Korean J Lab Med.  2008 Oct;28(5):353-361. 10.3343/kjlm.2008.28.5.353.

Detection of Anti-ENA and anti-dsDNA Antibodies Using Line Immunoassay in Systemic Autoimmune Diseases

• Kim JM
• Ihm CH
• Sin DH
• Ihm MK
• Sim SC

• KMID: 1781567
• DOI: http://doi.org/10.3343/kjlm.2008.28.5.353

Abstract

BACKGROUND: Detection of antibodies to extractable nuclear antigens (ENAs) and dsDNA is needed for the diagnosis of and predicting prognosis in systemic autoimmune diseases. Recently introduced line immunoassay (LIA) has the advantage of detecting several autoantibodies simultaneously, and we evaluated its usefulness in the diagnosis of autoimmune diseases in comparison with enzyme-linked immunosorbent assay (ELISA).
METHODS
Samples were collected from 437 patients referred by rheumatologists. FANA (fluorescent antinuclear antibody) test and LIA for the detection of 13 different autoantibodies, including 6 ENAs and dsDNA were performed. LIA-positive samples for ENA or dsDNA antibodies were further tested with ELISA. Final diagnosis was made by rheumatologists according to the diagnostic criteria. Agreement of results between LIA and ELISA was analyzed in 53 selected patients with systemic autoimmune diseases.
RESULTS
The LIA detected antibodies to ENA and dsDNA in 118 and 22 patients, respectively, and ELISA detected 70.3% (83/118) and 45.5% (10/22) of LIA positive samples. Especially, 60.2% (71/118) of patients with positive ENA antibody on LIA was diagnosed as systemic autoimmune diseases. Patients having strong FANA titer and homogenous/speckled pattern showed higher prevalence of autoantibodies, but a small proportion of FANA negative patients also showed positive reactivity (LIA 10.8%, ELISA 5.2%). LIA showed a good agreement with ELISA for the anti-ENA antibodies (> or =80%), and a lower agreement for the anti-dsDNA antibody (67.9%).
CONCLUSIONS
LIA detecting several autoantibodies simultaneously might replace ELISA for anti-ENA antibodies, but not for anti-dsDNA antibodies. When LIA is performed considering clinical manifestations and FANA, it could contribute to the diagnosis of systemic autoimmune disease.

Keyword

Autoimmune disease; Anti-ENA antibody; Anti-dsDNA antibody; Line immunoassay

MeSH Terms

Antibodies, Antinuclear/*analysis
Antigens, Nuclear/immunology
Autoimmune Diseases/*diagnosis
DNA/*immunology
Enzyme-Linked Immunosorbent Assay
Female
Fluorescent Antibody Technique, Indirect
Humans
*Immunoassay
Male
Middle Aged
Reagent Kits, Diagnostic
Reproducibility of Results

Figure

• 

  Fig. 1. Results of fluorescent ANA (FANA), line immunoassay (LIA) and enzyme linked immunosorbent assay (ELISA) for anti-extractable nuclear antigen (ENA) antibodies in 437 patients. Numbers in parentheses represent the number of patients with systemic autoimmune diseases.

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