白序列的修饰“瓜氨酸化”合成肽的市售ELISA（CCP-ELISA）。
我们分析了711例患有明确风湿性疾病患者的血清，其中包括240例RA患者。使用体外脱氨的重组大鼠丝聚蛋白作为免疫吸附剂的ELISA（ArFA-ELISA）检测抗丝聚蛋白自身抗体。所考虑的结果是在脱氨和未脱氨蛋白质上获得的光密度之间的差异。通过间接免疫荧光检测大鼠食管上皮抗体，通过免疫印迹以及使用脱氨重组人丝聚蛋白的最近描述的ELISA检测人丝聚蛋白抗体。最后，根据制造商的建议进行CCP-ELISA。
在达到诊断特异性为0.95、0.985和0.99的滴度阈值时，ArFA-ELISA的诊断敏感性分别为0.76、0.67和0.65。在这3个阈值下，其敏感性显著高于其他4种检测方法。尽管这5种检测方法存在不完全重叠，但ArFA-ELISA的高诊断性能使我们建议用该检测方法取代所有其他抗丝聚蛋白自身抗体检测方法。
就RA的诊断准确性而言，ArFA-ELISA似乎是现有用于检测抗丝聚蛋白自身抗体的检测方法中最有效的。其在早期RA中的诊断性能及其预后价值目前正在评估中。
