title: Comparison of antibody assays for detection of autoantibodies to Ro 52, Ro 60 and La associated with primary Sjögren's syndrome.
abstract: Anti-Ro(52/60) and anti-La constitute the hallmark autoantibodies in primary Sjögren's syndrome, being present in 40-70% of sera. Several anti-Ro/La assays exist, but antibody detection appears to be assay-specific, thus the aim of this study was to compare several anti-Ro/La assays. In total, 96 sera from individuals with primary Sjögren's syndrome and 114 healthy controls were tested for anti-Ro 52/60 and anti-La in 17 immunoassays. Especially the immunoassays used for detection of anti-Ro 52 differed in their sensitivity (48-79%), while only small differences in sensitivities were observed for the anti-Ro 60 (69-77%) anti-La (39-44%) assays. Concordances of 65%, 79% and 73% for the anti-Ro 52, anti-Ro 60 and anti-La assays were found, respectively. The majority of the assays yielded high specificities, primarily ranging from 97 to 100%, except from a single anti-Ro 60 assay, which yielded a specificity of 79%. Occasionally, reactivity levels were increased in a few assays, indicating that false-positive results can be obtained when applying assays of reduced specificity. In general, the commercial assays appeared to perform better than the in-house analyses. When correcting the in-house assays for background reactivity, sensitivities were reduced by approximately 7%, 17%, and 19% for anti-Ro 52, anti-Ro 60 and anti-La assays, respectively, illustrating the pitfalls when applying immunoassays for detection of autoantibodies, which in theory may apply to commercial assays as well. Finally, increased total sensitivities were obtained when combining assays. These studies contribute to clarify the clinical utility of immunoassays for detection of autoantibodies of Ro 52, Ro 60 and La and illustrate that the most efficient strategy to maximize antibody sensitivity is to combine several assays.
authors.affiliation: Statens Serum Institut, Department of Autoimmunology and Biomarkers, Artillerivej 5, DK-2300 Copenhagen, Denmark. Electronic address: nhp@ssi.dk.
authors.forename: Nicole Hartwig
authors.initials: NH
authors.lastname: Trier
authors.affiliation: Statens Serum Institut, Department of Autoimmunology and Biomarkers, Artillerivej 5, DK-2300 Copenhagen, Denmark.
authors.forename: Inger Ødum
authors.initials: IØ
authors.lastname: Nielsen
authors.affiliation: Statens Serum Institut, Department of Autoimmunology and Biomarkers, Artillerivej 5, DK-2300 Copenhagen, Denmark.
authors.forename: Tina
authors.initials: T
authors.lastname: Friis
authors.affiliation: Statens Serum Institut, Department of Autoimmunology and Biomarkers, Artillerivej 5, DK-2300 Copenhagen, Denmark.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Houen
authors.affiliation: Department of Rheumatology, Skåne University Hospital, Lund University, S-20502 Malmö, Sweden. Electronic address: elke.theander@med.lu.se.
authors.forename: Elke
authors.initials: E
authors.lastname: Theander
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000974:Antibodies, Antinuclear / Q000032:analysis*; D001324:Autoantigens / Q000276:immunology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012261:Ribonucleoproteins / Q000276:immunology*; D012680:Sensitivity and Specificity; D012859:Sjogren's Syndrome / Q000175:diagnosis* / Q000276:immunology; D013548:Sweden; D055815:Young Adult; D000097585:SS-B Antigen; D000099207:SS-A Antigen
chemical_list: D000974:Antibodies, Antinuclear; D001324:Autoantigens; D012261:Ribonucleoproteins; D000097585:SS-B Antigen; D000099207:SS-A Antigen
keywords: Autoantibodies; La; Non-specific reactivity; Primary Sjögren's syndrome; Ro; SSA/SSB