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Journal of Immunology Research
Volume 2014, Article ID 315179, 18 pages
http://dx.doi.org/10.1155/2014/315179
Review Article

Current Concepts and Future Directions for the Assessment of Autoantibodies to Cellular Antigens Referred to as Anti-Nuclear Antibodies

Michael Mahler,1 Pier-Luigi Meroni,2 Xavier Bossuyt,3 and Marvin J. Fritzler4

1INOVA Diagnostics, Inc., 9900 Old Grove Road, San Diego, CA 92131-1638, USA
2Rheumatology & Experimental Laboratory of Immuno-rheumatology, University of Milan, Istituto Auxologico Italiano, Via G. Zucchi 18, 20095 Cusano Milanino, Milan, Italy
3Department of Microbiology and Immunology, Laboratory Medicine, University Hospitals Leuven, KU Leuven, Belgium
4Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada T2N 4N1

Received 13 December 2013; Accepted 27 January 2014; Published 27 April 2014

Academic Editor: Ghislain Opdenakker

Copyright © 2014 Michael Mahler et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. A. H. Coons and M. H. Kaplan, “Localization of antigen in tissue cells; improvements in a method for the detection of antigen by means of fluorescent antibody,” The Journal of Experimental Medicine, vol. 91, no. 1, pp. 1–13, 1950. View at Google Scholar · View at Scopus
  2. G. J. Friou, S. C. Finch, and K. D. Detre, “Interaction of nuclei and globulin from lupus erythematosis serum demonstrated with fluorescent antibody,” Journal of Immunology, vol. 80, no. 4, pp. 324–329, 1958. View at Google Scholar · View at Scopus
  3. G. J. Friou, “Setting the scene: a historical and personal view of immunologic diseases, autoimmunity and ANA,” Clinical and Experimental Rheumatology, vol. 12, supplement 11, pp. S23–S25, 1994. View at Google Scholar · View at Scopus
  4. M. M. Hargraves, H. Richmond, and R. Morton, “Presentation of two bone marrow elements, the tart cell and the L.E. cell,” Proceedings of the Staff Meetings of the Mayo Clinic, vol. 23, pp. 25–28, 1948. View at Google Scholar
  5. H. R. Holman, H. R. Deicher, and H. G. Kunkel, “The L. E. cell and the L. E. serum factors,” Bulletin of the New York Academy of Medicine, vol. 35, no. 7, pp. 409–418, 1959. View at Google Scholar · View at Scopus
  6. A. E. Moore, L. Sabachewsky, and H. W. Toolan, “Culture characteristics of four permanent lines of human cancer cells,” Cancer Research, vol. 15, pp. 598–602, 1955. View at Google Scholar
  7. E. M. Tan, “Antinuclear antibodies in diagnosis and management,” Hospital Practice, vol. 18, no. 1, pp. 79–84, 1983. View at Google Scholar · View at Scopus
  8. M. Mahler and M. J. Fritzler, “Epitope specificity and significance in systemic autoimmune diseases,” Annals of the New York Academy of Sciences, vol. 1183, pp. 267–287, 2010. View at Publisher · View at Google Scholar · View at Scopus
  9. M. J. Fritzler and M. L. Fritzler, “The emergence of multiplexed technologies as diagnostic platforms in systemic autoimmune diseases,” Current Medicinal Chemistry, vol. 13, no. 21, pp. 2503–2512, 2006. View at Publisher · View at Google Scholar · View at Scopus
  10. M. J. Fritzler, “Advances and applications of multiplexed diagnostic technologies in autoimmune diseases,” Lupus, vol. 15, no. 7, pp. 422–427, 2006. View at Publisher · View at Google Scholar · View at Scopus
  11. A. S. Wiik, T. P. Gordon, A. F. Kavanaugh et al., Eds., “Cutting edge diagnostics in rheumatology: the role of patients, clinicians, and laboratory scientists in optimizing the use of autoimmune serology,” Arthritis Care and Research, vol. 51, no. 2, pp. 291–298, 2004. View at Google Scholar · View at Scopus
  12. P. L. Meroni and P. H. Schur, “ANA screening: an old test with new recommendations,” Annals of the Rheumatic Diseases, vol. 69, no. 8, pp. 1420–1422, 2010. View at Publisher · View at Google Scholar · View at Scopus
  13. A. S. Wiik, M. Høier-Madsen, J. Forslid, P. Charles, and J. Meyrowitsch, “Antinuclear antibodies: a contemporary nomenclature using HEp-2 cells,” Journal of Autoimmunity, vol. 35, no. 3, pp. 276–290, 2010. View at Publisher · View at Google Scholar · View at Scopus
  14. H. Holman and W. Robbins, “Antinuclear antibodies in systemic lupus erythematosus,” Arthritis & Rheumatology, vol. 2, pp. 468–471, 1959. View at Google Scholar
  15. K. Egerer, D. Roggenbuck, R. Hiemann et al., “Automated evaluation of autoantibodies on human epithelial-2 cells as an approach to standardize cell-based immunofluorescence tests,” Arthritis Research and Therapy, vol. 12, no. 2, article R40, 2010. View at Publisher · View at Google Scholar · View at Scopus
  16. S. Kivity, B. Gilburd, N. Agmon-Levin et al., “A novel automated indirect immunofluorescence autoantibody evaluation,” Clinical Rheumatology, vol. 31, no. 3, pp. 503–509, 2012. View at Publisher · View at Google Scholar · View at Scopus
  17. A. Melegari, C. Bonaguri, A. Russo, B. Luisita, T. Trenti, and G. Lippi, “A comparative study on the reliability of an automated system for the evaluation of cell-based indirect immunofluorescence,” Autoimmunity Reviews, vol. 11, pp. 713–716, 2012. View at Google Scholar
  18. M. R. Arbuckle, M. T. McClain, M. V. Rubertone et al., “Development of autoantibodies before the clinical onset of systemic lupus erythematosus,” The New England Journal of Medicine, vol. 349, no. 16, pp. 1526–1533, 2003. View at Publisher · View at Google Scholar · View at Scopus
  19. C. Eriksson, H. Kokkonen, M. Johansson, G. Hallmans, G. Wadell, and S. Rantapää-Dahlqvist, “Autoantibodies predate the onset of systemic lupus erythematosus in northern Sweden,” Arthritis Research and Therapy, vol. 13, no. 1, article R30, 2011. View at Publisher · View at Google Scholar · View at Scopus
  20. T. Kampfrath and S. S. Levinson, “Brief critical review: statistical assessment of biomarker performance,” Clinica Chimica Acta, vol. 419, pp. 102–107, 2013. View at Google Scholar
  21. N. Agmon-Levin, J. Damoiseaux, C. Kallenberg et al., “International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti-nuclear antibodies,” Annals of Rheumatic Diseases, vol. 73, pp. 17–23, 2014. View at Publisher · View at Google Scholar
  22. A. M. Abeles and M. Abeles, “The clinical utility of a positive antinuclear antibody test result,” American Journal of Medicine, vol. 126, pp. 342–348, 2013. View at Google Scholar
  23. E. M. Tan, T. E. W. Feltkamp, J. S. Smolen et al., “Range of antinuclear antibodies in “healthy” individuals,” Arthritis & Rheumatism, vol. 40, no. 9, pp. 1601–1611, 1997. View at Publisher · View at Google Scholar · View at Scopus
  24. D. A. González, A. C. D. León, A. R. Varela et al., “Autoantibody detection with indirect immunofluorescence on HEp-2 cells: starting serum dilutions for systemic rheumatic diseases,” Immunology Letters, vol. 140, no. 1-2, pp. 30–35, 2011. View at Publisher · View at Google Scholar · View at Scopus
  25. X. Bossuyt, “Clinical performance characteristics of a laboratory test. A practical approach in the autoimmune laboratory,” Autoimmunity Reviews, vol. 8, no. 7, pp. 543–548, 2009. View at Publisher · View at Google Scholar · View at Scopus
  26. P. Vermeersch and X. Bossuyt, “Comparative analysis of different approaches to report diagnostic accuracy,” Archives of Internal Medicine, vol. 170, no. 8, pp. 734–735, 2010. View at Publisher · View at Google Scholar · View at Scopus
  27. A. F. Kavanaugh, D. H. Solomon, P. Schur, J. D. Reveille, Y. R. S. Sherrer, and R. Lahita, “Guidelines for immunologic laboratory testing in the rheumatic diseases: an introduction,” Arthritis Care and Research, vol. 47, no. 4, pp. 429–433, 2002. View at Google Scholar · View at Scopus
  28. K. Op De Beeck, P. Vermeersch, P. Verschueren et al., “Detection of antinuclear antibodies by indirect immunofluorescence and by solid phase assay,” Autoimmunity Reviews, vol. 10, no. 12, pp. 801–808, 2011. View at Publisher · View at Google Scholar · View at Scopus
  29. K. Op De Beéck, P. Vermeersch, P. Verschueren et al., “Antinuclear antibody detection by automated multiplex immunoassay in untreated patients at the time of diagnosis,” Autoimmunity Reviews, vol. 12, pp. 137–143, 2012. View at Google Scholar
  30. S. Schouwers, M. Bonnet, P. Verschueren et al., “Value-added reporting of antinuclear antibody testing by automated indirect immunofluorescence analysis,” Clinical Chemistry and Laboratory Medicine, vol. 52, no. 4, pp. 547–551, 2014. View at Publisher · View at Google Scholar
  31. X. Bossuyt and S. Fieuws, “Detection of antinuclear antibodies: added value of solid phase assay?” Annals of the Rheumatic Diseases, vol. 73, article e10, 2014. View at Publisher · View at Google Scholar
  32. M. Vercammen, P. Meirlaen, J. Sennesael et al., “Diagnostic accuracy of the FIDIS multiplex fluorescent microsphere immunodetection system for anti-extractable nuclear antigen (ENA) antibodies in connective tissue diseases,” Clinical Chemistry and Laboratory Medicine, vol. 45, no. 4, pp. 505–512, 2007. View at Publisher · View at Google Scholar · View at Scopus
  33. J. Wenzel, R. Gerdsen, M. Uerlich, R. Bauer, T. Bieber, and I. Boehm, “Antibodies targeting extractable nuclear antigens: historical development and current knowledge,” British Journal of Dermatology, vol. 145, no. 6, pp. 859–867, 2001. View at Publisher · View at Google Scholar · View at Scopus
  34. J. G. M. C. Damoiseaux and J. W. Cohen Tervaert, “From ANA to ENA: how to proceed?” Autoimmunity Reviews, vol. 5, no. 1, pp. 10–17, 2006. View at Publisher · View at Google Scholar · View at Scopus
  35. Y. Sherer, A. Gorstein, M. J. Fritzler, and Y. Shoenfeld, “Autoantibody explosion in systemic lupus erythematosus: more than 100 different antibodies found in SLE patients,” Seminars in Arthritis and Rheumatism, vol. 34, no. 2, pp. 501–537, 2004. View at Publisher · View at Google Scholar · View at Scopus
  36. S. S. Copple, A. D. Sawitzke, A. M. Wilson, A. E. Tebo, and H. R. Hill, “Enzyme-linked immunosorbent assay screening then indirect immunofluorescence confirmation of antinuclear antibodies,” American Journal of Clinical Pathology, vol. 135, no. 5, pp. 678–684, 2011. View at Publisher · View at Google Scholar · View at Scopus
  37. V. K. Shanmugam, D. R. Swistowski, N. Saddic, H. Wang, and V. D. Steen, “Comparison of indirect immunofluorescence and multiplex antinuclear antibody screening in systemic sclerosis,” Clinical Rheumatology, vol. 30, no. 10, pp. 1363–1368, 2011. View at Publisher · View at Google Scholar · View at Scopus
  38. E. M. Tan, A. S. Cohen, and J. F. Fries, “The 1982 revised criteria for the classification of systemic lupus erythrematosus,” Arthritis & Rheumatism, vol. 25, no. 11, pp. 1271–1277, 1982. View at Google Scholar · View at Scopus
  39. M. Petri, A. M. Orbai, G. S. Alarcon et al., “Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus,” Arthritis & Rheumatology, vol. 64, pp. 2677–2686, 2012. View at Google Scholar
  40. L. Andreoli, F. Pregnolato, R. W. Burlingame et al., “Antinucleosome antibodies in primary antiphospholipid syndrome: a hint at systemic autoimmunity?” Journal of Autoimmunity, vol. 30, no. 1-2, pp. 51–57, 2008. View at Publisher · View at Google Scholar · View at Scopus
  41. S. Assassi, M. J. Fritzler, F. C. Arnett et al., “Primary biliary cirrhosis (PBC), PBC autoantibodies, and hepatic parameter abnormalities in a large population of systemic sclerosis patients,” Journal of Rheumatology, vol. 36, no. 10, pp. 2250–2256, 2009. View at Publisher · View at Google Scholar · View at Scopus
  42. Y. Zafrir, B. Gilburd, M. G. Carrasco et al., “Evaluation of an automated chemiluminescent immunoassay kit for antinuclear antibodies in autoimmune diseases,” Immunologic Research, vol. 56, pp. 451–456, 2013. View at Google Scholar
  43. A. Granito, P. Muratori, C. Quarneti, G. Pappas, R. Cicola, and L. Muratori, “Antinuclear antibodies as ancillary markers in primary biliary cirrhosis,” Expert Review of Molecular Diagnostics, vol. 12, no. 1, pp. 65–74, 2012. View at Publisher · View at Google Scholar · View at Scopus
  44. P. Muratori, A. Granito, G. Pappas, L. Muratori, M. Lenzi, and F. B. Bianchi, “Autoimmune liver disease 2007,” Molecular Aspects of Medicine, vol. 29, no. 1-2, pp. 96–102, 2008. View at Publisher · View at Google Scholar · View at Scopus
  45. D. P. Bogdanos and L. Komorowski, “Disease-specific autoantibodies in primary biliary cirrhosis,” Clinica Chimica Acta, vol. 412, no. 7-8, pp. 502–512, 2011. View at Publisher · View at Google Scholar · View at Scopus
  46. N. Agmon-Levin, Y. Shapira, C. Selmi et al., “A comprehensive evaluation of serum autoantibodies in primary biliary cirrhosis,” Journal of Autoimmunity, vol. 34, no. 1, pp. 55–58, 2010. View at Publisher · View at Google Scholar · View at Scopus
  47. J. A. Savige, M. Gallicchio, L. Chang, and J. D. Parkin, “Autoantibodies in systemic vasculitis,” Australian and New Zealand Journal of Medicine, vol. 21, no. 4, pp. 433–437, 1991. View at Google Scholar · View at Scopus
  48. F. Beigel, F. Schnitzler, R. Paul Laubender et al., “Formation of antinuclear and double-strand DNA antibodies and frequency of lupus-like syndrome in anti-TNF-α antibody-treated patients with inflammatory bowel disease,” Inflammatory Bowel Diseases, vol. 17, no. 1, pp. 91–98, 2011. View at Publisher · View at Google Scholar · View at Scopus
  49. C. Mancho, Á. Sainz, M. García-Sancho, A. Villaescusa, M. A. Tesouro, and F. Rodríguez-Franco, “Detection of perinuclear antineutrophil cytoplasmic antibodies and antinuclear antibodies in the diagnosis of canine inflammatory bowel disease,” Journal of Veterinary Diagnostic Investigation, vol. 22, no. 4, pp. 553–558, 2010. View at Google Scholar · View at Scopus
  50. H. Nielsen, A. Wiik, and J. Elmgreen, “Granulocyte specific antinuclear antibodies in ulcerative colitis: Aid in differential diagnosis of inflammatory bowel disease,” Acta Pathologica Microbiologica et Immunologica Scandinavica: C Immunology, vol. 91, no. 1, pp. 23–26, 1983. View at Google Scholar · View at Scopus
  51. D. Zauli, C. Crespi, and P. Dall'Amore, “Antibodies to the cytoskeleton components and other autoantibodies in inflammatory bowel disease,” Digestion, vol. 32, no. 2, pp. 140–144, 1985. View at Google Scholar · View at Scopus
  52. A. K. Al-Shukaili, A. A. Al-Jabri, and M. S. Al-Moundhari, “Prognostic value of auto-antibodies in the serum of Omani patients with gastric cancer,” Saudi Medical Journal, vol. 27, no. 12, pp. 1873–1877, 2006. View at Google Scholar · View at Scopus
  53. J. B. Armas, J. Dantas, D. Mendonça et al., “Anticardiolipin and antinuclear antibodies in cancer patients—a case control study,” Clinical and Experimental Rheumatology, vol. 18, no. 2, pp. 227–232, 2000. View at Google Scholar · View at Scopus
  54. F. Blaes, M. Klotz, H. Huwer et al., “Antineural and antinuclear autoantibodies are of prognostic relevance in non-small cell lung cancer,” Annals of Thoracic Surgery, vol. 69, no. 1, pp. 254–258, 2000. View at Publisher · View at Google Scholar · View at Scopus
  55. T. Daniels, J. Zhang, I. Gutierrez et al., “Antinuclear autoantibodies in prostate cancer: immunity to LEDGF/p75, a survival protein highly expressed in prostate tumors and cleaved during apoptosis,” Prostate, vol. 62, no. 1, pp. 14–26, 2005. View at Publisher · View at Google Scholar · View at Scopus
  56. H. Imai, Y. Nakano, K. Kiyosawa, and E. M. Tan, “Increasing titers and changing specificities of antinuclear antibodies in patients with chronic liver disease who develop hepatocellular carcinoma,” Cancer, vol. 71, pp. 26–35, 1993. View at Google Scholar
  57. A. Imran, F. Neelam, and M. Tariq, “Incidence of circulating antinuclear antibodies in cancer patients,” Indian journal of medical sciences, vol. 57, no. 3, pp. 113–116, 2003. View at Google Scholar · View at Scopus
  58. A. M. Borowoy, J. E. Pope, E. Silverman et al., “Neuropsychiatric lupus: the prevalence and autoantibody associations depend on the definition: results from the 1000 faces of lupus cohort,” Seminars in Arthritis and Rheumatism, vol. 42, pp. 179–185, 2012. View at Google Scholar
  59. A. Fernández, G. Quintana, E. L. Matteson et al., “Lupus arthropathy: historical evolution from deforming arthritis to rhupus,” Clinical Rheumatology, vol. 23, no. 6, pp. 523–526, 2004. View at Publisher · View at Google Scholar · View at Scopus
  60. C. Tani, D. D'Aniello, S. A. Delle et al., “Rhupus syndrome: assessment of its prevalence and its clinical and instrumental characteristics in a prospective cohort of 103 SLE patients,” Autoimmunity Reviews, vol. 12, pp. 537–541, 2013. View at Google Scholar
  61. H. Nossent and O. P. Rekvig, “Antinuclear antibody screening in this new millennium: farewell to the microscope?” Scandinavian Journal of Rheumatology, vol. 30, no. 3, pp. 123–126, 2001. View at Publisher · View at Google Scholar · View at Scopus
  62. A. Kavanaugh, R. Tomar, J. Reveille, D. H. Solomon, and H. A. Homburger, “Guidelines for clinical use of the antinuclear antibody test and tests for specific autoantibodies to nuclear antigens,” Archives of Pathology and Laboratory Medicine, vol. 124, no. 1, pp. 71–81, 2000. View at Google Scholar · View at Scopus
  63. M. Mahler, J. T. Ngo, J. Schulte-Pelkum, T. Luettich, and M. J. Fritzler, “Limited reliability of the indirect immunofluorescence technique for the detection of anti-Rib-P antibodies,” Arthritis Research and Therapy, vol. 10, no. 6, article R131, 2008. View at Publisher · View at Google Scholar · View at Scopus
  64. I. Kang, R. Siperstein, T. Quan, and M. L. Breitenstein, “Utility of age, gender, ANA titer and pattern as predictors of anti-ENA and -dsDNA antibodies,” Clinical Rheumatology, vol. 23, no. 6, pp. 509–515, 2004. View at Publisher · View at Google Scholar · View at Scopus
  65. X. Bossuyt and A. Luyckx, “Antibodies to extractable nuclear antigens in antinuclear antibody-negative samples,” Clinical Chemistry, vol. 51, no. 12, pp. 2426–2427, 2005. View at Publisher · View at Google Scholar · View at Scopus
  66. I. E. A. Hoffman, I. Peene, E. M. Veys, and F. De Keyser, “Detection of specific antinuclear reactivities in patients with negative anti-nuclear antibody immunofluorescence screening tests,” Clinical Chemistry, vol. 48, no. 12, pp. 2171–2176, 2002. View at Google Scholar · View at Scopus
  67. X. Bossuyt, G. Mariën, and S. Vanderschueren, “A 67-year-old woman with a systemic inflammatory syndrome and sicca,” Clinical Chemistry, vol. 56, no. 9, pp. 1508–1509, 2010. View at Publisher · View at Google Scholar · View at Scopus
  68. G. P. Tri, R. C. W. Wong, and S. Adelstein, “Autoantibodies to extractable nuclear antigens: making detection and interpretation more meaningful,” Clinical and Diagnostic Laboratory Immunology, vol. 9, no. 1, pp. 1–7, 2002. View at Publisher · View at Google Scholar · View at Scopus
  69. D. H. Solomon, A. J. Kavanaugh, P. H. Schur et al., “Evidence-based guidelines for the use of immunologic tests: antinuclear antibody testing,” Arthritis Care and Research, vol. 47, no. 4, pp. 434–444, 2002. View at Google Scholar · View at Scopus
  70. P. Perner, H. Perner, and B. Müller, “Mining knowledge for HEp-2 cell image classification,” Artificial Intelligence in Medicine, vol. 26, no. 1-2, pp. 161–173, 2002. View at Publisher · View at Google Scholar · View at Scopus
  71. R. Hiemann, T. Büttner, T. Krieger, D. Roggenbuck, U. Sack, and K. Conrad, “Challenges of automated screening and differentiation of non-organ specific autoantibodies on HEp-2 cells,” Autoimmunity Reviews, vol. 9, no. 1, pp. 17–22, 2009. View at Publisher · View at Google Scholar · View at Scopus
  72. A. Willitzki, R. Hiemann, V. Peters et al., “New platform technology for comprehensive serological diagnostics of autoimmune diseases,” Clinical and Developmental Immunology, vol. 2012, Article ID 284740, 8 pages, 2012. View at Publisher · View at Google Scholar
  73. J. Voigt, C. Krause, E. Rohwader et al., “Automated indirect immunofluorescence evaluation of antinuclear autoantibodies on HEp-2 cells,” Clinical and Developmental Immunology, vol. 2012, Article ID 651058, 7 pages, 2012. View at Publisher · View at Google Scholar
  74. D. Bertin, N. Jourde-Chiche, P. Bongrand, and N. Bardin, “Original approach for automated quantification of antinuclear autoantibodies by indirect immunofluorescence,” Clinical and Developmental Immunology, vol. 2013, Article ID 182172, 8 pages, 2013. View at Publisher · View at Google Scholar
  75. D. Roggenbuck, R. Hiemann, P. Schierack, D. Reinhold, and K. Conrad, “Digital immunofluorescence enables automated detection of antinuclear antibody endpoint titers avoiding serial dilution,” Clinical Chemistry and Laboratory Medicine, pp. 1–3, 2013. View at Google Scholar
  76. C. Bonroy, C. Verfaillie, V. Smith et al., “Automated indirect immunofluorescence antinuclear antibody analysis is a standardized alternative for visual microscope interpretation,” Clinical Chemistry and Laboratory Medicine, vol. 51, pp. 1771–1779, 2013. View at Google Scholar
  77. X. Bossuyt, S. Cooreman, B. H. De et al., “Detection of antinuclear antibodies by automated indirect immunofluorescence analysis,” Clinica Chimica Acta, vol. 415, pp. 101–106, 2013. View at Google Scholar
  78. P. Foggia, G. Percannella, P. Soda, and M. Vento, “Benchmarking HEp-2 cells classification methods,” IEEE Transactions on Medical Imaging, vol. 32, pp. 1878–1889, 2013. View at Google Scholar
  79. D. Roggenbuck, R. Hiemann, D. Bogdanos, D. Reinhold, and K. Conrad, “Standardization of automated interpretation of immunofluorescence tests,” Clinica Chimica Acta, vol. 421, pp. 168–169, 2013. View at Google Scholar
  80. K. Kidd, K. Cusi, R. Mueller, M. Goodner, B. Boyes, and E. Hoy, “Detection and identification of significant ANAs in previously determined ANA negative samples,” Clinical Laboratory, vol. 51, no. 9-10, pp. 517–521, 2005. View at Google Scholar · View at Scopus
  81. X. Bossuyt, J. Frans, A. Hendrickx, G. Godefridis, R. Westhovens, and G. Mariën, “Detection of anti-SSA antibodies by indirect immunofluorescence,” Clinical Chemistry, vol. 50, no. 12, pp. 2361–2369, 2004. View at Publisher · View at Google Scholar · View at Scopus
  82. A. Watanabe, M. Kodera, K. Sugiura et al., “Anti-DFS70 antibodies in 597 healthy hospital workers,” Arthritis & Rheumatism, vol. 50, no. 3, pp. 892–900, 2004. View at Publisher · View at Google Scholar · View at Scopus
  83. O. Shovman, B. Gilburd, O. Barzilai et al., “Evaluation of the BioPlex 2200 ANA screen. Analysis of 510 healthy subjects: incidence of natural/predictive autoantibodies,” Annals of the New York Academy of Sciences, vol. 1050, pp. 380–388, 2005. View at Publisher · View at Google Scholar · View at Scopus
  84. R. A. Gniewek, D. P. Stites, T. M. McHugh, J. F. Hilton, and M. Nakagawa, “Comparison of antinuclear antibody testing methods: immunofluorescence assay versus enzyme immunoassay,” Clinical and Diagnostic Laboratory Immunology, vol. 4, no. 2, pp. 185–188, 1997. View at Google Scholar · View at Scopus
  85. E. Avaniss-Aghajani, S. Berzon, and A. Sarkissian, “Clinical value of multiplexed bead-based immunoassays for detection of autoantibodies to nuclear antigens,” Clinical and Vaccine Immunology, vol. 14, no. 5, pp. 505–509, 2007. View at Publisher · View at Google Scholar · View at Scopus
  86. K. Sugisaki, I. Takeda, T. Kanno et al., “An anti-nuclear antibody-negative patient with systemic lupus erythematosus (SLE) accompanied with anti-ribosomal P antibody (anti-P),” Internal Medicine, vol. 41, no. 11, pp. 1047–1051, 2002. View at Google Scholar · View at Scopus
  87. Y. Muro, K. Sugiura, Y. Morita, and Y. Tomita, “Evaluation of anti-ribosomal P protein immunoassay in Japanese patients with connective tissue diseases: comparison with an indirect immunofluorescence assay,” Scandinavian Journal of Rheumatology, vol. 38, no. 6, pp. 460–463, 2009. View at Publisher · View at Google Scholar · View at Scopus
  88. I. Peene, W. Van Ael, M. Vandenbossche, T. Vervaet, E. Veys, and F. De Keyser, “Sensitivity of the HEp-2000 substrate for the detection of anti-SSA/Ro60 antibodies,” Clinical Rheumatology, vol. 19, no. 4, pp. 291–295, 2000. View at Google Scholar · View at Scopus
  89. M. J. Fritzler, C. Hanson, J. Miller, and T. Eystathioy, “Specificity of autoantibodies to SS-A/Ro on a transfected and overexpressed human 60 kDa Ro autoantigen substrate,” Journal of Clinical Laboratory Analysis, vol. 16, no. 2, pp. 103–108, 2002. View at Publisher · View at Google Scholar · View at Scopus
  90. N. Tanaka, Y. Muro, K. Sugiura, and Y. Tomita, “Anti-SS-A/Ro antibody determination by indirect immunofluorescence and comparison of different methods of anti-nuclear antibody screening,” Modern Rheumatology, vol. 18, no. 6, pp. 585–592, 2008. View at Publisher · View at Google Scholar · View at Scopus
  91. S. L. Wang, F. F. Wang, S. L. Chen et al., “Expression localization and clinical application of exogenous Smith proteins D1 in gene transfected HEp-2 cells,” International Journal of Rheumatic Diseases, vol. 16, pp. 303–309, 2013. View at Google Scholar
  92. C. Dahle, T. Skogh, A. K. Åberg, A. Jalal, and P. Olcén, “Methods of choice for diagnostic antinuclear antibody (ANA) screening: benefit of adding antigen-specific assays to immunofluorescence microscopy,” Journal of Autoimmunity, vol. 22, no. 3, pp. 241–248, 2004. View at Publisher · View at Google Scholar · View at Scopus
  93. M. J. Fritzler, J. B. Rattner, L. M. Luft et al., “Historical perspectives on the discovery and elucidation of autoantibodies to centromere proteins (CENP) and the emerging importance of antibodies to CENP-F,” Autoimmunity Reviews, vol. 10, no. 4, pp. 194–200, 2011. View at Publisher · View at Google Scholar · View at Scopus
  94. S. Khan, A. Alvi, S. Holding et al., “The clinical significance of antinucleolar antibodies,” Journal of Clinical Pathology, vol. 61, no. 3, pp. 283–286, 2008. View at Publisher · View at Google Scholar · View at Scopus
  95. N. Bizzaro, E. Tonutti, D. Visentini et al., “Antibodies to the lens and cornea in anti-DFS70-positive subjects,” Annals of the New York Academy of Sciences, vol. 1107, pp. 174–183, 2007. View at Publisher · View at Google Scholar · View at Scopus
  96. M. Okamoto, Y. Ogawa, A. Watanabe et al., “Autoantibodies to DFS70/LEDGF are increased in alopecia areata patients,” Journal of Autoimmunity, vol. 23, no. 3, pp. 257–266, 2004. View at Publisher · View at Google Scholar · View at Scopus
  97. N. Kuwabara, Y. Itoh, T. Igarshi, and Y. Fukunaga, “Autoantibodies to lens epithelium-derived growth factor/transcription co-activator P75 (LEDGF/P75) in children with chronic nonspecific complaints and with positive antinuclear antibodies,” Autoimmunity, vol. 42, no. 6, pp. 492–496, 2009. View at Publisher · View at Google Scholar · View at Scopus
  98. Y. Muro, K. Sugiura, Y. Morita, and Y. Tomita, “High concomitance of disease marker autoantibodies in anti-DFS70/LEDGF autoantibody-positive patients with autoimmune rheumatic disease,” Lupus, vol. 17, no. 3, pp. 171–176, 2008. View at Publisher · View at Google Scholar · View at Scopus
  99. V. Ganapathy and C. A. Casiano, “Autoimmunity to the nuclear autoantigen DFS70 (LEDGF): what exactly are the autoantibodies trying to tell us?” Arthritis & Rheumatism, vol. 50, no. 3, pp. 684–688, 2004. View at Publisher · View at Google Scholar · View at Scopus
  100. V. Ganapathy, T. Daniels, and C. A. Casiano, “LEDGF/p75: a novel nuclear autoantigen at the crossroads of cell survival and apoptosis,” Autoimmunity Reviews, vol. 2, no. 5, pp. 290–297, 2003. View at Publisher · View at Google Scholar · View at Scopus
  101. M. Mahler, J. G. Hanly, and M. J. Fritzler, “Importance of the dense fine speckled pattern on HEp-2 cells and anti-DFS70 antibodies for the diagnosis of systemic autoimmune diseases,” Autoimmunity Reviews, vol. 11, no. 9, pp. 642–645, 2012. View at Publisher · View at Google Scholar · View at Scopus
  102. M. Mahler and M. J. Fritzler, “The clinical significance of the dense fine speckled immunofluorescence pattern on HEp-2 cells for the diagnosis of systemic autoimmune diseases,” Clinical and Developmental Immunology, vol. 2012, Article ID 494356, 6 pages, 2012. View at Publisher · View at Google Scholar
  103. H. A. Mariz, E. I. Sato, S. H. Barbosa, S. H. Rodrigues, A. Dellavance, and L. E. Andrade, “Ana HEp-2 pattern is a critical parameter for discriminating ana-positive healthy individuals and patients with autoimmune rheumatic diseases,” Arthritis & Rheumatology. Arthritis Rheum. 2011;63:191-200.
  104. M. J. Fritzler, “The antinuclear antibody test: last or lasting gasp?” Arthritis & Rheumatism, vol. 63, no. 1, pp. 19–22, 2011. View at Publisher · View at Google Scholar · View at Scopus
  105. Y. Ogawa, K. Sugiura, A. Watanabe et al., “Autoantigenicity of DFS70 is restricted to the conformational epitope of C-terminal alpha-helical domain,” Journal of Autoimmunity, vol. 23, no. 3, pp. 221–231, 2004. View at Publisher · View at Google Scholar · View at Scopus
  106. M. Fenger, A. Wiik, M. Høier-Madsen et al., “Detection of antinuclear antibodies by solid-phase immunoassays and immunofluorescence analysis,” Clinical Chemistry, vol. 50, no. 11, pp. 2141–2147, 2004. View at Publisher · View at Google Scholar · View at Scopus
  107. E. Tonutti, D. Bassetti, A. Piazza et al., “Diagnostic accuracy of Elisa methods as an alternative screening test to indirect immunofluorescence for the detection of antinuclear antibodies. Evaluation of five commercial kits,” Autoimmunity, vol. 37, no. 2, pp. 171–176, 2004. View at Publisher · View at Google Scholar · View at Scopus
  108. P. Kern, M. Kron, and K. Hiesche, “Measurement of antinuclear antibodies: assessment of different test systems,” Clinical and Diagnostic Laboratory Immunology, vol. 7, no. 1, pp. 72–78, 2000. View at Google Scholar · View at Scopus
  109. M. López-Hoyos, V. Rodríguez-Valverde, and V. Martinez-Taboada, “Performance of antinuclear antibody connective tissue disease screen,” Annals of the New York Academy of Sciences, vol. 1109, pp. 322–329, 2007. View at Publisher · View at Google Scholar · View at Scopus
  110. D. Sinclair, M. Saas, D. Williams, M. Hart, and R. Goswami, “Can an ELISA replace immunofluorescence for the detection of anti-nuclear antibodies?—the routine use of anti-nuclear antibody screening ELISAs,” Clinical Laboratory, vol. 53, no. 3-4, pp. 183–191, 2007. View at Google Scholar · View at Scopus
  111. J. Schmitt and W. Papisch, “Recombinant autoantigens,” Autoimmunity Reviews, vol. 1, no. 1-2, pp. 79–88, 2002. View at Publisher · View at Google Scholar · View at Scopus
  112. J. Schulte-Pelkum, M. Fritzler, and M. Mahler, “Latest update on the Ro/SS-A autoantibody system,” Autoimmunity Reviews, vol. 8, no. 7, pp. 632–637, 2009. View at Publisher · View at Google Scholar · View at Scopus
  113. M. Mahler, E. D. Silverman, J. Schulte-Pelkum, and M. J. Fritzler, “Anti-Scl-70 (topo-I) antibodies in SLE: myth or reality?” Autoimmunity Reviews, vol. 9, no. 11, pp. 756–760, 2010. View at Publisher · View at Google Scholar · View at Scopus
  114. M. Mahler, “Sm peptides in differentiation of autoimmune diseases,” Advances in Clinical Chemistry, vol. 54, pp. 109–128, 2011. View at Publisher · View at Google Scholar · View at Scopus
  115. M. Mahler, E. D. Silverman, and M. J. Fritzler, “Novel diagnostic and clinical aspects of anti-PCNA antibodies detected by novel detection methods,” Lupus, vol. 19, no. 13, pp. 1527–1533, 2010. View at Publisher · View at Google Scholar · View at Scopus
  116. M. Mahler, K. Miyachi, C. Peebles, and M. J. Fritzler, “The clinical significance of autoantibodies to the proliferating cell nuclear antigen (PCNA),” Autoimmunity Reviews, vol. 11, pp. 771–775, 2012. View at Google Scholar
  117. L. Maes, D. Blockmans, P. Verschueren et al., “Anti-PM/Scl-100 and anti-RNA-polymerase III antibodies in scleroderma,” Clinica Chimica Acta, vol. 411, no. 13-14, pp. 965–971, 2010. View at Publisher · View at Google Scholar · View at Scopus
  118. M. Mahler, C. Gascon, S. Patel et al., “Rpp25 is a major target of autoantibodies to the Th/To complex as measured by a novel chemiluminescent assay,” Arthritis Research & Therapy, vol. 15, article R50, 2013. View at Google Scholar
  119. C. Bordet, “Performance of the Inno-Lia Ana test in the detection of the main autoantibodies involved in connective tissue diseases,” Annales de Biologie Clinique, vol. 59, no. 6, pp. 767–768, 2001. View at Google Scholar · View at Scopus
  120. S. A. Lee, J. Kahng, Y. Kim et al., “Comparative study of immunofluorescent antinuclear antibody test and line immunoassay detecting 15 specific autoantibodies in patients with systemic rheumatic disease,” Journal of Clinical Laboratory Analysis, vol. 26, pp. 307–314, 2012. View at Google Scholar
  121. F. J. López-Longo, M. Rodríguez-Mahou, M. Escalona-Monge, C. M. González, I. Monteagudo, and L. Carreño-Pérez, “Simultaneous identification of various antinuclear antibodies using an automated multiparameter line immunoassay system,” Lupus, vol. 12, no. 8, pp. 623–629, 2003. View at Publisher · View at Google Scholar · View at Scopus
  122. D. Almeida González, A. Cabrera de León, M. D. C. Rodríguez Pérez et al., “Efficiency of different strategies to detect autoantibodies to extractable nuclear antigens,” Journal of Immunological Methods, vol. 360, no. 1-2, pp. 89–95, 2010. View at Publisher · View at Google Scholar · View at Scopus
  123. O. Shovman, B. Gilburd, G. Zandman-Goddard, A. Yehiely, P. Langevitz, and Y. Shoenfeld, “Multiplexed AtheNA multi-lyte immunoassay for ANA screening in autoimmune diseases,” Autoimmunity, vol. 38, no. 1, pp. 105–109, 2005. View at Publisher · View at Google Scholar · View at Scopus
  124. J. G. Hanly, L. Su, V. Farewell, and M. J. Fritzler, “Comparison between multiplex assays for autoantibody detection in systemic lupus erythematosus,” Journal of Immunological Methods, vol. 358, no. 1-2, pp. 75–80, 2010. View at Publisher · View at Google Scholar · View at Scopus
  125. J. G. Hanly, K. Thompson, G. McCurdy, L. Fougere, C. Theriault, and K. Wilton, “Measurement of autoantibodies using multiplex methodology in patients with systemic lupus erythematosus,” Journal of Immunological Methods, vol. 352, no. 1-2, pp. 147–152, 2010. View at Publisher · View at Google Scholar · View at Scopus
  126. P. Caramaschi, O. Ruzzenente, S. Pieropan et al., “Determination of ANA specificity using multiplexed fluorescent microsphere immunoassay in patients with ANA positivity at high titres after infliximab treatment: preliminary results,” Rheumatology International, vol. 27, no. 7, pp. 649–654, 2007. View at Publisher · View at Google Scholar · View at Scopus
  127. S. S. Copple, T. B. Martins, C. Masterson, E. Joly, and H. R. Hill, “Comparison of three multiplex immunoassays for detection of antibodies to extractable nuclear antibodies using clinically defined sera,” Annals of the New York Academy of Sciences, vol. 1109, pp. 464–472, 2007. View at Publisher · View at Google Scholar · View at Scopus
  128. B. Gilburd, M. Abu-Shakra, Y. Shoenfeld et al., “Autoantibodies profile in the sera of patients with sjogren's syndrome: the ANA evaluation—a homogeneous, multiplexed system,” Clinical and Developmental Immunology, vol. 11, no. 1, pp. 53–56, 2004. View at Publisher · View at Google Scholar · View at Scopus
  129. A.-P. Nifli, G. Notas, M. Mamoulaki et al., “Comparison of a multiplex, bead-based fluorescent assay and immunofluorescence methods for the detection of ANA and ANCA autoantibodies in human serum,” Journal of Immunological Methods, vol. 311, no. 1-2, pp. 189–197, 2006. View at Publisher · View at Google Scholar · View at Scopus
  130. K. Uto, N. Hayashi, S. Kinoshita, S. Kawano, and S. Kumagai, “Evaluation of simultaneous detection of specific antinuclear antibodies using multiplexed technology,” Rinsho Byori, vol. 57, no. 10, pp. 941–953, 2009. View at Google Scholar · View at Scopus
  131. M. J. Fritzler, F. Behmanesh, and M. L. Fritzler, “Analysis of human sera that are polyreactive in an addressable laser bead immunoassay,” Clinical Immunology, vol. 120, no. 3, pp. 349–356, 2006. View at Publisher · View at Google Scholar · View at Scopus
  132. S. Bernardini, M. Infantino, L. Bellincampi et al., “Screening of antinuclear antibodies: comparison between enzyme immunoassay based on nuclear homogenates, purified or recombinant antigens and immunofluorescence assay,” Clinical Chemistry and Laboratory Medicine, vol. 42, no. 10, pp. 1155–1160, 2004. View at Publisher · View at Google Scholar · View at Scopus
  133. P. M. Bayer, S. Bauerfeind, J. Bienvenu et al., “Multicenter evaluation study on a new HEP2 ANA screening enzyme immune assay,” Journal of Autoimmunity, vol. 13, no. 1, pp. 89–93, 1999. View at Publisher · View at Google Scholar · View at Scopus
  134. P. M. Bayer, B. Fabian, and W. Hübl, “Immunofluorescence assays (IFA) and enzyme-linked immunosorbent assays (ELISA) in autoimmune disease diagnostics—technique, benefits, limitations and applications,” Scandinavian Journal of Clinical and Laboratory Investigation, Supplement, vol. 61, no. 235, pp. 68–76, 2001. View at Google Scholar · View at Scopus
  135. H.-P. Lehmann, D. Block, C. Markert-Hahn, and J. W. Zolg, “New concepts in systemic autoimmunity testing,” Scandinavian Journal of Clinical and Laboratory Investigation, Supplement, vol. 61, no. 235, pp. 84–90, 2001. View at Google Scholar · View at Scopus
  136. H.-P. Lehmann, I. Fuhling, C. Ott, B. Hudepohl, and M. Haass, “HEp2 ANA EIA: a new fully automated assay for the screening of antinuclear antibodies,” Israel Medical Association Journal, vol. 2, no. 8, pp. 646–648, 2000. View at Google Scholar · View at Scopus
  137. X. Bossuyt, “Evaluation of two automated enzyme immunoassays for detection of antinuclear antibodies,” Clinical Chemistry and Laboratory Medicine, vol. 38, no. 10, pp. 1033–1037, 2000. View at Google Scholar · View at Scopus
  138. N. Hayashi, T. Kawamoto, M. Mukai et al., “Detection of antinuclear antibodies by use of an enzyme immunoassay with nuclear HEp-2 cell extract and recombinant antigens: comparison with immunofluorescence assay in 307 patients,” Clinical Chemistry, vol. 47, no. 9, pp. 1649–1659, 2001. View at Google Scholar · View at Scopus
  139. G. A. Maguire, A. Ginawi, J. Lee et al., “Clinical utility of ANA measured by ELISA compared with ANA measured by immunofluorescence,” Rheumatology, vol. 48, no. 8, pp. 1013–1014, 2009. View at Publisher · View at Google Scholar · View at Scopus
  140. P. Ghillani, A. M. Rouquette, C. Desgruelles et al., “Evaluation of the LIAISON ANA screen assay for antinuclear antibody testing in autoimmune diseases,” Annals of the New York Academy of Sciences, vol. 1109, pp. 407–413, 2007. View at Publisher · View at Google Scholar · View at Scopus
  141. L. K. Peterson, D. Wells, L. Shaw, M.-G. Velez, R. Harbeck, and L. L. Dragone, “Novel method for quantitative ANA measurement using near-infrared imaging,” Journal of Immunological Methods, vol. 349, no. 1-2, pp. 1–8, 2009. View at Publisher · View at Google Scholar · View at Scopus
  142. K. Grossmann, D. Roggenbuck, C. Schröder, K. Conrad, P. Schierack, and U. Sack, “Multiplex assessment of non-organ-specific autoantibodies with a novel microbead-based immunoassay,” Cytometry A, vol. 79, no. 2, pp. 118–125, 2011. View at Publisher · View at Google Scholar · View at Scopus
  143. J. Smith, D. Onley, C. Garey et al., “Determination of ANA specificity using the UltraPlex™ platform,” Annals of the New York Academy of Sciences, vol. 1050, pp. 286–294, 2005. View at Publisher · View at Google Scholar · View at Scopus
  144. W. H. Robinson, C. DiGennaro, W. Hueber et al., “Autoantigen microarrays for multiplex characterization of autoantibody responses,” Nature Medicine, vol. 8, no. 3, pp. 295–301, 2002. View at Publisher · View at Google Scholar · View at Scopus
  145. P. J. Utz, “Multiplexed assays for identification of biomarkers and surrogate markers in systemic lupus erythematosus,” Lupus, vol. 13, no. 5, pp. 304–311, 2004. View at Publisher · View at Google Scholar · View at Scopus
  146. I. Balboni, C. Limb, J. D. Tenenbaum, and P. J. Utz, “Evaluation of microarray surfaces and arraying parameters for autoantibody profiling,” Proteomics, vol. 8, no. 17, pp. 3443–3449, 2008. View at Publisher · View at Google Scholar · View at Scopus
  147. C. González, B. García-Berrocal, M. Pérez, J. A. Navajo, O. Herraez, and J. M. González-Buitrago, “Laboratory screening of connective tissue diseases by a new automated ENA screening assay (EliA Symphony) in clinically defined patients,” Clinica Chimica Acta, vol. 359, no. 1-2, pp. 109–114, 2005. View at Publisher · View at Google Scholar · View at Scopus
  148. J. C. Parker and C. C. Bunn, “Sensitivity of the Phadia EliA connective tissue disease screen for less common disease-specific autoantibodies,” Journal of Clinical Pathology, vol. 64, no. 7, pp. 631–633, 2011. View at Publisher · View at Google Scholar · View at Scopus
  149. C. Bentow, A. Seaman, A. Swart, A. Shikhman, N. Goodman, and M. and Mahler, “Evaluation of a novel chemiluminescent assay (QUANTA Flash CTD Screen Plus) for the rapid detection of autoantibodies in systemic autoimmune rheumatic diseases,” in Proceedings of the 11th Dresden Symposium on Autoantibodies, Dresden, Germany, 2013.
  150. E. K. L. Chan, M. J. Fritzler, A. Wiik et al., “AutoAbSC.Org—autoantibody standardization committee in 2006,” Autoimmunity Reviews, vol. 6, no. 8, pp. 577–580, 2007. View at Publisher · View at Google Scholar · View at Scopus
  151. X. Bossuyt, C. Louche, and A. Wiik, “Standardisation in clinical laboratory medicine: an ethical reflection,” Annals of the Rheumatic Diseases, vol. 67, no. 8, pp. 1061–1063, 2008. View at Publisher · View at Google Scholar · View at Scopus
  152. M. J. Fritzler, A. Wiik, E. M. Tan et al., “A critical evaluation of enzyme immunoassay kits for detection of antinuclear autoantibodies of defined specificities. III. Comparative performance characteristics of academic and manufacturers' laboratories,” Journal of Rheumatology, vol. 30, no. 11, pp. 2374–2381, 2003. View at Google Scholar · View at Scopus
  153. J. S. Smolen, B. Butcher, M. J. Fritzler et al., “Reference sera for antinuclear antibodies: II. Further definition of antibody specificities in international antinuclear antibody reference sera by immunofluorescence and western blotting,” Arthritis & Rheumatism, vol. 40, no. 3, pp. 413–418, 1997. View at Publisher · View at Google Scholar · View at Scopus
  154. E. M. Tan, J. S. Smolen, J. S. McDougal et al., “A critical evaluation of enzyme immunoassays for detection of antinuclear autoantibodies of defined specificities. I. Precision, sensitivity, and specificity,” Arthritis & Rheumatology, vol. 42, pp. 455–464, 1999. View at Google Scholar
  155. E. M. Tan, J. S. Smolen, J. S. McDougal et al., “A critical evaluation of enzyme immunoassay kits for detection of antinuclear autoantibodies of defined specificities. II. Potential for quantitation of antibody content,” Journal of Rheumatology, vol. 29, no. 1, pp. 68–74, 2002. View at Google Scholar · View at Scopus
  156. K. James, A. B. Carpenter, L. Cook, R. Marchand, and R. M. Nakamura, “Development of the antinuclear and anticytoplasmic antibody consensus panel by the Association of Medical Laboratory Immunologists,” Clinical and Diagnostic Laboratory Immunology, vol. 7, no. 3, pp. 436–443, 2000. View at Publisher · View at Google Scholar · View at Scopus
  157. M. Mahler, M. J. Fritzler, and M. Blüthner, “Identification of a SmD3 epitope with a single symmetrical dimethylation of an arginine residue as a specific target of a subpopulation of anti-Sm antibodies,” Arthritis Research & Therapy, vol. 7, no. 1, pp. R19–R29, 2005. View at Google Scholar · View at Scopus
  158. T. E. W. Feltkamp, “Standards for ANA and anti-DNA,” Clinical Rheumatology, vol. 9, no. 1, pp. 74–81, 1990. View at Google Scholar · View at Scopus
  159. J. Damoiseaux, J. W. C. Tervaert, R. Derksen et al., “Autoantibody standardization in the Netherlands: the past, the present, and the future,” Annals of the New York Academy of Sciences, vol. 1173, pp. 10–14, 2009. View at Publisher · View at Google Scholar · View at Scopus
  160. U. Sack, K. Conrad, E. Csernok et al., “Standardization of autoimmune diagnostics in Germany: activities of the German group in the European autoimmune standardization initiative,” Annals of the New York Academy of Sciences, vol. 1109, pp. 31–36, 2007. View at Publisher · View at Google Scholar · View at Scopus
  161. P. L. Meroni, M. Biggioggero, S. S. Pierangeli, J. Sheldon, I. Zegers, and M. O. Borghi, “Standardization of autoantibody testing: a paradigm for serology in rheumatic diseases,” Nature Reviews Rheumatology, vol. 10, pp. 35–43, 2014. View at Publisher · View at Google Scholar