Changes in the result of antinuclear antibody immunofluorescence assay on HEp-2 cells reflect disease activity status in systemic lupus erythematosus

Author(s)

Prado, Monica Simon ^[1] ; Dellavance, Alessandra ^[2] ; Rodrigues, Silvia Helena ^[1] ; Marvulle, Valdecir ^[3] ; Coelho Andrade, Luis Eduardo ^{[1, 4]}

Affiliation

^[1] Univ Fed Sao Paulo, Rheumatol Div, Escola Paulista Med, Rua Botucatu 740, 3o Andar, BR-04023062 Sao Paulo, SP - Brazil

^[2] Fleury Med & Hlth Labs, Res & Dev Div, Sao Paulo - Brazil

^[3] ABC Fed Univ, Ctr Math Computat & Cognit, Santo Andre, SP - Brazil

^[4] Fleury Med & Hlth Labs, Immunol Div, Sao Paulo - Brazil

• Document type: Journal article
• Source: CLINICAL CHEMISTRY AND LABORATORY MEDICINE; v. 58, n. 8, p. 1271-1281, AUG 2020.
• Web of Science Citations: 0

Abstract

Background: The objective of the study was to determine whether the staining pattern and titer of indirect immunofluorescence assay on HEp-2 cells (HEp-2 IFA) are associated with systemic lupus erythematosus (SLE) disease activity. Methods: A total of 269 consecutive patients meeting the ACR and SLICC criteria for SLE were classified into three groups according to the SLE Disease Activity Index 2000 (SLEDAI2K): Remission (SLEDAI2K = 0; n = 47); Intermediate (SLEDAI2K = 1-5; n = 111); Active (SLEDAI2K >= 6; n = 111). All subjects were assessed for HEp-2 IFA titer and staining pattern and nine traditional parameters of SLE disease activity. After a 6 to 12-month interval, 101 of the 269 patients were reassessed. Results: HEp-2 IFA homogeneous nuclear pattern (AC-1) occurred more frequently in the Active Group compared to the Remission Group (p < 0.001). Fine speckled nuclear pattern (AC-4) tended to occur more frequently in the Remission Group compared to the Active Group (p = 0.054). Subjects with AC-1 pattern had higher SLEDAI (8.8 +/- 7.6) than those with AC-4 (4.8 +/- 5.2) (p < 0.001). HEp-2 IFA titer and anti-nuclear antibody by enzyme-linked immunosorbent assay (ANA-ELISA) values were lower in the Remission Group compared to the other two groups ( p < 0.001). Multivariate analyses identified only ELISA anti-dsDNA as an independent variable associated with disease activity. In follow-up analysis, HEp-2 IFA titer decreased significantly in the 33 subjects with decreased disease activity (p = 0.002). Receiver operator characteristic (ROC) curve analysis for determination of disease activity showed equivalent areas under the curve (AUC) for HEp-2 IFA titer and traditional disease activity parameters. Conclusions: HEp-2 IFA pattern and titer can reflect SLE disease activity and may be considered in conjunction with other laboratory and clinical parameters in the assessment of SLE disease activity. (AU)

• FAPESP's process: 13/00913-6 - Evaluation of the titer and immunofluorescence pattern of antinuclear antibody test in systemic lupus erythematosus patients according to disease activity status
• Grantee: Luiz Eduardo Coelho Andrade
• Support Opportunities: Regular Research Grants