Fluorescent Antibody Technique, Indirect

荧光抗体技术,Indirect
  • 文章类型: Journal Article
    犬新孢子虫是全球牛生殖丧失的主要原因,因为它导致流产和动物重新定位。虽然弓形虫不会引起牛的生殖问题,食用生牛肉或未煮熟的牛肉会带来传播风险。本研究旨在评估抗N的发生。caninum和反T.圣保罗州西部和西北地区的奶牛中的gondii抗体,巴西。使用间接免疫荧光测定法(IFA)分析了来自奶牛的总共653份血清样品。通过基于抗体存在的逻辑回归,将来自农场的流行病学数据与动物的血清学结果相关联。抗体频率分别为41.6%(272/653)和11.5%(75/653),分别。之间观察到统计学上的显着关联:血清抗N。犬抗体和品种,小牛补充食物的历史,引入后来出现生殖问题的外部动物,和妊娠三个月的生殖问题史。本研究强调了新孢子虫病在研究区域的奶牛中的重要性,并且在研究患有生殖障碍的动物时纳入这种寄生虫很重要。
    Neospora caninum is a major cause of reproductive loss in cattle worldwide as it leads to abortion and animal repositioning. Although Toxoplasma gondii does not cause a reproductive problem in cattle, consuming raw or uncooked beef poses the risk of transmission. This study aimed to evaluate the occurrence of anti-N. caninum and anti-T. gondii antibodies in dairy cattle in the West and Northwest regions of São Paulo State, Brazil. A total of 653 serum samples from dairy cows were analyzed using an indirect immunofluorescence assay (IFA). Epidemiological data from the farms were associated with the serological results of the animals by logistic regression based on the presence of antibodies. The frequencies of the antibodies against N. caninum and T. gondii were 41.6% (272/653) and 11.5% (75/653), respectively. A statistically significant association was observed between: the serum anti-N. caninum antibodies and breed, history of food supplementation for calves, introduction of outside animals that later presented reproductive problems, and history of reproductive problems by the trimester of gestation. The present study highlights the importance of neosporosis in dairy cattle in the study regions and that the inclusion of this parasite in the investigation of animals with reproductive disorders is important.
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  • 文章类型: Journal Article
    背景:由于其媒介性质,非生物因子在婴儿利什曼原虫感染的进化中起着重要作用。这项研究旨在评估Valdeorras(Ourense,西班牙西北部)在20年的时间内,以及不同的气候变量和预防措施可能如何影响它。
    方法:对参加“ServiciosVeterinariosdeSil”兽医诊所(Valdeorras,西班牙西北部)在2003年5月至2023年4月之间检测婴儿乳球菌的暴露。从一年的5月至次年的4月计算了婴儿乳球菌感染的新病例百分比。该地区的气候条件,记录了从2003年到2022年在兽医诊所交付的杀外寄生虫剂的全球销售和针对婴儿乳球菌的疫苗数量。进行了统计分析,以确定这些因素与婴儿乳球菌感染新病例百分比之间的关联。
    结果:共评估了2909只狗,在2003年5月至2023年4月之间进行了3785项IFAT测试。在研究的20年期间,新的血清阳性病例的平均百分比为21.65±10.8%,从研究期间的开始到结束都有所下降。与其他时期(2008年5月至2013年4月,2013年5月至2018年4月以及2018年5月至2023年4月)相比,该百分比在2003年5月至2008年4月期间显着提高。婴儿新感染病例的百分比与冬季最大相对湿度之间呈正相关。相反,新发病例的百分比与杀外寄生虫剂的销售和婴儿L.
    结论:这项研究是对固定位置的婴儿乳球菌感染的演变及其与包括气候条件和预防措施在内的外部因素的关联的最长评估之一。结果证实Valdeorras是婴儿乳球菌感染的高风险区域。已显示使用针对婴儿乳球菌的外寄生虫杀虫剂和疫苗在预防婴儿乳球菌感染中起重要作用,强调兽医在对抗这种疾病中的关键作用。
    BACKGROUND: Abiotic factors play a significant role in the evolution of Leishmania infantum infection due to its vectorial nature. This study aims to assess the evolution in the detection of new L. infantum infection cases in Valdeorras (Ourense, Northwestern Spain) over a 20-year period and how different climatic variables and preventive measures may have affected it.
    METHODS: Indirect immunofluorescence antibody tests (IFAT) were performed on serum samples collected from dogs attending the \'Servicios Veterinarios de Sil\' veterinary clinic (Valdeorras, Northwestern Spain) between May 2003 and April 2023 to detect L. infantum exposure. The percentage of new cases of L. infantum infection was calculated from May of one year to April of the following year. Climatic conditions in the region, global sales of ectoparasiticides and the number of vaccines against L. infantum delivered in the veterinary clinic from 2003 to 2022 were recorded. Statistical analyses were conducted to determine the associations between these factors and the percentage of new cases of L. infantum infection.
    RESULTS: A total of 2909 dogs were assessed, and 3785 IFAT tests were performed between May 2003 and April 2023. The mean percentage of new seropositive cases over the 20-year period studied was 21.65 ± 10.8%, with a decline from the beginning to the end of the period studied. The percentage was significantly higher between May 2003 and April 2008 compared with the other periods (May 2008 to April 2013, May 2013 to April 2018 and May 2018 to April 2023). There was a positive correlation between the percentage of new cases of L. infantum infection and the maximum relative humidity in winter. Conversely, there was a negative correlation between the percentage of new cases and sales of ectoparasiticides and vaccination against L. infantum.
    CONCLUSIONS: This study is one of the longest evaluations of the evolution of L. infantum infection in a fixed location and its association with external factors including climatic conditions and preventive measures. The results confirm that Valdeorras is a high-risk area for L. infantum infection. The use of ectoparasiticides and vaccines against L. infantum has been shown to play a significant role in preventing L. infantum infection, highlighting the crucial role of veterinarians in the fight against this disease.
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  • 文章类型: Journal Article
    抗杆和环(抗RR)抗体最近已被描述为HEp-2细胞上的自身抗体的基于IIF的筛选中的细胞质模式,并且ICAP将其命名为AC-23。最常见的是与药物诱导的抗体产生有关。本研究旨在探讨AC-23阳性的临床意义及其与相关疾病和/或药物使用的诊断和/或随访的相关性。
    从2017年1月至2021年12月,对来自蒂尔基耶六个不同省份的10家医院进行了一项多中心回顾性研究。分析了547.558例HEp-2IIFANA样本中600例抗RR抗体阳性患者的实验室数据和临床信息。
    按年份划分的AC-23阳性患者的分布表明,2017-2021年之间呈稳定增长。COVID-19后时期的抗RR患病率显着高于COVID-19前时期(p=0.00)。在56.5%的患者中检测到合并ANA阳性,最常见的模式是AC-4和AC-5(41.1%)。抗RR阳性患者中最常见的病理是自身免疫性疾病(19.83%);其中28.57%患有类风湿关节炎和17.65%的自身免疫性肝病。在600名患者中,65例(10.83%)被诊断为丙型肝炎病毒(HCV)感染。38名HCV患者的可用数据显示,其中71.05%有干扰素α+利巴韦林病史,其中28.95%有NS3/4/5A/5B聚合酶抑制剂或蛋白酶抑制剂药物使用史。与COVID-19前期相比,在COVID-19后期间观察到抗RR阳性率显着增加(p:0.00)。
    这是Türkiye关于抗RR抗体的临床关联的第一个多中心研究,在常规HEp-2IIF测试中可以忽略。在抗RR在自身免疫疾病和其他病理中的可能作用方面,应考虑HCV以外的病理。这项研究获得的初步数据表明,抗RR抗体的产生也可能与COVID-19有关,支持了先前与病毒引发自身抗体形成的潜力有关的几个数据。大规模前瞻性研究应阐明RR模式的临床意义,并确定其在患者诊断和随访中的作用。
    UNASSIGNED: Anti-rods and rings (anti-RR) antibodies have recently been described as a cytoplasmic pattern in IIF-based screening of autoantibodies on HEp-2 cells and ICAP has named it as AC-23. It is most frequently related to drug-induced antibody generation. This study aimed to investigate the clinical significance of AC-23 positivity and its relevance to the diagnosis and/or follow-up of the associated diseases and/or drug use.
    UNASSIGNED: A multicenter retrospective study was conducted among 10 hospitals from six different provinces in Türkiye from January 2017 to December 2021. The laboratory data and clinical information of 600 patients with positive anti-RR antibodies out of 547.558 HEp-2 IIF ANA samples were analyzed.
    UNASSIGNED: The distribution of AC-23 positive patients by year indicated a steady increase between 2017-2021. Anti-RR prevalence in post-COVID-19 period was significantly higher than that of pre-COVID-19 period (p=0.00). Concomitant ANA positivity was detected in 56.5% of patients, the most common patterns being AC-4 and AC-5 (41.1%). The most frequent pathology among the anti-RR positive patients was an autoimmune disease (19.83%); 28.57% of which had rheumatoid arthritis and 17.65% autoimmune liver disease. Among the 600 patients, 65 (10.83%) were diagnosed as hepatitis C virus (HCV) infection. Available data for 38 of the HCV patients revealed that 71.05% of them had a history of interferon alfa+ribavirin and 28.95% of them had a history of NS3/4/5A/5B polymerase inhibitor or protease inhibitor drug use. Significant increase in the rate of anti-RR positivity was observed in the post-COVID-19 period when compared to pre-COVID-19 period (p:0.00).
    UNASSIGNED: This is the first multicenter study in Türkiye about the clinical association of anti-RR antibodies which may be ignored during routine HEp-2 IIF testing. Pathologies other than HCV should be taken into consideration in terms of the possible role of anti-RR in autoimmune diseases and other pathologies. The preliminary data obtained in this study suggest that anti-RR antibody development might also be associated to COVID-19, supporting the several previous data related to the potential of viruses triggering the formation of autoantibodies. Large-scale prospective studies should elucidate the clinical significance of RR pattern and determine its role in patient diagnosis and follow-up.
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  • 文章类型: Journal Article
    猪流行性腹泻病毒(PEDV)感染给全球养猪业造成了巨大的经济损失。这种病原体可以感染所有猪,并对哺乳仔猪造成特别高的死亡风险。刺突蛋白的S1亚基是诱导可以拦截病毒与宿主相互作用并中和病毒感染性的特别中和抗体的关键靶蛋白。在本研究中,利用HEK293F真核表达系统成功表达和生产重组S1蛋白。通过定量分析,开发了五种特异性靶向PEDV重组S1蛋白的单克隆抗体(mAb),随后使用酶联免疫吸附测定(ELISA)进行评估,间接免疫荧光分析(IFA),和流式细胞术测定(FCA)。结果表明,所有五种mAb都属于IgG1同种型,以及在84.77、7.42、0.89、14.64和7.86pM时测得的它们的半最大有效浓度(EC50)值。所有这5种单克隆抗体均可用于ELISA,FCA,和IFA用于检测PEDV感染。MAb5-F9在ELISA中检测低至0.3125ng/mL的重组PEDV-S1蛋白的灵敏度最高,而在FCA中检测PEDV只需要0.096ng/mL的mAb5-F9。来自抗原表位分析的结果表明mAb8-G2是能够识别线性表位的唯一抗体。总之,这项研究产生了一种高免疫原性的S1蛋白和5种特异性靶向S1蛋白的高亲和力mAb.这些发现对于PEDV感染的早期检测具有重要意义,并为进一步研究病毒-宿主相互作用提供了坚实的基础。
    The porcine epidemic diarrhea virus (PEDV) infection inflicted substantial economic losses upon the global pig-breeding industry. This pathogen can infect all pigs and poses a particularly high fatality risk for suckling piglets. The S1 subunit of spike protein is a crucial target protein for inducing the particularly neutralizing antibodies that can intercept the virus-host interaction and neutralize virus infectivity. In the present study, the HEK293F eukaryotic expression system was successfully utilized to express and produce recombinant S1 protein. Through quantitative analysis, five monoclonal antibodies (mAbs) specifically targeting the recombinant S1 protein of PEDV were developed and subsequently evaluated using enzyme-linked immunosorbent assay (ELISA), indirect immunofluorescence assay (IFA), and flow cytometry assay (FCA). The results indicate that all five mAbs belong to the IgG1 isotype, and their half-maximal effective concentration (EC50) values measured at 84.77, 7.42, 0.89, 14.64, and 7.86 pM. All these five mAbs can be utilized in ELISA, FCA, and IFA for the detection of PEDV infection. MAb 5-F9 exhibits the highest sensitivity to detect as low as 0.3125 ng/mL of recombinant PEDV-S1 protein in ELISA, while only 0.096 ng/mL of mAb 5-F9 is required to detect PEDV in FCA. The results from antigen epitope analysis indicated that mAb 8-G2 is the sole antibody capable of recognizing linear epitopes. In conclusion, this study has yielded a highly immunogenic S1 protein and five high-affinity mAbs specifically targeting the S1 protein. These findings have significant implications for early detection of PEDV infection and provide a solid foundation for further investigation into studying virus-host interactions.
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  • 文章类型: Journal Article
    天疱疮(PF)是狗的一种自身免疫性皮肤病,其特征是表皮内脓疱中含有嗜中性粒细胞和解离的角质形成细胞,与循环和组织结合的IgG自身抗体相关。犬PF靶向桥蛋白-1(DSC1)中的IgG自身抗体子集,表皮内细胞间粘附复合物的一种成分。先前已显示,在没有浸润中性粒细胞的情况下,将IgG自身抗体从犬PF血清被动转移到小鼠会诱发皮肤病。为了确定导致中性粒细胞募集的机制,过去的研究评估了IgA自身抗体在犬PF血清中的患病率,其中<20%的受影响的狗中发现了它们。由于担心以前使用的方法的敏感性,我们重新评估了犬PF中抗DSC1IgA的患病率。我们假设抗DSC1IgA存在于大多数患有PF的狗中,但由于与并发抗DSC1IgG竞争结合其相互抗原靶标而未被检测到。尽管使用亲和层析从患者血清中去除大约80%的IgG,通过对犬DSC1转染的HEK293T细胞进行间接免疫荧光,我们未检测到抗DSC1IgA的增加.一起来看,我们的结果不支持致病性IgA在犬PF中的作用.
    Pemphigus foliaceus (PF) is an autoimmune skin disease of dogs characterized by intraepidermal pustules containing neutrophils and dissociated keratinocytes that develop in association with circulating and tissue-bound IgG autoantibodies. A subset of IgG autoantibodies in canine PF target desmocollin-1 (DSC1), a component of intercellular adhesion complexes within the epidermis. Passive transfer of IgG autoantibodies from canine PF sera to mice was previously shown to induce skin disease in the absence of infiltrating neutrophils. In attempts to identify a mechanism responsible for neutrophil recruitment, past studies evaluated the prevalence of IgA autoantibodies in canine PF sera where they were found in <20% of affected dogs. We re-evaluated the prevalence of anti-DSC1 IgA in canine PF due to concerns regarding the sensitivity of previously used methods. We hypothesized that anti-DSC1 IgA are present in most dogs with PF but have been under-detected due to competition with concurrent anti-DSC1 IgG for binding to their mutual antigenic target. Despite removing approximately 80% of IgG from patient sera using affinity chromatography, we did not detect an increase in anti-DSC1 IgA by performing indirect immunofluorescence on canine DSC1-transfected HEK293T cells. Taken together, our results do not support a role for pathogenic IgA in canine PF.
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  • 文章类型: Journal Article
    西尼罗河病毒(WNV)黄病毒科的一员,是一种新兴的蚊媒黄病毒,可在涉及中枢神经系统(CNS)的人类和动物中引起潜在的严重感染。由于其新兴趋势,WNV现在发生在其他黄病毒共同发生的许多地区。与黄病毒感染或疫苗接种的交叉反应抗体(例如,蜱传脑炎病毒(TBEV),Usutu病毒(USUV),黄热病毒(YFV),登革热病毒(DENV),因此,日本脑炎病毒(JEV))仍然是诊断黄病毒感染的主要挑战。病毒中和试验被认为是检测特异性黄病毒抗体的参考试验,但是很精致,耗时且需要生物安全3级设施。迫切需要一种简单而直接的测定,用于常规实验室的特异性WNVIgG抗体的区分和检测。在这项研究中,我们比较了两种市售的酶联免疫吸附试验(抗IgGWNVELISA和抗NS1-IgGWNV),一种市售的间接免疫荧光测定法,和新开发的用于检测WNV-NS1-IgG抗体的内部ELISA。将所有四个测试与内部NT进行比较,以确定四个测试系统的灵敏度和特异性。没有一种检测方法能与NT的特异性相匹配,尽管两种基于NS1-IgG的ELISA非常接近NT的特异性,分别为97.3%和94.6%。内部WNV-NS1-IgGELISA在灵敏度和特异性方面具有最佳性能。ELISA测定和间接免疫荧光测定的特异性不能满足必要的特异性和/或灵敏度。
    The West Nile Virus (WNV), a member of the family Flaviviridae, is an emerging mosquito-borne flavivirus causing potentially severe infections in humans and animals involving the central nervous system (CNS). Due to its emerging tendency, WNV now occurs in many areas where other flaviviruses are co-occurring. Cross-reactive antibodies with flavivirus infections or vaccination (e.g., tick-borne encephalitis virus (TBEV), Usutu virus (USUV), yellow fever virus (YFV), dengue virus (DENV), Japanese encephalitis virus (JEV)) therefore remain a major challenge in diagnosing flavivirus infections. Virus neutralization tests are considered as reference tests for the detection of specific flavivirus antibodies, but are elaborate, time-consuming and need biosafety level 3 facilities. A simple and straightforward assay for the differentiation and detection of specific WNV IgG antibodies for the routine laboratory is urgently needed. In this study, we compared two commercially available enzyme-linked immunosorbent assays (anti-IgG WNV ELISA and anti-NS1-IgG WNV), a commercially available indirect immunofluorescence assay, and a newly developed in-house ELISA for the detection of WNV-NS1-IgG antibodies. All four tests were compared to an in-house NT to determine both the sensitivity and specificity of the four test systems. None of the assays could match the specificity of the NT, although the two NS1-IgG based ELISAs were very close to the specificity of the NT at 97.3% and 94.6%. The in-house WNV-NS1-IgG ELISA had the best performance regarding sensitivity and specificity. The specificities of the ELISA assays and the indirect immunofluorescence assays could not meet the necessary specificity and/or sensitivity.
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  • 文章类型: Journal Article
    目的:囊性包虫病(CE)是由细粒棘球蚴的幼虫形式引起的。临床,放射学,病理性,和血清学结果应一起评估以诊断CE。血清学检查的敏感性和特异性可能因所用方法而异。在这项研究中,我们的目的是使用间接血凝试验(IHA)来检测特异性针对细粒大肠杆菌的IgG抗体,酶联免疫吸附测定(ELISA),间接荧光抗体(IFA)和蛋白质印迹(WB)测试。
    方法:在我们的研究中,使用两种不同的商业IHA测试研究了送往我们实验室怀疑CE的74名患者的血清样本,ELISA,IFA和WB测试。测试结果与放射学发现和组织病理学检查一起进行评估,后者是黄金标准。
    结果:在所有患者中,51(69%)为女性,23(31%)为男性。男性和女性之间存在统计学差异(χ2=9.7,p=0.002)。在74名患者中,西门子IHA的阳性率,FumouzeIHA,ELISA,IFA和WB检测阳性为33(44.6%),35(47.3%),43(58.1%),42(56.7%)和38(51.3%),分别。检测的敏感性和特异性如下:西门子IHA为66.67%和2.31%;FumouzeIHA为70.83%和96.15%;85.42%,ELISA检测为88.46%;IFA检测为83.33%和88.46%;WB检测为72.92%和88.46%。
    结论:所有五种方法之间存在统计学上的显着差异(p<0,001)。虽然特异性最高的测试是FumouzeIHA,灵敏度最高的测试是ELISA测试。结论IHA和ELISA试验因其适用性较大而在实践中更实用。
    OBJECTIVE: Cystic echinococcosis (CE) is caused by the larval form of Echinococcus granulosus. Clinical, radiologic, pathologic, and serologic findings should be evaluated together for the diagnosis of CE. The sensitivity and specificity oalf serologic tests may vary depending on the method used. In this study, we aimed to detect IgG antibodies specific to E. granulosus using indirect hemagglutination assay (IHA), enzyme-linked immunosorbent assay (ELISA), indirect fluorescent antibodies (IFA) and western blot (WB) tests.
    METHODS: In our study, the serum samples of 74 patients sent to our laboratory with suspicion of CE were studied using two different commercial IHA tests, ELISA, IFA and WB test. The test results were evaluated along with radiological findings and histopathological examinations, the latter being the gold standard.
    RESULTS: Of all the patients, 51 (69%) were female and 23 (31%) were male. There was a statistically significant difference between males and females (χ2 = 9.7, p = 0.002). Out of 74 patients, positivity rates for Siemens IHA, Fumouze IHA, ELISA, IFA and WB test were positive as 33 (44.6%), 35 (47.3%), 43 (58.1%), 42 (56.7%) and 38 (51.3%), respectively. The sensitivity and specificity of the tests were as follows: 66.67 and 2.31% for Siemens IHA; 70.83% and 96.15% for Fumouze IHA; 85.42%, and 88.46% for ELISA; 83.33% and 88.46% for IFA; 72.92% and 88.46% for WB test.
    CONCLUSIONS: There were statistically significant differences in between all five methods (p < 0,001). While the tests with the highest specificity was Fumouze IHA, the test with the highest sensitivity was the ELISA test. It was concluded that IHA and ELISA tests were more practical in practice because of their greater applicability.
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  • 文章类型: Journal Article
    背景:利用抗中性粒细胞胞浆抗体(ANCA)的间接免疫荧光测定(IIFA)被广泛用作自身免疫性血管炎的诊断测试。抗核抗体(ANA)的存在可能导致对ANCA的误导性解释。本研究旨在探讨ANA的存在对ANCA解释的影响。
    方法:这项回顾性研究通过IIFA检查了抗MPO和抗PR3ANCA阴性的样本,并探讨了ANA-IIFA结果与ANCA解释频率之间的相关性。我们的分析涉及使用合适的统计方法,包括卡方和卡帕统计。
    结果:当使用乙醇固定底物时,高达75.2%的ANCA-IIFA阳性样品表现出阳性p-ANCA模式,c-ANCA阳性率为24.8%。在ANA-IIFA阳性样本中,约77.3%在乙醇固定的底物上显示p-ANCA图案。ANA-IIFA滴度和p-ANCA结果的比较表明,p-ANCA阳性在滴度较高的样品中更为常见。发现这种相关性具有统计学意义。
    结论:IIFA测试的ANA阳性结果与p-ANCA解释的发生率更高有关,特别是在具有较高滴度模式的情况下。这种见解有助于实验室建立有效的工作流程来调查潜在的p-ANCA干扰。
    BACKGROUND: The indirect immunofluorescence assay (IIFA) utilizing antineutrophil cytoplasmic antibodies (ANCA) is widely used as a diagnostic test for autoimmune vasculitis. The presence of antinuclear antibodies (ANA) might lead to a misleading interpretation of ANCA. This study aims to explore the impact of the presence of ANA on the interpretation of ANCA.
    METHODS: This retrospective research examined samples negative for antiMPO and antiPR3 ANCA by IIFA and explored correlations between the ANA-IIFA results and the ANCA interpretation frequencies. Our analysis involved the use of suitable statistical methods, including Chi-square and kappa statistics.
    RESULTS: Up to 75.2% of the ANCA-IIFA-positive samples exhibited a positive p-ANCA pattern when using the ethanol-fixed substrate, with c-ANCA positivity at 24.8%. In the ANA-IIFA-positive samples, ~77.3% displayed p-ANCA patterns on ethanol-fixed substrates. A comparison between the ANA-IIFA titers and the p-ANCA results revealed that p-ANCA positivity was notably more common in samples with higher titers, and this correlation was found to be statistically significant.
    CONCLUSIONS: Positive ANA results by IIFA tests are linked to a higher incidence of p-ANCA interpretation, particularly in cases with higher titer patterns. This insight aids laboratories in establishing effective workflows to investigate potential p-ANCA interference.
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  • 文章类型: Journal Article
    在使用HEp-2细胞间接免疫荧光测定(HEp-2-IFA)进行自身抗体测试的日常实验室常规中,模式的组合是常见且具有挑战性的情况。最近,巴西自身抗体共识(BCA)将这些组合命名为复杂模式(CP),并将它们组织成3个亚型:多个,混合,和复合材料。本研究旨在根据该新命名法描述HEp-2-IIF模式的最常见组合。
    使用新的BCA分类审查了2017年1月和6月报告的常规HEp-2-IFA结果。由专家对HEp-2-IFA读数进行视觉模式识别,使用国际抗核抗体共识(ANA)模式(ICAP)和BCA建议。
    对来自不同患者的54,990份血清样本进行了ANA-HEp-2检测,滴度≥1/80时11,478份(20.9%)为阳性。在这些阳性样本中,1,111(9.7%)显示CP,分为95种不同的组合。在儿科年龄组中观察到较高比例的CP。多个,混合,和复合图案存在于85.3、5.4和9.5%的样品中,分别。在多重/混合模式组中(n=1,005),双,三重,在97.7%中观察到四重组合(ICAP/BCA代码),2.2%,和0.1%,分别。双核模式是观察到的最普遍的组合(67.6%)。最常见的注册CP是AC-4(核细小斑点)AC-6,7(核离散点)(n=264);AC-2(核致密细斑点)AC-6,7(n=201);AC-4AC-8,9,10(核仁)(n=129);和AC-3(着丝粒)AC-4(n=124)。所有这些组合都在多个亚组中。
    在HEp-2程序中几乎有10%的阳性结果显示了CP。在提出的3种CP亚型中,多重模式是最普遍的,尤其是在儿科人群中。AC-4、AC-2和AC-6,7是在本研究中描述的组合中观察到的最普遍的单一模式。年龄与大多数合并模式的患病率之间存在显着关联。AC-4+AC-6,7组合是检测到的最普遍的复杂模式,与年龄组无关。AC-2+AC-6,7在年轻人中更为普遍。CPs定义中涉及的概念应该为HEp-2-IIF测定的阅读和解释增加价值。
    The combination of patterns is a frequent and challenging situation in the daily laboratory routine of autoantibodies testing using HEp-2 cells indirect immunofluorescence assay (HEp-2-IFA). Recently, the Brazilian Consensus on Autoantibodies (BCA) named these combinations as complex patterns (CPs) and organized them into 3 subtypes: multiple, mixed, and composite. This study aimed to describe the most frequent combinations of HEp-2-IIF patterns according to this new nomenclature.
    Routine HEp-2-IFA results reported in January and June 2017 were reviewed using the new BCA classification. Visual pattern recognition was performed by experts on HEp-2-IFA readings, using the International Consensus on Antinuclear Antibodies (ANA) Patterns (ICAP) and BCA recommendations.
    54,990 serum samples from different patients were tested for ANA-HEp-2, and 11,478 (20.9%) were positive at a titer ≥ 1/80. Among these positive samples, 1,111 (9.7%) displayed CPs, divided into 95 different combinations. A higher proportion of CPs was observed in the pediatric age group. Multiple, mixed, and composite patterns were present in 85.3, 5.4, and 9.5% of the samples, respectively. In the multiple/mixed pattern group (n=1,005), double, triple, and quadruple combinations (ICAP/BCA codes) were observed in 97.7%, 2.2%, and 0.1%, respectively. The double nuclear pattern was the most prevalent combination observed (67.6%). The most common CPs registered were AC-4 (nuclear fine speckled) + AC-6,7 (nuclear discrete dots) (n=264); AC-2 (nuclear dense fine speckled) + AC-6,7 (n=201); AC-4+AC-8,9,10 (nucleolar) (n=129); and AC-3 (centromere)+AC-4 (n=124). All of these combinations were in the multiple subgroup.
    Almost 10% of positive results in the HEp-2 procedure displayed CPs. Among the 3 subtypes of CPs proposed, the multiple pattern was the most prevalent, especially in the pediatric population. The AC-4, AC-2, and AC-6,7 were the most prevalent single patterns observed in the combinations described in this study. There was a significant association between age and the prevalence of most combined patterns. The AC-4+AC-6,7 combination was the most prevalent complex pattern detected regardless of the age group. The AC-2+AC-6,7 was more prevalent in younger individuals. The concepts involved in the CPs definition should add value to the reading and interpretation of the HEp-2-IIF assay.
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  • 文章类型: Journal Article
    稀有抗核抗体(ANA)模式识别已成为临床实验室常规ANA筛查的广泛应用技术。近年来,深度学习方法在识别ANA模式中的应用取得了显著进步。然而,该领域的大多数研究主要集中在最常见的ANA模式的分类上,而另一个子集则集中在有丝分裂中期细胞的检测上。迄今为止,以前没有专门研究鉴定罕见的ANA模式.在本论文中,我们介绍了一个新颖的基于注意力的增强框架,设计用于识别ANA-间接免疫荧光图像中的罕见ANA模式。更具体地说,通过对比实验选择性能最好的算法作为目标检测网络。然后,我们通过一系列优化进一步开发和增强了所选的算法。然后,引入了注意力机制,以促进神经网络加快学习过程,为属于特定模式的目标特征提取更多的本质特征和特色特征。所提出的方法有助于获得86.40%的高精度,82.75%召回,在我们的数据集上,9类稀有ANA模式检测任务的平均精度为84.24%F1得分和84.64%。最后,我们评估了该模型作为医疗技术专家助理的潜力,并观察到技术专家在参考模型预测结果后的表现有所改善。这些有希望的结果突显了其作为帮助医疗技术人员进行临床实践的有效可靠工具的潜力。
    Rare antinuclear antibody (ANA) pattern recognition has been a widely applied technology for routine ANA screening in clinical laboratories. In recent years, the application of deep learning methods in recognizing ANA patterns has witnessed remarkable advancements. However, the majority of studies in this field have primarily focused on the classification of the most common ANA patterns, while another subset has concentrated on the detection of mitotic metaphase cells. To date, no prior research has been specifically dedicated to the identification of rare ANA patterns. In the present paper, we introduce a novel attention-based enhancement framework, which was designed for the recognition of rare ANA patterns in ANA-indirect immunofluorescence images. More specifically, we selected the algorithm with the best performance as our target detection network by conducting comparative experiments. We then further developed and enhanced the chosen algorithm through a series of optimizations. Then, attention mechanism was introduced to facilitate neural networks in expediting the learning process, extracting more essential and distinctive features for the target features that belong to the specific patterns. The proposed approach has helped to obtained high precision rate of 86.40%, 82.75% recall, 84.24% F1 score and 84.64% mean average precision for a 9-category rare ANA pattern detection task on our dataset. Finally, we evaluated the potential of the model as medical technologist assistant and observed that the technologist\'s performance improved after referring to the results of the model prediction. These promising results highlighted its potential as an efficient and reliable tool to assist medical technologists in their clinical practice.
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