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Journal of Laboratory Medicine

Official Journal of the German Society of Clinical Chemistry and Laboratory Medicine

Editor-in-Chief: Schuff-Werner, Peter

Ed. by Ahmad-Nejad, Parviz / Bidlingmaier, Martin / Bietenbeck, Andreas / Conrad, Karsten / Findeisen, Peter / Fraunberger, Peter / Ghebremedhin, Beniam / Holdenrieder, Stefan / Kiehntopf, Michael / Klein, Hanns-Georg / Kohse, Klaus P. / Kratzsch, Jürgen / Luppa, Peter B. / Meyer, Alexander von / Nebe, Carl Thomas / Orth, Matthias / Röhrig-Herzog, Gabriele / Sack, Ulrich / Steimer, Werner / Weber, Thomas / Wieland, Eberhard / Winter, Christof / Zettl, Uwe K.


IMPACT FACTOR 2018: 0.389

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2567-9430
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Volume 38, Issue 6

Issues

DFS70-Antikörper – Biomarker zum Ausschluss ANA-assoziierter rheumatischer Erkrankungen

DFS70 antibodies – biomarker for exclusion of ANA associated rheumatic diseases

Karsten Conrad
  • Corresponding author
  • Institut für Immunologie, Medizinische Fakultät der Technischen Universität Dresden, Dresden, Deutschland
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  • De Gruyter OnlineGoogle Scholar
/ Nadja Röber
  • Institut für Immunologie, Medizinische Fakultät der Technischen Universität Dresden, Dresden, Deutschland
  • Other articles by this author:
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/ Sebastian Rudolph / Michael Mahler
Published Online: 2014-12-02 | DOI: https://doi.org/10.1515/labmed-2014-0042

Zusammenfassung

Trotz aller Fortschritte bei der Etablierung spezifischer Autoantikörperassays ist das Screening auf antinukleäre Antikörper (ANA) mittels indirekter Immunfluoreszenz an HEp-2-Zellen für eine qualitätsgerechte Labordiagnostik von ANA-assoziierten rheumatischen Erkrankungen (AARE) weiterhin unabdingbar. Mit den Erkenntnissen zur Relevanz von DFS-Mustern und DFS70-Antikörpern eröffnen sich neue Möglichkeiten zur Optimierung der serologischen Stufendiagnostik bei Verdacht auf AARE. Das dicht-feingranuläre („dense fine speckled“, DFS) ANA-Muster ist relativ gut von den klassischen, mit dsDNA-Antikörpern assoziierten „homogenen“ ANA-Mustern differenzierbar. Die wichtigste bei diesem Muster nachweisbare ANA-Spezifität ist der DFS70-Antikörper (Synonym: LEDGF-Antikörper). Dieser Antikörper ist auch die häufigste bei ANA-positiven gesunden Personen nachweisbare ANA-Spezifität. Die Prävalenz von DFS70-Antikörpern in AARE-Patienten ist signifikant niedriger im Vergleich zur Prävalenz bei ANA gesunden Personen. Es besteht eine negative Assoziation der DFS70-Antikörper mit AARE, insbesondere wenn der Antikörper nicht in Begleitung von klinisch relevanten Autoantikörpern vorliegt. Isolierte DFS70-Antikörper findet man in weniger als 1% der AARE, aber in 5%–11% bei gesunden Personen. Beim Vorliegen eines isolierten DFS70-Antikörpers verringert sich die post-Test-Wahrscheinlichkeit für eine AARE deutlich. DFS70-Antikörper sind daher wertvolle neue Biomarker zur besseren Interpretation positiver ANA bei Negativität für AARE-assoziierte Autoantikörper und sollten in modifizierte Testalgorithmen zur Vermeidung unnötiger Überweisungen und Folgeuntersuchung von ANA positiven Personen integriert werden.

Abstract

Despite the progress in the establishment of specific autoantibody assays, screening for antinuclear antibodies (ANA) by indirect immunofluorescence on HEp-2 cells for quality-oriented laboratory diagnosis of ANA-associated rheumatic diseases (AARD) remains indispensable. Research results on the relevance of DFS pattern and DFS70 antibodies disclosed novel possibilities to optimize the serological stepwise diagnostics of AARD. The “dense, fine speckled” (DFS) pattern on HEp-2 cells is well differentiated from the classic “homogeneous” ANA pattern associated with dsDNA antibodies. In DFS pattern positive sera the most important detectable ANA specificity is the DFS70 antibody (synonym LEDGF antibody). This antibody is also the most frequent ANA specificity in ANA positive healthy persons. The prevalence of DFS70 antibodies in AARD patients is significantly lower compared with the prevalence in ANA-positive healthy persons. There is a negative association between DFS70 antibodies and AARD, especially if no concomitant AARD-specific autoantibodies are found. Isolated DFS70 antibodies are detectable in <1% of AARD, but are detectable in 5%–11% of healthy persons. In the presence of an isolated DFS70 antibody, the posttest probability for AARD is reduced significantly. DFS70 antibodies are valuable novel biomarkers for better interpretation of positive ANA in cases of negative AARD-associated autoantibodies and should be integrated in modified test algorithms to avoid unnecessary referrals and examinations of ANA-positive persons.

Reviewed publication

SackU.ConradK.

Schlüsselwörter:: antinukleäre Antikörper (ANA); ANA-assoziierte autoimmune rheumatische Erkrankungen; DFS70-Antikörper

Keywords: antinuclear antibodies (ANA); ANA-associated autoimmune rheumatic diseases; DFS70 antibodies

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About the article

Korrespondenz: PD Dr. med. Karsten Conrad, Institut für Immunologie, Medizinische Fakultät der Technischen Universität Dresden, 01307 Dresden, Fetscherstraße 74, Deutschland, Tel.: +49-351 458 6540, Fax: +49-351 458 6308, E-Mail:


Received: 2014-11-10

Accepted: 2014-11-11

Published Online: 2014-12-02

Published in Print: 2014-12-01


Citation Information: LaboratoriumsMedizin, Volume 38, Issue 6, Pages 299–307, ISSN (Online) 1439-0477, ISSN (Print) 0342-3026, DOI: https://doi.org/10.1515/labmed-2014-0042.

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