medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2023-31-21-25medalphabet-3462Research ArticleСтатьиОпределение антинуклеарных антител: рекомендации EFLM, EASI, ICAP И РАМЛДMethodological aspects of anti-nuclear antibodies detection: EFLM, EASI, ICAP AND RAMLD recommendationshttps://orcid.org/0000-0002-2738-2956НовиковА. А.NovikovA. A.

Новиков Александр Александрович - д.б.н., в.н.с. лаборатории клинической иммунологии.

Москва

Alexander A. Novikov - DBio Sci (habil.), leading researcher at Clinical Immunology Laboratory.

Moscow

a.novikov@mknc.ruhttps://orcid.org/0000-0003-4074-5907АлександроваЕ. Н.AleksandrovaE. N.

Александрова Елена Николаевна - д.м.н., зав. лабораторией клинической иммунологии.

Москва

Elena N. Aleksandrova - DM Sci (habil.), head of Clinical Immunology Laboratory.

Moscow

https://orcid.org/0000-0001-7958-5926ЛукинаГ. В.LukinaG. V.

Лукина Галина Викторовна - д.м.н., проф., зав. отделом ревматологии.

Москва

Galina V. Lukina - DM Sci (habil.), professor, head of Rheumatology Dept.

Moscow

https://orcid.org/0000-0001-6528-1059КазаковС. П.KazakovS. P.

Казаков Сергей Петрович - д.м.н., доцент, зав. кафедрой медицинской биохимии и иммунопатологии Академического образовательного центра трансляционной и фундаментальной медицины.

Москва

Sergei P. Kazakov - DM Sci (habil.), associate professor, head of Dept of Medical Biochemistry and Immunopathology of Academic Educational Centre for Translational and Fundamental Medicine.

Moscow

ГБУЗ «Московский клинический научно-практический центр имени А.С. Логинова Департамента здравоохранения Москвы»РоссияA.S. Loginov Moscow Clinical Scientific CenterRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияAcademic Educational Centre for Translational and Fundamental Medicine of Russian Medical Academy for Continuing Professional EducationRussian Federation202313012024031Ревматология в общей врачебной практике (2)2125Copyright © Новиков А.А., Александрова Е.Н., Лукина Г.В., Казаков С.П., 20242024Новиков А.А., Александрова Е.Н., Лукина Г.В., Казаков С.П.Novikov A.A., Aleksandrova E.N., Lukina G.V., Kazakov S.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/3462

Представлен обзор современных международных и российских рекомендаций исследования антинуклеарных антител (АНА) при иммуновоспалительных ревматических заболеваниях (ИВРЗ) и аутоиммунных заболеваниях печени (АИЗП), включающий описание наиболее важных методических аспектов, отобранных на основе накопленной к настоящему моменту доказательной базы. Основная цель лабораторной диагностики ИВРЗ и АИЗП – получение объективной информации о наличии и характере иммунопатологических изменений у пациента, что является важным инструментом для ранней диагностики, оценки активности, тяжести течения, прогноза болезни и эффективности проводимой терапии. Положительные результаты определения АНА являются одним из основных лабораторных маркеров ИВРЗ и АИЗП, входя в число диагностических критериев этих заболеваний. «Золотым стандартом» и первичным скрининговым методом определения АНА в сыворотке крови служит непрямая реакция иммунофлюоресценции (НРИФ). В качестве подтверждающих тестов используются антиген-специфичные методы твердофазного иммуноанализа. В отечественной литературе АНА, тестируемые методом НРИФ, традиционно обозначают как антинуклеарный фактор (АНФ). Стандартизация исследования АНА создает предпосылки для снижения внутри- и межлабораторной вариабельности полученных результатов, способствует оптимизации взаимодействия между специалистами лаборатории и врачами-клиницистами в вопросах назначения и клинической интерпретации лабораторных тестов. Решение проблемы стандартизации определения АНА становится особенно важным в связи с ростом числа лабораторий, выполняющих данный тест, и увеличением количества его определений, назначаемых не только ревматологами, но и врачами других специальностей.

This is a review of international and Russian recommendation for the study of anti-nuclear antibodies (ANA) in autoimmune inflammatory rheumatic diseases (AIRD) and autoimmune liver diseases (ALD), including a description of the most important methodological aspects. The main purpose of laboratory diagnostics of AIRD and ALD is to obtain objective information about the presence and immunopathological changes, which is an important tool for early diagnosis, assessment of activity, severity, prognosis of the disease and the effectiveness of therapy. The positive results of ANA determination are the main laboratory markers of AIRD and ALD, being among the diagnostic criteria for diseases. The ‘gold standard’ and primary screening method for determining ANA in serum is the indirect immunofluorescence assay (IFA). Antigen-specific solid phase assays methods are used as confirmatory tests. Standardization of the ANA determination contributes for reducing the intra- and inter-laboratory variability of the results, helps to optimize the interaction between laboratory specialists and clinicians in matters of prescribing and clinical interpretation of ANA tests. Solving the problem of ANA detection standardization is important because of the growing number of laboratories performing these tests and an increased referring for this investigation from rheumatologists and another medical specialist.

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The authors declare that there are no conflicts of interest present.