采用线性免疫分析法、酶联免疫吸附测定法和CLIF分析法测定系统性红斑狼疮患者的特异性自身抗体。

Determination of specific autoantibodies in patients with systemic lupus erythematosus by Line immunoassay, ELISA and CLIF assay.

作者信息

Wongjarit Kanphai, Thammacharoenrach Niramol, Dityen Kanthaporn, Kaewopas Yadah, Kositpesat Naravadee, Ukritchon Sittichai, Osiri Manathip, Wongpiyabovorn Jongkonnee

机构信息

Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Division of Immunology, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

出版信息

Asian Pac J Allergy Immunol. 2023 Mar;41(1):73-79. doi: 10.12932/AP-301019-0681.

DOI:10.12932/AP-301019-0681

PMID:32170924

Abstract

BACKGROUND

Detection of specific antinuclear-antibodies is very importance in term of diagnosis, prognosis and management of patients with systemic lupus erythematosus (SLE). To date, Line immunoassay (LIA), enzyme-linked immunosorbent assay (ELISA) and Crithidia luciliae indirect immunofluorescence (CLIF) assay are commonly used for detection of specific antinuclear-antibodies.

OBJECTIVE

To determine the performance of LIA, ELISA and CLIF for the detection of anti-double-stranded DNA (dsDNA), anti-nucleosome, and anti-extractable nuclear antigens (ENA) antibodies in patients with SLE.

METHODS

A total 100 sera from 50 patients with SLE, 25 patients with disease control and 25 healthy control subjects were tested for anti-dsDNA, anti-nucleosome, and anti-ENA antibodies by LIA, ELISA, and CLIF assay. Agreement and diagnostic performance of each assay were analyzed using Cohen's kappa coefficient and receiver operating characteristic curve analysis.

RESULTS

For the detection of anti-dsDNA antibody, ELISA had a substantial agreement with CLIF assay (? = 0.74) but LIA had a fair agreement with ELISA and CLIF assay (? = 0.37, and 0.35 respectively). For the detection of anti-nucleosome, anti-nRNP/Sm, anti-Sm, anti-SSA, and anti-SSB antibodies, LIA had a substantial to perfect agreement with ELISA (? = 0.64, 0.78, 0.68, 0.91, and 0.74, respectively). Anti-dsDNA-NcX ELISA and anti-dsDNA CLIF assay had equally diagnostic performance (sensitivity, 66% vs. 68%, and specificity, 96% vs. 94%, respectively) whereas, anti-dsDNA LIA has low sensitivity (22%) but high specificity (100%).

CONCLUSIONS

LIA, ELISA, and CLIF demonstrated comparable performance for the detection of specific antinuclear-antibodies. However, there were some discrepancy between assays particularly in the detection of anti-dsDNA antibody.

摘要

背景

在系统性红斑狼疮（SLE）患者的诊断、预后及管理方面，检测特异性抗核抗体非常重要。迄今为止，线性免疫分析（LIA）、酶联免疫吸附测定（ELISA）和利什曼原虫间接免疫荧光（CLIF）测定常用于检测特异性抗核抗体。

目的

确定LIA、ELISA和CLIF检测SLE患者抗双链DNA（dsDNA）、抗核小体和抗可提取核抗原（ENA）抗体的性能。

方法

采用LIA、ELISA和CLIF测定法，对来自50例SLE患者、25例疾病对照患者和25例健康对照者的共100份血清进行抗dsDNA、抗核小体和抗ENA抗体检测。使用Cohen卡方系数和受试者工作特征曲线分析来分析每种检测方法的一致性和诊断性能。

结果

对于抗dsDNA抗体的检测，ELISA与CLIF测定有高度一致性（κ = 0.74），但LIA与ELISA和CLIF测定的一致性一般（分别为κ = 0.37和0.35）。对于抗核小体、抗nRNP/Sm、抗Sm、抗SSA和抗SSB抗体的检测，LIA与ELISA有高度至完全一致性（κ分别为0.64、0.78、0.68、0.91和0.74）。抗dsDNA-NcX ELISA和抗dsDNA CLIF测定具有相同的诊断性能（敏感性分别为66%对68%，特异性分别为96%对94%），而抗dsDNA LIA敏感性低（22%）但特异性高（100%）。