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Cheung HC, Strodl E, Musial J, MacLaughlin HL, Byrnes A, Lewis CA, Ross LJ. Associations between diet composition, dietary pattern, and weight outcomes after bariatric surgery: a systematic review. Int J Obes (Lond) 2023; 47:764-790. [PMID: 37407830 PMCID: PMC10439005 DOI: 10.1038/s41366-023-01333-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/12/2023] [Accepted: 06/21/2023] [Indexed: 07/07/2023]
Abstract
INTRODUCTION Literature describing the impact of dietary intake on weight outcomes after bariatric surgery has not been synthesized. This study aimed to synthesize the evidence regarding any association between diet composition and weight outcomes post-bariatric surgery. METHODS CINAHL, Cochrane, Embase, MEDLINE and Scopus were searched for adult studies up to June 2021 that assessed any association between dietary intakes (≥1-macronutrient, food group, or dietary pattern) and weight outcomes at 12-months or longer after bariatric surgery. Risk of bias and quality assessments were conducted using the Scottish Intercollegiate Guidelines Network checklists and the NHMRC's Level of Evidence and Grades for Recommendations. Study findings were presented according to the time of post-surgery dietary intake assessment (≤12months, between 12 and 24 months, ≥24months). RESULTS 5923 articles were identified, 260 were retrieved for full text screening, and 36 were eligible for inclusion (9 interventional including five randomized-controlled trials, and 27 observational cohort studies; sample sizes: 20-1610; total sample: 5065; follow-up periods: 1 year-12 years; level of evidence: II to IV, risk of bias: low to high). Findings on the association between long-term weight outcomes and dietary composition up to 24-months were mixed. After 24-months, studies consistently suggested no significant associations between weight loss and macronutrient composition or core food group patterns, or between carbohydrate, protein or food group patterns and weight recurrence. A single cohort study reported a weak association between diet quality score and weight-recurrence after 24-months. CONCLUSION There was no strong evidence to support significant associations between diet composition and weight outcomes post-bariatric surgery. The heterogeneity in study design and quality may reduce generalizability to external populations. Individualized dietary recommendations may be useful to support long-term post-surgery weight outcomes. More studies are needed to define and measure diet quality in this patient cohort. REGISTRATION PROSPERO (CRD42021264120).
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Affiliation(s)
- H C Cheung
- Queensland University of Technology, School of Exercise and Nutrition Sciences, Faculty of Health, Brisbane, QLD, Australia.
| | - E Strodl
- Queensland University of Technology, School of Psychology and Counselling, Faculty of Health, Brisbane, QLD, Australia
| | - J Musial
- Department of Nutrition and Dietetics, Clinical Support Services, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - H L MacLaughlin
- Queensland University of Technology, School of Exercise and Nutrition Sciences, Faculty of Health, Brisbane, QLD, Australia
- Nutrition Research Collaborative, Department of Dietetics and Food Service, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD, Australia
| | - A Byrnes
- Nutrition Research Collaborative, Department of Dietetics and Food Service, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD, Australia
| | - C-A Lewis
- Nutrition Research Collaborative, Department of Dietetics and Food Service, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD, Australia
| | - L J Ross
- Queensland University of Technology, School of Exercise and Nutrition Sciences, Faculty of Health, Brisbane, QLD, Australia
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Kaminska-Winciorek G, Slowinska M, Krotowski J, Nasierowska-Guttmejer A, Musial J, Cybulska-Stopa B. Dermoscopy of external ear melanoma (EEM). Arch Dermatol Res 2022; 315:1381-1387. [PMID: 35298674 DOI: 10.1007/s00403-022-02342-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 01/26/2022] [Accepted: 02/07/2022] [Indexed: 11/26/2022]
Abstract
External ear melanoma (EEM) belongs to extremely rare melanoma locations. So far, only single cases of EEM have been described in terms of dermoscopic presentations. This case study report presents dermoscopic patterns of EEM in six patients. The retrospective case study was based on medical documentation (epidemiological, anamnestic, clinical, videodermoscopic, and histopathologic) of consecutive patients who were diagnosed with melanoma located on the external ear between January 2013 and May 2021 in three diagnostic dermatologic centers. In four of six cases, the melanoma was placed on the helix. The histopathological diagnoses included 1/6 lentigo maligna and 5/6 invasive melanomas. The dermoscopic pattern of facial melanoma (FM) was present in 3/6 cases, 1/6 exhibited the typical superficial spreading pattern (one with nodular invasion), 1/6 the multicomponent asymmetric pattern, and 1/6 the hypomelanotic type. Five melanomas presented numerous (3-6) dermoscopic structures characteristic for each dermoscopic subtype. In conclusion, dermoscopy has proved effective for detection of both difficult and easy-to-diagnose EEM, but also in differentiating their dermoscopic subtypes.
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Affiliation(s)
- Grazyna Kaminska-Winciorek
- Department of Bone Marrow Transplantation and Hematology-Oncology, Skin Cancer and Melanoma Team, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Ul. Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland.
- Center of Diagnostics and Treatment of Skin Diseases, All4Skin, Katowice, Poland.
| | - M Slowinska
- Department of Dermatology, Military Institute of Medicine, Warsaw, Poland
- Evimed Medical Center, Private Dermatologic Practice, Warsaw, Poland
| | - J Krotowski
- Department of Dermatology, Military Institute of Medicine, Warsaw, Poland
- Krotowscy Clinic, Pabianice, Poland
| | - A Nasierowska-Guttmejer
- Department of Pathomorphology, Central Clinical Hospital of Ministry of Internal Affairs and Administrative, Warsaw, Poland
- Faculty of Medicine, Lazarski University, Warsaw, Poland
| | - J Musial
- Department of Pathomorphology, Central Clinical Hospital of the Medical University of Lodz, Lodz, Poland
| | - B Cybulska-Stopa
- Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow, Poland
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Szczeklik A, Serwońska M, Lukasiewicz W, Mruk J, Musial J. Arachidonate Versus ADP-Induced Platelet Aggregation in Acute Myocardial Infarction. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1666929] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A Szczeklik
- Institute of Internal Medicine, Copernicus Academy of Medicine, Skawińska 8, Cracow, Poland
| | - M Serwońska
- Institute of Internal Medicine, Copernicus Academy of Medicine, Skawińska 8, Cracow, Poland
| | - W Lukasiewicz
- Institute of Internal Medicine, Copernicus Academy of Medicine, Skawińska 8, Cracow, Poland
| | - J Mruk
- Institute of Internal Medicine, Copernicus Academy of Medicine, Skawińska 8, Cracow, Poland
| | - J Musial
- Institute of Internal Medicine, Copernicus Academy of Medicine, Skawińska 8, Cracow, Poland
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Devreese KM, Poncet A, Lindhoff-Last E, Musial J, de Moerloose P, Fontana P. A multicenter study to assess the reproducibility of antiphospholipid antibody results produced by an automated system. J Thromb Haemost 2017; 15:91-95. [PMID: 27813343 DOI: 10.1111/jth.13560] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 06/07/2016] [Accepted: 10/24/2016] [Indexed: 12/01/2022]
Abstract
Essentials Inter-lab variation studies for antiphospholipid antibodies (aPL) with the same assay are lacking. We carried out an assessment of repeatability and reproducibility of an automated aPL assay. High intra-center repeatability for anticardiolipin and aβ2 GPI makes duplicate testing unnecessary. Inter-lab reproducibility was high except for aβ2GPI IgG. SUMMARY Background Inter-assay variability is a well-known problem in antiphospholipid antibody testing, because of the lack of standardization. Inter-laboratory reproducibility for the same assay is similarly important. Objectives Testing repeatability and reproducibility of HemosIL® AcuStar for anticardiolipin (aCL) and antiβ2-glycoprotein I antibodies (aβ2GPI) IgG and IgM. Patients/Methods In this observational study, out of 420 samples from the thrombophilia centers of Ghent and Geneva, 100 samples were randomly selected and successively analyzed in three centers: Ghent (C1, in duplicate for repeatability evaluation), Geneva (C2) and Frankfurt (C3). Results Results from 99 samples were available, including 25 from patients with antiphospholipid syndrome (APS) and 74 from non-APS patients. The intra-center repeatability expressed as intra-class correlation coefficient (ICC) was higher than 0.99 for each parameter. Differences between two measurements rarely exceeded 1 U mL-1 for values below 100 U mL-1 , except for aβ2GPI IgG, where differences varied from -4 to 4 U mL-1 . The inter-center ICCs were higher than 0.99, except for aCL IgM (ICC = 0.961). These ICCs remained high even when considering values below 100 U mL-1 (0.943, 0.964 and 0.977 for aCL IgG, aCL gM and aβ2GPI IgM, respectively), except for aβ2GPI IgG (ICC = 0.652). Qualitative comparison showed less than 5% discordant classification between centers, with somewhat more discordant results for aβ2GPI IgG. Conclusions In terms of discriminating properties, the HemosIL® AcuStar has excellent intra-center repeatability and a good inter-center reproducibility for aCL IgG, aCL IgM and aβ2GPI IgM. Some concern may arise for aβ2GPI IgG.
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Affiliation(s)
- K M Devreese
- Coagulation Laboratory, Department of Clinical Chemistry, Microbiology and Immunology, Ghent University Hospital, Ghent, Belgium
| | - A Poncet
- CRC and Division of Clinical-Epidemiology, Department of Health and Community Medicine, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
| | - E Lindhoff-Last
- Cardiology Angiology Center Bethanien (CCB) Vascular Center-Coagulation Center, Frankfurt, Germany
| | - J Musial
- Department of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - P de Moerloose
- Division of Angiology and Haemostasis, Faculty of Medicine, University Hospitals of Geneva and Geneva Platelet Group, Geneva, Switzerland
| | - P Fontana
- Division of Angiology and Haemostasis, Faculty of Medicine, University Hospitals of Geneva and Geneva Platelet Group, Geneva, Switzerland
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De Craemer AS, Musial J, Devreese KMJ. Role of anti-domain 1-β2 glycoprotein I antibodies in the diagnosis and risk stratification of antiphospholipid syndrome. J Thromb Haemost 2016; 14:1779-87. [PMID: 27314634 DOI: 10.1111/jth.13389] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [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: 09/23/2015] [Accepted: 05/12/2016] [Indexed: 11/26/2022]
Abstract
UNLABELLED Essentials Antibodies to domain 1 of β2 glycoprotein I (aD1) are a subset of antiphospholipid antibodies. We evaluated the added diagnostic value of an automated aD1 assay in antiphospholipid syndrome. AD1 IgG correctly classifies patients at risk for thrombosis. Agreement between aD1 and aβ2GPI IgG is high, limiting the added value of aD1 in our setting. Click to hear Professor de Groot's perspective on new mechanistic understanding in antiphospholipid syndrome SUMMARY Background Laboratory diagnosis of antiphospholipid syndrome (APS) includes lupus anticoagulant (LAC), anticardiolipin (aCL) or anti-β2 glycoprotein I (aβ2 GPI) antibodies. Antibodies targeting domain 1 of β2 GPI (aD1) constitute a pathogenic subset of autoantibodies. Objectives In this cohort study, we determined the clinical performance characteristics, additional diagnostic value and the contribution to APS risk stratification of an automated aD1 assay. Patients/Methods LAC, aCL, aβ2 GPI and aD1 IgG were measured in 101 APS patients, 123 patients with autoimmune disorders, 82 diseased controls and 120 healthy controls. aD1 antibodies were detected by QUANTA Flash(®) Beta2GPI-Domain 1 chemiluminescence immunoassay. Results With a cut-off value of 20.0 CU, the aD1 IgG assay identifies APS patients in a clinically affected patient cohort with a sensitivity of 53.5% and specificity of 98.8%. It implied a high odds ratio (OR) for clinical events (OR, 17.0; 95% confidence interval [CI], 7.1-40.5). aD1 IgG did not add diagnostic value to the formal aPL panel because aβ2 GPI IgG was nearly as specific but more sensitive for APS (sensitivity 56.4%) with a higher OR for clinical events (36.2; 95% CI, 11.1-117.9). High aD1 titers identify triple-positive patients and patients with thrombosis in a β2 GPI-dependent LAC-positive population. Agreement between aD1 IgG and aβ2 GPI IgG was high (positive and negative agreement 91.7% and 98.4%, respectively). Conclusion Detection of aD1 IgG correctly classifies patients at risk of thrombosis. However, the contribution of aD1 IgG to APS diagnosis and risk stratification depends upon the solid phase assays used for aCL and aβ2 GPI detection.
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Affiliation(s)
- A-S De Craemer
- Coagulation Laboratory, Department of Clinical Chemistry, Microbiology and Immunology, Ghent University Hospital, Ghent, Belgium
| | - J Musial
- Department of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - K M J Devreese
- Coagulation Laboratory, Department of Clinical Chemistry, Microbiology and Immunology, Ghent University Hospital, Ghent, Belgium.
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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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Jakiela B, Iwaniec T, Plutecka H, Celinska-Lowenhoff M, Dziedzina S, Musial J. Signs of impaired immunoregulation and enhanced effector T-cell responses in the primary antiphospholipid syndrome. Lupus 2015; 25:389-98. [PMID: 26657472 DOI: 10.1177/0961203315618267] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 10/26/2015] [Indexed: 12/31/2022]
Abstract
INTRODUCTION We investigated whether primary antiphospholipid syndrome (PAPS) is characterized by a deficiency in immunoregulatory pathways, a phenomenon recently implicated in the pathogenesis of autoimmune diseases. METHODS Serum levels of immunoregulatory (e.g., IL-10 and TGF-β1) and proinflammatory (e.g., IL-17A) cytokines were measured in PAPS, systemic lupus erythematosus (SLE) with secondary APS (SAPS), or without APS, and in healthy controls (n = 40 in each group). In a subgroup of PAPS patients we also compared phenotype and function (flow cytometry) of regulatory T-cells (Treg) and cytokine production by effector T-cells. RESULTS Our major finding was decreased levels of TGF-β1 in PAPS and SAPS as compared to SLE without APS and controls. TGF-β1 was the lowest in PAPS patients showing high levels of aPL IgG with significant negative correlation with the titer. SLE patients were characterized by lower serum levels of IL-2 and increased IL-17A, as compared to the other groups. The numbers of circulating Treg cells and their phenotype (e.g., FoxP3 isoforms) were not disturbed in PAPS. However, surface expression of latency associated peptide (binds TGF-β) in activated FoxP3 + cells and in vitro production of TGF-β1 were decreased in PAPS patients with high titers of aPL IgG. Moreover, frequencies of cytokine producing effector T-helper cells (including Th17) were significantly elevated in this group. CONCLUSIONS PAPS patients with high titers of aPL IgG antibodies were characterized by decreased systemic levels of TGF-β1 and its impaired production in vitro, suggesting impaired immunoregulation and enhanced adaptive autoimmune responses leading to the production of aPL antibodies.
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Affiliation(s)
- B Jakiela
- Jagiellonian University Medical College, Department of Medicine, Krakow, Poland
| | - T Iwaniec
- Jagiellonian University Medical College, Department of Medicine, Krakow, Poland
| | - H Plutecka
- Jagiellonian University Medical College, Department of Medicine, Krakow, Poland
| | | | - S Dziedzina
- Jagiellonian University Medical College, Department of Medicine, Krakow, Poland
| | - J Musial
- Jagiellonian University Medical College, Department of Medicine, Krakow, Poland
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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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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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Domagala T, Kotula-Horowitz K, Janczura M, Januszek R, Zagajewski J, Musial J. The impact of cigarette smoking on the pleiotropic effects of simvastatin in the coronary heart disease patients. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.757] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Jakiela B, Kleczynska W, Kosalka J, Plutecka H, Sanak M, Musial J. AB0029 Imbalance between Immunoregulatory and Effector TH17 Pathway in Active Sle. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3602] [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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Jakiela B, Wawrzycka K, Szczeklik W, Hubalewska-Mazgaj M, Surmiak M, Sanak M, Musial J. THU0498 Increase of CXCR3-CCR4+CCR6+CCR10- Memory T Helper Cells (TH17-LIKE) in Patients with Granulomatosis and Polyangiitis (GPA). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3614] [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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Abstract
The 9th meeting of the European Forum on Antiphospholipid Antibodies (Euro aPL Forum) was held in Krakow, Poland, on 16-18 May 2013. This was an excellent occasion for the exchange of information on current research in the area of antiphospholipid syndrome (APS), as well as a starting point for many new research projects. About 120 physicians and researchers from various medical specialities representing 15 European countries, USA, Argentina and Israel attended the event. This report summarizes the major studies and new research projects presented during the Forum.
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Affiliation(s)
- J Swadzba
- 1Department of Medicine, Jagiellonian University Medical College, Krakow, Poland
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Plazak W, Padjas A, Celinska-Lowenhoff M, Iwaniec G, Swadzba J, Luberda T, Musial J, Podolec P. Antiphospholipid antibodies and coronary atherosclerosis: the antiphospholipid syndrome patients. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Iwaniec T, Celinska-Lowehoff M, Goralczyk T, Musial J. AB0726 The utility of IGA antiphospholipid antibodies for prediction of thrombotic complications in secondary antiphospholipid syndrome. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.726] [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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Plazak W, Gryga K, Olszowska M, Mazurek A, Konieczynska M, Sznajd J, Milewski M, Musial J, Podolec P. SAT0243 Endothelial dysfunction reflected by high S-ICAM-1 and VWF levels accelerates coronary atherosclerosis in systemic lupus erythematosus patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3190] [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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Szczeklik W, Sokolowska B, Kuczia P, Gasior J, Maga M, Bartyzel S, Musial J. ANCA-positive and ANCA-negative phenotypes of eosinophilic granulamatosis and polyangiitis (EGPA): Outcome and long-term follow-up of 46 patients from a single Polish centre. Presse Med 2013. [DOI: 10.1016/j.lpm.2013.02.112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Abramczyk H, Jarota A, Brozek-Pluska B, Tondusson M, Freysz E, Musial J, Kordek R. Ultrafast dynamics and Raman imaging of metal complexes of tetrasulphonated phthalocyanines in human cancerous and noncancerous breast tissues. EPJ Web of Conferences 2013. [DOI: 10.1051/epjconf/20134107006] [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: 11/14/2022] Open
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Bazan-Socha S, Zuk J, Plutecka H, Marcinkiewicz C, Zareba L, Musial J. Collagen receptors α(1)β(1) and α(2)β(1) integrins are involved in transmigration of peripheral blood eosinophils, but not mononuclear cells through human microvascular endothelial cells monolayer. J Physiol Pharmacol 2012; 63:373-379. [PMID: 23070086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 08/20/2012] [Indexed: 06/01/2023]
Abstract
UNLABELLED Asthma development may be driven by T helper lymphocytes with eosinophils playing the role of major effector cells. Recruitment of the inflammatory cells from blood to the airways is mediated by adhesive molecules, e.g. selectins and integrins. The most important in cell trafficking are integrins containing α(4) and β(2) subunits. We hypothesized that also collagen receptors: α(1)β(1) and α(2)β(1), may be involved in cell migration to the inflammatory site in asthma. The aim of the study was to determine whether the inhibition of α(1)β(1) or α(2)β(1) integrins, affects transmigration of eosinophils and peripheral blood mononuclear cells (PBMC) through human microvascular endothelial cells monolayer (HMVEC) seeded on collagen IV coated wells in moderate persistent atopic asthmatics. METHODS PBMC from 9 asthmatics were separated by gradient centrifugation followed by negative magnetic separation of eosinophils. Snake venom derived anti-adhesive proteins: viperistatin and VP12 (potent and selective inhibitors of α(1)β(1) and α(2)β(1) integrins, respectively) as well as VLO4 (a non-selective inhibitor of α(4)β(1), α(5)β(1) and α(v)β(3) - used as a positive control), were used for inhibition studies. All anti-adhesive proteins studied, inhibited eosinophils, but only VLO4 affected PBMC transmigration through HMVEC. In bronchial asthma both collagen receptors α(1)β(1) and α(2)β(1) are likely to be involved in eosinophil transmigration to the inflammatory site. The role of α(2)β(1) on lymphocytes is probably different. As the α(2)β(1) integrin has been described as a stimulator of collagen accumulation, it might be, at least in part, responsible for asthma airway remodelling.
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Affiliation(s)
- S Bazan-Socha
- Second Department of Internal Medicine, Unit of Allergy and Clinical Immunology, Jagiellonian University Medical College, Cracow Poland.
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Čučnik S, Kveder T, Artenjak A, Gallova ZU, Swadzba J, Musial J, Iwaniec T, Stojanovich L, Alessandri C, Valesini G, Avčin T, Tervaert JWC, Rozman B, Božič B. Avidity of anti-β2-glycoprotein I antibodies in patients with antiphospholipid syndrome. Lupus 2012; 21:764-5. [DOI: 10.1177/0961203312440057] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [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
Antibodies against β2-glycoprotein I (anti-β2GPI) are one of the hallmarks of the antiphospholipid syndrome (APS). However, they are heterogenic regarding their epitope specificity, pathogenic mechanisms and their avidity. In the current study we present some outstanding issues about avidity of anti-β2GPI antibodies. Our results confirmed that high avidity anti-β2GPI are associated with thrombosis and APS, while in low avidity anti-β2GPI group non-APS (predominantly systemic lupus erythematosus) patients prevailed.
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Affiliation(s)
- S Čučnik
- University Medical Centre, Department of Rheumatology, Ljubljana, Slovenia
| | - T Kveder
- University Medical Centre, Department of Rheumatology, Ljubljana, Slovenia
| | - A Artenjak
- University Medical Centre, Department of Rheumatology, Ljubljana, Slovenia
| | - Z Ulcova Gallova
- Charles University, Medical School, Department of Gynecology and Obstetrics, Plzen- Lochotin, Czech Republic
| | - J Swadzba
- Jagiellonian University Medical College, Department of Medicine, Krakow, Poland
| | - J Musial
- Jagiellonian University Medical College, Department of Medicine, Krakow, Poland
| | - T Iwaniec
- Jagiellonian University Medical College, Department of Medicine, Krakow, Poland
| | - L Stojanovich
- Bezhanijska Kosa, University Medical Centre, Belgrade University, Serbia
| | - C Alessandri
- Sapienza University of Rome, Dipartimento di Medicina Interna e Specialità Mediche, Rome, Italy
| | - G Valesini
- Sapienza University of Rome, Dipartimento di Medicina Interna e Specialità Mediche, Rome, Italy
| | - T Avčin
- University Medical Centre, University Children’s Hospital Ljubljana, Department of Allergology, Rheumatology and Clinical Immunology, Ljubljana, Slovenia
| | - JW Cohen Tervaert
- Maastricht University Medical Center, Division of Clinical and Experimental Immunology, Department of Internal Medicine, Maastricht, the Netherlands
| | - B Rozman
- University Medical Centre, Department of Rheumatology, Ljubljana, Slovenia
| | - B Božič
- University Medical Centre, Department of Rheumatology, Ljubljana, Slovenia
- University in Ljubljana, Faculty of Pharmacy, Chair for Clinical Biochemistry, Ljubljana, Slovenia
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Swadzba J, Iwaniec T, Pulka M, De Laat B, De Groot PG, Musial J. Lupus anticoagulant: performance of the tests as recommended by the latest ISTH guidelines. J Thromb Haemost 2011; 9:1776-83. [PMID: 21707912 DOI: 10.1111/j.1538-7836.2011.04420.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [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: 11/30/2022]
Abstract
OBJECTIVES Lupus anticoagulant (LA) is clinically the most relevant among all antiphospholipid antibody tests. Recently, new guidelines for LA detection were published. The objective of this retrospective cohort study was to compare tests recommended under these guidelines with other methods used for LA detection. METHODS The study group consisted of 336 subjects suffering from various autoimmune diseases. We used activated partial thromboplastin time (aPTT), diluted Russell viper venom time (dRVVT) and diluted prothrombin time (dPT) tests for LA detection together with a ratio between sensitive and insensitive aPTT reagent. We also tested if LA was dependent on β(2) glycoprotein I (β(2) GPI) using one of the recently described methods. RESULTS All LA tests performed were associated with a history of thrombosis. The highest odds ratio (OR) for thrombosis was found for β(2) GPI-dependent LA but sensitivity was low (OR = 8.4; specificity/sensitivity = 98%/15%). All LA tests showed a much stronger association with thrombosis than with pregnancy failure. CONCLUSIONS LA tested by aPTT and/or dRVVT (at least one out of two tests positive), as recommended by the guidelines, was associated less strongly with a history of thrombosis (OR = 4.1) than either of these tests separately (OR = 5.0 and 4.3, respectively). With both tests positive ('double LA positivity') the association with thrombosis was stronger (OR = 6.5) compared with only one positive test. In fact, 'double LA positivity', detected by combinations of any of the tests studied, was markedly associated with a history of thrombosis.
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Affiliation(s)
- J Swadzba
- Department of Medicine, Jagiellonian University Medical College, Krakow, Poland.
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Čučnik S, Kveder T, Ulcova GZ, Swadzba J, Musial J, Valesini G, Avčin T, Rozman B, Božič B. The avidity of anti-β2-glycoprotein I antibodies in patients with or without antiphospholipid syndrome: a collaborative study in the frame of the European forum on antiphospholipid antibodies. Lupus 2011; 20:1166-71. [DOI: 10.1177/0961203311406308] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [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
Objective. The objective of this study was to extend the findings of the preliminary study by measuring the avidity of IgG anti-β2-glycoprotein I antibodies (anti-β2-GPI) on a larger group of patients with primary or secondary antiphospholipid syndrome (APS) and anti-β2-GPI positive patients without APS in the frame of the European Forum on antiphospholipid antibodies (aPL). Methods. Serum from 137 patients with primary APS, APS associated with autoimmune diseases, and patients with autoimmune diseases other than APS from five EU rheumatology centres were tested for anti-β2-GPI antibodies. The 109 patients who were sera positive for anti-β2-GPI by the in-house anti-β2-GPI enzyme-linked immunosorbent assay (ELISA) at the Immunology Laboratory, UMC Ljubljana were selected for further testing on avidity with chaotropic anti-β2-GPI ELISA. Results. High, low and heterogeneous avidity IgG anti-β2-GPI was found in 32/109, 17/109 and 60/109 patients respectively. Significantly more patients with APS were in the high avidity than in the low avidity anti-β2-GPI group, while the opposite was observed for non-APS (both p < 0.001). The most common clinical feature among patients with high avidity anti-β2-GPI was thrombosis, mainly due to venous thrombosis ( p < 0.01 and p < 0.001, versus low avidity anti-β2-GPI group). Conclusion. Patients with or without APS had anti-β2-GPI of high, low or heterogeneous avidity. High avidity anti-β2-GPI was associated with thrombosis and APS, while in the low avidity anti-β2-GPI group non-APS (predominantly SLE) patients prevailed. Determination of anti-β2-GPI avidity should be considered in the analytical strategies for further differentiation of patients with anti-β2-GPI antibodies.
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Affiliation(s)
- S Čučnik
- University Medical Centre, Department of Rheumatology, Ljubljana, Slovenia
| | - T Kveder
- University Medical Centre, Department of Rheumatology, Ljubljana, Slovenia
| | - GZ Ulcova
- Charles University, Medical School, Department of Gynaecology and Obstetrics, Plzen, LOCHOTIN, 30604 Czech Republic
| | - J Swadzba
- Jagiellonian University Medical College, Department of Medicine, Krakow, Poland
| | - J Musial
- Jagiellonian University Medical College, Department of Medicine, Krakow, Poland
| | - G Valesini
- University of Roma La Sapienza, Division of Rheumatology, Rome, Italy
| | - T Avčin
- University Medical Centre, University Children’s Hospital Ljubljana, Department of Allergy, Rheumatology and Clinical Immunology, Ljubljana, Slovenia
| | - B Rozman
- University Medical Centre, Department of Rheumatology, Ljubljana, Slovenia
| | - B Božič
- University Medical Centre, Department of Rheumatology, Ljubljana, Slovenia
- University in Ljubljana, Faculty of Pharmacy, Chair for Clinical Biochemistry, Ljubljana, Slovenia
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Plazak W, Gryga K, Milewski M, Podolec M, Kostkiewicz M, Podolec P, Musial J. Association of heart structure and function abnormalities with laboratory findings in patients with systemic lupus erythematosus. Lupus 2011; 20:936-44. [DOI: 10.1177/0961203311399607] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Conventional risk factors of coronary artery disease fail to explain the increased frequency of cardiovascular morbidity in patients with systemic lupus erythematosus (SLE). The study was conducted to determine possible association between the heart structure and function abnormalities with established prognostic value assessed by non-invasive imaging techniques and markers of autoimmune and inflammatory phenomena typical for SLE. Echocardiography and single photon emission computerized tomography (SPECT; Tc-99m-MIBI) at rest were performed in 60 SLE patients in a stable clinical condition of their disease. Laboratory evaluation included serum levels of C-reactive protein (CRP), complement C3c and C4 components and antiphospholipid antibodies (aPL). The latter included serum anticardiolipin (aCL) and anti-β2-glycoprotein I (antiβ2GPI) antibodies, both of IgG and IgM class, and lupus anticoagulant (LA) in plasma. Echocardiography revealed pathologic thickening of valvular leaflets and/or pericardium in more than 60% of patients. Right ventricular systolic pressure (RVSP) was elevated (>30 mmHg) in 16.7%. Myocardial perfusion defects were present in 36.7% of patients, despite normal ECG recordings and a lack of clinical symptoms of myocardial ischaemia. There was a significant association between thickening of valvular leaflets and/or pericardium and high CRP and low C3c and C4 concentrations. On the other hand, increased RVSP and the presence of myocardial perfusion defects were associated with the presence of anticardiolipin and antiβ2GPI antibodies of the IgG class. Increased anticardiolipin IgG levels predicted perfusion defects in SPECT study with 100% sensitivity and 68% specificity, whereas elevated antiβ2GPI IgG levels predicted RVSP elevation (>30 mmHg) with 100% sensitivity and 78% specificity. In stable SLE patients pericardial and valve abnormalities may be associated with markers of an ongoing inflammation. Also, pulmonary systolic pressure elevation and myocardial perfusion defects are combined with elevated levels of anticardiolipin and antiβ2GPI antibodies of the IgG class. These results indicate that even clinically silent pulmonary hypertension and myocardial perfusion defects in SLE patients could be causally related to the presence of antiphospholipid antibodies.
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Affiliation(s)
- W Plazak
- Department of Cardiac and Vascular Diseases, The John Paul II Hospital, Jagiellonian University Medical College, Krakow, Poland
| | - K Gryga
- Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - M Milewski
- Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - M Podolec
- Department of Coronary Heart Disease, The John Paul II Hospital, Jagiellonian University Medical College, Krakow, Poland
| | - M Kostkiewicz
- Department of Cardiac and Vascular Diseases, The John Paul II Hospital, Jagiellonian University Medical College, Krakow, Poland
| | - P Podolec
- Department of Cardiac and Vascular Diseases, The John Paul II Hospital, Jagiellonian University Medical College, Krakow, Poland
| | - J Musial
- Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
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Gorczynska E, Kalwak K, Owoc-Lempacj J, Janczak K, Dorobisz T, Kulej D, Ussowicz M, Mielcarek M, Dyla A, Chybicka A, Musial J, Nawrot U. Outcomes of Allogeneic Hematopoietic Stem Cell Recipients Diagnosed With Invasive Fungal Infection Prior to Transplant Procedure. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.501] [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: 11/30/2022]
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De Laat B, Derksen RHWM, Reber G, Musial J, Swadzba J, Bozic B, Cucnik S, Regnault V, Forastiero R, Woodhams BJ, De Groot PG. An international multicentre-laboratory evaluation of a new assay to detect specifically lupus anticoagulants dependent on the presence of anti-beta2-glycoprotein autoantibodies. J Thromb Haemost 2011; 9:149-53. [PMID: 20874780 DOI: 10.1111/j.1538-7836.2010.04068.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [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: 12/21/2022]
Abstract
BACKGROUND Antiphospholipid syndrome (APS) is diagnosed by the simultaneous presence of vascular thrombosis and/or pregnancy morbidity and detection of antiphospholipid antibodies in plasma. OBJECTIVES We have shown that prolongation of clotting time by anti-beta2-glycoprotein I (beta2GPI) antibodies correlates better with thrombosis than a positive classic lupus anticoagulant (LAC) assay in a single center study. To confirm or falsify this finding we have conducted a multicenter study. METHODS AND RESULTS In 325 LAC-positive samples, we found that the beta2GPI-dependent LAC correlated 2.0 times better with thrombosis than the classic LAC assay. Although significant, this was a minimal improvement compared with the 'classic' LAC. It was published that calcium influences the behavior of anti-beta2GPI antibodies in coagulation assays. To investigate whether calcium plays a role in the present study, we divided the patient population into two groups: (i) blood was collected in 0.109 m sodium citrate and (ii) blood was drawn in 0.129 m sodium citrate as anticoagulant. We found that a positive result with the beta2GPI-dependent LAC assay correlated better with thrombosis [odds ratio (OR): 3.3, 95% confidence interval (CI) 1.9-5.8] when 0.109 m sodium citrate was used compared with 0.129 m sodium citrate (OR: 0.4, 95% CI 0.1-1.1). CONCLUSION We were able to confirm in an international multicenter study that a positive result in a beta2GPI-dependent LAC assay correlates better with thrombosis than the classic LAC assay, but that the assay needs further study as it is sensitive to external factors such as the sodium citrate concentration used as anticoagulant in the test sample.
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Affiliation(s)
- B De Laat
- Department of Clinical Chemistry and Hematology, University Medical Center, Utrecht, the Netherlands.
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Affiliation(s)
- W Szczeklik
- Department of Medicine, Jagiellonian University Medical College, Skawińska 8, 31 – 066 Kraków, Poland.
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Szczeklik W, Sokolowska B, Mastalerz L, Miszalski-Jamka T, Musial J. Heart involvement detected by magnetic resonance in a patient with Churg-Strauss syndrome, mimicking severe asthma exacerbation. Allergy 2010; 65:1063-4. [PMID: 19958314 DOI: 10.1111/j.1398-9995.2009.02278.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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DE Moerloose P, Reber G, Musial J, Arnout J. Analytical and clinical performance of a new, automated assay panel for the diagnosis of antiphospholipid syndrome. J Thromb Haemost 2010; 8:1540-6. [PMID: 20345724 DOI: 10.1111/j.1538-7836.2010.03857.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [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: 11/29/2022]
Abstract
SUMMARY BACKGROUND Anticardiolipin (aCL) and anti-beta(2)glycoprotein I (abeta(2)GPI) antibodies are part of the criteria for antiphospholipid syndrome (APS). Therefore they are widely measured and about 30 commercial kits are available. OBJECTIVES To investigate the analytical and clinical performances of four fully automated, chemiluminescent assays: HemosIL AcuStar aCL IgG, HemosIL AcuStar aCL IgM, HemosIL AcuStar abeta(2)GPI IgG, and HemosIL AcuStar abeta(2)GPI IgM. METHODS Cut-off values were assessed by testing 250 blood donors. Total coefficients of variation (CV) were determined with six plasma pools and two controls ranging from 4.3 to 2694 U mL(-1) depending on the assay. Samples from 218 well-characterized patients and 103 controls were measured in three laboratories to determine inter-laboratory variation. The results of the 321 samples were compared with three commercial assays (REAADS, INOVA and VARELISA). RESULTS Cut-off values were assigned to 20 arbitrary units for all the tests. Total CV ranged from 4.3 to 11.2%. No interference of hemoglobin, bilirubin, triglycerides, heparins and rheumatoid factor was observed. Inter-laboratory variability was low and no sample changed status. Overall status agreement between HemosIL assays and the comparator kits ranged from 82 to 96%. Sensitivity, specificity, agreement when predicting APS and the odds ratios when predicting a thrombotic or obstetric event gave comparable results between HemosIL AcuStar and the three other assays. CONCLUSIONS Our study demonstrates that the fully automated HemosIL AcuStar aPL assay panel showed similar performances to the three commercial ELISAs commonly used by various laboratories to detect antiphospholipid antibodies.
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Affiliation(s)
- P DE Moerloose
- Haemostasis Unit, Faculty of Medicine and University Hospital Geneva, Geneva, Switzerland.
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Gorczynska E, Dyla A, Owoc-Lempch J, Musial J, Turkiewicz D, Kalwak K, Ussowicz M, Chybicka A, Pieczonka A, Jacek W, Wojcik B, Kowalczyk J. Long-Term Follow-Up After Allogeneic Hematopoietic Progenitor Cell Transplantation In Pediatric Patients-Multicenter Study. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.224] [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: 11/24/2022]
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de Laat B, Pengo V, Pabinger I, Musial J, Voskuyl AE, Bultink IEM, Ruffatti A, Rozman B, Kveder T, de Moerloose P, Boehlen F, Rand J, Ulcova-Gallova Z, Mertens K, de Groot PG. The association between circulating antibodies against domain I of beta2-glycoprotein I and thrombosis: an international multicenter study. J Thromb Haemost 2009; 7:1767-73. [PMID: 19694946 DOI: 10.1111/j.1538-7836.2009.03588.x] [Citation(s) in RCA: 212] [Impact Index Per Article: 14.1] [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: 11/28/2022]
Abstract
BACKGROUND Diagnosis of the antiphospholipid syndrome (APS) is difficult as a result of limited specificity of existing assays for detecting clinically relevant antiphospholipid antibodies. Anti-beta2-glycoprotein I (beta 2GPI) antibodies play a central role in the disease process of APS. OBJECTIVES We have investigated the relation between antiphospholipid antibodies with specificity for domain I of beta 2GPI and thrombosis/pregnancy morbidity in an international multicenter study. PATIENTS/METHODS Four hundred and seventy-seven patients derived from nine different centres met the inclusion criterion of having anti-beta 2GPI antibodies in their plasma/serum. Clinical data and results of tests for lupus anticoagulant, anti-cardiolipin antibodies and anti-beta 2GPI antibodies were established at the different centres of inclusion. After being re-tested for the presence of IgG and/or IgM anti-beta 2GPI antibodies, the samples were tested for the presence of IgG-directed against domain I of beta 2GPI and results were correlated with the thrombotic and obstetric history. RESULTS Re-testing for the presence of anti-beta 2GPI antibodies resulted in inclusion of 442/477 patients. IgG class anti-domain I antibodies were present in plasma of 243/442 patients (55%). 201/243 (83%) had a history of thrombosis. This resulted in an odds ratio of 3.5 (2.3-5.4, 95% confidence interval) for thrombosis. Anti-domain I IgG antibodies were also significantly correlated with obstetric complications [odds ratio: 2.4 (1.4-4.3, 95% confidence interval)]. CONCLUSION In this multicenter study, the detection of IgG antibodies that are directed against domain I of beta 2GPI proved to be more strongly associated with thrombosis and obstetric complications than those detected using the standard anti-beta 2GPI antibody assay.
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Affiliation(s)
- B de Laat
- Department of Plasma Proteins, Sanquin Research, Amsterdam, the Netherlands.
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Kalwak K, Porwolik J, Gorczynska E, Owoc-Lempach J, Ussowicz M, Musial J, Dyla A, Pazdzior D, Wojcik D, Skarzynska M, Chybicka A. Is There Really a Difference in Outcome and Incidence of Acute/Chronic GVHD in Patients Undergoing Unmanipulated MUD-PBSCT vs MUD-BMT? Single Large Pediatric Center Experience. Biol Blood Marrow Transplant 2009. [DOI: 10.1016/j.bbmt.2008.12.154] [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: 10/21/2022]
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Kalwak K, Owoc-Lempach J, Gorczynska E, Porwolik J, Ussowicz M, Musial J, Wojcik D, Pazdzior D, Skarzynska M, Dyla A, Chybicka A. Treosulfan in Conditioning Regimens in Children With Non-Malignant Disorders, Including Aplastic Anaemia-High Rate of Stable Engraftment and Low Transplant-Related Mortality. Biol Blood Marrow Transplant 2009. [DOI: 10.1016/j.bbmt.2008.12.076] [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: 10/21/2022]
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Dunoyer-Geindre S, Boehlen F, Favier R, Wahl D, Musial J, Korte W, Satta N, Kruithof E, de Moerloose P. Endothelial cell activation by immunoglobulins from patients with immune thrombocytopenic purpura or with antiphospholipid syndrome. Haematologica 2008; 93:635-6. [DOI: 10.3324/haematol.12358] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Zolcinski M, Bazan-Socha S, Zwolinska G, Musial J. Central nervous system involvement as a major manifestation of rheumatoid arthritis. Rheumatol Int 2007; 28:281-3. [PMID: 17690887 DOI: 10.1007/s00296-007-0428-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2007] [Accepted: 07/14/2007] [Indexed: 10/23/2022]
Abstract
A 58-year-old woman with an 8-year history of seropositive rheumatoid arthritis was admitted with right hemiparesis, history of seizures, fever, weight loss and headaches. Her blood tests revealed the presence of rheumatoid factor, elevated C-reactive protein and anti-cyclic citrullinated peptide antibodies (>200 RU/ml). Examination of cerebrospinal fluid demonstrated pleocytosis (118 cells/mm(3), predominantly lymphocytes) with elevated protein level (58 mg/dl); cultures were negative. Magnetic resonance imaging findings were suggestive for meningoencephalitis. Short course of high-dose corticosteroids and cyclophosphamide led to clinical improvement. Rheumatoid vasculitis was probably responsible for neurological symptoms.
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Affiliation(s)
- M Zolcinski
- Department of Internal Medicine, Jagiellonian University School of Medicine, Krakow, Poland
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Bazan-Socha S, Bukiej A, Pulka G, Marcinkiewicz C, Musial J. Increased expression of collagen receptors: alpha1beta1 and alpha2beta1 integrins on blood eosinophils in bronchial asthma. Clin Exp Allergy 2007; 36:1184-91. [PMID: 16961719 DOI: 10.1111/j.1365-2222.2006.02540.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Eosinophils are one of the major effector cells in bronchial asthma. Their infiltration of airways correlates with the asthma severity. Recruitment and activation of eosinophils are partially mediated by integrins alpha4beta1 and alpha4beta7. Collagens type I and IV constitute important components of extracellular matrix and vascular basement membrane, respectively. Therefore, collagen-binding integrins (alpha1beta1 and alpha2beta1) may also play a role in eosinophil lung infiltration. OBJECTIVE To evaluate the possible presence of alpha1beta1 and alpha2beta1 integrins on peripheral blood eosinophils from asthmatic subjects. METHODS Collagen receptors were studied on eosinophils separated by immunomagnetic CD16-negative method from healthy donors (n=13) and patients with moderate persistent atopic bronchial asthma (n=15). Surface receptor identification was performed by flow cytometry and cell adhesion assay. RESULTS Eosinophils isolated from the patients showed increased expression of both alpha1beta1 and alpha2beta1 integrins as compared with healthy controls. Moreover, adhesive function of eosinophils to collagen type IV was inhibited by snake venom disintegrins: viperistatin and obtustatin. These disintegrins contain KTS active motif and are specific inhibitors of alpha1beta1 integrin. CONCLUSION We demonstrated for the first time that collagen receptors: alpha1beta1 and alpha2beta1 integrins are overexpressed on the surface of peripheral blood eosinophils of asthmatic subjects. Further studies may reveal potential application of KTS-disintegrins or their structural analogs for therapy of bronchial asthma.
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Affiliation(s)
- S Bazan-Socha
- Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland
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Musial J, Rubinfeld I, Reickert C, Parker A, Shepard A, Dulchavsky S. P172. J Surg Res 2007. [DOI: 10.1016/j.jss.2006.12.508] [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: 11/26/2022]
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Finazzi G, Marchioli R, Brancaccio V, Schinco P, Wisloff F, Musial J, Baudo F, Berrettini M, Testa S, D'Angelo A, Tognoni G, Barbui T. A randomized clinical trial of high-intensity warfarin vs. conventional antithrombotic therapy for the prevention of recurrent thrombosis in patients with the antiphospholipid syndrome (WAPS). J Thromb Haemost 2005; 3:848-53. [PMID: 15869575 DOI: 10.1111/j.1538-7836.2005.01340.x] [Citation(s) in RCA: 429] [Impact Index Per Article: 22.6] [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: 11/27/2022]
Abstract
BACKGROUND The optimal intensity of oral anticoagulation for the prevention of recurrent thrombosis in patients with antiphospholipid antibody syndrome is uncertain. Retrospective studies show that only high-intensity oral anticoagulation [target international normalized ratio (INR) >3.0] is effective but a recent randomized clinical trial comparing high (INR range 3.0-4.0) vs. moderate (INR 2.0-3.0) intensities of anticoagulation failed to confirm this assumption. METHODS We conducted a randomized trial in which 109 patients with antiphospholipid syndrome (APS) and previous thrombosis were given either high-intensity warfarin (INR range 3.0-4.5, 54 patients) or standard antithrombotic therapy (warfarin, INR range 2.0-3.0 in 52 patients or aspirin alone, 100 mg day(-1) in three patients) to determine whether intensive anticoagulation is superior to standard treatment in preventing symptomatic thromboembolism without increasing the bleeding risk. RESULTS The 109 patients enrolled in the trial were followed up for a median time of 3.6 years. Mean INR during follow-up was 3.2 (SD 0.6) in the high-intensity warfarin group and 2.5 (SD 0.3) (P < 0.0001) in the conventional treatment patients given warfarin. Recurrent thrombosis was observed in six of 54 patients (11.1%) assigned to receive high-intensity warfarin and in three of 55 patients (5.5%) assigned to receive conventional treatment [hazard ratio for the high intensity group, 1.97; 95% confidence interval (CI) 0.49-7.89]. Major and minor bleeding occurred in 15 patients (two major) (27.8%) assigned to receive high-intensity warfarin and eight (three major) (14.6%) assigned to receive conventional treatment (hazard ratio 2.18; 95% CI 0.92-5.15). CONCLUSIONS High-intensity warfarin was not superior to standard treatment in preventing recurrent thrombosis in patients with APS and was associated with an increased rate of minor hemorrhagic complications.
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Affiliation(s)
- G Finazzi
- The Ospedali Riuniti, Bergamo, Italy
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Abstract
Integrins are a family of heterodimeric transmembrane glycoproteins that mediate cell-cell and cell-matrix interactions. They participate in inflammatory reactions mainly by regulation of leukocyte migration, activation and survival. Elevated expression of the cell adhesion molecules, such as VCAM, ICAM and MAdCAM on the lumenal surface of vascular endothelial cells is a critical early event in organ inflammatory processes - including the lung. Adhesive interactions with their counter-receptors on leukocytes, selectins and integrins, result in migration of the leukocytes to the inflammed tissues. Integrins also participate in physiological and pathological reorganization of the lung structure during e.g. pneumonia healing, airway remodeling, angiogenesis, emphysema and pulmonary fibrosis. Agents that could inhibit the function of one or more of these integrins could provide a novel therapeutic strategy targeted to inhibit inflammatory and immune phenomena in the lung.
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Affiliation(s)
- S Bazan-Socha
- Department of Internal Medicine, Jagiellonian University Medical College, Skawinska 8 Str., 31-066, Krakow, Poland.
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Musial J, Rys D, Brozek J, Swadzba J, Iwaniec T. More on: Fluvastatin inhibits upregulation of tissue factor expression by antiphospholipid antibodies on endothelial cells. J Thromb Haemost 2005; 3:614-5; author reply. [PMID: 15748273 DOI: 10.1111/j.1538-7836.2005.01200.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
BACKGROUND Administration of contrast agents may result in an acute reduction in renal function and occasionally end-stage renal disease. Risk factors for contrast-induced nephropathy (CN) are preexisting renal dysfunction, diabetes and reduced effective arterial volume. Hydration and use of nonionic contrast agents have been reported to ameliorate CN. Reactive oxygen species may have a role in the pathogenesis of CN. Statins decrease free oxygen radicals in animals. We retrospectively tested the hypothesis that administering statins prior to cardiac catheterization decreases the incidence of CN. METHODS A total of 1,002 patients were studied. Patients with a stable baseline serum creatinine (SCr) > or = 1.5 mg/dl who had cardiac catheterization between July 1997 and June 2002, were included in the study. None of the patients were taking statins before admission. 250 patients were started on a statin before the procedure and 752 patients were not. The SCr was followed for 7 days after the procedure looking for an acute decrement in renal function, dialysis requirement and survival. RESULTS The baseline characteristics, SCr, GFR, amount of intravenous fluids and contrast were similar in both groups. The post cath SCr (2.26 vs 3.1 mg/dl, p = 0.001) was significantly better in the statin group. Length of stay (2.72 vs 3.32 days, p = 0.01) and number of patients with acute renal failure (43 (17.2%) vs 168 (22.3%) patients, p = 0.028) were significantly lower in the statin group. Dialysis requirement within 7 days and 28-day survival were similar in both groups. CONCLUSION Prophylactic administration of statins along with hydration may be associated with less CN induced by a nonionic, low-osmolality contrast.
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Affiliation(s)
- N Attallah
- Division of Nephrology and Hypertension, Department of Medicine CFP-5, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, MI 48202, USA.
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Leonardi GS, Houthuijs D, Steerenberg PA, Fletcher T, Armstrong B, Antova T, Lochman I, Lochmanová A, Rudnai P, Erdei E, Musial J, Jazwiec-Kanyion B, Niciu EM, Durbaca S, Fabiánová E, Koppová K, Lebret E, Brunekreef B, van Loveren H. Immune biomarkers in relation to exposure to particulate matter: a cross-sectional survey in 17 cities of Central Europe. Inhal Toxicol 2003; 12 Suppl 4:1-14. [PMID: 12881884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Human population data on air pollution and its effects on the immune system are scarce. A survey was conducted within the framework of the Central European Study of Air Quality and Respiratory Health (CESAR) to measure a panel of immune biomarkers in children of Bulgaria, Czech Republic, Hungary, Poland, Romania, and Slovakia. Seventeen cities were chosen to represent a wide range of exposure to outdoor air pollution. In each, ambient particulate matter of less than 10 microns diameter and less than 2.5 microns diameter (PM10 and PM2.5) were measured with a Harvard impactor. Blood was collected from 366 school children aged 9 to 11 yr between 11 April and 10 May 1996. The percentage of B, total T, CD4+, CD8+, and natural killer (NK) lymphocytes was determined by flow cytometry (Becton Dickinson); total immunoglobulins of class G, M, A and E (IgG, IgM, IgA, and IgE) were measured in serum using nephelometry (Behring). Associations between PM and each log-transformed biomarker concentration were studied by linear regression, in a two-stage model. The yearly average concentrations varied from 41 to 96 micrograms/m3 for PM10 across the 17 study areas, from 29 to 67 micrograms/m3 for PM2.5, and from 12 to 38 micrograms/m3 for PM10-2.5 (coarse). Number of B, CD4+, CD8+, and NK lymphocytes increased with increasing concentration of PM, having adjusted for age, gender, parental smoking, laboratory of analysis, and recent respiratory illness. Differences in lymphocyte number were larger and statistically significant for exposure to PM2.5. Similar results were found when we examined the association between PM and lymphocyte number separately for each laboratory. Total IgG was increased with increasing concentration of PM, significantly in the case of PM2.5. When we repeated the analyses with two other statistical approaches the results did not differ from those reported here. The effect of coarse PM on lymphocyte numbers appears small in comparison to PM2.5. One possible interpretation of our findings is that long-term exposure to airborne particulates leads to inflammation of the airways and activation of the cellular and humoral immune system.
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Affiliation(s)
- G S Leonardi
- Environmental Epidemiology Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT.
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Sydor WJ, Sanak M, Bazan-Socha S, Szczeklik A, Musial J. Novel polymorphic short tandem repeat in the human alpha2 integrin gene promoter is associated with GPIa/IIa density on the platelet surface. J Thromb Haemost 2003. [DOI: 10.1111/j.1538-7836.2003.tb05706.x] [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: 11/29/2022]
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Brzezinska-Kolarz B, Undas A, Sydor WJ, Dziedzina S, Flak A, Musial J. Factor V Leiden and blood coagulation at the site of microvascular injury in coumadin treated patients and healthy control. J Thromb Haemost 2003. [DOI: 10.1111/j.1538-7836.2003.tb05577.x] [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: 11/30/2022]
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Undas A, Bazan-Socha S, Swadzba J, Musial J. Hereditary hemorrhagic telangiectasia, factor V Leiden and antiphospholipid syndrome: a case report. Blood Coagul Fibrinolysis 2002; 13:53-6. [PMID: 11994568 DOI: 10.1097/00001721-200201000-00008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [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
We report on a 57-year-old woman with three episodes of ischemic strokes and hereditary hemorrhagic telangiectasia (HHT). Tests for inherited and acquired thrombophilia showed elevated anticardiolipin immunoglobulin (Ig)M antibodies (on three separate occasions), anti-prothrombin IgG antibodies, and the heterozygous form of factor V Leiden. This is the first case of HHT, a primary antiphospholipid syndrome, combined with factor V Leiden. No detectable arteriovenous malformation was found and ischemic episodes, documented by computer tomography, were related to the presence of antiphospholipid antibodies and possibly the carriership of factor V Leiden mutation. Since aspirin provoked severe nasal hemorrhages, treatment with ticlopidine was initiated after the third stroke. Over an 18-month follow-up, ischemic episodes were absent and we regarded oral anticoagulation as unjustifiable.
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Affiliation(s)
- A Undas
- Department of Medicine, Jagiellonian University School of Medicine, Cracow, Poland
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Undas A, Brummel K, Musial J, Mann KG, Szczeklik A. Pl(A2) polymorphism of beta(3) integrins is associated with enhanced thrombin generation and impaired antithrombotic action of aspirin at the site of microvascular injury. Circulation 2001; 104:2666-72. [PMID: 11723016 DOI: 10.1161/hc4701.099787] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mechanisms by which the Pl(A2) (Leu33Pro) polymorphism of beta(3) integrins could lead to an increased risk for coronary events are unclear. This study was designed to examine the effect of this polymorphism on blood coagulation. METHODS AND RESULTS In normal subjects (12 with Pl(A1A1), 9 with Pl(A1A2), and 3 with Pl(A2A2)), we evaluated the activation of prothrombin, factor V, and factor XIII and fibrinogen removal by quantitative immunoblotting; thrombin-antithrombin III complex generation using ELISA; and levels of fibrinopeptide A and B by high-performance liquid chromatography in blood collected every 30 seconds at sites of standardized microvascular injury before and after 7 days of aspirin ingestion (75 mg/d). Compared with the Pl(A1A1) subjects, the Pl(A2) carriers exhibited higher maximum rates of thrombin B-chain generation (by 31.6%; P=0.005), thrombin-antithrombin III complex generation (by 30.7%; P=0.003), fibrinogen consumption (by 31.3%; P=0.002), prothrombin consumption (by 26.1%; P=0.011), and activation of factor V (by 14.1%; P=0.033) and factor XIII (by 27.0%; P=0.012). In the Pl(A1A1) homozygotes, aspirin ingestion resulted in reductions in the velocity of thrombin B-chain formation (by 32.1%; P=0.007), prothrombin consumption (by 30.4%; P=0.018), factor Va generation (by 28.9%; P=0.014), fibrinogen removal (by 41.2%; P=0.001), and factor XIII activation (by 22.6%; P=0.026). In the Pl(A2) carriers, aspirin did not alter the velocity of all these processes. After aspirin ingestion, fibrinopeptide A and B concentrations in the last 30-second interval were significantly reduced, but only in the Pl(A1A1) subjects. CONCLUSIONS The presence of the Pl(A2) allele is associated with enhanced thrombin formation and an impaired antithrombotic action of aspirin, which might favor coronary thrombosis in the Pl(A2) carriers.
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Affiliation(s)
- A Undas
- Department of Medicine, Jagellonian University School of Medicine, Krakow, Poland
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Szczeklik A, Undas A, Musial J, Gajewski P, Swadzba J, Jankowski M. Antithrombotic actions of statins. Med Sci Monit 2001; 7:1381-5. [PMID: 11687759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Aspirin depresses thrombin generation, probably through a mechanism independent of the cyclooxygenase inhibition, but rather related to acetylation of the platelet membrane macromolecules. This action of aspirin is blunted in hypercholesterolemia. In men with marked hypercholesterolemia, lowering serum cholesterol by a three-month simvastatin treatment is accompanied by a reduction of thrombin generation both at basal conditions in venous blood and after activation of hemostasis by microvascular injury. Similar results are obtained in patients with coronary heart disease and borderline - high cholesterol levels. We assessed tissue-factor initiated coagulation in blood samples collected every 30-seconds from bleeding time wounds in patients with advanced coronary artery disease and total cholesterol levels of 224 mg/dL. Three-month simvastatin treatment depressed blood clotting, leading to reduced rates of prothrombin activation, FVa generation, fibrinogen cleavage, FXIII activation, and an increased rate of FVa inactivation. Such a concerted influence of statins on the clotting cascade seems to be independent of their lipid-lowering action and may be the result of depressed isoprenoid production.
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Affiliation(s)
- A Szczeklik
- Department of Medicine, Jagiellonian University School of Medicine, Cracow, Poland.
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Abstract
The sequence of coagulant reactions in vivo following vascular injury is poorly characterized. Using quantitative immunoassays, the time courses were evaluated for activation of prothrombin, factor (F)V, FXIII, fibrinogen (Fbg) cleavage, and FVa inactivation in bleeding-time blood collected at 30-second intervals from 12 healthy subjects both before and after aspirin ingestion. Prothrombin decreased at a maximum rate of 14.2 +/- 0.6 nM per second to 10% of initial values at the end of bleeding. Significant amounts of alpha-thrombin B chain appeared rapidly at 90 seconds of bleeding and increased at a maximum rate of 0.224 +/- 0.03 nM per second to a peak value of 38 nM. Kinetics of prethrombin 2 generation was almost identical. Prothrombinase concentration reached a peak value of 22 pM at 150 seconds and then decreased to 9 pM at the end of bleeding. Prothrombin fragment 1.2 (F1.2) was produced explosively (0.673 +/- 0.05 nM per second), whereas thrombin-antithrombin III (TAT) complexes were generated at a much slower rate (0.11 +/- 0.008 nM per second; P =.002). FVa light chain was detectable 30 seconds later than the heavy chain (150 seconds) and was produced at a slightly slower rate (0.027 +/- 0.001 nM per second) when compared with the heavy chain (0.032 +/- 0.002 nM per second; P =.041). The 30 000 fragment (residues 307-506) of FVa heavy chain produced by activated protein C appeared as early as at 90 seconds and increased with time. Fbg was removed from the blood shed with a high rate of 0.047 +/- 0.02 microM/s and became undetectable at approximately 180 seconds of bleeding. The velocity of FXIII activation correlated with thrombin B-chain formation. A 7-day aspirin administration (75 mg/d) resulted in significant reductions in maximum rates of (1) prothrombin removal (by 29%; P =.008); generation of alpha-thrombin B-chain (by 27.2%; P =.022), and prethrombin 2 (by 26%; P =.014); formation of F1.2 (by 31.4%; P =.009) and TAT (by 30.3%; P = 0.013); (2) release of FVa heavy chain (by 25%; P =.003) and FVa light chain (by 29.6%; P =.007); (3) Fbg depletion from solution (by 30.5%; P =.002); and (4) FXIII activation (by 28.6%; P =.003). Total amounts of the proteins studied, collected at every interval, also significantly decreased following aspirin ingestion. These results indicate that low-dose aspirin impairs thrombin generation and reactions catalyzed by this enzyme at the site of the injury.
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Affiliation(s)
- A Undas
- Department of Medicine, Jagellonian University School of Medicine, Cracow, Poland
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Musial J. [In memory of Stefan Niewiarowski (1926-2001)]. Pol Arch Med Wewn 2001; 106:981-982. [PMID: 12018188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Leonardi GS, Houthuijs D, Steerenberg PA, Fletcher T, Armstrong B, Antova T, Lochman I, Lochmanová A, Rudnai P, Erdei E, Musial J, Jazwiec-Kanyion B, Niciu EM, Durbaca S, Fabiánová E, Koppová K, Lebret E, Brunekreef B, Van Loveren H. IMMUNE BIOMARKERS IN RELATION TO EXPOSURE TO PARTICULATE MATTER: A Cross-Sectional Survey in 17 Cities of Central Europe. Inhal Toxicol 2001. [DOI: 10.1080/08958370050164833] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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