Four anti-dsDNA antibody assays in relation to systemic lupus erythematosus disease specificity and activity
2014 (English)Manuscript (preprint) (Other academic)
Objective. Analysis of antibodies against double-stranded (ds) DNA is an important diagnostic tool for systemic lupus erythematosus (SLE), and changes in anti-dsDNA antibody levels are also used to assess disease activity. Herein, four assays were compared with regard to SLE specificity, sensitivity and disease activity variables.
Methods. Cross-sectional sera from 178 SLE patients, of which 18 were followed consecutively, from a regional Swedish SLE register were analyzed for IgG anti-dsDNA by a bead-based multiplex assay (FIDIS, Theradiag), a fluoroenzyme-immunoassay (EliA, Phadia/Thermo Fisher Scientific), the Crithidia luciliae immunofluorescence test (CLIFT, ImmunoConcepts) and lineblot (Euroline, Euroimmun). All SLE patients fulfilled the 1982 American College of Rheumatology and/or the 2012 Systemic Lupus International Collaborating Clinics classification criteria. Healthy individuals (n=100), patients with early rheumatoid arthritis (n=95), and primary Sjögren’s syndrome (n=54) served as controls.
Results. CLIFT had the highest SLE specificity (98%), whereas EliA had the highest sensitivity (35%). All methods correlated significantly with each other (rho≥0.41), but FIDIS and CLIFT had the highest concordance (84%). FIDIS performed best regarding association with disease activity in cross-sectional as well as in consecutive samples. Fisher’s exact test revealed differences between methods regarding associations with certain manifestations.
Conclusion. The present study reveals considerable differences between the anti-dsDNA assays. Since CLIFT had the highest disease specificity, but a mediocre correlation with disease activity, and FIDIS showed the highest association with activity, but a poor specificity, we suggest the use of CLIFT as a diagnostic tool, and FIDIS as an instrument for monitoring disease activity in SLE.
Place, publisher, year, edition, pages
Systemic lupus erythematosus, anti-dsDNA, disease activity, disease specificity, disease sensitivity, immunoassay, autoantibodies, inflammation, rheumatoid arthritis, primary Sjögren’s syndrome
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-105503OAI: oai:DiVA.org:liu-105503DiVA: diva2:707763