Laboratory diagnosis of autoimmune diseases – new technologies, old dilemmas
Ilza Salamunić
[*]
[1]
Author notes:
[*] Corresponding author: s_ilza@yahoo.com
An autoimmune disease occurs when the bodyʹs immune system begins to attack its own antigens. A hallmark is the production of high-affinity autoantibodies. Different techniques have been used to develop specific tests for autoantibody detection including immunodiffusion, immunoblotting techniques, immunofluorescence, enzyme immunoassays and recently flow cytometry for multiplex bead-based assays. Due to a variability in assays that has led to confusion in results it is inevitable to conduct appropriate standardization for techniques and methods. For diagnostics tests based on an antigen-autoantibody reaction, there are no reference methods, no exact value of the standard and serum samples are heterogeneous and differ from the standard. Clinical diagnostic companies often use a well respected commercial test as a reference method and large differences in test calibration lead to inadequate interpretation of test results. The laboratory may have dilemmas about techniques that are relevant and reliable to detect all clinically significant autoantibodies. At the same time, the applied method should be a tool for high throughput, efficient, easy to use and inexpensive.
Standardization of autoantibody assay, whether „old“ or „new“, is critical to their use in the clinic to predict diagnosis and treat a very diverse group of autoimmune disorders.
Keywords: autoimmune diseases; autoantibodies; diagnostics; technologies; standardization
