Disease Serological Markers Research Articles

Peroxidasin Is a Novel Target of Autoantibodies in Lupus Nephritis

Peroxidasin Is a Novel Target of Autoantibodies in Lupus Nephritis

Prevalence of celiac disease serological markers in a cohort of Italian rheumatological patients.

To assess the prevalence of celiac disease (CD) serological markers in a cohort of patients referred to an Italian rheumatological outpatient clinic. Current guidelines do not suggest CD screening in patients with rheumatological diseases and these subjects are not considered to be at high risk for CD. A total of 230 sera of rheumatological patients referred to the Division of Internal Medicine at the Department of Medical and Surgical Sciences between January 2005 and December 2013 were screened for CD by testing IgA antitransglutaminase (TTG IgA), IgG deamidated gliadin peptides (DGP IgG) and IgA antiendomysium (EMA) antibodies. Of the 230 patients tested, 67 had a diagnosis of rheumatoid arthritis (RA), 52 Sjögren's syndrome (SjS), 42 systemic sclerosis (SCL), 35 systemic lupus erythematosus (SLE), 15 mixed connective tissue disease, 11 polymyositis and 10 dermatomyositis. TTG IgA antibodies were identified in 7/230 cases (3%), 3 in SjS (3/42 - 5.8%), 2 in SCL (2/42 - 4.8%), 1 in RA (1/67 - 1.5%) and 1 in SLE sera (1/35 - 2.8%). All the seven sera were also positive for DGP IgG and EMA IgA. DGP IgG were the most frequent antibody detected, being found in 16 (7%) sera. This study identified a high prevalence of CD antibodies in adult patients referred to a rheumatology outpatient clinic. These results highlight the importance of CD screening in subjects presenting with rheumatological features.

Big differences in primary care celiac disease serological markers request in Spain.

IntroductionCeliac disease (CD) prevalence is increasing but the disorder remains undiagnosed. The study compares CD serology markers requested by General Practitioners (GPs) over time and geographical areas. The aim of the current research is to assess the inter-practice and temporal variability in the request of CD serology markers by GPs in Spain, and the differences between regions.Materials and methodsA cross-sectional study was conducted enrolling Spanish clinical laboratories. Primary care CD serology markers request in 2010, 2012 and 2014 from 15 autonomous communities (AACC), with more participants was reported. Test-utilization rates were calculated (tissue transglutaminase IgA antibodies (tTG-IgA) and deaminated peptide gliadine IgA antibodies (DGP-IgA) per 1000 inhabitants), and also the ratio of both tests request (DGP-IgA /tTG-IgA).ResultsThe request of tTG-IgA per 1000 inhabitants increased significantly along years (from 3.99 to 5.90 (P < 0.001)). The demand of DGP-IgA per 1000 inhabitants was maintained in 2010 and 2012 (0.68 and 0.6), and decreased in 2014 (0.35) (P = 0.927). DGP-IgA /tTG-IgA diminished over time (from 0.16 to 0.06 (P = 0.548)), and in the 2014 edition, there was a significant regional difference, ranging from 0.01 to 0.57 (P < 0.001).ConclusionsThe variability in the request in CD serology markers emphasizes the need of inter-regional cooperation to develop strategies to optimize the use of laboratory tests.

Evaluation of coeliac disease serological markers

Background: celiac disease, is an autoimmune inflammatory disease of the small intestine that is precipitated by the ingestion of gluten, a component of wheat protein, in genetically susceptible persons. Serologic tests for antibodies against Endomysium, Reticulin, and Gliadin identify most patients with the disease. Early diagnosis and management are important to forestall serious consequences of malabsorption, such as osteoporosis and anemiaAims of the study: This study compared the sensitivity, specificity, and predictive value of, anti-reticulin and anti-gliadin antibodies according to anti endomysium antibodies , in consecutive patients investigated for celiac disease antibodies.Patient&amp; Methods: Total 509 patients (236 males&amp;273 females) celiac disease patients who were referred to the immunology department in Teaching labs from January till December 2012 for serological detection of auto antibodies . Anti- Gliadin (IgG &amp;IgA ) were measured by Enzyme Linked Immunosorbent Assay. whereas Anti-Endomyseal IgA &amp; Anti-Reticulin IgA were detected by Indirect immunofluorescent technique on monkey oesophagus &amp; kidney tissue respectively.Results: Most the cases for celiac disease were reported in the age group (1-10)years as antibodies against Gliadin (IgG,IgA) ,Anti-Endomesial IgA antibodies and anti-Reticulin IgA were detected in 130(66.7%),127(65.8%),39(79.6%) and 49(68.1%) respectively. Both anti-Gliadin IgA and anti Reticulin were detected significantly in females p values( 0.047, 0.008) respectively. The study showed that anti-Gliadin IgA is the most sensitive according to anti Endomyseal IgA and anti Reticulin was the most specific for screening of celiac disease. ; While Receiver Operating Characteristic (ROC) curve showed that anti gliadin IgA had the best sensitivity and specificity according to anti Endomysium test results.Conclusion: Predictive performance of the serological celiac disease tests showed that anti Gliadin IgA had the best sensitivity &amp;specificity according to traditional anti Endomysium antibody test results.

تقيم المعلمات المناعية لحساسية الحنطة

الخلاصة: مرض حساسية الحنطة مرض التهاب المناعة الذاتية في الأمعاء الدقيقة بسبب تناول الغلوتين، وهو مكون من بروتين القمح، في الأشخاص الذين لديهم استعداد وراثي. اختبارات مصلية عن الأجسام المضادة ضد&nbsp; الاندوميسيم .الرتيكولين والغليادين&nbsp; لتحديد المرضى الذين يعانون من هذا المرض. حيث ان التشخيص والعلاج المبكر للمرض يمنع العواقب الوخيمة لسوء الامتصاص، مثل هشاشة العظام وفقر الدم. هدف الدراسة: قارنت هذه الدراسة الحساسية، والنوعية، والقيمة التنبؤية الأجسام المضادة لكل من الرتيكولين والغليادين وفقا للأجسام المضادة&nbsp; للاندوميسيم&nbsp; للمصابين بحساسية الحنطة.&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; المرضى وطرق العمل: تناولت الدراسة 509 مريضا من المصابين بمرض (حساسية الحنطة) والمحالين&nbsp; لقسم لشعبة المناعة السريرية المختبرات التعليمية/ مدينة الطب للفترة من (كانون الثاني ولغاية كانون الاول) لعام 2012.حيث اجريت لهم الفحوص المناعية للتحري عن الاجسام المضادة للغليادين بطريقة الامتزاز المناعي وللاجسام المضادة للريتيكولين وللاندوميسيم بطريقة المجهر الوامض. النتائج: معظم الحالات لمرضى حساسية الحنطة كانت ضمن الفئة العمرية (1-10) سنوات. حيث بلغت الأجسام المضادة ضد الكليادين نوع&nbsp;&nbsp; &nbsp;IgG &amp;IgA ) &nbsp;&nbsp;) , الاندوميسيم IgA,&nbsp; والرتيكولين 130(66,7%)&nbsp; IgA و127(65,8%) و39(79,6%) و49(68,1%) على التوالي.وجدت الاجسام المضادة للغليادين( (IgA والرتيكولين&nbsp; نوع ( IgA ) &nbsp;اكثر لدى النساء وبقيم معنوية(0.047و0,008)على التوالي .وجدت الدراسة ان الاجسام المضادة للغليادين نوع (( IgA كانت الاكثر حساسية وكانت الاجسام المضادة للريتيكولين ( IgA) الاكثر تحديدا لفحص مرضى حساسية الحنطة وفقاللاجسام المضادة للاندوميسيم(( IgA .اظهرت نتائج اختبار ان الاجسام المضادة للغليادين نوع (( IgA هي الاكثر حساسية وتحديدا للاصابة بمرض حساسية الحنطة وفقا للاجسام المضادة للاندوميسيم. الاستنتاج: )اظهر الاداء التنبؤي للاختبارات المناعية لمرضى حساسية الحنطة ان الاجسام المضادة للغليادين نوع IgA ) الافضل في تحديد الاصابة بمرض حساسية الحنطة مقارنة بنتائج الاجسن المضادة التقليدية للانوميسيم

Imaging Metal-on-Metal Hip Replacements: the Norwich Experience

BackgroundAdverse reaction to metal debris is a relatively recently described and often a silent complication of metal-on-metal (MOM) total hip replacements (THR). The Norfolk & Norwich University Hospital has been performing metal artefact reduction (MARS) MRI for 8 years in a variety of different types of MOM THR.Questions/purposesThe aims of this review are to describe the experience of using MARS MRI in Norwich and to compare our experience with that published by other groups.MethodsA MEDLINE keyword search was performed for studies including MRI in MOM THR. Relevant publications were reviewed and compared with published data from the Norfolk & Norwich University Hospital. The similarities and differences between these data were compared and possible explanations for these discussed.ResultsMARS MRI appears to be the most useful tool for diagnosing, staging and monitoring adverse reactions to metal debris (ARMD). There appears to be no clinically useful association between clinical and serological markers of disease and the severity of MR findings. Although severe early ARMD is associated with significant morbidity, mild disease is often stable for years. If patients with normal initial MR examinations develop ARMD, this usually occurs 7 years. A 1-year interval between MRI examinations is reasonable in asymptomatic patients.ConclusionsThere is a general international consensus that ARMD is prevalent in symptomatic and asymptomatic patients with MOM THR and that while appearances vary with the type of prosthesis, there are characteristic features that make MARS MRI essential for diagnosis, staging and surveillance of the disease.Electronic supplementary materialThe online version of this article (doi:10.1007/s11420-013-9357-5) contains supplementary material, which is available to authorized users.

AB0736 Myositis specific autoantibodies (msa) and myositis associated autoantibodies (maa). experience in a spanish cohort.

BackgroundIt has been suggested that MSA have a role in distinguishing subsets of IIM. Clinico-serological classifications have been proposed highlighting the importance of identifying the antibody profile.ObjectivesDescribe the prevalence of...

Multiplexed electrochemical immunosensor for detection of celiac disease serological markers

Celiac disease (CD) is a gluten-induced autoimmune enteropathy characterized by the presence of antibodies against gliadin (AGA) and anti-tissue transglutaminase (anti-tTG) antibodies. A disposable electrochemical dual immunosensor for the simultaneous detection of IgA and IgG type AGA and anti-tTG antibodies in real patient's samples is presented. The proposed immunosensor is based on a dual screen-printed carbon electrode, with two working electrodes, nanostructured with a carbon–metal hybrid system that worked as the transducer surface. The immunosensing strategy consisted of the immobilization of gliadin and tTG (i.e. CD specific antigens) on the nanostructured electrode surface. The electrochemical detection of the human antibodies present in the assayed serum samples was carried out through the antigen–antibody interaction and recorded using alkaline phosphatase labelled anti-human antibodies and a mixture of 3-indoxyl phosphate with silver ions was used as the substrate. The analytical signal was based on the anodic redissolution of enzymatically generated silver by cyclic voltammetry. The results obtained were corroborated with commercial ELISA kits indicating that the developed sensor can be a good alternative to the traditional methods allowing a decentralization of the analyses towards a point-of-care strategy.

Have Genomic Discoveries in Inflammatory Bowel Disease Translated into Clinical Progress?

Inflammatory bowel disease (IBD) is a heterogeneous disease that can be challenging to diagnose and manage. As a result, significant efforts have been made in attempting to identify clinical, genomic, and serologic markers of disease that can aid in patient assessment and treatment. Recent genomic discoveries have the potential to change clinical practice by identifying those susceptible to IBD, predict natural history and guide choice of therapy. Panels of genetic and genomic markers are more likely to emerge as clinical tools, as opposed to individual allelic variants. Serology and biomarkers are already being used and guiding management but await integration with genomic panels before achieving their maximal potential. This article reviews the current state of IBD genetics and evolving molecular approaches that may have potential clinical impact.

Hepatitis B in Children

1. Adam R. Davis, MD* 2. Philip Rosenthal, MD† 1. *Clinical Fellow, Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of California, San Francisco, Calif 2. †Professor of Pediatrics and Surgery; Medical Director, Pediatric Liver Transplant Program; Director, Pediatric Hepatology, University of California, San Francisco, Calif After completing this article, readers should be able to: 1. Describe the structure of the hepatitis B virus and the function of its proteins. 2. Delineate the mode of transmission of the virus and identify at-risk populations. 3. Interpret the results of screening laboratory tests for hepatitis B. 4. Describe the various disease presentations and the natural history and complications of chronic hepatitis B infection. 5. List the currently approved therapies for hepatitis B and identify when patients are most likely to benefit from intervention. 6. List the current recommendations for immunoprophylaxis in infants, children, and adolescents. One third of the world's population has been infected by the hepatitis B virus (HBV), causing an enormous worldwide burden of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Although the virus can infect people of any age, those who are infected perinatally or as children are at greatest risk for developing the potentially fatal complications of the infection. Approval of the hepatitis B vaccine in 1982 has been the most important development in the clinical approach to this virus, changing the major goal from treatment to prevention. In this article, we review the nature of the virus, its epidemiology, serologic markers of disease, clinical manifestations of infection, the prevention of transmission, and current treatments. HBV is a member of the hepadnavirus family, which is named for its hepatotropic nature and its double DNA genome. It is the only member of the family that causes disease in humans. The virion has two forms: an empty envelope that does not have the potential to infect or replicate and a complete virion. The complete virion is comprised of an envelope containing the capsid, a DNA polymerase, and the viral DNA (Figure⇓). The DNA is 3.2 kilobases long and circular. Hepadnaviruses are unique among DNA viruses in that they are partially double-stranded and …

The High False Positive Rate of Inflammatory Bowel Disease Serologic Markers in Patients with Irritable Bowel Syndrome

The High False Positive Rate of Inflammatory Bowel Disease Serologic Markers in Patients with Irritable Bowel Syndrome

Clinical and serological follow-up studies of endemic pemphigus foliaceus (fogo selvagem) in Western Parana, Brazil (2001-2002)

Fogo selvagem (FS) has been described in several regions of Brazil, including the Western regions of the state of Parana. In 1990, Empinotti et al. reported case studies of 213 patients with FS that were collected from 1976 to 1988. The same author (J.C.E.) has observed that the frequency of cases in these regions of Parana has decreased. The purpose of this study was to clinically and serologically evaluate a small group of the patients originally reported in 1990 and compare data with a group of control individuals. These patients were treated at the onset of the disease with systemic steroids. Patients with FS, their unaffected relatives (n = 80) and genetically unrelated controls (n = 15) were identified during a field study from 1 May 2001 to 30 June 2002. Sera from nine patients with FS and six normal controls that were collected in the 1976-1988 evaluation were available for this study. The sera were tested by indirect immunofluorescence, enzyme-linked immunosorbent assay (ELISA) and immunoprecipitation using recombinant human desmoglein 1 (Dsg1). Only 16 of the originally identified 213 patients with FS were found during the field studies. Thirteen of the 16 patients were in clinical and serological remission; 20% of normal controls (19 of 95) were positive in the Dsg1 ELISA. The majority of these subjects (17 of 19) were genetically related to FS patients. Six normal controls that were positive in the Dsg1 ELISA in the original survey were found to be negative or weakly positive in this evaluation. The reduced frequency of positive serological markers of disease in patients and normal controls from Western Parana, as well as the absence of recurrent disease in previously identified patients, suggest that environmental antigenic stimulation of the population at risk may have decreased in recent years.

Levels of serologic markers of celiac disease in patients with reflux esophagitis

To investigate the prevalence of celiac disease serologic markers (antigliadin IgA, IgG, and anti-endomysial IgA) in patients with reflux esophagitis and to detect the relationship between reflux esophagitis and celiac disease (CD). This study was performed prospectively between January 2003 and January 2004. Sixty-eight adult reflux esophagitis patients and 40 people as control group for symptoms related with gastrointestinal system were enrolled in this study. The diagnostic work-up included an accurate medical history with gastrointestinal symptoms, routine laboratory measurements, the detection of antibodies against gliadin (IgA and IgG) and endomysium (IgA), and an upper endoscopy with postbulbar biopsy. IgA-AGA and IgG-AGA were positive at 8.8% and 10.3% in patients with reflux esophagitis. In control group, it was found that 10% people had positive IgA-AGA, and 7.5% people had positive IgG-AGA. There was no significant relationship between patients and control group regarding positive IgA-AGA and IgG-AGA. The patients and persons in control group had no positive IgA-EMA. On postbulbar biopsies, no finding was detected concerning celiac disease. There were no symptoms and signs for gluten enteropathy in patients and control group. This review supports that an association does not exist between celiac disease and reflux esophagitis. We think these diseases exist independently from each other.

Ped-1. Evaluation of Celiac Disease Serologic Markers in Pediatric Patients with Type 1 Diabetes Mellitus

ped-1. Evaluation of Celiac Disease Serologic Markers in Pediatric Patients with Type 1 Diabetes Mellitus

Evaluation of coeliac disease serological markers in Down syndrome patients

Background. The increased incidence of coeliac disease in patients with Down syndrome makes screening of coeliac disease in this population advisable. Aim. Evaluation of efficiency of different serological markers to detect coeliac disease in Down syndrome patients. Patients. A total of 56 Down syndrome patients (aged: 1–17 years) were included in study. Methods. Patients were evaluated for both IgG and IgA anti-transglutaminase antibodies and for anti-gliadin IgA and IgG antibodies using either purified ω-gliadin, wheat ethanol extract or commercial gliadin. Patients who had at least one positive result were evaluated for anti-endomysium antibodies using either monkey oesophagus or human umbilical cord by indirect immunofluorescence. Coeliac disease was diagnosed by typical histological changes on duodenal mucosa. Results. Increased levels of at least one anti-gliadin IgA and IgG antibody marker were found in 27 out of 56 cases (26 for IgG and 9 for IgA). 11 56 were positive for IgG anti-transglutaminase antibodies and two of them were also positive for IgA anti-transglutaminase antibodies and anti-endomysium antibodies. These two patients were finally diagnosed as coeliacs. Gliadin antigenic fractions employed produced differences in the performance of the anti-gliadin IgA and IgG antibody test. The use of commercial gliadin or wheat ethanol extract showed low sensitivity in IgA anti-gliadin IgA and IgG antibody determination, whereas good sensitivity and specificity were observed with ω-gliadins. IgG anti-transglutaminase antibodies showed a high proportion of false positive results (9 out of 56), whereas anti-endomysium antibodies and IgA anti-transglutaminase antibodies presented an excellent correlation with presence of active coeliac disease. Conclusions. Two out of 56 Down syndrome patients were diagnosed as coeliacs, corresponding to an incidence of 3.6%. The use of ω-gliadin presented the best efficiency in anti-gliadin IgA and IgG antibody determination whereas IgA anti-transglutaminase antibodies and anti-endomysium antibody determination showed an absolute correlation with presence of active coeliac disease.

Serological Markers and Celiac Disease

We analyze the diagnostic efficacy of two celiac disease serological markers: anti-gliadin (IgA and IgG class) and anti-endomysium IgA-class (EmA-IgA) antibodies applied to 336 serum samples from celiac patients on both gluten-challenge and gluten-free diets, and a control group. The anti-gliadin and anti-endomysium antibodies levels were significantly higher among the gluten-consuming celiac patients than in the other groups. The greatest efficacy in diagnosing celiac disease was achieved in the Ema-IgA class test. The IgA-class anti-gliadin antibodies proved to be more specific, with a higher positive test predictive value than the IgG-class anti-gliadin antibodies, whereas the latter proved to be more sensitive, with a higher negative test predictive value than those of the IgA-class anti-gliadin antibodies. Our results also demonstrate that the simultaneous assessment of anti-gliadin IgA- and IgG-class antibodies constitutes a valid test in selecting patients suspected of having celiac disease. In turn the EmA-IgA antibodies constitute a confirmative test for indication of an intestinal biopsy.

Serological Markers and Celiac Disease

SummaryWe analyze the diagnostic efficacy of two celiac disease serological markers: anti‐gliadin (IgA and IgG class) and anti‐endomysium IgA‐class (EmA‐IgA) antibodies applied to 336 serum samples from celiac patients on both gluten‐challenge and gluten‐free diets, and a control group. The anti‐gliadin and anti‐endomysium antibodies levels were significantly higher among the gluten‐consuming celiac patients than in the other groups. The greatest efficacy in diagnosing celiac disease was achieved in the Ema‐IgA class test. The IgA‐class anti‐gliadin antibodies proved to be more specific, with a higher positive test predictive value than the IgG‐class anti‐gliadin antibodies, whereas the latter proved to be more sensitive, with a higher negative test predictive value than those of the IgA‐class anti‐gliadin antibodies. Our results also demonstrate that the simultaneous assessment of anti‐gliadin IgA‐ and IgG‐class antibodies constitutes a valid test in selecting patients suspected of having celiac disease. In turn the EmA‐IgA antibodies constitute a confirmative test for indication of an intestinal biopsy.