May ELISA tests replace IIF in the diagnostic work-up of patients with suspected ANCA-associated vasculitis? The answer is clearly yes according to recently published results of the European Vasculitis Study Group.1
Rheumatoid factor (RF) is one of the best known serological markers in rheumatology – development of the test dates back into the 1940ies. Since this time the toolkit of serological diagnostic tests for rheumatoid arthritis (RA) has been complemented by the more specific anti-citrullinated protein antibody (ACPA) tests. However, none of the various ACPA tests has completly replaced RF until now.
In contrast, the significance of RF has been further substantiated with the definition of the 2010 ACR criteria for classification of RA. Moreover, recent studies have shown the potential of RF as a contributor to disease pathogenesis.
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease with manifold manifestations. SLE belongs to the family of autoimmune disorders, diseases that occur, when a mislead immune system attacks the body’s own structures. SLE can affect almost any organ system, thus its presentation and course are highly variable, and diagnosis and therapy may be challenging.
With the intention to classify SLE patients for research and surveillance studies and to support clinicians in confirming a diagnosis, a set of clinical and laboratory classification criteria has been developed and released by the American College of Rheumatology (ACR). The first classification criteria for SLE were originally published in 1971 [1,2]. They have been updated 1982  and 1997  to incorporate new immunologic knowledge and improve patient classification. In contrast to the 1987 criteria, the 1997 criteria have not been validated.
The most recent addendum to the classification criteria for SLE dates from 2012, when the Systemic Lupus International Collaborating Clinics (SLICC) group published a revision and validation of the ACR criteria .
Celiac disease diagnostics revised
The diagnostic criteria for celiac disease (CD) have remained unchanged for more than 20 years, after the 1990 revision of the guidelines originally formulated in 1969. During this period the disease has been intensively studied and scientific findings have unveiled the genetic background of celiac disease, linked to the human leukocyte antigen (HLA)-DQ2 and HLA-DQ8 haplotypes. The key autoantigen tissue transglutaminase (tTG) has been identified and reliable laboratory tests for disease specific autoantibodies now contribute to diagnostics and complement the methodological repertoire of clinical observations and histologic findings in duodenal biopsy samples. Finally, the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) has now published New Guidelines for the Diagnosis of Celiac Disease.
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 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…)
Anti-CCP hs (high sensitive)®: a new biomarker for the serological diagnosis of early rheumatoid arthritis
Timely diagnosis is of critical importance to the progression of rheumatoid arthritis (RA) because the rapid implementation of intensive treatment can inhibit damage to the joints and maintain function. In conjunction with medical history, clinical examination, and imaging procedures, serological tests form the foundation for an early diagnosis.
In addition to rheumatoid factors, autoantibodies against citrullinated antigens (ACPA) have proven to be valuable tools for the serological diagnosis of early RA. They have become a critical component of the new 2010 ACR criteria for the classification of RA, and account for three of the six points required to verify a diagnosis of RA. (more…)
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…)
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…)
Our Point-of-Care-Test rheumachec for Diagnosing Rheumatoid Arthritis – a Highly Accessed Research Article in Arthritis Research & Therapy!
Several days ago, a colleague pointed out to me a publication in the journal Arthritis Research & Therapy that came about largely through collaboration with scientists at ORGENTEC Diagnostika. Needless to say that this article was already familiar to me – already before its initial online publication in the summer of this year, I had read excerpts from it and extensively discussed the work and the results of this evaluation study with co-workers and clients. (more…)
A link between B cell receptor expression and autoantibody production in rheumatoid arthritis
By now, it is a well known fact, that B cells play an important role in the development of autoimmunity. On the one hand, they are the precursors of the antibody-secreting plasmablasts and memory cells; on the other hand they also act as antigen-presenting cells.
Various cells of the immune system express a plethora of receptors that bind to the
Fc-portion of immune complexes containing IgG (Fc-gamma-receptors, FcγR), but
B cells and plasma cells only express the low affinity FcγRIIb. This receptor has repressive functions and mediates the deletion of autoreactive B cells and the inhibition of IgG secretion, thereby helping to preserve B cell tolerance.
Human autoimmune diseases that are characterized by an abnormal production of autoreactive antibodies have been suspected to come along with impaired FcγRIIb function. Alterations of the expression of FcγRIIb on B cells have been shown for Lupus erythematosus and several other autoimmune diseases, but until now, data have been lacking for rheumatoid arthritis. (more…)