Detection of anti-dsDNA as diagnostic tool.

University of Amsterdam, Amsterdamo, North Holland, Netherlands
Annals of the Rheumatic Diseases (Impact Factor: 9.27). 03/1981; 40(1):45-9. DOI: 10.1136/ard.40.1.45
Source: PubMed

ABSTRACT The diagnostic significance of anti-dsDNA determinations was evaluated in 2 different groups of patients. When the immunofluorescence technique (IFT) with Crithidia luciliae and the Farr assay with 3H-labelled-PM2 DNA were applied to a selected panel of 536 sera from patients with various well-defined autoimmune diseases, positive results were obtained only with serum samples from patients with systemic lupus erythematosus (SLE). On the other hand when we screened 4431 sera sent to our laboratory for diagnostic reasons, we observed a high incidence of antibodies to dsDNA in patients who did not fulfil the preliminary American Rheumatism Association's criteria for SLE and did not have the diagnosis SLE. Furthermore, a significant number of the positive sera showed peculiar behaviour in that they were positive only in the IFT on Crithidia luciliae and not in the Farr assay.

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    ABSTRACT: An enzyme immunoassay was developed to detect antibodies to native DNA; DNA coating conditions that maximized sensitivity, specificity, and reproducibility were selected. Sera of patients with systemic lupus erythematosus (SLE) were positive more frequently by this immunoassay than by the Crithidia luciliae assay or by counterimmunoelectrophoresis. By enzyme immunoassay, 94% of sera with active SLE and 70% of sera from patients with inactive SLE were positive, as were 16% from those suspected of having SLE, and 2.5% of normal persons. Specificity for native DNA was shown for both SLE and normal sera by inhibition studies and by S1 nuclease treatment of polystyrene-bound native DNA. The enzyme immunoassay correlated more with serum hemolytic complement levels than did the other 2 assays, suggesting that it detects biologically more relevant anti-DNA antibodies than do the other 2 tests.
    Arthritis & Rheumatology 01/1983; 26(1):52 - 62. DOI:10.1002/art.1780260109 · 7.87 Impact Factor
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    ABSTRACT: Objectives: To verify the diagnostic accuracy of anti-double-stranded DNA (anti-dsDNA) antibodies detected by the Crithidia luciliae immunofluorescence test (CLIFT) in a cohort of unselected patients, referred to a rheumatologist due to recent onset of rheumatic symptoms. Method: A total of 1073 consecutive patients were screened for anti-nuclear antibodies (ANAs). Serum samples from 292 ANA-positive and 292 matching ANA-negative patients were tested three times for anti-dsDNA antibodies, using two different CLIFT kits (ImmunoConcepts(®) and Euroimmun(®)). An initial clinical diagnosis was made by rheumatologists unaware of the results. The diagnoses were updated after a median follow-up of 4.8 years. Results: CLIFT was positive at least once in 60 patients but only 23 patients were CLIFT positive in all of the assays. Diagnosis of systemic lupus erythematosus (SLE) was made initially in 65 patients, of whom 24 (37%) were CLIFT positive. Many other diagnoses were observed among the CLIFT-positive patients. Overall, 16 (5.5%) ANA-negative patients were CLIFT positive. After approximately 5 years, the diagnosis of SLE remained unchanged in 63 patients (23 CLIFT positive) and altered in only two (one CLIFT positive). Among the 36 CLIFT-positive patients who were not diagnosed with SLE at study entry, only one developed SLE during the follow-up period. Conclusions: CLIFT was not reliable as a diagnostic tool in unselected patients with rheumatic symptoms. ANAs were of little value as a screening test before the CLIFT analysis. CLIFT had surprisingly low positive predictive value (PPV) for the diagnosis of SLE despite its high specificity. For non-SLE patients, being CLIFT positive poses little risk of developing SLE within 5 years.
    Scandinavian journal of rheumatology 03/2013; DOI:10.3109/03009742.2013.765032 · 2.61 Impact Factor


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