Antigen-Specific ANCA ELISAs Have Different Sensitivities for Active and Treated Vasculitis and for Nonvasculitic Disease

This study evaluated the performance of 12 assays for antineutrophil cytoplasmic antibodies (ANCA) directed against proteinase 3 (PR3) and myeloperoxidase (MPO) in 55 active and 68 treated cases of vasculitis and in nonvasculitic disease. It examined within- and between-assay precision; binding curv...

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Bibliographic Details
Published in:American journal of clinical pathology 2008, Vol.129 (1), p.42-53
Main Authors: TREVISIN, Michelle, POLLOCK, Wendy, DIMECH, Wayne, MELNY, Joy, PASPALIARIS, Bill, GILLIS, David, WONG, Richard, SAVIGE, Judy
Format: Article
Language:English
Subjects:
Antibodies, Antineutrophil Cytoplasmic - immunology
Biological and medical sciences
Enzyme-Linked Immunosorbent Assay - methods
Epitopes
Fluorescent Antibody Technique, Indirect
Granulomatosis with Polyangiitis - diagnosis
Granulomatosis with Polyangiitis - drug therapy
Granulomatosis with Polyangiitis - immunology
Humans
Investigative techniques, diagnostic techniques (general aspects)
Medical sciences
Myeloblastin - blood
Myeloblastin - immunology
Neutrophils - metabolism
Neutrophils - pathology
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Peroxidase - blood
Peroxidase - immunology
Prognosis
Reproducibility of Results
ROC Curve
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Sensitivity and Specificity
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Summary:This study evaluated the performance of 12 assays for antineutrophil cytoplasmic antibodies (ANCA) directed against proteinase 3 (PR3) and myeloperoxidase (MPO) in 55 active and 68 treated cases of vasculitis and in nonvasculitic disease. It examined within- and between-assay precision; binding curves, binding levels, and interassay consistency; and sensitivity, specificity, and receiver operating characteristic analysis. All assays were highly sensitive for active vasculitis (median, 94%; range, 91%-96%), but sensitivities were more varied in treated disease (median, 69%; range, 57%-82%). Binding curves and binding levels were also very variable in PR3-ANCA and MPO-ANCA assays. This has implications for studies correlating ANCA levels with disease activity and in developing ANCA-based treatment guidelines. PR3-ANCA and MPO-ANCA assays need to be standardized as a matter of urgency, but in the meantime, individual laboratories must understand the limitations of the assays used, especially with low-level ANCA in treated vasculitis and nonvasculitic disease.
ISSN:0002-9173
1943-7722
DOI:10.1309/F6L4C48RHFMT4AAU