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Bizzaro, Nicola

Pathology - Journal of the RCPA: 2009 - Volume 41 - Issue - p 41

Laboratorio di Patologia Clinica, Ospedale Civile, Tolmezzo, Italy

Several studies have shown that autoimmune diseases are preceded by a long pre‐clinical phase, and that many autoantibodies can be detected in the serum of asymptomatic subjects years before the clinical manifestations become evident. It is also clear that the progression towards a given autoimmune disease, and its severity, can be predicted from the type of antibody, the antibody level, and the number of antibodies present. Tests for these autoantibodies could therefore be used in principle in screening studies on unselected populations to identify individuals predisposed to the development of the disease at an early stage, and start treatment or adopt preventive measures where possible. This aspect has aroused particular interest, as multiplex investigation techniques are already available, and microarray methods are under development, which will probably allow tens or hundreds of autoantibodies to be measured simultaneously. However, as no antibody assay offers 100% specificity, and the results are strongly dependent on the assay method used to measure the autoantibodies, it is essential to use assay methods with high diagnostic specificity to minimise false positives. Whether the use of this special sero‐immunological characteristic in screening strategies on healthy populations is useful and advisable, requires detailed methodological, clinical and ethical evaluations.

© 2009 Royal College of Pathologists of Australasia