Polyreactivity assay: HEp-2 cell staining assay

The HEp-2 cell-staining assay was performed using kits purchased from Aesku Diagnostics (Oakland, CA) according to manufacturer's instructions. These Aesku slides use optimally fixed human epithelial (HEp-2) cells (ATCC) as substrate and affinity purified, FITC-conjugated goat anti-human IgG for the detection. Briefly, 25 μl of 100 μg/ml mAb and controls were incubated on HEp-2 slides in a moist chamber at room temperature for 30 min. Slides were then rinsed and submerged in PBS and 25 μl of FITC-conjugated goat anti-human IgG was immediately applied to each well. Slides were incubated again for 30 min. and washed as above before mounting on coverslips using the provided medium. Slides were viewed at 20x magnification and photographed on an EVOS f1 fluorescence microscope at a 250 ms exposure with 100% intensity. Positive and negative control sera were provided by the vendor. Samples showing fluorescence greater than the negative or PG9 HC/LC control were considered positive for HEp-2 staining. PG9 antibodies were tested within one week after purification.