Abstract：
BACKGROUND: Indirect immunofluorescence (IIF) plays a crucial role in the diagnosis of pemphigus and bullous pemphigoid (BP) by detecting the presence of circulating autoantibodies in the serum of patients. The standard serum transportation method requires delivery to laboratories at 2-8 °C within a day and storage at -20 to -80 °C. However, this protocol poses logistical challenges.
OBJECTIVE: We conducted a study to assess how temperature variations affect the effectiveness of IIF tests.
METHODS: This case-control study analysed 203 serum specimens: 102 from patients with pemphigus and 101 from patients with BP. Specimens were stored at -80 °C (control), 24 °C, and 40 °C for seven days before analysis to investigate variations in IIF titres compared to the control conditions.
RESULTS: In pemphigus serum, 95% at 24 °C and 76% at 40 °C showed no titre difference compared to controls. Similarly, 89% of BP serum at 24 °C and 82% at 40 °C matched the control titres. While 57 specimens across both groups experienced reduced titres, the decrease was primarily marginal (one-step reduction in 54 cases, two-step in 3), with no transition from positive to negative results.
CONCLUSIONS: Storing serum at 24-40 °C for up to seven days before testing slightly influences IIF outcomes for pemphigus and BP. These findings could prompt a significant revision in the existing strict transport guidelines, ensuring efficient use of resources without sacrificing the accuracy of diagnostic tests.
OBJECTIVE: We conducted a study to assess how temperature variations affect the effectiveness of IIF tests.
METHODS: This case-control study analysed 203 serum specimens: 102 from patients with pemphigus and 101 from patients with BP. Specimens were stored at -80 °C (control), 24 °C, and 40 °C for seven days before analysis to investigate variations in IIF titres compared to the control conditions.
RESULTS: In pemphigus serum, 95% at 24 °C and 76% at 40 °C showed no titre difference compared to controls. Similarly, 89% of BP serum at 24 °C and 82% at 40 °C matched the control titres. While 57 specimens across both groups experienced reduced titres, the decrease was primarily marginal (one-step reduction in 54 cases, two-step in 3), with no transition from positive to negative results.
CONCLUSIONS: Storing serum at 24-40 °C for up to seven days before testing slightly influences IIF outcomes for pemphigus and BP. These findings could prompt a significant revision in the existing strict transport guidelines, ensuring efficient use of resources without sacrificing the accuracy of diagnostic tests.
摘要：
背景：间接免疫荧光（IIF）通过检测患者血清中循环自身抗体的存在，在天疱疮和大疱性类天疱疮（BP）的诊断中起着至关重要的作用。标准的血清运输方法需要在一天内在2-8°C的温度下输送到实验室，并在-20至-80°C的温度下储存。然而,这项协议带来了后勤挑战。
目的：我们进行了一项研究，以评估温度变化如何影响IIF测试的有效性。
方法：本病例对照研究分析了203份血清标本：天疱疮患者102份，BP患者101份。将样品储存在-80°C(对照),24°C,和40°C持续7天，然后进行分析，以研究与对照条件相比IIF滴度的变化。
结果：在天疱疮血清中，与对照相比,在24°C下95%和在40°C下76%没有显示滴度差异。同样，在24°C下89%的BP血清和在40°C下82%的BP血清与对照滴度相匹配。虽然两组57个标本的滴度都降低了，减少主要是边际的(一步减少54例，两步3），没有从积极到消极的过渡结果。
结论：在测试前将血清在24-40°C下储存7天对天疱疮和BP的IIF结局有轻微影响。这些发现可能会促使对现有的严格运输准则进行重大修订，确保资源的有效利用，而不牺牲诊断测试的准确性。
目的：我们进行了一项研究，以评估温度变化如何影响IIF测试的有效性。
方法：本病例对照研究分析了203份血清标本：天疱疮患者102份，BP患者101份。将样品储存在-80°C(对照),24°C,和40°C持续7天，然后进行分析，以研究与对照条件相比IIF滴度的变化。
结果：在天疱疮血清中，与对照相比,在24°C下95%和在40°C下76%没有显示滴度差异。同样，在24°C下89%的BP血清和在40°C下82%的BP血清与对照滴度相匹配。虽然两组57个标本的滴度都降低了，减少主要是边际的(一步减少54例，两步3），没有从积极到消极的过渡结果。
结论：在测试前将血清在24-40°C下储存7天对天疱疮和BP的IIF结局有轻微影响。这些发现可能会促使对现有的严格运输准则进行重大修订，确保资源的有效利用，而不牺牲诊断测试的准确性。
