商业线印迹法检测肌炎自身抗体的诊断性能和验证。
Diagnostic performance and validation of autoantibody testing in myositis by a commercial line blot assay.
机构信息
Department of Clinical and Experimental Medicine, Division of Rheumatology, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
出版信息
Rheumatology (Oxford). 2010 Dec;49(12):2370-4. doi: 10.1093/rheumatology/keq281. Epub 2010 Aug 19.
OBJECTIVE
Serological testing for myositis-specific or associated autoantibodies [myositis-specific antibody (MSA) and myositis-associated antibody (MAA)] is useful for the diagnosis of idiopathic inflammatory myopathies (IIMs). However, available assays are neither standardized nor validated. The objective is to evaluate the accuracy of a commercial line blot assay for myositis diagnosis.
METHODS
IgG antibodies against Jo-1, PL-7, PL-12, PM/Scl, Ku, Mi-2 and Ro52 antigens were detected by a line blot and in-house RNA immunoprecipitation or immunoblot. We tested sera from 208 IIM patients, 50 healthy subjects and 180 control patients (11 non-autoimmune myopathy, 23 muscular dystrophy, 11 UCTD, 68 SLE, 36 SSc, 22 SS and 9 arthropathy).
RESULTS
MSAs or MAAs were detected in 98 (47%) out of the 208 IIM patients by line blot: anti-Jo-1 in 43 (21%), anti-PL-7 or anti-PL-12 in 8 (4%), anti-Mi-2 in 9 (4%), anti-PM/Scl in 9 (4%), anti-Ku in 10 (5%) and anti-Ro52 in 49 (24%). Overall specificity was: 100% for anti-Jo-1, anti-PL-7 or PL-12 and anti-PM/Scl; 96% for anti-Ku; 98% for anti-Mi-2; and 76% for anti-Ro52. In-house testing confirmed line blot results regarding anti-Jo-1, anti-PM/Scl and anti-Ku, while it was more accurate than line blot in detecting anti-Mi-2 (7 vs 4% sensitivity, 100 vs 98% specificity), and anti-aminoacyl-tRNA synthetase (anti-ARS) non-Jo-1 antibodies (11 vs 4% sensitivity, 97 vs 99% specificity).
CONCLUSIONS
Line blot could be a suitable serological test in the diagnostic workup for myositis, and it represents a reliable alternative to more time-consuming procedures. Continuous effort is recommended in order to improve its accuracy.
目的
肌炎特异性或相关自身抗体（肌炎特异性抗体[MSA]和肌炎相关抗体[MAA]）的血清学检测有助于特发性炎性肌病（IIM）的诊断。然而，现有的检测方法既没有标准化，也没有得到验证。本研究旨在评估一种商业线印迹检测法在肌炎诊断中的准确性。
方法
通过线印迹和内部 RNA 免疫沉淀或免疫印迹检测 IgG 抗体针对 Jo-1、PL-7、PL-12、PM/Scl、Ku、Mi-2 和 Ro52 抗原。我们检测了 208 例 IIM 患者、50 名健康受试者和 180 例对照患者（11 例非自身免疫性肌病、23 例肌肉营养不良、11 例UCTD、68 例 SLE、36 例 SSc、22 例 SS 和 9 例关节炎）的血清。
结果
通过线印迹检测到 208 例 IIM 患者中的 98 例（47%）存在 MSA 或 MAA：抗-Jo-1 43 例（21%），抗-PL-7 或抗-PL-12 8 例（4%），抗-Mi-2 9 例（4%），抗-PM/Scl 9 例（4%），抗-Ku 10 例（5%），抗-Ro52 49 例（24%）。总体特异性为：抗-Jo-1、抗-PL-7 或 PL-12 和抗-PM/Scl 为 100%；抗-Ku 为 96%；抗-Mi-2 为 98%；抗-Ro52 为 76%。内部检测结果与抗-Jo-1、抗-PM/Scl 和抗-Ku 的线印迹结果一致，而在检测抗-Mi-2（7%对 4%的敏感性，100%对 98%的特异性）和非-Jo-1 抗氨酰-tRNA 合成酶（抗-ARS）抗体（11%对 4%的敏感性，97%对 99%的特异性）方面，内部检测比线印迹更准确。
结论
线印迹可以作为肌炎诊断中一种合适的血清学检测方法，它是一种比耗时更长的方法更可靠的替代方法。建议继续努力提高其准确性。
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