ADVANCING AUTOANTIBODY DETECTION: A JOURNEY FROM CONVENTIONAL TO STATE OF THE ART METHODS

Autoimmune diseases constitute a diverse array of disorders characterized by immune dysregulation leading to abnormal B cell and T cell responses against the body’s own components. Among the hallmarks of these conditions is the common presence of autoantibodies. These autoantibodies often target various intracellular or extracellular components such as nucleic acids, structural proteins, enzymes, RNA binding proteins, receptors, and cytokines, underscoring the complexity of the immune responses involved. The detection of autoantibodies plays a pivotal role in diagnosing and classifying individuals with autoimmune diseases. Moreover, research indicates that certain autoantibodies can emerge years prior to the clinical onset of autoimmune diseases. Traditionally, methods such as enzyme-linked immunosorbent assay (ELISA), immunofluorescence, and fixed tissue or cell-based assays have been commonly employed for autoantibody detection. However, these technologies exhibit limitations in terms of sensitivity, specificity, and sample throughput. Consequently, ongoing efforts focus on developing novel experimental techniques to uncover new autoantigens associated with autoimmune diseases. Despite technological advancements, challenges in the detection of autoantibodies persist. Issues such as sensitivity and specificity, temporal variability in autoantibody levels, technical constraints, subjective interpretation, and the absence of standardized quality controls pose hurdles. It is crucial to recognize that autoantibody tests alone are diagnostic tools and should be complemented by clinical evaluation for accurate diagnosis. In this chapter, we will explore the technologies utilized in the detection of both classic and emerging autoantibodies. We will delve into the assessment of clinical relevance, accuracy, validation processes, and potential regulatory requirements necessary for establishing these diagnostic tests as approved tools for routine clinical practice.