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2016 ; 95
(44
): e5225
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Simultaneous comprehensive multiplex autoantibody analysis for rapidly
progressive glomerulonephritis
#MMPMID27858870
Sowa M
; Trezzi B
; Hiemann R
; Schierack P
; Grossmann K
; Scholz J
; Somma V
; Sinico RA
; Roggenbuck D
; Radice A
Medicine (Baltimore)
2016[Nov]; 95
(44
): e5225
PMID27858870
show ga
Rapidly progressive glomerulonephritis (RPGN) is mainly caused by anti-glomerular
basement membrane (GBM) antibody-mediated glomerulonephritis, immune-complex or
anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides and leads to
rapid loss of renal function. Detection of ANCA and autoantibodies (autoAbs) to
GBM and dsDNA enables early diagnosis and appropriate treatment of RPGN aiding in
preventing end-stage renal disease.Determination of ANCA on neutrophils (ANCA) as
well as autoAbs to myeloperoxidase (MPO-ANCA), proteinase 3 (PR3-ANCA), GBM, and
dsDNA was performed by the novel multiplex CytoBead technology combining cell-
and microbead-based autoAb analyses by automated indirect immunofluorescence
(IIF). Forty patients with granulomatosis with polyangiitis (GPA), 48 with
microscopic polyangiitis (MPA), 2 with eosinophilic GPA, 42 with systemic lupus
erythematosus (SLE), 43 with Goodpasture syndrome (GPS), 57 with infectious
diseases (INF), and 55 healthy subjects (HS) were analyzed and findings compared
with classical single testing.The CytoBead assay revealed for GPA, MPA, GPS, and
SLE the following diagnostic sensitivities and for HS and INF the corresponding
specificities: PR3-ANCA, 85.0% and 100.0%; MPO-ANCA, 77.1% and 99.1%; anti-GBM
autoAb, 88.4% and 96.4%; anti-dsDNA autoAb, 83.3% and 97.3%; ANCA, 91.1% and
99.1%, respectively. Agreement with classical enzyme-linked immunosorbent assay
and IIF was very good for anti-GBM autoAb, MPO-ANCA, PR3-ANCA, and ANCA,
respectively. Anti-dsDNA autoAb comparative analysis demonstrated fair agreement
only and a significant difference (P?=?0.0001).The CytoBead technology provides a
unique multiplex reaction environment for simultaneous RPGN-specific autoAb
testing. CytoBead RPGN assay is a promising alternative to time-consuming single
parameter analysis and, thus, is well suited for emergency situations.