Four Anti-dsDNA Antibody Assays in Relation to Systemic Lupus Erythematosus Disease Specificity and Activity
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Objective.: Analysis of antibodies against dsDNA is an important diagnostic tool for systemic lupus erythematosus (SLE), and changes in anti-dsDNA antibody levels are also used to assess disease activity. Herein, 4 assays were compared with regard to SLE specificity, sensitivity, and association with disease activity variables. Methods.: Cross-sectional sera from 178 patients with SLE, of which 11 were followed consecutively, from a regional Swedish SLE register were analyzed for immunoglobulin G (IgG) anti-dsDNA by bead-based multiplex assay (FIDIS; Theradig), fluoroenzyme-immunoassay (EliA; Phadia/Thermo Fisher Scientific), Crithidia luciliae immunofluorescence test (CLIFT; ImmunoConcepts), and line blot (EUROLINE; Euroimmun). All patients with SLE fulfilled the 1982 American College of Rheumatology and/or the 2012 Systemic Lupus International Collaborating Clinics (SLICC-12) classification criteria. Healthy individuals (n = 100), patients with rheumatoid arthritis (n = 95), and patients with primary Sjögren syndrome (n = 54) served as controls. Results.: CLIFT had the highest SLE specificity (98%) whereas EliA had the highest sensitivity (35%). When cutoff levels for FIDIS, EliA, and EUROLINE were adjusted according to SLICC-12 (i.e., double the reference limit when using ELISA), the specificity and sensitivity of FIDIS was comparable to CLIFT. FIDIS and CLIFT also showed the highest concordance (84%). FIDIS performed best regarding association with disease activity in cross-sectional and consecutive samples. Fisher’s exact test revealed striking differences between methods regarding associations with certain disease phenotypes. Conclusion.: CLIFT remains a good choice for diagnostic purposes, but FIDIS performs equally well when the cutoff is adjusted according to SLICC-12. Based on results from cross-sectional and consecutive analyses, FIDIS can also be recommended to monitor disease activity.
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All studies that evaluated correlation with disease activity showed a positive correlation between SLEDAI and anti-dsDNA autoantibody titers measured by bead-based multiplex assay.
“All studies that evaluated correlation with disease activity showed a positive correlation between SLEDAI and anti-dsDNA autoantibody titers measured by bead-based multiplex assay [48], [52], [59], [64], [75], [76].”
From Laboratory evaluation of anti-dsDNA antibodies. (2022) · cites this paper as [59]
The Discussion reports positive correlations between anti-dsDNA levels and some disease-activity variables, but explicitly says these were not recorded for SLEDAI-2K or PGA. FIDIS was the bead-based multiplex assay, so this study does not support the citing sentence’s claim of a positive SLEDAI correlation. Page numbers are unavailable in our copy. (LLM, conf=0.87)
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Experimental — accuracy not yet measuredEnocsson et al. compared CLIFT, FEIA, multiplexed immunoassay and line blot at a cutoff that corresponded to a specificity of 98% and found that the multiplexed assay had the highest sensitivity.
“Enocsson et al. compared CLIFT, FEIA, multiplexed immunoassay and line blot at a cutoff that corresponded to a specificity of 98% and found that the multiplexed assay had the highest sensitivity [59].”
From Laboratory evaluation of anti-dsDNA antibodies. (2022) · cites this paper as [59]
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References 37 · Cited by 73
- Authors
- Enocsson, H., Sjöwall, C., Wirestam, L., Dahle, C., Kastbom, A., Rönnelid, J., Wetterö, J., & Skogh, T.
- Affiliations
- Linköping University (SE)
- ORCID
- Venue
- The Journal of Rheumatology
- Publisher
- The Journal of Rheumatology
- Published
- 2015-02-15
- Volume
- 42
- Issue
- 5
- Pages
- 817-825
- ISSN
- 0315-162X (ISSN-L)
- 1499-2752
- OpenAlex
- W2149255315
- Semantic Scholar
- 331f0268c1f145b1455bb184152c125fecc17df2
- Cited by
- 73
- References
- 37
- Citations by year
- 2026: 6 · 2025: 1 · 2024: 5 · 2023: 8 · 2022: 8 · 2021: 11 · 2020: 2 · 2019: 6 · 2018: 6 · 2017: 5 · 2016: 8 · 2015: 7
- FWCI
- 7.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Rheumatology (publishedVersion)
- PubMed (publishedVersion)
- DiVA (Linkoping University) (submittedVersion, other-oa)
- Funders
- Svenska Sällskapet för Medicinsk Forskning
- Linköpings Universitet
- Vetenskapsrådet (K2011-68X-20611-04-3)
- Uppsala Universitet
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
- Keywords
- anti-dsDNA antibodies, systemic lupus erythematosus, assay comparison, sensitivity and specificity, disease activity monitoring, disease phenotypes
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, DNA, Female, Humans, Immunoassay, Lupus Erythematosus, Systemic, Male, Middle Aged, Sensitivity and Specificity, Severity of Illness Index, Young Adult
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