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Related Experiment Videos

Problems in ANA test interpretation: a comparison of two substrates.

J H Rippey, S Carter, P Hood

    Diagnostic Immunology
    |January 1, 1985
    PubMed
    Summary
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    Choosing the right substrate for antinuclear antibody (ANA) testing is crucial. HEp-2 slides offer better specificity for systemic lupus erythematosus, while mouse kidney slides detect more nonspecific ANA.

    Area of Science:

    • Immunology
    • Clinical Chemistry
    • Autoimmunity

    Background:

    • Antinuclear antibody (ANA) testing is a key diagnostic tool for autoimmune diseases.
    • Different substrate slides, such as HEp-2 cells and mouse kidney sections, are used for ANA detection.
    • Variations in substrate can influence test results and their interpretation.

    Purpose of the Study:

    • To compare the performance of HEp-2 cell and mouse kidney substrates in ANA testing.
    • To evaluate the impact of substrate choice on end-point titers, pattern production, and clinical correlation.
    • To provide guidance on optimal substrate selection for ANA assays.

    Main Methods:

    • Serum samples were tested for ANA using both HEp-2 cell and mouse kidney substrates.
    • End-point titers and immunofluorescence patterns were recorded.

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  • Qualitative results and correlation with clinical status were analyzed.
  • The influence of manufacturer-suggested versus laboratory-established screening titers was assessed.

    • Main Results:

    • Significant differences were observed in end-point titers and pattern production between HEp-2 and mouse kidney substrates.
    • Qualitative results and clinical correlation varied significantly when using manufacturer-suggested screening titers.
    • Mouse kidney slides showed higher sensitivity for nonspecific ANA, while HEp-2 slides demonstrated greater specificity for systemic lupus erythematosus (SLE)-associated ANA.
    • Laboratory-established screening titers reduced some observed differences.

    Conclusions:

    • Substrate selection for ANA testing critically impacts sensitivity and specificity.
    • HEp-2 substrates are more specific for SLE, whereas mouse kidney substrates are more sensitive for detecting a broader range of ANA.
    • Standardization of screening titers within laboratories and consideration of substrate are essential for valid interlaboratory comparisons and reliable follow-up testing.