IMMUNOLOGY Posters presented at the meeting. Evaluation of a new chemiluminescent immunoassay for connective tissue disease autoantibodies Integrated autoimmune IT solution to help support ISO 15189:2012 standards


Work flow analysis to demonstrate how an automated IFA autoimmune solution can increase staff productivity


Detection of anti-tissue transglutaminase by chemiluminescence (CIA) Validation of the QUANTA Flash h-tTG IgA antibody detection system


Verification of the use of anti-AB neutralising reagent to prevent false-positive intercellular staining patterns in indirect immunofluorescence for bullous skin disease


Anti-phosphatidylserine antibodies as diagnostic markers of antiphospholipid syndrome Evaluation of anti-cyclic citrullinated peptide antibodies using the Werfen BIO-FLASH system


Validation of a fully-automated chemiluminescent assay system for the semi-quantitative detection of myeloperoxidase and proteinase 3 antibodies


A fully-automated chemiluminescent assay system for the semi-quantitative detection of double-stranded DNA antibodies: validation and effect on turnaround times


inflammatory conditions but are rare in SARD. This makes them an ideal candidate for use in identifying non-SARD-positive ANAs, potentially reducing follow-up testing and referrals. It is thought that up to 50% of ANA positives in healthy populations are due to DFS70. Werfen currently offers two tests that can


be used to identify the presence of DFS70 antibodies (QUANTA Flash DFS70 chemilumnescence assay, NOVA Lite HEp-2 Select, IFA screen). The latter utilises a diluent containing DFS70 that binds any DFS70 antibody present in the sample prior to incubation on HEp-2 cells, meaning that any ANAs found are more likely to be ‘true’ ANAs, which require follow-up and are not derived from DFS70 antibodies. This method has the added benefit of allowing visualisation of any ‘true’ ANAs present in a sample that may be masked by DFS70 antibodies. Dr Sadia Noorani reported on an ongoing


study in her laboratory which aimed to establish the incidence of DFS70 antibodies and whether or not there is an association (positive or negative) with SARD. Testing for DFS70 antibody is performed on positive ANAs using the QUANTA Flash DFS70 assay and BIO-FLASH chemiluminescence system. As well as identifying the incidence of DFS70 antibodies, the study aims to correlate results with available clinical information and establish if the use of DFS70 could reduce costs related to laboratory follow-up testing and patient referral in the diagnosis of SARD.


Myositis/scleroderma The final subject area covered during the meeting was myositis/scleroderma. First, Dr Harsha Gunwardena gave an interesting talk on myositis-scleroderma overlap antibodies and their clinical association. He


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‘It is beneficial to keep written procedures for in-house assays as simple as possible, as you must do, and be able to justify, everything that is written in the procedure’


talked about the clinical differentiation of these diseases and also the importance of autoantibody testing in diagnosis. Antinuclear antibody patterns can be very weak, particularly in myositis, but specific antibodies such as Scl 70 and Jo-1 can still be demonstrated; it is therefore important to ensure that these patterns are reported, even at low titres. A number of interesting, rare myositis/scleroderma-related conditions were then discussed including antisynthetase syndrome, necrotising myopathy and amyopathic dermatomyositis, along with their autoantibody associations. The final speaker of the day, Kim


Fligelstone, gave a thought-provoking account of her life living with systemic scleroderma. Kim shared her story from time of diagnosis through to the present day. She was diagnosed at age 29, up to which point she had been fit and well. Her symptoms began with tiredness that became more extreme over time, until she reached the stage that her life consisted only of work and bed, as she was too tired to do anything else. Other symptoms such as numbness and pins and needles also began to occur, at which point she visited her GP who diagnosed Raynaud’s and referred her to a specialist.


Saas M, Engledew E, Ferry B (Basingstoke and North Hampshire Hospital)


Gorrie S (Heart of England NHS Foundation Trust, Birmingham)


Campbell G (Southwest Pathology Services, Taunton)


Davies S (Royal Liverpool Hospital)


Saleh F, Martin K, Lavender J, Tarzi M (Royal Sussex County Hospital, Brighton)


Sevier-Guy C, Furrie E, Dye G, Austin W,


Connacher M, Marshall S (NHS Tayside)


Reeson S (Queen Elizabeth Hospital, Gateshead)


Al-Baghdadi S, McKechnie K, Gall A (Aberdeen Royal Infirmary)


Jessop K, Martin K, Saleh F, Tarzi M


(Royal Sussex County Hospital, Brighton) Jessop K, Martin K, Saleh F, Tarzi M


(Royal Sussex County Hospital, Brighton)


Full diagnosis then took around six months and came both as a relief and a shock. Following diagnosis, Kim said it was


difficult to know what to do next. She explained how she had to adapt to deal with a number of debilitating symptoms such as tight skin, difficulty walking and breathing, and how the symptoms affected her day-to- day life, making her unable to work and perform simple activities such as preparing her own food. She shared how she learned to cope with the disease on a day-to-day basis by adapting the way she carried out tasks, using aids such as specially adapted knives and forks so that she can live as independent a life as possible. This was a very interesting presentation as


being based in the laboratory we very rarely have the opportunity hear the patient’s perspective on the diseases investigated.


Shared experiences The Autoimmune Focus meeting covered various subjects in the field of clinical immunology and the presentations stimulated interesting questions and comments from the audience. There were also a number of excellent posters available to view throughout the day, along with the opportunity to view and discuss the current instrumentation and products available from Werfen. Overall, it was a very informative and enjoyable day, which, as well as being educational, provided an opportunity to talk and share experiences with colleagues from other laboratories, particularly on the subject of UKAS accreditation.


Alison Gall is a senior biomedical scientist in the immunology laboratory at Aberdeen Royal Infirmary.


AUGUST 2016 THE BIOMEDICAL SCIENTIST


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