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Related Experiment Video

Updated: Jun 15, 2025

Laparoscopic Technique for Serial Collection of Liver and Mesenteric Lymph Nodes in Macaques
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Laparoscopic Technique for Serial Collection of Liver and Mesenteric Lymph Nodes in Macaques

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Macaque liver substrate for evaluating dense fine speckled-like patterns on HEp2010 cells.

Anthea Anantharajah1, Roger A Silvestrini1, David Campbell1

  • 1Department of Immunopathology - ICPMR, Westmead Hospital, Westmead, NSW, Australia.

Pathology
|August 21, 2024
PubMed
Summary

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Dense fine speckled (DFS) antinuclear antibody (ANA) patterns can mask other clinically relevant findings. Using a liver substrate alongside HEp2010 in indirect immunofluorescence assays helps rule out other extractable nuclear antigen (ENA) antibodies in DFS-like patterns.

Area of Science:

  • Immunology
  • Autoimmunity
  • Clinical Diagnostics

Background:

  • Antinuclear antibody (ANA) detection via indirect immunofluorescence (IIF) is crucial for diagnosing systemic autoimmune diseases (SADs).
  • Dense fine speckled (DFS) ANA patterns typically indicate anti-DFS70 antibodies, which are generally associated with the absence of SAD.
  • However, DFS patterns can obscure other potentially significant ANA patterns.

Purpose of the Study:

  • To investigate if negative liver nucleus immunofluorescence can exclude extractable nuclear antigen (ENA) antibodies in sera exhibiting DFS-like ANA patterns.
  • To evaluate the utility of a liver substrate in conjunction with HEp2010 for comprehensive ANA screening.

Main Methods:

  • One hundred consecutive sera with DFS-like ANA patterns and 15 control sera were analyzed.
Keywords:
Antinuclear antibodyanti-extractable nuclear antigensdense fine speckledimmunology

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  • Samples were examined on HEp2010 and liver substrates by two independent readers using IIF.
  • Anti-DFS70 antibodies were quantified using line and chemiluminescent immunoassays.

    • Main Results:

    • DFS-like sera were more frequently liver nucleus-negative than control sera.
    • Among liver-negative sera, 95.3% were negative for anti-ENA antibodies.
    • The liver substrate demonstrated a sensitivity of 90.0% and a negative predictive value of 95.4% for anti-ENA detection.

    Conclusions:

    • Concurrent evaluation using a liver substrate aids in ruling out other anti-ENA antibodies in cases with DFS-like ANA patterns.
    • This approach serves as a safeguard against masking of clinically relevant anti-ENA by DFS-like patterns on IIF.
    • The liver substrate enhances the diagnostic accuracy of ANA testing in complex cases.