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Olle EW, Deogracias MP, Messamore JE, McClintock SD, Barron AG, Anderson TD, Johnson KJ. Screening of serum samples from Wegener's granulomatosis patients using antibody microarrays. Proteomics Clin Appl 2007; 1:1212-20. [PMID: 21136620 DOI: 10.1002/prca.200600906] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2006] [Indexed: 02/02/2023]
Abstract
Wegener's Granulomatosis (WG) is an idiopathic granulomatosis autoimmune vasculitis that primarily affects small vessels and is associated with glomerulonephritis and pulmonary granulomatous vasculitis. Anti-neutrophil cytoplasmic auto-antibodies (cANCA) against proteinase-3 are used to identify WG, but ANCA titers are not present in some patients with the localized disease. The objective of this study was to develop an antibody array to help identify protein expression patterns in serum from patients with WG as compared to normals. The arrays were tested for limits of detection, background, and cross reactivity using standard proteins. The arrays were hybridized with either normal patient serum (n = 30) or with serum samples from a population of WG patients (n = 26) that were age and sex matched. Data analysis and curve fitting of the standard dilution series calculated r(2) values and determined a sensitivity of <50 pg/mL for the majority of proteins. A total of 24 proteins were assessed. Several statistically significant increases (p<0.05) were seen in the expression of: angiotensin converting enzyme-I, IFN-γ, IL-8, s-ICAM-1 and s-VCAM in WG patients as compared to controls. Utilizing the antibody microarray technology has led to the identification of potential biomarkers of vascular injury in the serum of WG patients.
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Affiliation(s)
- Eric W Olle
- University of Michigan, Department of Pathology, Ann Arbor, MI, USA; Safety Sciences, Pfizer Global Research & Development, Ann Arbor, MI, USA
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Kwon CI, Park PW, Kang H, Kim GI, Cha ST, Kim KS, Ko KH, Hong SP, Hwang SG, Rim KS. The usefulness of angiotensin converting enzyme in the differential diagnosis of Crohn's disease and intestinal tuberculosis. Korean J Intern Med 2007; 22:1-7. [PMID: 17427637 PMCID: PMC2687597 DOI: 10.3904/kjim.2007.22.1.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Since the pathologic findings of Crohn's disease (CD) and intestinal tuberculosis (IT) overlap to a large degree, the development of other biomarkers will be of great help for making the differential diagnosis of these 2 diseases. The aim of the present study is to examine the clinical efficacy of using the tissue angiotensin converting enzyme (ACE) assay in making the differential diagnosis between CD and IT. METHODS Tissue specimens were obtained from 36 patients who were diagnosed with CD or IT by the colonoscopic biopsy, as well as by the clinical findings. The expression of tissue ACE was detected by immunohistochemical staining. The optimal cut-off value of the immunoreactive scoring (IRS) system we used to differentiate CD from IT was determined by analysis of the ROC curve and AUROC. RESULTS Granuloma was present in 15 of 19 patients with CD (78.9%) and in 15 of 17 patients with IT (88.2%). ACE was present in the cytoplasm of the epithelioid cells in the granulomas from 13 of 15 patients with CD and in 14 of 15 patients with IT. The IRS scores of ACE were greater in the patients with CD than that of the patients with IT (8.07 +/- 4.38 vs. 4.13 +/- 2.47, respectively, p = 0.006). In differentiating CD from IT, the AUROC curve for the IRS of ACE was 0.767 with a sensitivity of 66.7%, a specificity of 93.3% and the cut-off point was 7.5. CONCLUSIONS The results of our study suggest that the assessment of the tissue ACE expression can be helpful for making the differential diagnosis between CD and IT.
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Affiliation(s)
- Chang-Il Kwon
- Department of Internal Medicine, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Seongnam, Korea
| | - Pil Won Park
- Department of Internal Medicine, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Seongnam, Korea
| | - Haeyoun Kang
- Department of Pathology, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Seongnam, Korea
| | - Gwang Il Kim
- Department of Pathology, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Seongnam, Korea
| | - Sung Tae Cha
- Department of Internal Medicine, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Seongnam, Korea
| | - Kyung Soo Kim
- Department of Internal Medicine, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Seongnam, Korea
| | - Kwang Hyun Ko
- Department of Internal Medicine, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Seongnam, Korea
| | - Sung Pyo Hong
- Department of Internal Medicine, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Seongnam, Korea
| | - Seong Gyu Hwang
- Department of Internal Medicine, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Seongnam, Korea
| | - Kyu Sung Rim
- Department of Internal Medicine, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Seongnam, Korea
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Noël JM, Katona IM, Piñeiro-Carrero VM. Sarcoidosis resulting in duodenal obstruction in an adolescent. J Pediatr Gastroenterol Nutr 1997; 24:594-8. [PMID: 9161957 DOI: 10.1097/00005176-199705000-00018] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- J M Noël
- Department of Pediatrics and Medicine, F Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814-4799, USA
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Mombaerts I, Schlingemann RO, Goldschmeding R, Koornneef L. Idiopathic granulomatous orbital inflammation. Ophthalmology 1996; 103:2135-41. [PMID: 9003349 DOI: 10.1016/s0161-6420(96)30378-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Granulomatous orbital inflammation may occur as an isolated condition of unknown origin. These idiopathic granulomatous lesions are believed to belong to the orbital pseudotumor group by some authors, whereas others consider them sarcoidosis limited to the orbit. The aim of this study is to define the clinicotherapeutic aspects of these lesions. METHODS The records of all patients with diagnosis of orbital pseudotumor and orbital sarcoidosis from the Orbital Center Amsterdam in the period between 1976 and 1994 were reviewed to define those with idiopathic granulomatous orbital inflammation. The authors studied the clinicotherapeutic aspects and histopathology of idiopathic granulomatous orbital inflammation by analysis of their own series and the literature. RESULTS Their study group encompassed seven patients with idiopathic granulomatous orbital inflammation. The mean follow-up was 9.5 years (range, 3.5-16.0 years). All had unilateral orbital presentation, with localization in the lacrimal gland in three patients. The lesions clinically presented with signs of mass effect or inflammation or both and were treated successfully with surgery, systemic corticosteroids, a combination of surgery and systemic corticosteroids, or systemic corticosteroids followed by irradiation. Histopathologic analysis showed a spectrum of granulomatous inflammation, admixed with nongranulomatous inflammation and fibrosis. There have been 30 similar cases described in the literature with comparable clinicotherapeutic characteristics. CONCLUSIONS Based on this study and the literature, it appears that idiopathic granulomatous orbital inflammation is more related to orbital pseudotumor than to orbital sarcoidosis.
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Affiliation(s)
- I Mombaerts
- Department of Ophthalmology, Academic Medical Center, University of Amsterdam, The Netherlands
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 35-1996. A 57-year-old woman with fever, sweats, neuropathy, and multiple pulmonary nodules. N Engl J Med 1996; 335:1514-21. [PMID: 8890104 DOI: 10.1056/nejm199611143352008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 31-1995. A 43-year-old man with multifocal neurologic problems and confusion. N Engl J Med 1995; 333:992-9. [PMID: 7666921 DOI: 10.1056/nejm199510123331509] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Abstract
Recent research is helping us understand the complex interactions that occur between platelets and their environment. The several intracellular events that occur during platelet activation are being identified as ar their effects on other platelets, the endothelium and coagulation factors. Heightened platelet activation is seen early in essential hypertension and probably plays an important role in the initiation and progression of atherosclerosis and the disorders associated with it. This review identifies some of the changes in platelet structure and function in essential hypertension and their role in the pathogenesis of hypertensive vascular disease.
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Affiliation(s)
- I F Islim
- Cardiology Department, City Hospital, Birmingham, U.K
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Gross WL, Schmitt WH, Csernok E. ANCA and associated diseases: immunodiagnostic and pathogenetic aspects. Clin Exp Immunol 1993; 91:1-12. [PMID: 8419069 PMCID: PMC1554662 DOI: 10.1111/j.1365-2249.1993.tb03345.x] [Citation(s) in RCA: 214] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
The past decade has seen an explosion of data on the new group of autoantibodies known collectively as ANCA (anti-neutrophil cytoplasmic antibodies). ANCA are specific for granule proteins of granulocytes and monocytes and induce distinct fluorescence patterns, e.g. the cytoplasmic (classic) cANCA and the perinuclear pANCA. cANCA is induced by antibodies directed against Proteinase 3 (PR3; PR3-ANCA) in about 90% of all ANCA-positive sera, and pANCA is induced by antibodies against myeloperoxidase (MPO; MPO-ANCA) in about 40%. A further staining pattern, which does not have a clear cut association with a distinct granule protein, is sometimes seen in chronic inflammatory bowel diseases. PR3-ANCA are serological markers for Wegener's granulomatosis (WG) and MPO-ANCA are associated with certain subtypes of primary vasculitides. Evidence exists that both the autoantigen and ANCA participate in the pathogenesis of at least the group of 'ANCA-associated vasculitides'.
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Affiliation(s)
- W L Gross
- Department of Clinical Rheumatology, Medical University of Lübeck, Bad Bramstedt, Germany
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Fuss M, Pepersack T, Gillet C, Karmali R, Corvilain J. Calcium and vitamin D metabolism in granulomatous diseases. Clin Rheumatol 1992; 11:28-36. [PMID: 1582115 DOI: 10.1007/bf02207080] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Overproduction of the active metabolite of vitamin D 1,25-dihydroxyvitamin D (1,25(OH)2D) has been described in sarcoidosis and other granulomatous diseases. High circulating concentrations of 1,25(OH)2D lead to increased intestinal absorption of calcium, possibly to enhanced bone resorption, and may result in hypercalcaemia and/or hypercalciuria. Data obtained in vivo and in vitro demonstrated that the unregulated production of 1,25(OH)2D lies within the granulomatous tissue and is controlled by glucocorticoids. This abnormal production of 1,25(OH)2D seems to be a general phenomenon of granulomatous processes, which is not exceptional in sarcoidosis, but appears seldom in tuberculosis. These abnormalities, however, are not pathognomonic of granulomatous processes, since they have been described in other diseases such as lymphomas.
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Affiliation(s)
- M Fuss
- Department of Internal Medicine, Endocrinology and Metabolism, Brugmann University Hospital, Université Libre de Bruxelles, Belgium
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Pellegrini V, Ohno S, Hirose S, Matsuda H, Hiraga Y. Subretinal neovascularisation and snow banking in a case of sarcoidosis: case report. Br J Ophthalmol 1986; 70:474-7. [PMID: 2424490 PMCID: PMC1041046 DOI: 10.1136/bjo.70.6.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A 49-year-old Japanese man presented with chronic granulomatous uveitis in his left eye. Later he developed macular subretinal neovascularisation. The chest x-ray showed bilateral hilar lymphadenopathy. Bronchoscopy and gallium-67 scanning were positive, PPD skin test negative, and serum angiotensin converting enzyme (ACE) levels increased. Ophthalmoscopy and fluorescein angiography of the left eye showed perivasculitis, retinochoroidal exudates, snow banking, and vitreous opacity. On these findings, the diagnosis of sarcoidosis was made. Treatment was based on topical corticosteroids, mydriatics, beta blockers, and oral carbonic anhydrase inhibitors. After 15 months the visual acuity decreased in the left eye, and a neovascular membrane was observed in the macula. Fluorescein angiography confirmed subretinal neovascularisation. Almost two years later the patient still has the neovascular membrane in his left eye.
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Niarchos AP, Resnick LM, Weinstein DL, Laragh JH. Angiotensin I converting enzyme activity in hypertension. Relationship to blood pressure, renin-sodium profiles, and antihypertensive therapy. Am J Med 1985; 79:435-44. [PMID: 2864856 DOI: 10.1016/0002-9343(85)90030-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The activity of the angiotensin I converting enzyme was measured in 55 patients with untreated essential hypertension, 11 patients with untreated renovascular hypertension, five patients with untreated primary aldosteronism, and 23 normotensive subjects. Converting enzyme activity was significantly higher (p less than 0.025 or less) in essential hypertension (28 +/- 1 units/ml) and renovascular hypertension (28.5 +/- 3 units/ml) when compared with the activity in the normotensive subjects (21 +/- 1.5 units/ml). Seventeen (31 percent) of the patients with essential hypertension and three (27 percent) patients with renovascular hypertension had an elevated converting enzyme activity above the mean +2 standard deviations value of the normotensive subjects (32.8 units/ml), ranging from 33 to 55.8 units/ml. Converting enzyme activity was similar in black and white patients and in male and female patients, but it tended to decrease with increasing age in both the hypertensive and the normotensive subjects. In the untreated patients with essential hypertension (n = 55), converting enzyme activity was inversely related to mean arterial pressure and age (r = -0.34, p less than 0.01) and positively related to plasma renin activity (r = 0.31, p less than 0.05). Converting enzyme activity was always decreased during captopril therapy, and it was not affected by beta blockers, but it was increased by diuretics. These findings indicate that converting enzyme activity is elevated in patients with essential and renovascular hypertension.
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Grange JM, Mitchell DN, Kemp M, Kardjito T. Serum angiotensin-converting enzyme and delayed hypersensitivity in pulmonary tuberculosis. TUBERCLE 1984; 65:117-21. [PMID: 6087522 DOI: 10.1016/0041-3879(84)90063-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
In contrast to sarcoidosis, there was no difference between serum angiotensin-converting enzyme (ACE) levels in a group of 100 adult Indonesian patients with active pulmonary tuberculosis and in 108 matched healthy control subjects. There was a significant inverse correlation between the diameter of the cutaneous reaction to tuberculin and serum ACE levels. It is postulated that, as both delayed hypersensitivity and ACE synthesis within granulomas appear to be the result of T-cell induced secretory activities of macrophages, this inverse relationship results from competition for receptor sites for the relevant signal molecules on the macrophage surface.
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Davies SF, Rohrbach MS, Thelen V, Kuritsky J, Gruninger R, Simpson ML, DeRemee RA. Elevated serum angiotensin-converting enzyme (SACE) activity in acute pulmonary histoplasmosis. Chest 1984; 85:307-10. [PMID: 6321112 DOI: 10.1378/chest.85.3.307] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Serum angiotensin-converting enzyme (SACE) levels were measured in 44 subjects six weeks after acute pulmonary histoplasmosis. All patients were infected in a common-source outbreak of histoplasmosis which occurred on one day. All patients had both strictly defined clinical and serologic evidence of infection. The SACE activity was elevated at six weeks compared to normal controls, and seven of the 44 had levels more than 2 SD above the normal mean. SACE levels were also measured at three and 24 weeks after acute infection in a smaller number of the same subjects. Serial observations demonstrated that all subjects (including those with normal and elevated SACE at six weeks) had a rise and fall in SACE activity following symptomatic acute pulmonary histoplasmosis. Our findings suggest that elevated SACE does not reliably separate sarcoidosis from histoplasmosis, although elevations in histoplasmosis are much less common and may occur only briefly following acute pulmonary histoplasmosis. More important, it seems that SACE activity rises acutely in all patients with symptomatic acute histoplasmosis and then falls gradually toward baseline over several months, coinciding temporally with the granulomatous response.
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Abstract
A 37-year-old Caucasian woman presented with a blind left eye and granulomatous panuveitis in the right eye. There was a subretinal neovascular membrane with haemorrhage beneath the macula and widespread subretinal lesions that were interpreted as choroidal granulomas in the right eye. A chest x-ray that showed diffuse pulmonary fibrosis without hilar lymphadenopathy was the only contributory clinical finding. Systemic and subconjunctival steroids and photocoagulation to the right macula brought about temporary remission. The painful left eye was enucleated. Histopathological examination revealed diffuse, noncaseating granulomas in the iris and ciliary body, retina, choroid, optic nerve, sclera and scleral emissaria, and inferior oblique muscle. A preretinal membrane was studied by electron microscopy. It was composed of a collagenous matrix containing fibroblasts and fibrous astrocytes. Some vessels, surrounded by a multilaminar basement membrane, revealed many features of normal retinal vasculature. Others were lined by markedly attenuated endothelial cells with occasional "open' junctions and fenestrations.
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Borowsky SA, Lieberman J, Strome S, Sastre A. Elevation of Serum Angiotensin-Converting Enzyme Level. ACTA ACUST UNITED AC 1982. [DOI: 10.1001/archinte.1982.00340180051011] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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