Antibody Seropositivity Research Articles

Development of blocking ELISA for detection anti-PRRSV antibodies and serological investigation of PRRSV in China.

Porcine reproductive and respiratory syndrome virus (PRRSV) demonstrates a significantly high prevalence among swine populations. Monoclonal antibodies (mAbs) with high affinity for conserved epitopes of PRRSV can facilitate the development of a broad-spectrum detection method for this virus. This study identified two PRRSV-specific mAbs, designated 2B1 and 2C6, which recognized two conformation-dependent epitopes through indirect immunofluorescence assay (IFA) and Western blot analysis. Further investigation via immunoprecipitation and eukaryotic expression studies confirmed that both mAbs specifically target the Nucleocapsid (N) protein of PRRSV. Importantly, these two epitopes exhibit high conservation across PRRSV isolates, including DV, CH-1a, HuN4, NADC30-like strains, NADC34-like strains and VR2332. The mAb 2C6 was effectively blocked by sera from pigs positive for PRRSV-1 and PRRSV-2. Consequently, a blocking enzyme-linked immunosorbent assay (b-ELISA) based on 2C6 was developed to detect anti-PRRSV antibodies, achieving enhanced sensitivity and specificity. The results obtained using this method demonstrated a higher concordance rate compared to those derived from commercial kit. Additionally, a total of 451 animals from various provinces in China were sampled, revealing an overall IgG antibody seropositivity against PRRSV of 77.38 % (349/451), with nursery pigs at 33.48 % (151), growing pigs at 15.96 % (72), fattening pigs at 39.69 % (179) and sows at 10.86 % (49). Collectively, the established b-ELISA represents an optimal method for large-scale serological investigations into PRRSV antibodies within farming operations.

Anti-sulfatide antibody-positive Guillain–Barré syndrome in adults following off-craniotomy for cerebellar contusion: A case report

Rationale: Gullain–Barré syndrome (GBS) is a rare autoimmune condition primarily presenting with symmetrical progressive limb weakness. It is frequently associated with sensory and autonomic symptoms and autonomic disturbances and often manifests seropositivity for anti-ganglioside antibodies. Infections are considered major precipitants; however, GBS post-craniotomy for severe traumatic brain injury is a rarity. Patient concerns: A 79-year-old female underwent craniotomy for a cerebellar contusion sustained from severe traumatic brain injury, leading to quadriplegia, autonomic dysfunction, dilated pupils, and respiratory failure. However, the patient’s GBS manifested slightly differently. Her limb weakness was asymmetric and progressed from 1 upper limb to the other. Diagnoses: The diagnosis of GBS was confirmed based on clinical presentation, cerebrospinal fluid analysis showing albuminocytologic dissociation, and the detection of anti-sulfatide antibodies in serum. Interventions: The patient received intravenous immunoglobulin (IVIG) therapy at 2 g/kg daily, along with supportive measures including mechanical ventilation and rehabilitation. Outcomes: The patient demonstrated significant improvement within 5 days of IVIG treatment, achieving near-complete functional recovery with grade 4 muscle strength at discharge 6 weeks post-intervention. Lessons: This case highlights the need to consider GBS in postoperative patients with acute limb weakness, even in atypical presentations. Early recognition and timely IVIG treatment are critical for favorable outcomes.

Unmet Needs and Current Challenges of Rheumatoid Arthritis: Difficult-to-Treat Rheumatoid Arthritis and Late-Onset Rheumatoid Arthritis.

Despite remarkable advances in the management of RA, there are still unmet needs that rheumatologists need to address. In this review, we focused on difficult-to-treat RA (D2T RA) and late-onset RA (LORA), and summarized their characteristics and management. The prevalence of D2T RA is reported to be 6-28% and many factors have been identified as risk factors for D2T RA, including female sex, long disease duration, seropositivity for rheumatoid factor and anti-cyclic citrullinated peptide antibody and their high titer, baseline high disease activity, and comorbidities. D2T RA is broadly divided into inflammatory and non-inflammatory conditions, and clinical features differ according to background. A proportion of D2T RA can be managed with treatment modification, mainly with interleukin-6 receptor inhibitors or Janus kinase inhibitors, but some D2T RA patients have a poor prognosis; thus, the implementation of precision medicine by stratifying patients according to disease status is needed. In the aging society, the epidemiology of RA is changing and the prevalence of LORA is increasing worldwide. LORA has distinct clinical features compared with young-onset RA, such as acute onset, low seropositivity, and high inflammation. The pathogenesis of LORA remains to be elucidated, but proinflammatory cytokines, including interleukin-6, have been reported to be significantly elevated. LORA has several management concerns other than RA itself, such as geriatric syndrome and multimorbidity. The treat-to-target strategy is effective for LORA, but the evidence is still lacking; thus, it is important to accumulate clinical and related basic data to establish the optimal treatment strategy for LORA.

Seroprevalence of Antibodies to Filoviruses with Outbreak Potential in Sub-Saharan Africa: A Systematic Review to Inform Vaccine Development and Deployment.

Background/Objectives: Orthoebolaviruses and orthomarburgviruses are filoviruses that can cause viral hemorrhagic fever and significant morbidity and mortality in humans. The evaluation and deployment of vaccines to prevent and control Ebola and Marburg outbreaks must be informed by an understanding of the transmission and natural history of the causative infections, but little is known about the burden of asymptomatic infection or undiagnosed disease. This systematic review of the published literature examined the seroprevalence of antibodies to orthoebolaviruses and orthomarburgviruses in sub-Saharan Africa. Methods: The review protocol was registered on PROSPERO (ID: CRD42023415358) and previously published. Eighty-seven articles describing 85 studies were included, of which seventy-six measured antibodies to orthoebolaviruses and forty-one measured antibodies to orthomarburgviruses. Results: The results highlight three central findings that may have implications for vaccine development and deployment. First, substantial antibody seropositivity to Ebola virus (EBOV) and Sudan virus (SUDV) was observed in populations from outbreak-affected areas (≤33% seroprevalence among general populations; ≤41% seroprevalence among healthcare workers and close contacts of disease cases). Second, antibody seropositivity to EBOV, SUDV, and Marburg virus (MARV) was observed among populations from areas without reported outbreaks, with seroprevalence ranging from <1 to 21%. Third, in Central and East Africa, MARV antibody seroprevalence was substantially lower than EBOV or SUDV antibody seroprevalence, even in outbreak-affected areas and in populations at a moderate or high risk of infection (with MARV seroprevalence mostly ranging from 0 to 3%). Conclusions: Whilst gaps remain in our understanding of the significance of antibody seropositivity in some settings and contexts, these findings may be important in considering target indications for novel filovirus vaccines, in defining study designs and strategies for demonstrating vaccine efficacy or effectiveness, and in planning and evaluating vaccine deployment strategies to prevent and control outbreaks.

Analysis of sero-epidemiological characteristics of varicella in healthy children in Wuxi, China

ABSTRACT The aim of this study was to evaluate seroepidemiology of varicella in Wuxi, China, after two doses of immunization of varicella vaccine (VarV) for better control of varicella transmission. Participants were selected randomly by multistage stratified sampling. The positive rate of antibody and geometric antibody titer (GMC) was determined with enzyme-linked immunosorbent assays. Logistic and linear regressions were used to analyze the correlations between antibody seropositivity, GMCs, and corresponding factors. Serum samples (n = 697) were obtained from healthy children <7 years-of-age. Seropositivity and GMC were 67.84% and 190.97 mIU/mL, respectively, in subjects receiving two doses of VarV. Multivariate analysis revealed that both the rate of varicella-zoster virus immunoglobulin G seropositivity and GMC in vaccinated subjects were higher compared to those who had not been vaccinated. The strongest overall response was observed in subjects with two doses of VarV (4.055, 95% CI: 2.774 ~ 5.928). In 470 subjects with a history of VarV application, the antibody GMC value was reduced 4 years after vaccination. Two-dose vaccination with VarV was an effective prevention strategy varicella and should be included in a national immunization program.

Real-world clinical outcomes and rationale for initiating abatacept as a first-line biologic for patients with anticitrullinated protein antibody- and rheumatoid factor-positive rheumatoid arthritis.

Aim: In rheumatoid arthritis (RA), seropositivity for both anticitrullinated protein antibody (ACPA) and rheumatoid factor (RF) is associated with disease severity and therapeutic response. Biologic (b) disease-modifying antirheumatic drugs (DMARDs) such as abatacept are recommended after inadequate response or contraindication to conventional synthetic DMARDs. This retrospective cohort study aimed to describe changes in Clinical Disease Activity Index (CDAI) measures over 12months among patients with ACPA+ and RF+ RA with an inadequate response to methotrexate treated with abatacept as a first-line bDMARD. Patients & methods: Patient data were abstracted from medical records by treating rheumatologists. Analyses included McNemar tests for paired proportions or paired t-tests to assess longitudinal changes in CDAI scores, and Kaplan-Meier methods for time-to-event outcomes. Serious AEs and rationale for initiating treatment were recorded. Results: Overall, 296 patients were included. Mean CDAI scores improved (decreased) by 34.0, 61.0 and 74.0% (all p<0.001) from baseline to 3-6months, 6-12months and ≥12months after abatacept initiation, respectively. Of 279 patients not in CDAI low disease activity (LDA) or remission at baseline, 24.7% of patients achieved it within 6months, 56.3% within 12months and 71.0% at any point during follow-up after abatacept initiation. Median time to CDAI LDA/remission was 10.2months. Serious AEs were reported in 2.4% of patients. Common reasons reported by rheumatologists for initiating abatacept were effectiveness/efficacy (52.7%), safety (31.4%) and patient preference (25.3%). Conclusion: In this analysis of patients with ACPA+ and RF+ RA treated with abatacept as a first-line bDMARD in a clinical practice setting, clinical outcomes and remission rates were improved at all time points, providing real-world evidence to further support the use of abatacept in this patient population.

Toxoplasma, Rubella and Cytomegalovirus Seroprevalence and Distribution by Age in Pregnant Women in Diyarbakir: Eight Years Experience

Objective: Toxoplasma, rubella and cytomegalovirus (CMV) infections can cause malformations in the fetus, usually in the first three months of pregnancy. In this study, we aimed to examine the distribution of Immunoglobulin M (IgM) type and immunoglobulin G (IgG) type antibodies against toxoplasma, rubella and CMV in pregnant women in XXX over an 8-year period according to age groups. Methods: Pregnant women aged 15-49 years who applied to our hospital between 2015-2022 were included in this study. IgM and IgG antibodies for toxoplasma, rubella and CMV were studied with the Triturus automatic ELISA (Grifols SA, Barcelona, Spain) system and the Dia. ProDiagnostic Bioprobes (Milan, Italy) brand kit. Relationships between age groups and antibody seropositivity were investigated with the chi-square method at the p

Seropositivity of antibody to hepatitis B core antigen among hepatitis B surface antigen-negative vaccinated individuals aged 5–12 years in North West Ethiopia

BackgroundInfection with the hepatitis B virus (HBV) is still a major global public health concern, especially in Ethiopia. Evidence suggests that some children in Ethiopia who have received hepatitis B vaccinations are still contracting HBV. ObjectiveThe main aim of this study was to detect antibodies to hepatitis B core antigen (anti-HBc) among vaccinated hepatitis B surface antigen (HBsAg)-negative individuals in North-West Ethiopia. Methods and materialsA community-based cross-sectional study was conducted among 158 children aged 5–12 years from April 2021 to November 2021. A simple random sampling technique was used to recruit study participants. After 3–5 ml of venous blood was drawn from each study participant, a serum sample was utilized to determine hepatitis B surface antigen (HBsAg) and anti-hepatitis B core antibodies (anti-HBc) by enzyme-linked immunosorbent assay (ELISA). Logistic regression with a 95 % CI was used to show the statistical association. ResultsThe total seropositivity of anti-HBc among vaccinated HBsAg-negative participants was 8/158 (5.1 %) (95 % CI: 2.0–9.0). Multivariable logistic regression revealed that children who had a previous history of blood transfusion were six times (AOR: 6.135, 95 % CI: 4.063, 10.752) (P < 0.006) more likely to develop anti-HBc. Moreover, children who had a previous history of surgery were five times (AOR: 5.116, 95 % CI: 3.123, 8.718) (P < 0.002) more likely to become anti-HBc seropositive. ConclusionThere was a significant seroprevalence of anti-HBc in our study area, suggesting possible exposure to the virus despite immunization.

HPV16/18 antibodies 16-years after single dose of bivalent HPV vaccination: Costa Rica HPV vaccine trial.

The Costa Rica HPV Vaccine Trial provided initial evidence that 1 dose of the bivalent human papillomavirus (HPV) vaccine induces stabilizing antibody levels that may provide extended protection against HPV-16/18 infections. We report antibody seropositivity and stability 11 to 16 years after vaccination. We invited a random subset of Costa Rica HPV Vaccine Trial participants (n = 398) who had received 3 doses and all women (n = 203) who had received 1 dose at 18 to 25 years of age to follow-up visits 11, 14, and 16 years after vaccination. We calculated HPV-16 and HPV-18 seropositivity and assessed change in enzyme-linked immunosorbent assay antibody levels 11 to 16 years after vaccination among 500 participants. By year 16, 99.4% (95% confidence interval [CI] = 96.8% to 100.0%) and 100.0% (95% CI = 98.9% to 100.0%) of 1-dose and 3-dose recipients, respectively, were HPV-16 seropositive and 98.8% (95% CI = 95.9% to 99.9%) and 100% (95% CI = 98.9% to 100.0%) of 1-dose and 3-dose recipients, respectively, were HPV-18 seropositive. Between years 11 and 16, women who had received 3 doses had a small but statistically significant decrease in the geometric mean concentration for HPV-16 of ‒12.4% (95% CI = ‒16.3% to ‒8.4%) and HPV-18 of ‒13.4% (95% CI = ‒17.2% to ‒9.4%). Among women who had received 1 dose, the decrease was statistically significant for HPV-16 at ‒8.9 (95% CI = ‒14.2% to ‒3.1%) but nonsignificant for HPV-18. Geometric mean concentration ratios of 3:1 dose (year 16) were 3.0 and 2.2 for HPV-16 and HPV-18, respectively. HPV-16/18 seropositivity remained exceedingly high 16 years after vaccination. Over 5 years, small declines in antibodies were observed. Women should have protection for at least 20 years and likely much longer at the observed rate of decline.

Investigation of Seropositivity of Anti-Toxoplasma gondii Antibodies and Possible Risk Factors in Pregnant Women with Diabetes at Risk.

Toxoplasmosis is a parasitic infection caused by Toxoplasma gondii. Immunocompromised individuals and pregnant women are at risk, with the latter group being susceptible to miscarriages. This study aimed to determine the seropositivity of T. gondii antibodies and potential risk factors in pregnant women diagnosed with diabetes mellitus. The research was conducted at the Ankara City Hospital Perinatology Clinic between October 2021 and June 2022. The study included 277 pregnant women diagnosed with diabetes mellitus and 277 healthy pregnant women who had given birth. Retrospective analysis of anti-T. gondii immunoglobulin (Ig)G and IgM levels was performed for patients between January 2020 and February 2022. Participants were administered an informed consent form and a questionnaire. Data were analysed using SPSS 22. Among pregnant women with diabetes, IgG seropositivity was 18.4%, IgM was 0.0%, and IgG+IgM was 0.0%. In healthy pregnant women, IgG seropositivity was 12.3%, IgM was 0.4%, and IgG+IgM was 0.4%. Overall, seropositivity rates were 15.3% for IgG, 0.2% for IgM, and 0.2% for IgG+IgM. The difference between the two groups was statistically significant (p<0.05). Among pregnant women with diabetes, there was a significant statistical difference (p<0.05) in anti-T. gondii IgG seropositivity related to education, employment status, number of pregnancies and live births, history of toxoplasmosis diagnosis in children, previous toxoplasmosis diagnosis, hygiene, nutrition, and social habits. Among healthy pregnant women, significant statistical differences were found (p<0.05) in IgG seropositivity related to age, income, education level, number of pregnancies and live births, previous toxoplasmosis diagnosis, hygiene, nutrition, and social habits. No invasive interventions were performed on infants born to seropositive mothers, and perinatal data were not available. The seroprevalence of toxoplasmosis in Ankara appears to be decreasing, but T. gondii infections continue to pose a public health concern and are significant in pregnant women with diabetes mellitus.

Assessment of human Herpes Virus-8 infection in Iranian cirrhotic patients on the waiting list for liver transplantation: A cross-sectional analysis

BackgroundHuman Herpes Virus 8 (HHV-8) is involved in autoimmunity. However, its association with advanced liver disease has not been fully explained. Herein, the prevalence of HHV-8 viremia was assessed in Iranian liver transplant candidates with a confirmed diagnosis of cirrhosis. MethodsThis cross-sectional study was conducted on 230 patients with cryptogenic cirrhosis, virus-related cirrhosis, and autoimmune hepatitis, as well as 140 healthy blood donors from April 2022 to September 2023. The HHV-8 IgG antibody concentration and viral load were evaluated via ELISA and RT‒PCR, respectively. ResultsAnti-HHV-8 IgG antibodies were detected in 25 cirrhotic patients (10.8 %) and four healthy individuals (2.6 %) (p = 0.022). The majority of the seropositive patients had cryptogenic cirrhosis (20.4 %), followed by autoimmune hepatitis (13.1 %) and virus-related cirrhosis (4.7 %). The seropositivity of HHV-8 IgG antibody was significantly different among the etiologies of liver cirrhosis (p = 0.011). However, HHV-8 genomic DNA was not detected in the sera of the patients or healthy blood donors. ConclusionThe role of HHV-8 infection in the development of posttransplant diseases, together with the higher seroprevalence of HHV-8 antibodies in cirrhotic patients than in healthy individuals, highlights the importance of both primary and latent infections in liver transplantation. Therefore, serological and molecular screening of HHV-8 is highly suggested for liver transplant candidates and organ donors. The possibility of antibody-mediated epitope mimicry in cryptogenic and autoimmune groups with moderate HHV-8 antibody positivity and negative viral loads may account for the development of advanced liver diseases.

Laryngeal Myasthenia Gravis in Voice Patients: Clinical, Serologic, and Neuromuscular Characterization of Seronegative Patients for Antibodies Against the Acetylcholine Receptor and Muscle-Specific Kinase

OBJECTIVELaryngeal myasthenia gravis (MG) is a focal manifestation of MG, and most patients are seronegative for antibodies against the acetylcholine receptor (AChR) and muscle specific kinase (MuSK). The purpose of this study was to determine the incidence of anti-AChR and anti-Musk antibodies in voice patients and to characterize the clinical and neuromuscular profiles of these patients in order to guide the diagnosis of laryngeal MG. STUDY DESIGNThis was a retrospective case-control study that included patients over the age of 18 who underwent laryngeal electromyography as part of their evaluation for neuromuscular junction dysfunction. METHODSCases and controls were evaluated serologically, for the anti-AChR, anti-MuSK, and anti-striational muscle antibodies, and neuromuscularly using the Tensilon test in some patients, repetitive nerve stimulation (RNS) test, and a treatment trial of pyridostigmine bromide. Cases were defined as either (1) positive anti-AChR or anti-MuSK, or (2) a positive Tensilon test or positive pyridostigmine bromide trial. RESULTSTwo hundred and eleven patients were screened; 61 (29%) patients were identified with laryngeal MG, and 77 (36%) patients were selected as controls. All case and control patients were seronegative for the anti-AChR and anti-MuSK antibodies with no significant difference between case and control status for seropositivity for anti-striational muscle antibodies. Of the case patients with an electrically positive Tensilon test (80.6%) who completed a treatment trial, 100% had symptom improvement. Of the case patients with a symptomatically positive Tensilon test (16.1%), only 60% of patients had improvement with a treatment trial. The RNS was more likely to be positive in case patients than control patients, and cases had a higher severity of paresis in all laryngeal muscles with LEMG evaluation. CONCLUSIONSLaryngeal MG is an underrecognized condition in the otolaryngology community owing in part to its seronegative presentation. Electrical improvement with a Tensilon test, or electrical or substantial symptomatic improvement with pyridostigmine bromide represent the most robust diagnostic criteria in these patients.

Efficacy and Safety of SARS-COV-2 Vaccines in Breast Cancer Patients

Abstract Background Breast cancer (BC) is a major public health problem. COVID-19 pandemic impacted all areas of daily life, including medical care. In particular, delivering care for patients with cancer or suspected cancer during the crisis was challenging given the competing risks of death from untreated cancer versus serious complications from SARS- CoV-2, and the likely higher lethality of COVID-19 in immunocompromised patients. Aim of the Work This study aims to assess the efficacy and immunogenicity of SARS COV 2 vaccines in breast cancer patients by evaluating anti spike antibodies in vaccinated and non vaccinated patients and also through assessing the infection with covid after vaccination (in vaccinated patients) and in non vaccinated patients. The study also aims to assess the Safety of SARS COV 2 vaccine in breast Cancer patients (local and systemic Toxicity). Patients and Methods Our population consisted of 120 female patients diagnosed with early and locally advanced breast cancer, in the breast cancer unit, Clinical oncology department, Ain Shams University Hospitals. All on systemic therapy (on neoadjuvant or adjuvant treatment). Sixty vaccinated and 60 unvaccinated against COVID-19. The cutoff value of SARS COV-2 antibody is 50 BAL/mL (&amp;gt;/= 50 seropositive, &amp;lt;50 seronegative) Results Out of 120 patients, Anti-SARS COV-2 Antibody seropositivity was found to be 48 vs. 58 pts (80% vs. 96.7%) in non vaccinated Vs. Vaccinated patients, with a P-value=0.0046), which was statistically significant. The median titre in both groups was found to be 1434.5 vs. 2500, (P = 0.0026). In the 120 patients, 26 patients had covid infection with a significant difference, Non vaccinated Vs. Vaccinated: 21 vs. 5 pts (35% vs. 8.3 %, P = 0.0004). In the sixty vaccinated patients, mild local adverse events were reported such as warmness at site of injection in 17 patients, representing (28.3%) of patients, Pain 11 (18.3%), Swelling 11 (18.3%), Itch 8 (13.3%), and Redness 6 (60%) representing the least adverse event. The patients experienced mild systemic adverse events, the highest incidence was Fatigue 28 (46.7%), then Myalgia/arthralgia 17(28.3%), headache 2 (3.3%),and fever 16 (26.7%). Conclusion Anti SARS COV2 are effective and safe in localized breast cancer patients on systemic therapy.

Immunogenicity and safety of an inactivated COVID-19 vaccine (CoronaVac®) co-administered with an inactivated enterovirus type 71 vaccine (Inlive®): A phase 4, randomized, controlled trial

ABSTRACT This study aimed to provide evidence for co-administration of the COVID-19 and EV71 vaccines in children aged 3 to 5 years. We conducted a phase 4, open-label, randomized, and controlled study. A total of 520 children were randomly allocated to two groups: Group C received the COVID-19 and EV71 vaccines simultaneously, while Group N received the two vaccines separately. The primary immunogenicity endpoints were the seroconversion rates of anti-SARS-CoV-2 and anti-EV71 antibodies 28 days after the second dose of each respective vaccine. Before vaccination, none of the participants was seropositive for anti-SARS-CoV-2 antibodies, and the baseline seropositivity for anti-EV71 antibodies was low (Group C: 14.86%; Group N: 17.83%). After completing full vaccination, the seroconversion rate of anti-SARS-CoV-2 antibodies reached 100% in both groups, while for anti-EV71 antibodies, the seroconversion rates were 97.99% in Group C and 98.70% in Group N. The lower limit of the 95% confidence interval for the difference in seroconversion rates between the two groups for both COVID-19 and EV71 vaccines met the predefined non-inferiority criteria. Six months post-vaccination, the antibody levels remained high for both vaccines, with the seropositive rates of anti-SARS-CoV-2 antibodies at 91.21% in Group C and 92.77% in Group N, and the seropositive rates of anti-EV71 antibodies at 99.16% in Group C and 99.15% in Group N. Safety analysis revealed a lower incidence of adverse reactions in Group C compared to Group N (28.85% vs 45.56%), primarily solicited. Co-administration of the COVID-19 and EV71 vaccines demonstrated a positive safety profile and non-inferior immune responses. Trial registration Number NCT04993365 (ClinicalTrials.gov).

Human hypofunctional NCF1 variants promote pulmonary fibrosis in the bleomycin-induced mouse model and patients with systemic sclerosis via expansion of SPP1+ monocytes-derived macrophages

ObjectiveWe assessed the role of a systemic lupus erythematosus causal hypofunctional variant, neutrophil cytosolic factor 1 (NCF1)-p.Arg90His (p.R90H) substitution, in systemic sclerosis (SSc).MethodsAssociation of NCF1-H90 with SSc was performed in...

Effective management of necrotizing crescentic glomerulonephritis using an aggressive combination therapy including avacopan in a patient double-seropositive for anti-GBM antibodies and ANCA: a case report.

The prognosis of anti-glomerular basement membrane (anti-GBM) nephritis, often accompanied by the presence of antineutrophil cytoplasmic antibodies (ANCA), is poor, and even with aggressive therapeutic approaches, kidney replacement therapy (KRT) is typically required. Here, we present a case of necrotizing crescentic glomerulonephritis in a patient double-seropositive for anti-GBM antibodies and ANCA who successfully achieved dialysis independence following aggressive treatment, including avacopan. The patient was a 77-year-old woman with rapidly progressive glomerulonephritis and double seropositivity for myeloperoxidase-ANCA and anti-GBM antibodies. A kidney biopsy revealed diffuse cellular crescents with necrosis and immunoglobin (Ig)G1 and IgG3 positivity on immunofluorescence staining, leading to a histological diagnosis of anti-glomerular basement membrane nephritis. Our treatment approach involved a novel combination of glucocorticoids, rituximab, low-dose cyclophosphamide, and plasma exchange complemented by avacopan. Temporary hemodialysis was required, and the patient successfully discontinued dialysis after 12 sessions despite a poor histological prognosis. This case underscores the significance of considering aggressive therapeutic strategies, including avacopan, for severe anti-GBM nephritis, even in the absence of lung involvement, to avert the need for KRT.

Identification and validation of anti-protein arginine methyltransferase 5 (PRMT5) antibody as a novel biomarker for systemic sclerosis (SSc)

ObjectivesIn the complex panorama of autoimmune diseases, the characterisation of pivotal contributing autoantibodies that are involved in disease progression remains challenging. This study aimed to employ a global antibody profiling...

An Undetected Expansion, Spread, and Burden of Chikungunya and Dengue Cocirculating Antibodies in Nigeria

Chikungunya and dengue are arboviral diseases transmitted by mosquitoes that have been increasingly recognized as public health concerns in Sub-Saharan Africa. Several studies conducted in Nigeria and other West African countries have revealed the seroprevalence burden and cocirculation of antibodies against mosquito-borne infections, thereby revealing a significant burden and clinical outcome complexities that have largely gone undetected. The current research study has important implications for disease surveillance, prevention strategies, and healthcare planning in Nigeria and other Sub-Saharan countries. A cross-sectional study was conducted on 871 outpatients and pregnant women from three regions of Nigeria. CHIKV and DENV immunoblot molecular diagnostic assays were used to analyze the serum samples for the presence of arboviral antibody serological markers IgG (Mikrogen Diagnostik, Germany) with DENV nonstructural protein 1 and DENV Equad and CHIKV virus-like particles (VLPs), according to the manufacturer’s instructions. A total of 871 participants were recruited from three geographical regions in Nigeria. Among them, 17.5% (152/871) were from Abia (southern Nigeria), 34.4% (300/871) were from Kaduna (northern Nigeria), and 48.1% (419/871) were from Nasarawa (central Nigeria). The ages of the participants ranged from 0 months to 80 years, with a mean age of 36.6 years. Of the 871 subjects, 71.0% (619/871) were female, and 29.0% (252/871) were male. The overall cohort detectable antibody seropositivity against CHIKV was 64.9% (565/871), 95% CI (61.74–68.06); DENV, 44.7% (389/871), 95% CI (41.41–47.99); and CHIKV-DENV cocirculation antibodies, 31.6% (95% CI 29–35). This study highlighted the unpredictably high seroprevalence, expansion, magnitude, and undetected burden of chikungunya and dengue in Nigeria.

Development and Validation of a Novel Nomogram to Screen for Liver Fibrosis in Individuals with Hepatitis B Core Antibody Seropositivity

Development and Validation of a Novel Nomogram to Screen for Liver Fibrosis in Individuals with Hepatitis B Core Antibody Seropositivity

Characterizing Myasthenia Gravis Symptoms, Exacerbations, and Crises From Neurologist's Clinical Notes Using Natural Language Processing.

Background Myasthenia gravis (MG) is a rare, autoantibody neuromuscular disorder characterized by fatigable weakness. Real-world evidence based on administrative and structured datasets regarding MG may miss important details related to the clinical encounter. Examination of free-text clinical progress notes has the potential to illuminate aspects of MG care. Objective The primary objective was to examine and characterize neurologist progress notes in the care of individuals with MG regarding the prevalence of documentation of clinical subtypes, antibody status, symptomatology, and MG deteriorations, including exacerbations and crises.The secondary objectives were to categorize MG deteriorations into practical, objective states as well as examine potential sources of clinical inertia in MG care. Methods We performed a retrospective, cross-sectional analysis of de-identified neurologist clinical notes from 2017 to 2022. A qualitative analysis of physician descriptions of MG deteriorations and a discussion of risks in MG care (risk for adverse effects, risk for clinical decompensation, etc.) was performed. Results Of the 3,085 individuals with MG, clinical subtypes and antibody status identified included gMG (n = 400; 13.0%), ocular MG (n = 253; 8.2%), MG unspecified (2,432; 78.8%), seropositivity for acetylcholine receptor antibody (n = 441; 14.3%), and MuSK antibody (n = 29; 0.9%). The most common gMG manifestations were dysphagia (n = 712; 23.0%), dyspnea (n = 626; 20.3%), and dysarthria (n = 514; 16.7%). In MG crisis patients, documentation of difficulties with MG standard therapies was common (n = 62; 45.2%). The qualitative analysis of MG deterioration types includes symptom fluctuation, symptom worsening with treatment intensification, MG deterioration with rescue therapy, and MG crisis. Qualitative analysis of MG-related risks included the toxicity of new therapies and concern for worsening MG because of changing therapies. Conclusions This study of neurologist progress notes demonstrates the potential for real-world evidence generation in the care of individuals with MG. MG patients suffer fluctuating symptomatology and a spectrum of clinical deteriorations. Adverse effects of MG therapies are common, highlighting the need for effective, less toxic treatments.