The diagnostic and prognostic value of a line immunoblot assay in Taiwanese patients with systemic sclerosis

Tsai-Hung Yen; Jun-Peng Chen; Tsu-Yi Hsieh; Wei-Ting Hung; Kuo-Lung Lai; Chia-Wei Hsieh; Hsin-Hua Chen; Wen-Nan Huang; Yi-Hsing Chen; Yi-Ming Chen

doi:10.1016/j.cca.2023.117457

The diagnostic and prognostic value of a line immunoblot assay in Taiwanese patients with systemic sclerosis

Clin Chim Acta. 2023 Jul 1:547:117457. doi: 10.1016/j.cca.2023.117457. Epub 2023 Jun 29.

Authors

Affiliations

¹ Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Division of General Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
² Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, Taiwan.
³ Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
⁴ Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
⁵ Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Precision Medicine Research Center, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
⁶ Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Division of General Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; Precision Medicine Research Center, College of Medicine, National Chung Hsing University, Taichung, Taiwan; School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan.
⁷ Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan.
⁸ Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; Precision Medicine Research Center, College of Medicine, National Chung Hsing University, Taichung, Taiwan; School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan; Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan. Electronic address: ymchen1@vghtc.gov.tw.

PMID: 37390945
DOI: 10.1016/j.cca.2023.117457

Abstract

Background and aims: We aimed to evaluate the diagnostic performance and prognostic value of disease-specific antibodies and anti-Ro52 using a commercial line immunoblot assay (LIA) in Taiwanese patients with systemic sclerosis (SSc).

Materials and methods: We retrospectively enrolledall individuals at the Taichung Veterans General Hospital. We evaluated the diagnostic performance of LIA, anti-nuclear antibody (ANA) by indirect immunofluorescence (IIF) and also the association between the autoantibodies and the clinical phenotype using multivariable logistic regression.

Results: The LIA exhibited a sensitivity of 65.4% and a specificity of 65.4%, at the optimal cutoff values of 2 + signal intensity. By taking the result of ANA into consideration, the optimal cutoff point was redefined as 1+. We observed a higher risk of diffuse cutaneous SSc (dcSSc) in those with negative autoantibodies, positive anti-Scl-70, anti-RNA polymerase III, and anti-Ro-52. Interstitial lung disease (ILD) was associated with negative autoantibodies, as well as positive anti-Scl-70 and anti-Ro52. Anti-Ro52 positivity was also associated with pulmonary arterial hypertension (PAH) and gastrointestinal tract involvement.

Conclusion: The presence of anti-Ro52 or the absence of SSc-specific autoantibodies may potentially indicate advanced diseases in patients with SSc. The incorporation of both IIF and LIA testing may improve the diagnostic specificity of SSc.

Keywords: Anti-Ro52; Autoantibody; Immunoblot; Interstitial lung disease; Pulmonary arterial hypertension; Systemic sclerosis.

MeSH terms

Antibodies, Antinuclear
Asian People
Autoantibodies
Humans
Prognosis
Retrospective Studies
Scleroderma, Systemic* / diagnosis

Substances

Autoantibodies
Antibodies, Antinuclear