title: Automated direct immunofluorescence analyses of skin biopsies.
abstract: BACKGROUND
  Diagnosis of autoantibody- and immune complex-induced skin diseases is primarily based on direct immunofluorescence (DIF) microscopy. DIF staining is usually performed manually and, therefore, is labor intensive. The quality of immunohistochemical results considerably depends on the experience of the person conducting the tests. The novel EUROTide(™) technique in combination with the biochip-based system EUROPath represents a new technology for automation of DIF staining.
  
  
  METHODS
  Frozen sections of previously characterized skin biopsies from bullous pemphigoid and pemphigus vulgaris patients were incubated with fluorescein-labelled anti-human IgG and complement C3c following the standard manual procedure and, for comparison, applying EUROTide/EUROPath in an automated version.
  
  
  RESULTS
  Both, the manual and the automated procedure, detected IgG and C3c deposits in all samples. However, DIF stainings performed with EUROTide/EUROPath displayed more intense specific IF signals and distinctly less background staining. The detecting antibody could be used at a ×4 higher dilution.
  
  
  CONCLUSIONS
  EUROTide/EUROPath applied in an automated system improves diagnostic accuracy and saves reagents. Larger studies in other routine laboratories may further explore the value of the EUROTide/EUROPath technology and may include comparison with other automated stainers.
authors.affiliation: Department of Dermatology, University of Lübeck, Lübeck, Germany.|Human Immunophenotyping Laboratory, University of Lübeck, Lübeck, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Lemcke
authors.affiliation: Euroimmun AG, Lübeck, Germany.
authors.forename: Siegmar
authors.initials: S
authors.lastname: Sokolowski
authors.affiliation: Euroimmun AG, Lübeck, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Rieckhoff
authors.affiliation: Euroimmun AG, Lübeck, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Buschtez
authors.affiliation: Euroimmun AG, Lübeck, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Kaffka
authors.affiliation: Department of Dermatology, University of Lübeck, Lübeck, Germany.|Human Immunophenotyping Laboratory, University of Lübeck, Lübeck, Germany.
authors.forename: Antje
authors.initials: A
authors.lastname: Winter-Keil
authors.affiliation: Euroimmun AG, Lübeck, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Schaller
authors.affiliation: Euroimmun AG, Lübeck, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Rottmann
authors.affiliation: Department of Dermatology, University of Lübeck, Lübeck, Germany.
authors.forename: Christian D
authors.initials: CD
authors.lastname: Sadik
authors.affiliation: Euroimmun AG, Lübeck, Germany.
authors.forename: Winfried
authors.initials: W
authors.lastname: Stöcker
authors.affiliation: Department of Dermatology, University of Lübeck, Lübeck, Germany.|Human Immunophenotyping Laboratory, University of Lübeck, Lübeck, Germany.
authors.forename: Detlef
authors.initials: D
authors.lastname: Zillikens
authors.affiliation: Department of Dermatology, University of Lübeck, Lübeck, Germany.|Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.
authors.forename: Enno
authors.initials: E
authors.lastname: Schmidt
mesh_terms: D001331:Automation; D001706:Biopsy; D015932:Complement C3c / Q000378:metabolism*; D005260:Female; D005455:Fluorescent Antibody Technique / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism*; D008297:Male; D012867:Skin / Q000378:metabolism / Q000473:pathology
chemical_list: D007074:Immunoglobulin G; D015932:Complement C3c
keywords: basement membrane zone; dermatology; immunopathology; pemphigus