Tozzoli Renato
Laboratorio Analisi Chimico-cliniche e Microbiologia, Ospedale di Latisana (Udine), Italy.
Autoimmun Rev. 2007 Jun;6(6):334-40. doi: 10.1016/j.autrev.2007.01.005. Epub 2007 Feb 2.
Conventional immunological methods for the detection of serum autoantibodies have been an essential tool for the diagnosis of autoimmune diseases for 40 years: in the last decade autoantibody tests have become accepted criteria for the diagnosis and classification of the main systemic and organ-specific autoimmune diseases. The high degree of purification reached by the autoantigens used in these methods has allowed high diagnostic sensitivity and specificity, especially in the case of some new autoantibodies of particular clinical significance, such as anti-nucleosome, anti-transglutaminase, anti-TSH receptor and anti-citrullinated protein autoantibodies. In the last 5 years the advent of proteomic technology, which allows the simultaneous measurement of a number of autoantibodies (multiplexing), has opened up new horizons in the diagnosis of autoimmune diseases. Multiplexing is particularly interesting for clinical laboratories, for organisational, logistical/managerial, physiopathological and research reasons. The emerging technologies are represented by systems based on planar or non-planar (suspension) arrays: the latter include methods which use addressable microbeads or nanobarcoded particles. Within a few years, the new methods will allow testing of individual autoantibody profiles, which will probably improve understanding of the physiopathology of autoimmunity, allow early diagnosis (due to the predictive value of autoantibodies), and drive the diffusion of antigen-specific therapies in autoimmune diseases.
40年来，传统的血清自身抗体检测免疫学方法一直是诊断自身免疫性疾病的重要工具：在过去十年中，自身抗体检测已成为主要系统性和器官特异性自身免疫性疾病诊断和分类的公认标准。这些方法中使用的自身抗原达到的高纯度使得诊断具有高灵敏度和特异性，特别是在一些具有特殊临床意义的新自身抗体的情况下，如抗核小体、抗转谷氨酰胺酶、抗促甲状腺激素受体和抗瓜氨酸化蛋白自身抗体。在过去5年中，蛋白质组学技术的出现使得能够同时检测多种自身抗体（多重检测），为自身免疫性疾病的诊断开辟了新的前景。由于组织、后勤/管理、生理病理和研究等方面的原因，多重检测对临床实验室特别有吸引力。新兴技术以基于平面或非平面（悬浮）阵列的系统为代表：后者包括使用可寻址微珠或纳米条形码颗粒的方法。在几年内，新方法将允许检测个体自身抗体谱，这可能会增进对自身免疫生理病理学的理解，实现早期诊断（由于自身抗体的预测价值），并推动自身免疫性疾病中抗原特异性疗法的普及。
