Mark L. Fritzler

The use and abuse of commercial kits used to detect autoantibodies

The detection of autoantibodies in human sera is an important approach to the diagnosis and management of patients with autoimmune conditions. To meet market demands, manufacturers have developed a wide variety of easy to use and cost-effective diagnostic kits that are designed to detect a variety of human serum autoantibodies. A number of studies over the past two decades have suggested that there are limitations and concerns in the use and clinical application of test results derived from commercial kits. It is important to appreciate that there is a complex chain of users and circumstances that contributes to variations in the apparent reliability of commercial kits. The goal of this review is to identify the principal links in this chain, to identify the factors that weaken the chain and to propose a plan of resolution. It is suggested that a higher level of commitment and partnership between all of the participants is required to achieve the goal of improving the quality of patient care through the use of autoantibody testing and analysis.

The Emergence of Multiplexed Technologies as Diagnostic Platforms in Systemic Autoimmune Diseases

In the last decade, there has been a rapid proliferation of new technologies that are capable of identifying an increasing spectrum of autoantibodies and other biomarkers in autoimmune diseases. These newer diagnostic technologies include line immunoassays, addressable laser bead immunoassays, microarrays in microfluidics platforms and nanobarcode particles. Multiplexed bead assays are a particularly robust platform because they are adaptable to the detection of a variety of disease specific biomarkers, such as autoantibodies, cytokines, adipokines, drugs, oligonucleotides and single nucleotide polymorphisms, Although many laboratories have adopted a variety of these diagnostic platforms to improve turn around times and meet budget constraints, there is an urgent need to ensure that the rapid adoption of new technologies is attended by an appropriate balance of assay sensitivity and specificity.

Identification of GW182 and its novel isoform TNGW1 as translational repressors in Ago2-mediated silencing.

RNA interference is triggered by small interfering RNA and microRNA, and is a potent mechanism in post-transcriptional regulation for gene expression. GW182 (also known as TNRC6A), an 182-kDa protein encoded by TNRC6A, is important for this process, although details of its function remain unclear. Here, we report a novel 210-kDa isoform of human GW182, provisionally named trinucleotide GW1 (TNGW1) because it contains trinucleotide repeats in its mRNA sequence. TNGW1 was expressed independently of GW182 and was present in human testis and various human cancer cells. Using polyclonal and monoclonal antibodies, we detected TNGW1 in only ∼30% of GW bodies. Expression of EGFP-tagged TNGW1 in HeLa cells was colocalized to cytoplasmic foci enriched in Ago2 (also known as EIF2C2) and RNA decay factors. Tethering TNGW1 or GW182 to the 3′-UTR of a luciferase-reporter mRNA led to strong repression activity independent of Ago2, whereas the tethered Ago2-mediated suppression was completely dependent on TNGW1 and/or GW182. Our data demonstrated that GW182 and, probably, TNGW1 acted as a repressor in Ago2-mediated translational silencing. Furthermore, TNGW1 might contribute to diversity in the formation and function of GW and/or P bodies.

A panel of monoclonal antibodies to cytoplasmic GW bodies and the mRNA binding protein GW182.

GW182 is a mRNA binding protein characterized by 60 repeats of glycine (G):tryptophan (W) motifs and is localized in cytoplasmic structures referred to as GW bodies (GWBs). Current evidence suggests that this unique protein plays a role in mRNA processing. To enable a more detailed study of GW182 and GWBs in cells and tissues, including their role in mRNA processing, we developed four monoclonal antibodies (MAbs) that bind the human recombinant GW182 protein. These MAbs can be used for Western blot analysis and indirect immunofluorescence (IIF) on cultured cells and tissues. Of special interest, one of the MAbs, 2D6, can be used to identify GW182 and GWBs in formalin-fixed and paraffin-embedded tissues after using an antigen retrieval method (ARM). All the MAbs described in this study immunoprecipitate the GW182 protein. Epitope mapping using overlapping 15-mer peptides representing the full-length GW182 showed that the major antibody-binding domains of these MAbs are distinct. These MAbs are valuable tools for cell biologists and pathologists to study the location and function of the novel GW182 protein in tissue culture cells, as well as cryopreserved or archived tissues.

Identification of the B-cell epitopes of the early endosome antigen 1 (EEA1).

Early endosome antigen 1 (EEA1) is a target autoantigen in patients diagnosed with neurological and other autoimmune conditions. Eighteen of 65 sera (28%) that displayed a vesicular cytoplasmic staining pattern also immunoprecipitated the recombinant EEA1. These 18 sera were selected for further clinical, serological and epitope mapping studies. Thirty-six percent of the 18 patients had neurological diseases. Seventeen sera (94%) reacted with the partial length EEA1 constructs that included the C-terminal zinc finger (+FYVE) and the methyl accepting domain (LeuMA: amino acids 82-1411) in an addressable laser bead assay suggesting that the assay may be used for rapid laboratory detection of anti-EEA1 antibodies. Three of seven sera selected for epitope mapping studies bound to EEA1 peptides represented by amino acids 1096-1125, and two reacted with peptides represented by amino acids 1296-1320. One serum reacted only with the C-terminal peptide 1096-1125. The remaining serum reacted with other EEA1 epitopes. This data was supported by the observations that all the sera immunoprecipitated the C-terminal +FYVE (EEA1 1064-1411) construct, a peptide that also contained the linear epitopes 1096-1140. The limited epitope mapping studies suggest that the sera from patients with non-neurological diseases recognized epitopes in the central and C-terminal EEA1 domains, whereas the patients with neurological disease recognized a more restricted set of epitopes in the C-terminal.

Inflammatory biomarkers of pediatric focal cerebral arteriopathy

Focal cerebral arteriopathy (FCA), defined as unifocal or multifocal stenosis of the large or medium-sized blood vessels, is a leading etiology of childhood arterial ischemic stroke (AIS).[1][1] Pathophysiology is poorly understood but inflammatory mechanisms are suspected.[2][2] Recurrence is high

Microbead-based technologies in diagnostic autoantibody detection.

BACKGROUND There is a rapid proliferation of new technologies to identify a spectrum of autoantibodies in medical conditions that range from organ-specific autoimmune diseases to systemic rheumatic diseases. Although many laboratories have adopted high-throughput diagnostic platforms such as enzyme linked immunoassays (ELISA), other technologies such as microbead-based assays are emerging as an alternative diagnostic platform. OBJECTIVE To understand the performance and importance of bead based immunoassays in clinical diagnostics and therapeutics. METHOD Current literature was reviewed using the PubMed search engine combining keywords of immunoassay and Luminex, as well as a personal literature database. Included in the evaluation and commentary are bead-based assays such as addressable laser bead immunoassays and related magnetic bead assays. CONCLUSIONS Comparison with other conventional technologies has indicated that laser microbead immunoassays are reliable, accurate, cost-effective, highly sensitive and have rapid turn around time for results. While there are advantages to this diagnostic platform, there are challenges that must be addressed before wider acceptance or long-term use of this technology platform in the routine clinical diagnostic laboratory.