Document Detail

Myth and reality: practical test system for the measurement of anti-DNA antibodies in the diagnosis of systemic lupus erythematosus (SLE).
MedLine Citation:
PMID:  20333761     Owner:  NLM     Status:  MEDLINE    
The myth persists that only the labor intensive Farr radioimmunoassay and Crithidia luciliae immunofluorescence (CL-IFA) are systemic lupus erythematosus (SLE)-specific tests. We compared them to ELISA with bacteriophage lambda DNA (EL-dsDNA) and denatured calf thymus DNA (EL-ssDNA). By percentile ranking, the specificity cut-off level was set both out of clinical context (SOCC) on 100 blood bank donors, and in clinical context (SICC) on 100 patients with either rheumatoid arthritis or scleroderma (50/50). Clinical sensitivity was calculated on 100 random SLE patients. At 95% SICC, the sensitivity of Farr, CL-IFA, EL-dsDNA, and EL-ssDNA was similar (95%CI): 76% (66-84), 76% (66-84), 63% (53-72), and 75% (65-83), respectively; 87% of the patients were positive by at least one method and 55%by all methods. At 99% SICC, the sensitivity was also similar (95% CI): 57% (47-67), 47% (37-57), 58% (47-67), and 43% (33-53), respectively. The areas under ROC curve were similar (95% CI) when patients were used as controls for specificity. At 99% SOCC, EL-ssDNA identified 89% positive, 2 negative but positive by another method at 95% SICC, and 9 negative (i.e. 89/2/9), followed by CL-IFA (80/6/14), Farr (76/12/12), and EL-dsDNA (64/23/13). Thus, at relatively low cost and easy automation, under the same conditions of specificity, the two ELISA tests combined were at least as good, if not superior, to CL-IFA or Farr: they showed similar clinical sensitivity and also identified more patients with anti-DNA antibodies.
Laura J McCloskey; Paul Christner; Dana Jacobs-Kosmin; Troy D Jaskowski; Harry R Hill; Gabriella Lakos; Marius Teodorescu
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of clinical laboratory analysis     Volume:  24     ISSN:  1098-2825     ISO Abbreviation:  J. Clin. Lab. Anal.     Publication Date:  2010  
Date Detail:
Created Date:  2010-03-29     Completed Date:  2010-06-22     Revised Date:  2010-09-30    
Medline Journal Info:
Nlm Unique ID:  8801384     Medline TA:  J Clin Lab Anal     Country:  United States    
Other Details:
Languages:  eng     Pagination:  77-84     Citation Subset:  IM    
Copyright Information:
(c) 2010 Wiley-Liss, Inc.
Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107-4998, USA.
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MeSH Terms
Antibodies, Antinuclear / analysis*
Crithidia / immunology
DNA / immunology*
Enzyme-Linked Immunosorbent Assay*
Fluorescent Antibody Technique
Lupus Erythematosus, Systemic / diagnosis*,  immunology
Predictive Value of Tests
ROC Curve
Reg. No./Substance:
0/Antibodies, Antinuclear; 9007-49-2/DNA

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