Turkiye Klinikleri Journal of Internal Medicine

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Otoantikorların Belirlenmesi İçin Alternatif İmmün Yöntemler: Geleneksel Derleme
Alternative Immune Methods for the Determination of Autoantibodies: Narrative Reviews
Rasim ŞAHİNa
aMersin Şehir Eğitim ve Araştırma Hastanesi, Mikrobiyoloji Laboratuvarı, Mersin, TÜRKİYE
Turkiye Klinikleri J Intern Med. 2021;6(1):39-43
doi: 10.5336/intermed.2020-75994
Article Language: TR
Full Text
ÖZET
 Otoantikor tespiti, sistemik lupus eritematozus, romatoid artrit, Sjögren sendromu, sistemik skleroz ve antifosfolipid sendromu gibi sistemik ve otoimmün tiroid hastalıkların yanı sıra primer biliyer siroz ve otoimmün hepatit gibi organa özgül olan çeşitli otoimmün hastalıkların tanısı için çok önemlidir. Çok sayıda otoimmün hastalık doğada kroniktir, yıllar boyunca ilerler ve varlığı tam gelişmiş hastalıktan aylarca veya yıllarca önce gelebilen özgün otoantikorlarla karakterizedir. Klinik laboratuvarlarda otoantikor testi için taleplerin ve test sayısının artması, saptanması ve ölçülmesi için daha verimli, daha az emek gerektiren, daha objektif yöntemlere ihtiyaç duyulmasına neden olmuştur. Farklı performans özelliklerine sahip çeşitli manuel veya otomatik tek veya çok aşamalı immünolojik testler; enzim bağlı immünoassay, kemilüminesans temelli immünolojik testler geliştirilmiştir. Kemilüminesans temelli immünolojik testlerin, immünoenzimatik yöntemlerden daha geniş dinamik aralık, sayısal değerde ifade edilen sonuçların yüksek duyarlılığı ve özgüllüğü, yüksek otomasyon derecesi ve sonuç verme süresindeki azalma ve çalışılan antikor testi sayısındaki artış sayesinde bu teknolojiyi, iş laboratuvarı ve immünoloji laboratuvarının organizasyonunda en gelişmiş yöntem hâline getirdi. Önümüzdeki yıllarda, akış enjeksiyonlu kemilüminesans immünoassay, kemilüminesans multipleks immünoassay için 2 boyutlu çözünürlük ve manyetik nanopartiküller kemilüminesans immünoassay gibi yeni analitik sistemlerin geliştirilmesi beklenmektedir. Yeni geliştirilen teknikler ve güncellemelere rağmen otoantikor tayinininde immün floresan teknik, hâlâ altın standart olarak kabul edilmektedir.

Anahtar Kelimeler: Otoantikor; immünolojik testler; kemilüminesans; immünofloresan
ABSTRACT
 Systemic and autoimmune thyroid diseases such as autoantibody detection, systemic lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome, systemic sclerosis and antiphospholipid syndrome, as well as various organ-specific diseases such as primary biliary cirrhosis and autoimmune hepatitis. It is very important. A large number of autoimmune diseases are chronic in nature, progress over the years and are characterized by unique autoantibodies, the presence of which can come months or years before a fully developed disease. In clinical laboratories, the demand for autoantibody testing and the number of tests increased required more efficient, less labor-intensive and objective methods to detect and measure. Various manual or automatic single or multi-stage immunological tests with different performance characteristics; enzyme bound immoassay, chemiluminescent based immunological tests have been developed in immunology laboratory. Chemiluminescence-based immunological tests have made this technology the most advanced method in the organization of the business laboratory and immunology laboratory, thanks to the wider dynamic range than immunoenzymatic methods, the high sensitivity and specificity of the results expressed in numerical value, the high degree of automation and the increase in the number of antibody tests studied. In the coming years, new analytical systems such as chemiluminescence immunoassay for flow injection, chemiluminescence multiplex immunoassay, and magnetic nanoparticles chemiluminescence immunoassay are expected to be developed. Despite the newly developed techniques and updates, immunofluorescent technique is still accepted as the gold standard in auto antibody detection.

Keywords: Autoantibody; immunological tests; chemiluminescent; immunofluorescent
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30.03.2014

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