Issues in autoantibody tests used in the classification criteria for autoimmune rheumatic diseases: the laboratory autoimmunologist's perspective

• Published in: Autoimmunity reviews 2024-09, Vol.23 (9), p.103604, Article 103604
• Main Authors: Bizzaro, Nicola, Mazzoni, Alessio, Carbone, Teresa, Cinquanta, Luigi, Villalta, Danilo, Radice, Antonella, Pesce, Giampaola, Manfredi, Mariangela, Infantino, Maria
• Format: Article
• Language: English
• Subjects: Autoantibodies; Classification criteria; Connective tissue diseases; Systemic autoimmune rheumatic diseases
• ISSN: 1568-9972
• DOI: 10.1016/j.autrev.2024.103604

Classification criteria of autoimmune rheumatic diseases are an important means to define homogenous groups of patients that can be compared across studies for clinical trials and research purposes. The measurement of autoantibodies is a relevant aspect in the definition of classification criteria, with a significant weight in the scores necessary to classify patients with autoimmune rheumatic diseases. The impact of autoantibodies has gradually increased over the years, contributing to the evolution and improvement of the classification criteria. However, these criteria often do not take into consideration how autoantibodies are measured, i.e. differences in diagnostic accuracy of the methods. This is a critical point especially when obsolete analytical methods that are no longer used in many clinical laboratories are taken into consideration. In this review we have critically examined assays and methods for the determination of autoantibodies that are (or could be) included among the classification criteria of autoimmune rheumatic diseases in light of more recent evidence and technology evolution. •Almost all rheumatic diseases include autoantibodies in classification criteria•These criteria often do not take into consideration how autoantibodies are measured•We reviewed classification criteria from the laboratory immunologist's perspective