Autoantibody Assays: Performance, Interpretation, and Standardization

Rapid advances in diagnostic technologies used to detect autoantibodies have made it challenging for clinicians and even the most modern laboratory to keep abreast of the constantly evolving diagnostic assays and revised diagnostic algorithms. Autoantibody testing has traditionally served the realm of diagnostic medicine, but along with genomics, transcriptomics, proteomics, and metabolomics, it is achieving importance in precision medicine, case finding, and disease prevention. The effective use and interpretation of autoantibody testing is dependent upon keep abreast of new autoantibodies and emerging diagnostic technologies that have an impact on diagnostic and clinical care pathways. Despite the best efforts of educators, clinicians, diagnosticians, regulators, and manufacturers, false-positive and false-negative autoantibody test results remain an issue. While major gaps of standardized assay performance and autoantibody nomenclature are being addressed, there are still significant gaps in our understanding of the origin and roles of autoantibodies.