Abstract:
Antinuclear antibodies (ANA) are the most widely used immunological test for the diagnosis of autoimmune diseases. Despite the recommendations of experts, there is some variability in performing and interpreting this test in routine practice. In this context, the Spanish Group on Autoimmune Diseases (GEAI) of the Spanish Society of Immunology (SEI) conducted a national survey of 50 autoimmunity laboratories. Here we report the survey results on ANA testing, detection of related antigens, and our recommendations. The survey showed that most of the participating laboratories use a similar approach for most key practices: 84% perform ANA by indirect immunofluorescence (IIF) on HEp-2 cells as the screening methodology while the other laboratories use IIF to confirm positive screens; 90% report ANA test results as either negative or positive with titer and pattern; 86% indicated that the ANA pattern conditioned follow-up testing for specific antigen-related antibodies; and 70% confirm positive anti-dsDNA. However, testing practices were highly heterogeneous for certain items, such as sera dilutions and the minimum time period for repeating ANA and related antigen determinations. Overall, this survey shows that most autoimmune laboratories in Spain use a similar approach but that further standardization of testing and reporting protocols is needed.
摘要:
抗核抗体(ANA)是用于诊断自身免疫性疾病的最广泛使用的免疫学测试。尽管有专家的建议,在常规实践中执行和解释此测试时存在一些差异。在这种情况下,西班牙免疫学会(SEI)的西班牙自身免疫性疾病小组(GEAI)对50个自身免疫实验室进行了一项全国性调查.在这里,我们报告了ANA测试的调查结果,检测相关抗原,和我们的建议。调查显示,大多数参与实验室在大多数关键实践中都使用类似的方法:84%的人通过对HEp-2细胞的间接免疫荧光(IIF)进行ANA作为筛选方法,而其他实验室则使用IIF确认阳性筛选;90%的人报告ANA测试结果为滴度和模式为阴性或阳性;86%表示ANA模式条件后续测试特定抗原相关抗体;70%确认抗dsDNA阳性。然而,测试实践对于某些项目是高度异构的,例如血清稀释度和重复ANA和相关抗原测定的最短时间段。总的来说,这项调查显示,西班牙的大多数自身免疫实验室使用类似的方法,但需要进一步标准化检测和报告方案.