ArticleAnnals of the rheumatic diseases2022
Longitudinal analysis of ANA in the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort.
Article in Annals of the rheumatic diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 21 citations in OpenAlex.
- Cell-based ELISA using intact HEp-2 cells: an alternative approach for antinuclear antibody detection.Immunologic research · 2026Article
- A Rare Case of Seronegative Lupus Nephritis Presenting as Immune Complex Diffuse Glomerulonephritis.Cureus · 2025Article
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- Comparison of cell type and disease subset chromatin modifications in SLE.Clinical epigenetics · 2024Article
- Anti-KIF20B autoantibodies are associated with cranial neuropathy in systemic lupus erythematosus.Lupus science & medicine · 2024Article
- Mapping theme evolution and identifying hotspots in biomarkers of systemic lupus erythematosus based on global research.Biomarkers in medicine · 2024Article
- Longitudinal antinuclear antibody titers in systemic lupus erythematosus and other rheumatic diseases.Frontiers in medicine · 2024Article
- Redefining serological diagnostics with immunoaffinity proteomics.Clinical proteomics · 2023Review
- Annals of the Rheumatic Diseases collection on autoantibodies in the rheumatic diseases: new insights into pathogenesis and the development of novel biomarkers.Annals of the rheumatic diseases · 2023Review
- Machine learning identifies clusters of longitudinal autoantibody profiles predictive of systemic lupus erythematosus disease outcomes.Annals of the rheumatic diseases · 2023Article
- Serological and clinical associations of autoantibodies in Chinese patients with new-onset systemic lupus erythematosus.Scientific reports · 2023Article
- [Lupus nephritis: from diagnosis to treatment].Innere Medizin (Heidelberg, Germany) · 2023Review
- Autoantibodies associated with systemic sclerosis in three autoimmune diseases imprinted by type I interferon gene dysregulation: a comparison across SLE, primary Sjögren's syndrome and systemic sclerosis.Lupus science & medicine · 2022Article
- Duration biased distribution of clinical and immunological phenotypes in active SLE.Frontiers in immunology · 2022Article
- Anti-Phospholipid Antibodies and Coronavirus Disease 2019: Vaccination Does Not Trigger Early Autoantibody Production in Healthcare Workers.Frontiers in immunology · 2022Article
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Authors and funding
38 authors at 20 institutions in 10 countries.
Funding
Abstract
objectivesA perception derived from cross-sectional studies of small systemic lupus erythematosus (SLE) cohorts is that there is a marked discrepancy between antinuclear antibody (ANA) assays, which impacts on clinicians' approach to diagnosis and follow-up. We compared three ANA assays in a longitudinal analysis of a large international incident SLE cohort retested regularly and followed for 5 years.
methodsDemographic, clinical and serological data was from 805 SLE patients at enrolment, year 3 and 5. Two HEp-2 indirect immunofluorescence assays (IFA1, IFA2), an ANA ELISA, and SLE-related autoantibodies were performed in one laboratory. Frequencies of positivity, titres or absorbance units (AU), and IFA patterns were compared using McNemar, Wilcoxon and kappa statistics, respectively.
resultsAt enrolment, ANA positivity (≥1:80) was 96.1% by IFA1 (median titre 1:1280 (IQR 1:640-1:5120)), 98.3% by IFA2 (1:2560 (IQR 1:640-1:5120)) and 96.6% by ELISA (176.3 AU (IQR 106.4 AU-203.5 AU)). At least one ANA assay was positive for 99.6% of patients at enrolment. At year 5, ANA positivity by IFAs (IFA1 95.2%; IFA2 98.9%) remained high, while there was a decrease in ELISA positivity (91.3%, p<0.001). Overall, there was >91% agreement in ANA positivity at all time points and ≥71% agreement in IFA patterns between IFA1 and IFA2.
conclusionIn recent-onset SLE, three ANA assays demonstrated commutability with a high proportion of positivity and titres or AU. However, over 5 years follow-up, there was modest variation in ANA assay performance. In clinical situations where the SLE diagnosis is being considered, a negative test by either the ELISA or HEp-2 IFA may require reflex testing.
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