Antibody-negative Group Research Articles

Specificity of anti-SSB as a diagnostic marker for the classification of systemic lupus erythematosus

The aim of the present study was to investigate the sensitivity and specificity of anti-Sjögren’s syndrome type B (SSB) antibodies for diagnosing systemic lupus erythematosus (SLE) and to understand the correlation between anti-SSB antibodies and the clinical manifestations of SLE. A line immunoassay (LIA) was used to detect the presence of serum anti-SSB antibodies in SLE patients. The clinical manifestations of the patients were recorded to enable their correlation with the serum anti-SSB antibodies to be analyzed. In 25.7% of the 74 SLE patients, the serum was positive for anti-SSB antibodies, whereas only 3.3% of the 30 control cases were positive. The specificity of anti-SSB antibodies for detecting SLE was 96.7%. In anti-SSB antibody-positive SLE patients, the incidence of cheek erythema, alopecia, serositis, secondary Sjögren’s syndrome (sSS), leukocytopenia, elevated immunoglobulin (Ig)G and positive presence of anti-Sjögren’s syndrome type A (SSA)60 or anti-SSA52 antibodies was higher than in the anti-SSB antibody-negative group (P<0.05). Anti-SSB antibodies are important for the diagnosis of SLE and are associated with cheek erythema, alopecia, serositis, sSS, leukocytopenia, the elevation of IgG and positive presence of anti-SSA60 or anti-SSA52 antibodies.

Effects of Metformin on Thyroid Function in Patients of Subclinical Hypothyroidism

Background : To study the effect of metformin on thyroid function test (TFT) in patients of subclinical hypothyroidism (SCH). Methods: A total of 30 patients of SCH with TSH between 5 - 10 mIU/L were given 2, 000 mg/day of metformin for12 weeks. Patients were divided into two groups based on presence or absence of thyroid peroxidase antibody (TPO). Baseline anthropometric characteristics, fT3, fT4, TSH, serum insulin, HOMA-IR and quality of life were assessed at baseline and at 12 weeks. Results: A total of 23 patients (76.7%) who were TPO antibody negative (group 1) showed statistically significant decrease in TSH concentration at 12 weeks with no significant change in fT3 and fT4 in contrast to 7 patients (23.3%) who were TPO antibody positive (group 2). Patients in group 1 were significantly more obese, had higher serum insulin and HOMA-IR as compared to group 2. Body weight, waist circumference, BMI and percentage body fat decreases significantly in both the groups at 12 weeks as compared to baseline but on intergroup comparison this decrease was not significant statistically (P = 0.46). The HOMA-IR of group 1 was significantly higher than that of group 2 at baseline (P &lt;= 0.02). Serum insulin and HOMA-IR decreased significantly in both the groups but again on intergroup comparison, no significant difference was observed. A positive correlation between serum TSH and serum insulin level and HOMA-IR level (r = 0.608, P &lt;= 0.01 and r = 0.592, P &lt;= 0.01 respectively) was observed in group 1. Conclusion: Metformin suppresses serum TSH levels without affecting fT3 and fT4 levels in SCH without any evidence of autoimmune thyroiditis. J Endocrinol Metab. 2013;3(4-5):105-110 doi: https://doi.org/10.4021/jem188w

Chlamydia pneumoniae and progression of subclinical atherosclerosis

Cross-sectional investigation between presence of antibodies and coronary artery calcification (CAC) in past studies has shown no relationship, but progression over time has not been investigated. The objective of this study was to determine the relationship between presence of Chlamydia pneumoniae antibodies and progression of CAC and ankle-brachial index (ABI). The Multiethnic Study of Atherosclerosis (MESA) is a prospective population-based cohort of racially and ethnically diverse male and female participants recruited from six communities in the USA, age 45-84 years, free of clinical cardiovascular disease at baseline. The main outcomes were progression of mean CAC and ABI between exams 1 (2000-02) and 3 (2004-05) (median follow-up of 3.13 years) by C. pneumoniae antibody. Multivariate models adjusting for demographics, obesity, smoking, alcohol use, and physical activity were computed. Of 2223 subjects analysed, 76% were positive for C. pneumoniae antibodies. Progression of CAC was significantly higher in the antibody-positive group (93.8 vs. 78.2 agatston units, p = 0.02) and in antibody-positive subjects with CAC ≥10 at baseline (216.5 vs. 178.6, p = 0.02) than antibody-negative group. Smoking and body mass index ≥30 kg/m(2) both had interactions with presence of C. pneumoniae yielding significantly greater CAC progression. Progression of ABI did not significantly differ by C. pneumoniae antibody status in models adjusted for covariates. C. pneumoniae antibodies are related to progression of CAC, particularly in individuals with CAC present at baseline. This provides evidence that certain groups are at higher risk of atherosclerotic progression and may be useful for risk stratification and treatment.

Non-HLA and Anti-HLA Antibodies in a Long Term Follow-Up; Incidence and Importance in Renal Transplantation

Introduction: The detection of antibody mediated injury is becoming increasingly important in post-transplant patient care. The role of donor specific anti-HLA antibodies in kidney transplant damage is known, while the significance of non-HLA antibodies remains an unresolved concern. Non-HLA antibodies develop to self-antigens, which are present also in the allograft tissue. Aim: The aim of the study was to determine the presence of non- HLA and anti-HLA antibodies in “stable” patients 5 years after kidney transplantation and their influence on renal function. Methods: We evaluated the presence of non-HLA and anti-HLA antibodies in 35 consecutive renal transplant patients with stable renal function (the increase of creatinine < 0.2 mg/dL) 5 years after transplantation. Pre-transplant screening for donor specific antibodies carried out by CDC cross-match was negative in all patients. Anti-endothelial cell antibodies (AECA), anti-angiotensin II type 1 receptor antibodies (anti-AT1R), and anti-endothelin receptor antibodies (anti- ETAR) were assayed as non-HLA antibodies. AECA were detected by an indirect immunofluorescent test and anti-AT1R and anti-ETAR by ELISA. Anti-HLA antibodies were tested by Flow-PRA. Results: Non-HLA antibodies were found in 12 (34%) patients including: AECA in 5 (14%), anti-AT1R in 6 (17%), anti-ETAR in 4 (11%), both anti-AT1R and anti-ETAR were present in 3 patients. Anti-HLA antibodies were present in 13 (37%) patients including anti- HLA class I and class II antibodies in 3 patients, class I only in 7 and class II only in 3 patients. Seven patients had both non-HLA antibodies and anti-HLA antibodies: 1 patient had AECA, 3 anti-AT1R and 3 anti-ETAR antibodies. The patients were divided in two groups: an antibody-negative group included patients without any antibodies (n=13) and an antibody-positive group included patients with antibodies (non-HLA and/or anti-HLA; n=22). The number of HLA mismatches was 3.00 and 3.06 in the groups. Renal function in the antibody-negative group was significantly better comparing to the antibody-positive group (Table).Table: [Transplant renal function (serum creatinine-mg/dl)]Biopsy proven acute rejection occurred in 2/13 (15%) patients from the antibody-negative group but in 8/22 (36%) patients from the antibody-positive group. Antibody mediated rejection was diagnosed in 2 patients with anty-HLA antibodies (one patient had additionally AECA). Conclusions: Our preliminary data showed high prevalence of the production of autoantibodies and alloantibodies in stable patients 5 years after kidney transplantation. Simultaneous production of these antibodies and their association with renal function may suggest active humoral immune response, which is poorly controlled by immunosuppression.

Autoimmune Thyroid Disease in Patients With Vitiligo: Prevalence Study in India

To identify the prevalence of autoimmune thyroid disease (AITD) in Asian Indian patients with vitiligo and to compare the clinical profile between thyroid peroxidase (TPO) antibody-positive and TPO antibody-negative groups. In this cross-sectional, case-controlled study, 50 patients with vitiligo (29 women and 21 men) were included. Patients with previous disorders, irradiation, or surgical procedures involving the thyroid were excluded from the study. All participants underwent a complete physical examination, and a single fasting blood sample was analyzed for thyroid function (triiodothyronine, thyroxine, thyroid-stimulating hormone, and TPO and thyroglobulin antibodies), inflammatory and immunologic markers (erythrocyte sedimentation rate, C-reactive protein, and rheumatoid factor), and serum calcium, phosphorus, and alkaline phosphatase concentrations. All patients underwent thyroid ultrasonography, and the data were analyzed by appropriate statistical methods. The mean age of the study participants was 42.7 ± 17 years, and 14 of 50 patients (28%) had TPO antibody positivity. A goiter was present in 11 of 50 patients, and the thyroid volume by ultrasonography was similar between the 2 groups. Subclinical hypothyroidism was found in 14 of 50 patients (28%) but more frequently in the TPO antibody-positive group (8 of 14 or 57%) than in the TPO antibody-negative group (6 of 36 or 17%). The prevalence of AITD was 20 of 50 patients (40%) when the TPO antibody-positive group and those with subclinical hypothyroidism were considered collectively. None of the patients had overt hypothyroidism or hyperthyroidism. All other clinical, biochemical, and inflammatory variables did not differ significantly between the TPO antibody-positive and antibody-negative groups. Our data showed a 40% prevalence of thyroid disease in patients with vitiligo in India. The risk is exacerbated in patients with thyroid autoimmunity; thus, regular screening of patients with vitiligo for AITD is needed.

Positive rate of PF4/H antibody, its risk factors and association with thrombosis in maintenance hemodialysis patients

Objective To study the positive rate of PF4/H antibodies in maintenance hemodialysis patients,and to analyze its risk factor and association with thrombosis.Methods A total of 157 maintenance hemodialysis patients were recruited in the present study.A cross-sectional and a longitude study were designed,and statistical analysis was used to analyze the risk factors of PF4/H antibody level and its association with thrombosis event.Results We found that 40.8%(64/157) of the patients were positive for PF4/H antibody.Past-thrombosis events,heparin types,duration and weekly dialysis hours were significantly different between antibody-positive group and antibody-negative group(P0.05).Incidence of thrombosis event in antibody-positive group was significantly lower than that in the antibody-negative group(P0.05).The risk ratio of antibody positivity for thrombosis event was 2.349.The incidence of thrombotic event in antibody-positive patients who took anti-platelet agents was lower than that in those who did not take.Conclusion The positive rate of PF4/H antibody has been found to be 40.8% in the present group.Thrombosis events,heparin types,duration and weekly dialysis hours are the risk factors of PF4/H antibody level.PF4/H antibody can serve as a marker for thrombotic events,and anti-platelet agents are effective for preventing from thrombotic events in PF4/H antibody positive patients.

Prevalence and Clinical Implications of Positive Serum Anti-Microsomal Antibodies in Symptomatic Patients with Ileal Pouches

Background and aimAutoimmune disorders (AID) have been shown to be associated with chronic antibiotic-refractory pouchitis (CARP). The role of anti-microsomal antibodies in ileal pouch disorders has not been investigated. The aims of the study were to investigate the prevalence of positive anti-microsomal antibody in symptomatic patients with ileal pouches and to investigate its clinical implications. MethodsA total of 118 consecutive symptomatic patients with ileal pouches were included between January and October 2010. Anti-microsomal antibodies were measured at the time of presentation. Demographic, clinical, and laboratory characteristics were compared between patients with positive and negative anti-microsomal antibody. ResultsThere were 14 patients (11.9%) with positive serum anti-microsomal antibody. The mean age of patients in the antibody positive and negative groups were 41.8±14.4 and 42.0±14.0 years, respectively (p = 0.189). All 14 patients in the antibody positive group (100%) had some form of AID, as compared to 20 patients (19.2%) in the antibody negative group (p < 0.001). Four (28.6%) patients in the antibody positive group had at least one AID in addition to Hashimoto’s thyroiditis in contrast to four (3.8%) in the antibody negative group (p = 0.003). In addition, five (35.7%) patients had associated primary sclerosing cholangitis (PSC) in the antibody positive group compared to nine (8.7%) in the antibody negative group (p = 0.012). Eleven patients (78.6%) in the antibody positive group required steroids for treatment of pouch related symptoms in contrast to 26/104 (25%) patients in the antibody negative group (p = 0.002). ConclusionsAnti-microsomal antibodies were common in pouch patients presenting with symptoms. Patients with positive anti-microsomal antibodies were much more likely to have concurrent AID and PSC. These patients were more likely to require therapy with steroids.

Research on the correlation between the PTR and platelet antibody of the oatients suffering from HD

Objective To explore the correlation between the apheresis platelet transfusion resistance (PTR) and platelet antibody of the patients suffering from hematological diseases (HD). Methods In the light of the corrected count increment(CCI), the effect of platelet transfusion among 207 cases patients who suffered from HD were observed, then the platelet antibody were detected by the use of SEPSA(simplified sensitized erythrocyte platelet serology assay) and counting the occurrence of PTR and positive rate of platelet antibody. The patients were divided into positive platelet antibody group and negative platelet antibody group. The effects of platelet transfusion, 1 hCCI values and 24 hCCI values in two groups were compared. Results The PTR rate was 43.0% and positive rate of platelet antibody was 37.2% The PTR rates in positive platelet antibody group and negative platelet antibody group were absolutely different, which had statistical significance, (P＜ 0. 01).The 1 hCCI and 24 hCCI values in the positive platelet antibody group was obviously lower than those in the negative platelet antibody group, which also had statistical significance, (P＜ 0. 01). Conclusion When the apheresis platelets transfusion is conducted on the HD patients, the platelet antibody detection and platelet typing for positive platelet antibody patients should be made, so as to effectively prevent the occurrence of immune platelet transfusion resistance. Key words: Simplified sensitized erythrocyte platelet serology assay; Platelet antibody; Platelet transfusion resistance; Hematological diseases

Preconception Steroid Treatment in Infertile Women with Antithyroid Autoimmunity Undergoing Ovarian Stimulation and Intrauterine Insemination: A Double-Blind, Randomized, Prospective Cohort Study

Objective This study investigated the role of a steroid pretreatment on the pregnancy rate and pregnancy outcomes in patients positive for antithyroid antibodies who were undergoing induction of ovulation and intrauterine insemination (IUI). Methods A double-blind, randomized, prospective cohort study was conducted on infertile women who met the following criteria: infertility for ≥1 year, age 20−38 years, no more than 2 previous assisted reproduction treatment cycles, regular spontaneous menstrual cycles, no treatments 1 month before recruitment, normal uterine cavity, and bilateral tubal patency. The patients were divided into 2 groups: a study group of infertile women with antithyroid autoimmunity (radioimmunoassay positive with titer >100 U/mL) and a control group of infertile women without antithyroid autoimmunity. The patients with antithyroid autoimmunity were randomly assigned in a blinded manner to an intervention group treated with prednisone (administered orally for 4 weeks before IUI) or a group given matching placebo. The primary objective was to compare the pregnancy and miscarriage rates among all 3 the groups. Results The study included 98 infertile women: 48 with antithyroid autoimmunity (antibody positive) and 50 without antithyroid autoimmunity (antibody negative). The study groups were comparable for baseline characteristics (age, race, body mass index, hormonal pattern, number of smokers, previous miscarriage). In the antithyroid antibody−positive group, the pregnancy rate was 33.3% (8/24) among women treated with prednisone compared with 8.4% (2/24) among women who received placebo (odds ratio [OR] = 5.5; 95% CI, 1.13–25.76; P = 0.03). In the antibody-negative group, the pregnancy rate was 8.0% (4/50). Among the pregnancies, the miscarriage rate was 70% (7/10) versus 75% (3/4) for women with or without antithyroid antibodies, respectively ( P = NS); the miscarriage rate was 75% (6/8) for women treated with prednisone versus 50% (1/2) for women taking placebo ( P = 0.49). No adverse effects were reported. Conclusions In this small cohort study of infertile women with antithyroid antibodies undergoing induction of ovulation and IUI, prophylactic therapy with prednisone was associated with a significantly higher rate of pregnancy compared with placebo. The miscarriage rate was not significantly different among the 3 groups.

The impact of anti-HLA antibodies on unrelated cord blood transplantations

AbstractThe majority of cord blood transplantations (CBTs) have human leukocyte antigen (HLA) disparities. We investigated the impact that patients' pretransplantation anti-HLA antibodies have on the outcome of CBTs. Testing for anti-HLA antibody and its specificity was performed retrospectively at the Japanese Red Cross Tokyo Blood Center with sensitive solid-phase antibody detection assays. Among 386 CBTs, which were first myeloablative stem cell transplantations for malignancies and used a single unit of cord blood, 89 tested positive. Among the antibody-positive group, the cord blood did not have the corresponding HLA type for the antibody in 69 cases (ab-positive), while 20 cases had specificity against the cord blood HLA (positive-vs-CB). Cumulative incidence of neutrophil recovery 60 days after transplantation was 83% (95% confidence interval [CI], 79%-87%) for the antibody-negative group (ab-negative), 73% (95% CI, 61%-82%) for ab-positive, but only 32% (95% CI, 13%-53%) for the positive-vs-CB (P < .0001, Gray test). With multivariate analysis, the ab-positive showed significantly lower neutrophil recovery than the ab-negative (relative risk [RR] = 0.69, 95% CI, 0.49-0.96, p = .027). The positive-vs-CB had significantly lower neutrophil recovery (RR = 0.23, 95% CI, 0.09-0.56, P = .001) and platelet recovery (RR = 0.31, 95% CI, 0.12-0.81, P = .017) than the ab-negative. Patients' pretransplantation anti-HLA antibodies should be tested and considered in the selection of cord blood.

Close temporal relationship between onset of cancer and scleroderma in patients with RNA polymerase I/III antibodies

This study was undertaken to examine the temporal relationship between scleroderma development and malignancy, and to evaluate whether this differs by autoantibody status among affected patients. Study participants had a diagnosis of scleroderma, a diagnosis of cancer, cancer, an available serum sample, and a cancer pathology specimen. Sera were tested for autoantibodies against topoisomerase I, centromere, and RNA polymerase I/III by immunoprecipitation and/or enzyme-linked immunosorbent assay. Clinical and demographic characteristics were compared across autoantibody categories. Expression of RNA polymerases I and III was evaluated by immunohistochemistry using cancerous tissue from patients with anti-RNA polymerase antibodies. Twenty-three patients were enrolled. Six patients tested positive for anti-RNA polymerase I/III, 5 for anti-topoisomerase I, and 8 for anticentromere, and 4 were not positive for any of these antigens. The median duration of scleroderma at cancer diagnosis differed significantly between groups (-1.2 years in the anti-RNA polymerase I/III group, +13.4 years in the anti-topoisomerase I group, +11.1 years in the anticentromere group, and +2.3 years in the group that was negative for all antigens tested) (P = 0.027). RNA polymerase III demonstrated a robust nucleolar staining pattern in 4 of 5 available tumors from patients with antibodies to RNA polymerase I/III. In contrast, nucleolar RNA polymerase III staining was not detected in any of 4 examined tumors from the RNA polymerase antibody-negative group (P = 0.048). Our findings indicate that there is a close temporal relationship between the onset of cancer and scleroderma in patients with antibodies to RNA polymerase I/III, which is distinct from scleroderma patients with other autoantibody specificities. In this study, autoantibody response and tumor antigen expression are associated. We propose that malignancy may initiate the scleroderma-specific immune response and drive disease in a subset of scleroderma patients.

Thyroid Autoimmunity, Pregnancy and Finally, Data from Kerala

In a prospective study of euthyroid pregnant women, subjects with anti-TPO positivity were either treated with LT4 (n=57) or not treated (n=58). The authors reported that LT4 therapy in euthyroid TPO+ve pregnancies could improve miscarriage rate by 75% and premature deliveries by 69%.27 Antibody positive subjects had a higher TSH at baseline (though within the euthyroid range) as compared with antibody negative group. The results of this study suggest that subjects with the autoimmune thyroid disease may have a subtle deficiency of thyroid hormones due to impaired adaptability, and also implies that the judicious use of levothyroxine, at least in subjects with a high-normal TSH, could improve outcomes. The authors carried out thyroid function in a selected group of neonates born to these mothers, and from the results conclude that such thyroid autoimmunity alone does not “necessarily” imply neonatal thyroid dysfunction. This is indeed an excellent effort at generating valuable data on this intriguing illness.

Detection of circulating antierythropoietin antibodies in patients with end stage renal disease on regular hemodialysis

Recombinant human erythropoietin (rHuEPO) has been successfully and safely used to treat anemia in patients with end stage renal disease (ESRD). The safety profile of rHuEPO had been considered to be excellent with possible exception of hypertension and increased risk of dialysis access thrombosis. Recently, antibody-mediated pure red cell aplasia associated with administration of rHuEPO has been identified as a cause of major concern; we aimed to detect and evaluate the presence of anti-EPO antibodies in patients with ESRD on regular dialysis who are using rHuEPO. Serum anti-EPO antibodies were detected by enzyme-linked immunosorbant assay technique in a total of 90 patients who are currently on regular hemodialysis and using rHuEPO alpha subcutaneously for more than 6 months. All patients were subjected to full history taking and clinical examination. Complete blood count, reticulocytes count, serum creatinine, blood urea, serum albumin, serum ferritin, and hepatitis markers were performed for all patients. Our results showed that 35 patients (38.9%) had the anti-EPO antibodies in their blood, while 55 patients (61.1%) did not have the circulating antibodies. The mean hemoglobin (Hb) level was significantly lower in the antibody positive group (8.8 g/dl +/- 1.35) than in the antibody negative group (9.42 g/dl +/- 1.32) (P = 0.000). The reticulocytes count was also significantly much lower in the patients who had anti-EPO antibodies with mean of (1.99 +/- 1.14) vs. (3.15 +/- 0.89) in the antibody negative (P = 0.000). The dose of EPO administrated in both studied groups was insignificantly different. The incidence of anti-EPO antibodies is high in ESRD patients on maintenance hemodialysis. Its presence is associated with increased incidence of anemia possibly due to immune-mediated inhibition of erythropoiesis as evidenced by reticulocytopenia.

Immunological characteristics and islet function in first-degree relatives of latent autoimmune diabetes in adults

To investigate the immunological features and pancreatic beta cell function of first-degree relatives of latent autoimmune diabetes in adults (LADA). Oral glucose tolerance test (OGTT) was performed in 209 first-degree relatives of LADA patients and 340 first-degree relatives of classic T1DM patients. Radioligand assay was used to detect glutamic acid decarboxylase antibody (GADAb) and protein tyrosine phosphatase antibody (IA-2Ab). Intravenous glucose tolerance tests were performed in 39 normal controls and 46 first-degree relatives. Among them, 9 were GAD-Ab positive and 9 GAD-Ab negative first-degree relatives of patients with LADA while 12 were GAD-Ab positive and 16 GAD-Ab negative first-degree relatives of patients with classic T1DM. (1) Immunological characteristics of first-degree relatives of patients with LADA. Similar with the first-degree relatives of patients with classic T1DM (18/340, 5.3%), the detection rate of GAD-Ab was 4.3% (9/209) in first-degree relatives of patients with LADA. (2) Islet function of first-degree relatives of patients with LADA. Compared with the control group, the first phase insulin release and the first phase insulin peak secretion averages were lower in the antibody positive group of first-degree relatives of patients with LADA (P < 0.05); HOMA-IR was higher in the antibody negative group of first-degree relatives of patients with LADA (P < 0.05). (3) Analysis on glucose metabolism of different immune status for first-degree relatives of patients with LADA. (1) The detection rate of impaired glucose tolerance (IGT) was 16.7% (35/209) and diabetes (DM) rate 10.0% (21/209). (2) The detection rate of IGT was higher in the antibody positive group than the antibody negative group in first-degree relatives of patients with LADA (37.5% vs 15.0%, P < 0.05). Among first-degree relatives of patients with LADA, a certain extent of islet autoimmune antibody markers could be measured, and insulin resistance and insulin secretion defects were detected. The rate of IGT was higher in the antibody positive group than the antibody negative group.

A novel genotype of hepatitis E virus prevalent among farmed rabbits in China

In total, 335 serum samples were collected from rabbits from two farms in Gansu province, China, and tested for anti-hepatitis E virus (HEV) antibody using EIA and for HEV RNA using nested RT- PCR with ORF2 primers. The overall prevalence of anti-HEV antibody and HEV RNA was 57.0% (191/335) and 7.5% (25/335), respectively. The positivity rate of HEV RNA in the anti-HEV antibody negative group (7.6% (11/144)) did not differ significantly from that in the positive group (7.3% (14/191)). The concordance between HEV RNA and anti-HEV antibody was 43.3% with no significant correlation (P < 0.05). All 25 amplicons from the ORF2 region were cloned and sequenced. On the basis of nucleotide sequence comparison, they had 84-99% identity to each other and 73-77%, 70-76%, 75-82%, 71-77%, and 53-65% with the corresponding regions of genotypes 1, 2, 3, 4, and avian HEV, respectively. Samples that were positive with the ORF2 primers were amplified using ORF1 region primers; 17 were positive and shared 71-78%, 73-76%, 74-82%, 72-78%, and 39-58% identity with the corresponding regions of genotypes 1, 2, 3, 4, and avian HEV, respectively, at the nucleotide level. Two representative full-length sequences were determined. These two sequences shared 85% identity with each other and had 74%, 73%, 78-79%, 74-75%, and 46-47% identity to full-length genotypes 1, 2, 3, 4, and avian HEV, respectively. Thus, the sequences isolated from the rabbits represent a novel genotype of HEV. This study provides novel information about HEV genotypes infecting rabbits as well as evidence of a new mammalian genotype of HEV.

Living donor renal transplantation in the presence of donor-specific human leukocyte antigen antibody detected by solid-phase assay

Presensitization of donor human leukocyte antigens (HLA) demonstrated through a positive crossmatch is detrimental to allograft function and best avoided through donor exclusion. The clinical significance of alloantibody detectable by sensitive solid-phase assay is not completely defined and is the focus of this study. Pretransplant sera from 64 consecutive living-donor renal transplant recipients were screened by enzyme-linked immunosorbent assay (ELISA) and Luminex assays. Results were analyzed for correlation with clinical outcome. Luminex proved more sensitive than ELISA for alloantibody detection, with three identifiable patterns. Twenty-eight patients were antibody negative, 24 had non-donor-specific antibody (non-DSA), and 12 had donor-specific antibody (DSA). The highest number of rejections ( n = 4) and graft losses ( n = 6) occurred in the antibody-negative group. The non-DSA group had two graft losses, as did the DSA group. The two graft losses in the DSA group were caused by recurrent focal segmental glomerulosclerosis (FSGS) at 35 months and death with a functioning graft at 32 months. Overall, there were no cases of antibody-mediated rejection and allograft function to 4 years was comparable among all three groups. Under our standard immunosuppression protocol and crossmatch criteria for histocompatibility, alloantibody detectable by Luminex was not detrimental to successful living-donor transplantation.

Effect of hCG in the Presence of hCG Antibodies on the Follicle, Hormone Concentrations, and Oocyte in Mares

Follicle blood flow, follicular-fluid and plasma hormone concentrations, and oocyte quality were studied 30 h after an ovulation-inducing hCG treatment when the pre-ovulatory follicle was 32 mm. Mares were grouped as positive (n = 16) and negative (n = 44) for hCG antibodies before the experimental hCG treatment. Percentage of the follicle wall with blood flow signals was less (p < 0.05) in the antibody positive group than in the negative group. The concentrations of follicular-fluid oestradiol and free IGF1, and plasma oestradiol were greater (p < 0.001), and follicular-fluid progesterone (p < 0.001) and plasma LH (p < 0.02) were less in the antibody-positive group than in the negative group. For recovered oocytes at 30 h (n = 37), the antibody-positive group had fewer (p < 0.001) mature (MII) oocytes than the antibody-negative group. Results were attributable to highly effective neutralization of the hCG in the antibody-positive group.

Churg-Strauss syndrome: 2005–2008 update

Churg-Strauss syndrome (CSS) is a rare necrotizing small-vessel vasculitis associated with eosinophil-rich granulomatous inflammation of tissues and vessels and is also associated with asthma and eosinophilia. Epidemiologic studies continue to show that CSS is the rarest of the necrotizing small-vessel vasculitides. However, it is not possible to know with any certainty if there has been an increase in incidence. There has been an attempt to divide the patients with CSS into an antineutrophil cytoplasmic antibody-positive and cytoplasmic antibody-negative group. The former group has an increased frequency of renal involvement, parenchymal pulmonary disease, constitutional symptoms, and peripheral and central nervous system involvement, whereas the latter group has more frequent cardiac disease. The role of eosinophils and antineutrophil cytoplasmic antibodies remains poorly defined but provocative. Leukotriene receptor antagonists do not appear to induce CSS but facilitate the tapering of glucocorticoids, which unmasks the condition. Glucocorticoids and cyclophosphamide remain the foundation of treatment for vasculitis, but there are other promising and less toxic alternatives on the horizon.

Follicle-stimulating hormone autoantibody is involved in idiopathic spermatogenic dysfunction

To detect the anti-follicle-stimulating hormone (FSH) antibody in idiopathic infertile patients and fertile subjects in order to determine the role of this antibody in patients with spermatogenic dysfunction. The anti-FSH antibody in serum was detected by an enzyme-linked immunosorbent assay (ELISA). The functional and structural integrity of the sperm membrane was evaluated with hypo-osmotic swelling (HOS) test and the ultrastructure of the spermatozoa was investigated by transmission electron microscopy (TEM). The extent of positive FSH antibody in the patients with oligozoospermia and/or asthenozoospermia was significantly higher than that in the fertile subjects and infertile patients with normal sperm concentration and motility, but it was significantly lower than that in the patients with azoospermia. The extent of anti-FSH antibody in the patients with azoospermia was significantly greater than that in patients with oligospermia and/or asthenospermia, infertile people with normal sperm density and motility and fertile people. The hypo-osmotic swelling test showed that the percentage of HOS-positive spermatozoa (swollen) was 45.1 mu 3.5% in the FSH antibody-positive group and 59.1% micro 6.2% in the FSH antibody-negative control group. The percentage of functional membrane damage to spermatozoa was significantly higher in the anti-FSH antibody-positive group than in the control group. TEM showed that the outer acrosomal membrane was located far from the nucleus, and detachment of the acrosome was found in the FSH autoantibody-positive group. These data suggest that the presence of anti-FSH antibody is strongly correlated with the sperm quantity and quality in idiopathic male infertility. Anti-FSH antibody may be an important factor causing spermatogenic dysfunction and infertility.

Maternal Antibody Protected Chicks from Growth Retardation and Immunosuppression Induced by Early Reticuloendotheliosis Virus Infection

Abstract To determine if the maternal antibody from breeders vaccinated with cell culture-adapted reticuloendotheliosis virus (REV) could protect chicks from early REV infection, one-day-old chicks with or without anti-REV maternal antibodies were inoculated with REV, and then their growth rates and antibody titers to Newcastle disease virus (NDV) and avian influenza virus (AIV), after vaccination with inactivated vaccines, were compared. This study indicated that REV infection could cause growth retardation and severely inhibit immune reactions to inactivated vaccines against NDV and Avian influenza virus (AIV, H9 and H5) in one-day-old broilers without maternal antibodies specific to REV. Maternal antibody from breeders vaccinated with an attenuated REV vaccine effectively protected REV-challenged birds from growth retardation and immunosuppression on antibody reactions to NDV and AIV vaccines. Four weeks after vaccination, the HI titers to NDV, AIV-H9, and AIV-H5 in maternal antibody positive and negative groups were 3.36±2.04 versus 1.58±1.69 ( P<0.01), 6.27±3.87 versus 0.71±1.60 ( P<0.01), and 6.72±3.92 versus 0.54±1.44 ( P<0.01). Maternal antibodies from breeders vaccinated with REV vaccine could successfully protect chicks from REV infection and effectively prevent REV-induced growth retardation and immunosuppression in antibody responses to NDV and AIV.