TABLE 3.

Comparison of the advantages and disadvantages of the methods commonly used for the detection of anti-ENA antibodies

MethodEpitopesAdvantagesDisadvantages
DIDConformational and linearInexpensiveLow sensitivity
High specificitySlow turnaround time
Detects wide range of anti-ENA antibodiesSubjective
Labour-and skill-intensive
Requires well-defined reference sera
CIEPConformational and linearInexpensiveMay miss some antibodies to 52-kDa SS-A, SS-B, and Scl-70
More sensitive and more specific than DIDSame disadvantages as DID
Faster turnaround time than DID
ELISAConformational and linearRapid turnaround timeRelatively expensive (although less expensive than IB)
More sensitive than DID and CIEPRequires purified antigen
Objective and quantitativeLow specificity
Less skill and training required
Capacity for automation
IBLinear onlyMore sensitive than DID and CIEPExpensive
May miss some antibodies to 60-kDa SS-A and Scl-70
Labor-and skill-intensive (especially for in-house assays)