Department of Microbiology and Immunology, Clinical and Diagnostic Immunology, KU Leuven, Leuven, Belgium.
Department of Laboratory Medicine, Immunology Service, University Hospitals Leuven, Leuven, Belgium.
Clin Chem Lab Med. 2020 Sep 25;58(10):1623-1633. doi: 10.1515/cclm-2019-1031.
Background Both enzyme-linked immunosorbent assays (ELISAs) and indirect immunofluorescence (IIF) are available for the diagnosis of autoimmune bullous diseases (AIBD). Many studies have reported on the performance of ELISAs and concluded that ELISAs could replace IIF. This study compares the diagnostic accuracy of ELISA and IIF for the detection of autoantibodies to desmoglein 1 (DSG1), desmoglein 3 (DSG3), bullous pemphigoid antigen 2 (BP180) and bullous pemphigoid antigen 1 (BP230) to support the diagnosis of pemphigus vulgaris (PV), pemphigus foliaceus (PF) and bullous pemphigoid (BP). Methods A literature search was performed in the PubMed database. The meta-analysis was performed using summary values and a bivariate random effect model. Results The five included studies on PV did not demonstrate significant differences between IIF and DSG3-ELISA (sensitivity 82.3% vs. 81.6%, p = 0.9284; specificity 95.6% vs. 93.9%, p = 0.5318; diagnostic odds ratio [DOR] 101.60 vs. 67.760, p = 0.6206). The three included studies on PF did not demonstrate significant differences between IIF and DSG1-ELISA (sensitivity 80.6% vs. 83.1%, p = 0.8501; specificity 97.5% vs. 93.9%, p = 0.3614; DOR 160.72 vs. 75.615, p = 0.5381). The eight included studies on BP showed that BP230-ELISA differed significantly from both IIF on monkey esophagus (MO) and BP180-ELISA with regard to DOR (11.384 vs. 68.349, p = 0.0008; 11.384 vs. 41.699, p = 0.0125, respectively) Conclusions Our meta-analysis shows that ELISA performs as well as IIF for diagnosing PV, PF and BP.
背景 酶联免疫吸附测定（ELISA）和间接免疫荧光（IIF）均可用于自身免疫性大疱性疾病（AIBD）的诊断。许多研究已经报道了 ELISA 的性能，并得出结论认为 ELISA 可以替代 IIF。本研究比较了 ELISA 和 IIF 检测桥粒芯糖蛋白 1（DSG1）、桥粒芯糖蛋白 3（DSG3）、大疱性类天疱疮抗原 2（BP180）和大疱性类天疱疮抗原 1（BP230）自身抗体的诊断准确性，以支持天疱疮（PV）、落叶型天疱疮（PF）和大疱性类天疱疮（BP）的诊断。
方法 在 PubMed 数据库中进行文献检索。使用汇总值和双变量随机效应模型进行荟萃分析。
结果 纳入的五项关于 PV 的研究未显示 IIF 与 DSG3-ELISA 之间存在显著差异（敏感性 82.3% vs. 81.6%，p=0.9284；特异性 95.6% vs. 93.9%，p=0.5318；诊断比值比 [DOR] 101.60 vs. 67.760，p=0.6206）。纳入的三项关于 PF 的研究未显示 IIF 与 DSG1-ELISA 之间存在显著差异（敏感性 80.6% vs. 83.1%，p=0.8501；特异性 97.5% vs. 93.9%，p=0.3614；DOR 160.72 vs. 75.615，p=0.5381）。纳入的八项关于 BP 的研究表明，BP230-ELISA 在诊断比值比（DOR）方面与 IIF 对猴食管（MO）和 BP180-ELISA 显著不同（11.384 vs. 68.349，p=0.0008；11.384 vs. 41.699，p=0.0125）。
结论 我们的荟萃分析表明，ELISA 用于诊断 PV、PF 和 BP 的性能与 IIF 相当。
