Extended report
Performance of two ELISAs for antifilaggrin autoantibodies, using
either affinity purified or deiminated recombinant human filaggrin, in
the diagnosis of rheumatoid arthritis
L Nogueiraa, M Sebbaga, C Vincenta, M Arnaudb, B Fourniéc, A Cantagreld, M Jolivetb, G Serrea
a Department of
Biology and Pathology of the Cell, Institut National de la Santé et
de la Recherche Médicale (CJF 96-02), Toulouse-Purpan School of
Medicine, University of Toulouse III (IFR Claude de Préval,
INSERM
CNRSUPS - CHU), France, b Department of
Immunoassays, bioMérieux, Marcy l'Étoile, France, c Department of Rheumatology,
Purpan hospital, Toulouse, France, d Department
of Rheumatology, Rangueil hospital, Toulouse, France
Correspondence to: Professor G Serre, Laboratoire de Biologie Cellulaire et Cytologie, CHU Purpan, Place du Dr Baylac, 31059 Toulouse cedex France serre.g{at}chu-toulouse.fr
Accepted for publication 9 February
2001
OBJECTIVETo develop a
standardisable enzyme linked immunosorbent assay (ELISA), using human
filaggrin, for detection of antifilaggrin autoantibodies in rheumatoid
arthritis (RA). To compare the diagnostic performance of the ELISA with
those of reference tests: "antikeratin antibodies" ("AKA"), and
antibodies to human epidermis filaggrin detected by immunoblotting
(AhFA-IB).
METHODSTwo ELISAs
were developed using either affinity purified neutral-acidic human
epidermis filaggrin (AhFA-ELISA-pur) or a recombinant human filaggrin
deiminated in vitro (AhFA-ELISA-rec) as immunosorbent. Antifilaggrin
autoantibodies were assayed in 714 serum samples from patients with
well characterised rheumatic diseases, including 241 RA and 473 other
rheumatic diseases, using the two ELISAs. "AKA" and AhFA-IB tests
were carried out in the same series of patients. The diagnostic
performance of the four tests was compared and their relationships analysed.
RESULTSThe titres of
"AKA", AhFA-IB, and the AhFA-ELISAs correlated strongly with each
other. The diagnostic sensitivity of the AhFA-ELISA-rec, which was
better than that of AhFA-ELISA-pur, was 0.52 for a specificity of 0.95. This performance was similar to those of "AKA" or AhFA-IB. However,
combining AhFA-ELISA-rec with AhFA-IB led to a diagnostic sensitivity
of 0.55 for a specificity of 0.99.
CONCLUSIONA simple
and easily standardisable ELISA for detection of antifilaggrin
autoantibodies was developed and validated on a large series of
patients using a citrullinated recombinant human filaggrin. The
diagnostic performance of the test was similar to that of the "AKA"
and AhFA-IB. Nevertheless, combining the AhFA-ELISA-rec with one of the
other tests clearly enhanced the performance.
© 2001 by Annals of the Rheumatic Diseases
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