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2. Autoimmunity and atherosclerosis
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8. Pathogenic mechanisms of autoantibodies: circulating and local antibodies that form immune complexes
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9. Pathogenic mechanisms of autoantibodies: antibodies to intracellular and membrane-bound antigens
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10. What causes primary biliary cholangitis?
- Dr. M. Eric Gershwin
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11. Capillaroscopy in autoimmune rheumatic diseases
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- Advances in Diagnostic Methodologies (I)
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12. The past, present & future of ANA testing: history and challenges of ANA
- Prof. Marvin J. Fritzler
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13. The past, present & future of ANA testing: changing bandwidth and future of ANA
- Prof. Marvin J. Fritzler
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14. Diagnostic methods in autoimmunity
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16. Systemic lupus erythematosus: novel aspects of pathogenesis and treatment 2
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23. Adjuvants and autoimmunity
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24. Antiphospholipid syndrome (APS): from pathogenesis to treatment
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25. Vitamin D and autoimmunity
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26. Pregnancy in rheumatic diseases
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27. Pathogenic mechanisms of autoantibodies
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29. Apoptotic cell clearance deficiency
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30. Auto-antibodies as predictors of autoimmune disease
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31. Innate immunity and natural autoantibodies
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32. Accelerated atherosclerosis in autoimmune rheumatic disease
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33. Pregnancy in autoimmune rheumatic diseases
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36. Immunologic mechanisms in systemic lupus erythematosus
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37. Osteoimmunology
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38. ANCA-associated systemic vasculitides
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42. Vitamin D and autoimmunity
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43. Intravenous immunoglobulins: myth and reality
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Printable Handouts
Navigable Slide Index
- Introduction
- Outline
- Brief history: ANA testing
- Autoantibody diagnostic technologies
- ANA testing/screening
- ‘Anapatterns’
- Nuclear HEp-2 IIFA patterns
- Cytoplasmic HEp-2 IIFA patterns
- Mitotic/Cell cycle HEp-2 IIFA patterns
- ANA patterns - Nuclear patterns
- AC-1 - Nuclear homogeneous
- ANA IFA patterns in SLE
- ANA IFA patterns in SLE: homogeneous vs. DFS
- Autobody explosion
- Esoteric/Orphan autoantibodies
- Snapshot of ANA in SLE and other AARD
- SLE autoantibodies: pathogenic and protective
- Anti-dsDNA decreased risk of cancer in SLE
- SLE autoantibodies: predictive, prognostic, passé
- Barriers to improving outcomes in SLE
- Key publications
- Persisting challenges
Topics Covered
- Brief history of anti-nuclear antibody (ANA) testing
- The explosion of autoantibody discoveries
- The changing bandwidth of ANA testing
- ANA testing used in clinical practice
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Fritzler, M.J. (2020, June 30). The past, present & future of ANA testing: history and challenges of ANA [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 9, 2024, from https://doi.org/10.69645/NJHY5252.Export Citation (RIS)
Publication History
Financial Disclosures
- Disclosure Statement: Dr. Fritzler received honoraria and research gifts in kind from Inova Diagnostics/Werfen International; Euroimmun AG-A Perkin Elmer Company; BioRad and Alexion Canada. He is Medical Director of Mitogen Advanced Diagnostics Laboratory. He does not own or trade shares in any companies referred to in this presentation.
The past, present & future of ANA testing: history and challenges of ANA
Published on June 30, 2020
26 min
A selection of talks on Clinical Practice
Transcript
Please wait while the transcript is being prepared...
0:00
Hello, I'm Dr. Marvin Fritzler.
I'm a professor of Medicine at the Cumming School of Medicine at
the University of Calgary in Calgary, Alberta, Canada.
I want to go over with you the past history,
what's happening today, and the future of antinuclear antibody testing.
I intend to take both a clinical and a research perspective.
0:23
In the first part of my presentation,
I want to speak to a history of ANA and autoantibody testing.
Talk about how there's been a tremendous increase or
explosion in autoantibodies described in diseases like lupus.
Talk about where are we now in terms of challenges of ANA and autoantibody testing,
and how it can be applied in the clinical setting with
a specific focus on ANA immunofluorescence patterns as they're being described today.
In the second part, I want to talk about
the changing bandwidth of ANA and autoantibody testing.
Address the question,
is the ANA indirect immunofluorescence assay the gold standard for ANA testing?
Talk briefly about that seronegative gap,
or ANA-negative lupus and related diseases.
Then finish our discussion on where are we
going with ANA and autoantibody testing in the future,
looking at converging mega-trends,
precision health, and lupus diagnostics.
In that setting, looking at an explosion of not only biomarkers,
but technology where we're moving to solid phase multi-analyte arrays with
algorithmic analysis that is grounded in artificial intelligence, and machine learning.
1:38
First, a brief history of anti-nuclear antibody testing.
In most minds we trace the history of
anti-nuclear antibody testing to the serendipitous finding of
Hargraves and his colleagues at the Mayo Clinic when they
discovered the LE cell and published it in 1948.
Shortly after, indirect immunofluorescence was used as a method to detect
autoantibodies to cell tissues, using cryopreserved mouse and rat organ sections.
That was followed in the 1960s by the development of immunodiffusion, hemagglutination,
and complement fixation as technologies to measure
anti-nuclear antibodies in a more quantitative and semi-quantitative way.
That was followed in the 1970s by counter-immunoelectrophoresis,
western blot and enzyme-linked immunosorbent assay or ELISA.
By the mid 1970s,
falling on the golden era of molecular biology was
when autoantibodies and their description exploded in the literature.
This is largely attributed to the use of
new anti-nuclear antibody substrates such as the HEp-2 substrate,
which is still used today.
From the 1980s to the present,
we use newer technologies of antigen arrays on planar surfaces,
addressable laser bead immunoassays and today other related multi-analyte arrays.
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