Evaluation of a multiparametric immunofluorescence assay for standardization of neuromyelitis optica serology
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Published on: December 12, 2011
Letizia Granieri1, Fabiana Marnetto, Paola Valentino
1Clinical Neurobiology Unit, Regional Referring Multiple Sclerosis Centre, University Hospital San Luigi Gonzaga, Orbassano, Turin, Italy. letiziagranieri@libero.it
Background:
Neuromyelitis optica (NMO) is a severely disabling autoimmune disorder of the central nervous system, which predominantly affects the optic nerves and spinal cord. In a majority of cases, NMO is associated with antibodies to aquaporin-4 (AQP4) (termed NMO-IgG).
Aims:
In this study, we evaluated a new multiparametric indirect immunofluorescence (IIF) assay for NMO serology.
Methods:
Sera from 20 patients with NMO, 41 patients with multiple sclerosis (MS), 30 healthy subjects, and a commercial anti-AQP4 IgG antibody were tested in a commercial composite immunofluorescence assay ("Neurology Mosaic 17"; Euroimmun, Germany), consisting of five different diagnostic substrates (HEK cells transfected with AQP4, non-transfected HEK cells, primate cerebellum, cerebrum, and optic nerve tissue sections).
Results:
We identified AQP4 specific and non-specific fluorescence staining patterns and established positivity criteria. Based on these criteria, this kit yielded a high sensitivity (95%) and specificity (100%) for NMO and had a significant positive and negative likelihood ratio (LR+ = ∞, LR- = 0.05). Moreover, a 100% inter- and intra-laboratory reproducibility was found.
Conclusions:
The biochip mosaic assay tested in this study is a powerful tool for NMO serology, fast to perform, highly sensitive and specific for NMO, reproducible, and suitable for inter-laboratory standardization as required for multi-centre clinical trials.
