Advantages of anti-myeloperoxidase and anti-proteinase-3 antibodies detection by chemiluminescence method in patients with ANCA-associated vasculitis

Czech version

Authors: I. Francová ¹; Z. Hrušková ²; K. Malíčková ¹; H. Lahoda Brodská ¹; V. Tesař ²; T. Zima ¹
Authors‘ workplace: Ústav lékařské biochemie a laboratorní diagnostiky Všeobecné fakultní nemocnice a 1. lékařské fakulty University Karlovy, U Nemocnice 2, 128 08 Praha 2, Česká republika ¹; Klinika nefrologie Všeobecné fakultní nemocnice a 1. lékařské fakulty University Karlovy, U Nemocnice 2, 128 08 Praha 2, Česká republika ²
Published in: Klin. Biochem. Metab., 26, 2018, No. 3, p. 119-125

Overview

Objective:

To verify diagnostic sensitivity and specificity of the novel chemiluminescence method for the detection of the autoantibodies against myeloperoxidase (anti-MPO) and proteinase 3 (anti-PR3). To compare this method with commonly used enzyme linked immunoassays (ELISA) and evaluate the mutual agreement of the methods with indirect immunofluorescence method (IIF). To assess the utility of chemiluminescent immunoassay (CLIA) as a screening test for ANCA associated vasculitis (AAV) patients.

Design:

retrospective

Materials and Methods:

Sera of 101 patients with AAV with kidney involvement were tested for presence of anti-MPO and anti-PR3 by three detection systems – CLIA, 1^st generation ELISA of two producers and by IIF for presence of ANCA.

Results:

Diagnostic sensitivity and specificity of the CLIA for anti-MPO was 91.7 % and 100 %, for anti-PR3 it was 96.2 % and 100 %, respectively. Our study didn’t show mutual quantitative agreement between methods for their whole measurement range, the quantitative difference between methods is increasing in favour of CLIA with the increasing concentration of the antibodies. Highest total qualitative agreement was found between IIF and CLIA, for both observed autoantibodies, anti-MPO (91.9 %) and anti-PR3 (90.6 %). The moderate strength of agreement was found only between CLIA and IIF (kappa = 0.455 for anti-MPO and kappa = 0.410 for anti-PR3) by Cohen kappa analysis.

Conclusion:

We have verified the sensitivity and specificity values of the novel chemiluminescence method and the results obtained in our group of patients were applicable in agreement with manufacturer’s data. We have demonstrated higher diagnostic sensitivity for CLIA compared to common used ELISAs for both observed autoantibodies. We have also demonstrated acceptable strength of qualitative agreement between CLIA and IIF. The suitability of the CLIA for the ANCA screening and for the routine laboratory ANCA testing was proven. The great advantage of CLIA compared to ELISA is much shorter time of testing and the random access, which all make CLIA suitable for the testing in statim mode.

Keywords:

Anti-neutrophil cytoplasmic antibody, ANCA, myeloperoxidase, proteinase 3, ANCA associated vasculitis, chemiluminescent immunoassay, CLIA.

Sources

1. Jennette, J. C., Falk, R. J., Bacon, P. A., Basu, N., Cid, M. C., Ferrario, F., Flores-Suarez, L. F., Gross, W. L., Guillevin, L., Hagen, E. C., Hoffman, G. S., Jayne, D. R., Kallenberg, C. G. M., Lamprecht, P., Langford, C. A., Luqmani, R. A., Mahr, A. D., Matteson, E. L., Merkel, P. A., Ozen, S., Pusey, C. D., Rasmussen, N., Rees, A. J., Scott, D. G. I., Specks, U., Stone, J. H., Takahashi, K. and Watts, R. A. Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis & Rheumatism, 2012, 65, s. 1–11. doi:10.1002/art.37715

2. Kallenberg, C. G. M. Pathogenesis of ANCA-associated vasculitides. Annals of the Rheumatic Diseases, 2011, 70, i59-i63.

3. Lionaki, S., Blyth, E. R., Hogan, S. L., Hu, Y., Senior, J. B. A., Jennette, C. E., Nachman P. H., Jennette J. C., Falk, R. J. Classification of ANCA vasculitides: The role of anti-neutrophil cytoplasmic autoantibody specificity for MPO or PR3 in disease recognition and prognosis. Arthritis and Rheumatism, 2012, 64(10), s. 3452–3462. http://doi.org/10.1002/art.34562.

4. Mahler, M., Radice, A., Yang, W., Bentow, C., Seaman, A., Bianchi, L., Sinico, R. A. Development and performance evaluation of novel chemiluminescence assays for detection of anti-PR3 and anti-MPO antibodies. Clin Chim Acta. 2012, 413(7-8), s. 719–726. Published online 2012 Jan 13. doi: 10.1016/j.cca. 2012.01.004

5. Lochman, I. Postup pro vyšetřování ANCA. Alergie 2/2012

6. Csernok E., Damoiseaux J., Bossuyt X. CS_1 evised international consensus recommendation on testing of anti-neutrophil cytoplasm antibodies (ANCA) in small vessel vasculitis: evaluation of ANCA testing by antigen specific assays, Rheumatology, 2017, 56(3), s. iii41–iii42.

7. Landis, J. R., Koch, G. G. The measurement of observer agreement for categorical data. Biometrics. 1977, 33(1), s. 159-74.

8. Savige, J., Gillis, D., Benson, E., Davies, D, Esnault, V., Falk, R. J., Hagen, E. C., Jayne, J., Jennette, J. C., Paspaliaris, B., Pollock, W., Pusey, C., Savage C. O. S., Silvestrini, J., Van der Woude, F., Wieslander, J., Wiik, A. International Consensus Statement on Testing and Reporting of Antineutrophil Cytoplasmic Antibodies (ANCA), American Journal of Clinical Pathology, 1999, 111(4), s. 507–513, https://doi.org/10.1093/ajcp/111.4.507.

9. Csernok E. and Moosig F. Current and emerging techniques for ANCA detection in vasculitis. Nature Reviews Rheumatology, 2014, 10(8), s. 494-501.

10. Damoiseaux, J., Csernok, E., Rasmussen, N., Moosig, F., van Paassen, P., Baslund, B., Vermeersch, P., Blockmans, D.,Tervaert, J.W.C, Bossuyt, X. Detection of antineutrophil cytoplasmic antibodies (ANCAs): a multicentre European Vasculitis Study Group (EUVAS) evaluation of the value of indirect immunofluorescence (IIF) versus antigen-specific immunoassays. Annals of the rheumatic diseases, Published Online First: 01 August 2016. doi: 10.1136/annrheumdis-2016-209507.

11. Hirose, O., Itabashi, M., Takei, T., Nitta, K.. Comparison of a novel chemiluminescence enzyme immunoassay (CLEIA) with enzyme-linked immunosorbent assay (ELISA) for the determination of MPO-ANCA in patients with ANCA-associated vasculitis, Mod Rheumatol., 2015, 25(2), s. 230-4. doi: 10.3109/14397595.2014.951113. Epub 2014 Nov 12.

12. Trevisin, M., Pollock, W., Dimech, W., Savige, J. Evaluation of a multiplex flow cytometric immunoassay to detect PR3-and MPO-ANCA in active and treated vasculitis, and in inflammatory bowel disease (IBD). Journal of immunological methods, 2008, 336(2), s. 104-112.

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Article was published in

Clinical Biochemistry and Metabolism

2018 Issue 3