Dragon-Durey Marie-Agnès, Fabien Nicole, Chyderiotis Georges, Musset Lucile, Pham Bach-Nga, Olsson Niels
Laboratoire d'immunologie, Hôpital européen Georges Pompidou, AP-HP, Université Paris Descartes, Paris, France.
Service d'immunologie, UF auto-immunité, Hospices civils de Lyon, CHLS, Pierre-Bénite, France.
Ann Biol Clin (Paris). 2017 Oct 1;75(5):531-541. doi: 10.1684/abc.2017.1273.
Anti-neutrophil cytoplasmic antibodies (ANCA) are mainly searched for the diagnosis of autoimmune vasculitis. They may be found also in other conditions with chronic inflammation. Testing ANCA is based on two main technics: indirect immunofluorescence (IFI) and immunochemical technics to identify the antigenic specificity of the autoantibodies. There is heterogeneity among the laboratories' daily practice. An international group called EASI (European autoimmunity standardisation initiative), composed of 15 countries, comprising France, works to harmonize the practices of the biological diagnosis of the autoimmune diseases. It elaborated a survey consisting of 54 questions related to the analytic parameters of the technics, the algorithms for their use and their biological interpretation; and submitted it to European laboratories. We propose an analysis of the answers obtained from 36 French laboratories specialized in autoimmunity. We compare them to the ones obtained from the other countries and discussed them according to the international recommendations. The analysis reveals a predominant use of IFI as a first step with variable strategies for the identification of the antigenic specificity of the autoantibodies. Overall, the practices are chiefly conformed to the recommendations for the diagnosis of vasculitis, but they are less consensual when the ANCA are performed in other clinical situations.
抗中性粒细胞胞浆抗体（ANCA）主要用于自身免疫性血管炎的诊断。在其他伴有慢性炎症的疾病中也可能检测到。检测ANCA主要基于两种技术：间接免疫荧光法（IFI）和免疫化学技术，以确定自身抗体的抗原特异性。各实验室的日常操作存在异质性。一个由包括法国在内的15个国家组成的名为EASI（欧洲自身免疫标准化倡议）的国际组织致力于协调自身免疫性疾病生物学诊断的操作。该组织制定了一项包含54个问题的调查，这些问题涉及技术的分析参数、使用算法及其生物学解释，并将其提交给欧洲各实验室。我们对来自36家法国自身免疫专业实验室的答案进行了分析。我们将它们与其他国家获得的答案进行比较，并根据国际建议进行讨论。分析表明，IFI作为第一步被广泛使用，在确定自身抗体抗原特异性方面有不同的策略。总体而言，这些操作主要符合血管炎诊断的建议，但在其他临床情况下进行ANCA检测时，共识较少。
