Introduction: Several immunological methods are used to determine the serum antinuclear antibodies (ANA). Indirect immunofluorescence assay (IFA) with tissue slices or HEp-2 cells is the standard technique considered the gold standard for their screening. Serum-free McCoy-Plovdiv cell line may also be used as substrate for IFA. Another method for detection of total and specific ANA is the enzyme-linked immunosorbent assay (ELISA). Immunoblot is also applied in specific ANA confirmation. The aim of the current study was to determine and propose a justified immunological approach for identification of clinically significant ANA by comparing the screening tests - ANA-IFA on serum-free McCoy-Plovdiv cell substrate with ELISA for total ANA, and confirmative methods for specific ANA-ELISA with immunoblot.

Materials And Methods: Serum samples from 38 patients screened for totalANA by ELISA (Trinity Biotech, NY, USA) and IFA-ANA with McCoy-Plovdiv cell line, were included in the study. Positive samples were confirmed by immunoblot (Orgentec Diagnostika, Germany) and ELISA for specificity of confirmed ANA.

Results: No significant difference (P > 0.05) and very good agreement were found between the two screening tests. Very good agreement for specific antibodies against SS-A, SS-B, dsDNA, moderate for anti-Sm and anti-Sm/RNP and fair for anti-histone/nucleosomal antibodies was found between confirmative methods. No agreement was found for anti-Scl-70 antibodies.

Conclusion: IFA-ANA with serum-free McCoy-Plovdiv cell line and screening ELISA may be recommended for determination of total ANA, and immunoblot and ELISA- for confirmation and identification of specific ANA.

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http://dx.doi.org/10.2478/v10153-011-0063-0DOI Listing

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