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Screening Tests for Antinuclear Antibodies (ANA): Selective Use of Central Nuclear Antigens as a Rational Basis for Screening by ELISA

https://doi.org/10.1006/jaut.1999.0295Get rights and content

Abstract

Rational, fully automated ELISA screening tests for ANA have become accessible for routine use. Full length, recombinant or purified naturally expressed antigens can be selected to deliver well defined screening tests, designed to detect ANAs of established clinical significance, while unknown specificities with no clear biological impact are omitted. By comparing results of ANA screening by immunofluorescence (IIF) on tissue section with HEp-2 cells, a correlation of 88% was revealed, while 86% of HEp-2-positive sera bound tissue sections. Eighty-nine percent of HEp-2 ANA-positive sera bound in ANA ELISA I. Seventy-five percent of ANAs detected in ELISA I also bound in ELISA II. These correlations were statistically significant. ANAs detected in ANA ELISA I were all detected upon retesting in both ANA screening ELISA systems, and also by antigen-specific ELISAs. Specific ANAs defined by ELISA, immunodiffusion or Crithidia tests were detected in both ANA ELISA tests. These data demonstrate that most ANAs detected by immunofluorescence tests contain a dominating repertoire of specificities covered by the ANA ELISA systems. The sensitivity of the different ELISA tests can easily be adjusted to internationally defined consensus levels, and screening for ANA using both ELISA systems detects expected ANA specificities in ongoing international quality assessment programs.

References (24)

  • E.M. Tan

    Antinuclear antibodies: diagnostic markers for autoimmune diseases and probes for cell biology

    Adv. Immunol.

    (1989)
  • I. Cohen et al.

    Autoimmunity, microbial immunity, and the immunological homunculus

    Immunol. Today.

    (1991)
  • M.B. Oldstone

    Molecular mimicry and immune-mediated diseases

    FASEB J.

    (1998)
  • L.R. Haaheim et al.

    Serum antibodies from patients with Sjøgren's syndrome and systemic lupus erythematosus recognize multiple epitopes on the La (SS-B) autoantigen resembling viral sequences

    Scand. J. Immunol.

    (1996)
  • U. Moens et al.

    In vivo expression of a single viral DNA-binding protein generates systemic lupus erythematosus-related autoimmunity to double-stranded DNA and histones

    Pro. Natl. Acad. Sci. USA

    (1995)
  • O.P. Rekvig et al.

    Experimental expression in mice and spontaneous expression in human SLE of polyomavirus T-antigen: a molecular bases for induction of antibodies to DNA and eukaryotic transcription factors

    J. Clin. Invest.

    (1997)
  • X. Dong et al.

    Initiation of autoimmunity to the p53 tumor suppressor protein by complexes of p53 and SV40 large T antigen

    J. Exp. Med.

    (1994)
  • D.M. Klinman et al.

    Systemic autoimmune disease arise from polyclonal B cell activation

    J. Exp. Med.

    (1987)
  • C. Mohan et al.

    Nucleosome: a major immunogen for pathogenic autoantibody-inducing T cells of lupus

    J. Exp. Med.

    (1993)
  • A. Desai-Mehta et al.

    Structure and specificity of T cell receptors expressed by potentially pathogenic anti-DNA autoantibody-inducing T cells in human lupus

    J. Clin. Invest.

    (1995)
  • W.J. van Venrooij

    Autoantigens in connective tissue diseases

  • O.P. Rekvig et al.

    Anti-DNA antibodies — towards an understanding of their origin and pathophysiological impact

    Scand. J. Rheum.

    (1998)
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    Correspondence to: Ole Petter Rekvig, Department of Molecular Genetics, Institute of Medical Biology, University of Tromsø, N-9037 Tromsø, Norway. E-mail:[email protected]

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