Bagnasco Marcello, Grassia Lidia, Pesce Giampaola
Dipartimento di Patologie Immunoendocrinologiche, Laboratorio di Autoimmunità, Azienda Ospedale-Università San Martino, Genova, Italy.
Autoimmun Rev. 2007 Jun;6(6):347-53. doi: 10.1016/j.autrev.2007.01.011. Epub 2007 Feb 15.
Different autoantibodies are often measured simultaneously; this typically occurs when using indirect immunofluorescence on tissue sections or multiplex detection systems and may generate clinically "unexpected" positivities (i.e., without any relation to the disease under investigation). Their number is expected to increase with the development of microarray systems in autoantibody assays. In general, when examining patients with such unexpected findings, it is necessary to take into account that: a) autoantibody positivities are much more frequent than autoimmune diseases; b) the positive predictive value of an autoantibody positivity depends upon the diagnostic accuracy of the test and disease prevalence; c) autoantibodies may be risk factors for autoimmune disease or may also have a pathogenetic role by themselves. In this article we will highlight the possible problems raised by some relatively common situations, related to anti-nuclear, anti-thyroid, anti-phospholipid and anti-tissue transglutaminase autoantibodies. The need for specific strategies is outlined.
不同的自身抗体通常会同时进行检测；这在对组织切片使用间接免疫荧光法或多重检测系统时很常见，可能会产生临床上“意外”的阳性结果（即与所研究的疾病毫无关联）。随着自身抗体检测中微阵列系统的发展，预计其数量会增加。一般来说，在检查有此类意外发现的患者时，有必要考虑到：a）自身抗体阳性比自身免疫性疾病更为常见；b）自身抗体阳性的阳性预测值取决于检测的诊断准确性和疾病患病率；c）自身抗体可能是自身免疫性疾病的危险因素，或者其本身也可能具有致病作用。在本文中，我们将重点介绍一些相对常见的情况所引发的可能问题，这些情况与抗核抗体、抗甲状腺抗体、抗磷脂抗体和抗组织转谷氨酰胺酶自身抗体有关。文中概述了采取特定策略的必要性。
