Welcome to the Autoimmunity 2021 Congress Calendar
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MULTI-ANALYTE DETECTION PAIRED WITH AUGMENTED INTELLIGENCE ENHANCE PRECISION MEDICINE IN AUTOIMMUNITY
PERSONALIZED MEDICINE IN RHEUMATOID ARTHRITIS (RA)
AUTOANTIBODIES AND THE P-VALUE MATRIX
PREDICTIVE VALUE OF AUTOANTIBODIES IN RHEUMATOID ARTHRITIS (RA)
NEW TECHNOLOGIES FOR ANTI-DSDNA ANTIBODIES DETECTION: THERE IS STILL NEED OF HARMONIZATION
Abstract
Background and Aims
Anti-double stranded DNA antibodies (anti-dsDNA) are considered a specific marker for SLE. Although the Farr technique has been considered the “gold standard” for their detection, currently it has been replaced by numerous newly developed assays. However, there is still no solid evidence of the equivalence of these methods in terms of diagnostic accuracy and of their correlation with the Crithidia luciliae immunofluorescence test (CLIFT).
Methods
Anti-dsDNA antibody levels were measured in 60 patients suffering from different connective tissue diseases, and in 20 diseased controls using four different immunoassays (fluorescence enzyme immunoassay, microdot array, chemiluminescent immunoassay, multiplex flow immunoassay) and by two CLIFT methods.
Results
Average agreement among methods for positive/negative results assessed by the Cohen’s Kappa was 0.71, ranging from moderate to almost perfect (0.53-0.92) (Table1).
Conclusions
Despite good individual performance, new technologies for anti-dsDNA antibody detection are not fully comparable. In particular, their different correlation with CLIFT influences their positioning in the diagnostic algorithm for SLE (either in association or sequentially). Considering the high inter-method variability, harmonization of anti-dsDNA antibody testing remains an unachieved goal.
FAST TRACK ALGORITHM: HOW TO DIFFERENTIATE A "SCLERODERMA PATTERN" FROM A "NON-SCLERODERMA PATTERN"
Abstract
Background and Aims
This study was designed to propose a simple “Fast Track algorithm” (Figure 1) for worldwide capillaroscopists of any level of experience to differentiate “scleroderma patterns” from “non-scleroderma patterns” on capillaroscopy (Figure 2) and to assess its inter-rater reliability.
Methods
Based on existing definitions to categorise capillaroscopic images as “scleroderma patterns” and taking into account the real life variability of capillaroscopic images described standardly according to the EULAR Study Group on Microcirculation in Rheumatic Diseases (EULAR SG MC/RD), a fast track decision tree, the “Fast Track algorithm” was created by the principal expert (VS) to facilitate swift categorisation of an image as “non-scleroderma pattern (category 1)” or “scleroderma pattern (category 2)”. Mean inter-rater reliability between all raters (experts/attendees) of the 8th EULAR capillaroscopy course (Genoa, 2018) and, as external validation, of the 8th EUSTAR course on systemic sclerosis (SSc) (Nijmegen, 2019) versus the principal expert, as well as reliability between the rater pairs themselves was assessed by mean Cohen’s and Light’s kappa coefficients.
Results
Mean Cohen’s kappa was 1/0.96 for the 6 experts/135 attendees of the 8th EULAR capillaroscopy course and 1/0.94 for the 3 experts/85 attendees of the 8th EUSTAR SSc course. Light’s kappa was 1/0.92 at the 8th EULAR capillaroscopy course, and 1/0.87 at the 8th EUSTAR SSc course.
Conclusions
For the first time, a clinical expert based fast track decision algorithm has been developed to differentiate a “non-scleroderma” from a “scleroderma pattern” on capillaroscopic images, demonstrating excellent reliability when applied by capillaroscopists with varying levels of expertise versus the principal expert.
A UNIQUE TECHNOLOGY FOR THE SEROLOGICAL DIAGNOSTICS OF ANTI-DFS70 ANTIBODIES
Abstract
Background and Aims
The immunofluorescence assay is the gold standard for the screening of antinuclear antibodies (ANA) for the serological diagnosis of systemic autoimmune rheumatic diseases (SARD). In this context, the diagnostic value of anti-lens epithelium-derived growth factor antibodies also referred to as anti-dense fine speckled 70 antibodies (anti-DFS70) due to the corresponding dense fine speckled pattern in ANA fluorescence test has been discussed recently. Anti-DFS70 appear to have the potential to discriminate SARD from non-SARD patients. Monospecific anti-DFS70 are characteristic for non-SARD patients whereas the occurrence or concurrence of other ANA is typical for SARD. The CytoBead technology offers a unique opportunity to simultaneously analyze ANA and anti-DFS70.
Methods
One hundred human sera (50 healthy blood donors [BD], 50 anti-DFS-70 positives, pre-characterized with chemiluminescence immunoassay [CLIA]) were tested in the CytoBead ANA+anti-DFS70 assay. Results were compared to data obtained by line immunoassay (LIA; ANA 18 LINE).
Results
The method comparison showed a very good agreement between CytoBead ANA+anti-DFS70 and LIA, CytoBead ANA+anti-DFS70 and CLIA as well as LIA and CLIA (Cohen’s kappa 0.953, 0.976, 0.959, respectively). Furthermore, the fluorescent ANA pattern on HEp-2 cells showed very good agreement with the specific anti-DFS70 [Cohen’s kappa 0.952]. Five out of 50 sera tested anti-DFS70 positive with CLIA showed multiple dots or cytoplasmic mixed ANA patterns. These findings were confirmed with LIA.
Conclusions
The novel CytoBead ANA+anti-DFS70 assay enables the simultaneous analysis of ANA and anti-DFS70 in human sera. This can increase the specificity of ANA screening by immunofluorescence test.