Helena Enocsson1, Christopher Sjöwall2, Lina Wirestam2, Charlotte Dahle2, Alf Kastbom2, Johan Rönnelid2, Jonas Wetterö2, Thomas Skogh2. 1. From the Department of Clinical and Experimental Medicine, Linköping University, Linköping, and the Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.H. Enocsson, Postdoctoral, PhD; C. Sjöwall, MD, PhD, Associate Professor; L. Wirestam, MSc, PhD-student; C. Dahle, MD, PhD, Associate Professor; A. Kastbom, MD, PhD; J. Wetterö, PhD, Associate Professor; T. Skogh, MD, PhD, Professor, Department of Clinical and Experimental Medicine, Linköping University; J. Rönnelid, MD, PhD, Professor, Department of Immunology, Genetics and Pathology, Uppsala University. helena.enocsson@liu.se. 2. From the Department of Clinical and Experimental Medicine, Linköping University, Linköping, and the Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.H. Enocsson, Postdoctoral, PhD; C. Sjöwall, MD, PhD, Associate Professor; L. Wirestam, MSc, PhD-student; C. Dahle, MD, PhD, Associate Professor; A. Kastbom, MD, PhD; J. Wetterö, PhD, Associate Professor; T. Skogh, MD, PhD, Professor, Department of Clinical and Experimental Medicine, Linköping University; J. Rönnelid, MD, PhD, Professor, Department of Immunology, Genetics and Pathology, Uppsala University.
Abstract
OBJECTIVE: Analysis of antibodies against dsDNA is an important diagnostic tool for systemic lupus erythematosus (SLE), and changes in anti-dsDNA antibody levels are also used to assess disease activity. Herein, 4 assays were compared with regard to SLE specificity, sensitivity, and association with disease activity variables. METHODS: Cross-sectional sera from 178 patients with SLE, of which 11 were followed consecutively, from a regional Swedish SLE register were analyzed for immunoglobulin G (IgG) anti-dsDNA by bead-based multiplex assay (FIDIS; Theradig), fluoroenzyme-immunoassay (EliA; Phadia/Thermo Fisher Scientific), Crithidia luciliae immunofluorescence test (CLIFT; ImmunoConcepts), and line blot (EUROLINE; Euroimmun). All patients with SLE fulfilled the 1982 American College of Rheumatology and/or the 2012 Systemic Lupus International Collaborating Clinics (SLICC-12) classification criteria. Healthy individuals (n = 100), patients with rheumatoid arthritis (n = 95), and patients with primary Sjögren syndrome (n = 54) served as controls. RESULTS: CLIFT had the highest SLE specificity (98%) whereas EliA had the highest sensitivity (35%). When cutoff levels for FIDIS, EliA, and EUROLINE were adjusted according to SLICC-12 (i.e., double the reference limit when using ELISA), the specificity and sensitivity of FIDIS was comparable to CLIFT. FIDIS and CLIFT also showed the highest concordance (84%). FIDIS performed best regarding association with disease activity in cross-sectional and consecutive samples. Fisher's exact test revealed striking differences between methods regarding associations with certain disease phenotypes. CONCLUSION: CLIFT remains a good choice for diagnostic purposes, but FIDIS performs equally well when the cutoff is adjusted according to SLICC-12. Based on results from cross-sectional and consecutive analyses, FIDIS can also be recommended to monitor disease activity.
OBJECTIVE: Analysis of antibodies against dsDNA is an important diagnostic tool for systemic lupus erythematosus (SLE), and changes in anti-dsDNA antibody levels are also used to assess disease activity. Herein, 4 assays were compared with regard to SLE specificity, sensitivity, and association with disease activity variables. METHODS: Cross-sectional sera from 178 patients with SLE, of which 11 were followed consecutively, from a regional Swedish SLE register were analyzed for immunoglobulin G (IgG) anti-dsDNA by bead-based multiplex assay (FIDIS; Theradig), fluoroenzyme-immunoassay (EliA; Phadia/Thermo Fisher Scientific), Crithidia luciliae immunofluorescence test (CLIFT; ImmunoConcepts), and line blot (EUROLINE; Euroimmun). All patients with SLE fulfilled the 1982 American College of Rheumatology and/or the 2012 Systemic Lupus International Collaborating Clinics (SLICC-12) classification criteria. Healthy individuals (n = 100), patients with rheumatoid arthritis (n = 95), and patients with primary Sjögren syndrome (n = 54) served as controls. RESULTS: CLIFT had the highest SLE specificity (98%) whereas EliA had the highest sensitivity (35%). When cutoff levels for FIDIS, EliA, and EUROLINE were adjusted according to SLICC-12 (i.e., double the reference limit when using ELISA), the specificity and sensitivity of FIDIS was comparable to CLIFT. FIDIS and CLIFT also showed the highest concordance (84%). FIDIS performed best regarding association with disease activity in cross-sectional and consecutive samples. Fisher's exact test revealed striking differences between methods regarding associations with certain disease phenotypes. CONCLUSION: CLIFT remains a good choice for diagnostic purposes, but FIDIS performs equally well when the cutoff is adjusted according to SLICC-12. Based on results from cross-sectional and consecutive analyses, FIDIS can also be recommended to monitor disease activity.
Authors: Maria Infantino; M Manfredi; M Merone; V Grossi; M Benucci; F Li Gobbi; F Bandinelli; A Damiani; P Soda Journal: Immunol Res Date: 2018-06 Impact factor: 2.829
Authors: Lina Wirestam; Hanna Schierbeck; Thomas Skogh; Iva Gunnarsson; Lars Ottosson; Helena Erlandsson-Harris; Jonas Wetterö; Christopher Sjöwall Journal: Arthritis Res Ther Date: 2015-11-23 Impact factor: 5.156