To the Editor:
Aggarwal, et al1 reported that assessing patients for anticytoplasmic autoantibody (anti-CytAb) serves as an excellent screen for antisynthetase antibody (anti-SynAb)–positive patients using simple indirect immunofluorescence. Cytoplasmic staining should be assessed and reported for patients suspected of having antisynthetase syndrome and a negative antinuclear antibody (ANA) should not be used to exclude this diagnosis. However, we noticed in the Discussion that the authors recognized that cytoplasmic staining includes several patterns, such as fine speckled (associated with anti-SynAb), diffuse (associated with anti-signal recognition particle), mitochondrial, lysosomal, golgi, actin, vimentin, etc. Herein, we are very confused as to what is the definition of the anti-CytAb. For the immunology laboratory, the ANA screening is usually divided into the following 4 parts: (1) nuclear pattern, (2) cytoplasmic staining (Jo1, rRNP, mitochondrial, lysosomal, golgi, peroxisome, interphase cytoplasm foci protein), (3) cytoskeleton pattern (actin, vimentin, tropomyosin, cytokeratin, vinculin), and (4) cell cycle pattern (proliferating cell nuclear antigen, centriole spindle, spindle fiber, spindle pole, midbody pattern, chromo, tubulin), and the cytoplasmic staining is regarded as the anti-CytAb. In the article, we wonder whether the anti-CytAb is only the cytoplasmic staining or includes the following 3 parts: cytoplasmic staining, cytoskeleton pattern, and cell cycle pattern. This is very important for the immunology laboratory members to report.
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