Clinical evaluation of various selected ELISA kits for the detection of anti-DNA antibodies

Abstract

Fifty four coded sera, 38 from eight patients with systemic lupus erythematosus (SLE), four from one patient with systemic vasculitis, one from one patient with polyarthritis and 11 normal controls were tested for anti-dsDNA antibodies using seven commercial enzyme linked immunosorbent assays (ELISA) and the radioimmunoassay method (RIA) routinely used in our unit. Sensitivity, specificity and predictive values were tested for both SLE diagnosis and disease activity. Using anti- dsDNA antibodies as a diagnostic test for SLE there were differences in sensitivity (from 66% to 95%), specificity (from 75% to 100%), predictive positive values (from 89% to 100%) and predictive negative values (from 50% to 87%) among ELISA kits. The RIA method was either more specific or equal to ELISA kits. Using 'equivocal' values as positive values an increase in sensitivity was observed but at the expense of specificity. Similar differences and trends were observed when the results were used as a measure for disease activity. This suggests that there are differences in sensitivity, specificity and predictive values among ELISA kits both in the diagnosis of SLE as well as in the determination of disease activity.

Keywords

DNA antibodies disease activity ELISA

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References

Ceppelini R. , Rolli E. , Celada F. DNA reacting factor in serum of a patient with lupus erythematosus difusus. Proc Soc Exp Biol Med 1957; 97: 572-574.

Miescher P. , Strassle R. New serological methods for the detection of the LE factor with increased sensitivity. Vox Sang 1957; 2: 288-293.

Tzioufas AG et al. Enzyme immunoassays for the detection of IgG and IgM anti-dsDNA antibodies: clinical significance and specificity. Clin Exp Rheumatol 1987 ; 5: 247-253.

Wold RT et al. Deoxyribonucleic acid antibody, a method to detect its primary interaction with deoxyribonucleic acid. Science 1968; 161: 806-815.

Aarden LA , DeGroot ER , Felkamp Tew. Immunology of DNA. III. Critithidia luciliae a simple substrate for the determination of anti-dsDNA with the immunofluorescence technique. Ann NY Acad Sci 1975; 245: 505-515.

Isenberg DA et al. Measurement of anti-DNA antibodies: a reappraisal using five different methods. Ann Rheum Dis 1987; 46: 448-456.

Lachman PJ Detection and measurement of anti-DNA antibodies. Ann Rheum Dis 1977; 36(suppl.): 67-75.

Somerfield S. , Roberts MW , Booth RJ Double-stranded DNA antibodies: a comparison of four methods of detection. J Clin Pathol 1981; 34: 1032-1035.

Tzioufas AG et al. Determination of anti-DNA antibodies by three different methods: comparison of sensitivity, specificity and correlation with lupus activity index (LAI). Clin Rheum 1990; 9: 186-192.

10.

Smeenk R. , van der Lelij G. , Aarden L. Avidity of antibodies to dsDNA: comparison of IFT on Crithidia luciliae, Farr assay and PEG assay. J Immunol 1982 ; 128: 73-78.

11.

Davis P. , Russell AS , Percy JS A comparative study of techniques for the detection of antibodies to native deoxyribonucleic acid (n-DNA). Am J Clin Pathol 1977; 67: 374-378.

12.

Davis P. , Christian B. , Russell AS Immunofluorescent technique for the detection of antibodies to n-DNA: comparison with radioimmunoassay. J Rheumatol 1977; 4: 15-20.

13.

Davis P. , Makinen D. Antibody to synthetic poly dAT: correlation with antibody to native DNA and specificity for SLE. J Clin Pathol 1980; 33: 648-652.

14.

Tan EM et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982; 25: 1271-1277.

15.

Bombardier C. et al. Derivation of the SLEDAI: a disease activity index for lupus patients. Arthritis Rheum 1992; 35: 630-640.

16.

Hardin JA The lupus autoantigens and the pathogenesis of systemic lupus erythematosus . Arthritis Rheum 1986; 29: 457-460.

17.

Tan EM Autoantibodies to nuclear antigens (ANA): their immunobiology and medicine . Adv Immunol 1982; 33: 167-240.

18.

Eilat D. Anti-DNA antibodies: problems in their study and interpretation. Clin Exp Immunol 1986; 65: 215-222.

19.

Guzman J. et al. The c ontribution of resting heart rate and routine blood tests to the clinical assessment of disease activity in systemic lupus erythematosus . J Rheumatol 1994; 21: 1845-1848.