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Validation of a new screening strategy for anti-extractable nuclear antigen antibodies

Jens Van Praet UGent, Bert Vander Cruyssen UGent, CAROLIEN BONROY, Vanessa Smith UGent, Joris Delanghe UGent and Filip De Keyser UGent (2009) CLINICAL AND EXPERIMENTAL RHEUMATOLOGY. 27(6). p.971-976
abstract
Objective: Although indirect immunofluorescence (IIF) is the most widely applied screening test for antinuclear antibodies (ANA), it lacks specificity for the identification of specific diseases or antigen reactivities. The aim of the present study was to validate an anti-extractable nuclear antigen (ENA) screening strategy encompassing a three-step cascade whereby all ELISA with pooled specific ENA is positioned between the IIF and the final anti-ENA identification. Methods: Sera from 4 populations were tested for anti-ENA using all automated ELISA (EliA Symphony) and a line immunoassay (INNO-LIA ANA update). Results: At the manufacturer's cut-off, a 96% sensitivity (95% CI 94%-98%) and 96% specificity (95% Cl 94%-98%) of EliA Symphony for anti-ENA was obtained in a consecutive selection of 328 IIF positive serum samples referred for ANA testing. In addition, a high sensitivity was demonstrated for anti-ENA reactivities in patients with SLE (99%, 95% CI 97%-101%) and SSc (100%), and for anti-ENA monoreactivities. Conclusion: The EliA Symphony test was shown to be a sensitive second-line screening test for anti-ENA antibodies. In the context of a high clinical suspicion of connective tissue disease or autoreactivities not included in the EliA Symphony assay, third-line testing may be useful, even if the anti-ENA screening is negative.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
AUTOANTIBODIES, CONNECTIVE-TISSUE DISORDERS, SYSTEMIC-LUPUS-ERYTHEMATOSUS, MULTICENTER VALIDATION, ANTINUCLEAR ANTIBODIES, REVISED CRITERIA, ASSAY, RHEUMATIC-DISEASES, ANA, CLASSIFICATION
journal title
CLINICAL AND EXPERIMENTAL RHEUMATOLOGY
Clin. Exp. Rheumatol.
volume
27
issue
6
pages
971 - 976
Web of Science type
Article
Web of Science id
000274264700013
JCR category
RHEUMATOLOGY
JCR impact factor
2.396 (2009)
JCR rank
15/24 (2009)
JCR quartile
3 (2009)
ISSN
0392-856X
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
872794
handle
http://hdl.handle.net/1854/LU-872794
alternative location
http://www.clinexprheumatol.org/abstract.asp?a=153
date created
2010-02-22 11:30:45
date last changed
2016-12-19 15:44:28
@article{872794,
  abstract     = {Objective: Although indirect immunofluorescence (IIF) is the most widely applied screening test for antinuclear antibodies (ANA), it lacks specificity for the identification of specific diseases or antigen reactivities. The aim of the present study was to validate an anti-extractable nuclear antigen (ENA) screening strategy encompassing a three-step cascade whereby all ELISA with pooled specific ENA is positioned between the IIF and the final anti-ENA identification.
Methods: Sera from 4 populations were tested for anti-ENA using all automated ELISA (EliA Symphony) and a line immunoassay (INNO-LIA ANA update).
Results: At the manufacturer's cut-off, a 96\% sensitivity (95\% CI 94\%-98\%) and 96\% specificity (95\% Cl 94\%-98\%) of EliA Symphony for anti-ENA was obtained in a consecutive selection of 328 IIF positive serum samples referred for ANA testing. In addition, a high sensitivity was demonstrated for anti-ENA reactivities in patients with SLE (99\%, 95\% CI 97\%-101\%) and SSc (100\%), and for anti-ENA monoreactivities.
Conclusion: The EliA Symphony test was shown to be a sensitive second-line screening test for anti-ENA antibodies. In the context of a high clinical suspicion of connective tissue disease or autoreactivities not included in the EliA Symphony assay, third-line testing may be useful, even if the anti-ENA screening is negative.},
  author       = {Van Praet, Jens and Vander Cruyssen, Bert and BONROY, CAROLIEN and Smith, Vanessa and Delanghe, Joris and De Keyser, Filip},
  issn         = {0392-856X},
  journal      = {CLINICAL AND EXPERIMENTAL RHEUMATOLOGY},
  keyword      = {AUTOANTIBODIES,CONNECTIVE-TISSUE DISORDERS,SYSTEMIC-LUPUS-ERYTHEMATOSUS,MULTICENTER VALIDATION,ANTINUCLEAR ANTIBODIES,REVISED CRITERIA,ASSAY,RHEUMATIC-DISEASES,ANA,CLASSIFICATION},
  language     = {eng},
  number       = {6},
  pages        = {971--976},
  title        = {Validation of a new screening strategy for anti-extractable nuclear antigen antibodies},
  url          = {http://www.clinexprheumatol.org/abstract.asp?a=153},
  volume       = {27},
  year         = {2009},
}

Chicago
Van Praet, Jens, Bert Vander Cruyssen, CAROLIEN BONROY, Vanessa Smith, Joris Delanghe, and Filip De Keyser. 2009. “Validation of a New Screening Strategy for Anti-extractable Nuclear Antigen Antibodies.” Clinical and Experimental Rheumatology 27 (6): 971–976.
APA
Van Praet, Jens, Vander Cruyssen, B., BONROY, C., Smith, V., Delanghe, J., & De Keyser, F. (2009). Validation of a new screening strategy for anti-extractable nuclear antigen antibodies. CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, 27(6), 971–976.
Vancouver
1.
Van Praet J, Vander Cruyssen B, BONROY C, Smith V, Delanghe J, De Keyser F. Validation of a new screening strategy for anti-extractable nuclear antigen antibodies. CLINICAL AND EXPERIMENTAL RHEUMATOLOGY. 2009;27(6):971–6.
MLA
Van Praet, Jens, Bert Vander Cruyssen, CAROLIEN BONROY, et al. “Validation of a New Screening Strategy for Anti-extractable Nuclear Antigen Antibodies.” CLINICAL AND EXPERIMENTAL RHEUMATOLOGY 27.6 (2009): 971–976. Print.