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Abstract
A dense fine speckled pattern (DFS) caused by antibodies to the DFS70 kDa nuclear protein is a relatively common finding while testing for anti-nuclear antibodies (ANA) by indirect immunofluorescence (IIF) on HEp-2 cells. However, despite many efforts and numerous studies, the clinical significance of anti-DFS70 antibodies is still unknown as they can be found in patients with various disorders and even in healthy subjects. In this study we aimed at verifying whether these antibodies are associated with thrombotic events or with unexplained recurrent pregnancy loss (RPL). We studied 443 patients with venous or arterial thrombosis or RPL and 244 controls by IIF on HEp-2 cells and by a DFS70-specific chemiluminescent immunoassay (CIA). The DFS pattern was observed in IIF in 31/443 (7.0%) patients and in 6/244 (2.5%) controls (p = 0.01) while anti-DFS70 specific antibodies were detected by CIA in 11 (2.5%) patients and in one (0.4%) control (p = 0.06). Positive samples, either by IIF or by CIA, were then assayed by a second DFS70-specific line-immunoassay (LIA) method: 83.3% of the CIA positive samples were confirmed DFS70 positive versus only 29.7% of the IIF positive samples. These findings show that IIF overestimates anti-DFS70 antibody frequency and that results obtained by specific CIA and LIA assays do not indicate that venous or arterial thrombosis or RPL are linked to a higher prevalence of anti-DFS70 antibodies.
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1 Laboratorio di Patologia Clinica, Ospedale San Antonio, Azienda Sanitaria Universitaria Integrata di Udine, Tolmezzo, Italy (GRID:grid.411492.b)
2 Laboratorio Diagnostico di Autoimmunologia, IRCCS Ospedale Policlinico San Martino, Genova, Italy (GRID:grid.411492.b); Dipartimento di Medicina Interna e Specialità Mediche (DIMI), Università degli Studi di Genova, Genova, Italy (GRID:grid.5606.5) (ISNI:0000 0001 2151 3065)
3 Unità Operativa di Laboratorio, Ospedale G. Fracastoro, Verona, Italy (GRID:grid.5606.5)
4 Laboratorio Diagnostico di Autoimmunologia, IRCCS Ospedale Policlinico San Martino, Genova, Italy (GRID:grid.5606.5)
5 Laboratorio centralizzato SDN Spa, Gruppo SYNLAB, Salerno, Italy (GRID:grid.5606.5)
6 Laboratorio Immunologia Allergologia, Dipartimento di Medicina di Laboratorio, Ospedale San Giovanni di Dio, Azienda Usl Toscana Centro, Firenze, Italy (GRID:grid.5606.5)
7 Patologia Clinica, AOU San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy (GRID:grid.5606.5)
8 Laboratorio di Autoimmunologia UOC di Patologia Clinica Universitaria, Azienda Ospedaliero-Universitaria, Policlinico di Bari, Italy (GRID:grid.411482.a)
9 Laboratorio Analisi Chimico Cliniche, ASST Papa Giovanni XXIII, Bergamo, Italy (GRID:grid.411482.a)
10 Servizio di Patologia Clinica, Ospedale Santa Maria Delle Grazie, Asl Napoli 2 Nord, Pozzuoli-Napoli, Italy (GRID:grid.411482.a)
11 UOC di Procreazione Medicalmente Assistita, Ospedale S.M. delle Grazie, Pozzuoli, Italy (GRID:grid.411482.a)
12 Immunologia e Allergologia, Presidio Ospedaliero S. Maria degli Angeli, Pordenone, Italy (GRID:grid.411482.a)
13 Patologia Clinica, Ospedale Buccheri La Ferla FBF, Palermo, Italy (GRID:grid.411482.a)
14 Patologia Clinica, Presidio Ospedaliero Annunziata, Taranto, Italy (GRID:grid.411482.a)
15 Laboratorio Patologia Clinica P.O. Santo Spirito, Pescara, Italy (GRID:grid.411482.a)
16 IReL – Istituto Reumatologico Lucano – Ospedale San Carlo, Potenza, Italy (GRID:grid.416325.7)
17 Ostetricia e Ginecologia, Ospedale San Carlo, Potenza, Italy (GRID:grid.416325.7)
18 Chirurgia Vascolare, Ospedale G. Fracastoro, Verona, Italy (GRID:grid.416325.7)
19 Clinica di Medicina Interna 1, Dipartimento di Medicina Interna e Centro di Eccellenza per le Ricerche Biomediche (CEBR), Università degli Studi di Genova, Genoa, Italy (GRID:grid.5606.5) (ISNI:0000 0001 2151 3065); IRCCS Ospedale Policlinico San Martino, Genoa, Italy (GRID:grid.5606.5)
20 Laboratorio Diagnostico di Autoimmunologia, IRCCS Ospedale Policlinico San Martino, Genova, Italy (GRID:grid.5606.5); Dipartimento di Medicina Sperimentale DiMES, Università degli Studi di Genova, Genoa, Italy (GRID:grid.5606.5) (ISNI:0000 0001 2151 3065)
21 Dipartimento di Medicina, Chirurgia e Neuroscienze, Università degli Studi di Siena, Siena, Italy (GRID:grid.9024.f) (ISNI:0000 0004 1757 4641)
22 Dipartimento Biotecnologie Mediche, Università degli Studi di Siena, UOC Laboratorio Patologia Clinica, Policlinico S. Maria alle Scotte, AOU Senese, Siena, Italy (GRID:grid.9024.f) (ISNI:0000 0004 1757 4641)