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The role of the autoimmunity laboratory in autoimmune diseases
Authors: SS Hasson, MS Al-Balushi, AA Al-Jabr
Number of views: 287
Laboratory testing is of great value when evaluating a patient with a suspected autoimmune
disease. The results can confirm a diagnosis, estimate disease severity, aid in assessing
prognosis and are useful to follow disease activity. Components of the laboratory exam include
complete blood count with differential, comprehensive metabolic panel, inflammatory markers,
autoantibodies, and flow cytometry. Currently, autoimmunity laboratories are very vibrant owing
to the constant and increasing availability of new tests, mainly due to the detection of new
autoantibodies. The main characteristic that differentiates the autoimmunity laboratory from
other laboratories is the use of immunoassays such as enzyme-linked immunosorbent assay
(ELISA), as basic techniques which determines antibodies (autoantibodies) and not antigens. For
this reason, immunoassay techniques must employ antigens as reagents. However, over the last
few years, a significant trend at autoimmunity laboratories has been the gradual replacement of
immunofluorescence microscopy by immunoassay. Nowadays the revolution of new technology
has taken place significantly, for examples; recombinant DNA technology has allowed the
production of large quantities of antigens for autoantibody analysis. Flow cytometry for the
analysis of microsphere-based immunoassays allows the simultaneous measurement of several
autoantibodies. In the same way, autoantigen microarrays provide a practical means to analyse
biological fluids in the search for a high number of autoantibodies. We are now at the beginning
of an era of multiplexed analysis, with a high capacity of autoantibody specificities. The future
tendency in this field will include immunoassays with greater analytical sensitivity, specificity,
simultaneous multiplexed capability, the use of protein microarrays, and the use of other
technologies such as microfluidics.