Fluorescence intensity of anti—nuclear antibodies patterns on anti—extractable nuclear antigens detection
Keywords:
anti-nuclear antibodies, Fluorescence intensity, anti-extractable nuclear antigensAbstract
OBJECTIVE
To provide assistive information for diagnosis of patients with autoantibodies.
METHODS
This study reviewed laboratory records of patients who were suspected of autoimmune diseases by clinicians and underwent ANA and anti—ENA tests at Khon Kaen Hospital, Thailand, from January 2012 to January 2016. 543 anti—ENA results with positive ANA were analyzed. Anti—ENA test was used to identify a group of specific autoantibodies, including anti—RNP, anti—Sm, anti—SSA, anti—Ro52, anti—SSB and anti—Scl70 antibodies.
RESULTS
The detection rate of anti—ENA antibodies in ANA positive serum samples was 66.1% (95% confidence interval (CI); 62 to 70). ANA patterns of homogeneous and fine speckled types with high fluorescence intensities from 3+ to 4+ showed 23.4%—35.9% of anti—SSA and anti—Ro52 antibodies detection. Meanwhile, the coarse speckle 3+ to 4+ could detect anti—SSA and anti—Ro52 antibodies by up to 50.0%—63.6% and started to detect anti—Sm antibody by 18.8% and 33.8%. Moreover, the coarse speckle 4+ showed 66.2% of anti—RNP and 20.8% of anti—SSB antibodies detection. Nucleolar 4+ showed the highest detection rate of anti—Scl70 antibody at 77.8%. Similar tendency of anti—Scl70 antibody detection could be found from low to high intensities of fine speckled and homogeneous patterns, which usually show up in mix patterns. Centromere pattern 4+ showed 10.5%—26.3% of anti—SSA, anti—Ro52, anti—SSB and anti—Scl70 antibodies detection. At low fluorescence intensities, fine speckled 1+ and homogeneous 1+ (titer 1:100) could detect anti—SSA antibody with highest probability of 17.5% and 13.5%, respectively. The coarse speckle 1+ also showed 5.6% of anti—SSA, anti—Ro52 and anti—SSB antibodies detection, while speckle 2+ had the increasing rate of anti—SSA, anti—Ro52 and anti—RNP antibodies detection from 15.1% to 33.3%.
CONCLUSION
The tendency of detection of some specific anti—ENA antibodies can be roughly estimated as the fluorescence intensity is 3+ or above. However, low intensities 2+ or below do not rule out the expected anti—ENA antibodies related to clinical diagnosis.
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