QAS Newsletter Contribution – June 2023

June 20, 2023Quality Assessment and Standardization Committee (QAS)

By Edward E. K. Chan, Wilson de Melo Cruvinel, and Luis Eduardo C. Andrade on behalf of ASC and ICAP members

ICAP Smartphone App – connecting to our new generation of users

The Autoantibody Standardization Committee (ASC) is a subcommittee of the IUIS Quality Assessment and Standardization Committee with a focus on human autoantibodies often detected in patients with systemic autoimmune rheumatic diseases. A major effort for the committee to date is the generation of reference materials that are primarily human serum/plasma and in some cases also monoclonal antibodies. The goal is to ensure the correct detection of autoantibodies in clinical and research laboratories worldwide. These reference materials are distributed free of charge except some handling and shipping fees by an independent company the Plasma Services Group. 

A second major effort with ASC is the International Consensus on Antinuclear antibody Patterns (ICAP) initiative started in 2014.  Six workshops were held since then and the 7th workshop is planned for 11 September, 2023 in Dresden immediately before the 16th Dresden Symposium on Autoantibodies. The main goal of the ICAP is to promote consensus regarding the standardization of antinuclear antibody (ANA) patterns observed in the indirect immunofluorescence assay on HEp-2 cells (HEp-2 IFA) test. The HEp-2 IFA patterns convey important information to the interpretation of the test, because each pattern is associated with a restricted array of autoantibodies. Therefore, the correct interpretation of the HEp-2 IFA pattern allows reflex or follow-up testing in autoantibody-specific immunoassays. For example, a sample yielding the nuclear homogeneous (AC-1) pattern probably has autoantibodies against double-stranded DNA, nucleosome or histones. To date, 30 patterns have been defined in the ICAP classification tree available on the website that also offers representative images and the clinical relevance for each pattern. The ICAP website is accessed by circa 200,000 users per year from 186 countries and is translated into 16 languages. During the last ICAP workshop, a survey was used to gauge the suggested need for a smartphone App. There was overwhelming support from ICAP users that a smartphone App would be highly useful, especially among the younger users. Fund was raised to generate such an App including the majority of functions currently available on the ICAP website. Figure 1 illustrates many of the functions with the recently launched ICAP smartphone App, which is developed for both iOS and Android operating systems and available free of charge download from Apple and Google Stores.  Use the search words “ANA patterns” and select “ICAP Official App.”  The App is now in beta testing and is freely available to all users. Interested users should note that they must first register for a free login account at www.ANApatterns.org. It is anticipated that this new media will increase the reach out of ICAP initiative and the usage of ICAP HEp-2 IFA patterns.

Figure 1. Outline of the functions available in the ICAP smartphone App with Welcome page (lower left panel) opening to the main menu with five subheadings: Nomenclature/classification tree, HEp-2 IFA images, Patterns description/antigen association, clinical relevance, and FAQ (frequently asked questions).

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