Improved accuracy in DFS pattern interpretation using a novel HEp-2 ELITE system

  • Maria InfantinoEmail author
  • O. Shovman
  • B. Gilburd
  • M. Manfredi
  • V. Grossi
  • Maurizio Benucci
  • A. Damiani
  • D. Chimenti
  • K. Malyavantham
  • Y. Shoenfeld
Original Article
Part of the following topical collections:
  1. Autoimmune Collection 2018



Accurate interpretation of DFS70 (dense fine speckled 70) and mixed antinuclear antibodies (ANAs) patterns can be challenging using conventional HEp-2 immunofluorescence (IIF) method. We evaluated a novel HEp-2 IIF substrate (HEp-2 ELITE/DFS70-KO) composed of a mixture of engineered HEp-2 devoid of the DFS70 autoantigen and conventional HEp-2 cells. The study assessed the utility of the new substrate in ANA screening and its advantages.


One thousand and five consecutive routine samples sent for ANA screening were tested on both standard HEp-2 and the HEp-2 ELITE DFS70 KO substrates (ImmuGlo ANA HEp-2 and HEp-2 ELITE/DFS70-KO, Trinity Biotech, Buffalo, NY). Anti-DFS70 antibody specificity was additionally determined by immunoblot (IB). Clinical and serological data were included in the analysis of the overall impact of the novel HEp-2 substrate on DFS pattern interpretation.


Of the 22 cases suspected as positive for DFS pattern alone or in combination with homogeneous or speckled patterns on conventional HEp-2 cells, 17 were interpreted with a higher accuracy using the new HEp-2 ELITE method as positive for DFS70 (monospecific DFS70 (10), mixed DFS70 (7)), speckled (3), and DFS (2) patterns.


The new substrate was not only useful in deciphering unclear mixed ANA patterns but also highly sensitive in detecting DFS70 pattern in comparison to the DFS70 positivity obtained using IB.


Anti-DFS70 Antinuclear antibodies Autoantibodies Autoimmune disease HEp2-cells 


Compliance with ethical standards




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  • Maria Infantino
    • 1
    Email author return OK on get
  • O. Shovman
    • 2
    • 3
  • B. Gilburd
    • 2
  • M. Manfredi
    • 1
  • V. Grossi
    • 1
  • Maurizio Benucci
    • 4
  • A. Damiani
    • 4
  • D. Chimenti
    • 5
  • K. Malyavantham
    • 6
  • Y. Shoenfeld
    • 2
    • 3
    • 7
  1. 1.Immunology and Allergology Laboratory UnitS. Giovanni di Dio Hospital, Azienda Usl Toscana CentroFlorenceItaly
  2. 2.Zabludowitz Center for Autoimmune DiseasesSheba Medical CenterRamat GanIsrael
  3. 3.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  4. 4.Rheumatology UnitS. Giovanni di Dio Hospital, Azienda Usl Toscana CentroFlorenceItaly
  5. 5.A.Menarini DiagnosticsFlorenceItaly
  6. 6.Trinity BiotechBuffaloUSA
  7. 7.Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune DiseasesTel Aviv UniversityTel AvivIsrael

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