间接免疫荧光抗核抗体筛查中致密细斑点模式的临床特征及其与DFS70自身抗体的关联

Clinical Aspects of the Dense Fine Speckled Pattern in Indirect Immunofluorescence-Antinuclear Antibody Screening and Its Association with DFS70 Autoantibodies.

作者信息

La Jeon You, Kang So Young, Lee Woo-In, Kim Myeong Hee

机构信息

Department of Laboratory Medicine, School of Medicine, Kyung Hee University and Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.

Department of Laboratory Medicine, School of Medicine, Kyung Hee University and Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea

出版信息

Ann Clin Lab Sci. 2019 Sep;49(4):496-502.

PMID:31471339

Abstract

GOALS

The existence of anti-dense fine speckled (DFS) 70 autoantibodies are considered an exclusionary biomarker for systemic autoimmune rheumatic diseases (SARDs). Several tests to confirm the presence of anti-DFS70 autoantibodies have been introduced, and the use of them in specimens with a DFS pattern in indirect immunofluorescence-antinuclear antibody (IIF-ANA) testing has been suggested. However, these additional tests have only been evaluated in a small number of samples; their clinical usefulness therefore requires further evaluation.

METHODS

A total of 213 serum specimens showing DFS (n=155) or homogeneous (H; n=58) patterns were included. All specimens were tested by western blotting (WB) and enzyme immunoassay (EIA). Clinical information regarding SARDs was analyzed.

RESULTS

The detection rates for WB and EIA for anti-DFS70 autoantibodies in specimens with a DFS pattern were 86.5% and 73.5%, respectively. Detection rates in specimens with a low IIF-ANA titer were significantly lower than those in specimens with a high titer. The detection rate of anti-DFS70 autoantibodies in 58 specimens with an H pattern was 10.3% (6/58). Among 155 subjects with a DFS pattern in IIF-ANA staining, only five were diagnosed with SARD.

CONCLUSIONS

There is little need to confirm the presence of anti-DFS70 autoantibodies using other methods. When a DFS pattern is observed in IIF-ANA staining, it is more important to confirm the presence of other autoantibodies related to SARDs than to identify anti-DFS70 autoantibodies. Finally, more careful interpretation of IIF-ANA to specimens with a low IIF-ANA titer is needed.

摘要

目标

抗致密细斑点（DFS）70自身抗体的存在被视为系统性自身免疫性风湿病（SARDs）的排除性生物标志物。已经引入了几种用于确认抗DFS70自身抗体存在的检测方法，并有人建议在间接免疫荧光抗核抗体（IIF-ANA）检测中对具有DFS模式的标本使用这些方法。然而，这些额外的检测仅在少数样本中进行了评估；因此，它们的临床实用性需要进一步评估。

方法

总共纳入了213份显示DFS模式（n = 155）或均质（H；n = 58）模式的血清标本。所有标本均通过蛋白质印迹法（WB）和酶免疫测定法（EIA）进行检测。分析了有关SARDs的临床信息。

结果

具有DFS模式的标本中，WB和EIA检测抗DFS70自身抗体的检出率分别为86.5%和73.5%。IIF-ANA滴度低的标本中的检出率明显低于滴度高的标本。58份具有H模式的标本中抗DFS70自身抗体的检出率为10.3%（6/58）。在IIF-ANA染色呈DFS模式的155名受试者中，只有5人被诊断为SARD。