University Hospital of Montpellier

Autoimmune nodopathy (AN) is a disabling peripheral nerve disorder mediated by four pathogenic autoantibodies targeting the node of Ranvier: anti-neurofascin-155 (Nfasc155); anti-Nfasc155 and Nfasc186 (PanNfasc); anti-contactin-1; and anti-contactin-associated protein 1 autoantibodies. Several autoantibody detection assays exist; however, which assay yields the best performance remains unclear. We evaluated the performance of five diagnostic assays individually and in combinations to identify a gold standard assay for diagnosing AN and improve diagnostic accuracy. Sera from 290 individuals from a European cohort, including healthy controls and patients with Guillain-Barré syndrome, chronic inflammatory demyelinating polyradiculoneuropathy, monoclonal gammopathy, Charcot-Marie-Tooth disease, and AN were tested using five diagnostic assays for AN: ImmunoDOT (D-tek, Mons, Belgium); ELISA; an in-house cell-based assay (CBA); a commercial CBA (Euroimmun, Bussy-Saint-Martin, France); and peripheral nerve immunohistochemistry (IHC). The sensitivity (Se) and specificity (Sp) of the individual assays and their combinations were estimated using Bayesian latent class analysis. The overall Se was 84% (95% credibility interval [CI], 79-88) for ImmunoDOT, 86% (81-90) for ELISA, 96% (93-98) for the in-house CBA, 92% (89-96) for the commercial CBA, and 91% (87-94) for IHC. For all assays, the overall Sp was ≥ 97%. Among the tested assays, in-house CBA showed the best performance, with the highest Se and Sp. The assay combinations demonstrated excellent analytical performance (Se ≥ 91% and Sp ≥ 98%). Inter-laboratory validation revealed excellent repeatability, with a Gwet's agreement coefficient of >0.94 for most assays. Our research suggests that combining two assays, CBA and ImmunoDOT enhances the accuracy of AN diagnosis. This approach can facilitate the establishment of standardized assays for AN diagnosis and aid in the better differentiation of AN from other similar pathologies.

As part of the Joint Action PreventNCD, the Health Literacy (HL) task, which includes experts from 18 institutions across 15 European countries, is committed to improving HL across Europe, particularly aiming to reduce health inequalities. In an era where access to health information is vital, it is crucial to ensure that everyone, especially the most vulnerable, can effectively understand and use health information to promote equity in the prevention of non-communicable diseases (NCDs). The HL task is divided into several projects, including the Data Project and the Evidence Project. In collaboration with the WHO Action Network M-POHL through its HLS24 initiative, the Data Project is collecting high-quality, comparable HL data in 10 countries through nationally representative surveys. 3 countries conduct additional surveys covering ethnic minority and immigrant populations. In parallel, the Evidence Project is conducting a scoping review of HL interventions that support the prevention of NCDs and collecting national models of good practice, involving 9 countries. Key findings will be synthesized and published. The HL surveys reveal HL challenges, highlight disparities and identify vulnerable groups. While all populations experience challenges, ethnic minorities, immigrant populations, and other vulnerable groups are particularly affected. The scoping review identifies evaluated HL interventions and groups them according to the populations studied, the type of HL addressed, the type of interventions, the outcomes studied, the study location and the study design used. This is complemented by the collection of national good practice models. Together, the HL Data & Evidence projects provide concrete insights for research, policy and practice. By combining robust HL data with evidence on effective interventions, the HL Task supports the development and implementation of targeted and context-specific interventions to improve HL to promote NCD prevention in Europe.