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International consensus on antinuclear antibody patterns: definition of the AC-29 pattern associated with antibodies to DNA topoisomerase I
Univ Fed Sao Paulo, Escola Paulista Med, Dept Med, Rheumatol Div, Rua Botucatu 740, BR-04023062 Sao Paulo, SP, Brazil;Fleury Med & Hlth Labs, Immunol Div, Sao Paulo, Brazil.
Med Univ Innsbruck, Dept Internal Med 2, Innsbruck, Austria.
Med Univ Innsbruck, Dept Internal Med 2, Innsbruck, Austria.
Tech Univ Dresden, Inst Immunol, Dresden, Germany.
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2018 (English)In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 56, no 10, p. 1783-1788Article in journal (Refereed) Published
Abstract [en]

The indirect immunofluorescence assay (IFA) on HEp-2 cells is the reference method for autoantibody screening. The HEp-2 IFA pattern provides useful information on the possible autoantibodies in the sample. The International Consensus on Antinuclear Antibody Patterns (ICAP) initiative seeks to define and harmonize the nomenclature of HEp-2 IFA patterns. The most relevant and usual patterns have been assigned an alphanumeric code from anti-cell (AC)-1 to AC-28 and were organized into a classification algorithm (www.ANApatterns.org). The systemic sclerosis-associated autoantibodies to DNA topoisomerase I (Topo I) produce a peculiar composite 5-element HEp-2 IFA pattern (Topo I-like pattern) comprising the staining of the nucleus, metaphase chromatin plate, nucleolar organizing region, cytoplasm and nucleolus. In a recent assessment of the European Consensus Finding Study Group on autoantibodies, a well-defined anti-Topo I sample was blindly analyzed and classified according to ICAP AC patterns by 43 participant laboratories across Europe. There were wide variations among these laboratories in reporting nuclear, nucleolar and cytoplasmic patterns, indicating the inadequacy of the existing AC patterns to report the Topo I-like pattern. Several ICAP member laboratories independently demonstrated the overall consistency of the HEp-2 IFA Topo I-like pattern using HEp-2 slides from different manufacturers. The ICAP committee reviewed 24 candidate images and selected the four most representative images to be available on the ICAP website. The proper recognition of the AC-29 pattern should trigger suspicion of the presence of anti-Topo I antibodies, which may engender appropriate analyte-specific reflex tests to confirm the autoantibody specificity.

Place, publisher, year, edition, pages
WALTER DE GRUYTER GMBH , 2018. Vol. 56, no 10, p. 1783-1788
Keywords [en]
antinuclear antibodies, autoantibodies, HEp-2 cell, indirect immunofluorescence
National Category
Biochemistry and Molecular Biology
Identifiers
URN: urn:nbn:se:uu:diva-365287DOI: 10.1515/cclm-2018-0188ISI: 000443548000032PubMedID: 29813025OAI: oai:DiVA.org:uu-365287DiVA, id: diva2:1263173
Available from: 2018-11-14 Created: 2018-11-14 Last updated: 2018-11-14Bibliographically approved

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