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Technology Insight: can autoantibody profiling improve clinical practice?

Nature Clinical Practice Rheumatology volume 3, pages 96–103 (2007)Cite this article

Abstract

A hallmark of autoimmune diseases is the production of high titers of highly specific autoantibodies, which are routinely measured to guide clinical decision-making. Multiplex antigen microarrays are powerful tools that can provide profiles of the autoantibodies found in blood and other biological fluids. This high-throughput technology allows for rapid identification of antibody and antigen biomarker sets, which is sorely needed in the clinic to improve diagnosis, predictions of prognosis, and selection of targeted therapies. In this article we will describe the antigen microarray technologies that are currently available, and those that are in development. We highlight recent applications for antibody profiling, as well as the challenges that need to be faced before such technologies enter the clinic.

Key Points

  • Antigen arrays are available for rapid detection of multiple autoantibodies in microliter volumes of biological fluids

  • Multiplex antigen arrays are invaluable tools for identifying disease-specific autoantibody signatures

  • Autoantibody profiles can be followed over time as markers of disease remission or relapse

  • Novel antigens can be identified by testing reactivity of autoimmune sera to candidate antigens

  • Antigen-array technologies and the tools necessary for data interpretation are developing at an unprecedented rate

  • Individual autoantibody signatures can form the basis for patient-specific therapies

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Figure 1: A schematic diagram that illustrates the steps involved in content generation, processing and data analysis for antigen microarrays.
Figure 2: Protein microarray for connective tissue diseases.

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Acknowledgements

We thank members of the laboratories of PJ Utz, William H Robinson and Larry Steinman for the development of some of the technologies described in this article. V Sharp was funded by an NIH grant. PJ Utz is the recipient of a Donald E and Delia B Baxter Foundation Career Development Award, and was supported by the Dana Foundation, the Floren Family Trust, the Northern California Chapter of the Arthritis Foundation, NIH grants, and a proteomics contract from the National Heart, Lung, and Blood Institute.

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Authors and Affiliations

  1. V Sharp is a Postdoctoral Research Fellow and PJ Utz is an Associate Professor of Medicine in the Department of Medicine, Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA, USA.,

    Veronika Sharp & Paul J Utz

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  1. Veronika Sharp
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  2. Paul J Utz
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Corresponding author

Correspondence to Veronika Sharp.

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Competing interests

PJ Utz states the following conflict of interest disclosures: that in the past 3 years he has served as a consultant at Centocor (Horsham, PA), Biogen Idec (Cambridge, MA), and Genentech, Inc (South San Francisco, CA), and Avanir, Inc (La Jolla, CA); he is a member of the Scientific Advisory Board of Monogram Biosciences (South San Francisco, CA) and XDx, Inc (South San Francisco, CA), and is a co-founder of and consultant to Bayhill Therapeutics (Palo Alto, CA).

V Sharp declared no competing interests.

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Sharp, V., Utz, P. Technology Insight: can autoantibody profiling improve clinical practice?. Nat Rev Rheumatol 3, 96–103 (2007). https://doi.org/10.1038/ncprheum0404

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