IgG-positive Patients Research Articles

Cytomegalovirus-Associated Autoantibody against TAF9 Protein in Patients with Systemic Lupus Erythematosus

Background: Evidence indicates a causal link between cytomegalovirus (CMV) infection and the triggering of systemic lupus erythematosus (SLE). Animal studies have revealed that CMV phosphoprotein 65 (pp65) induces autoantibodies against nuclear materials and causes the autoantibody attack of glomeruli. IgG eluted from the glomeruli of CMVpp65-peptide-immunized mice exhibited cross-reactivity against dsDNA and TATA-box-binding protein associated factor 9 (TAF9). Whether the elevation of anti-TAF9 IgG is associated with anti-CMV reactivity in human lupus remains unclear. Methods: The sera from patients with rheumatic diseases, including ankylosing spondylitis (AS), gout, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and Sjögren syndrome (SS) were examined using ELISA for antibodies of CMV, CMVpp65, and TAF9. Results: In total, 83.8% of the rheumatic patients had acquired CMV infections. The SLE patients had a high prevalence of anti-CMV IgM. The highest seropositivity rates for anti-HCMVpp65 and anti-TAF9 IgG were observed in the SLE patients. Purified anti-CMVpp65 IgG from CMVpp65/TAF9 dual-positive SLE sera reacted to both TAF9 and dsDNA. An increased prevalence of proteinuria and low hemoglobin levels were found in CMV IgG- and CMVpp65 IgG-positive SLE patients. Conclusions: This observation suggests that immunity to CMVpp65 is associated with cross-reactivity with TAF9 and dsDNA and that it is involved in the development of clinical manifestations in SLE.

D-Dimer Levels Are Not Elevated in SARS-CoV-2 IgG Positive Patients Undergoing Elective Orthopedic Surgery.

Introduction: In acute COVID-19, D-Dimer levels can be elevated and those patients are at risk for thromboembolic events. This study aims to investigate differences in preoperative D-Dimer levels in SARS-CoV-2 IgG positive and negative patients undergoing primary total knee and total hip replacement (TJA) or spine surgery. Methods: D-Dimer levels of 48 SARS-CoV-2 IgG positive and 718 SARS-CoV-2 IgG negative spine surgery patients were compared to those of 249 SARS-CoV-2 IgG positive and 2102 SARS-CoV-2 IgG negative TJA patients. Patients were assigned into groups based on D-Dimer levels as follows: <200 ng/mL, 200–400 ng/mL, and >400 ng/mL D-Dimer Units (DDU). Results: D-Dimer levels did neither differ significantly between SARS-CoV-2 IgG positive spine surgery patients and TJA patients (p = 0.1), nor between SARS-CoV-2 IgG negative spine surgery and TJA patients (p = 0.7). In addition, there was no difference between SARS-CoV-2 IgG positive and negative spine surgery patients and SARS-CoV-2 IgG positive and negative TJA patients (p = 0.3). Conclusions: There is no difference in D-Dimer levels between SARS-CoV-2 IgG positive and negative patients and there does not seem to be any difference for different orthopedic specialty patients. Routine testing of D-Dimer levels is not recommended for patients undergoing elective orthopedic surgery.

Preoperative ferritin and hemoglobin levels are lower in patients with a history of COVID-19 but blood loss and transfusion requirements are not increased.

IntroductionA history of COVID-19 (Coronavirus Disease 2019), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may have an impact on hemoglobin and ferritin levels predisposing patients to increased blood transfusion requirements following total joint arthroplasty (TJA). The current study compares ferritin levels, hemoglobin levels, and transfusion rates between SARS-CoV-2 IgG positive and SARS-CoV-2 IgG negative TJA patients.Materials and methodsPreoperative ferritin levels, pre- and postoperative hemoglobin levels, postoperative change in hemoglobin, and transfusion rates of 385 consecutive SARS-CoV-2 IgG positive patients undergoing TJA were compared to those of 5156 consecutive SARS-CoV-2 IgG negative patients undergoing TJA.ResultsPreoperative hemoglobin levels were significantly lower in SARS-CoV-2 IgG positive patients [13.3 g/dL (range 8.9–17.7 g/dL)] compared to 13.5 g/dl (7.3–18.3 g/dL; p value 0.03). Ferritin levels were significantly lower in SARS-CoV-2 IgG positive patients (mean of 106.1 ng/ml (2.1–871.3.3 ng/ml) vs. 123.7 ng/ml (1.4–1985 ng/ml) (p value 0.02)). Hemoglobin on postoperative day (POD) one, after four–six weeks, and transfusion rates did not differ between the two groups.ConclusionAlthough preoperative hemoglobin and ferritin levels are lower in SARS-CoV2 IgG positive patients, there was no difference in hemoglobin on POD one, recovery of hemoglobin levels at four—six weeks postoperatively, and transfusion rates after surgery. Routine ferritin testing prior to TJA is not recommended in SARS-CoV-2 IgG positive patients.

Serum GFAP and NfL as disease severity and prognostic biomarkers in patients with aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder

BackgroundNeuromyelitis optica spectrum disorder (NMOSD) is a frequently disabling neuroinflammatory syndrome with a relapsing course. Blood-based disease severity and prognostic biomarkers for NMOSD are a yet unmet clinical need. Here, we evaluated serum glial fibrillary acidic protein (sGFAP) and neurofilament light (sNfL) as disease severity and prognostic biomarkers in patients with aquaporin-4 immunoglobulin (Ig)G positive (AQP4-IgG+) NMOSD.MethodssGFAP and sNfL were determined by single-molecule array technology in a prospective cohort of 33 AQP4-IgG+ patients with NMOSD, 32 of which were in clinical remission at study baseline. Sixteen myelin oligodendrocyte glycoprotein IgG-positive (MOG-IgG+) patients and 38 healthy persons were included as controls. Attacks were recorded in all AQP4-IgG+ patients over a median observation period of 4.25 years.ResultsIn patients with AQP4-IgG+ NMOSD, median sGFAP (109.2 pg/ml) was non-significantly higher than in MOG-IgG+ patients (81.1 pg/ml; p = 0.83) and healthy controls (67.7 pg/ml; p = 0.07); sNfL did not substantially differ between groups. Yet, in AQP4-IgG+, but not MOG-IgG+ patients, higher sGFAP was associated with worse clinical disability scores, including the Expanded Disability Status Scale (EDSS, standardized effect size = 1.30, p = 0.007) and Multiple Sclerosis Functional Composite (MSFC, standardized effect size = − 1.28, p = 0.01). While in AQP4-IgG+, but not MOG-IgG+ patients, baseline sGFAP and sNfL were positively associated (standardized effect size = 2.24, p = 0.001), higher sNfL was only non-significantly associated with worse EDSS (standardized effect size = 1.09, p = 0.15) and MSFC (standardized effect size = − 1.75, p = 0.06) in patients with AQP4-IgG+ NMOSD. Patients with AQP4-IgG+ NMOSD with sGFAP > 90 pg/ml at baseline had a shorter time to a future attack than those with sGFAP ≤ 90 pg/ml (adjusted hazard ratio [95% confidence interval] = 11.6 [1.3–105.6], p = 0.03). In contrast, baseline sNfL levels above the 75th age adjusted percentile were not associated with a shorter time to a future attack in patients with AQP4-IgG+ NMOSD.ConclusionThese findings suggest a potential role for sGFAP as biomarker for disease severity and future disease activity in patients with AQP4-IgG+ NMOSD in phases of clinical remission.

Impact of SARS-CoV-2 pandemic among health care workers in a secondary teaching hospital in Spain.

The COVID-19 pandemic has posed a huge challenge to healthcare systems and their personnel worldwide. The study of the impact of SARS-CoV-2 infection among healthcare workers (HCW), through prevalence studies, will let us know viral expansion, individuals at most risk and the most exposed areas in healthcare organizations. The aim of this study is to gauge the impact of SARS-CoV-2 pandemic in our hospital workforce and identify groups and areas at increased risk. This is a cross-sectional and incidence study carried out on healthcare workers based on molecular and serological diagnosis of SARS-CoV-2 infection. Of the 3013 HCW invited to participate, 2439 (80.9%) were recruited, including 674 (22.4%) who had previously consulted at the Occupational Health Service (OHS) for confirmed exposure and/or presenting symptoms suggestive of COVID-19. A total of 411 (16.9%) and 264 (10.8%) healthcare workers were SARS-CoV-2 IgG and rRT-PCR positive, respectively. The cumulative prevalence considering all studies (IgG positive HCW and/or rRT-PCR positive detection) was 485 (19.9%). SARS-CoV-2 IgG-positive patients in whom the virus was not detected were 221 (9.1%); up to 151 of them (68.3%) did not report any compatible symptoms nor consult at the OHS for this reason. Men became more infected than women (25% vs 18.5%, p = 0.0009), including when data were also classified by age. COVID-19 cumulative prevalence among the HCW assigned to medical departments was higher (25.2%) than others, as well as among medical staff (25.4%) compared with other professional categories (p<0.01). The global impact of the COVID-19 pandemic on HCW of our centre has been 19.9%. Doctors and medical services personnel have had the highest prevalence of SARS-CoV-2 infection, but many of them have not presented compatible symptoms. This emphasizes the performance of continuous surveillance methods of the most exposed health personnel and not only based on the appearance of symptoms.

Comparison of Rubella, Cytomegalovirus, Toxoplasma gondii seroprevalence, Still Birth and Preterm Birth Rates in Pregnant Patients Admitted to Our Hospital, IgG Avidity in IgG Positive Patients

Comparison of Rubella, Cytomegalovirus, Toxoplasma gondii seroprevalence, Still Birth and Preterm Birth Rates in Pregnant Patients Admitted to Our Hospital, IgG Avidity in IgG Positive Patients

Evaluation of Hepatitis B Seroprevalence and Hepatitis B Reactivation Frequency in Rheumatology Patients Using Biological Drug Therapy

Objective: The presence of hepatitis B virus (HBV) infection in patients using biological drug therapy may cause reactivation. There is insufficient data on the frequency of HBV reactivation, especially after the use of new biological drugs such as tofacitinib, tocilizumab, and secukinumab. This study aims to examine HBV seroprevalence in rheumatology patients using biological drug therapy and investigate the frequency of reactivation in patients with previous HBV infection. Methods: The charts of 275 patients who were followed up in the rheumatology department and used biological drug therapy were examined to evaluate the HBsAg, anti-HBc IgG, and anti-HBs test results. The frequency of reactivation was investigated by examining the HBV DNA test results before and after the biological drug therapy and the alanin aminotransferase test results were checked throughout the biological drug therapy in anti-HBc IgG-positive patients. Results: Among the patients, HBsAg was positive in 0.4%, anti-HBs in 34.4%, and anti-HBc IgG in 25.1%. The reactivation frequency was investigated in 53 biological drug therapies applied in 41 patients. The use of prophylactic antiviral drugs, where reactivation was evaluated, was found as 28.6% in TNF inhibitors, 100% in rituximab, 75.0% in tofacitinib, 0% in tocilizumab, 50% in abatacept, and 0% in secukinumab. Reactivation was detected in one of the fifty-three biological drug therapies. The reactivation case was a patient with isolated anti-HBc IgG and initial HBV DNA tests positive, using tocilizumab and cortisone, and not using entecavir prophylactic treatment regularly. Conclusions: The frequency of previous HBV infection is high in patients using biological therapy. Although prophylactic antiviral drug therapy for HBV has not been used frequently during the use of biological drug therapies other than rituximab in anti-HBc IgG positive patients, reactivation is rare. The risk of reactivation may be low in those receiving tofacitinib and secukinumab therapy and high in those receiving tocilizumab therapy.

Hepatitis E Virus Seroprevalence in Patients With Chronic Hepatitis C at a University Hospital in Brazil

Aim: We investigated the prevalence of anti-hepatitis E virus (HEV) antibodies in patients with chronic hepatitis C and the relationship with liver injury stage. Materials &amp; methods: In total, 451 patients were included and the presence of anti-HEV antibodies was evaluated by ELISA. Results: Anti-HEV IgG antibodies were detected in 45 (10.0%) patients and anti-HEV IgM were detected in two IgG-positive patients (4.4%). The distributions of liver fibrosis, steatosis, inflammatory activity, homeostasis model assessment of insulin resistance and liver enzyme levels were similar between HEV-positive and HEV-negative patients. However, HEV-positive patients had a higher mean age (p = 0.030). The seroprevalence by age group increased from 2.2 (18–30 years) to 53.3% (&gt;60 years). HEV infection was not related to advanced fibrosis. Conclusion: This investigation showed that the seroprevalence of HEV among patients with chronic hepatitis C is similar to that of blood donors in the same region.

Seroprevalence of SARS-CoV2 in IBD Patients Treated with Biologic Therapy.

Background and aimsA similar course of COVID-19 in patients with inflammatory bowel diseases (IBD) and in the general population has been reported. However, disease prevalence in IBD patients is presently unknown. In this prospective observational study we aimed at determining SARS-CoV2 infection prevalence in IBD patients treated with biological therapy.Methods354 sera from IBD patients under biological therapy recruited from three different locations in Italy and Germany were evaluated for antibody presence by RBD ELISA. Control groups were i) age-matched healthy subjects tested in the same time period in Milan, Italy; ii) healthy subjects collected in the pre-COVID era; iii) IBD patients under biological therapy collected in the pre-COVID era.Results8 out of 354 patients tested positive for the anti-RBD-SARS-CoV2 IgG antibody (prevalence 2.3%). IgG positive patients’ percentage recruited from Milan was significantly higher than those recruited from other locations (prevalence 5.4% vs. 0.4% p < 0.005). IgG positive patients reported a significantly higher incidence of fever, anosmia and ageusia, and were more likely to have entered in close contact with COVID-19 positive subjects before the study enrolment.ConclusionsSeroprevalence of SARS-CoV2 in IBD patients treated with biological therapy reflects values measured in the local general population. Specific symptoms and contact history with SARS-CoV2-infected individuals strongly increase the likelihood of SARS-CoV2 seropositivity.

Immune Modulation and CMV Reactivation In Sepsis-Induced Immunosuppression

Abstract Introduction/Objective Sepsis is a global health priority and is often accompanied by a transient immune paralysis, associated with impairment in innate and adaptive immunity leading to progressive immunosuppression and higher susceptibility to secondary infections. Reactivation of Cytomegalovirus (CMV) occurs frequently and has been associated with adverse outcomes even in immunocompetent patients, with sepsis. Study objective was to evaluate the association between incidence of CMV reactivation and immune alteration in sepsis-induced immunosuppression in patients with prolonged sepsis. Methods Prospective observational study, which included consecutive patients admitted to hospital ICU, with severe sepsis and length of stay &amp;gt; 48 hours. Patients with other causes of immune-suppression and anti-CMV treatment were excluded. Blood samples were collected on enrolment and further weekly until 21 days or death/discharge. Quantification of CMV viremia was done using RT-PCR (qPCR). Markers used to evaluate immune suppression using Flow Cytometry were i) lymphocyte subsets (CD3+,CD19+,CD16+CD56+,CD4+,CD8+ and regulatory T cells - CD25+ CD127-), ii) surface receptor expression of HLA-DR on monocytes, and Programmed Death marker expression (PD-1) on T lymphocyte, iii) Measurement of pro-inflammatory(IL-6,TNF-a,IFN-g) and anti-inflammatory cytokines(IL-4,IL-10) by Cytometric Bead Array (CBA) assay. Results A total of 25 CMV IgG positive patients and 11 healthy controls were analyzed. CMV reactivation occurred in 20 patients. Median time for reactivation was 7 days. Patients with CMV reactivation had significant T-cell lymphopenia (p&amp;lt;0.01). PD-1 expression on both CD4+ and CD8+ T cells in these patients was markedly elevated as compared to non-reactive group. HLA-DR expression was significantly low on monocytes in all sepsis patients (p&amp;lt;0.01) vs healthy controls; however it did not show any significant correlation. Levels of IL-6 showed marked elevation from day 7 while, IL-10 was observed to be significantly higher from day 0 in CMV reactivated group as compared to the CMV non-reactive group of patients. Conclusion Our study evidence suggests that monitoring lymphocyte subsets, PD-1expression on T lymphocyte, and levels of IL-6/IL-10 using flow cytometry, may serve as indicators for reactivation of CMV. Individualized immune therapy such as PD-1 receptor blockade drugs can be used to optimize treatment of patients with severe sepsis.

The N gene of SARS-CoV-2 was the main positive component in repositive samples from a cohort of COVID-19 patients in Wuhan, China

BackgroundRepositivity of SARS-CoV-2 nucleic acid in discharged COVID-19 patients was reported recently. However, the characteristics of repositive results are still not well understood, leading to a lack of effective monitoring strategies. MethodsIn the present study, a total of 59 COVID-19 patients were enrolled, and the characteristics of the repositive samples were analyzed. ResultsThe repositive rate in this cohort was 15.79%. The N gene was the main target gene that was positive in the repositive results as well as in the last positive results of all patients. The median duration from diagnosis to the last positive test was 20 days (IQR, 16–31 days), and the longest duration was 40 days. Repositivity was only observed in IgM single- or both IgM- and IgG-positive patients, instead of IgG single-positive patients. ConclusionsThere was a significant proportion of repositives in the recovered COVID-19 patients, and increasing the required number of negatives for consecutive nucleic acid tests may reduce the incidence of repositives. The recommended monitoring strategy for repositivity is monitoring the N gene in IgM-positive patients. This can ensure high sensitivity while reducing the time and cost of nucleic acid detection.

Kronik Hepatit B Virüs enfeksiyonu olan hastalarda Hepatit A Virüs seroprevalansı

Amaç: Bu çalışmada, Kronik Hepatit B tanısı ile takipli hastaların Hepatit A seroprevalansının retrospektif olarak araştırılması ve duyarlı kişilerin aşılanması amaçlanmıştır.&#x0D; Gereç ve Yöntemler: Kasım 2018–Kasım 2019 tarihleri arasında hastanemiz enfeksiyon hastalıkları polikliniğine başvuran kronik hepatit B tanılı hastaların HAV Ab-IgG sonuçları değerlendirildi. HAVAb-IgG tetkiki, ARCHITECT i2000SR analizatöründe ARCHITECT® HAVAb-IgG test kiti ile Kemilüminesan Mikropartikül İmmünoassay (CMIA) yöntemi kullanılarak araştırılmıştır. Verilerin istatistiksel analiz Statistical Package for Social Scienses (SPSS) 21 (Inc. Chicago, Illinois, ABD) istatistik paket programıyla analiz edilmiştir. &#x0D; Bulgular: Kronik hepatit B tanısıyla izlenen 138 hasta değerlendirildi. Hastaların 27’sinde HAV Ab-IgG tetkiki yapılmamıştı. Çalışmaya 111 hasta dahil edildi. Hastaların 64’ü (%57,7) kadın, 47’si (%42,3) erkekti. Hastalar 15-84 yaş aralığına sahipti. Yaş ortalaması 48,01±11,86 yıl olarak tespit edildi. Anti-HAV IgG 105 (%94,6) hastada pozitif, 6 (%5,4) hastada negatifti. Anti-HAV IgG pozitif hastaların yaş ortalaması 49,25±11,31 tespit edildi. Anti-HAV IgG negatif olan hastaların 2’si (%33,3) kadın, 4’ü (%66,7) erkekti. Hastalar 15-36 yaş aralığına sahipti. Yaş ortalaması 26,16±5,16 yıl olarak tespit edildi. &#x0D; Sonuç: Kronik hepatit B virüs enfeksiyonu olan hastalarda hepatit A virüs seroprevalansı %94,6 olarak bulundu. HBV enfeksiyonu olan hastalarda HAV Ab-IgG tetkiki yapılmalı ve Anti-HAV IgG negatif olan hastalar aşılama programına alınmalıdır.

Relationship between natural and infection-induced antibodies in systemic autoimmune diseases (SAD): SLE, SSc and RA.

Infection or vaccine-induced T cell-dependent immune response and the subsequent high-affinity neutralizing antibody production have been extensively studied, while the connection between natural autoantibodies (nAAbs) and disease-specific antibodies has not been thoroughly investigated. Our goal was to find the relationship between immunoglobulin (Ig)M and IgG isotype nAAbs and infection or vaccine-induced and disease-related autoantibody levels in systemic autoimmune diseases (SAD). A previously described indirect enzyme-linked immunosorbent assay (ELISA) test was used for detection of IgM/IgG nAAbs against citrate synthase (anti-CS) and F4 fragment (anti-F4) of DNA topoisomerase I in 374 SAD samples, with a special focus on systemic lupus erythematosus (SLE) (n=92), rheumatoid arthritis (n=73) and systemic sclerosis (n=157) disease groups. Anti-measles IgG and anti-dsDNA IgG/IgM autoantibodies were measured using commercial and in-house indirect ELISA tests. In all SAD groups the anti-measles IgG-seropositive cases showed significantly higher anti-CS IgG titers (P=0·011). In anti-dsDNA IgG-positive SLE patients, we detected significantly higher levels of anti-CS and anti-F4 IgG nAAbs (P=0·001 and<0·001, respectively). Additionally, we found increased levels of IgM isotypes of anti-CS and anti-F4 nAAbs in anti-dsDNA IgM-positive SLE patients (P=0·002 and 0·016, respectively). The association between IgG isotypes of pathogen- or autoimmune disease-related antibodies and the IgG nAAbs may underscore the immune response-inducible nature of the diseases investigated. The relationship between protective anti-dsDNA IgM and the IgM isotype of anti-F4 and anti-CS may provide immunoserological evidence for the beneficial roles of nAAbs in SLE patients.

False-positive SARS-CoV-2 serology in 3 children with Kawasaki disease

BackgroundKawasaki disease (KD) is an acute febrile and eruptive disease with systemic vasculitis predominantly affecting young East Asian children. Recent reports showed that children with KD-like disease from KD low prevalence regions had positive SARS-CoV-2 serology despite a negative SARS-CoV-2 polymerase chain reaction (PCR) in respiratory samples. ObjectivesTo describe 3 pediatric Kawasaki Disease patients with false positive SARS-CoV-2 serology. Study designWe retrospectively recruited children with KD diagnosed during the COVID-19 outbreak in Hong Kong. Clinical characteristics and laboratory test results including SARS-CoV-2 PCR results were retrieved. We performed a microparticle-based immunoassay for the detection of IgG against nucleoprotein (NP) and spike protein receptor binding domain (RBD), and a microneutralization assay for the detection of neutralizing antibodies. ResultsThree Chinese children with typical KD were identified. They had no epidemiological links with COVID-19 patients and tested negative for SARS-CoV-2 NPA PCR. They were treated with IVIG and aspirin, and were discharged without complications. Subsequently 2 of them were tested positive against anti-RBD and anti-NP antibodies and 1 was tested positive against anti- RBD antibodies. However, microneutralization assay showed that neutralizing antibodies were absent, suggesting a false-positive IgG result. ConclusionDetection of neutralizing antibodies is recommended to confirm previous SARS-CoV-2 infection in IgG-positive but PCR-negative patients.

Assessment of serological markers of dengue and it’s correlation to thrombocytopenia Running title: Platelet counts and serological markers of dengue infection

Background:Dengue is an acute, potentially fatal viral infection that can culminate in dengue hemorrhagic fever and dengue shock syndrome. The present study was conducted to assess the correlation between platelet counts and serological markers of dengue infection. Materials and Methods: The present study was conducted among 120 patients suspected of dengue fever. Serum samples were collected from suspected dengue fever patients. The samples were tested for NS1 antigen, IgM, and IgG antibodies using the ICT test kit. The platelet count was recorded in dengue parameter-positive and -negative cases. Results: Out of 120 patients, males were 70 and females were 50. NS1 only was detected in 62, IgM only in 20, IgG only in 14, NS1 and IgM only in 10, NS1 and IgG only in 8 and IgM and IgG only in 6 cases. 62 patients that were positive for NS 1, thrombocytopenia was seen in 48, 12 out of 20 IgM positive patients, 10 out of 14 IgG positive patients, 6 out of 10 NS1 and IgM only positive patients, 4 out of 8 NS1 and IgG only positive patients and 2 out of 6 IgM and IgG only positive patients were detected. The difference was significant (P&lt; 0.05). Conclusion:In fever, thrombocytopenia is observed more uniformly in subjects positive for dengue. WheneverIgM is detected as compared to NS1 and can be used asan indicator to reduce the complication of dengue disease. The use of NS1 in the diagnosis of dengue increases the detection rate significantly.

Toxoplasma infection in patients with myocardial infarction.

Toxoplasma gondiiis awidespreadprotozoanparasitethat infects one third of the globalhumanpopulation. Very little information is known about the impact of T.gondii on patients with heart disease. The aim of the present study was to determine the association between T.gondii exposure and patients suffering from myocardial infarction.The infection rate of anti-Toxoplasma IgG antibodies in 86patients with myocardial infarction (troponin‑T positive) and 86age and gender-matched controls (troponin‑T negative) was examined using enzyme-linked immunoassays. The DNA extraction was performed on separated buffy coats of serologically positive blood samples (32samples with high titer of anti-Toxoplasma IgG).The GRA6 gene ofT. gondii was amplified using PCR. The existence of polymorphic restriction sites for endonuclease MseI was used with the PCR-RFLP method and the bases of GRA6 gene were sequenced to determine the type of strains (I, II and III).A positive anti-Toxoplasma IgG level was found in 61.6% of the myocardial infarction samples and in 24.4% of the healthy controls (P-value < 0.05). The PCR results showed that only 3 of the anti-Toxoplasma IgG positive patients were found to be positive with GRA6 gene for T.gondii. The PCR-RFLP results showed that 2 of the 3positive sample had 75bp and 623 bp DNA fragments belonging to typeII genotype. The sequencing result confirmed the genotype II of T. gondii. Toxoplasma infection should be considered in myocardial infarction cases.

P0490IS THE SEVERITY OF GLOMERULAR IGG STAINING IN PATIENT WITH IGA NEPHROPATHY USEFUL FOR PREDICTING POOR RENAL PROGNOSIS? THE DATA FROM TSN-GOLD WORKING GROUP

Abstract Background and Aims In IgA nephropathy (IgAN), which is characterized by mesangial IgA accumulation, there is the formation of circulating autoantibodies against galactose deficient IgA1s (Gd-IgA1). IgG / Gd-IgA1 immunocomplexes accumulate in the glomerular mesangium and play a role in the pathogenesis of IgAN. Recent studies have suggested a relationship between glomerular IgG deposition and the severity of glomerular inflammation. However, detection of the presence and severity of IgG in routine immunofluorescence microscopy (IFM) may fail. This study aims to investigate whether IgG positivity detected by IFM is associated with poor renal prognostic indicators and whether renal prognosis can be predicted according to IgG positivity. Method 4399 patients who were enrolled between May 2009-June 2019 in database of Turkish Society of Nephrology, Glomerular Diseases Working Group (TSN-GOLD) including 44 centers were evaluated. After exclusion criteria, 994 primary IgAN patients were included in the study. Glomerular IgG negative and positive patients were compared by means of Oxford classification scores, histopathological evaluations, proteinuria, creatinine, albumin, blood pressures. IgG positive patients were divided into subgroups according to the grade of the IFM positivity. The relationship between IgG positivity and poor prognosis criteria were evaluated. Results Demographic and biochemical findings of glomerular IgG positive and negative patients at the time of biopsy are shown in Table 1. No difference was found between the groups. There was no difference in the demographic and biochemical findings at the time of biopsy in IgG subgroup analyses (Table 2). There was no difference between the histopathological and Oxford MEST scores of the subgroups. Glomerular IgG positivity was not associated with diastolic blood pressure, systolic blood pressure, urea, uric acid, age, eGFR, albumin, proteinuria (p&amp;gt; 0.05 for all, r= -0.084, r= -0.102, r= -0.006, r=0.062, r= 0.014, r= -0.044, r= -0.061, r= -0.066, r= 0.150, respectively). Conclusion Glomerular IgG positivity detected by routine IFM in IgAN is not associated with poor renal prognostic indicators. It is difficult to predict renal prognosis by looking at the severity of IgG positivity at the baseline evaluation.

Integrity of plasma DNA is inversely correlated with vaccine-induced antitumor immunity in ovarian cancer patients

Cancer immunotherapy including vaccine therapy is a promising modality for cancer treatment, but few patients show its clinical benefits currently. The identification of biomarkers that can identify patients who will benefit from cancer immunotherapy is thus important. Here, we investigated the potential utility of the circulating cell-free DNA (cfDNA) integrity—a ratio of necrotic cell-derived, longer DNA fragments versus apoptotic cell-derived shorter fragments of Alu gene—as a biomarker of vaccine therapy for patients with ovarian cancer. We analyzed plasma samples from 39 patients with advanced or recurrent ovarian cancer enrolled in clinical trials for personalized peptide vaccinations. We observed that (1) the cfDNA integrity was decreased after the first cycle of vaccination, and (2) the decreased levels of cfDNA integrity were correlated with vaccine-induced immune responses; i.e., decreased cfDNA integrity was observed in 91.7% and 59.3% of the IgG-positive and negative patients, respectively (p = 0.0445). Similarly, decreased cfDNA integrity was observed in 92.9% and 56.0% of CTL response-positive and negative patients, respectively (p = 0.0283). These results suggest that the circulating cfDNA integrity is a possible biomarker for cancer vaccine therapy.

Higher seroprevalence of hepatitis E virus in autoimmune hepatitis: Role of false-positive antibodies.

Recent studies have found an increase in the seroprevalence of hepatitis E virus (HEV) infection in patients with autoimmune hepatitis (AIH). We aimed to assess the prevalence of positive anti-HEV IgM and IgG, and HEV-RNA in a cohort of patients with AIH, to determine the impact of positive HEV serology on patient outcome, and to evaluate the role of hypergammaglobulinemia and positive autoantibodies in the presence of positive anti-HEV serology. One hundred and five patients tested for HEV infection between 2014 and 2018 were included in the study: 50 with chronic AIH (more than 1year on treatment), and 55 with an acute hepatitis (30 patients with acute AIH and 25 with non-AIH). Seroprevalence of HEV was higher in patients with acute AIH (17% vs 10% in patients with chronic AIH and 8% in patients with non-AIH). Patients with acute AIH and positive anti-HEV IgG were older (58 vs 40; P=.006), had higher IgG levels (27g/dL vs 13g/dL; P=.03) and antismooth muscle antibodies (ASMA) titres (1:160 vs 1:80; P=.045), and were more likely to have another autoimmune disease (60% vs 16%; P=.03). At the time of HEV testing, anti-HEV IgG positive patients had significantly higher serum IgG levels (17g/L vs 11g/L; P=.009), ANA (1:160 vs 1:60; P=.026) and ASMA titres (1:80 vs 1:40; P=.021). Seroprevalence of HEV in patients with AIH in Catalonia does not differ from that of the general population. The higher HEV seroprevalence in patients with acute AIH with higher levels of gammaglobulins and high antibody titres suggest the presence of cross-reactivity between HEV and liver antigens.

High Proportion of SARS-CoV-2 RNA Persistence in IgG-Positive Patients with COVID-19

Background: Antibody mass testing to identify SARS-CoV-2 seropositive people represents one of the major strategies to combat emergence of COVID-19 Postulating