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Aquaporin-4 Autoantibody Detection by ELISA: A Retrospective Characterization of a Commonly Used Assay
OBJECTIVE: Aquaporin-4 (AQP4) serum autoantibodies are detected by a variety of methods. The highest sensitivity is achieved with cell-based assays, but the enzyme-linked immunosorbent assay (ELISA) is still commonly utilized by clinicians worldwide. METHODS: We performed a retrospective review to i...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8492278/ https://www.ncbi.nlm.nih.gov/pubmed/34621549 http://dx.doi.org/10.1155/2021/8692328 |
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author | Williams, Jon P. Abbatemarco, Justin R. Galli, Jonathan J. Rodenbeck, Stefanie J. Peterson, Lisa K. Haven, Thomas R. Street, Meagan Rose, John W. Greenlee, John E. Soldan, M. Mateo Paz Clardy, Stacey L. |
author_facet | Williams, Jon P. Abbatemarco, Justin R. Galli, Jonathan J. Rodenbeck, Stefanie J. Peterson, Lisa K. Haven, Thomas R. Street, Meagan Rose, John W. Greenlee, John E. Soldan, M. Mateo Paz Clardy, Stacey L. |
author_sort | Williams, Jon P. |
collection | PubMed |
description | OBJECTIVE: Aquaporin-4 (AQP4) serum autoantibodies are detected by a variety of methods. The highest sensitivity is achieved with cell-based assays, but the enzyme-linked immunosorbent assay (ELISA) is still commonly utilized by clinicians worldwide. METHODS: We performed a retrospective review to identify all patients at the University of Utah who had AQP4 ELISA testing at ARUP Laboratories from 2010 to 2017. We then reviewed their diagnostic evaluation and final diagnosis based on the ELISA titer result. RESULTS: A total of 750 tests for the AQP4 ELISA were analyzed, and 47 unique patients with positive titers were identified. Less than half of these patients (49%) met the clinical criteria for neuromyelitis optica spectrum disorder (NMOSD). In cases of low positive titers (3.0–7.9 U/mL, n = 19), the most common final diagnosis was multiple sclerosis (52.6%). In the moderate positive cohort (8.0–79.9 U/mL, n = 14), only a little more than half the cohort (64.3%) had NMOSD. In cases with high positives (80–160 U/mL, n = 14), 100% of patients met clinical criteria for NMOSD. CONCLUSIONS: Our data illustrates diagnostic uncertainty associated with the AQP4 ELISA, an assay that is still commonly ordered by clinicians despite the availability of more sensitive and specific tests to detect AQP4 autoantibodies in patients suspected of having NMOSD. In particular, low positive titer AQP4 ELISA results are particularly nonspecific for the diagnosis of NMOSD. The importance of accessibility to both sensitive and specific AQP4 testing cannot be overemphasized in clinical practice. |
format | Online Article Text |
id | pubmed-8492278 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-84922782021-10-06 Aquaporin-4 Autoantibody Detection by ELISA: A Retrospective Characterization of a Commonly Used Assay Williams, Jon P. Abbatemarco, Justin R. Galli, Jonathan J. Rodenbeck, Stefanie J. Peterson, Lisa K. Haven, Thomas R. Street, Meagan Rose, John W. Greenlee, John E. Soldan, M. Mateo Paz Clardy, Stacey L. Mult Scler Int Research Article OBJECTIVE: Aquaporin-4 (AQP4) serum autoantibodies are detected by a variety of methods. The highest sensitivity is achieved with cell-based assays, but the enzyme-linked immunosorbent assay (ELISA) is still commonly utilized by clinicians worldwide. METHODS: We performed a retrospective review to identify all patients at the University of Utah who had AQP4 ELISA testing at ARUP Laboratories from 2010 to 2017. We then reviewed their diagnostic evaluation and final diagnosis based on the ELISA titer result. RESULTS: A total of 750 tests for the AQP4 ELISA were analyzed, and 47 unique patients with positive titers were identified. Less than half of these patients (49%) met the clinical criteria for neuromyelitis optica spectrum disorder (NMOSD). In cases of low positive titers (3.0–7.9 U/mL, n = 19), the most common final diagnosis was multiple sclerosis (52.6%). In the moderate positive cohort (8.0–79.9 U/mL, n = 14), only a little more than half the cohort (64.3%) had NMOSD. In cases with high positives (80–160 U/mL, n = 14), 100% of patients met clinical criteria for NMOSD. CONCLUSIONS: Our data illustrates diagnostic uncertainty associated with the AQP4 ELISA, an assay that is still commonly ordered by clinicians despite the availability of more sensitive and specific tests to detect AQP4 autoantibodies in patients suspected of having NMOSD. In particular, low positive titer AQP4 ELISA results are particularly nonspecific for the diagnosis of NMOSD. The importance of accessibility to both sensitive and specific AQP4 testing cannot be overemphasized in clinical practice. Hindawi 2021-09-28 /pmc/articles/PMC8492278/ /pubmed/34621549 http://dx.doi.org/10.1155/2021/8692328 Text en Copyright © 2021 Jon P. Williams et al. https://creativecommons.org/licenses/by/4.0/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. |
spellingShingle | Research Article Williams, Jon P. Abbatemarco, Justin R. Galli, Jonathan J. Rodenbeck, Stefanie J. Peterson, Lisa K. Haven, Thomas R. Street, Meagan Rose, John W. Greenlee, John E. Soldan, M. Mateo Paz Clardy, Stacey L. Aquaporin-4 Autoantibody Detection by ELISA: A Retrospective Characterization of a Commonly Used Assay |
title | Aquaporin-4 Autoantibody Detection by ELISA: A Retrospective Characterization of a Commonly Used Assay |
title_full | Aquaporin-4 Autoantibody Detection by ELISA: A Retrospective Characterization of a Commonly Used Assay |
title_fullStr | Aquaporin-4 Autoantibody Detection by ELISA: A Retrospective Characterization of a Commonly Used Assay |
title_full_unstemmed | Aquaporin-4 Autoantibody Detection by ELISA: A Retrospective Characterization of a Commonly Used Assay |
title_short | Aquaporin-4 Autoantibody Detection by ELISA: A Retrospective Characterization of a Commonly Used Assay |
title_sort | aquaporin-4 autoantibody detection by elisa: a retrospective characterization of a commonly used assay |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8492278/ https://www.ncbi.nlm.nih.gov/pubmed/34621549 http://dx.doi.org/10.1155/2021/8692328 |
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