Summary
The aim of this study was to evaluate the agreement in assay results between commercial
kits for the measurement of anti- β2glycoprotein I antibodies. Ten manufacturers provided
one IgG and one IgM kit to three testing centres. Samples from patients with primary
(n=13) or secondary (n=3) antiphospholipid syndrome (APS), from lupus patients without
APS features (n=6) and from normal individuals (n=2) were tested in the three centres
according to manufacturers’ instructions. Dilutions in normal serum of a pool made
from positive patients’ samples (Forum Calibrators) and dilutions of humanized monoclonal
antibodies (MoAbs) were used as additional calibrators. The calibration curves obtained
with each calibrator differed widely between kits. The rate of positivity of patients’
samples varied from 7 to 16 for IgG and from 2 to 17 for IgM, depending on the kit.
Perfect agreement occurred in 12/22 samples for IgG and 5/22 samples for IgM. Samples
from normals were found negative by all kits. Between kits, cutoff values varied up
to five fold when expressed in Forum Calibrators arbitrary units and up to three fold
when expressed in MoAbs equivalents. Examination of discrepant samples indicated that
about half of the discrepancies, scoring 8:2 and 9:1, involved the same few kits.
In highly discrepant samples, some kits appeared as high responders as compared to
others. In conclusion, with the exception of a few kits, agreement in assay results
was acceptable. In conclusion, additional efforts are however necessary, especially
concerning the way to assess the cutoff point and the adoption of a reference calibrator,
in order to improve standardization of the assays.
Keywords
Anti-β2glycoprotein I antibodies - assays - standardization - antiphospholipid antibodies