Ora Shovman1, Boris Gilburd2, Chen Chayat2, Howard Amital3, Pnina Langevitz4, Abdulla Watad5, Adi Guy5, Dolores Perez2, Danielle Azoulay2, Miri Blank6, Yael Segal6, Chelsea Bentow7, Michael Mahler7, Yehuda Shoenfeld8. 1. Zabludowitz Centre for Autoimmune Diseases; Department of Internal Medicine 'B'; Rheumatology Unit, Sheba Medical Centre, Tel Hashomer, Israel. 2. Zabludowitz Centre for Autoimmune Diseases, Sheba Medical Centre, Tel Hashomer, Israel. 3. Zabludowitz Centre for Autoimmune Diseases; Department of Internal Medicine 'B', Sheba Medical Centre, Tel Hashomer; and Sackler Faculty of Medicine, Tel Aviv University, Israel. 4. Rheumatology Unit, Sheba Medical Centre, Tel Hashomer; and Sackler Faculty of Medicine, Tel Aviv University, Israel. 5. Department of Internal Medicine 'B', Sheba Medical Centre, Tel Hashomer, Israel. 6. Zabludowitz Centre for Autoimmune Diseases, Sheba Medical Centre, Tel Hashomer; and Sackler Faculty of Medicine, Tel Aviv University, Israel. 7. Research and Development, Inova Diagnostics, San Diego, CA, USA. 8. Zabludowitz Centre for Autoimmune Diseases, Sheba Medical Centre, Tel Hashomer; Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel Aviv University, Israel. shoenfel@post.tau.ac.il.
Abstract
OBJECTIVES: Autoantibodies to the dense fine speckled 70 (DFS70) antigen are common among antinuclear antibodies (ANA) positive healthy individuals (HI). We assessed the prevalence of anti-DFS70 antibodies in patients with and without ANA-associated rheumatic diseases (AARDs) by two methods: chemiluminescent immunoassay (CIA) and an indirect immunofluorescence (IIF) assay based on immunoadsorption for DFS70. METHODS: Fifty-one ANA-positive sera samples from patients with confirmed clinical diagnosis of AARD, 92 samples from HI and 85 samples submitted to a reference laboratory for routine ANA testing were evaluated for the presence of anti-DFS70 antibodies. The samples were evaluated by QUANTA Flash DFS70 CIA using BIO-FLASH instrument and by NOVA Lite selected HEp-2 kit on NOVA View - an automated IIF system. Sera with DFS positive pattern were pre-absorbed with highly purified human DFS70 antigen, and then tested again. RESULTS: Twenty-four samples (10.5%) tested by QUANTA Flash DFS70 CIA were positive for anti-DFS70 antibodies. The prevalence of monospecific anti-DFS70 antibodies was significantly higher in healthy subjects than in patients with AARDs (10.9% vs. 1.9%, p=0.02). The frequency of anti-DFS70 antibodies in samples submitted for routine ANA testing was 15.2%. A very good agreement was found between CIA and the DFS pattern identified by the automated HEp-2 IIF (kappa=0.97). In 80% of the samples obtained from patients without AARDs, immunoadsorption effectively inhibited the anti-DFS70 antibodies. CONCLUSIONS: The data confirm that mono-specific anti-DFS70 antibodies are a strong discriminator between ANA positive HI and AARD patients, and their evaluation should be included in ANA testing algorithms.
OBJECTIVES: Autoantibodies to the dense fine speckled 70 (DFS70) antigen are common among antinuclear antibodies (ANA) positive healthy individuals (HI). We assessed the prevalence of anti-DFS70 antibodies in patients with and without ANA-associated rheumatic diseases (AARDs) by two methods: chemiluminescent immunoassay (CIA) and an indirect immunofluorescence (IIF) assay based on immunoadsorption for DFS70. METHODS: Fifty-one ANA-positive sera samples from patients with confirmed clinical diagnosis of AARD, 92 samples from HI and 85 samples submitted to a reference laboratory for routine ANA testing were evaluated for the presence of anti-DFS70 antibodies. The samples were evaluated by QUANTA Flash DFS70 CIA using BIO-FLASH instrument and by NOVA Lite selected HEp-2 kit on NOVA View - an automated IIF system. Sera with DFS positive pattern were pre-absorbed with highly purified humanDFS70 antigen, and then tested again. RESULTS: Twenty-four samples (10.5%) tested by QUANTA Flash DFS70 CIA were positive for anti-DFS70 antibodies. The prevalence of monospecific anti-DFS70 antibodies was significantly higher in healthy subjects than in patients with AARDs (10.9% vs. 1.9%, p=0.02). The frequency of anti-DFS70 antibodies in samples submitted for routine ANA testing was 15.2%. A very good agreement was found between CIA and the DFS pattern identified by the automated HEp-2 IIF (kappa=0.97). In 80% of the samples obtained from patients without AARDs, immunoadsorption effectively inhibited the anti-DFS70 antibodies. CONCLUSIONS: The data confirm that mono-specific anti-DFS70 antibodies are a strong discriminator between ANA positive HI and AARD patients, and their evaluation should be included in ANA testing algorithms.
Authors: Maria Infantino; O Shovman; B Gilburd; M Manfredi; V Grossi; Maurizio Benucci; A Damiani; D Chimenti; K Malyavantham; Y Shoenfeld Journal: Clin Rheumatol Date: 2019-01-07 Impact factor: 2.980
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