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Liver Disease Diagnostics: Antibody-based Diagnosis of Autoimmune Liver Diseases


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Liver Disease Diagnostics: Antibody-Based Diagnosis of Autoimmune Liver Disease

For the launch of our Liver-9-Line immunoblot test (to our press release “Liver Disease Diagnostics by Immunoblot” of May 16, 2011), I dug through a pile of literature on the topic of autoantibody-based diagnosis of autoimmune diseases of the liver. In the last week I picked it all up again and worked through it systematically.

The interior surface of the liver. A reproduction of a lithograph plate from Gray’s Anatomy.

The reason for my renewed interest is that we brought four more ELISA tests for liver diagnostics to the market two weeks ago. They are the Anti-LKM-1, Anti-SLA, Anti-gp210, and Anti-Sp100 tests, all designed for fully automated autoimmune diagnosis with our Alegria system. All four test systems assist the formulation of a diagnosis when autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) are suspected, or for differential diagnosis when another disorder of the liver is assumed. (more…)

A short History of Indirect Immunofluorescence Technology

The GRÜNER CLUB AUTOIMMUN blog featured a fine post about the history of indirect immunofluorescence. In that article my Austrian colleague Barbara Fabian, community manager of GRÜNER CLUB AUTOIMMUN, described in great detail how indirect immunofluorescence technology, or: IFT, and also referred to as IIF assay,  has become an indispensible tool of autoimmune disease diagnostics over the last two decades, and how IFT has become a standard laboratory technique used in serological autoimmune diagnostics.

Without further ado I have translated Barbara’s post in order to make you this text, and especially the interesting images, available. – Here it is:

The Development of Indirect Immunofluorescence Technology (IFT)

by Barbara Fabian, MSc, Community Manager of GRÜNER CLUB AUTOIMMUN

Over the last 20 years, the detection of autoantibodies has developed into an indispensible component of autoimmune diagnostics. Along with serological and clinical data, autoimmune status has become an important building block in the formation of diagnoses. (more…)

Why Are Autoimmune Diseases More Common in Women than Men?

No matter if it’s rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or multiple sclerosis (MS): most autoimmune diseases affect women significantly more often than men. It is possible that this could be at least partially explained by the occurrence of age-associated B cells (ABCs), as described in an article recently published in Blood, the journal of the American Society of Hematology. (more…)

IL-22 as a Prognostic Biomarker: Predictability of Disease Progression for Rheumatoid Arthritis

According to a recent study, a new biomarker may make it possible to make a prognosis regarding the progression of the autoimmune disease rheumatoid arthritis (RA).

The results of the study, which was carried out at the University of Munich Clinics, were recently published in the Annals of the Rheumatic Diseases, The EULAR Journal. At the centre of this study lies an analysis of the cell hormone interleukin-22, IL-22, and its significance as a prognostic marker for RA. The researchers examined the relationship between the serum levels of interleukin-22 and the risk of bone erosion and joint damage in RA patients. (more…)

Predicting Arthritis Outcome: Anti-MCV for Monitoring Subclinical Atherosclerosis in Rheumatoid Arthritis

Antibodies to Modified Citrullinated Vimentin Are Associated with Subclinical Atherosclerosis in Early Rheumatoid Arthritis

Rheumatoid arthritis (RA) is associated with increased morbidity and mortality due to cardiovascular disease (CVD), especially accelerated atherosclerosis (1-3). There is evidence that this already occurs early in the disease process. Well known common CVD risk factors interact with the systemic auto-inflammatory response during the disease process and speed up the development of atherosclerosis in patients suffering from rheumatoid arthritis. heartbeat

Antibodies against citrullinated protein and peptide antigens (ACPA) are highly sensitive and specific markers for early rheumatoid arthritis. Antibodies to Modified Citrullinated Vimentin (anti-MCV) predict poor outcome and appear to play a major role in the pathogenesis of rheumatoid arthritis. 

A recently published study by Amal El-Barbary and his co-workers may now shed light on the relationship between anti-MCV antibodies and cardiovascular co-morbidities in patients with rheumatoid arthritis (4). They investigated the correlation of anti-MCV antibodies in early RA with disease activity and cardiovascular risk factors compared to antibodies against cyclic citrullinated peptides (anti-CCP3). (more…)

Research Update: Prognosis of Outcomes for Rheumatoid Arthritis – What are the Risk Factors?

Research Update: Prognosis of Outcomes for Rheumatoid Arthritis – What are the Risk Factors?

In the past, it has only been possible to explain some of the joint damage caused by rheumatoid arthritis (RA) based on known risk factors. In order to improve treatment for RA, future approaches to treatment will increasingly need to be tailored to individual patients and individually configured.

 

Personalized medicine in RA treatment

The goal is to develop individual treatments tailored to the needs of the individual patient, “personalized medicine” for rheumatoid arthritis diagnosis and treament (for more on the subject of personalized medicine, refer to the background article Early Detection and Personalised Medicine – What Biomarkers Tell Us on our rheumachec homepage). (more…)

Rheumatology Diagnostics: Indirect Immunofluorescence Tests (IIF assays) on HEp-2 Cells

Immunofluorescence patterns help eliminate “false positives” in diagnosing autoimmune rheumatic diseases

The detection of anti-nuclear antibodies, the ANA test, is a clear (laboratory-) diagnostic indicator of rheumatic autoimmune disease. One of the standard laboratory tests for the detection of these antinuclear antibodies is IIF, the indirect immunofluorescence assay, on human HEp-2 cells (ANA-HEp-2 test).

This pictures shows anti-RNP pattern on HEp-2 cells after ANA-HEp-2 indirect immunofluorescence assay

ANA-HEp-2 indirect immunofluorescence test (IIF): antibodies against RNP (ribonucleoproteins) – interphase nucleoli: coarse granular positive, nucleoli neglected; mitotic cells: negative (400x) – © ORGENTEC Diagnostika, Mainz

However, for up to 13% of healthy individuals, indirect immunofluorescence may detect anti-nuclear antibodies. Most of these healthy people will not develop an autoimmune disease – despite the positive ANA test. It is thus a challenge for the physician to differentiate these healthy, false-positive patients from those ANA-positive patients who already have an inflammatory rheumatic disease or who truly have an increased risk of developing such an autoimmune disease.

 

Several very specific IIF patterns

In a large study, Brazilian IIF experts have now worked out the fundamental differences between the ANA-HEp-2 test results on serum samples from healthy individuals and the immunofluorescence patterns from serum samples of patients with rheumatic disease; they have described various IIF patterns that can be used to differentiate between the two patient groups (Mariz et al. 2011). This study was published a few weeks ago in the January issue of Arthritis & Rheumatism, the journal of the American College of Rheumatology (ACR). In their article, the scientists from the Universidade Federal de São Paulo, Brazil, explain in detail that there are several very specific immunofluorescence patterns in the ANA-HEp-2 assay with which the autoimmune rheumatic diseases (ARD) are truly associated. (more…)

Autoantibodies precede manifestation of Lupus by years

Antibodies to various autoantigens may be present in sera of patients who will develop Lupus erythematosus up to seven years before onset of disease symptoms

 

Immunoflurescence image of anti-dsDNA-antibodies for the diagnosis of SLE

Autoantibodies against dsDNA are diagnostic markers for Systemic Lupus Erythematosus.

Autoantibodies are specific and sensitive biomarkers for autoimmune diseases and indispensible diagnostic tools. They may also be involved in pathogenic processes underlying the disease and will potentially occur in sera of apparently healthy people long before onset of the first symptoms.

C. Eriksson, S. Raantapaa-Dalquist and their colleagues from Umeå University in Sweden have focused on this preclinical phase in the development of Systemic Lupus Erythematosus (SLE). (more…)

Anti-MCV Antibodies: our ACPA Test for Rheumatoid Arthritis

ACPA in rheumatism diagnostics: new and highly promising biomarkers for rheumatoid arthritis

The diagnosis and treatment of rheumatoid arthritis (RA) have made tremendous progress in the last few years. Experts are even suggesting that a paradigm shift has occurred in the field of rheumatology.

According to rheumatologists, this radical change can be seen in the completely new rheumatoid arthritis medications that have resulted in entirely new treatment options. Again and again, the paradigm shift in rheumatology is attributed to the new possibilities in rheumatoid arthritis diagnostics. Modern RA diagnostics are said to make it increasingly possible for rheumatologists to objectively determine the activity level of RA and thus to predict the progression of this autoimmune disease. (more…)

Research Update: Common Adult Vaccinations do not Increase the Risk of developing Rheumatoid Arthritis

The EIRA Study: Vaccinations and RA Risk – no Association found!

“Common adult immunizations are not associated with an increased risk of developing rheumatoid arthritis” – that is the result of research published in the October issue of The Annals of the Rheumatic Disease, the EULAR journal. Last week that data were also presented at the American College of Rheumatology ACR Annual Scientific Meeting (took place from 6th to 11th November).

Common adult vaccinations don’t increase the risk of developing RA, recent results of the Swedish EIRA Study Group say.

Common adult vaccinations don’t increase the risk of developing RA, recent results of the Swedish EIRA Study Group say.

“Vaccinations are among the events which have long been postulated as inciting agents for rheumatoid arthritis, as well as for many other chronic inflammatory diseases of unknown origin,” lead investigator in the study, Camilla Bengtsson, PhD, stated in her lecture last Monday at the Georgia World Congress Center in Atlanta, USA.

No increased RA risk following immunizations

“In our case-control study including incident cases of newly diagnosed rheumatoid arthritis, no increased risk of RA following immunization was observed, at least not in the five years prior to disease onset”, the epidemiologist at the Institute of Environmental Medicine at Karolinska Institutet in Stockholm, Sweden, explained in more detail, noting that the study is still ongoing. From Dr. Bengtsson’s point of view these results are indicating that immunological provocation with commonly used vaccines in their present form do not carry a risk of rheumatoid arthritis in adults. (more…)

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