The Clinical Relevance of Anti-DFS70 Autoantibodies Conrad, Karsten; Röber, Nadja; Andrade, Luis E. C. ...
Clinical Reviews in Allergy & Immunology,
04/2017, Volume:
52, Issue:
2
Journal Article, Book Review
Peer reviewed
Despite all the progress in the establishment of specific autoantibody assays, screening for antinuclear antibodies (ANA) by indirect immunofluorescence on HEp-2 cells for quality-oriented laboratory ...diagnosis of ANA associated rheumatic diseases (AARD) remains indispensable but is not without limitations. Recent data on the relevance of the dense fine speckled (DFS) pattern and anti-DFS70 antibodies disclosed novel possibilities to optimize the serological stepwise diagnostics of AARD. The DFS pattern on HEp-2 cells is well differentiated from the classic “homogeneous” ANA pattern associated with dsDNA antibodies. This is the most frequent pattern in high titer ANA-positive healthy persons. The most characteristic ANA specificity associated with DFS pattern is the anti-DFS70 antibody (synonym LEDGF antibody). The prevalence of anti-DFS70 antibodies in AARD patients is significantly lower compared with the prevalence in ANA-positive healthy persons. There is a negative association between anti-DFS70 antibodies and AARD, especially if no concomitant AARD-specific autoantibodies are found. Isolated anti-DFS70 antibodies are detectable in less than 1 % of AARD but are detectable in 2–22 % of healthy persons. In the presence of an isolated anti-DFS70 antibody, the posttest probability for AARD is reduced significantly. The significance of anti-DFS70 antibodies as a criterion that helps to exclude AARD is also confirmed by follow-up studies on anti-DFS70 antibodies of positive, healthy individuals, who did not develop any AARD during a 4 year observation period. Consequently, anti-DFS70 antibodies are valuable novel biomarkers for better interpretation of positive ANA in cases of negative AARD-associated autoantibodies and should be integrated in modified test algorithms to avoid unnecessary referrals and examinations of ANA-positive persons.
During the 12th International Workshop on Autoantibodies and Autoimmunity held in Sao Paulo, Brazil, on August 28, 2014, a full day session was devoted to establishing a consensus on the nomenclature ...of staining patterns observed in the antinuclear antibody (ANA) indirect immunofluorescence test on HEp-2 cells. The current report summarizes the collective agreements with input from the host Brazilian and international communities that represented research, clinical, and diagnostic service laboratories. Patterns are categorized in three major groups (nuclear, cytoplasmic, and mitotic patterns) and each pattern has been defined and described in detail. The consensus nomenclature and representative patterns are made available online at the international consensus on antinuclear antibody pattern (ICAP) website (www.ANApatterns.org). To facilitate continuous improvement and input, specific comments on ICAP are encouraged and these will be discussed in subsequent ICAP meetings. The ultimate goal with the establishment of the ICAP is to promote harmonization and understanding of autoantibody test nomenclature, as well as interpretation guidelines for ANA testing, thereby optimizing usage in patient care.
Results of the anti-nuclear antibodies-indirect immunofluorescence assay (anti-cell antibodies test) on HEp-2 cell substrates should be communicated to clinicians in a standardized way, adding value ...to laboratory findings and helping with critical clinical decisions. This paper proposes a test report based on the practices informed by 118 laboratories in 68 countries, with recommendations from the International Consensus on ANA Patterns (ICAP) group. Major focus is placed on the report format containing endpoint titers, immunofluorescence patterns together with anti-cell (AC) nomenclature, remarks on follow-up or reflex testing, and possible other autoantibody associations. ISO 15,189 directives were integrated into the test report. Special situations addressed include serum screening dilutions and endpoint titers, relevance of immunofluorescence patterns with special attention to cytoplasmic patterns, mixed and compound patterns, and how to report different titers corresponding to multiple patterns or autoantibodies in the same sample. This paper suggests a subtitle for the HEp-2-IIFA, namely anti-cell antibodies test, which could gradually substitute the original outdated ANA nomenclature. This ICAP
pro forma
report represents a further step in harmonizing the way relevant clinical information could be provided by laboratories.
AbstractObjectiveTo determine whether tocilizumab improves clinical outcomes for patients with severe or critical coronavirus disease 2019 (covid-19).DesignRandomised, open label trial.SettingNine ...hospitals in Brazil, 8 May to 17 July 2020.ParticipantsAdults with confirmed covid-19 who were receiving supplemental oxygen or mechanical ventilation and had abnormal levels of at least two serum biomarkers (C reactive protein, D dimer, lactate dehydrogenase, or ferritin). The data monitoring committee recommended stopping the trial early, after 129 patients had been enrolled, because of an increased number of deaths at 15 days in the tocilizumab group.InterventionsTocilizumab (single intravenous infusion of 8 mg/kg) plus standard care (n=65) versus standard care alone (n=64).Main outcome measureThe primary outcome, clinical status measured at 15 days using a seven level ordinal scale, was analysed as a composite of death or mechanical ventilation because the assumption of odds proportionality was not met.ResultsA total of 129 patients were enrolled (mean age 57 (SD 14) years; 68% men) and all completed follow-up. All patients in the tocilizumab group and two in the standard care group received tocilizumab. 18 of 65 (28%) patients in the tocilizumab group and 13 of 64 (20%) in the standard care group were receiving mechanical ventilation or died at day 15 (odds ratio 1.54, 95% confidence interval 0.66 to 3.66; P=0.32). Death at 15 days occurred in 11 (17%) patients in the tocilizumab group compared with 2 (3%) in the standard care group (odds ratio 6.42, 95% confidence interval 1.59 to 43.2). Adverse events were reported in 29 of 67 (43%) patients who received tocilizumab and 21 of 62 (34%) who did not receive tocilizumab.ConclusionsIn patients with severe or critical covid-19, tocilizumab plus standard care was not superior to standard care alone in improving clinical outcomes at 15 days, and it might increase mortality.Trial registrationClinicalTrials.gov NCT04403685.
Photoluminescence quantum yields denote a critical variable to characterise a fluorophore and its potential performance. Their determination, by means of methodologies employing reference standard ...materials, inevitably leads to large uncertainties. In response to this, herein we report for the first time an innovative and elegant methodology, whereby the use of neat solvent/reference material required by thermal lens approaches is eliminated by coupling it to photoluminescence spectroscopy, allowing for the discrimination between materials with similar photoluminescence quantum yields. To achieve this, both radiative and non-radiative transitions are simultaneously measured using a photoluminescence spectrometer coupled to a multiwavelength thermal lens spectroscopy setup in a mode-mismatched dual-beam configuration, respectively. The absorption factor independent ratio of the thermal lens and photoluminescence signals can then be used to determine the fluorescence quantum yield both accurately and precisely. We validated our reported method using rhodamine 6G and further applied it to three novel structurally related diketopyrrolopyrrole based materials, which, in contrast to results obtained by other methods, unveiled significant differences in their photoluminescence quantum yields.
A novel true absolute method to determine photoluminescence quantum yields by coupling thermal lens and photoluminescence spectroscopy is demonstrated.
The world’s eyes are on Latin America as a place of radical political inspiration and as an alternative to the neoliberal model. Each country in the region deals differently in its method of ...government, yet there are common cultural themes that tie the continent’s trajectory together. Religion without Redemption looks at the sociology of religion, political philosophy and the history of ideas of the continent, in an attempt to show how Western understanding fails to come close to a correct analysis of how and why political and economic characteristics work as they do. Luis Martínez Andrade focuses on how the centrality of religion for the people of Latin America has influenced how they interact with the changes in the modern economic system. Capitalism, for example, has taken on religious characteristics: it has sacred places of worship (the shopping mall) as well as its own prophets. Martínez Andrade discusses how this form of ‘cultural religion’ accompanies many aspects of life in a contradictory manner: not only does it fulfil the role of legitimating oppression, it also can be a powerful source of rebellion, unveiling thus a subversive side to the status quo. Religion Without Redemption advances the ideas of liberation theory into the 21st century, and challenges the provincialism to which many Latin American thinkers are usually consigned.
The indirect immunofluorescence assay (IIFA) on HEp-2 cells is widely used for detection of antinuclear antibodies (ANA). The dichotomous outcome, negative or positive, is integrated in diagnostic ...and classification criteria for several systemic autoimmune diseases. However, the HEp-2 IIFA test has much more to offer: besides the titre or fluorescence intensity, it also provides fluorescence pattern(s). The latter include the nucleus and the cytoplasm of interphase cells as well as patterns associated with mitotic cells. The International Consensus on ANA Patterns (ICAP) initiative has previously reached consensus on the nomenclature and definitions of HEp-2 IIFA patterns. In the current paper, the ICAP consensus is presented on the clinical relevance of the 29 distinct HEp-2 IIFA patterns. This clinical relevance is primarily defined within the context of the suspected disease and includes recommendations for follow-up testing. The discussion includes how this information may benefit the clinicians in daily practice and how the knowledge can be used to further improve diagnostic and classification criteria.
The use of silver nanoparticles (AgNPs) in commercial products has increased significantly in recent years. However, findings on the toxic effects of the AgNPs are still limited. This paper reports ...an investigation on the cytotoxic and genotoxic potential of the AgNPs on root cells of Allium cepa. Germination (GI), root elongation (REI), mitotic (MI), nuclear abnormality (NAI), and micronucleus index (MNI) were determined for seeds exposed to various AgNPs diameters (10, 20, 51, and 73 nm) as well as to the silver bulk (AgBulk) (micrometer-size particles) at the concentration of 100 mg·L−1. Transmission electron microscopy (TEM) provided the particle size distribution, while dynamic light scattering (DLS) was used to get the hydrodynamic size, polydispersity index, and zeta potential of the AgNPs. Laser-induced breakdown spectroscopy (LIBS) and inductively coupled plasma/optical emission spectrometry (ICP OES) were applied for quantifying the AgNPs content uptake by roots. Silver dissolution was determined by dialysis experiment. Results showed that the AgNPs penetrated the roots, affecting MI, GI, NAI, and MNI in meristematic cells. Changes in these indicators were AgNPs diameter-dependent so that cytotoxic and genotoxic effects in Allium cepa increased with the reduction of the particle diameter. The results also revealed that the AgNPs were the main responsible for the cytotoxicity and genotoxicity since negligible silver dissolution was observed.
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•Allium cepa seeds were exposed to different AgNPs dimensions (10, 20, 51, and 73 nm)•Cytotoxic and genotoxic effects of the AgNPs on root cells of the A. cepa were tested.•AgNPs were able to penetrate in plant cell and cause cell toxicity.•Cytotoxic and genotoxic effects increased with decreasing AgNPs diameter.•AgNPs were the main responsible for the toxicity.
We aim to evaluate the prevalence of vitamin D deficiency in patients with systemic lupus erythematosus (SLE) and investigate the association between total, free and bioavailable vitamin D serum ...concentrations and disease activity. Patients with SLE (ACR 1997) consecutively seen at UNIFESP's outpatient's clinics had disease activity measured after clinical and laboratory evaluation using SLEDAI (Systemic Lupus Erythematosus Disease Activity Index). 25-hydroxyvitamin D (25(OH)D) serum concentrations measured by chemiluminescence and vitamin D binding protein (DBP) measured by ELISA were used to calculate free and bioavailable vitamin D. Healthy blood donors were used as controls. A total of 142 patients (71.4%) had 25(OH)D serum concentrations below 30 ng/mL. Total 25(OH)D serum concentration was associated with disease activity categorized in 5 continuous groups of SLEDAI. 25(OH)D serum concentrations were higher among patients with SLEDAI 1-5 and lower in those with severe activity (SLEDAI≥20) (p <0.05). On the other hand, no statistically significant difference was observed for DBP, free and bioavailable vitamin D measurements in the disease activity subgroups evaluated. Vitamin D deficiency is highly prevalent among patients with SLE and was associated with higher disease activity. DBP serum level and calculation of free and bioavailable vitamin D were not associated with SLE disease activity.
The indirect immunofluorescence assay on HEp-2 cells (HEp-2 IFA) is still considered the reference method to detect anti-nuclear antibodies (ANA) because of its high sensitivity and represents a ...relevant tool for the diagnosis of autoimmune rheumatic diseases. During the last decade, the International Consensus on ANA Patterns (ICAP) initiative promoted harmonization and understanding of HEp-2 IFA staining pattern nomenclature, as well as promoting their use in patient care by providing interpretation for HEp-2 IFA test results. In conjunction with a nationwide survey on the evolution of autoantibody diagnostics in autoimmune rheumatic diseases, we focused on the adherence of the Italian laboratories to the ICAP nomenclature analyzing its lights and shadows. The recent ICAP-oriented report, largely used today among Italian laboratories, also represents a further step in harmonizing and improving communication with the clinicians, adding value to laboratory findings and helping with critical clinical decisions.
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