| Myth and reality: practical test system for the measurement of anti-DNA antibodies in the diagnosis of systemic lupus erythematosus (SLE). | |
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MedLine Citation:
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PMID: 20333761 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Laura J McCloskey; Paul Christner; Dana Jacobs-Kosmin; Troy D Jaskowski; Harry R Hill; Gabriella Lakos; Marius Teodorescu |
Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article |
Journal Detail:
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Title: Journal of clinical laboratory analysis Volume: 24 ISSN: 1098-2825 ISO Abbreviation: J. Clin. Lab. Anal. Publication Date: 2010 |
Date Detail:
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Created Date: 2010-03-29 Completed Date: 2010-06-22 Revised Date: 2010-09-30 |
Medline Journal Info:
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Nlm Unique ID: 8801384 Medline TA: J Clin Lab Anal Country: United States |
Other Details:
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Languages: eng Pagination: 77-84 Citation Subset: IM |
Copyright Information:
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(c) 2010 Wiley-Liss, Inc. |
Affiliation:
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Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107-4998, USA. laura.mccloskey@jefferson.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Antibodies, Antinuclear / analysis* Cattle Crithidia / immunology DNA / immunology* Enzyme-Linked Immunosorbent Assay* Fluorescent Antibody Technique Humans Lupus Erythematosus, Systemic / diagnosis*, immunology Predictive Value of Tests ROC Curve Radioimmunoassay* |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Antinuclear; 9007-49-2/DNA |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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