Working Algorithms and Detection Methods of Autoantibodies in Autoimmune Liver Disease: A Nationwide Study

Diagnostics

on behalf of the 2020 GEAI-SEI Workshop Participants¹  Albert Pérez-Isidro²  Estíbaliz Ruiz-Ortiz²  Guillermo Muñoz-Sánchez²  Luz Yadira Bravo-Gallego²  Iñaki Ortiz de Landazuri²  Odette Viñas²  Antonio López-Gómez³  Maria Rosa Julià³  Milagros Garcia-Ormaechea⁴ 

[1] ;Department of Immunology, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Villarroel 170-Escala 4, Planta 0, 08036 Barcelona, Spain;Department of Immunology, Hospital Universitari Son Espases, 07120 Palma de Mallorca, Spain;Lime Tree Surgery NHS, Worthing BN14 0DL, UK;

关键词: autoimmune hepatitis;    autoimmune liver diseases;    autoantibodies;    indirect immunofluorescence assays;    antigen-specific techniques;    primary biliary cholangitis;   

DOI  :  10.3390/diagnostics12030697

来源: DOAJ

【 摘 要 】

Autoantibody detection is the cornerstone of autoimmune liver diseases (AILD) diagnosis. Standardisation of working algorithms among autoimmunity laboratories, as well as being aware of the sensitivity and specificity of various commercial techniques in daily practice, are still necessary. The aim of this nationwide study is to report the results of the 2020 Autoimmunity Workshop organised by the Autoimmunity Group of the Spanish Society of Immunology and to provide useful information to clinicians and laboratory specialists to improve the management of autoantibody detection in AILD diagnoses. Serum samples from 17 patients with liver diseases were provided by the organisers of the 2020 Autoimmunity Workshop and were subsequently analysed by the 40 participating laboratories. Each laboratory used different techniques for the detection of autoantibodies in each patients’ serum sample, according to their working algorithm. Thus, almost 680 total complete patient reports were obtained, and the number of results from different autoantibody detection techniques was >3000. Up to eight different working algorithms were employed, including indirect immunofluorescence assays (IFA) and antigen-specific techniques (AgST). The IFA of HEp-2 cells was more sensitive than IFA of rat triple tissue for the study of anti-nuclear autoantibodies (ANA) associated with AILD. The IFA of a human neutrophil study for the analysis of anti-neutrophil cytoplasmic autoantibodies was not carried out systemically in all patients, or by all laboratories. AgSTs were the most sensitive methods for the detection of anti-smooth muscle/F-actin, soluble liver antigen, liver cytosol-1, M2-mitochondrial autoantibodies, and ANA associated with primary biliary cholangitis. The main differences in AMA detection were due to patients with autoantibodies against the non-dominant epitope of pyruvate dehydrogenase complex. Given that they are complementary, IFA and AgST should be performed in parallel. If there is high suspicion of AILD, AgST should always be performed.

【 授权许可】

Unknown