ArticleNeurology(R) neuroimmunology & neuroinflammation2025
Assessing Commercial Tissue-Based Assays for Autoimmune Neurologic Disorders (I): Antibodies to Intracellular Antigens.
Article in Neurology(R) neuroimmunology & neuroinflammation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Relative Frequency and Distinctive Features of Anti-Ma2 Nonparaneoplastic Neurologic Disorders: A French Cohort Study.Neurology(R) neuroimmunology & neuroinflammation · 2026Pooled it
- Antibody-Dependent Cellular Phagocytosis and Cytotoxicity in Patients With LGI1 and CASPR2 Encephalitis.Neurology(R) neuroimmunology & neuroinflammation · 2026Article
- Diagnosing autoimmune encephalitis in psychiatry: clinical recommendations and unresolved challenges from the GENERATE network.Molecular psychiatry · 2026Review
- MOGAD-Like Encephalitic Syndromes Without MOG Antibodies in Children.Neurology(R) neuroimmunology & neuroinflammation · 2026Article
- Evaluating the Value of Tissue-Based Assays in the Diagnosis of AE.Revista de neurologia · 2026Article
- Current and Future Biomarkers in the Diagnosis of Autoimmune Encephalitis: A Review of Biomarker Detection Techniques and Their Performance.Medicina (Kaunas, Lithuania) · 2026Review
- Detection of neural autoantibodies in dogs with non-infectious inflammatory central nervous system disorders.Journal of veterinary internal medicine · 2026Article
- Neuronal autoantibodies in neurodegenerative dementia: From evidence to clinical framework.The journal of prevention of Alzheimer's disease · 2026Review
- Testing for neural antibodies in autoimmune encephalitis: who, what, where, when, why, and how.Therapeutic advances in neurological disorders · 2026Review
- Differential Diagnosis of Infectious Versus Autoimmune Encephalitis Using Artificial Intelligence-Based Modeling.Journal of clinical medicine · 2025Article
- Beyond the Lab Slip: Why Laboratory Expertise Matters in Neuronal Antibody Testing and Why Clinicians Should Care.Neurology(R) neuroimmunology & neuroinflammation · 2025Article
- Baseline neuronal antibodies in patients with small cell lung cancer are not necessarily associated with post-immune checkpoint inhibitors neurotoxicities.Frontiers in immunology · 2025Article
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Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesCurrent strategies to detect autoantibodies against intracellular neural antigens (IC-Abs) include tissue-based assays (TBAs) alongside line blots or cell-based assays (CBAs). Many clinical laboratories use commercially available TBAs as a screening test, but their diagnostic yield has not been assessed. We determined the performance of 2 commercial TBAs in detecting IC-Abs.
methodsWe analyzed samples from 100 patients with autoimmune or paraneoplastic neurologic syndromes harboring IC-Abs (confirmed by in-house TBAs and line blots or CBAs) and 50 negative controls. IC-Abs samples included serum (10 each for Hu, Yo, Ri, SOX1, CV2, Ma2, Tr, amphiphysin, and GAD65 antibodies) or CSF (10 with GFAP antibodies) samples. Two commercial indirect immunofluorescence (IIF) TBAs (INOVA and EUROIMMUN) were assessed by 2 experienced investigators and 3 less experienced raters, all blinded to antibody status. Discordant results were re-evaluated through interrater discussion and assessed using Cohen's kappa.
resultsThe 2 experienced raters showed substantial agreement (85% for INOVA, 83% for EUROIMMUN) on negative/positive results, which increased to >95% after interrater discussion (Cohen's kappa 0.95 and 0.93, respectively). With IIF-INOVA, they correctly identified 118 of 150 samples (79%) and misclassified 28 of 150 (19%, 2 false positives and 26 false negatives) while results remained discordant in the remaining 4 of 150 samples (2%). With IIF-EUROIMMUN, they correctly identified 105 of 150 samples (70%) and misclassified 40 of 150 (27%, 6 false positives, 34 false negatives), with discordance in 5 of 150 samples (3%). Overall, the sensitivity was 73% for IIF-INOVA and 66% for IIF-EUROIMMUN. The specificity was 96% for IIF-INOVA and 88% for IIF-EUROIMMUN. Both TBAs showed low sensitivity in detecting CV2, SOX1, and amphiphysin antibodies while Ma2 antibodies were missed mainly by IIF-EUROIMMUN and Hu/Ri antibodies by IIF-INOVA. Antibody-specific immunostaining patterns were correctly identified in 62 of 100 positive samples with IIF-INOVA and 55 of 100 with IIF-EUROIMMUN ( DISCUSSION: The performance of commercial IIF-TBAs for IC-Abs detection is suboptimal, exhibiting high false-negative rates of 25%-35%. Therefore, commercial TBAs should not be used alone for IC-Abs screening, but alongside more sensitive techniques, such as line blots. Discordant results between 2 techniques should prompt retesting in reference centers with in-house TBAs, particularly when the suspicion of an autoimmune or paraneoplastic syndrome is high.
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