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Open Access Commentary

Automated tests of ANA immunofluorescence as throughput autoantibody detection technology: strengths and limitations

Pier Luigi Meroni125*, Nicola Bizzaro3, Ilaria Cavazzana4, Maria Orietta Borghi12 and Angela Tincani4

Author Affiliations

1 Department of Clinical Sciences & Community Health, University of Milan, Milan, Italy

2 Istituto Auxologico Italiano, Milan, Italy

3 Laboratory of Clinical Pathology, Ospedale San Antonio, Tolmezzo, Italy

4 Rheumatology Unit and Chair, Spedali Civili di Brescia, Università degli Studi di Brescia, Brescia, Italy

5 Division of Rheumatology, Istituto G. Pini, Piazza C. Ferrari, 1, 20122 Milan, Italy

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BMC Medicine 2014, 12:38  doi:10.1186/1741-7015-12-38

Published: 3 March 2014


Anti-nuclear antibody (ANA) assay is a screening test used for almost all autoimmune rheumatic diseases, and in a number of these cases, it is a diagnostic/classification parameter. In addition, ANA is also a useful test for additional autoimmune disorders. The indirect immunofluorescence technique on monolayers of cultured epithelial cells is the current recommended method because it has higher sensitivity than solid phase assays. However, the technique is time-consuming and requires skilled operators. Automated ANA reading systems have recently been developed, which offer the advantage of faster and much easier performance as well as better harmonization in the interpretation of the results. Preliminary validation studies of these systems have given promising results in terms of analytical specificity and reproducibility. However, these techniques require further validation in clinical studies and need improvement in their recognition of mixed or less common staining patterns.

Anti-nuclear antibodies; Indirect immunofluorescence; Autoimmunity