Clinical evaluation of hsPR3-ANCA ELISA for detection of antineutrophil cytoplasmatic antibodies directed against proteinase 3.

摘要

Antineutrophil cytoplasmatic antibodies (ANCA) are used as a diagnostic marker for Wegener's granulomatosis (WG), microscopic polyangiitis (MPA) and Churg-Strauss syndrome (CSS), as high levels of ANCA are found in these conditions. Consensus guidelines currently recommend performing an immunofluorescence test (IFT) together with an ELISA to detect the ANCA pattern and the target antigen. Conventional ELISAs using proteinase 3 (PR3) immobilised to the surface of the ELISA plate show great variations in performance and often lack sensitivity. Capture ELISA is superior in overall diagnostic performance to direct ELISA, but the sensitivity of capture ELISA may be reduced by the capturing antibodies hiding relevant epitopes. hsPR3-ANCA ELISA immobilises PR3 via a bridging molecule to the plastic plate and preserves nearly all epitopes for the binding of ANCA; it was superior to direct ELISA and capture ELISA in a study in patients with WG.