Anti-Tif-1 Gamma Antibody Detection Using A Commercial Kit Vs In-House Immunoblot: Usefulness In Clinical Practice

ObjectivesAnti-TIF-1 gamma autoantibody detection is important for cancer screening in patients with dermatomyositis. The gold standard for anti-TIF-1 gamma detection, immunoprecipitation, is only available from a few specialized laboratories worldwide, so commercial ELISA/immunoblot tests have emerged in recent years. To analyze their usefulness in diagnosing cancer-associated dermatomyositis, we compared Euroimmun Euroline profile with our previously validated in-house immunoblot assay with human recombinant TIF-1 gamma.MethodsWe included 308 adult patients from Hospital de la Santa Creu I Sant Pau and Vall Hebron Hospital (Barcelona, Spain) tested for anti-TIF-1 gamma autoantibodies using the Euroline profile and an in-house immunoblot assay.ResultsA total of 27 anti-TIF-1 gamma were detected by the Euroline and 12 by the in-house assay. Fair agreement was observed between Euroline and the in-house immunoblot Cohen's kappa 0.3163. Expected prevalence of anti-TIF-1 gamma autoantibodies was observed for the two methods for dermatomyositis and undifferentiated connective tissue diseases, but unexpectedly high prevalence of anti-TIF-1 gamma autoantibodies was detected by Euroline compared to the in-house immunoblot for other diseases (16.5% Euroline vs 0.8% in-house immunoblot, p<0.01). The in-house IB compared to Euroline more reliably detected cancer in patients with DM with anti-TIF-1 gamma antibodies (p=0.0014 vs p=0.0502 for in-house immunoblot vs Euroline).ConclusionWe recommend using a second validated method to confirm Euroline-detected anti-TIF-1 gamma antibodies when the dermatomyositis diagnosis is not definitive. Furthermore, in the context of definite DM diagnosis with negative anti-TIF-1 gamma antibodies by Euroline and no other myositis specific antibody, is also recommendable to confirm by a second validated method.