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Clinical Chemistry and Laboratory Medicine (CCLM)

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Volume 57, Issue 11


Only monospecific anti-DFS70 antibodies aid in the exclusion of antinuclear antibody associated rheumatic diseases: an Italian experience

Maria Infantino
  • Corresponding author
  • SOS Laboratorio Immunologia e Allegologia Ospedale S. Giovanni di Dio Firenze, Florence, Italy
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Francesca Pregnolato
  • Istituto Auxologico Italiano, IRCCS, Experimental Laboratory of Immunorheumatology, Cusano Milanino, Milan, Italy
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Chelsea Bentow / Michael Mahler / Maurizio Benucci / Francesca Li Gobbi / Arianna Damiani / Valentina Grossi
  • SOS Laboratorio Immunologia e Allegologia Ospedale S. Giovanni di Dio Firenze, Florence, Italy
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Franco Franceschini / Caterina Bodio
  • Istituto Auxologico Italiano, IRCCS, Experimental Laboratory of Immunorheumatology, Cusano Milanino, Milan, Italy
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Maria Orietta Borghi
  • Istituto Auxologico Italiano, IRCCS, Experimental Laboratory of Immunorheumatology, Cusano Milanino, Milan, Italy
  • Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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  • De Gruyter OnlineGoogle Scholar
/ Mariangela Manfredi
  • SOS Laboratorio Immunologia e Allegologia Ospedale S. Giovanni di Dio Firenze, Florence, Italy
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2019-07-18 | DOI: https://doi.org/10.1515/cclm-2019-0454



The dense fine speckled (DFS) is one of the most common patterns that can be observed as a result of the anti-nuclear antibodies (ANA) test on HEp-2 cells and is mostly caused by antibodies to DFS70 as the main antigenic target. As was recently demonstrated, isolated anti-DFS70 positivity can be used as an aid in the exclusion of ANA associated rheumatic diseases (AARD) due to the opportunity to better interpret unexplained positive IIF ANA results.


Our study included 333 subjects with AARD, 51 undifferentiated connective tissue disease (UCTD) patients, 235 disease controls and 149 healthy blood donors from an Italian cohort. All samples were tested for anti-DFS70 and anti-ENA antibodies using QUANTA Flash assays (Inova Diagnostics, San Diego, CA, USA).


No differences in the prevalence of anti-DFS70 antibodies were seen among AARD, non-AARD and UCTD (2.1% [7/333] vs. 2.3% [9/384] vs. 5.9% [3/51], respectively; p-value = 0.188). AARD patients positive for anti-DFS70 antibodies showed in all cases an accompanying anti-ENA specificity. In contrast, monospecific anti-DFS70 antibodies showed a significantly different distribution with a clear trend across the main groups (AARD vs. non-AARD vs. UCTD: 0% [0/7] vs. 22% [2/9] vs. 100% [3/3], p = 0.007). Anti-DFS70 antibody levels among AARD, non-AARD and UCTD patients were not significantly different (p = 0.094). Within the anti-DFS70 antibody positive cases, AARD cohort showed a higher variability (median [min–max]: 3.2 [3.2–450.8] CU) compared to non-AARD (median [min–max]: 3.2 [3.2–75.7] CU) and UCTD patients (median [min–max]: 3.2 [3.2–59.0] CU).


Our preliminary data showed a similar frequency of anti-DFS70 antibodies in AARD, UCTD and non-AARD cohorts. Monospecificity of anti-DFS70 antibodies but not their mere presence is the key element in the diagnostic algorithm. Mono-specific anti-DFS70 antibodies might be a helpful biomarker to discriminate individuals with AARD from non-AARD presenting with a positive ANA.

Keywords: antinuclear antibodies; autoantibodies; autoimmune disease; DFS


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About the article

Corresponding author: Dr. Maria Infantino, SOS Laboratorio Immunologia e Allegologia Ospedale S. Giovanni di Dio Firenze, Florence, Italy, Phone: +390556932502, Fax: +390556932289

Received: 2019-04-30

Accepted: 2019-06-18

Published Online: 2019-07-18

Published in Print: 2019-10-25

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 57, Issue 11, Pages 1764–1769, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2019-0454.

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