Prevalence Of Antibodies In Patients Research Articles

COMPREHENSIVE ANALYSIS OF SALMONELLA ANTIBODY PREVALENCE IN PATIENTS USING WIDAL TITER AT A TERTIARY CARE INSTITUTION IN NORTHEAST DELHI

Introduction: Enteric fever continues to pose a significant public health challenge in India. The detection of enteric fever through laboratory diagnosis relies predominantly on serological tests. Among these tests, the widal test stands out as a cost-effective, readily accessible, and widely employed method for serologically diagnosing enteric fever. Objective: This study aimed for comprehensive analysis of Salmonella antibody prevalence in patients using widal titer at a tertiary care institution in north-east Delhi. Method: This is a cross-sectional observational study, that employed the widal tube agglutination test to 9,665 blood samples over a period of eighteen months (January 2022 to July 2023) for the serodiagnosis of enteric fever. Results: In a year and a half study, 11% of the population exhibited significant agglutination titre of ≥1:128, indicating exposure to infection. The estimated prevalence of enteric fever by Salmonella Typhi, paratyphi A and B detected by the widal test was 10.98%, 0.54%, and 0.052%, respectively. Notably, two distinct surges in enteric cases were observed during the late winter to early spring and during monsoon. Enteric predominantly affected females (55.7%) compared to males (44.2%). The age group most affected was 11 to 30 years, with a prevalence of 51.9%, followed by young children aged between 1-10 years (30.5%). Conclusion: Enteric fever remains a significant healthcare concern in India, particularly among the younger demographic. The diagnosis of enteric fever still predominantly relies on serological testing, such as the widal test, in developing nations.

Alloimmunization in children with sickle cell disease: A tertiary care experience

IntroductionPatients with sickle cell disease (SCD) show a high prevalence of red blood cell (RBC) alloimmunization, however, few studies have focused on children. The present study was undertaken to determine the prevalence of alloimmunization and autoimmunity in children with SCD and to assess any correlation with age, number of transfusions received, and the number and frequency of crisis. Material & methodsSixty children affected with homozygous SCD, aged between five to eighteen years and having received more than one packed red blood cell (PRBC) transfusion were enrolled in the study.The preliminary tests included antiglobulin test (indirect and direct), alloantibody screening by three panel, antibody typing using 11 panel and auto-control test to detect autoantibodies. ResultsDirect antiglobulin test was negative in all the 60 patients, whereas indirect antiglobulin test was positive in 4/60 (6.6%) patients. Specific typing of alloantibodies revealed anti-D and anti-Kell antibodies in 2 (3.3%) each. Patients with alloantibody (4) had a higher mean age at onset of first symptom (7.05 ± 2.12 years) and age at first transfusion (7.5 ± 2.12 years) as compared to those without alloantibody, (4.48 ± 3.09 and 4.91 ± 3.12 years respectively). Patients with alloantibody received more PRBC transfusions, maintained low hemoglobin, required higher doses of hydroxyurea and also had a larger liver and spleen. ConclusionThe present study found a low prevalence of antibodies in patients with SCD. Patients presenting with symptoms of SCD at younger age received hydroxyurea at an earlier age. Starting hydroxyurea at an earlier age may decrease subsequent alloantibodies development. Larger studies to compare groups of patients related to administration of hydroxyurea are required to confirm this hypothesis.

ASSOCIATION OF SERUM AUTO-ANTIBODIES AND THYROID FUNCTION TEST IN PATIENTS WITH NON-NEOPLASTIC THYROID DISEASES IN SHENDI LOCALITY, SUDAN

Background: Thyroid disorders are the most second endocrine problem after diabetes mellitus in society. Environmental, immunological, and genetic factors lead to the development of thyroid disorders. Objectives: The study intended to evaluate the role of thyroid antibodies and hormones in the diagnosis of thyroid diseases, as well as the prevalence of thyroid antibodies in patients having thyroid disorders living in Shendi locality. Study design: The current research was prospective, case - control, hospital-based study carried out from 2013-2017, in El-Mek Nimir Uiversity Hospital in Shendi town- Northern Sudan.-. River Nile State. Two hundred and eighty-three (283) participants selected randomly as study population, of whom Hundred and eleven (111) patients with hypothyroidism; Seventy-two (72) patients with hyperthyroidism; Hundred (100) healthy normal subjects as control group. Participants were recruited from outpatient clinics in El-Mek Nimir Uiversity Hospital in Shendi Thyroid hormones profile (TSH, T4, T3, fT3, and fT4) and Thyroid antibodies (Anti-thyroid peroxidase and antithyroglobulin) were measured. Results: The study revealed that (60.7%) had hypothyroidism, (39.3%) had hyperthyroidism, (91.9%) of hypothyroidism were female, and only (8.1%) were male, while (84.7%) of hyperthyroidism were female while male represented only (15.3%) of them. The current study revealed that 107 of the case group (58.5%) were positive when evaluated for thyroid peroxidase antibodies (TPO Ab), with level more than (40.0 IU/ml). 72 (64.9%) of them were hypothyroidism, whereas a 35 (48.6%) of them were hyperthyroidism. As regard Thyroglobulin antibodies (Tg Ab), 73 (39.9%) of the case studied were positive, 51 (69.9%) of them were hypothyroidism, and 22 (30.1%) of them were hyperthyroidism. The study also revealed statistically significant positive correlation between the presence of TPO Ab and the values of fT3

Antibody prevalence and immunotherapy response in Chinese patients with epilepsy and encephalopathy scores for patients with different neuronal surface antibodies.

Background:The scale assessment was helpful in predicting the presence of antibodies to autoimmune encephalitis. This study aimed to evaluate the application of antibody prevalence in Chinese patients with epilepsy and encephalopathy (APE2-CHN) and response to immunotherapy in Chinese patients with epilepsy and encephalopathy (RITE2-CHN) for patients with different neuronal surface antibodies.Methods:A total of 1365 patients with epileptic seizures as the prominent feature in Xuanwu Hospital, Capital Medical University, from June 2016 to June 2020 were enrolled in our study. Of these, 915 patients with epilepsy of unknown etiology whose serum and/or cerebrospinal fluid samples were examined for autoimmune antibodies were selected. All patients were scored with antibody prevalence in patients with epilepsy and encephalopathy (APE2), response to immunotherapy with epilepsy and encephalopathy (RITE2), APE2-CHN, and RITE2-CHN scores.Results:Of the 915 patients, 191 patients were positive for neural-surface specific antibodies (115 N-methyl-D-aspartate receptor (NMDAR) Ab, 47 leucine-rich glioma-inactivated protein 1 (LGI1) Ab, 8 contactin-associated protein 2 (CASPR2) Ab, 4 AMPA2R-Ab, and 11 GABAR-B-Ab; 3 CASPR2-Ab and LGI1-Ab, 2 NMDAR-Ab and CASPR2-Ab, and 1 NMDAR-Ab and myelin-oligodendrocyte glycoprotein [MOG] Ab). The sensitivity and specificity of APE2 ≥4 in predicting the presence of neural-surface specific antibodies in our study were 74.35% and 81.77%, respectively, and the sensitivity and specificity of APE2-CHN ≥4 were 75.92% and 84.53%, respectively. Eight cases had an APE2 score <4 and APE2-CHN score ≥5; all these patients had memory decline as the prominent manifestation. We divided the patients into six groups according to the different antibodies. APE2-CHN scores showed higher sensitivity for the prediction of NMDAR-Ab, but lower sensitivity for LGI1-Ab. A total of 187/191 (97.91%) patients received immunotherapy and 142/191 (74.35%) patients benefited from the treatments. The patients who were positive for LGI1-Ab with RITE2-CHN ≥8 responded well to immunotherapy.Conclusions:APE2-CHN had the highest value for predicting the positivity of NMDAR-Ab and RITE2-CHN evaluated the response of immunotherapy for anti-LGI1 encephalitis appropriately. However, RITE2 and RITE2-CHN do not appear to be good predictors of immunotherapy outcomes for patients with specific neuronal-surface antibodies and high APE2-CHN scores are often indicative of a poor response to immunotherapy.

Autoimmune psychosis

Psychosis is a common presenting symptom in cases of autoimmune encephalitis, and there are many lines of evidence to suggest that a proportion of psychosis has an autoimmune basis. Antibodies against NMDAR or other neuronal cell surface targets are considered pathogenic in people with encephalitis, however their relevance in patients with purely psychiatric presentations has been seen as controversial and screening for antibodies, and treatment when they are detected, is not readily available. There have been mixed findings of increased prevalence of antibodies in patients with psychosis and a variety of testing methods used.

P-105 PREVALENCE OF ANTIMITOCHONDRIAL ANTIBODIES IN PATIENTS WITH PRIMARY BILE CHOLANGITIS AND ITS OUTCOME IN LIVER TRANSPLANTATION

The presence of antimitochondrial antibodies has been described as a diagnostic criterion for primary biliary cholangitis. However, no studies have been established in the South American population to describe the prevalence of these antibodies in patients with biliary cholangitis. Furthermore, it would be important to assess the prevalence and identify whether the presence of these antibodies influences the recurrence of the disease. To describe the prevalence of antimitochondrial antibodies in patients with cirrhosis due to primary biliary cholangitis undergoing liver transplantation. To assess the recurrence of primary biliary cholangitis and its relationship with the presence of antimitochondrial antibodies. It is a descriptive, cross-sectional observational study that evaluated transplant patients from 2006 to 2019 Fifty patients with liver transplantation were identified with a greater representation of the female gender (47 cases, 94%), with an average age of 51 years (32-64), with only 1 patient being transplanted with severity according to the Child A scale (2%).), while 66% (33) of the transplanted patients had Child C severity at the time of surgery. A prevalence of 68% (34) of antimitochondrial antibodies was found in patients who underwent transplantation. Recurrence identified 5 years after transplantation was identified in only 10% (5) of the patients who underwent transplantation, and most of them with positive antimitochondrial antibodies (3 patients) The prevalence of antimitochondrial antibodies in primary biliary cholangitis is much lower when compared to several series in the literature, as well as the 5-year recurrence rate of the disease was quite low, which could suggest that the behavior of this disease in our Colombian population (mainly mestizo and indigenous) with a lower prevalence of these antibodies, it could influence the recurrence of the disease in transplant patients.

Prevalence of IA-2 antibody in patients suffering from diabetes and their first-degree relatives

Type 1 diabetes mellitus (T1DM) is an autoimmune disorder accompanied by activation of auto-reactive B cells, autoantibody production, and consequently insulin-producing beta cell destruction. Some evidences support the value of autoantibodies such as anti-islet cell antigen (IA-2) auto-antibody in T1DM diagnosis and prognosis. The present study investigated the presence of IA-2 antibody in T1DM patients and their first-degree relatives as well as T2DM patients and healthy people to evaluate the diagnostic and prognostic value of anti-IA-2 in T1DM. In total 264 cases including 38 T1DM patients, 36 first-degree relatives, 88 T2DM patients, and 102 age-/sex-matched healthy controls participated in this study. After venous blood collection, sera were isolated and the level of IA-2 antibody was measured by ELISA method. Routine hematologic and biochemical tests including complete blood count (CBC), fasting blood sugar (FBS), hemoglobin A1c (HbA1C), urea, creatinine, as well as lipid profile and liver function tests were analyzed. Upregulated level of IA-2 antibody was observed in 47.4 and 5.6% of T1DM and their relatives, respectively; however, the level was significantly higher in T1DM compared to T1DM first-degree relatives (p < 0.05). In addition, none of the T2DM patients nor healthy controls were positive for IA-2 autoantibody. There was not any significant correlation between anti-IA-2 levels and total daily dose of insulin and the biochemical and hematological parameters. It seems that the measurement of anti-IA-2 antibody has no value in prediction or management of T1DM. Further studies need to reveal the reason for high anti-IA-2 titer in some patients.

Prevalence of antiphospholipid antibodies in patients with overt myocardial dysfunction in systemic lupus erythematosus. A case-control study.

Small case-series have reported overt myocardial dysfunction to be associated with positive antiphospholipid antibodies in patients of systemic lupus erythematosus (SLE). However, there is no case-control study that has examined this association. This case-control study recruited patients of SLE (fulfilling SLICC criteria) with overt myocardial dysfunction as cases and those without this as controls. Overt myocardial dysfunction was defined by echocardiography as global left ventricular dysfunction and reduced ejection fraction (<50%). Those patients with a prior diagnosis of anti-phospholipid antibody syndrome, coronary artery disease, rheumatic heart disease or severe pulmonary artery hypertension were excluded. Antibodies tested included lupus anticoagulant, anticardiolipin antibodies (IgM and IgG) and anti-beta 2 glycoprotein 1 antibodies (IgM and IgG). Patients with positive tests underwent repeat testing for persistent positivity after 12 weeks. This study included 51 patients (21 cases and 30 controls) having a mean (SD) age of 33 (13.3) years, and disease duration (median, IQR) of 28 months (12-38 months). The mean ejection fraction of cases was 31.7 (9.3)% while that of controls was 55.7 (1.7)% (p = 0.03). The frequency (percentage) of positive antiphospholipid antibodies was not significantly different between cases and controls (43%, 40%, p = 0.8). The frequency (percentage) of anti-cardiolipin antibody was also not significant between the groups (38%, 37%, p = 0.57). Serositis and leucopenia were more prevalent in SLE patients with myocardial dysfunction (p = 0.005). This study did not find any significant association of anti-phospholipid antibodies with overt myocardial dysfunction in patients of SLE.

Helicobacter pylori CagA seropositivity in adult Bangladeshi patients with peptic ulcer and erosion

Background: CagA IgG antibody in sera might indicate presence of virulent Helicobacter pylori in patients with peptic ulcer disease. Present study was performed to find out the prevalence of CagA IgG antibody in patients with peptic ulcer/erosion.&#x0D; Methods: Any case that had peptic ulcer/erosion, plus positive for rapid urease test (RUT) or H. pylori stool antigen (HpSAg) or serum anti-H. pylori IgG/IgA were included in the study and named as H. pylori positive case. H. pylori positive cases were tested for CagA IgG antibody. Anti-H. pylori IgG, IgA and CagA IgG antibodies were determined by enzyme-linked immunosorbent assay (ELISA) and stool antigen by rapid immunochromatographic test (ICT). Urease production in biopsy sample was detected by RUT.&#x0D; Results: Total 86 H. pylori positive patients were included in the study. Out of 86 patients, CagA IgG was positive in 34 (39.5%; 95% CI: 0.30,0.50) cases. CagA seropositivity rate in ulcer and erosion cases were 58.8% (95% CI: 0.36,0.78) and 34.8% (95% CI: 0.25,0.47) respectively. H. pylori stool antigen and IgA antibodies were positive in all (100%) CagA antibody positive ulcer cases while the rates were significantly less among the CagA antibody negative cases (42.8% and 28.6%; p&lt;0.05). However, in CagA antibody positive erosion cases, the rates were not significantly different from CagA antibody negative cases.&#x0D; Conclusion: The study has demonstrated that the CagA positive strain is less prevalent in erosion than ulcer cases.&#x0D; Ibrahim Med. Coll. J. 2020; 14(1): 36-40

A Pilot Study on the Effect of Anti-Thrombopoietin Antibody on Platelet Count in Patients with Type 2 Diabetes.

Thrombopoietin (THPO) is a circulatory cytokine that plays an important role in platelet production. The presence of anti-THPO antibody relates to thrombocytopenia and is rarely seen in hematopoietic and autoimmune diseases. To date, there had been no reports that focused on the anti-THPO antibody in patients with type 2 diabetes mellitus (T2DM). To evaluate prevalence of the anti-THPO antibody in patients with T2DM and the relationship between anti-THPO antibody and platelet count, a cross-sectional study was performed on 82 patients with T2DM. The anti-THPO antibody was measured by ELISA using preserved sera and detected in 13 patients. The average platelet count was significantly lower in patients with the anti-THPO antibody than in those without the anti-THPO antibody. Multivariate linear regression analyses showed a significant relationship between the anti-THPO antibody and platelet count, after adjusting for other variables. To our best knowledge, this was the first report on the effect of the anti-THPO antibody on platelet count in patients with T2DM. Further investigation is needed to validate the prevalence and pathological significance of the anti-THPO antibody in patients with T2DM.

P175 Prevalence of non-HLA antibodies in patients with autoimmune diseases

P175 Prevalence of non-HLA antibodies in patients with autoimmune diseases

Recurrence of measles in central Italy: the experience of a hospital in Rome

Measles continue to be a major public health issue worldwide with high morbidity and mortality rates. The disease is still endemic in Europe and during 2017 a vast outbreak was described in Italy, Romania and Hungary, which led to thousands of new cases and several deaths. In Italy, 3931 confirmed cases of measles were reported to the Italian national surveillance system from many Italian administrative regions; Lazio, in central Italy, exhibited the highest number of infected patients 1322 (33.63%) and as well as the highest incidence. In this study, we describe the results of a retrospective analysis, carried out during 2016 and 2017, concerning the measles antibody prevalence in patients and healthcare workers attending the Sant’Andrea Hospital of Rome (Lazio). A total of 94 patients (median 30 years of age) were screened in 2016, and 316 (median 40 years of age) during 2017, with an increase of 236% compared to previous year. During 2017, 41 confirmed cases of measles were reported while none in 2016 (P&lt;0.007), and we found a suboptimal immunization coverage in our cohort of patients. Furthermore, measles surveillance of Sant’Andrea healthcare workers during the study period involved 208 personnel units (median &gt;47 years of age) and only one confirmed measles infection was recorded in 2017. These results suggest that there is still an unvaccinated portion of the adult population, who sustain the endemic circulation of measles in Italy. In addition to reach herd immunization on children of 2 years old, catch-up vaccination campaign targeting adult population in Italy and other European countries needs to be implemented to prevent future measles outbreak.

38. DO NMDAR ANTIBODIES CAUSE SCHIZOPHRENIA?

Overall : NMDAR antibodies have been described in association with some people with schizophrenia. However the finding is still controversial, and in particular some groups describe equal prevalence of antibodies in patients with schizophrenia as other disease controls, or in healthy control subjects. this symposium includes the leading academics undertaking research in this area and will discuss the hot topics in the area, reviewing the latest evidence from a range of perspectives. This will include comparison of testing methods for NMDAR antibodies, discussion of functional effects of NMDAR antibodies with relevance to schizophrenia, an update on prevalence studies of antibodies in psychosis and at risk mental states, and clinical data on the experience of screening patients for NMDAR antibodies in psychiatric hospitals. The discussant is Sarosh Irani, associate professor in neurology at the University of Oxford, who led the first European case series description of NMDAR antibodies.

124 Prevalence of coeliac antibodies in patients with primary Sjögrens syndrome

124 Prevalence of coeliac antibodies in patients with primary Sjögrens syndrome

What is the significance of onconeural antibodies for psychiatric symptomatology? A systematic review

BackgroundPatients with intracellular onconeural antibodies may present with neuro-psychiatric syndromes. We aimed to evaluate the evidence for an association between well-characterized onconeural antibodies and psychiatric symptoms in patients with and without paraneoplastic central nervous system syndromes.MethodsEligible studies were selected from 1980 until February 2017 according to standardized review criteria and evaluated using Quality Assessment of Diagnostic Accuracy Studies−2 (QUADAS-2). We included studies describing the psychiatric symptomatology of onconeural antibody positive patients and the prevalence of onconeural antibodies in patients with psychiatric disorders.ResultsTwenty-seven studies met the inclusion criteria. Six studies reported on the prevalence of well-characterized onconeural antibodies in patients with different psychiatric disorders, ranging from 0% to 4.9%. Antibody prevalence in controls was available from three studies, ranging from 0% to 2.8%. Data heterogeneity precluded a meta-analysis. Two cerebrospinal fluid studies found well-characterized onconeural antibodies in 3.5% and 0% of patients with psychotic and depressive syndromes, respectively.ConclusionsThe available evidence suggests that the prevalence of well-characterized onconeural antibodies in patients with psychiatric disorders is generally low. However, the question whether onconeural antibodies are important in select patients with a purely psychiatric phenotype needs to be addressed by appropriately designed studies in the future.

Ganglionic acetylcholine receptor autoantibodies in patients with autoimmune diseases including primary biliary cirrhosis

Objectives: Autonomic dysfunction is closely associated with autoimmune diseases (AID) including primary biliary cirrhosis (PBC). The objective of this study was to determine the prevalence of anti-ganglionic (nicotinic) acetylcholine receptor (gAChR) antibodies in patients with AID.Methods: We determined the presence of gAChR antibodies in serum samples from 146 patients (systemic lupus erythematosus [SLE] = 32; rheumatoid arthritis [RA] = 43; systemic sclerosis [SSc] = 38; PBC= 33) without information regarding autonomic symptoms, as well as 34 patients with other neurological diseases [OND], and 73 healthy controls [HC]. We specifically analyzed sera for anti-gAChRα3 and -β4 antibodies using the luciferase immunoprecipitation system (LIPS) assay.Results: LIPS assay detected anti-gAChRα3 and -β4 antibodies in the sera from patients with SLE (12.5%, 4/32), RA (18.6%, 8/43), SSc (13.2%, 5/38), PBC (9.1%, 3/33), OND (2.9%, 1/34), and HC (0.0%, 1/73). There were no significant correlations between the levels of anti-gAChRα3 and -β4 antibodies, and the total titers of autoantibodies in AID.Conclusions: The results demonstrated a significant prevalence of anti-gAChR antibodies in patients with AID, which is independent of the production of other autoantibodies in patients with autoimmune diseases. These anti-gAChR antibodies could mediate the autonomic dysfunction involved in the autoimmune mechanisms of AID.

Anti-JC virus seroprevalence in a Finnish MS cohort.

The risk of progressive multifocal leukoencephalopathy (PML) caused by the JC virus (JCV) is increased in patients with multiple sclerosis receiving biological therapies. To determine the seroprevalence of anti-JCV antibodies in Finnish patients with multiple sclerosis (MS) and clinically isolated syndrome and to assess the clinical risk factors for JCV seropositivity. The JCV seroprevalence was analyzed in 503 patients using a second-generation two-step ELISA. Sixty-seven patients underwent longitudinal serological evaluation over 4.5 years. The overall seroprevalence of JCV was 57.4%. The seropositivity was higher in men than in women, tended to increase with age, and was not affected by different immunomodulatory therapies. However, in patients with ongoing natalizumab treatment (n = 72), the anti-JCV antibody screening index was lower than in patients without such therapy [median 0.3 (range 0.1-3.1) vs 0.6 (0.1-3.1), respectively, P = 0.01]. Over 4.5 years, 4/19 (21%) initially seronegative patients converted to seropositivity, whereas 4/48 (8.3%) initially seropositive patients reverted to seronegativity. Fluctuations in serostatus were observed in 3/67 patients. The study confirmed a high anti-JCV antibody prevalence in patients with MS and its association with age and male gender but not with disease-modifying therapies. Our data suggest that therapy with natalizumab may cause a decrease in anti-JCV antibody levels, suggesting an immunosuppressive effect of natalizumab without an impact on JCV seroprevalence. The results of studies performed until now confirm the predictive value of anti-JCV antibody measurement in the assessment of PML risk; however, changes in serostatus need to be considered.

Prevalence of HLA-DP antibodies in patients awaiting renal transplantation

Aim To determine the prevalence of HLA-DP IgG antibodies in patients on Renal Transplant waitlist at Rush University Medical Center, Chicago, IL. Introduction: Role of HLA-DP antibodies in solid organ and stem cell transplantation is evolving. Isolated reports on possible involvement of only HLA-DP DSA in acute rejection episodes (cases where the Donor/Recipient pairs are matched at HLA-Class , DR and DQ)] show the importance of this issue. In the light of HLA molecular typing and antigen specific HLA antibody assays there is an opportunity to evaluate the role of HLA-DP in allograft rejection. As part of this goal we investigated the prevalence of DP antibodies in our renal transplant candidates. Patients: A total of 532 patients with multiple serum samples tested. Methods HLA-specific antibodies were determined by solid phase assay (One Lambda, Inc. ®). HLA- specific antibody was scored as strong, moderate, or weak depending on their mean fluorescent index (MFI) value of > 5000, 2000–5000, 700–2000, respectively. Results Of the 532 patients, 143 (26.9%) had antibodies against Class II HLA-DP. The number of specific HLA-DP antibodies per patient ranged from 1 to 17 antibodies (Strong, Moderate, Weak), but could also be found entirely in one category as in the case with one patient in which all 16 of the anti-DP antibodies were in the strong MFI category. Conclusions Quarter of renal transplant candidates on waiting at Rush University Medical center have detectable HLA-DP antibodies with varying MFIs. While 36.5% of those antibodies express a low MFI, 31.4% of the patients had strong MFI. Multiple case studies from various centers have shown that transplant patients perfectly matched per UNOS requirements to their donor may still have antibody mediated rejection due to a mismatched at HLA-DP. Hence donor typing for HLA-DP and monitoring of patients for HLA-DP antibodies seems to be important

Natalizumab discontinuation in the increasing complexity of multiple sclerosis therapy

The infusion of 300 mg of natalizumab every 4 weeks is an effective therapy for reducing disease activity in relapsing-remitting multiple sclerosis (MS).1,2 Its use is limited, however, by the risk of progressive multifocal leukoencephalopathy (PML), which increases after 2 years of therapy in JC virus (JCV) antibody–positive patients3: the incidence of PML in these patients is between 1/85 and 1/454, with the higher frequency in those with previous use of immunosuppressant drugs.4 Therefore, discontinuation of natalizumab therapy after the second year is recommended to minimize the risk of PML, particularly in JCV antibody–positive patients. The prevalence of JCV antibodies in patients with MS who start natalizumab therapy is high (around 54%5), making discontinuation of therapy a relevant issue for a large number of patients.

176 Prevalence of autoimmune antibodies in patients with cystic fibrosis after lung transplantation

176 Prevalence of autoimmune antibodies in patients with cystic fibrosis after lung transplantation