The clinical and the laboratory autoimmunologist: Where do we stand?
(Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - July 7, 2020 Category: Allergy & Immunology Source Type: research

Recurrent angioedema, Guillain-Barr é, and myelitis in a girl with systemic lupus erythematosus and CD59 deficiency syndrome
ConclusionCD59 deficiency can be presented with various clinical features such as neurologic, hematologic, dermatologic, and rheumatologic problems including systemic lupus erythematosus. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - June 29, 2020 Category: Allergy & Immunology Source Type: research

Profiles of criteria and non-criteria anti-phospholipid autoantibodies are associated with clinical phenotypes of the antiphospholipid syndrome
AbstractBackgroundSpecific anti-phospholipids antibodies (aPLs) are used as classification criteria of the antiphospholipid syndrome (APS). These aPLs, although essential for diagnosis, do not predict disease phenotypes, which may require specific therapies. Non-criteria aPLs are rarely evaluated and their role is yet to be defined. In the current study, we aimed to examine the association between criteria and non-criteria aPLs and APS phenotypes.MethodsSerum samples from 188 subjects, 130 APS patients and 58 controls were analyzed for the presence of 20 aPLs (IgG and IgM isotypes to cardiolipin (CL), beta2-glycoprotein1 (...
Source: Autoimmunity Highlights - May 15, 2020 Category: Allergy & Immunology Source Type: research

A comprehensive analysis of antigen-specific autoimmune liver disease related autoantibodies in patients with multiple sclerosis
ConclusionsDespite the relatively frequent presence of liver autoantibodies, tested either by IF or molecular assays, overt AILD is rather infrequent discouraging autoantibody screening strategies of MS patients in the absence of clinical suspicion. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - April 10, 2020 Category: Allergy & Immunology Source Type: research

The search for the Holy Grail: autoantigenic targets in primary sclerosing cholangitis associated with disease phenotype and neoplasia
AbstractUnlike in other autoimmune liver diseases such as autoimmune hepatitis and primary biliary cholangitis, the role and nature of autoantigenic targets in primary sclerosing cholangitis (PSC), a progressive, chronic, immune-mediated, life threatening, genetically predisposed, cholestatic liver illness, is poorly elucidated. Although anti-neutrophil cytoplasmic antibodies (ANCA) have been associated with the occurrence of PSC, their corresponding targets have not yet been identified entirely. Genome-wide association studies revealed a significant number of immune-related and even disease-modifying susceptibility loci f...
Source: Autoimmunity Highlights - March 16, 2020 Category: Allergy & Immunology Source Type: research

Anti-domain 1 β2 glycoprotein antibodies increase expression of tissue factor on monocytes and activate NK Cells and CD8+ cells in vitro
ConclusionsTaking together, our study shows the ability of patient-derived aPL to induce immune cell activation and TF expression on monocytes. For the first time, we demonstrated the influence of anti-D1 β2GPI on the activation status of monocytes, NK and cytotoxic T cells. Our findings further support a crucial role of D1 epitope in the promotion of thrombosis and obstetrical complications in APS. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - March 2, 2020 Category: Allergy & Immunology Source Type: research

The perspective on standardisation and harmonisation: the viewpoint of the EASI president
AbstractStandardisation of immuno-assays for autoantibodies is a major challenge. Although multiple organisations participate in the generation of internationally accepted standards, adequate standardisation of assays has not yet been achieved. Harmonisation may offer an alternative approach to better align requesting, testing, reporting and interpretation of autoimmune diagnostics. The European Autoimmunity Standardisation Initiative (EASI) was founded to facilitate both standardisation as well as harmonisation of autoantibody tests, but over the years the focus has drifted away from standardisation in favour of harmonisa...
Source: Autoimmunity Highlights - February 6, 2020 Category: Allergy & Immunology Source Type: research

Twenty years of research on the DFS70/LEDGF autoantibody-autoantigen system: many lessons learned but still many questions
AbstractThe discovery and initial characterization 20  years ago of antinuclear autoantibodies (ANAs) presenting a dense fine speckled (DFS) nuclear pattern with strong staining of mitotic chromosomes, detected by indirect immunofluorescence assay in HEp-2 cells (HEp-2 IIFA test), has transformed our view on ANAs. Traditionally, ANAs have been conside red as reporters of abnormal immunological events associated with the onset and progression of systemic autoimmune rheumatic diseases (SARD), also called ANA-associated rheumatic diseases (AARD), as well as clinical biomarkers for the differential diagnosis of these dise...
Source: Autoimmunity Highlights - February 3, 2020 Category: Allergy & Immunology Source Type: research

Associations between HLA and autoimmune neurological diseases with autoantibodies
We report the main alleles and haplotypes, and discuss the clinical and pathogenic implications of these findings. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - January 22, 2020 Category: Allergy & Immunology Source Type: research

Receptor autoimmunity: diagnostic and therapeutic implications
AbstractReceptor autoimmunity is one of the ways in which autoimmune diseases appear in humans. Graves ’ disease, myasthenia gravis, idiopathic membranous nephropathy, and autoimmune acute encephalitis are the major autoimmune diseases belonging to this particular group. Receptor autoimmune disease are dependent on the presence of autoantibodies directed against cell-surface antigens, namely TSH re ceptor in thyrocytes, acetylcholine receptor in neuromuscular junction, phospholipase 2 receptor in podocytes, and NMDA receptor in cortical neurons. In this article we outline the distinctive features of receptor autoimmu...
Source: Autoimmunity Highlights - January 7, 2020 Category: Allergy & Immunology Source Type: research

Association of CD58 polymorphism and multiple sclerosis in Malaysia: a pilot study
ConclusionsThe impact of theCD58 gene polymorphism was not prominent in this pilot study, implying that genetic composition contributing to multiple sclerosis may be different between different populations, thus results in a heterogeneity of disease manifestation and distribution. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - December 17, 2019 Category: Allergy & Immunology Source Type: research

HERV-K and HERV-W transcriptional activity in myalgic encephalomyelitis/chronic fatigue syndrome
ConclusionsThis is the first report about HERV-K differential expression in moderate ME/CFS. Although the relationship between HERVs and ME/CFS has yet to be proven, the observation of this phenomenon deserves further attention. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - November 15, 2019 Category: Allergy & Immunology Source Type: research

Preclinical studies on the toxicology, pharmacokinetics and safety of K1-70 TM a human monoclonal autoantibody to the TSH receptor with TSH antagonist activity
ConclusionsThe toxicology, pharmacodynamic and pharmacokinetic data in this preclinical study were helpful in designing the first in human study with K1-70 ™ administered to subjects with Graves’ disease. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - November 7, 2019 Category: Allergy & Immunology Source Type: research

Evolving liver inflammation in biochemically normal individuals with anti-mitochondria antibodies
AbstractBackgroundAnti-mitochondria autoantibodies (AMA) occur in>  95% primary biliary cholangitis (PBC) patients. Biochemically normal AMA-positive (BN/AMA+) individuals, occasionally noticed by indirect immunofluorescence (IIF) on HEp-2 cells and confirmed in AMA-specific assays, may represent early stages of PBC. The Enhanced Liver Fibrosis (ELF) score is a s urrogate marker for liver fibrosis. This prospective study investigated the ELF score in BN/AMA+ individuals and PBC patients, considering autoantibody avidity and serum levels along the years.Methods327 samples from 35 PBC and 59 BN/AMA+ were prospectiv...
Source: Autoimmunity Highlights - October 31, 2019 Category: Allergy & Immunology Source Type: research

Antiphospholipid syndrome: a case report with an unusual wide spectrum of clinical manifestations
ConclusionBased on the patient ’s medical history and all the examination results, it was possible to make a diagnosis of primary APS and, starting from diagnosis of thrombocytopenia, we were allowed to conclude that all of manifestation were epi-phenomena of a unique clinical entity, rather than unrelated diseases. Though APS is one of the most common thrombocytophilias, unfortunately, it is not recognized often enough. The lack of prevention in undiagnosed patients may cause severe complications which can in turn result in the death of those patients. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - October 19, 2019 Category: Allergy & Immunology Source Type: research

Look granulomatosis with polyangiitis (GPA) straight in the face: missed opportunities leading to a delayed diagnosis
We report a case with GPA, which was diagnosed only after new and advancing symptoms belied the original diagnosis of bilateral facial palsy and aortic mural thrombus. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - September 17, 2019 Category: Allergy & Immunology Source Type: research

Brain atrophy in multiple sclerosis: mechanisms, clinical relevance and treatment options
AbstractMultiple sclerosis (MS) is an immune-mediated disease of the central nervous system characterized by focal or diffuse inflammation, demyelination, axonal loss and neurodegeneration. Brain atrophy can be seen in the earliest stages of MS, progresses faster compared to healthy adults, and is a reliable predictor of future physical and  cognitive disability. In addition, it is widely accepted to be a valid, sensitive and reproducible measure of neurodegeneration in MS. Reducing the rate of brain atrophy has only recently been incorporated as a critical endpoint into the clinical trials of new or em...
Source: Autoimmunity Highlights - August 10, 2019 Category: Allergy & Immunology Source Type: research

The clinical significance of atypical indirect immunofluorescence patterns on primate cerebellum in paraneoplastic antibody screening
ConclusionsAn atypical indirect immunofluorescence pattern on primate cerebellum in the screening for paraneoplastic antibodies has only very minor relevance with respect to paraneoplastic neurological syndromes or any other neurological disease, recommending clinicians to interpret the results of positive screening assays for such antibodies with care. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - July 25, 2019 Category: Allergy & Immunology Source Type: research

A new M23-based ELISA assay for anti-aquaporin 4 autoantibodies: diagnostic accuracy and clinical correlation
AbstractPurposeAlthough many assays have been developed to detect anti-aquaporin-4 (AQP4) antibodies, most of these assays require sophisticated techniques and are thus only available at specialized laboratories. The aim of this study was to evaluate the analytical and clinical performance of a new commercial enzyme-linked immunosorbent assay (ELISA RSR, AQP4 Ab Version 2) to detect anti-AQP4 antibodies performed on a fully automated system (SkyLAB 752).MethodsSerum samples from 64 patients with neuromyelitis optica spectrum disorders (NMOSD) (including NMO, longitudinally extensive myelitis-LETM, optical neuritis and myel...
Source: Autoimmunity Highlights - June 19, 2019 Category: Allergy & Immunology Source Type: research

Neutrophil/lymphocyte ratio and lymphocyte/monocyte ratio in ulcerative colitis as non-invasive biomarkers of disease activity and severity
AbstractBackgroundApart from endoscopic interventions, readily attainable cost-effective biomarkers for ulcerative colitis (UC) assessment are required. For this purpose, we evaluated differential leucocytic ratio, mainly neutrophil –lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) as simple available indicators of disease activity in patients with ulcerative colitis.MethodsStudy conducted on 80 UC patients who were classified into two groups of 40 each according to Mayo score and colonoscopic findings. Group 1 (active UC) and group 2 (inactive UC). Another 40 group-matched healthy participants were enrolle...
Source: Autoimmunity Highlights - May 15, 2019 Category: Allergy & Immunology Source Type: research

Anti- β2-glycoprotein I and anti-phosphatidylserine/prothrombin antibodies exert similar pro-thrombotic effects in peripheral blood monocytes and endothelial cells
ConclusionsOur data support the significant and independent role of aPS/PT in the pathogenesis of the thrombotic events in APS patients, possibly adding new light to the therapeutic management of cases characterized by the sole presence of aPS/PT IgG antibodies. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - April 6, 2019 Category: Allergy & Immunology Source Type: research

Association of HLA-B27 and Behcet ’s disease: a systematic review and meta-analysis
ConclusionsThere is a significant correlation between HLA-B27 and Behcet ’s Disease, but it was weak. Environmental and genetic factors might determine which the “HLA-B27” alleles manifest Behcet’s disease progression. Future researches is required to perform about what factors can do to positively and separately influence Behcet’s disease. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - March 19, 2019 Category: Allergy & Immunology Source Type: research

Protective effect of TSLP and IL-33 cytokines in ulcerative colitis
ConclusionsIn this study, we showed decreased mRNA expression levels of TSLP and IL-33 in UC patients and also a negative correlation between expression of TSLP and IL-33 and severity of UC disease. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - March 14, 2019 Category: Allergy & Immunology Source Type: research

Regulatory B and T lymphocytes in multiple sclerosis: friends or foes?
AbstractCurrent clinical experience with immunomodulatory agents and monoclonal antibodies in principle has established the benefit of depleting lymphocytic populations in relapsing –remitting multiple sclerosis (RRMS). B and T cells may exert multiple pro-inflammatory actions, but also possess regulatory functions making their role in RRMS pathogenesis much more complex. There is no clear correlation of Tregs and Bregs with clinical features of the disease. Herein, we discus s the emerging data on regulatory T and B cell subset distributions in MS and their roles in the pathophysiology of MS and its murine model, ex...
Source: Autoimmunity Highlights - November 10, 2018 Category: Allergy & Immunology Source Type: research

Performance analysis of automated evaluation of antinuclear antibody indirect immunofluorescent tests in a routine setting
ConclusionsThe ANA IIF results reported by the EPa software are in very good agreement with the results reported by the observer with respect to being negative/positive, pattern recognition and titer, making automated ANA IIF evaluation an objective and time-efficient tool for routine testing. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - September 21, 2018 Category: Allergy & Immunology Source Type: research

Remission of aggressive autoimmune disease (dermatomyositis) with removal of infective jaw pathology and ozone therapy: review and case report
ConclusionDental focus of occult infection may be a prime cause/trigger of autoimmune disorders and inflammatory disorders, requiring surgical intervention to remove. Ozone therapy, little known in conventional medicine, has been shown in the literature and in this case to be a powerful and safe immune modulator and anti-infective agent. This case has significant relevance across the entire spectrum of both medical and dental practice. It also emphasizes the need for individualized assessment and treatment rather than symptomatic pharmacological approaches treating a “disease” rather than the patient. Subclinic...
Source: Autoimmunity Highlights - June 30, 2018 Category: Allergy & Immunology Source Type: research

Anti-phospholipid IgG antibodies detected by line immunoassay differentiate patients with anti-phospholipid syndrome and other autoimmune diseases
ConclusionsaD1/aD4 –5 (ELISA) and aPG IgG (LIA) differentiate APS from SARD patients. PG appears to interact with β2GPI of APS patients and exposes D1 thereof for disease-specific aPL binding in LIA. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - May 29, 2018 Category: Allergy & Immunology Source Type: research

Rhabdomyolysis secondary to systemic lupus erythematosus
We present a case report of a patient with an SLE exacerbation as well as concurrent rhabdomyolysis with massively elevated CPK (304,700  U/L). Though a rarely reported effect of SLE, rhabdomyolysis can be severe and potentially lethal secondary or concurrent to an acute SLE episode. This case report demonstrates the association between SLE and rhabdomyolysis, which is not well described in the current literature. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - April 6, 2018 Category: Allergy & Immunology Source Type: research

Isolated acute lupus pneumonitis as the initial presentation of systemic lupus erythematosus in an 8-year-old girl
AbstractSystemic lupus erythematosus (SLE) is a systemic autoimmune disease which has broad pleuropulmonary manifestations. One of the rare and mortal complications is acute lupus pneumonitis, which is reported very rarely, especially in childhood. Herein, we report an 8-year-old girl with isolated acute lupus pneumonitis as the initial presentation that required a lung biopsy for diagnosis. Although she had improvement with the administration of steroids, steroid treatment was reduced due to the drug ’s side effects resulting in the addition of azathioprine and mycophenolate mofetil to the treatment regimen. After t...
Source: Autoimmunity Highlights - March 27, 2018 Category: Allergy & Immunology Source Type: research

Diagnostic accuracy of a new fluoroenzyme immunoassay for the detection of TSH receptor autoantibodies in Graves ’ disease
ConclusionsThe diagnostic performance of ELiA™-TSH-R assay is comparable to that of some current TRAb assays. It may be adopted into clinical practice for the differential diagnosis of hyperthyroidism, to screen for transient hyperthyroidism, and to monitor disease activity and treatment effects. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - February 12, 2018 Category: Allergy & Immunology Source Type: research

Platelet-activating factor acetylhydrolase in primary antiphospholipid syndrome
(Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - February 10, 2018 Category: Allergy & Immunology Source Type: research

Role of vitamin D deficiency in systemic lupus erythematosus incidence and aggravation
AbstractVitamin D is one of the main groups of sterols; playing an important role in phospho-calcic metabolism. The conversion of 7-dehydrocholesterol to pre- vitamin D3 in the skin, through solar ultraviolet B radiation, is the main source of vitamin D. Since lupus patients are usually photosensitive, the risk of developing vitamin D deficiency in is high in this population. Although evidences showed the connotation between systemic lupus erythematosus (SLE) and vitamin D through which SLE can lead to lower vitamin D levels, it is also important to consider the possibility that vitamin D deficiency may have a causative ro...
Source: Autoimmunity Highlights - December 26, 2017 Category: Allergy & Immunology Source Type: research

Next-generation anti-CD20 monoclonal antibodies in autoimmune disease treatment
AbstractThe clinical success of anti-CD20 monoclonal antibody (mAb)-mediated B cell depletion therapy has contributed to the understanding of B cells as major players in several autoimmune diseases. The first therapeutic anti-CD20 mAb, rituximab, is a murine –human chimera to which many patients develop antibodies and/or experience infusion-related reactions. A second generation of anti-CD20 mAbs has been designed to be more effective, better tolerated, and of lower immunogenicity. These include the humanized versions: ocrelizumab, obinutuzumab, and v eltuzumab, and the fully human, ofatumumab. We conducted a literat...
Source: Autoimmunity Highlights - November 16, 2017 Category: Allergy & Immunology Source Type: research

HLA-DQ2 and -DQ8 haplotypes frequency and diagnostic utility in celiac disease patients of Gaza strip, Palestine
ConclusionsAbsence of HLA-DQ2 and HLA-DQ8 genotyping in the workup of patients may result in CD misdiagnosis, particularly in a setting with poor histopathological diagnostic capacity. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - November 15, 2017 Category: Allergy & Immunology Source Type: research

Personalized medicine in rheumatology: the paradigm of serum autoantibodies
AbstractThe sequencing of the human genome is now well recognized as the starting point of personalized medicine. Nonetheless, everyone is unique and can develop different phenotypes of the same disease, despite identical genotypes, as well illustrated by discordant monozygotic twins. To recognize these differences, one of the easiest and most familiar examples of biomarkers capable of identifying and predicting the outcome of patients is represented by serum autoantibodies. In this review, we will describe the concept of personalized medicine and discuss the predictive, prognostic and preventive role of antinuclear antibo...
Source: Autoimmunity Highlights - July 12, 2017 Category: Allergy & Immunology Source Type: research

Chemiluminescent immunoassay technology: what does it change in autoantibody detection?
AbstractDiagnostic technology is rapidly evolving, and over the last decade, substantial progress has been made even for the identification of antibodies, increasingly approaching this type of diagnostic to that of automated clinical chemistry laboratory. In this review, we describe the analytical and diagnostic characteristics of chemiluminescence technology in its strength and in its applicability for a more rapid and accurate diagnosis of autoimmune diseases. The wide dynamic range, greater than that of immunoenzymatic methods, the high sensitivity and specificity of the results expressed in quantitative form, the high ...
Source: Autoimmunity Highlights - June 24, 2017 Category: Allergy & Immunology Source Type: research

Definition of the upper reference limit for thyroglobulin antibodies according to the National Academy of Clinical Biochemistry guidelines: comparison of eleven different automated methods
ConclusionsDespite the efforts for harmonization, TgAb methods cannot be used interchangeably. Therefore, additional effort is required to improve analytical performance taking into consideration approved protocols and guidelines. Moreover, TgAb URL should be used with caution in the management of differentiated thyroid carcinoma patients since the presence and/or the degree of TgAb interference in Tg measurement has not yet been well defined. (Source: Autoimmunity Highlights)
Source: Autoimmunity Highlights - June 19, 2017 Category: Allergy & Immunology Source Type: research