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Detection of circulating anti-skin antibodies by indirect immunofluorescence and by ELISA: a comparative systematic review and meta-analysis

  • Otto Van de gaer EMAIL logo , Petra de Haes and Xavier Bossuyt
Published/Copyright: April 25, 2020
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 58 Issue 10

Abstract

Background

Both enzyme-linked immunosorbent assays (ELISAs) and indirect immunofluorescence (IIF) are available for the diagnosis of autoimmune bullous diseases (AIBD). Many studies have reported on the performance of ELISAs and concluded that ELISAs could replace IIF. This study compares the diagnostic accuracy of ELISA and IIF for the detection of autoantibodies to desmoglein 1 (DSG1), desmoglein 3 (DSG3), bullous pemphigoid antigen 2 (BP180) and bullous pemphigoid antigen 1 (BP230) to support the diagnosis of pemphigus vulgaris (PV), pemphigus foliaceus (PF) and bullous pemphigoid (BP).

Methods

A literature search was performed in the PubMed database. The meta-analysis was performed using summary values and a bivariate random effect model.

Results

The five included studies on PV did not demonstrate significant differences between IIF and DSG3-ELISA (sensitivity 82.3% vs. 81.6%, p = 0.9284; specificity 95.6% vs. 93.9%, p = 0.5318; diagnostic odds ratio [DOR] 101.60 vs. 67.760, p = 0.6206). The three included studies on PF did not demonstrate significant differences between IIF and DSG1-ELISA (sensitivity 80.6% vs. 83.1%, p = 0.8501; specificity 97.5% vs. 93.9%, p = 0.3614; DOR 160.72 vs. 75.615, p = 0.5381). The eight included studies on BP showed that BP230-ELISA differed significantly from both IIF on monkey esophagus (MO) and BP180-ELISA with regard to DOR (11.384 vs. 68.349, p = 0.0008; 11.384 vs. 41.699, p = 0.0125, respectively)

Conclusions

Our meta-analysis shows that ELISA performs as well as IIF for diagnosing PV, PF and BP.

Keywords: autoimmune bullous diseases; ELISA; IIF; pemphigus; pemphigoid

  1. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: Authors state no conflict of interest.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2019-1031).

Received: 2019-10-07
Accepted: 2020-03-03
Published Online: 2020-04-25
Published in Print: 2020-09-25

©2020 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2019-1031
Keywords for this article
autoimmune bullous diseases; ELISA; IIF; pemphigus; pemphigoid

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Blood sampling for metanephrines: to stick or stick and wait?
  4. Review
  5. Glycan-specific antibodies as potential cancer biomarkers: a focus on microarray applications
  6. Mini Review
  7. Detection of circulating anti-skin antibodies by indirect immunofluorescence and by ELISA: a comparative systematic review and meta-analysis
  8. Opinion Papers
  9. The shift of the paradigm between ageing and diseases
  10. Managing COVID-19 outbreak in Nigeria: matters arising
  11. Circulating tumor DNA (ctDNA) is not a good proxy for liquid biopsies of tumor tissues for early detection
  12. General Clinical Chemistry and Laboratory Medicine
  13. Exact time of venous blood sample collection – an unresolved issue, on behalf of the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE)
  14. Percentile transformation and recalibration functions allow harmonization of thyroid-stimulating hormone (TSH) immunoassay results
  15. Interference of anti-streptavidin antibodies in immunoassays: a very rare phenomenon or a more common finding?
  16. Blood sampling for metanephrines comparing venipuncture vs. indwelling intravenous cannula in healthy subjects
  17. Volumetric absorptive microsampling and dried blood spot microsampling vs. conventional venous sampling for tacrolimus trough concentration monitoring
  18. Trueness evaluation and verification of inter-assay agreement of serum folate measuring systems
  19. Effects of endurance exercise on serum concentration of calcitonin gene-related peptide (CGRP): a potential link between exercise intensity and headache
  20. Comprehensive characterization and resolution of discrepant spectrophotometric bilirubin results in patients on eltrombopag therapy
  21. Influence of pancreatic status on circulating plasma sterols in patients with cystic fibrosis
  22. Influence of isotopically labeled internal standards on quantification of serum/plasma 17α-hydroxyprogesterone (17OHP) by liquid chromatography mass spectrometry
  23. Reference Values and Biological Variations
  24. The European Biological Variation Study (EuBIVAS): weekly biological variation of cardiac troponin I estimated by the use of two different high-sensitivity cardiac troponin I assays
  25. Cardiovascular Diseases
  26. Comparison of the diagnostic performance with whole blood and plasma of four rapid antibody tests for SARS-CoV-2
  27. Infectious Diseases
  28. Exploring the possibilities of infrared spectroscopy for urine sediment examination and detection of pathogenic bacteria in urinary tract infections
  29. Letters to the Editors
  30. Towards the rational utilization of SARS-CoV-2 serological tests in clinical practice
  31. Response of anti-SARS-CoV-2 total antibodies to nucleocapsid antigen in COVID-19 patients: a longitudinal study
  32. Development, optimization and validation of an absolute specific assay for active myeloperoxidase (MPO) and its application in a clinical context: role of MPO specific activity in coronary artery disease
  33. The early antibody response to SARS-Cov-2 infection
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  35. Serum prealbumin deserves more significance in the early triage of COVID-19 patients
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  43. Antidepressant use limits serotonin as a marker for neuroendocrine tumor disease activity by lowering of circulating serotonin concentrations
  44. Limitations of rapid diagnostic testing in the work-up of dengue infection – a case report
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