Automated direct immunofluorescence analyses of skin biopsies

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<jats:sec><jats:title>Background</jats:title><jats:p>Diagnosis of autoantibody‐ and immune complex‐induced skin diseases is primarily based on direct immunofluorescence (<jats:styled-content style="fixed-case">DIF</jats:styled-content>) microscopy. <jats:styled-content style="fixed-case">DIF</jats:styled-content> staining is usually performed manually and, therefore, is labor intensive. The quality of immunohistochemical results considerably depends on the experience of the person conducting the tests. The novel <jats:styled-content style="fixed-case">EUROTide</jats:styled-content><jats:sup>™</jats:sup> technique in combination with the biochip‐based system <jats:styled-content style="fixed-case">EUROPath</jats:styled-content> represents a new technology for automation of <jats:styled-content style="fixed-case">DIF</jats:styled-content> staining.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Frozen sections of previously characterized skin biopsies from bullous pemphigoid and pemphigus vulgaris patients were incubated with fluorescein‐labelled anti‐human <jats:styled-content style="fixed-case">IgG</jats:styled-content> and complement C3c following the standard manual procedure and, for comparison, applying <jats:styled-content style="fixed-case">EUROTide</jats:styled-content>/<jats:styled-content style="fixed-case">EUROPath</jats:styled-content> in an automated version.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Both, the manual and the automated procedure, detected <jats:styled-content style="fixed-case">IgG</jats:styled-content> and C3c deposits in all samples. However, <jats:styled-content style="fixed-case">DIF</jats:styled-content> stainings performed with <jats:styled-content style="fixed-case">EUROTide</jats:styled-content>/<jats:styled-content style="fixed-case">EUROPath</jats:styled-content> displayed more intense specific <jats:styled-content style="fixed-case">IF</jats:styled-content> signals and distinctly less background staining. The detecting antibody could be used at a ×4 higher dilution.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p><jats:styled-content style="fixed-case">EUROTide</jats:styled-content>/<jats:styled-content style="fixed-case">EUROPath</jats:styled-content> applied in an automated system improves diagnostic accuracy and saves reagents. Larger studies in other routine laboratories may further explore the value of the <jats:styled-content style="fixed-case">EUROTide</jats:styled-content>/<jats:styled-content style="fixed-case">EUROPath</jats:styled-content> technology and may include comparison with other automated stainers.</jats:p></jats:sec>

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