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Antibody Profiling by Luciferase Immunoprecipitation Systems LIPS
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Antiphospholipid antibody testing and standardization.

K M J Devreese1

  • 1Coagulation Laboratory, Department of Clinical Chemistry, Microbiology and Immunology, Ghent University Hospital, Ghent, Belgium.

International Journal of Laboratory Hematology
|April 23, 2014
PubMed
Summary
This summary is machine-generated.

Diagnosing antiphospholipid syndrome (APS) is challenging due to methodological issues with lupus anticoagulant (LAC) and antiphospholipid antibody (aPL) tests. Ongoing standardization efforts aim to improve diagnostic accuracy and reduce interlaboratory variations.

Keywords:
Antiphospholipid syndromeanti-β2 glycoprotein I antibodiesanticardiolipin antibodiesguidelineslupus anticoagulantstandardization

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Area of Science:

  • Clinical Immunology
  • Laboratory Medicine
  • Rheumatology

Background:

  • Antiphospholipid syndrome (APS) diagnosis relies on specific laboratory criteria: lupus anticoagulant (LAC), anticardiolipin antibodies, and anti-β2 glycoprotein I antibodies (aβ2GPI).
  • Current laboratory assays for these antiphospholipid antibodies (aPL) possess inherent methodological shortcomings, impacting diagnostic reliability.
  • The combination of tests with varying sensitivity, specificity, and clinical utility complicates the laboratory diagnosis of APS.

Purpose of the Study:

  • To review the progress and challenges in standardizing antiphospholipid antibody (aPL) testing.
  • To evaluate the strengths and weaknesses of current laboratory methods for APS diagnosis.
  • To highlight the importance of ongoing efforts in reducing interlaboratory and interassay variations in aPL testing.

Main Methods:

  • Review of published consensus guidelines and proposals for antiphospholipid antibody (aPL) testing over the past 20 years.
  • Analysis of methodological shortcomings and interlaboratory/interassay variations in current aPL assays.
  • Evaluation of the clinical utility and standardization achievements in laboratory diagnosis of APS.

Main Results:

  • Significant improvements in aPL testing have been achieved through consensus guidelines, though complete standardization remains elusive.
  • Ongoing efforts are crucial for reducing interlaboratory and interassay variations, even if absolute standardization is not feasible.
  • Methodological limitations persist, underscoring the need for detailed guidelines to ensure adequate performance of aPL testing.

Conclusions:

  • Standardization of antiphospholipid antibody (aPL) testing has progressed but is not yet complete.
  • Addressing methodological shortcomings and reducing assay variations are critical for accurate APS laboratory diagnosis.
  • Enhanced guidelines are necessary to support the adequate performance of aPL testing in clinical practice.