Detection Of Autoantibodies In Patients Research Articles

Evaluation of visceral involvement and detection of autoantibodies in patients with systemic sclerosis

Objective To investigate clinical characteristics of systemic sclerosis (SSc) , and to explore the correlation between visceral involvement and autoantibodies. Methods Clinical data, laboratory examination and auxiliary examination findings were collected from 63 patients with SSc in the Department of Dermatology of Zhongshan Hospital affiliated to Fudan University between 2012 and 2015, and the correlation of autoantibodies with visceral involvement and clinical phenotypes was analyzed. Results The 63 patients with SSc included 29 with diffuse SSc, 29 with limited SSc and 5 with overlap syndrome. Of the 63 patients, 30 had pulmonary interstitial fibrosis, 32 had lung function impairment which manifested as reduced diffusing capacity for carbon monoxide, and 12 had increased pulmonary arterial pressure. Among 29 patients with anti- DNA topoisomerase Ⅰ (SCL-70) antibody, 19 (65.52%) had pulmonary interstitial fibrosis, while 11 (32.35%) of 34 patients without anti-SCL-70 antibody had pulmonary interstitial fibrosis. Pulmonary interstitial fibrosis also occurred in 13 (68.42%) of 19 patients with anti-Sjogren′s syndrome antigen A (SSA) antibody, as well as in 17 (38.64%) of 44 patients without anti-SSA antibody. The incidence of pulmonary interstitial fibrosis was significantly higher in the patients with anti-SCL-70 or anti-SSA antibody than in the patients without anti-SCL-70 or anti-SSA antibody respectively (χ2= 6.901, 4.720, respectively, both P < 0.05) . Among the 63 patients, 22 had fingertip ulcers, and 16 (72.73%) of the 22 patients had pulmonary interstitial fibrosis, while 14 (34.15%) of 41 patients without fingertip ulcers had pulmonary interstitial fibrosis, and the incidence of pulmonary interstitial fibrosis significantly differed between the two groups (χ2= 8.544, P < 0.01) . Of the 63 patients, 50 (79.40%) initially presented with Raynaud′s phenomenon, and the average duration between the occurrence of Raynaud′s phenomenon and the diagnosis of SSc was 48.3 months. Conclusions Patients with SSc usually present with a high incidence of pulmonary interstitial fibrosis, which is complicated by lung function impairment and pulmonary hypertension. Raynaud′s phenomenon usually occurs as the initial symptom. There is a high incidence of pulmonary interstitial fibrosis in the patients with fingertip ulcers and anti-SCL-70 and anti-SSA antibodies. Key words: Scleroderma, systemic; Lung diseases, Interstitial; Autoantibodies; Hypertension, pulmonary

Detection of Anti-basement Membrane Zone Antibodies in the Blister Fluid in Subepidermal Autoimmune Bullous Diseases.

Background:Subepidermal autoimmune bullous diseases (sAIBD) are diverse of conditions with clinicopathological overlap. Circulating autoantibodies in the serum can be demonstrated using indirect immunofluorescence (IIF) microscopy. Artificially split normal human skin is considered as an optimum substrate for the demonstration of anti-basement membrane zone (BMZ) antibodies using IIF in sAIBD; it not only helps to detect the presence of circulating antibodies in the serum but also helps to subclassify these conditions into “roof” and “floor” binding disorders.Aim:In this study, we evaluated the utility of IIF to detect anti-BMZ antibodies in the blister fluid of patients with sAIBD.Materials and Methods:Twenty-two patients with a clinical diagnosis of sAIBD were enrolled in the study. IIF of serum and blister fluid were done simultaneously using salt-split skin as a substrate.Results:Anti-BMZ antibodies could be detected in the blister fluid using IIF in all patients in the study group.Limitation:We could not do enzyme-linked immunosorbent assay of blister fluid. This would have given us the quantitative data of circulating antibodies in the blister fluid.Conclusion:Blister fluid offers an alternate source for the detection of autoantibodies in patients with sAIBD. It may be of particular help in children and in elderly with poor venous access.

膠原病患者におけるBioPlex2200 ANA Screenを用いた自己抗体測定の評価

膠原病患者におけるBioPlex2200 ANA Screenを用いた自己抗体測定の評価

Autoantibodies and the immune hypothesis in psychotic brain diseases: challenges and perspectives.

The pathophysiology of psychosis is poorly understood, with both the cognitive and cellular changes of the disease process remaining mysterious. There is a growing body of evidence that points to dysfunction of the immune system in a subgroup of patients with psychosis. Recently, autoantibodies directed against neuronal cell surface targets have been identified in a range of syndromes that feature psychosis. Of interest is the detection of autoantibodies in patients whose presentations are purely psychiatric, such as those suffering from schizophrenia. Autoantibodies have been identified in a minority of patients, suggesting that antibody-associated mechanisms of psychiatric disease likely only account for a subgroup of cases. Recent work has been based on the application of cell-based assays—a paradigm whose strength lies in the expression of putative antigens in their natural conformation on the surface of live cells. The responsiveness of some of these newly described clinical syndromes to immune therapy supports the hypothesis that antibody-associated mechanisms play a role in the pathogenesis of psychotic disease. However, further investigation is required to establish the scope and significance of antibody pathology in psychosis. The identification of a subgroup of patients with antibody-mediated disease would promise more effective approaches to the treatment of these high-morbidity conditions.

Serum autoantibodies for the diagnosis and management of autoimmune liver diseases

The spectrum of autoimmune liver diseases (AILD) includes primary biliary cirrhosis, primary sclerosing cholangitis and autoimmune hepatitis. The immunological mechanisms triggering the initiation and perpetuation of AILD remains unknown, while autoantigens are now recognized in most cases, and are generally nontraditional in their widespread distribution. Sensitive and specific methods for the detection of serum autoantibodies in patients affected by AILD represent a challenge for researchers and clinicians who desire to obtain an early and certain diagnosis as well as markers of disease control. To this regard, the use and interpretation of serum autoantibodies in AILD may be seen as paradigmatic for the large gaps in our knowledge based on the lack of true population-based studies. The present review article will critically discuss the available evidence on the use of autoantibody findings in the diagnosis or management of autoimmune liver disease.

Human adjuvant disease induced by foreign substances: a new model of ASIA (Shoenfeld's syndrome)

To investigate the clinical, laboratory and histological manifestations of patients who received illegal injections of foreign substances for cosmetic purposes. We studied patients who met the following inclusion criteria: 1) history of application of foreign substances for cosmetic purposes, 2) clinical data of autoimmune disease or non-specific autoimmune manifestation (i.e. arthralgias, myalgia, malaise, fever, and weight loss), 3) detection of autoantibodies in patients' sera, 4) histological evidence of chronic inflammation and/or granulomatous reaction to foreign body. Fifty female patients aged 44.4 ± 10 years were studied. The mean time between application of foreign substances and onset of symptoms was 4.5 ± 4.3 years. Patients were followed for 12 ± 7.5 years. Forty-one patients were injected with mineral oil, nine patients received other substances: three iodine gadital, one guayacol, one guayacol plus silicone fluid, two collagen, two silicone fluid. The sites of application were: buttocks (36), legs and/or thighs (11), breasts (eight) hands and face (one), face (two) (seven patients received an injection to more than one site). Thirty patients presented with non-specific autoimmune manifestations, whereas 20 patients fulfilled the criteria for a defined autoimmune disease such as systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, overlap syndrome, autoimmune hemolytic anemia, autoimmune thyroiditis, autoimmune hepatitis, and ulcerative colitis. Cases of human adjuvant disease following illegal injections of oil substances for cosmetic purposes are reported. Patients presented with defined autoimmune diseases as well as with non-specific autoimmune manifestations. Illegal injection of these substances could lead to serious local and systemic complications, even to death. These cases represent another model of Autoimmune/inflammatory Syndrome Induced by Adjuvants (ASIA). The use of these substances should be prohibited.

Detection of multiple autoantibodies in patients with ankylosing spondylitis using nucleic acid programmable protein arrays

Detection of multiple autoantibodies in patients with ankylosing spondylitis using nucleic acid programmable protein arrays

Islet cell autoantibodies in African patients with Type 1 and Type 2 diabetes in Dar es Salaam Tanzania: a cross sectional study

BackgroundThe aim of the present study was to assess the occurrence of glutamic acid decarboxylase autoantibodies (GADA) and insulinoma antigen 2 autoantibodies (IA2A) among patients of African origin in Dar es Salaam, Tanzania and to compare the occurrence of autoimmune mediated Type 1 diabetes with findings previously reported from the same place and from other African diabetic populations.MethodsTwo hundred and forty five patients from the diabetic clinic at Muhimbili Hospital were recruited for a cross sectional study. Patients were clinically classified into groups with Type 1 (T1D) and Type 2 diabetes (T2D); there were 94 patients with T1D and 151 with T2D. Autoantibodies for GAD and IA2 were measured with an assay based on radioligand binding. Fasting and random blood glucose, HbA1c, and C-peptide levels were also determined.ResultsOf the patients with T1D, 28 (29.8%) were GADA positive and 20 (21.3%) were IA2A positive. The overall occurrence of any autoantibody was 42.6%. The GAD and IA2 autoantibodies were detected more frequently among patients with T1D than among patients with T2D (P < 0.001). A higher autoantibody prevalence was observed with combined GADA and IA2A measurements compared to individual autoantibody measurements; 40 (42.6%) patients with T1D versus 11 (7.3%) with T2D had at least one positive autoantibody titer. There was no correlation between duration of disease and detection of autoantibodies in patients with T1D. There was a strong association with family history of diabetes among the autoantibody positive versus autoantibody negative patients with T1D (p < 0.01).ConclusionThe prevalence of GAD and IA2 autoantibodies among African patients with T1D in Dar es Salaam was the same as that reported previously for South Africa and Ethiopia. It was much higher than the prevalence of islet cell autoantibodies (ICA) reported from the same clinic about 15 years ago. For unknown reasons the prevalence of pancreatic related autoantibodies in this African population is lower than the prevalence found among Caucasian populations.

Evaluation of F-Actin ELISA for the Diagnosis of Autoimmune Hepatitis

Antibodies to F-actin have been proposed to increase specificity in the diagnosis of autoimmune hepatitis (AIH). We compared the diagnostic value of a new F-actin enzyme-linked immunosorbent assay (ELISA) with the current gold standard of detection of smooth muscle antibodies by indirect immunofluorescence (SMA-IFT). Archived sera of 47 patients with SMA positive AIH were tested with the F-actin ELISA and SMA-IFT. Prospectively collected sera of 123 patients with various liver diseases, 35 of whom had AIH, were analyzed by both assays. Different cutoff limits were considered for the F-actin ELISA (increments between 20 and 60 ELISA units) and SMA-IFT (titers of 1:40, 1:80, and 1:160). The F-actin ELISA had a sensitivity of 100% to detect all of 47 SMA positive AIH sera and the value of the ELISA units correlated with that of SMA titers (p < 0.0001). In prospective analysis, F-actin ELISA showed a superior sensitivity (74% vs 34%) and a similar specificity (98% vs 99%) and positive predictive value (88% vs 92%), compared with SMA-IFT. Combining both assays improved neither sensitivity nor specificity. The new F-actin ELISA seems to be a useful diagnostic tool with similar specificity and superior sensitivity for the diagnosis of AIH, compared with standard SMA-IFT. Due to its simplicity and operator independency, the F-actin ELISA may become a preferred screening technique for detection of autoantibodies in patients with suspected AIH.

REGULARITIES AND CLINICAL SIGNIFICANCE OF AUTOANTIBODIES IN CHRONIC HCV-INFECTION

Results of the detection of autoantibodies in patients with chronic HCV-infection are presented. The comparison of importance of autoantibodies both organ specific (to liver specific protein) and organ non-specific (antinuclear and antimitochondrial) is done. The clinical significance of organ specific autoantibodies (to liver specific protein) is high.

Detection of basophil-activating IgG autoantibodies in chronic idiopathic urticaria by induction of CD63

Approximately 40% to 50% of patients with chronic idiopathic urticaria (CIU) have functional IgG autoantibodies against FcepsilonRIalpha or IgE, which induce histamine release from basophils and cutaneous mast cells. A positive autologous serum skin test response is believed to reflect the presence of these autoantibodies. We sought to further define the functional properties of and develop a sensitive functional assay for detection of autoantibodies in patients with CIU. Sera from patients with CIU (n=61) and sera from healthy control subjects (n=23) were incubated with donor basophils. Activation of basophils was determined on the basis of CD 63 surface expression, as analyzed on a FACScan flow cytometer. A positive basophil activation test result was found in 51% of patients with CIU, and basophil-activating properties were present in the IgG fractions of sera. When both the in vitro test and the autologous serum skin test were considered, basophil/mast cell-activating autoantibodies were present in 62% of the patients. Patients with a positive basophil activation test result had a significantly higher prevalence of other autoantibodies, had more severe urticaria, and were more likely to have angioedema. The results demonstrate the presence of basophil-activating autoantibodies in about 50% of patients with CIU. The data support the autoimmune cause of the disease and provide a simple test for detection of these autoantibodies.

164 Detection of autoantibodies in patients with atopic dermatitis

164 Detection of autoantibodies in patients with atopic dermatitis

Detection of autoantibodies in patients with chronic bronchitis

In 120 patients with chronic bronchitis and 104 healthy individuals, circulating autoantibodies to the bronchial mucosa were studied. Exacerbation of the chronic inflammatory process in the bronchi is accompanied by a significant increase in autoantibody titers. A direct relationship was found between the level of autoantibodies, the severity and duration of the disease. By the time of discharge from the hospital in some patients, autoantibody titers remain at a high level, often up to six months. Determination of anti-bronchial antibodies in the dynamics of chronic bronchitis can be used to recognize the activity of the inflammatory process and predict its outcome.