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Updated: Jun 26, 2026
Anti-Nuclear Antibody Screening Using HEp-2 Cells
Published on: June 23, 2014
Antinuclear antibody detection beyond anti-dsDNA and anti-ENA: New insights from intact HEp-2 nucleus ELISA
1Bingöl University, Faculty of Physiotherapy and Rehabilitation, Department of Basic Physiotherapy, Bingöl, Turkey.
Background:
Intact HEp-2 nucleus-based ELISA tests are occasionally preferred for antinuclear antibody (ANA) screening, although their correlation with clinically relevant autoantibodies such as anti-dsDNA and anti-ENA remains unclear. This study analyzed the correlation between HEp-2 nucleus-based ELISA and anti-dsDNA and anti-ENA tests in a large sample to provide analytical insight into their relationship.
Material And Methods:
A total of 900 serum samples were included in the study (mean age: 39.7 years; 481 females and 419 males). Anti-dsDNA, anti-ENA, and intact HEp-2 nucleus-based ELISA tests were performed in all samples using validated ELISA methods. Correlation analyses between test results were performed using Spearman's rank correlation coefficient due to non-normal data distribution.
Results:
HEp-2 ELISA showed a moderate correlation with anti-dsDNA (r=0.431, p<0.001) and a stronger correlation with anti-ENA (r=0.625, p<0.001). Among the 431 individuals who tested positive in at least one of the three assays, 96 were positive for all three. Additionally, 41 individuals were positive for both anti-dsDNA and HEp-2, and 44 for both anti-ENA and HEp-2. Isolated positivity was observed in 112 individuals for anti-dsDNA, 48 for anti-ENA, and 54 for HEp-2. This distribution reflects both overlapping and distinct patterns of antibody detection among the tests.
Conclusions:
HEp-2 nucleus-based ELISA demonstrated analytical concordance with both anti-dsDNA and anti-ENA assays. Moreover, its ability to detect distinct autoantibody reactivities not identified by conventional methods suggests its value as a complementary tool in comprehensive ANA screening.
