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Significance of Anti-TPO as an Early Predictive Marker in Thyroid Disease 抗tpo作为甲状腺疾病早期预测指标的意义

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2019-07-28 DOI: 10.1155/2019/1684074

Thushani Siriwardhane, K. Krishna, Vinodh Ranganathan, V. Jayaraman, Tianhao Wang, K. Bei, S. Ashman, Karenah E. Rajasekaran, J. Rajasekaran, H. Krishnamurthy

Even though most thyroid subjects are undiagnosed due to nonspecific symptoms, universal screening for thyroid disease is not recommended for the general population. In this study, our motive is to showcase the early appearance of thyroid autoantibody, anti-TPO, prior to the onset of thyroid hormone disruption; hence the addition of anti-TPO in conjunction with traditional thyroid markers TSH and FT4 would aid to reduce the long-term morbidity and associated health concerns. Here, a total of 4581 subjects were tested multiple times for TSH, FT4, anti-TPO, and anti-Tg and followed up for 2 years. We streamlined our subjects into two groups, A1 (euthyroid at first visit, but converted to subclinical/overt hypothyroidism in follow-up visits) and A2 (euthyroid at first visit, but converted to hyperthyroidism in follow-up visits). According to our results, 73% of hypothyroid subjects (from group A1) and 68.6% of hyperthyroid subjects (from group A2) had anti-TPO 252 (±33) and 277 (±151) days prior to the onset of the thyroid dysfunction, respectively. Both subclinical/overt hypothyroidism and hyperthyroidism showed a significantly higher percentage of subjects who had anti-TPO prior to the onset of thyroid dysfunction compared to the combined control group. However, there was no significant difference in the subjects who had anti-Tg earlier than the control group. Further assessment showed that only anti-TPO could be used as a standalone marker but not anti-Tg. Our results showcase that anti-TPO appear prior to the onset of thyroid hormone dysfunction; hence testing anti-TPO in conjunction with TSH would greatly aid to identify potentially risk individuals and prevent long-term morbidity.

尽管大多数甲状腺患者由于非特异性症状而未被诊断，但不建议对普通人群进行甲状腺疾病的普遍筛查。在这项研究中，我们的目的是展示甲状腺自身抗体抗tpo的早期出现，在甲状腺激素紊乱发作之前;因此，加入抗tpo与传统甲状腺标志物TSH和FT4将有助于减少长期发病率和相关的健康问题。本研究共对4581名受试者进行了多次TSH、FT4、抗tpo和抗tg检测，随访2年。我们将受试者分为两组，A1(首次就诊时甲状腺功能正常，但在随访中转为亚临床/显性甲状腺功能减退)和A2(首次就诊时甲状腺功能正常，但在随访中转为甲状腺功能亢进)。根据我们的研究结果，73%的甲状腺功能减退患者(A1组)和68.6%的甲状腺功能亢进患者(A2组)在甲状腺功能障碍发病前分别有252(±33)天和277(±151)天的抗tpo抗体。与联合对照组相比，亚临床/显性甲状腺功能减退和甲状腺功能亢进患者在甲状腺功能障碍发病前进行抗tpo治疗的比例明显更高。然而，早于对照组的抗tg组与对照组无显著性差异。进一步的评估表明，只有抗tpo可以作为独立的标志物，而抗tg不能。我们的研究结果表明，抗tpo出现在甲状腺激素功能障碍的发病之前;因此，结合TSH检测抗tpo将极大地有助于识别潜在风险个体并预防长期发病。

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引用次数: 32

Galectin-1, -4, and -7 Were Associated with High Activity of Disease in Patients with Rheumatoid Arthritis 半乳糖凝集素-1、-4和-7与类风湿关节炎患者疾病高活性相关

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2019-07-22 DOI: 10.1155/2019/3081621

K. M. Vilar, M. Pereira, A. Dantas, M. Rêgo, I. Pitta, C. Marques, R. Gonçalves, Laurindo Ferreira da Rocha Júnior, A. Duarte, M. Pitta

Background Due to the variety of functions that galectins (Gal) possess, it is clear that they participate in the pathogenesis of rheumatoid arthritis (RA). Although some studies demonstrate their functions, there is still no correlation with the clinical data of the disease, having the physiological meaning still unknown. Objectives To compare serum levels of Gal-1, -4, and -7 in patients with RA and healthy controls and to correlate them with clinical parameters. Methods Serum samples were collected from patients with RA and healthy donors to determine the serum levels of Gal-1, -4, and -7. Results Serum levels of Gal-1, -4, and -7 were significantly higher in RA patients compared to controls. We evaluated disease activity (CDAI) with serum levels of galectins and found that patients who were high in disease activity had high levels of galectin compared to the moderate activity group. Galectin-4 had higher levels in patients who were in high activity when compared to the group in remission or low activity. Evaluating the activity of the individual disease (DAS28), patients in high individual activity had high levels of Gal-4 when compared to the group in remission or low activity. We also found an association between positive rheumatoid factor and Gal-1 and Gal-4 levels. Conclusion Our results show for the first time the relationship between serum levels of galectin and the clinical parameters of patients with RA. Demonstrating their role in pathogenesis, new studies with galectins are needed to assess how they function as a biomarker in RA.

由于半凝集素(galectin, Gal)具有多种功能，很明显它们参与了类风湿关节炎(RA)的发病机制。虽有研究证实其功能，但仍与本病的临床资料无相关性，其生理意义尚不清楚。目的比较类风湿关节炎患者和健康对照者血清Gal-1、-4和-7的水平，并探讨其与临床参数的相关性。方法采集RA患者和健康供者血清，测定血清中Gal-1、-4、-7的水平。结果RA患者血清Gal-1、-4和-7水平明显高于对照组。我们用血清半乳糖凝集素水平评估疾病活动性(CDAI)，发现与中度活动组相比，疾病活动性高的患者具有高水平的半乳糖凝集素。高活动期患者的半乳糖凝集素-4水平高于缓解期或低活动期患者。评估个体疾病的活动性(DAS28)，与缓解或低活动性组相比，高个体活动性患者具有高水平的Gal-4。我们还发现类风湿因子阳性与Gal-1和Gal-4水平之间存在关联。结论本研究结果首次揭示了RA患者血清凝集素水平与临床参数的关系。为了证明它们在发病机制中的作用，需要对凝集素进行新的研究，以评估它们如何作为RA的生物标志物发挥作用。

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引用次数: 7

Neuronal Antibodies and Associated Syndromes. 神经元抗体和相关综合征。

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2019-07-09 eCollection Date: 2019-01-01 DOI: 10.1155/2019/2135423

Borros M Arneth

Introduction Multiple well-recognized conditions, such as Lambert–Eaton myasthenic syndrome (LEMS) and myasthenia gravis (MG), have been associated with neuronal antibodies. Materials and Methods A search was performed using Embase, PubMed, and CINAHL. An initial search of each database was conducted using keywords and terms related to the aim of the current review. Additional articles were obtained by examining the reference lists and citations in the selected records. Results The studies identified through the search process used different designs and methods to explore neuronal antibodies and associated syndromes. Previous studies have shown that neurological and psychiatric disorders can be mediated and influenced by various antibodies. The identification of autoantibodies can help with the accurate diagnosis of conditions and commencement of early treatment. Discussion A review of selected studies identified in the literature implicated that classic anti-neuronal antibodies, such as anti-Ri and anti-Hu, play a role in the development of neurological diseases. More recent studies have indicated that other novel antibodies act on neuronal cell surface antigens to contribute to the development of neurological disorders. Conclusion Existing research provides evidence revealing a spectrum of antibodies linked to the development and progression of neurological diseases. However, further antibody testing and studies should be performed to validate the relationship between conditions and antibodies.

引言：多种公认的疾病，如Lambert Eaton肌无力综合征（LEMS）和重症肌无力（MG），都与神经元抗体有关。材料和方法：使用Embase、PubMed和CINAHL进行检索。使用与当前审查目标相关的关键词和术语对每个数据库进行了初步搜索。通过检查所选记录中的参考文献列表和引文，获得了更多的文章。结果：通过搜索过程确定的研究使用了不同的设计和方法来探索神经元抗体和相关综合征。先前的研究表明，神经和精神疾病可以由各种抗体介导和影响。自身抗体的鉴定有助于准确诊断病情并开始早期治疗。讨论：对文献中选定研究的综述表明，经典的抗神经元抗体，如抗Ri和抗Hu，在神经系统疾病的发展中发挥作用。最近的研究表明，其他新型抗体作用于神经元细胞表面抗原，有助于神经系统疾病的发展。结论：现有研究提供了证据，揭示了一系列与神经系统疾病的发展和进展有关的抗体。然而，应该进行进一步的抗体测试和研究，以验证条件和抗体之间的关系。

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引用次数: 5

Case Reports of DRESS Syndrome and Symptoms Consistent with DRESS Syndrome Following Treatment with Recently Marketed Monoclonal Antibodies 最近上市的单克隆抗体治疗后的DRESS综合征病例报告和与DRESS综合征一致的症状

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2019-06-09 DOI: 10.1155/2019/7595706

James C Di Palma-Grisi, K. Vijayagopal, Muhammad A Muslimani

Background Monoclonal antibodies constitute a potent and broadly tolerable drug class, representing for some conditions the first newly approved treatment in years. As such, many are afforded “fast-track” or “breakthrough therapy” designations by the U.S. Food and Drug Administration, leading to provisional approval before Phase III clinical trials are reported. Although these drugs are usually safe, some patients experience life-threatening complications—myositis and encephalitis have led to permanent or temporary recalls. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a hypersensitivity condition easily missed due to its long incubation period and nonspecific presentation. This minireview is primarily intended as an abbreviated guide for practitioners who may be using these powerful treatments. Methodology We searched PubMed using a string of symptoms consistent with DRESS syndrome and monoclonal antibodies approved by the FDA since 2015. Then, we excluded studies reporting dermatological complications of reactivation of nonherpetic infection, immunodeficiency-related infection, or reactions to the injection site or infusion. We searched for and accessed prior reviews and background studies via PubMed, Mendeley, and Google Scholar. Results Two cases of DRESS syndrome were identified in the literature, both the result of treatment with daclizumab. There was one additional case of encephalitis without cutaneous symptoms caused by daclizumab. Drug-induced hypersensitivity dermatitis was reported following treatment with nivolumab and two cases of combination treatment with ipilimumab and either nivolumab or durvalumab produced maculopapular rash and bullae in the first patient and lichenoid dermatitis and blisters in the second patient. Conclusions Daclizumab was the only recently approved monoclonal antibody associated with DRESS syndrome as such. Limitations in the diagnostic reliability of DRESS syndrome as a clinical entity and the lack of negative clinical trial reporting suggest enhanced vigilance on the part of clinicians and regulators may be warranted.

单克隆抗体是一种有效且广泛耐受的药物类别，代表了近年来第一个新批准的治疗方法。因此，许多药物被美国食品和药物管理局授予“快速通道”或“突破性疗法”的称号，从而在III期临床试验报告之前获得临时批准。虽然这些药物通常是安全的，但有些患者会出现危及生命的并发症——肌炎和脑炎会导致永久性或暂时性的召回。药物反应伴嗜酸性粒细胞增多及全身症状(DRESS)综合征是一种易被忽视的超敏性疾病，其潜伏期长且表现非特异性。这篇迷你评论主要是为了给那些可能正在使用这些强有力的治疗方法的从业者提供一个简短的指南。我们使用一系列与DRESS综合征一致的症状和FDA自2015年以来批准的单克隆抗体在PubMed中进行检索。然后，我们排除了报告非疱疹性感染再激活、免疫缺陷相关感染或注射部位或输注反应的皮肤病并发症的研究。我们通过PubMed、Mendeley和Google Scholar搜索并访问了之前的评论和背景研究。结果文献中发现2例DRESS综合征，均为daclizumab治疗的结果。另外还有一例无皮肤症状的脑炎病例由daclizumab引起。在纳武单抗治疗后报告了药物性过敏性皮炎，两例伊匹单抗联合纳武单抗或杜伐单抗治疗，第一例患者出现斑疹丘疹和大疱，第二例患者出现地衣样皮炎和水疱。Daclizumab是最近批准的唯一与DRESS综合征相关的单克隆抗体。DRESS综合征作为一种临床实体的诊断可靠性存在局限性，而且缺乏负面的临床试验报告，这表明临床医生和监管机构有必要提高警惕。

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引用次数: 15

Therapeutic Plasma Exchange as Management of Complicated Systemic Lupus Erythematosus and Other Autoimmune Diseases. 血浆置换治疗复杂系统性红斑狼疮及其他自身免疫性疾病。

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2019-03-11 eCollection Date: 2019-01-01 DOI: 10.1155/2019/5350960

David Aguirre-Valencia, Juan Naranjo-Escobar, Iván Posso-Osorio, María Carmenza Macía-Mejía, Ivana Nieto-Aristizábal, Tatiana Barrera, María Alejandra Obando, Gabriel J Tobón

Introduction: Autoimmune diseases include a diverse and complex group of pathologies with a broad clinical spectrum due to the production of autoantibodies, which generates multisystemic compromise. Therapeutic plasma exchange (TPE) is a good additive treatment for immunosuppression due to its action over the autoantibodies.

Objectives: To describe the main clinical characteristics and outcomes of patients with systemic lupus erythematosus and other systemic autoimmune diseases managed with TPE.

Methodology: This descriptive retrospective study enrolled patients with systemic autoimmune diseases who received TPE.

Results: In total, 66 patients with a median age of 33.5 years (24-53 years) were included; the majority were females [n=51 (77.27%)]. Forty (60.61%) patients were diagnosed with systemic lupus erythematosus. In these cases, the main indication for TPE was diffuse alveolar hemorrhage (DAH; n=20, 30.3%) and neurolupus (n=9, 13.6%). No TPE-related deaths occurred, and the main complication was hemorrhage, without significant differences among the four types of TPE solutions used. The overall outcome was improvement in 41 (62.12%) patients.

Conclusion: TPE is safe and effective in patients with severe manifestations of autoimmune diseases.

自身免疫性疾病包括多种复杂的病理，由于自身抗体的产生，产生多系统损害，具有广泛的临床谱。治疗性血浆交换(TPE)由于其对自身抗体的作用，是一种很好的免疫抑制治疗方法。目的:描述TPE治疗系统性红斑狼疮和其他系统性自身免疫性疾病患者的主要临床特征和预后。方法:这项描述性回顾性研究纳入了接受TPE治疗的系统性自身免疫性疾病患者。结果:共纳入66例患者，中位年龄33.5岁(24-53岁);以女性居多[n=51(77.27%)]。40例(60.61%)被诊断为系统性红斑狼疮。在这些病例中，TPE的主要指征是弥漫性肺泡出血(DAH;N =20, 30.3%)和神经性红斑狼疮(N =9, 13.6%)。无TPE相关死亡发生，主要并发症为出血，使用的四种TPE溶液之间无显著差异。41例(62.12%)患者的总体结果得到改善。结论:TPE治疗严重自身免疫性疾病安全有效。

{"title":"Therapeutic Plasma Exchange as Management of Complicated Systemic Lupus Erythematosus and Other Autoimmune Diseases.","authors":"David Aguirre-Valencia, Juan Naranjo-Escobar, Iván Posso-Osorio, María Carmenza Macía-Mejía, Ivana Nieto-Aristizábal, Tatiana Barrera, María Alejandra Obando, Gabriel J Tobón","doi":"10.1155/2019/5350960","DOIUrl":"https://doi.org/10.1155/2019/5350960","url":null,"abstract":"Introduction: Autoimmune diseases include a diverse and complex group of pathologies with a broad clinical spectrum due to the production of autoantibodies, which generates multisystemic compromise. Therapeutic plasma exchange (TPE) is a good additive treatment for immunosuppression due to its action over the autoantibodies.Objectives: To describe the main clinical characteristics and outcomes of patients with systemic lupus erythematosus and other systemic autoimmune diseases managed with TPE.Methodology: This descriptive retrospective study enrolled patients with systemic autoimmune diseases who received TPE.Results: In total, 66 patients with a median age of 33.5 years (24-53 years) were included; the majority were females [n=51 (77.27%)]. Forty (60.61%) patients were diagnosed with systemic lupus erythematosus. In these cases, the main indication for TPE was diffuse alveolar hemorrhage (DAH; n=20, 30.3%) and neurolupus (n=9, 13.6%). No TPE-related deaths occurred, and the main complication was hemorrhage, without significant differences among the four types of TPE solutions used. The overall outcome was improvement in 41 (62.12%) patients.Conclusion: TPE is safe and effective in patients with severe manifestations of autoimmune diseases.","PeriodicalId":46314,"journal":{"name":"Autoimmune Diseases","volume":"2019 ","pages":"5350960"},"PeriodicalIF":4.0,"publicationDate":"2019-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/5350960","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37315380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 29

Identification of Levels of Serum Amyloid A and Apolipoprotein A1 in Serum Proteomic Analysis of Neuropsychiatric Systemic Lupus Erythematosus Patients. 神经精神系统性红斑狼疮患者血清蛋白质组学分析中血清淀粉样蛋白A和载脂蛋白A1水平的鉴定。

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2018-11-21 DOI: 10.1155/2018/6728541

Nancy P Duarte-Delgado, Tania P Lujan, Álvaro Arbeláez-Cortés, Jenny García-Valencia, Adriana Zapata, Mauricio Rojas, Mauricio Restrepo-Escobar, Gloria Vásquez, Blanca L Ortiz-Reyes

Neuropsychiatric Systemic Lupus Erythematosus (NPSLE) has multiple pathogenic mechanisms that cause diverse manifestations and whose diagnosis is challenging because of the absence of appropriate diagnostic tests. In the present study the application of proteomics using two-dimensional electrophoresis (2D) and mass spectrometry (MS) allowed the comparison of the protein profile of the serum low and high abundance protein fractions of NPSLE patients (NPSLE group) and SLE without neuropsychiatric syndromes (SLE group), Neuropsychiatric syndromes not associated with SLE (NPnoSLE groups), and healthy controls (CTRL group). The gels obtained were digitalized and analyzed with the PDQuest software. The statistical analysis of the spots was performed using the nonparametric Kruskal Wallis and Dunn's multiple comparison tests. Two spots showed significant differences and were identified by MS. Spot 4009 was significantly lower in NPSLE with regard to NPnoSLE (p= 0,004) and was identified as apolipoprotein A1 (APOA1) (score 809-1132). Spot 8001 was significantly higher in NPSLE regarding CTRL and NPnoSLE (p= 0,01 y 0,03, respectively) and was identified as serum amyloid A (SAA) (score 725-2488). The proinflammatory high density lipoproteins (HDL) have been described in SLE. In this HDL the decrease of APOA1 is followed by an increase in SAA. This altered level of both proteins may be related to the inflammatory state that is characteristic of an autoimmune disease like SLE, but this is not specific for NPSLE.

神经精神系统性红斑狼疮（NPSLE）具有多种致病机制，可引起不同的表现，由于缺乏适当的诊断测试，其诊断具有挑战性。在本研究中，使用二维电泳（2D）和质谱（MS）的蛋白质组学应用允许比较NPSLE患者（NPSLE组）和无神经精神综合征的SLE（SLE组）、与SLE无关的神经精神综合症（NPnoSLE组）的血清低丰度和高丰度蛋白质组分的蛋白质谱，健康对照组（CTRL组）。将获得的凝胶数字化，并用PDQuest软件进行分析。使用非参数Kruskal-Wallis和Dunn多重比较检验对斑点进行统计分析。两个斑点显示出显著差异，并通过MS鉴定。斑点4009在NPSLE中显著低于NPnoSLE（p=0.004），并被鉴定为载脂蛋白A1（APOA1）（得分809-1132）。关于CTRL和NPnoSLE，斑点8001在NPSLE中显著更高（分别为p=0.01 y 0,03），并被鉴定为血清淀粉样蛋白A（SAA）（得分725-2488）。系统性红斑狼疮中存在促炎性高密度脂蛋白（HDL）。在这种HDL中，APOA1的降低之后是SAA的增加。这两种蛋白质水平的改变可能与炎症状态有关，炎症状态是SLE等自身免疫性疾病的特征，但这对NPSLE不是特异性的。

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引用次数: 3

Nail Involvement in Patients with Psoriatic Arthritis in Northern Iran. 伊朗北部银屑病关节炎患者的指甲受累。

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2018-10-15 eCollection Date: 2018-01-01 DOI: 10.1155/2018/4608490

O Zargari, E Kazemnezhad Leyli, S Z Azimi

Background: Psoriatic arthritis (PsA) results in an increased burden of psoriasis and impairs both quality of life and an individual's functional capacity. The relationship between nail involvement and PsA in psoriasis is not fully characterized.

Aim: To evaluate the frequency and characteristics of nail involvement in psoriatic patients and to assess the relationship with joint involvement.

Methods: A total of 197 patients with moderate-to-severe psoriasis were consecutively invited to participate in this cross-sectional study. The patients are divided into two groups: those with and those without psoriatic arthritis.

Results: 69.5% of psoriatic (137 out of 197) patients had nail involvement. The most common nail abnormality was onycholysis, followed by pitting and oil droplet changes. Nail involvement was more common in patients with psoriatic arthritis (82.1% versus 57.8%, p=0.001).

Conclusion: Nail involvement is commonly associated with PsA. Onycholysis, splinter hemorrhage, and oil drop were significantly more common in the PsA group as opposed to patients with just skin findings. In general, psoriatic patients with arthritis had more severe disease.

背景:银屑病关节炎(PsA)导致银屑病负担增加，并损害生活质量和个人的功能能力。银屑病患者指甲受累与PsA之间的关系尚未完全明确。目的:了解银屑病患者指甲受累的频率和特点，并探讨其与关节受累的关系。方法:连续邀请197例中重度牛皮癣患者参加横断面研究。患者分为两组:银屑病关节炎患者和非银屑病关节炎患者。结果:197例银屑病患者中有137例(69.5%)有甲受累。最常见的指甲异常是骨化，其次是麻点和油滴变化。银屑病关节炎患者指甲受累更常见(82.1%对57.8%，p=0.001)。结论:指甲受累通常与PsA相关。与仅有皮肤表现的患者相比，PsA组的骨髓瘤溶解、碎片出血和油滴明显更常见。一般来说，银屑病伴关节炎患者病情更为严重。

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引用次数: 11

Relationships among Antibodies against Extractable Nuclear Antigens, Antinuclear Antibodies, and Autoimmune Diseases in a Brazilian Public Hospital. 巴西一家公立医院抗可提取核抗原抗体、抗核抗体和自身免疫性疾病的关系

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2018-09-30 eCollection Date: 2018-01-01 DOI: 10.1155/2018/9856910

Fernanda Weyand Banhuk, Bruna Corrêa Pahim, Alex Sandro Jorge, Rafael Andrade Menolli

One characteristic of autoimmune diseases (ADs) is the production of autoantibodies for extractable nuclear autoantigens, which may aid in the discrimination of the different types of autoimmune diseases and is related to different antinuclear antibody (ANA) patterns. The present study verified the profile of patient samples tested for extractable nuclear antigens (ENA) antibodies in a public hospital and correlated the ENA results with ANA patterns and patient diagnoses. The study reviewed data in the medical records of patients who underwent anti-ENA tests at a public hospital in the West of the State of Paraná from February 2011 to January 2017. Patients were classified according to age, ethnicity, gender, anti-ENA test results, ANA results, and the presence or absence of AD. Thirty-six (20.9%) samples of the 172 anti-ENA tests were positive, seven (4.1%) samples were undetermined, and 129 (75%) exhibited negative results. The ANA reagent was found in 84.3% of the anti-ENA-positive samples. The anti-SSA/Ro autoantibody exhibited the highest frequency in the group, 41.7% (15/36). The most common pattern was nuclear fine speckled, which was found in 24.3% of the samples. The association results indicated a significant relationship between ANA titer and diagnosis in the anti-ENA- and ANA-positive patients. The anti-ENA-negative patients were diagnosed with an AD in 35% (45/129) of the cases, and 75% (27/36) of the anti-ENA-positive patients were diagnosed with an AD. Systemic lupus erythematosus and scleroderma were the most common pathologies in the antigen-positive patients. The anti-ENA test is a good marker to aid in the complex clinical diagnosis of patients with autoimmune diseases.

自身免疫性疾病(ADs)的一个特征是产生可提取的核自身抗原的自身抗体，这可能有助于区分不同类型的自身免疫性疾病，并与不同的抗核抗体(ANA)模式有关。本研究验证了在公立医院检测可提取核抗原(ENA)抗体的患者样本的概况，并将ENA结果与ANA模式和患者诊断相关联。该研究回顾了2011年2月至2017年1月在帕拉纳州西部一家公立医院接受抗ena测试的患者医疗记录中的数据。患者根据年龄、种族、性别、抗ena检测结果、ANA结果以及是否存在AD进行分类。172份抗ena检测中阳性36份(20.9%)，未确定7份(4.1%)，阴性129份(75%)。在84.3%的抗ena阳性样本中发现ANA试剂。抗ssa /Ro自身抗体出现频率最高，为41.7%(15/36)。最常见的模式是核细斑，在24.3%的样本中发现。相关结果表明，抗ena和ANA阳性患者的ANA滴度与诊断有显著关系。抗ena阴性患者中有35%(45/129)诊断为AD，抗ena阳性患者中有75%(27/36)诊断为AD。系统性红斑狼疮和硬皮病是抗原阳性患者最常见的病理。抗ena试验是一种很好的标志物，有助于自身免疫性疾病患者的复杂临床诊断。

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引用次数: 16

Role of Mast Cells in Oral Lichen Planus and Oral Lichenoid Reactions. 肥大细胞在口腔扁平苔藓和类地衣反应中的作用。

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2018-01-17 eCollection Date: 2018-01-01 DOI: 10.1155/2018/7936564

Suganya Ramalingam, Narasimhan Malathi, Harikrishnan Thamizhchelvan, Narasimhan Sangeetha, Sharada T Rajan

Introduction: Oral lichen planus (OLP) is a chronic T cell mediated disease of oral mucosa, skin, and its appendages with a prevalence of 0.5 to 2.6% worldwide. Oral lichenoid reactions (OLR) are a group of lesions with diverse aetiologies but have clinical and histological features similar to OLP, thereby posing a great challenge in differentiating both lesions. Mast cells are multifunctional immune cells that play a major role in the pathogenesis of lichen planus by release of certain chemical mediators. Increased mast cell densities with significant percentage of degranulation have been observed as a consistent finding in pathogenesis of oral lichen planus.

Aim: The current study was aimed at quantifying the mast cells in histopathological sections of OLP and OLR thereby aiding a means of distinguishing these lesions.

Materials and methods: The study group involved 21 cases of oral lichen planus, 21 cases of oral lichenoid reactions, and 10 control specimens of normal buccal mucosa. All the cases were stained with Toluidine Blue and routine haematoxylin and eosin and the mast cells were quantified.

Statistical analysis used: The results were analyzed using the Kruskal-Wallis test and an intergroup analysis was performed using Mann-Whitney U test.

Conclusion: The number of mast cells showed an increased value in oral lichen planus when compared to oral lichenoid reaction and thus an estimation of mast cells count could aid in distinguishing OLP from OLR histopathologically.

口腔扁平苔藓(OLP)是一种慢性T细胞介导的口腔粘膜、皮肤及其附属物疾病，全球患病率为0.5 - 2.6%。口腔苔藓样反应(OLR)是一组病因多样的病变，但其临床和组织学特征与OLP相似，因此对两者的鉴别提出了很大的挑战。肥大细胞是一种多功能免疫细胞，通过释放某些化学介质在扁平苔藓的发病过程中发挥重要作用。肥大细胞密度的增加与脱颗粒的显著百分比已被观察到作为一个一致的发现在口腔扁平苔藓的发病机制。目的:目前的研究旨在定量的肥大细胞在OLP和OLR的组织病理切片，从而帮助区分这些病变的手段。材料与方法:研究组21例口腔扁平苔藓，21例口腔类苔藓反应，10例正常口腔黏膜对照。所有病例均行甲苯胺蓝染色及常规苏木精、伊红染色，并定量肥大细胞。采用统计学分析:采用Kruskal-Wallis检验对结果进行分析，采用Mann-Whitney U检验进行组间分析。结论:与口腔类地衣反应相比，口腔扁平苔藓中肥大细胞的数量增加，因此肥大细胞数量的估计有助于从组织病理学上区分OLP和OLR。

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引用次数: 13

Anti-Myeloperoxidase Antibodies Associate with Future Proliferative Lupus Nephritis. 抗髓过氧化物酶抗体与未来的增殖性狼疮肾炎有关。

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2017-01-01 Epub Date: 2017-12-24 DOI: 10.1155/2017/1872846

S W Olson, J J Lee, M Poirier, D J Little, L K Prince, T P Baker, J D Edison, K C Abbott

Background: The subclinical pathophysiology of proliferative lupus nephritis (PLN) has not been fully elucidated. Myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) is associated with PLN, but prediagnostic levels have not been reported.

Methods: We performed a retrospective case-control Department of Defense Serum Repository (DoDSR) study comparing MPO-ANCA levels in longitudinal prediagnostic serum samples for 23 biopsy confirmed proliferative lupus nephritis (PLN) patients to DoDSR identified age, sex, race, and age of serum matched healthy and SLE without LN disease controls. We also compared the temporal relationship of MPO-ANCA to anti-double stranded DNA antibodies (dsDNAab).

Results: A greater proportion of PLN patients had prediagnostic MPO-ANCA levels above ≥3 U/mL and ≥6 U/mL compared to SLE without LN (91% versus 43%, p < 0.001; 57% versus 5%, p < 0.001, resp.). In subgroup analysis, the MPO-ANCA threshold of ≥3 U/mL was significant at <1 year (88% versus 39%, p = 0.007) and 1-4 years (87% versus 38%, p = 0.009) prior to diagnosis. Statistically significant subclinical MPO-ANCA levels (≥3 U/mL) occurred prior to statistically significant dsDNAab ≥ 3 IU/ml (89% versus 11%, p = 0.003).

Conclusions: Subclinical MPO-ANCA levels could distinguish future PLN from SLE without LN. MPO-ANCA manifests prior to clinical disease and subclinical dsDNAab to suggest that it may contribute directly to PLN pathogenicity.

背景:增殖性狼疮性肾炎(PLN)的亚临床病理生理尚未完全阐明。髓过氧化物酶抗中性粒细胞胞浆抗体(MPO-ANCA)与PLN相关，但诊断前水平未见报道。方法:我们进行了一项回顾性病例对照国防部血清库(DoDSR)研究，比较了23例活检确诊的增生性狼疮肾炎(PLN)患者的纵向诊断前血清样本中的MPO-ANCA水平，与DoDSR确定的年龄、性别、种族和年龄相匹配的健康和无LN疾病对照的SLE患者的血清。我们还比较了MPO-ANCA与抗双链DNA抗体(dsDNAab)的时间关系。结果:与没有LN的SLE相比，PLN患者诊断前MPO-ANCA水平分别高于≥3u /mL和≥6u /mL的比例更高(91%对43%，p < 0.001;57%对5% (p < 0.001)。在亚组分析中，MPO-ANCA阈值≥3u /mL在诊断前1-4年(87%对38%，p = 0.009)具有显著性意义。有统计学意义的亚临床MPO-ANCA水平(≥3u /mL)发生在有统计学意义的dsDNAab≥3iu /mL之前(89%对11%，p = 0.003)。结论:亚临床MPO-ANCA水平可以区分未来的PLN和无LN的SLE。MPO-ANCA表现于临床疾病和亚临床dsDNAab之前，表明它可能直接促进PLN的致病性。

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引用次数: 9