Antinuclear Antibodies

Screening determinations of ANAs are routinely performed by indirect immunofluorescence on cryostat sections of rat liver, kidney, and stomach as well as on HEp2 cell slides. Most commonly, a homogeneous or speckled immunofluorescence pattern is detectable in all three tissues. The most precise definition of an ANA pattern is obtained using HEp2 cells, a cell line derived from laryngeal carcinoma with prominent nuclei. ANAs represent the most common autoanti-bodies in AIH and occur in high titers, usually exceeding 1:160. However, the titer does not correlate with disease course, disease activity, prognosis, progression, requirement of transplantation, or disease reoccurrence after transplantation. Furthermore, ANAs are not specific for autoimmune hepatitis and can also be detected in other autoimmune disorders such as systemic lupus erythemato-sus. In the future, more refined techniques using recombinant nuclear antigens and immunoassay formats may enable the identification of reactants and assessment of their specificity for diagnosis of and possible roles in pathogenesis.

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