{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T10:00:53Z","timestamp":1780567253849,"version":"3.54.1"},"reference-count":84,"publisher":"Walter de Gruyter GmbH","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>For the serological diagnosis of systemic autoimmune rheumatic diseases, a two-tier approach starting with sensitive antinuclear antibody (ANA) detection by indirect immunofluorescence (IIF) on HEp-2 cells followed by characterization of positive findings with different immunoassays is recommended. To overcome drawbacks of this approach, we developed a novel technique allowing the combination of screening and simultaneous confirmatory testing. For the first time, this creates the basis for second generation ANA testing.<\/jats:p><jats:p>ANA and autoantibodies (autoAbs) to double-stranded DNA (dsDNA), CENP-B, SS-A\/Ro52, SS-A\/Ro60, SS-B\/La, RNP-Sm, Sm, and Scl-70 were determined by IIF and enzyme-linked immunosorbent assay (ELISA), respectively, and compared to simultaneous analysis thereof by second generation ANA analysis in patients with systemic lupus erythematosus (n=174), systemic sclerosis (n=103), Sj\u00f6gren\u2019s syndrome (n=46), rheumatoid arthritis (n=36), mixed and undetermined connective tissue diseases (n=13), myositis (n=21), infectious disease (n=21), autoimmune liver disease (n=93), inflammatory bowel disease (n=78), paraproteinemia (n=11), and blood donors (n=101).<\/jats:p><jats:p>There was very good agreement of second generation ANA testing with classical one by IIF and ELISA regarding testing for ANA and autoAbs to dsDNA, CENP-B, SS-B, RNP-Sm, Scl-70, SS-A\/Ro52, and SS-A\/Ro60 (Cohen\u2019s \u03ba&gt;0.8). The agreement for anti-Sm autoAb was good (\u03ba=0.77). The differences of both approaches were not significant for autoAbs to SS-B\/La, RNP-Sm, Scl-70, SS-A\/Ro60, and SS-A\/Ro52 (McNemar\u2019s test, p&gt;0.05, respectively).<\/jats:p><jats:p>Second generation ANA testing can replace the two-tier analysis by combining IIF screening with multiplex confirmative testing. This addresses shortcomings of classical ANA analysis like false-negative ANA findings and lack of laboratory efficiency and standardization.<\/jats:p>","DOI":"10.1515\/cclm-2015-0083","type":"journal-article","created":{"date-parts":[[2015,5,28]],"date-time":"2015-05-28T19:39:43Z","timestamp":1432841983000},"source":"Crossref","is-referenced-by-count":28,"title":["Second generation analysis of antinuclear antibody (ANA) by combination of screening and confirmatory testing"],"prefix":"10.1515","volume":"53","author":[{"given":"Juliane","family":"Scholz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Grossmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilka","family":"Kn\u00fctter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rico","family":"Hiemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandy","family":"Sowa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadja","family":"R\u00f6ber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"R\u00f6diger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Schierack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Reinhold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios P.","family":"Bogdanos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Luigi","family":"Meroni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Radice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten","family":"Conrad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Roggenbuck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","reference":[{"key":"ref671","first-page":"9","article-title":"Digital immunofluorescence enables automated detection of antinuclear antibody endpoint titers avoiding serial dilution","author":"Roggenbuck","year":"2014","journal-title":"Clin Chem Lab Med"},{"key":"ref91","doi-asserted-by":"crossref","DOI":"10.1186\/ar3258","article-title":"Autoantibodies predate the onset of systemic lupus erythematosus in northern Sweden","volume":"13","author":"Eriksson","year":"2011","journal-title":"Arthritis Res Ther"},{"key":"ref481","first-page":"73","article-title":"International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti - 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