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Lakota K, Perdan-Pirkmajer K, Sodin-Šemrl S, Čučnik S, Šubelj V, Prosenc K, Mrak Poljšak K, Tomšič M, Ambrožič A, Praprotnik S. The immunogenicity of seasonal and pandemic influenza vaccination in autoimmune inflammatory rheumatic patients-a 6-month follow-up prospective study. Clin Rheumatol 2019; 38:1277-1292. [PMID: 30761436 DOI: 10.1007/s10067-019-04439-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/07/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Influenza may cause severe complications in patients with autoimmune inflammatory rheumatic disease (AIRD), to whom vaccinations are especially recommended. However, AIRD patients require cautious scrutiny of immunogenicity as they might exhibit poor antibody response to vaccination, especially when taking immunomodulatory medications. AIM The aim was to determine immunogenicity of seasonal and pandemic influenza vaccine in AIRD patients, its timeline/persistence, and influence of medications on immune response. METHODS One hundred and thirty-seven AIRD and 54 healthy controls were vaccinated with trivalent seasonal influenza. After 3-5 weeks, 15 healthy controls and 93 AIRD were vaccinated with pandemic influenza vaccine, and 63 of patients were vaccinated a second time after 3-5 weeks. Sera were collected before vaccination, 18-90 days after each vaccination, and more than 180 days after the last vaccination. The immune response was measured using hemagglutination inhibition (HI) assay and IgG/IgA antibodies against influenza A/B with ELISA. RESULTS Our findings indicate that following vaccination with seasonal influenza vaccine, seroprotection, seroresponse, and change in geometric mean titers (GMT) in AIRD patients was not compromised compared to healthy. Similarly, we report for pandemic influenza vaccination little added benefit of the second dose. We confirm lowest increase in HI titer in rituximab-treated AIRD compared to other medications. Vaccination largely tilts the balance from negative ELISA A IgG and IgA titers to positive titers in seasonal H1N1 seroresponsive AIRD patients and controls. A significant decrease in HI GMT and seroprotection was observed only in AIRD at > 180 days after vaccination highlighting an absent persistence of immunogenic response in AIRD patients. Due to high initial HI titers for influenza vaccine, we foresee their benefit in personalized medicine in the future. CONCLUSION Influenza vaccination is immunologically active for AIRD, with little value of the second dose of the pandemic vaccine and further scrutiny on persistence of immune response to vaccine in AIRD is needed.
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Affiliation(s)
- K Lakota
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, 1000, Slovenia.
- Faculty of Mathematics, Natural Science and Information Technologies, University of Primorska, 6000, Koper, Slovenia.
| | - K Perdan-Pirkmajer
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, 1000, Slovenia
| | - S Sodin-Šemrl
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, 1000, Slovenia
- Faculty of Mathematics, Natural Science and Information Technologies, University of Primorska, 6000, Koper, Slovenia
| | - S Čučnik
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, 1000, Slovenia
- Chair of Pharmacy, University of Ljubljana, 1000, Ljubljana, Slovenia
| | - V Šubelj
- Laboratory for public health virology, National Laboratory for Health, Environment and Food, Ljubljana, 1000, Slovenia
| | - K Prosenc
- Laboratory for public health virology, National Laboratory for Health, Environment and Food, Ljubljana, 1000, Slovenia
| | - K Mrak Poljšak
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, 1000, Slovenia
| | - M Tomšič
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, 1000, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000, Ljubljana, Slovenia
| | - A Ambrožič
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, 1000, Slovenia
| | - S Praprotnik
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, 1000, Slovenia
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Lakota K, Švec T, Kveder T, Sodin-Šemrl S, Žigon P, Ambrožič A, Ogrič M, Markez S, Božič B, Tomšič M, Čučnik S. Autoantibodies against dsDNA measured with nonradioactive Farr assay—an alternative for routine laboratories. Clin Rheumatol 2018; 38:353-359. [DOI: 10.1007/s10067-018-4271-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 07/30/2018] [Accepted: 08/20/2018] [Indexed: 10/28/2022]
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Amengual O, Forastiero R, Sugiura-Ogasawara M, Otomo K, Oku K, Favas C, Delgado Alves J, Žigon P, Ambrožič A, Tomšič M, Ruiz-Arruza I, Ruiz-Irastorza G, Bertolaccini ML, Norman GL, Shums Z, Arai J, Murashima A, Tebo AE, Gerosa M, Meroni PL, Rodriguez-Pintó I, Cervera R, Swadzba J, Musial J, Atsumi T. Evaluation of phosphatidylserine-dependent antiprothrombin antibody testing for the diagnosis of antiphospholipid syndrome: results of an international multicentre study. Lupus 2016; 26:266-276. [PMID: 27510605 DOI: 10.1177/0961203316660203] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective A task force of scientists at the International Congress on Antiphospholipid Antibodies recognized that phosphatidylserine-dependent antiprothrombin antibodies (aPS/PT) might contribute to a better identification of antiphospholipid syndrome (APS). Accordingly, initial and replication retrospective, cross-sectional multicentre studies were conducted to ascertain the value of aPS/PT for APS diagnosis. Methods In the initial study (eight centres, seven countries), clinical/laboratory data were retrospectively collected. Serum/plasma samples were tested for IgG aPS/PT at Inova Diagnostics (Inova) using two ELISA kits. A replication study (five centres, five countries) was carried out afterwards. Results In the initial study ( n = 247), a moderate agreement between the IgG aPS/PT Inova and MBL ELISA kits was observed ( k = 0.598). IgG aPS/PT were more prevalent in APS patients (51%) than in those without (9%), OR 10.8, 95% CI (4.0-29.3), p < 0.0001. Sensitivity, specificity, positive (LR+) and negative (LR-) likelihood ratio of IgG aPS/PT for APS diagnosis were 51%, 91%, 5.9 and 0.5, respectively. In the replication study ( n = 214), a moderate/substantial agreement between the IgG aPS/PT results obtained with both ELISA kits was observed ( k = 0.630). IgG aPS/PT were more prevalent in APS patients (47%) than in those without (12%), OR 6.4, 95% CI (2.6-16), p < 0.0001. Sensitivity, specificity, LR + and LR- for APS diagnosis were 47%, 88%, 3.9 and 0.6, respectively. Conclusions IgG aPS/PT detection is an easily performed laboratory parameter that might contribute to a better and more complete identification of patients with APS.
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Affiliation(s)
- O Amengual
- 1 Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - R Forastiero
- 2 Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Departamento de Fisiologia, Hemostasia y Trombosis, Buenos Aires, Argentina
| | - M Sugiura-Ogasawara
- 3 Department of Obstetrics and Gynecology, Nagoya City University, Graduated School of Medical Sciences, Nagoya, Japan
| | - K Otomo
- 1 Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - K Oku
- 1 Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - C Favas
- 4 Department of Medicine IV, Fernando Fonseca Hospital, Amadora and CEDOC/NOVA Medical School, Lisbon, Portugal
| | - J Delgado Alves
- 4 Department of Medicine IV, Fernando Fonseca Hospital, Amadora and CEDOC/NOVA Medical School, Lisbon, Portugal
| | - P Žigon
- 5 Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - A Ambrožič
- 5 Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - M Tomšič
- 5 Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - I Ruiz-Arruza
- 6 Autoimmune Diseases Research Unit, Department of Internal Medicine, Biocruces Health Research Institute, Hospital Universitario Cruces, University of The Basque Country, Spain
| | - G Ruiz-Irastorza
- 6 Autoimmune Diseases Research Unit, Department of Internal Medicine, Biocruces Health Research Institute, Hospital Universitario Cruces, University of The Basque Country, Spain
| | - M L Bertolaccini
- 7 Academic Department of Vascular Surgery, Cardiovascular Division, King's College London, UK
| | - G L Norman
- 8 Inova Diagnostics Inc., San Diego, CA, USA
| | - Z Shums
- 8 Inova Diagnostics Inc., San Diego, CA, USA
| | - J Arai
- 9 Medical and Biological Laboratories, Co. Ltd, Nagano, Japan
| | - A Murashima
- 10 Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - A E Tebo
- 11 Department of Pathology, University of Utah and ARUP Laboratories, Salt Lake City, UT, USA
| | - M Gerosa
- 12 Department of Clinical Sciences and Community Health, Istituto Auxologico Italiano, University of Milan, Milan, Italy
| | - P L Meroni
- 12 Department of Clinical Sciences and Community Health, Istituto Auxologico Italiano, University of Milan, Milan, Italy
| | - I Rodriguez-Pintó
- 13 Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain
| | - R Cervera
- 13 Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain
| | - J Swadzba
- 14 Department of Medicine Jagiellonian University, Cracow, Poland
| | - J Musial
- 14 Department of Medicine Jagiellonian University, Cracow, Poland
| | - T Atsumi
- 1 Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Ješe R, Ambrožič A, Gašperšič N, Hočevar A, Lestan B, Plešivčnik Novljan M, Praprotnik S, Rotar Ž, Šipek A, Šuput Skvarča D, Pavic Nikolic M, Tomsic M. AB0238 The Performance of A Single Centre Interventional Clinic in Early Rheumatoid Arthritis: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Perdan Pirkmajer K, Blokar E, Čepar M, Melik Ž, Ambrožič A, Cankar K. FRI0334 Altered Cutaneous Microvascular Function in Patients with Antiphospholipid Syndrome. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Perdan-Pirkmajer K, Pirkmajer S, Thevis M, Thomas A, Praprotnik S, Hočevar A, Rotar Ž, Gašperšič N, Sodin-Šemrl S, Žibert J, Omersel J, Chibalin AV, Tomšič M, Ambrožič A. Methotrexate reduces HbA1c concentration but does not produce chronic accumulation of ZMP in patients with rheumatoid or psoriatic arthritis. Scand J Rheumatol 2016; 45:347-55. [PMID: 26726793 DOI: 10.3109/03009742.2015.1105290] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The mechanism by which methotrexate (MTX) improves glucose homeostasis in patients with rheumatoid (RA) and psoriatic arthritis (PsA) remains undetermined. Animal studies indicate a role for intracellular accumulation of 5-aminoimidazole-4-carboxamide-1-β-d-ribofuranosyl 5'-monophosphate (ZMP) but this has not been directly demonstrated in humans. We explored whether accumulation of ZMP is associated with improvements in glucose homeostasis during MTX therapy. METHOD MTX-naïve, non-diabetic RA (n = 16) and PsA (n = 10) patients received uninterrupted MTX treatment for 6 months. To evaluate whether ZMP accumulated during MTX therapy, we measured the concentration of ZMP in erythrocytes and the concentration of its dephosphorylated derivative 5-aminoimidazole-4-carboxamide-1-β-d-ribofuranoside (AICAR) in urine using liquid chromatography mass spectrometry (LC-MS/MS). To assess glucose homeostasis, we determined the concentration of glycated haemoglobin (HbA1c) and homeostasis model assessment of insulin resistance [HOMA-IR: fasting glucose (mmol/L) × fasting insulin (μU/mL)/22.5]. RESULTS Erythrocyte ZMP and urinary AICAR concentrations did not increase during 6 months of MTX therapy. HbA1c concentration was reduced from 5.80 ± 0.29% at baseline to 5.51 ± 0.32% at 6 months (p < 0.001), while HOMA-IR remained unaltered. Reduction in HbA1c concentration was not associated with increased ZMP or AICAR concentrations. CONCLUSIONS MTX therapy probably does not produce a chronic increase in erythrocyte ZMP or urinary AICAR concentrations. Collectively, our data do not support the hypothesis that MTX improves glucose homeostasis through chronic accumulation of ZMP.
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Affiliation(s)
- K Perdan-Pirkmajer
- a Department of Rheumatology , University Medical Centre Ljubljana , Slovenia
| | - S Pirkmajer
- b Institute of Pathophysiology, Faculty of Medicine , University of Ljubljana , Slovenia
| | - M Thevis
- c Institute of Biochemistry, Centre for Preventive Doping Research , German Sport University Cologne , Germany
| | - A Thomas
- c Institute of Biochemistry, Centre for Preventive Doping Research , German Sport University Cologne , Germany
| | - S Praprotnik
- a Department of Rheumatology , University Medical Centre Ljubljana , Slovenia
| | - A Hočevar
- a Department of Rheumatology , University Medical Centre Ljubljana , Slovenia
| | - Ž Rotar
- a Department of Rheumatology , University Medical Centre Ljubljana , Slovenia
| | - N Gašperšič
- a Department of Rheumatology , University Medical Centre Ljubljana , Slovenia
| | - S Sodin-Šemrl
- a Department of Rheumatology , University Medical Centre Ljubljana , Slovenia
| | - J Žibert
- d Faculty of Health Sciences , University of Ljubljana , Slovenia
| | - J Omersel
- e Faculty of Pharmacy , University of Ljubljana , Slovenia
| | - A V Chibalin
- f Department of Molecular Medicine and Surgery, Integrative Physiology , Karolinska Institutet , Stockholm , Sweden
| | - M Tomšič
- a Department of Rheumatology , University Medical Centre Ljubljana , Slovenia
| | - A Ambrožič
- a Department of Rheumatology , University Medical Centre Ljubljana , Slovenia
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Artenjak A, Locatelli I, Brelih H, Simonič DM, Ulcova-Gallova Z, Swadzba J, Musial J, Iwaniec T, Stojanovich L, Conti F, Valesini G, Avčin T, Cohen Tervaert JW, Shoenfeld Y, Blank M, Ambrožič A, Sodin-Semrl S, Božič B, Čučnik S. Immunoreactivity and avidity of IgG anti-β2-glycoprotein I antibodies from patients with autoimmune diseases to different peptide clusters of β2-glycoprotein I. Immunol Res 2015; 61:35-44. [PMID: 25395339 DOI: 10.1007/s12026-014-8578-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The pathogenicity of antibodies against β2-glycoprotein I (anti-β2GPI) depends on multiple factors such as subclass type, epitope binding and avidity. Due to their large heterogeneity, their impact on antiphospholipid syndrome (APS) onset is still not fully clarified. We studied the binding characteristics of IgG anti-β2GPI with known avidity from sera of 201 autoimmune patients (87 with APS, 67 with APS associated with systemic lupus erythematosus (SLE), 47 with only SLE) to six β2GPI peptides corresponding to amino acid clusters on domains I-II, II, III and III-IV by indirect ELISA and evaluated their association with clinical features of APS. Peptides A (LKTPRV; domain I-II), B (KDKATF; domain IV) and C (TLRVYK; domain III) were derived from a hexapeptide phage display library previously shown to react with pathogenic monoclonal anti-β2GPI. Peptides D (NGPANSK; domain III), E (YNPLWFV; domain II) and F (KMDGNHP; domain III-IV) represent surface amino acid clusters on β2GPI. The percentage of patients positive for peptides were observed as follows: 30.3% for peptide D, 28.90% for B, 25.9% for C, 24.9% for E, 24.4% for F and 10.0% for A. The anti-peptide antibodies in studied serum samples were predominantly of heterogeneous avidity, followed by law avidity anti-peptide antibodies, whereas only a few were of high avidity. Positive and negative correlations were found between several anti-peptide antibodies and the rate of thrombosis. Our results indicated diverse reactivity of IgG anti-β2GPI to different epitopes on β2GPI. Classification of IgG anti-β2GPI into subgroups regarding epitope specificity and avidity could represent an additional tool in understanding their pathogenicity in APS.
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Affiliation(s)
- A Artenjak
- Lek Pharmaceuticals d.d., Sandoz Biopharmaceuticals Mengeš, Kolodvorska 27, 1234, Menges, Slovenia
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Žigon P, Ambrožič A, Tomšič M, Šemrl S, Čučnik S. SAT0418 IGA Anti-Phosphatidylserin/Prothrombin Antibodies Present a Thrombotic Risk in Patients with Systemic Autoimmune Diseases: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hočevar A, Rotar Ž, Ambrožič A, Plešivčnik Novljan M, Lestan B, Praprotnik S, Tomšič M. FRI0249 IGAV Score – A Feasible Predictor of IGA Vasculitis Severity: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Perdan-Pirkmajer K, Pirkmajer S, Thevis M, Thomas A, Praprotnik S, Hočevar A, Rotar Ž, Gašperšič N, Sodin-Šemrl S, Žibert J, Omersel J, Chibalin A, Tomišič M, Ambrožič A. SAT0219 Methotrexate-Induced Reduction in Concentration of HBA1C in Rheumatoid and Psoriatic Arthritis is Not Correlated with Sustained Increase in Erythrocyte ZMP or Urinary Aicar Concentration. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Salobir B, Tercelj M, Mlakar P, Toplišek J, Ambrožič A, Čučnik S, Sodin-Semrl S. SAT0028 Serum Amyloid a is Associated with Chronic Inflammation and Markers of Disease Severity in Adult Patients with Pulmonary Hypertension. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gašperšič N, Zaletel M, Kobal J, Žigon P, Čučnik S, Šemrl S, Tomšič M, Ambrožič A. SAT0414 Antiphospholipid Antibodies in Patients with Cerebrovascular Events. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Amengual O, Forastiero R, Sugiura-Ogasawara M, Otomo K, Kenji O, Favas C, Delgado Alves J, Žigon P, Ambrožič A, Tomšič M, Ruiz Arruza I, Ruiz Irastorza G, Bertolaccini M, Norman G, Shums Z, Jiro A, Murashima A, Tebo A, Gerosa M, Meroni P, Rodriguez-Pintό I, Cervera R, Swadzba J, Musial J, Atsumi T. OP0223 Significance of IGG Phosphatidylserine-Dependent Antiprothrombin Antibody Testing for the Diagnosis of Antiphospholipid Syndrome: Results from the Initial and Validation International Multi-Centre Studies. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Amengual O, Forastiero R, Sugiura-Ogasawara M, Oku K, Otomo K, Alves J, Favas C, Žigon P, Ambrožič A, Tomšič M, Ruiz-Irastorza G, Ruiz-Arruza I, Bertolaccini M, Norman G, Shums Z, Arai J, Atsumi T. SAT0202 International Multi-Centre Study to Evaluate the Clinical Significance of Phosphatidylserine-Dependent Antiprothrombin Antibodies for the Diagnosis of Antiphospholipid Syndrome. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Perdan-Pirkmajer K, Pirkmajer S, Hočevar A, Rotar Ž, Gašperšič N, Praprotnik S, Tomšič M, Ambrožič A. AB0334 Methotrexate Reduces Hba1c in Non-Diabetic Patients with Newly Diagnosed Rheumatoid Arthritis or Psoriatic Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Žigon P, Čučnik S, Ambrožič A, Šemrl SS, Kveder T, Božič B. Antibodies to phosphatidylserine/prothrombin complex as an additional diagnostic marker of APS? Lupus 2012; 21:790-2. [DOI: 10.1177/0961203312444173] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Antiprothrombin antibodies can be measured by ELISA using either a prothrombin/phosphatidylserine complex (aPS/PT) or prothrombin alone (aPT) as antigen. We aimed to compare the clinical features of autoimmune patients with avidity of aPS/PT and determine the diagnostic efficiency of aPS/PT and aPT for assessing antiphospholipid syndrome (APS). aPS/PT were of low ( n = 9), heterogeneous ( n = 31) and high ( n = 8) avidity out of 48 cases. None of the samples with low avidity were positive in aPT ELISA. Among patients with heterogeneous or high avidity aPS/PT, there was a significantly greater number of patients with APS as compared to patients with low avidity (38/39 vs. 7/9; p < 0.05). No SLE patients had high avidity antiprothrombin antibodies.
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Affiliation(s)
- P Žigon
- University Medical Centre, Department of Rheumatology, Slovenia
| | - S Čučnik
- University Medical Centre, Department of Rheumatology, Slovenia
| | - A Ambrožič
- University Medical Centre, Department of Rheumatology, Slovenia
| | - S Sodin Šemrl
- University Medical Centre, Department of Rheumatology, Slovenia
| | - T Kveder
- University Medical Centre, Department of Rheumatology, Slovenia
| | - B Božič
- University Medical Centre, Department of Rheumatology, Slovenia
- University of Ljubljana, Faculty of Pharmacy, Slovenia
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Jeromel M, Jevtič V, Serša I, Ambrožič A, Tomšič M. Quantification of synovitis in the cranio-cervical region: dynamic contrast enhanced and diffusion weighted magnetic resonance imaging in early rheumatoid arthritis--a feasibility follow up study. Eur J Radiol 2012; 81:3412-9. [PMID: 22578877 DOI: 10.1016/j.ejrad.2012.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Revised: 04/09/2012] [Accepted: 04/10/2012] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To test the feasibility of dynamic contrast enhanced (DCEI) and diffusion weighted (DWI) magnetic resonance imaging (MRI) for quantifying synovitis of the cranio-cervical (C-C) region in patients with early rheumatoid arthritis (RA) and neck pain at the beginning and at a six month follow up. METHODS 27 patients with duration of RA of less than 24 months and neck pain were studied with standard qualitative MRI evaluation and two quantitative MRI methods (DCEI and DWI) at the level of atlantoaxial joints. Rate of early enhancement (REE), enhancement gradient (Genh) and apparent diffusion coefficient (ADC) were extracted from DCEI and DWI data. MRI was coupled with clinical assessment and radiographic imaging. RESULTS Using standard qualitative MRI evaluation, unequivocal active synovitis (grade 2 or 3 contrast enhancement) was proved in 16 (59%) patients at baseline and 14 (54%) at follow up. DCEI and DWI measurements confirmed active synovitis in 25 (93%) patients at baseline and 24 (92%) at follow up. Average REE, Genh and ADC values decreased during follow up, however the difference was not statistically significant (p>0.05). Both qualitative and quantitative MRI methods confirmed active inflammatory disease in the C-C region following therapy although all clinical criteria showed signs of improvement of the peripheral disease. CONCLUSIONS The study proved the feasibility of DCEI and DWI MRI for quantifying synovitis of the C-C region in patients with early RA and neck pain. Both techniques can be used as additional method for evaluation of synovitis of the C-C region in RA.
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Affiliation(s)
- M Jeromel
- Institute of Radiology, Department for Neuroradiology, University Medical Centre Ljubljana, Zaloska cesta 2, 1000 Ljubljana, Slovenia.
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Perdan-Pirkmajer K, Thallinger GG, Snoj N, Čučnik S, Žigon P, Kveder T, Logar D, Praprotnik S, Tomšič M, Sodin-Semrl S, Ambrožič A. Autoimmune response following influenza vaccination in patients with autoimmune inflammatory rheumatic disease. Lupus 2012; 21:175-83. [DOI: 10.1177/0961203311429817] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Vaccines have undoubtedly brought overwhelming benefits to mankind and are considered safe and effective. Nevertheless, they can occasionally stimulate autoantibody production or even a recently defined syndrome known as autoimmune/inflammatory syndrome induced by adjuvants (ASIA). There is scarce data regarding autoimmune response after seasonal/influenza A (H1N1) vaccine in patients with autoimmune inflammatory rheumatic disease (AIRD). The objective of our study was therefore to determine autoimmune response in a large group of AIRD patients vaccinated against seasonal and/or H1N1 influenza. We conducted a prospective cohort study with a 6-month follow-up. Two-hundred and eighteen patients with AIRD (50 vaccinated against seasonal influenza, six against H1N1, 104 against both, 58 non-vaccinated controls) and 41 apparently healthy controls (nine vaccinated against seasonal influenza, three against H1N1, 18 against both, 11 non-vaccinated controls) were included. Blood samples were taken and screened for autoantibodies [antinuclear antibody (ANA), anti-extractable nuclear antigen (anti-ENA), anticardiolipin (aCL) IgG/IgM antibodies, anti-beta 2-glycoprotein I (anti-β2GPI)] at inclusion in the study, before each vaccination, 1 month after the last vaccination and 6 months after inclusion. For non-vaccinated participants (patients and healthy controls) blood samples were taken at the time of inclusion in the study and 6 months later. We report that after the administration of seasonal/H1N1 vaccine there were mostly transient changes in autoantibody production in AIRD patients and in healthy participants. However, a small subset of patients, especially ANA-positive patients, had a tendency towards anti-ENA development. Although no convincing differences between the seasonal and H1N1 vaccines were observed, our results imply that there might be a slight tendency of the H1N1 vaccine towards aCL induction. Although seasonal and H1N1 vaccines are safe and effective, they also have the potential to induce autoantibodies in selected AIRD patients and healthy adults. Follow-up of such individuals is proposed and further research is needed.
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Affiliation(s)
- K Perdan-Pirkmajer
- University Medical Centre Ljubljana, Department of Rheumatology, Ljubljana, Slovenia
| | - GG Thallinger
- Graz University of Technology, Institute for Genomics and Bioinformatics, Graz, Austria
| | - N Snoj
- University Medical Centre Ljubljana, Institute of Clinical Chemistry and Biochemistry, Ljubljana, Slovenia
| | - S Čučnik
- University Medical Centre Ljubljana, Department of Rheumatology, Ljubljana, Slovenia
| | - P Žigon
- University Medical Centre Ljubljana, Department of Rheumatology, Ljubljana, Slovenia
| | - T Kveder
- University Medical Centre Ljubljana, Department of Rheumatology, Ljubljana, Slovenia
| | - D Logar
- University Medical Centre Ljubljana, Department of Rheumatology, Ljubljana, Slovenia
| | - S Praprotnik
- University Medical Centre Ljubljana, Department of Rheumatology, Ljubljana, Slovenia
| | - M Tomšič
- University Medical Centre Ljubljana, Department of Rheumatology, Ljubljana, Slovenia
| | - S Sodin-Semrl
- University Medical Centre Ljubljana, Department of Rheumatology, Ljubljana, Slovenia
| | - A Ambrožič
- University Medical Centre Ljubljana, Department of Rheumatology, Ljubljana, Slovenia
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