Comparison of enzyme-linked immunosorbent assay and rapid chemiluminescent analyser in the detection of myeloperoxidase and proteinase 3 autoantibodies

Pathology. 2017 Jun;49(4):413-418. doi: 10.1016/j.pathol.2017.02.006. Epub 2017 May 23.

Abstract

Antibodies to myeloperoxidase (MPO) and proteinase 3 (PR3) are vital in the diagnosis and management of ANCA-associated vasculitis. A chemiluminescent immunoassay (CLIA; Quanta Flash) provides MPO and PR3 antibody results in 30 minutes, which is much faster than enzyme-linked immunosorbent assay (ELISA). We compared the performance of ELISA (Orgentec) and CLIA (Quanta Flash) for MPO and PR3 antibody quantitation on 303 samples, comprising 196 consecutive samples received in a single diagnostic laboratory over a 3 month period, and 107 samples collected from 42 known vasculitis patients over a 40 month period. We observed a correlation between both methods using spearman correlation coefficients (MPO, rs = 0.63, p < 0.01; PR3, rs = 0.69, p < 0.01). There was agreement between both methods in determining a positive or negative result. In the vasculitis cohort, CLIA performed well at clinically important stages of disease; diagnosis (eight samples all positive by both assays) and disease relapse (correlation for both MPO and PR3 antibody quantitation rs = 0.84, p = 0.03 and rs = 0.78, p < 0.01, respectively). Three samples were discordant at clinical relapse, testing positive by CLIA, including one high positive associated with relapse requiring a change in treatment. In summary, CLIA appears to be at least as accurate as ELISA for measurement of MPO and PR3 antibodies.

Keywords: ANCA-associated vasculitis; Enzyme-linked immunosorbent assay; chemiluminescent immunoassay; granulomatosis with polyangiitis; microscopic polyangiitis; myeloperoxidase; proteinase 3.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Antineutrophil Cytoplasmic / immunology
  • Autoantibodies / immunology*
  • Child
  • Enzyme-Linked Immunosorbent Assay* / methods
  • Female
  • Fluorescent Antibody Technique, Indirect / methods
  • Humans
  • Immunoassay / methods
  • Luminescent Measurements* / methods
  • Male
  • Middle Aged
  • Myeloblastin / analysis*
  • Myeloblastin / immunology
  • Myeloblastin / metabolism
  • Peroxidase / analysis*
  • Peroxidase / immunology
  • Peroxidase / metabolism
  • Vasculitis / diagnosis
  • Young Adult

Substances

  • Antibodies, Antineutrophil Cytoplasmic
  • Autoantibodies
  • Peroxidase
  • Myeloblastin