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Gallo CDA, Dellavance A, Gama RA, Silva AE, Silva ISDSE, Andrade LEC, Ferraz MLG. Anti-ribosomal P (anti-P) antibodies in patients with autoimmune hepatitis. Einstein (Sao Paulo) 2023; 21:eAO0375. [PMID: 37991088 PMCID: PMC10691313 DOI: 10.31744/einstein_journal/2023ao0375] [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] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 05/01/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE Anti-P-ribosomal antibody is a biomarker of systemic lupus erythematosus mainly associated with renal, nervous, and hepatic involvement. Systemic lupus erythematosus may present with features similar to autoimmune hepatitis. This study aimed to investigate the association of Anti-P-ribosomal antibodies in systemic lupus erythematosus compared to autoimmune hepatitis in the general Brazilian population. Autoimmune hepatitis and systemic lupus erythematosus share several clinical features. ۪Anti-P ribosomal antibody is a biomarker for systemic lupus erythematosus. The association between anti-P ribosomal antibody and autoimmune hepatitis has shown conflicting results. Our results showed no association between anti-P ribosomal antibody and autoimmune hepatitis. Published studies have shown associations between anti-ribosomal P (anti-P) antibody and systemic lupus erythematosus with hepatic manifestations. This has been reported also in autoimmune hepatitis. However, the consistency of the latter association remains controversial. This study aimed to evaluate the frequency of anti-P antibodies in autoimmune hepatitis using two different immunoassays. METHODS One-hundred and seventy-seven patients with autoimmune hepatitis were screened, and 142 were analyzed for anti-P antibody positivity. The samples were first analyzed using two different immunoassays: enzyme-linked immunosorbent assay (ELISA) and chemiluminescence and then compared with a group of 60 patients with systemic lupus erythematous. The positive samples were subjected to western blot analysis. RESULTS Anti-P was found in 5/142 autoimmune hepatitis cases (3.5%) by chemiluminescence and in none by ELISA. Among the five chemiluminescence-positive autoimmune hepatitis samples, on anti-P western blot analysis one was negative, two were weakly positive, and two were positive. In contrast, anti-P was detected in 10/60 patients with systemic lupus erythematosus (16.7%) and presented higher chemiluminescence units than the autoimmune hepatitis samples. CONCLUSION A low frequency of anti-P antibodies was observed in autoimmune hepatitis, suggesting that this test is not useful for the diagnosis or management of this disease.
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Affiliation(s)
- Clarisse de Almeida Gallo
- Division of GastroenterologyUniversidade Federal de São PauloSão PauloSPBrazil Division of Gastroenterology , Universidade Federal de São Paulo , São Paulo , SP , Brazil .
| | - Alessandra Dellavance
- Research and Development DivisionGrupo FleurySão PauloSPBrazil Research and Development Division , Grupo Fleury , São Paulo , SP , Brazil .
| | - Raimundo Araújo Gama
- Division of GastroenterologyUniversidade Federal de São PauloSão PauloSPBrazil Division of Gastroenterology , Universidade Federal de São Paulo , São Paulo , SP , Brazil .
| | - Antônio Eduardo Silva
- Division of GastroenterologyUniversidade Federal de São PauloSão PauloSPBrazil Division of Gastroenterology , Universidade Federal de São Paulo , São Paulo , SP , Brazil .
| | - Ivonete Sandra de Souza e Silva
- Division of GastroenterologyUniversidade Federal de São PauloSão PauloSPBrazil Division of Gastroenterology , Universidade Federal de São Paulo , São Paulo , SP , Brazil .
| | - Luis Eduardo Coelho Andrade
- Division of RheumatologyUniversidade Federal de São PauloSão PauloSPBrazil Division of Rheumatology , Universidade Federal de São Paulo , São Paulo , SP , Brazil .
- Division of ImmunologyGrupo FleurySão PauloSPBrazil Division of Immunology , Grupo Fleury , São Paulo , SP , Brazil .
| | - Maria Lúcia Gomez Ferraz
- Division of GastroenterologyUniversidade Federal de São PauloSão PauloSPBrazil Division of Gastroenterology , Universidade Federal de São Paulo , São Paulo , SP , Brazil .
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Zarur EB, Rodrigues SH, Ambrogini O, Ferraz MLG, Mastroianni-Kirsztajn G, Andrade LEC, Souza AWSD. Improvement of indirect immunofluorescence technique to detect antineutrophil cytoplasmic antibodies and its impact on test positivity rate. Braz J Med Biol Res 2023; 56:e12636. [PMID: 37493768 PMCID: PMC10361643 DOI: 10.1590/1414-431x2023e12636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/10/2023] [Indexed: 07/27/2023] Open
Abstract
The indirect immunofluorescence (IIF) technique for antineutrophil cytoplasmic antibodies (ANCA) detection is subject to substantial differences across laboratories. This study aimed to assess the impact of improvements in the IIF-ANCA technique on the positivity rate of ANCA tests. A cross-sectional study was performed with serum samples from patients with ANCA-associated vasculitis (AAV), autoimmune hepatitis (AIH), and ulcerative colitis (UC). A paired analysis was performed for IIF-ANCA results using the traditional method and a modified protocol after a series of specific adjustments in the technique based on the protocol of IIF-ANCA test performed at a nation-wide private laboratory in Brazil. ANCA specificity was assessed by ELISA for anti-proteinase 3 (PR3) and anti-myeloperoxidase (MPO) antibodies. Sixty-one patients were evaluated. The positivity rate of IIF-ANCA tests at disease presentation performed at the University reference laboratory was 32.3% in AAV, AIH, and UC patients, whereas the positivity rates of IIF-ANCA and ELISA tests in other laboratories were 75.0 and 72.7%, respectively. After modifications in the IIF-ANCA technique, there was a significant increase in the positivity rate (14.8 vs 34.3%; P=0.0002) and in median titers [1/40 (1/30-1/160) vs 1/80 (1/40-1/80); P=0.0003] in AAV, AIH, and UC patients. UC had the highest increment in positive results from 5.3 to 36.8%. There was poor agreement between MPO- or PR3-ANCA and both IIF-ANCA techniques. In conclusion, modifications in the IIF-ANCA protocol led to a significant improvement in its positivity rate and titers.
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Affiliation(s)
- E B Zarur
- Divisão de Reumatologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - S H Rodrigues
- Divisão de Reumatologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - O Ambrogini
- Divisão de Gastroenterologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - M L G Ferraz
- Divisão de Gastroenterologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - G Mastroianni-Kirsztajn
- Divisão de Nefrologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - L E C Andrade
- Divisão de Reumatologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - A W S de Souza
- Divisão de Reumatologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
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Keppeke GD, Diogenes L, Gomes K, Andrade LEC. "Untargeting" autoantibodies using genome editing, a proof-of-concept study. Clin Immunol 2023; 251:109343. [PMID: 37094742 DOI: 10.1016/j.clim.2023.109343] [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: 01/28/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 04/26/2023]
Abstract
Autoantibodies (AAbs) are useful biomarkers and many have direct pathogenic role. Current standard therapies for elimination of specific B/plasma-cell clones are not fully efficient. We apply CRISPR/Cas9 genome-editing to knockout V(D)J rearrangements that produce pathogenic AAbs in vitro. HEK293T cell-lines were established stably expressing a humanized anti-dsDNA Ab (clone 3H9) and a human-derived anti-nAChR-α1 Ab (clone B12L). For each clone, five CRISPR/Cas9 heavy-chain's CDR2/3-targeting guided-RNAs (T-gRNAs) were designed. Non-Target-gRNA (NT-gRNA) was control. After editing, levels of secreted Abs were evaluated, as well as 3H9 anti-dsDNA and B12L anti-AChR reactivities. T-gRNAs editing decreased expression of heavy-chain genes to ~50-60%, compared to >90% in NT-gRNA, although secreted Abs levels and reactivity to their respective antigens in T-gRNAs decreased ~90% and ~ 95% compared with NT-gRNA for 3H9 and B12L, respectively. Sequencing indicated indels at Cas9 cut-site, which could lead to codon jam, and consequently, knockout. Additionally, remaining secreted 3H9-Abs presented variable dsDNA reactivity among the five T-gRNA, suggesting the exact Cas9 cut-site and indels further interfere with antibody-antigen interaction. CRISPR/Cas9 genome-editing was very effective to knockout the Heavy-Chain-IgG genes, considerably affecting AAbs secretion and binding capacity, fostering application of this concept to in vivo models as a potential novel therapeutic approach for AAb-mediated diseases.
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Affiliation(s)
| | - Larissa Diogenes
- Rheumatology Division, Department of Medicine, Federal University of Sao Paulo, Brazil
| | - Kethellen Gomes
- Rheumatology Division, Department of Medicine, Federal University of Sao Paulo, Brazil
| | - Luis Eduardo Coelho Andrade
- Rheumatology Division, Department of Medicine, Federal University of Sao Paulo, Brazil; Immunology Division, Fleury Laboratory, Sao Paulo, Brazil
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4
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Keppeke GD, Satoh M, Kayser C, Matos P, Hasegawa T, Tanaka S, Diogenes L, Amaral RQ, Rodrigues S, Andrade LEC. A cell-based assay for detection of anti-fibrillarin autoantibodies with performance equivalent to immunoprecipitation. Front Immunol 2022; 13:1011110. [PMID: 36225928 PMCID: PMC9549361 DOI: 10.3389/fimmu.2022.1011110] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
Anti-fibrillarin autoantibodies are useful for the diagnosis and prognosis of systemic sclerosis (SSc). Anti-fibrillarin produces a clumpy nucleolar pattern in indirect immunofluorescence assay on HEp-2 cells (HEp-2 IFA). Here we develop and validate a reliable cell-based anti-fibrillarin assay (Fibrillarin/CBA) for use in clinical diagnostic laboratories. A TransMembrane Signal was fused to the human fibrillarin gene (TMS-fibrillarin). HEp-2 cells overexpressing transgenic TMS-fibrillarin at the cytoplasmic membrane were used as IFA substrate in the Fibrillarin/CBA. Sixty-two serum samples with nucleolar pattern in the HEp-2 IFA (41 clumpy; 21 homogeneous/punctate) were tested for anti-fibrillarin using Fibrillarin/CBA, immunoprecipitation (IP), line-blot and ELISA. In addition, samples from 106 SSc-patients were evaluated with Fibrillarin/CBA and the results were correlated with disease phenotypes. Thirty-eight of 41 samples with the clumpy nucleolar pattern (92.7%) were positive in the Fibrillarin/CBA, while all 21 samples with other nucleolar patterns were negative. Fibrillarin/CBA results agreed 100% with IP results. Among the 38 Fibrillarin/CBA-positive samples, only 15 (39.5%) and 11 (29%) were positive for anti-fibrillarin in line-blot and ELISA, respectively. Higher frequency of diffuse cutaneous SSc (dcSSc) phenotype (72.7% vs 36.8%; p=0.022), cardiac involvement (36.4% vs 6.5%; p=0.001) and scleroderma renal crisis (18.2% vs 3.3% p = 0.028) was observed in SSc patients with positive compared to negative Fibrillarin/CBA result. Performance of Fibrillarin/CBA in the detection of anti-fibrillarin autoantibodies was comparable to the gold standard IP. Positive Fibrillarin/CBA results correlated with disease phenotypes known to be associated with anti-fibrillarin autoantibodies, underscoring the clinical validation of this novel assay.
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Affiliation(s)
- Gerson Dierley Keppeke
- Rheumatology Division, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
- *Correspondence: Gerson Dierley Keppeke,
| | - Minoru Satoh
- Department of Clinical Nursing, School of Health Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
- Department of Medicine, Kitakyushu Yahata-Higashi Hospital, Kitakyushu, Japan
| | - Cristiane Kayser
- Rheumatology Division, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Pedro Matos
- Rheumatology Division, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Tomoko Hasegawa
- Department of Clinical Nursing, School of Health Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shin Tanaka
- Department of Human, Information, and Science, School of Health Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Larissa Diogenes
- Rheumatology Division, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | - Silvia Helena Rodrigues
- Rheumatology Division, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Luis Eduardo Coelho Andrade
- Rheumatology Division, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
- Immunology Division, Fleury Laboratory, Sao Paulo, Brazil
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5
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Cruvinel WDM, Andrade LEC, Dellavance A, Ximenes AC, Bichara CDA, Mangueira CLP, Bonfá E, de Almeida Brito F, Mariz HA, Dos Anjos LME, Pasoto SG, Valim V, Dos Santos WFS, Gomes CM, Neves RA, Francescantonio PLC. VI Brazilian consensus guidelines for detection of anti-cell autoantibodies on HEp-2 cells. Adv Rheumatol 2022; 62:34. [PMID: 36071498 DOI: 10.1186/s42358-022-00266-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/24/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The VI Brazilian Consensus on Autoantibodies against HEp-2 cells for determination of autoantibodies against cellular constituents on HEp-2 cells was held on September, 2019, in Fortaleza (CE, Brazil). The guidelines in this edition were formulated by the group of Brazilian experts discussing the classification of complex patterns, the classification of the nuclear discrete dots (few and multiple), the identification of the discrete fine speckled pattern (AC-4a) and improvements on the ANA report. MAINBODY Sixteen Brazilian researchers and experts from universities and clinical laboratories representing the various geographical regions of Brazil participated in the meeting. Four main topics were discussed: (1) How to classify patterns with fluorescence in more than one cell compartment considering three relevant categoris: composite patterns, mixed patterns and multiple patterns; (2) The splitting of the discrete nuclear dots pattern into the multiple discrete nuclear dots (AC-6) and few discrete nuclear dots (AC-7) patterns, respectively; (3) Inclusion of a novel nuclear pattern characterized by discrete fine speckled pattern highly associated with antibodies to SS-A/Ro60, classified as AC-4a. In addition, adjustments on the Brazilian Consensus nomenclature were implemented aiming to harmonize the designation of some patterns with the International Consensus on ANA Patterns (ICAP). Furthermore, the designations of the PCNA-like pattern (AC-13), CENP-F-like pattern (AC-14) and Topo I-like pattern (AC-29) were adjusted in accordance to ICAP. Finally, there was a recommendation for adjustment in the test report in order to address the status of nuclear envelope staining. For all topics, the aim was to establish specific guidelines for laboratories and clinicians. All recommendations were based on consensus among participants. All recommendations from the V Consensus were maintained and there was relevant progress in the BCA/HEp-2 guidelines and further harmonization with ICAP. CONCLUSION The VI BCA/HEp-2 edition was successful in establishing important recommendations regarding the classification of complex patterns, in supporting the identification of a novel pattern within the AC-4 group and in the harmonization process with the ICAP terminology.
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Affiliation(s)
- Wilson de Melo Cruvinel
- School of Medical and Life Sciences, Escola de Ciências Médicas e da Vida, Pontifícia Universidade Católica de Goiás (PUC GOIÁS), Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, 74605-010, Brazil.
| | - Luis Eduardo Coelho Andrade
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Alessandra Dellavance
- Immunology Division, Fleury Medicine and Health Laboratories, São Paulo, Brazil.,Divisão de Pesquisa, Inovação e Desenvolvimento, Fleury Medicina E Saúde, São Paulo, SP, Brazil
| | | | - Carlos David Araújo Bichara
- Centro Universitário Metropolitano da Amazônia (UNIFAMAZ), Amaral Costa Medicina Diagnóstica, Belém, PA, Brazil
| | | | - Eloísa Bonfá
- Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Fabiano de Almeida Brito
- Department of Clinical Pathology, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Hermes Pardini Group, Vespasiano, MG, Brazil
| | - Henrique Ataíde Mariz
- Rheumatology Department, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
| | | | - Sandra Gofinet Pasoto
- Serviço de Reumatologia e Laboratório de Autoimunidade da Divisão de Laboratório Central do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Valeria Valim
- Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | | | - Clayson Moura Gomes
- School of Medical and Life Sciences, Escola de Ciências Médicas e da Vida, Pontifícia Universidade Católica de Goiás (PUC GOIÁS), Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, 74605-010, Brazil
| | - Roberpaulo Anacleto Neves
- School of Medical and Life Sciences, Escola de Ciências Médicas e da Vida, Pontifícia Universidade Católica de Goiás (PUC GOIÁS), Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, 74605-010, Brazil
| | - Paulo Luiz Carvalho Francescantonio
- School of Medical and Life Sciences, Escola de Ciências Médicas e da Vida, Pontifícia Universidade Católica de Goiás (PUC GOIÁS), Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, 74605-010, Brazil
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Perazzio SF, Palmeira P, Moraes-Vasconcelos D, Rangel-Santos A, de Oliveira JB, Andrade LEC, Carneiro-Sampaio M. A Critical Review on the Standardization and Quality Assessment of Nonfunctional Laboratory Tests Frequently Used to Identify Inborn Errors of Immunity. Front Immunol 2021; 12:721289. [PMID: 34858394 PMCID: PMC8630704 DOI: 10.3389/fimmu.2021.721289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 10/05/2021] [Indexed: 12/24/2022] Open
Abstract
Inborn errors of immunity (IEI), which were previously termed primary immunodeficiency diseases, represent a large and growing heterogeneous group of diseases that are mostly monogenic. In addition to increased susceptibility to infections, other clinical phenotypes have recently been associated with IEI, such as autoimmune disorders, severe allergies, autoinflammatory disorders, benign lymphoproliferative diseases, and malignant manifestations. The IUIS 2019 classification comprises 430 distinct defects that, although rare individually, represent a group affecting a significant number of patients, with an overall prevalence of 1:1,200-2,000 in the general population. Early IEI diagnosis is critical for appropriate therapy and genetic counseling, however, this process is deeply dependent on accurate laboratory tests. Despite the striking importance of laboratory data for clinical immunologists, several IEI-relevant immunoassays still lack standardization, including standardized protocols, reference materials, and external quality assessment programs. Moreover, well-established reference values mostly remain to be determined, especially for early ages, when the most severe conditions manifest and diagnosis is critical for patient survival. In this article, we intend to approach the issue of standardization and quality control of the nonfunctional diagnostic tests used for IEI, focusing on those frequently utilized in clinical practice. Herein, we will focus on discussing the issues of nonfunctional immunoassays (flow cytometry, enzyme-linked immunosorbent assays, and turbidimetry/nephelometry, among others), as defined by the pure quantification of proteins or cell subsets without cell activation or cell culture-based methods.
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Affiliation(s)
- Sandro Félix Perazzio
- Division of Rheumatology, Universidade Federal de São Paulo, Sao Paulo, Brazil.,Immunology Division, Fleury Medicine and Health Laboratory, Sao Paulo, Brazil
| | - Patricia Palmeira
- Laboratório de Investigação Médica (LIM-36), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil
| | - Dewton Moraes-Vasconcelos
- Laboratório de Investigação Médica (LIM-56), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil
| | - Andréia Rangel-Santos
- Laboratório de Investigação Médica (LIM-36), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil
| | | | - Luis Eduardo Coelho Andrade
- Division of Rheumatology, Universidade Federal de São Paulo, Sao Paulo, Brazil.,Immunology Division, Fleury Medicine and Health Laboratory, Sao Paulo, Brazil
| | - Magda Carneiro-Sampaio
- Laboratório de Investigação Médica (LIM-36), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil.,Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil
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Prado MS, Dellavance A, Rodrigues SH, Marvulle V, Andrade LEC. Changes in the result of antinuclear antibody immunofluorescence assay on HEp-2 cells reflect disease activity status in systemic lupus erythematosus. Clin Chem Lab Med 2021; 58:1271-1281. [PMID: 32623848 DOI: 10.1515/cclm-2019-0638] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 06/25/2019] [Accepted: 02/09/2020] [Indexed: 02/06/2023]
Abstract
Background The objective of the study was to determine whether the staining pattern and titer of indirect immunofluorescence assay on HEp-2 cells (HEp-2 IFA) are associated with systemic lupus erythematosus (SLE) disease activity. Methods A total of 269 consecutive patients meeting the ACR and SLICC criteria for SLE were classified into three groups according to the SLE Disease Activity Index 2000 (SLEDAI2K): Remission (SLEDAI2K = 0; n = 47); Intermediate (SLEDAI2K = 1-5; n = 111); Active (SLEDAI2K ≥ 6; n = 111). All subjects were assessed for HEp-2 IFA titer and staining pattern and nine traditional parameters of SLE disease activity. After a 6 to 12-month interval, 101 of the 269 patients were reassessed. Results HEp-2 IFA homogeneous nuclear pattern (AC-1) occurred more frequently in the Active Group compared to the Remission Group (p < 0.001). Fine speckled nuclear pattern (AC-4) tended to occur more frequently in the Remission Group compared to the Active Group (p = 0.054). Subjects with AC-1 pattern had higher SLEDAI (8.8 ± 7.6) than those with AC-4 (4.8 ± 5.2) (p < 0.001). HEp-2 IFA titer and anti-nuclear antibody by enzyme-linked immunosorbent assay (ANA-ELISA) values were lower in the Remission Group compared to the other two groups (p < 0.001). Multivariate analyses identified only ELISA anti-dsDNA as an independent variable associated with disease activity. In follow-up analysis, HEp-2 IFA titer decreased significantly in the 33 subjects with decreased disease activity (p = 0.002). Receiver operator characteristic (ROC) curve analysis for determination of disease activity showed equivalent areas under the curve (AUC) for HEp-2 IFA titer and traditional disease activity parameters. Conclusions HEp-2 IFA pattern and titer can reflect SLE disease activity and may be considered in conjunction with other laboratory and clinical parameters in the assessment of SLE disease activity.
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Affiliation(s)
- Mônica Simon Prado
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Alessandra Dellavance
- Research and Development Division, Fleury Medicine and Health Laboratories, Sao Paulo, Brazil
| | - Silvia Helena Rodrigues
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Valdecir Marvulle
- Center of Mathematic, Computation and Cognition, ABC Federal University, Santo André, Brazil
| | - Luis Eduardo Coelho Andrade
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.,Immunology Division, Fleury Medicine and Health Laboratories, Sao Paulo, Brazil
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8
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Chang CC, Keppeke GD, Antos CL, Peng M, Andrade LEC, Sung LY, Liu JL. CTPS forms the cytoophidium in zebrafish. Exp Cell Res 2021; 405:112684. [PMID: 34129847 DOI: 10.1016/j.yexcr.2021.112684] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 03/21/2021] [Revised: 05/30/2021] [Accepted: 06/01/2021] [Indexed: 12/26/2022]
Abstract
Cytidine triphosphate synthase (CTPS) catalyzes the rate-limiting step of de novo CTP biosynthesis. An intracellular structure of CTPS, the cytoophidium, has been found in many organisms including prokaryotes and eukaryotes. Formation of the cytoophidium has been suggested to regulate the activity and stability of CTPS and may participate in certain physiological events. Herein, we demonstrate that both CTPS1a and CTPS1b in zebrafish are able to form the cytoophidium in cultured cells. A point mutation, H355A, abrogates cytoophidium assembly of zebrafish CTPS1a and CTPS1b. In addition, we show the presence of CTPS cytoophidia in multiple tissues of larval and adult fish under normal conditions, while treatment with a CTPS inhibitor 6-diazo-5-oxo-l-norleucine (DON) can induce more cytoophidia in some tissues. Our findings reveal that forming the CTPS cytoophidium is a natural phenomenon of zebrafish and provide valuable information for future research on the physiological importance of this intracellular structure in vertebrates.
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Affiliation(s)
- Chia-Chun Chang
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China
| | - Gerson Dierley Keppeke
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China; Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, SP 04023-062, Brazil
| | - Christopher L Antos
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China
| | - Min Peng
- Institute of Biotechnology, National Taiwan University, Taipei, 106, Taiwan
| | - Luis Eduardo Coelho Andrade
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, SP 04023-062, Brazil
| | - Li-Ying Sung
- Institute of Biotechnology, National Taiwan University, Taipei, 106, Taiwan; Agricultural Biotechnology Research Center, Academia Sinica, Taipei, 115, Taiwan
| | - Ji-Long Liu
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China; Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, OX1 3PT, United Kingdom.
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9
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Keppeke GD, Chang CC, Antos CL, Peng M, Sung LY, Andrade LEC, Liu JL. IMPDH forms the cytoophidium in zebrafish. Dev Biol 2021; 478:89-101. [PMID: 34048735 DOI: 10.1016/j.ydbio.2021.05.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 09/20/2020] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 02/07/2023]
Abstract
Inosine monophosphate dehydrogenase (IMPDH) catalyzes the rate-limiting step in de novo guanine nucleotide biosynthesis. Its activity is negatively regulated by the binding of GTP. IMPDH can form a membraneless subcellular structure termed the cytoophidium in response to certain changes in the metabolic status of the cell. The polymeric form of IMPDH, which is the subunit of the cytoophidium, has been shown to be more resistant to the inhibition by GTP at physiological concentrations, implying a functional correlation between cytoophidium formation and the upregulation of GTP biosynthesis. Herein we demonstrate that zebrafish IMPDH1b and IMPDH2 isoforms can assemble abundant cytoophidium in most of cultured cells under stimuli, while zebrafish IMPDH1a shows distinctive properties of forming the cytoophidium in different cell types. Point mutations that disrupt cytoophidium structure in mammalian models also prevent the aggregation of zebrafish IMPDHs. In addition, we discover the presence of the IMPDH cytoophidium in various tissues of larval and adult fish under normal growth conditions. Our results reveal that polymerization and cytoophidium assembly of IMPDH can be a regulatory machinery conserved among vertebrates, and with specific physiological purposes.
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Affiliation(s)
- Gerson Dierley Keppeke
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China; Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, SP, 04023-062, Brazil
| | - Chia-Chun Chang
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China
| | - Christopher L Antos
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China
| | - Min Peng
- Institute of Biotechnology, National Taiwan University, Taipei, 106, Taiwan
| | - Li-Ying Sung
- Institute of Biotechnology, National Taiwan University, Taipei, 106, Taiwan; Agricultural Biotechnology Research Center, Academia Sinica, Taipei, 115, Taiwan
| | - Luis Eduardo Coelho Andrade
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, SP, 04023-062, Brazil
| | - Ji-Long Liu
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China.
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Quaio CRDC, Moreira CM, Novo‐Filho GM, Sacramento‐Bobotis PR, Groenner Penna M, Perazzio SF, Dutra AP, Silva RA, Santos MNP, Arruda VYN, Freitas VG, Pereira VC, Pintao MC, Fornari ARDS, Buzolin AL, Oku AY, Burger M, Ramalho RF, Marco Antonio DS, Ferreira EN, Pereira OJE, Cantagalli VD, Trindade ACG, Sousa RRF, Reys Furuzawa C, Verzini F, Matalhana SD, Romano N, Paixão D, Olivati C, Spolador GM, Maciel GAR, Rocha VZ, Miguelez J, Carvalho MHB, Souza AWS, Andrade LEC, Chauffaille MDL, Perazzio ADSB, Catelani ALPM, Mitne‐Neto M, Kim CA, Baratela WADR. Diagnostic power and clinical impact of exome sequencing in a cohort of 500 patients with rare diseases. Am J Med Genet 2020; 184:955-964. [DOI: 10.1002/ajmg.c.31860] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/03/2020] [Accepted: 11/09/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Caio Robledo D'Angioli Costa Quaio
- Fleury Medicina e Saúde Grupo Fleury São Paulo SP Brazil
- Instituto da Crianca (Children's Hospital) Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo Sao Paulo SP Brazil
| | | | | | | | | | - Sandro Felix Perazzio
- Fleury Medicina e Saúde Grupo Fleury São Paulo SP Brazil
- Rheumatology Division, Department of Medicine, Escola Paulista de Medicina Universidade Federal de Sao Paulo São Paulo SP Brazil
| | | | - Rafael Alves Silva
- Fleury Medicina e Saúde Grupo Fleury São Paulo SP Brazil
- Escola Paulista de Medicina, Laboratório de Hepatologia Molecular Aplicada (LHeMA) Universidade Federal de São Paulo São Paulo SP Brazil
| | | | | | - Vanessa Galdeno Freitas
- Fleury Medicina e Saúde Grupo Fleury São Paulo SP Brazil
- Instituto de Matemática e Estatística da Universidade de São Paulo e Instituto de Ensino e Pesquisa do Hospital Sírio Libanês São Paulo SP Brazil
| | | | | | | | | | - Andre Yuji Oku
- Fleury Medicina e Saúde Grupo Fleury São Paulo SP Brazil
| | - Matheus Burger
- Fleury Medicina e Saúde Grupo Fleury São Paulo SP Brazil
| | | | | | | | | | | | | | | | | | | | | | - Naiade Romano
- Fleury Medicina e Saúde Grupo Fleury São Paulo SP Brazil
| | - Daniele Paixão
- Fleury Medicina e Saúde Grupo Fleury São Paulo SP Brazil
| | | | | | - Gustavo Arantes Rosa Maciel
- Fleury Medicina e Saúde Grupo Fleury São Paulo SP Brazil
- Discipline of Gynecology Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo São Paulo SP Brazil
| | - Viviane Zorzanelli Rocha
- Fleury Medicina e Saúde Grupo Fleury São Paulo SP Brazil
- Heart Institute (InCor) Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo São Paulo SP Brazil
| | | | - Mario Henrique Burlacchini Carvalho
- Fleury Medicina e Saúde Grupo Fleury São Paulo SP Brazil
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia Faculdade de Medicina FMUSP, Universidade de Sao Paulo São Paulo SP Brazil
| | - Alexandre Wagner Silva Souza
- Fleury Medicina e Saúde Grupo Fleury São Paulo SP Brazil
- Rheumatology Division, Department of Medicine, Escola Paulista de Medicina Universidade Federal de Sao Paulo São Paulo SP Brazil
| | - Luis Eduardo Coelho Andrade
- Fleury Medicina e Saúde Grupo Fleury São Paulo SP Brazil
- Rheumatology Division, Department of Medicine, Escola Paulista de Medicina Universidade Federal de Sao Paulo São Paulo SP Brazil
| | | | | | | | | | - Chong Ae Kim
- Instituto da Crianca (Children's Hospital) Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo Sao Paulo SP Brazil
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11
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Belem JMFM, Fraga AM, Andrade LEC, de Souza AWS. HLA-B*51 and its main subtypes in Brazilian patients with Behçet's disease. Clin Exp Rheumatol 2020; 38 Suppl 127:53-59. [PMID: 33124572] [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] [Received: 02/17/2020] [Accepted: 06/16/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES This study aimed to evaluate the frequency of HLA-B*51 and its subtypes in Brazilian patients with Behçet's disease (BD) and healthy controls (HC) and to assess possible associations with disease manifestations. METHODS A cross-sectional study with sequential BD patients and HC. HLAB*51 presence was determined by sequence-specific polymerase chain reaction (SSP-PCR) and HLA-B*51 subtypes by the Sanger sequencing method. RESULTS Eighty-three BD patients and 258 HC were evaluated. HLA-B*51 was found in 30.1% of DB patients and in 15.5% of HC (p=0.003). The most prevalent subtypes in DB patients were HLA-B*51:01 (60.0%), HLA-B*51:08 (20.0%), HLA-B*51:22 (8.0%), HLAB* 51:29 (8.0%) and HLA-B*51:02 (4.0%), while HLA-B*51:01 (77.5%) and HLA-B*51:55 (7.5%) were the most prevalent in HC. HLA-B*51 was less frequently found in patients with neurologic involvement (8.0% vs. 29.3%; p=0.034) while HLAB*51:01 was more observed in patients with ocular involvement (93.3% vs. 60.3%; p=0.014). No BD patient with neurologic or vascular involvement presented HLA-B*51:01. HLAB*51:08 was more frequent in patients with vascular manifestations (60.0% vs. 15.4%; p=0.012). In multivariate analysis, HLA-B*51 was an independent risk factor for BD (OR=2.410; 95%CI: 1.332-4.361; p=0.004) and HLA-B*51:08 had an independent association with vascular manifestations of BD (OR = 14.843; 95%CI: 1.550 - 142.115; p=0.019). CONCLUSIONS The prevalence of HLAB*51 is higher in Brazilian BD patients compared to HC, and it is a risk factor for BD. The HLA-B*51:08 subtype was independently associated with vascular manifestations of BD.
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Affiliation(s)
- Joice Moraes F M Belem
- Rheumatology Division, Department of Medicine, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil
| | | | - Luis Eduardo Coelho Andrade
- Rheumatology Division, Department of Medicine, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, and Fleury Group, Research and Development, São Paulo, Brazil
| | - Alexandre W S de Souza
- Rheumatology Division, Department of Medicine, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, and Fleury Group, Research and Development, São Paulo, Brazil.
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12
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Andrade LEC, Damoiseaux J, Chan EK. Response to 'Decision making value of nuclear dense fine speckled pattern in systemic autoimmune rheumatic disease: trick or treat?' by Deng et al. Ann Rheum Dis 2020; 79:e93. [PMID: 31092413 DOI: 10.1136/annrheumdis-2019-215640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 11/04/2022]
Affiliation(s)
| | - Jan Damoiseaux
- Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Edward K Chan
- Department of Oral Biology, University of Florida, Gainesville, Florida, USA
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de Farias DLC, Prats J, Cavalcanti AB, Rosa RG, Machado FR, Berwanger O, de Azevedo LCP, Lopes RD, Avezum Á, Kawano-Dourado L, Damiani LP, Rojas SSO, de Oliveira CZ, Andrade LEC, Sandes AF, Pintão MC, de Castro Júnior CG, Scheinberg P, Veiga VC. Rationale and design of the "Tocilizumab in patients with moderate to severe COVID-19: an open-label multicentre randomized controlled" trial (TOCIBRAS). Rev Bras Ter Intensiva 2020; 32:337-347. [PMID: 32965395 PMCID: PMC7595725 DOI: 10.5935/0103-507x.20200060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 07/22/2020] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Pro-inflammatory markers play a significant role in the disease severity of patients with COVID-19. Thus, anti-inflammatory therapies are attractive agents for potentially combating the uncontrolled inflammatory cascade in these patients. We designed a trial testing tocilizumab versus standard of care intending to improve the outcomes by inhibiting interleukin-6, an important inflammatory mediator in COVID-19. METHODS AND ANALYSIS This open-label multicentre randomized controlled trial will compare clinical outcomes of tocilizumab plus standard of care versus standard of care alone in patients with moderate to severe COVID-19. Two of the following four criteria are required for protocol enrolment: D-dimer > 1,000ng/mL; C reactive protein > 5mg/dL, ferritin > 300mg/dL, and lactate dehydrogenase > upper limit of normal. The primary objective will be to compare the clinical status on day 15, as measured by a 7-point ordinal scale applied in COVID-19 trials worldwide. The primary endpoint will be assessed by an ordinal logistic regression assuming proportional odds ratios adjusted for stratification variables (age and sex). ETHICS AND DISSEMINATION The TOCIBRAS protocol was approved by local and central (national) ethical committees in Brazil following current national and international guidelines/directives. Each participating center had the study protocol approved by their institutional review boards before initiating protocol enrolment. The data derived from this trial will be published regardless of the results. If proven active, this strategy could alleviate the consequences of the inflammatory response in COVID-19 patients and improve their clinical outcomes.
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Affiliation(s)
| | - João Prats
- BP - A Beneficência Portuguesa de São Paulo - São Paulo (SP), Brazil
| | - Alexandre Biasi Cavalcanti
- Brazilian Research in Intensive Care Network (BRICNet) - São Paulo (SP), Brazil
- Research Institute, HCor-Hospital do Coração - São Paulo (SP), Brazil
| | - Regis Goulart Rosa
- Brazilian Research in Intensive Care Network (BRICNet) - São Paulo (SP), Brazil
- Hospital Moinhos de Vento - Porto Alegre (RS), Brazil
| | | | - Otávio Berwanger
- Academic Research Organization, Hospital Israelita Albert Einstein - São Paulo (SP), Brazil
| | - Luciano César Pontes de Azevedo
- Brazilian Research in Intensive Care Network (BRICNet) - São Paulo (SP), Brazil
- Hospital Sírio-Libanês - São Paulo (SP), Brazil
| | - Renato Delascio Lopes
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, Estados Unidos
- Brazilian Clinical Research Institute - São Paulo (SP), Brazil
| | - Álvaro Avezum
- International Research Center, Hospital Alemão Oswaldo Cruz - São Paulo (SP), Brazil
| | | | | | | | | | | | | | | | - Claudio Galvão de Castro Júnior
- Academic Research Organization, Hospital Israelita Albert Einstein - São Paulo (SP), Brazil
- Santa Casa de Porto Alegre - Porto Alegre (RS), Brazil
| | | | - Viviane Cordeiro Veiga
- BP - A Beneficência Portuguesa de São Paulo - São Paulo (SP), Brazil
- Brazilian Research in Intensive Care Network (BRICNet) - São Paulo (SP), Brazil
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14
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Keppeke GD, Andrade LEC, Barcelos D, Fernandes M, Landman G. IMPDH-Based Cytoophidium Structures as Potential Theranostics in Cancer. Mol Ther 2020; 28:1557-1558. [PMID: 32534605 DOI: 10.1016/j.ymthe.2020.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Gerson Dierley Keppeke
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
| | | | - Denise Barcelos
- Department of Pathology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Mariana Fernandes
- Department of Pathology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Gilles Landman
- Department of Pathology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Damoiseaux J, Andrade LEC. Response to: ‘Antinuclear antibodies: mitotic patterns and their clinical
associations’ by Betancur and Gómez-Puerta. Ann Rheum Dis 2020; 79:e64. [DOI: 10.1136/annrheumdis-2019-215439] [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] [Received: 04/05/2019] [Accepted: 04/07/2019] [Indexed: 11/03/2022]
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de Melo Cruvinel W, Andrade LEC, von Mühlen CA, Dellavance A, Ximenes AC, Bichara CD, Bueno C, Mangueira CLP, Bonfá E, de Almeida Brito F, Flumian FB, da Silva GG, Rêgo J, Dos Anjos LME, Slhessarenko N, Pasoto SG, Neves SPF, Valim V, Dos Santos WS, Francescantonio PLC. Correction to: V Brazilian consensus guidelines for detection of anti-cell autoantibodies on hep-2 cells. Adv Rheumatol 2020; 60:6. [PMID: 31907077 DOI: 10.1186/s42358-019-0103-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
After publication of the original article [1], we were notified that there is a mistake in Fig. 2.
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Affiliation(s)
- Wilson de Melo Cruvinel
- Pontifícia Universidade Católica de Goiás (PUC Goiás), Escola de Ciências Médicas, Farmacêuticas e Biomédicas, Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, CEP 74605-010, Brazil.
| | - Luis Eduardo Coelho Andrade
- Disciplina de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Divisão de Imunologia, Fleury Medicina e Saúde, São Paulo, SP, Brazil
| | | | - Alessandra Dellavance
- Divisão de Pesquisa, Inovação e Desenvolvimento, Fleury Medicina e Saúde, São Paulo, SP, Brazil
| | | | - Carlos David Bichara
- Faculdade de Medicina Famaz, Amaral Costa Medicina Diagnóstica, Belém, PA, Brazil
| | - Cleonice Bueno
- Laboratórios de Investigação Médica, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (FM-USP), São Paulo, SP, Brazil
| | | | - Eloísa Bonfá
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | | | | | | | - Jozelia Rêgo
- Faculdade de Medicina, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil
| | | | - Natasha Slhessarenko
- Universidade Federal de Mato Grosso (UFMT) e Grupo DASA Cuiabá, Cuiabá, MT, Brazil
| | - Sandra Gofinet Pasoto
- Serviço de Reumatologia e Laboratório de Autoimunidade da Divisão de Laboratório Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Suzane Pretti Figueiredo Neves
- Departamento de Propedêutica Complementar da Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Valéria Valim
- Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | - Wilton Silva Dos Santos
- Escola Superior de Ciências da Saúde do Distrito Federal e Laboratório Sabin, Brasília, DF, Brazil
| | - Paulo Luiz Carvalho Francescantonio
- Pontifícia Universidade Católica de Goiás (PUC Goiás), Escola de Ciências Médicas, Farmacêuticas e Biomédicas, Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, CEP 74605-010, Brazil.
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Pereira KMC, Perazzio S, Faria AGA, Moreira ES, Santos VC, Grecco M, da Silva NP, Andrade LEC. Impact of C4, C4A and C4B gene copy number variation in the susceptibility, phenotype and progression of systemic lupus erythematosus. Adv Rheumatol 2019; 59:36. [PMID: 31387635 DOI: 10.1186/s42358-019-0076-6] [Citation(s) in RCA: 6] [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: 03/25/2019] [Accepted: 07/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Complement component 4 (C4) gene copy number (GCN) affects the susceptibility to systemic lupus erythematosus (SLE) in different populations, however the possible phenotype significance remains to be determined. This study aimed to associate C4A, C4B and total C4 GCN and SLE, focusing on the clinical phenotype and disease progression. METHODS C4, C4A and C4B GCN were determined by real-time PCR in 427 SLE patients and 301 healthy controls, which underwent a detailed clinical evaluation according to a pre-established protocol. RESULTS The risk of developing SLE was 2.62 times higher in subjects with low total C4 GCN (< 4 copies, OR = 2.62, CI = 1.77 to 3.87, p < 0.001) and 3.59 times higher in subjects with low C4A GCN (< 2 copies; OR = 3.59, CI = 2.15 to 5.99, p < 0.001) compared to those subjects with normal or high GCN of total C4 (≥4) and C4A (≥2), respectively. An increased risk was also observed regarding low C4B GCN, albeit to a lesser degree (OR = 1.46, CI = 1.03 to 2.08, p = 0.03). Furthermore, subjects with low C4A GCN had higher permanent disease damage as assessed by the Systemic Lupus International Collaborating Clinics - Damage Index (SLICC-DI; median = 1.5, 95% CI = 1.2-1.9) than patients with normal or high copy number of C4A (median = 1.0, 95% CI = 0.8-1.1; p = 0.004). There was a negative association between low C4A GCN and serositis (p = 0.02) as well as between low C4B GCN and arthritis (p = 0.02). CONCLUSIONS This study confirms the association between low C4 GCN and SLE susceptibility, and originally demonstrates an association between low C4A GCN and disease severity.
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Affiliation(s)
- Kaline Medeiros Costa Pereira
- Disciplina de Reumatologia, Universidade Federal de São Paulo, Rua Botucatu 740, 3o andar, São Paulo, SP, ZIP: 04023-062, Brazil
| | - Sandro Perazzio
- Disciplina de Reumatologia, Universidade Federal de São Paulo, Rua Botucatu 740, 3o andar, São Paulo, SP, ZIP: 04023-062, Brazil
| | - Atila Granado A Faria
- Disciplina de Reumatologia, Universidade Federal de São Paulo, Rua Botucatu 740, 3o andar, São Paulo, SP, ZIP: 04023-062, Brazil
| | - Eloisa Sa Moreira
- Departamento de Genética e Biologia Evolutiva, Centro de Estudos do Genoma Humano, Instituto de Biociências, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Viviane C Santos
- Disciplina de Reumatologia, Universidade Federal de São Paulo, Rua Botucatu 740, 3o andar, São Paulo, SP, ZIP: 04023-062, Brazil
| | - Marcelle Grecco
- Disciplina de Reumatologia, Universidade Federal de São Paulo, Rua Botucatu 740, 3o andar, São Paulo, SP, ZIP: 04023-062, Brazil
| | - Neusa Pereira da Silva
- Disciplina de Reumatologia, Universidade Federal de São Paulo, Rua Botucatu 740, 3o andar, São Paulo, SP, ZIP: 04023-062, Brazil
| | - Luis Eduardo Coelho Andrade
- Disciplina de Reumatologia, Universidade Federal de São Paulo, Rua Botucatu 740, 3o andar, São Paulo, SP, ZIP: 04023-062, Brazil.
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Cruvinel WDM, Andrade LEC, von Mühlen CA, Dellavance A, Ximenes AC, Bichara CD, Bueno C, Mangueira CLP, Bonfá E, de Almeida Brito F, Flumian FB, da Silva GG, Rêgo J, Dos Anjos LME, Slhessarenko N, Pasoto SG, Neves SPF, Valim V, Dos Santos WS, Francescantonio PLC. V Brazilian consensus guidelines for detection of anti-cell autoantibodies on hep-2 cells. Adv Rheumatol 2019; 59:28. [PMID: 31269997 DOI: 10.1186/s42358-019-0069-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 02/26/2019] [Accepted: 06/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The V Brazilian Consensus for determination of autoantibodies against cellular constituents on HEp-2 cells, held in Brasilia (DF, Brazil) on August 27, 2016, discussed the harmonization between the Brazilian Consensus on ANA (BCA) guidelines and the International Consensus on ANA Patterns (ICAP) recommendations ( www.anapatterns.org ). Initial guidelines were formulated by the group of Brazilian experts with the purpose of guiding and enabling Brazilian clinical laboratories to adopt recommendations and to provide a common standard for national and international consensuses. MAINBODY Twenty Brazilian researchers and experts from universities and clinical laboratories representing the various geographical regions of the country participated in the meeting. Three main topics were discussed, namely the harmonization between the BCA guidelines and latest recommendations of the ICAP initiative, the adjustment of the terminology and report on HEp-2 patterns, and a reassessment of quality assurance parameters. For the three topics, our aim was to establish specific guidelines. All recommendations were based on consensus among participants. There was concrete progress in the adjustment of the BCA guidelines to match the ICAP guidelines. To a certain extent, this derives from the fact that ICAP recommendations were largely based on the algorithm and recommendations of the IV Brazilian ANA Consensus, as consistently recognized in the ICAP publications and presentations. However, although there is great overlap between the two Consensuses, there are some point divergences. These specific items were individually and extensively discussed, and it was acknowledged that in several points ICAP improved recommendations previously issued by the Brazilian ANA Consensus and these changes were readily implemented. Regarding some specific topics, the BCA panel of experts felt that the previously issued recommendations remained relevant and possibly will require further discussion with ICAP. The term anti-cell antibodies was adopted as the recommended designation, recognizing that the assay addresses antibodies against antigens in the nucleus and in other cell compartments. However, the acronym ANA HEp-2 was maintained due to historical and regulatory reasons. It was also signalized that the latest trend in ICAP is to adopt the term Indirect Immunofluorescent Assay on HEp-2 cell substrate (HEp-2 IIFA). In addition, the quality assurance strategies previously presented were ratified and emphasized. CONCLUSION The V BCA edition was successful in establishing an overall harmonization with the ICAP recommendations for interpretation of the HEp-2 IIFA test, pinpointing the perspectives in filling the remaining gaps between both initiatives.
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Affiliation(s)
- Wilson de Melo Cruvinel
- Pontifícia Universidade Católica de Goiás (PUC Goiás), Escola de Ciências Médicas, Farmacêuticas e Biomédicas, Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, CEP, 74605-010, Brazil.
| | - Luis Eduardo Coelho Andrade
- Disciplina de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Divisão de Imunologia, Fleury Medicina e Saúde, São Paulo, SP, Brazil
| | | | - Alessandra Dellavance
- Divisão de Pesquisa, Inovação e Desenvolvimento, Fleury Medicina e Saúde, São Paulo, SP, Brazil
| | | | - Carlos David Bichara
- Faculdade de Medicina Famaz, Amaral Costa Medicina Diagnóstica, Belém, PA, Brazil
| | - Cleonice Bueno
- Laboratórios de Investigação Médica, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (FM-USP), São Paulo, SP, Brazil
| | | | - Eloísa Bonfá
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | | | | | | | - Jozelia Rêgo
- Faculdade de Medicina, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil
| | | | - Natasha Slhessarenko
- Universidade Federal de Mato Grosso (UFMT) e Grupo DASA Cuiabá, Cuiabá, MT, Brazil
| | - Sandra Gofinet Pasoto
- Serviço de Reumatologia e Laboratório de Autoimunidade da Divisão de Laboratório Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Suzane Pretti Figueiredo Neves
- Departamento de Propedêutica Complementar da Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Valéria Valim
- Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | - Wilton Silva Dos Santos
- Escola Superior de Ciências da Saúde do Distrito Federal e Laboratório Sabin, Brasília, DF, Brazil
| | - Paulo Luiz Carvalho Francescantonio
- Pontifícia Universidade Católica de Goiás (PUC Goiás), Escola de Ciências Médicas, Farmacêuticas e Biomédicas, Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, CEP, 74605-010, Brazil.
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19
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Agustinelli RA, Rodrigues SH, Mariz HA, Prado MS, Andrade LEC. Distinctive features of positive anti-cell antibody tests (indirect immunofluorescence on HEp-2 cells) in patients with non-autoimmune diseases. Lupus 2019; 28:629-634. [PMID: 31027463 DOI: 10.1177/0961203319838348] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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 The objective of this study was to determine whether characteristics of positive results in the indirect immunofluorescence assay on HEp-2 cells for anti-cell antibodies (HEp-2 IFA) differ between patients with non-autoimmune diseases (NADs) and patients with systemic autoimmune rheumatic diseases (SARDs). METHODS Cross-sectional observational study comparing HEp-2 IFA test results in three groups: (a) 558 NAD patients comprising four subgroups (cancer ( n = 95), infectious diseases ( n = 148), psychiatric diseases ( n = 163), common non-infectious chronic diseases ( n = 152)); (b) 194 SARD patients; (c) 1217 healthy individuals (HIs). Sera were tested at 1:80 dilution and diluted to the end titer. Slides were analyzed by two independent blinded examiners. RESULTS A positive HEp-2 IFA test occurred in 102 (18.3%) NAD patients, 170 (87.6%) SARD patients and 150 (12.3%) HIs. The four NAD subgroups did not differ regarding HEp-2 IFA frequency, titer or pattern. HEp-2 IFA titer was higher in NAD patients than in HIs and both had lower titer than SARD patients. Nuclear dense fine speckled pattern was more frequent in NAD patients and HIs than in SARD patients ( p < 0.001). Nuclear homogeneous and nuclear coarse speckled patterns were more frequent in SARD patients than in the other groups ( p < 0.001). The nuclear fine speckled pattern was prevalent in all three groups, but presented a gradient in titer across them; HIs and NAD patients had low and intermediary titers, which were significantly lower than in SARD patients ( p < 0.001). CONCLUSION Positive HEp-2 IFA frequency, pattern and titer present differential features in NAD and SARD patients, and this attribute adds value to the test in the diagnosis of SARDs.
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Affiliation(s)
- R A Agustinelli
- 1 Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - S H Rodrigues
- 1 Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - H A Mariz
- 2 Rheumatology Division, Universidade Federal de Pernambuco, Recife, Brazil
| | - M S Prado
- 1 Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - L E C Andrade
- 1 Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil.,3 Immunology Division, Fleury Medicine and Health Laboratories, São Paulo, Brazil
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20
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Damoiseaux J, Andrade LEC, Carballo OG, Conrad K, Francescantonio PLC, Fritzler MJ, Garcia de la Torre I, Herold M, Klotz W, Cruvinel WDM, Mimori T, von Muhlen C, Satoh M, Chan EK. Clinical relevance of HEp-2 indirect immunofluorescent patterns: the International Consensus on ANA patterns (ICAP) perspective. Ann Rheum Dis 2019; 78:879-889. [PMID: 30862649 PMCID: PMC6585284 DOI: 10.1136/annrheumdis-2018-214436] [Citation(s) in RCA: 169] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/23/2019] [Indexed: 12/21/2022]
Abstract
The indirect immunofluorescence assay (IIFA) on HEp-2 cells is widely used for detection of antinuclear antibodies (ANA). The dichotomous outcome, negative or positive, is integrated in diagnostic and classification criteria for several systemic autoimmune diseases. However, the HEp-2 IIFA test has much more to offer: besides the titre or fluorescence intensity, it also provides fluorescence pattern(s). The latter include the nucleus and the cytoplasm of interphase cells as well as patterns associated with mitotic cells. The International Consensus on ANA Patterns (ICAP) initiative has previously reached consensus on the nomenclature and definitions of HEp-2 IIFA patterns. In the current paper, the ICAP consensus is presented on the clinical relevance of the 29 distinct HEp-2 IIFA patterns. This clinical relevance is primarily defined within the context of the suspected disease and includes recommendations for follow-up testing. The discussion includes how this information may benefit the clinicians in daily practice and how the knowledge can be used to further improve diagnostic and classification criteria.
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Affiliation(s)
- Jan Damoiseaux
- Central Diagnostic Laboratory, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Orlando Gabriel Carballo
- Department of Immunology, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.,Laboratory of Immunology, Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | - Karsten Conrad
- Immunology, Medical Faculty TU Dresden, Dresden, Germany
| | | | | | | | - Manfred Herold
- Rheumatology Unit, Clinical Department of General Internal Medicine, Innsbruck Medical University, Innsbruck, Austria
| | - Werner Klotz
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate school of Medicine, Kyoto, Japan
| | | | - Minoru Satoh
- Department of Clinical Nursing, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Edward K Chan
- Department of Oral Biology, University of Florida, Gainesville, Florida, USA
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21
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de Brito Rocha S, Baldo DC, Andrade LEC. Clinical and pathophysiologic relevance of autoantibodies in rheumatoid arthritis. Adv Rheumatol 2019; 59:2. [PMID: 30657101 DOI: 10.1186/s42358-018-0042-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [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: 11/07/2018] [Accepted: 11/29/2018] [Indexed: 12/20/2022] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune/inflammatory disease affecting 0.5 to 1% of adults worldwide and frequently leads to joint destruction and disability. Early diagnosis and early and effective therapy may prevent joint damage and lead to better long-term results. Therefore, reliable biomarkers and outcome measures are needed. Refinement of the understanding of molecular pathways involved in disease pathogenesis have been achieved by combining knowledge on RA-associated genes, environmental factors and the presence of serological elements. The presence of autoantibodies is a distinctive feature of RA. Rheumatoid Factor and Anti-Citrullinated Protein Antibodies are the two most remarkable autoantibodies in RA and provide different clinical and pathophysiological information. They precede the onset of disease symptoms and predict a more severe disease course, indicating a pathogenetic role in RA. Therefore, they promote a more accurate prognosis and contribute for a better disease management. Several RA-associated autoantibody systems have been identified: Anti-Carbamylated Antibodies, Anti-BRAF, Anti-Acetylated, Anti-PAD4 antibodies and others. Hopefully, the characterization of a comprehensive array of novel autoantibody systems in RA will provide unique pathogenic insights of relevance for the development of diagnostic and prognostic approaches compatible with an effective personalized medicine.
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Affiliation(s)
- Sara de Brito Rocha
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Disciplina de Reumatologia, Rua Botucatu 740, 3o andar, São Paulo, SP, ZIP:04023-062, Brazil.
| | - Danielle Cristiane Baldo
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Disciplina de Reumatologia, Rua Botucatu 740, 3o andar, São Paulo, SP, ZIP:04023-062, Brazil
| | - Luis Eduardo Coelho Andrade
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Disciplina de Reumatologia, Rua Botucatu 740, 3o andar, São Paulo, SP, ZIP:04023-062, Brazil
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22
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Keppeke GD, Chang CC, Peng M, Chen LY, Lin WC, Pai LM, Andrade LEC, Sung LY, Liu JL. IMP/GTP balance modulates cytoophidium assembly and IMPDH activity. Cell Div 2018; 13:5. [PMID: 29946345 PMCID: PMC6004095 DOI: 10.1186/s13008-018-0038-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 06/06/2018] [Indexed: 02/07/2023] Open
Abstract
Background Inosine monophosphate dehydrogenase (IMPDH), the rate-limiting enzyme in de novo GTP biosynthesis, plays an important role in cell metabolism and proliferation. It has been demonstrated that IMPDH can aggregate into a macrostructure, termed the cytoophidium, in mammalian cells under a variety of conditions. However, the regulation and function of the cytoophidium are still elusive. Results In this study, we report that spontaneous filamentation of IMPDH is correlated with rapid cell proliferation. Intracellular IMP accumulation promoted cytoophidium assembly, whereas elevated GTP level triggered disassociation of aggregates. By using IMPDH2 CBS domain mutant cell models, which are unable to form the cytoophidium, we have determined that the cytoophidium is of the utmost importance for maintaining the GTP pool and normal cell proliferation in the condition that higher IMPDH activity is required. Conclusions Together, our results suggest a novel mechanism whereby cytoophidium assembly upregulates IMPDH activity and mediates guanine nucleotide homeostasis. Electronic supplementary material The online version of this article (10.1186/s13008-018-0038-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gerson Dierley Keppeke
- 1Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, OX1 3PT UK
| | - Chia Chun Chang
- 1Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, OX1 3PT UK.,2Institute of Biotechnology, National Taiwan University, Taipei, 106 Taiwan, ROC
| | - Min Peng
- 2Institute of Biotechnology, National Taiwan University, Taipei, 106 Taiwan, ROC
| | - Li-Yu Chen
- 1Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, OX1 3PT UK
| | - Wei-Cheng Lin
- 3Molecular Medicine Research Center, College of Medicine, Chang Gung University, Tao-Yuan, 333 Taiwan, ROC
| | - Li-Mei Pai
- 3Molecular Medicine Research Center, College of Medicine, Chang Gung University, Tao-Yuan, 333 Taiwan, ROC.,4Graduate Institute of Biomedical Science, College of Medicine, Chang Gung University, Tao-Yuan, 333 Taiwan, ROC.,5Department of Biochemistry, College of Medicine, Chang Gung University, Tao-Yuan, 333 Taiwan, ROC
| | - Luis Eduardo Coelho Andrade
- 6Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, SP 04023-062 Brazil
| | - Li-Ying Sung
- 2Institute of Biotechnology, National Taiwan University, Taipei, 106 Taiwan, ROC.,7Agricultural Biotechnology Research Center, Academia Sinica, Taipei, 115 Taiwan, ROC
| | - Ji-Long Liu
- 1Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, OX1 3PT UK.,8School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210 China
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23
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Perazzio SF, Soeiro-Pereira PV, Dos Santos VC, de Brito MV, Salu B, Oliva MLV, Stevens AM, de Souza AWS, Ochs HD, Torgerson TR, Condino-Neto A, Andrade LEC. Soluble CD40L is associated with increased oxidative burst and neutrophil extracellular trap release in Behçet's disease. Arthritis Res Ther 2017; 19:235. [PMID: 29052524 PMCID: PMC5649058 DOI: 10.1186/s13075-017-1443-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 09/25/2017] [Indexed: 12/11/2022] Open
Abstract
Background Studies have suggested that soluble factors in plasma from patients with active (aBD) and inactive (iBD) Behçet’s disease (BD) stimulate neutrophil function. Soluble CD40 ligand (sCD40L) is an important mediator of inflammation in BD. Its expression and effect on neutrophil oxidative burst and neutrophil extracellular trap (NET) release have not been characterized. In this study, we sought to investigate the role of plasma and the CD40L pathway on NET release and the oxidative burst profile in patients with aBD and iBD. Methods Neutrophils and peripheral blood mononuclear cells (PBMCs) were obtained from patients with aBD (n = 30), patients with iBD (n = 31), and healthy control subjects (HCs; n = 30). sCD40L plasma concentration was determined in individual samples. A pool of plasma for each group was created. In some experiments, plasma pools were treated with recombinant CD40 (rhCD40-muIg) for sCD40L blockade. NET release and H2O2/O2− production were determined after stimulation with phorbol 12-myristate 13-acetate, sCD40L, or plasma pool. Flow cytometric analysis was performed to evaluate the expression of (1) CD40, Mac-1, and phosphorylated NF-κB p65 on neutrophils and monocytes and (2) CD40L on activated T cells and platelets. CD40L gene expression in PBMCs was determined by qRT-PCR. Results sCD40L plasma levels were significantly higher in patients with iBD (median 17,234, range 2346–19,279 pg/ml) and patients with aBD (median 18,289, range 413–19,883 pg/ml) than in HCs (median 47.5, range 33.7–26.7 pg/ml; p < 0.001). NET release was constitutively increased in BD compared with HC. NET release and H2O2/O2− were higher after stimulation with sCD40L or BD plasma and decreased after sCD40L blockade. Mac-1 expression was constitutively increased in neutrophils of patients with aBD (88.7 ± 13.2% of cells) and patients with iBD (89.2 ± 20.1% of cells) compared with HC (27.1 ± 18.8% of cells; p < 0.01). CD40 expression on phagocytes and CD40L expression on platelets were similar in the three groups. PBMCs as well as nonactivated and activated CD4+ T cells from patients with BD showed higher CD40L expression. Conclusions Plasma from patients with aBD exerts a stimulus on NET release and oxidative burst, probably induced by sCD40L. Electronic supplementary material The online version of this article (doi:10.1186/s13075-017-1443-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sandro Félix Perazzio
- Division of Rheumatology, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Botucatu 740, 3° Andar, 04023-062, Sao Paulo, SP, Brazil. .,Fleury Group - Research and Development, Avenida General Valdomiro de Lima, 508, 04344-070, Sao Paulo, SP, Brazil. .,Seattle Children's Research Institute, University of Washington and Center for Immunity and Immunotherapies, 1900 9th Avenue, JMB-7, Seattle, WA, 98101, USA.
| | - Paulo Vitor Soeiro-Pereira
- Department of Immunology, Institute of Biomedical Sciences, University of Sao Paulo, Avenida Professor Lineu Prestes, 2415, 03178-200, Sao Paulo, SP, Brazil.,Department of Pathology, Federal University of Maranhao, Avenida dos Portugueses, 65065-545, Sao Luiz, MA, Brazil
| | - Viviane Cardoso Dos Santos
- Division of Rheumatology, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Botucatu 740, 3° Andar, 04023-062, Sao Paulo, SP, Brazil
| | - Marlon Vilela de Brito
- Department of Biochemistry and Molecular Biology, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Três de Maio, 100, 5° Andar, 04044-020, Sao Paulo, SP, Brazil
| | - Bruno Salu
- Department of Biochemistry and Molecular Biology, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Três de Maio, 100, 5° Andar, 04044-020, Sao Paulo, SP, Brazil
| | - Maria Luiza Vilela Oliva
- Department of Biochemistry and Molecular Biology, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Três de Maio, 100, 5° Andar, 04044-020, Sao Paulo, SP, Brazil
| | - Anne Margherite Stevens
- Seattle Children's Research Institute, University of Washington and Center for Immunity and Immunotherapies, 1900 9th Avenue, JMB-7, Seattle, WA, 98101, USA
| | - Alexandre Wagner Silva de Souza
- Division of Rheumatology, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Botucatu 740, 3° Andar, 04023-062, Sao Paulo, SP, Brazil.,Fleury Group - Research and Development, Avenida General Valdomiro de Lima, 508, 04344-070, Sao Paulo, SP, Brazil
| | - Hans D Ochs
- Seattle Children's Research Institute, University of Washington and Center for Immunity and Immunotherapies, 1900 9th Avenue, JMB-7, Seattle, WA, 98101, USA
| | - Troy R Torgerson
- Seattle Children's Research Institute, University of Washington and Center for Immunity and Immunotherapies, 1900 9th Avenue, JMB-7, Seattle, WA, 98101, USA
| | - Antonio Condino-Neto
- Department of Immunology, Institute of Biomedical Sciences, University of Sao Paulo, Avenida Professor Lineu Prestes, 2415, 03178-200, Sao Paulo, SP, Brazil
| | - Luis Eduardo Coelho Andrade
- Division of Rheumatology, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Botucatu 740, 3° Andar, 04023-062, Sao Paulo, SP, Brazil.,Fleury Group - Research and Development, Avenida General Valdomiro de Lima, 508, 04344-070, Sao Paulo, SP, Brazil
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24
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Prado MS, Bendtzen K, Andrade LEC. Biological anti-TNF drugs: immunogenicity underlying treatment failure and adverse events. Expert Opin Drug Metab Toxicol 2017; 13:985-995. [DOI: 10.1080/17425255.2017.1360280] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Mônica Simon Prado
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Klaus Bendtzen
- Institute for Inflammation Research, Rigshospitalet University Hospital, Copenhagen, Denmark
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25
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Lopes SRM, Gormezano NWS, Gomes RC, Aikawa NE, Pereira RMR, Terreri MT, Magalhães CS, Ferreira JC, Okuda EM, Sakamoto AP, Sallum AME, Appenzeller S, Ferriani VPL, Barbosa CM, Lotufo S, Jesus AA, Andrade LEC, Campos LMA, Bonfá E, Silva CA. Outcomes of 847 childhood-onset systemic lupus erythematosus patients in three age groups. Lupus 2017; 26:996-1001. [PMID: 28134038 DOI: 10.1177/0961203317690616] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 11/16/2022]
Abstract
Objective The objective of this study was to assess outcomes of childhood systemic lupus erythematosus (cSLE) in three different age groups evaluated at last visit: group A early-onset disease (<6 years), group B school age (≥6 and <12 years) and group C adolescent (≥12 and <18 years). Methods An observational cohort study was performed in ten pediatric rheumatology centers, including 847 cSLE patients. Results Group A had 39 (4%), B 395 (47%) and C 413 (49%). Median disease duration was significantly higher in group A compared to groups B and C (8.3 (0.1-23.4) vs 6.2 (0-17) vs 3.3 (0-14.6) years, p < 0.0001). The median Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI) (0 (0-9) vs 0 (0-6) vs 0 (0-7), p = 0.065) was comparable in the three groups. Further analysis of organ/system damage revealed that frequencies of neuropsychiatric (21% vs 10% vs 7%, p = 0.007), skin (10% vs 1% vs 3%, p = 0.002) and peripheral vascular involvements (5% vs 3% vs 0.3%, p = 0.008) were more often observed in group A compared to groups B and C. Frequencies of severe cumulative lupus manifestations such as nephritis, thrombocytopenia, and autoimmune hemolytic anemia were similar in all groups ( p > 0.05). Mortality rate was significantly higher in group A compared to groups B and C (15% vs 10% vs 6%, p = 0.028). Out of 69 deaths, 33/69 (48%) occurred within the first two years after diagnosis. Infections accounted for 54/69 (78%) of the deaths and 38/54 (70%) had concomitant disease activity. Conclusions This large multicenter study provided evidence that early-onset cSLE group had distinct outcomes. This group was characterized by higher mortality rate and neuropsychiatric/vascular/skin organ damage in spite of comparable frequencies of severe cumulative lupus manifestations. We also identified that overall death in cSLE patients was an early event mainly attributed to infection associated with disease activity.
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Affiliation(s)
- S R M Lopes
- 1 Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - N W S Gormezano
- 1 Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - R C Gomes
- 2 Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - N E Aikawa
- 1 Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, Brazil.,2 Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - R M R Pereira
- 1 Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - M T Terreri
- 3 Pediatric Rheumatology Unit, Universidade Federal de São Paulo, Brazil
| | - C S Magalhães
- 4 Pediatric Rheumatology Division, São Paulo State University (UNESP) - Faculdade de Medicina de Botucatu, Brazil
| | - J C Ferreira
- 2 Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - E M Okuda
- 5 Pediatric Rheumatology Unit, Irmandade da Santa Casa de Misericórdia de São Paulo, Brazil
| | - A P Sakamoto
- 3 Pediatric Rheumatology Unit, Universidade Federal de São Paulo, Brazil
| | - A M E Sallum
- 2 Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - S Appenzeller
- 6 Pediatric Rheumatology Unit, State University of Campinas (UNICAMP), Brazil
| | - V P L Ferriani
- 7 Pediatric Rheumatology Unit, Ribeirão Preto Medical School - University of São Paulo, Brazil
| | - C M Barbosa
- 8 Pediatric Rheumatology Unit, Hospital Infantil Darcy Vargas, Brazil
| | - S Lotufo
- 9 Pediatric Rheumatology Unit, Hospital Menino Jesus, Brazil
| | - A A Jesus
- 2 Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - L E C Andrade
- 3 Pediatric Rheumatology Unit, Universidade Federal de São Paulo, Brazil
| | - L M A Campos
- 2 Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - E Bonfá
- 1 Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - C A Silva
- 1 Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, Brazil.,2 Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina da Universidade de São Paulo, Brazil
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26
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Eloi M, Horvath DV, Ortega JC, Prado MS, Andrade LEC, Szejnfeld VL, de Moura Castro CH. 25-Hydroxivitamin D Serum Concentration, Not Free and Bioavailable Vitamin D, Is Associated with Disease Activity in Systemic Lupus Erythematosus Patients. PLoS One 2017; 12:e0170323. [PMID: 28085957 PMCID: PMC5234837 DOI: 10.1371/journal.pone.0170323] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 01/03/2017] [Indexed: 12/18/2022] Open
Abstract
We aim to evaluate the prevalence of vitamin D deficiency in patients with systemic lupus erythematosus (SLE) and investigate the association between total, free and bioavailable vitamin D serum concentrations and disease activity. Patients with SLE (ACR 1997) consecutively seen at UNIFESP's outpatient's clinics had disease activity measured after clinical and laboratory evaluation using SLEDAI (Systemic Lupus Erythematosus Disease Activity Index). 25-hydroxyvitamin D (25(OH)D) serum concentrations measured by chemiluminescence and vitamin D binding protein (DBP) measured by ELISA were used to calculate free and bioavailable vitamin D. Healthy blood donors were used as controls. A total of 142 patients (71.4%) had 25(OH)D serum concentrations below 30 ng/mL. Total 25(OH)D serum concentration was associated with disease activity categorized in 5 continuous groups of SLEDAI. 25(OH)D serum concentrations were higher among patients with SLEDAI 1-5 and lower in those with severe activity (SLEDAI≥20) (p <0.05). On the other hand, no statistically significant difference was observed for DBP, free and bioavailable vitamin D measurements in the disease activity subgroups evaluated. Vitamin D deficiency is highly prevalent among patients with SLE and was associated with higher disease activity. DBP serum level and calculation of free and bioavailable vitamin D were not associated with SLE disease activity.
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Affiliation(s)
- Marina Eloi
- Rheumatology Division, Universidade Federal de São Paulo/Escola Paulista de Medicina (Unifesp/ EPM), São Paulo—Brazil
| | - Daniela Vargas Horvath
- Rheumatology Division, Universidade Federal de São Paulo/Escola Paulista de Medicina (Unifesp/ EPM), São Paulo—Brazil
| | - João Carlos Ortega
- Rheumatology Division, Universidade Federal de São Paulo/Escola Paulista de Medicina (Unifesp/ EPM), São Paulo—Brazil
| | - Mônica Simon Prado
- Rheumatology Division, Universidade Federal de São Paulo/Escola Paulista de Medicina (Unifesp/ EPM), São Paulo—Brazil
| | - Luis Eduardo Coelho Andrade
- Rheumatology Division, Universidade Federal de São Paulo/Escola Paulista de Medicina (Unifesp/ EPM), São Paulo—Brazil
| | - Vera Lúcia Szejnfeld
- Rheumatology Division, Universidade Federal de São Paulo/Escola Paulista de Medicina (Unifesp/ EPM), São Paulo—Brazil
| | - Charlles Heldan de Moura Castro
- Rheumatology Division, Universidade Federal de São Paulo/Escola Paulista de Medicina (Unifesp/ EPM), São Paulo—Brazil
- * E-mail:
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27
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Keppeke GD, Prado MS, Nunes E, Perazzio SF, Rodrigues SH, Ferraz MLG, Chan EKL, Andrade LEC. Differential capacity of therapeutic drugs to induce Rods/Rings structures in vitro and in vivo and generation of anti-Rods/Rings autoantibodies. Clin Immunol 2016; 173:149-156. [PMID: 27746381 DOI: 10.1016/j.clim.2016.10.004] [Citation(s) in RCA: 21] [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] [Received: 07/25/2016] [Revised: 09/26/2016] [Accepted: 10/09/2016] [Indexed: 12/27/2022]
Abstract
Some HCV patients using ribavirin and interferon alpha (IFN-α) develop anti-rods and rings (RR) autoantibodies, the main target of which is inosine monophosphate dehydrogenase (IMPDH), the rate-determining enzyme in de novo GTP biosynthesis. In vitro inhibition of IMPDH by ribavirin induces RR formation. Here we investigate whether other commonly used drugs that interfere with GTP biosynthesis can induce RR structures in vitro and vivo and elicit generation of autoantibodies. HEp-2 cells treated for 24h with ribavirin, mycophenolic acid (MPA), azathioprine, methotrexate or acyclovir were positive for RR structures. However, adefovir, entecavir, tenofovir and lamivudine did not induce RR structures in these cells. Structures induced by ribavirin in HEp-2 cells are stable after 24h drug-washout, while structures induced by other drugs are relatively labile, disappearing within 2h. Looking at patients treated with these drugs, HCV patients treated with ribavirin (n=17) showed higher average percentage of RR-positive peripheral mononuclear cells than autoimmune patients treated with RR-inducing immunosuppressant drugs (n=21). Serum from 173 autoimmune patients who had been treated with MPA, azathioprine or methotrexate was tested for presence of anti-RR autoantibodies, and only one sample was found to be positive. Conversely, of 48 anti-RR autoantibody positive samples identified at Fleury Laboratories over 30months, 94% were from HCV patients treated with ribavirin plus IFN-α. These data indicate that RR structures can be induced by a variety of drugs in vitro and in vivo, but anti-RR autoantibody production is mostly restricted to HCV patients under ribavirin+IFN-α treatment.
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Affiliation(s)
- Gerson Dierley Keppeke
- Rheumatology Division, Federal University of Sao Paulo, Sao Paulo, SP 04023-062, Brazil.
| | - Monica Simon Prado
- Rheumatology Division, Federal University of Sao Paulo, Sao Paulo, SP 04023-062, Brazil
| | - Eunice Nunes
- Gastroenterology Division, Federal University of Sao Paulo, Sao Paulo, SP 04023-062, Brazil
| | - Sandro Felix Perazzio
- Rheumatology Division, Federal University of Sao Paulo, Sao Paulo, SP 04023-062, Brazil; Immunology Division, Fleury Medicine and Health Laboratories, Sao Paulo SP 04102-050, Brazil
| | | | | | - Edward K L Chan
- Department of Oral Biology, University of Florida, Gainesville, FL 32610-0424, USA
| | - Luis Eduardo Coelho Andrade
- Rheumatology Division, Federal University of Sao Paulo, Sao Paulo, SP 04023-062, Brazil; Immunology Division, Fleury Medicine and Health Laboratories, Sao Paulo SP 04102-050, Brazil.
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Kayser C, Alberto FL, da Silva NP, Andrade LEC. Decreased number of T cells bearing TCR rearrangement excision circles (TREC) in active recent onset systemic lupus erythematosus. Lupus 2016; 13:906-11. [PMID: 15645744 DOI: 10.1191/0961203304lu2031oa] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 11/05/2022]
Abstract
Systemic lupus erythematosus (SLE) is characterized by several T lymphocyte abnormalities. An indirect assessment of recent thymus emigrants (RTE) has been recently been made available by measuring the number of TCR recombination excision circles (TREC) in peripheral T cells. We studied TREC levels in peripheral blood mononuclear cells (PBMC) of 32 SLE patients with active disease and 32 normal age- and sex-matched controls. Signal-joint TREC concentration was determined by real-time quantitative-PCR as the number of TREC copies/μg PBMC DNA. SLE patients had lower TREC levels (4.1 ±3.9 ×104 TREC/μg DNA) than controls (8.9 ±7.9 ×104/μg DNA) ( P = 0.004). There was an inverse correlation between age and TREC levels in controls ( r = 20.41, P = 0.02) but not in SLE patients. No clinical association was observed between TREC levels and clinical and laboratory SLE manifestations. TREC levels tended to be lower in patients with SLEDAI above 20 than in the rest of the patients ( P = 0.08). The decreased PBMC TREC levels is indicative of a low proportion of RTE in SLE and could be caused by decreased RTE output and/or by increased peripheral T cell proliferation in this disease. The under-representation of RTE in the peripheral T cell pool may play a role in the immune tolerance abnormalities observed in SLE.
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Affiliation(s)
- C Kayser
- Universidade Federal de São Paulo, São Paulo, Brazil
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Perazzio SF, Silva NPD, Carneiro-Sampaio M, Andrade LEC. Mild and moderate Mannose Binding Lectin deficiency are associated with systemic lupus erythematosus and lupus nephritis in Brazilian patients. Rev Bras Reumatol Engl Ed 2016; 56:220-7. [PMID: 27267640 DOI: 10.1016/j.rbre.2016.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 12/18/2014] [Accepted: 09/17/2015] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The potential association of mannose binding lectin (MBL) deficiency and systemic lupus erythematosus (SLE) has been investigated in several studies, but results have been mixed. One explanation for the conflicting results could be differences in ethnic background of study subjects. In this study we investigated the association of MBL deficiency and SLE in a large cohort of Brazilian SLE patients and controls. METHODS Serum MBL and Complement levels were determined for 286 Brazilian adult SLE patients and 301 healthy Brazilian adults as controls. MBL deficiency was classified as mild (<1000 and ≥500μg/L), moderate (<500 and ≥100μg/L) or severe (<100μg/L). RESULTS SLE patients presented higher frequency of mild and moderate MBL deficiency compared to controls. SLE patients with MBL deficiency presented higher frequency of lupus nephritis compared to those without MBL deficiency. MBL deficiency was not associated with any other clinical manifestation, use of immunosuppressant therapy, disease activity, disease severity serum or Complement levels. CONCLUSION This study shows that an association between MBL deficiency and SLE does exist in the Brazilian population. We also found an association between MBL deficiency and lupus nephritis. These findings support the hypothesis that MBL deficiency contributes to the development of SLE and lupus nephritis.
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Affiliation(s)
- Sandro Félix Perazzio
- Division of Rheumatology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Grupo Fleury, São Paulo, SP, Brazil
| | - Neusa Pereira da Silva
- Division of Rheumatology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Magda Carneiro-Sampaio
- Department of Pediatrics, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Luis Eduardo Coelho Andrade
- Division of Rheumatology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Grupo Fleury, São Paulo, SP, Brazil.
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Conrad K, Andrade LEC, Chan EKL, Mahler M, Meroni PL, Pruijn GJM, Steiner G, Shoenfeld Y. From autoantibody research to standardized diagnostic assays in the management of human diseases – report of the 12th Dresden Symposium on Autoantibodies. Lupus 2016; 25:787-96. [DOI: 10.1177/0961203316644337] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Testing for autoantibodies (AABs) is becoming more and more relevant, not only for diagnosing autoimmune diseases (AIDs) but also for the differentiation of defined AID subtypes with different clinical manifestations, course and prognosis as well as the very early diagnosis for adequate management in the context of personalized medicine. A major challenge to improve diagnostic accuracy is to harmonize or even standardize AAB analyses. This review presents the results of the 12th Dresden Symposium on Autoantibodies that focused on several aspects of improving autoimmune diagnostics. Topics that are addressed include the International Consensus on ANA Patterns (ICAP) and the International Autoantibody Standardization (IAS) initiatives, the optimization of diagnostic algorithms, the description and evaluation of novel disease-specific AABs as well as the development and introduction of novel assays into routine diagnostics. This review also highlights important developments of recent years, most notably the improvement in diagnosing and predicting the course of rheumatoid arthritis, systemic sclerosis, idiopathic inflammatory myopathies, and of autoimmune neurological, gastrointestinal and liver diseases; the potential diagnostic role of anti-DFS70 antibodies and tumor-associated AABs. Furthermore, some hot topics in autoimmunity regarding disease pathogenesis and management are described.
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Affiliation(s)
- K Conrad
- Institute of Immunology, Medical Faculty of the Technical University of Dresden, Germany
| | - L E C Andrade
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
- Immunology Division, Fleury Medicine and Health Laboratories, São Paulo, Brazil
| | - E K L Chan
- Department of Oral Biology, University of Florida, Gainesville, FL, USA
| | - M Mahler
- INOVA Diagnostics, Inc., San Diego, CA, USA
| | - P L Meroni
- Department of Clinical Sciences and Community Health, University of Milan, Laboratory of Immunorheumatology Research, Istituto Auxologico Italiano, Milan, Italy
| | - G J M Pruijn
- Department of Biomolecular Chemistry, Radboud University Nijmegen, The Netherlands
| | - G Steiner
- Department of Rheumatology, Internal Medicine III, Medical University of Vienna, Austria
| | - Y Shoenfeld
- Sackler Faculty in Medicine, Sheba Medical Center, Tel-Aviv University, Israel
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
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Chan EKL, Damoiseaux J, de Melo Cruvinel W, Carballo OG, Conrad K, Francescantonio PLC, Fritzler MJ, Garcia-De La Torre I, Herold M, Mimori T, Satoh M, von Mühlen CA, Andrade LEC. Report on the second International Consensus on ANA Pattern (ICAP) workshop in Dresden 2015. Lupus 2016; 25:797-804. [DOI: 10.1177/0961203316640920] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The second meeting for the International Consensus on Antinuclear antibody (ANA) Pattern (ICAP) was held on 22 September 2015, one day prior to the opening of the 12th Dresden Symposium on Autoantibodies in Dresden, Germany. The ultimate goal of ICAP is to promote harmonization and understanding of autoantibody nomenclature, and thereby optimizing ANA usage in patient care. The newly developed ICAP website www.ANApatterns.org was introduced to the more than 50 participants. This was followed by several presentations and discussions focusing on key issues including the two-tier classification of ANA patterns into competent-level versus expert-level, the consideration of how to report composite versus mixed ANA patterns, and the necessity for developing a consensus on how ANA results should be reported. The need to establish on-line training modules to help users gain competency in identifying ANA patterns was discussed as a future addition to the website. To advance the ICAP goal of promoting wider international participation, it was agreed that there should be a consolidated plan to translate consensus documents into other languages by recruiting help from members of the respective communities.
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Affiliation(s)
- E K L Chan
- Department of Oral Biology, University of Florida, Gainesville, Florida, USA
| | - J Damoiseaux
- Central Diagnostic Laboratory, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - O G Carballo
- Laboratory of Immunology, Hospital Carlos G. Durand, and Department of Immunology, Instituto Universitario del Hospital Italiano, Buenos Aires, Argentina
| | - K Conrad
- Institute of Immunology, Technical University of Dresden, Dresden, Germany
| | | | - M J Fritzler
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - I Garcia-De La Torre
- Department of Immunology and Rheumatology, Hospital General de Occidente and University of Guadalajara, Guadalajara, Mexico
| | - M Herold
- Department of Internal Medicine VI, Medical University of Innsbruck, Innsbruck, Austria
| | - T Mimori
- Department of the Control for Rheumatic Diseases and Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - M Satoh
- Department of Clinical Nursing, University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | - L E C Andrade
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo; Immunology Division, Fleury Medicine and Health Laboratories, São Paulo, Brazil
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Perazzio SF, Silva NPD, Carneiro‐Sampaio M, Andrade LEC. As deficiências leve e moderada de lectina ligadora de manose estão associadas ao lúpus eritematoso sistêmico e à nefrite lúpica em pacientes brasileiros. Revista Brasileira de Reumatologia 2016. [DOI: 10.1016/j.rbr.2015.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Mesquita D, Cruvinel WM, Resende LS, Mesquita FV, Silva NP, Câmara NOS, Andrade LEC. Follicular helper T cell in immunity and autoimmunity. ACTA ACUST UNITED AC 2016; 49:e5209. [PMID: 27096200 PMCID: PMC4843212 DOI: 10.1590/1414-431x20165209] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/27/2016] [Indexed: 11/22/2022]
Abstract
The traditional concept that effector T helper (Th) responses are mediated by Th1/Th2 cell subtypes has been broadened by the recent demonstration of two new effector T helper cells, the IL-17 producing cells (Th17) and the follicular helper T cells (Tfh). These new subsets have many features in common, such as the ability to produce IL-21 and to express the IL-23 receptor (IL23R), the inducible co-stimulatory molecule ICOS, and the transcription factor c-Maf, all of them essential for expansion and establishment of the final pool of both subsets. Tfh cells differ from Th17 by their ability to home to B cell areas in secondary lymphoid tissue through interactions mediated by the chemokine receptor CXCR5 and its ligand CXCL13. These CXCR5+ CD4+ T cells are considered an effector T cell type specialized in B cell help, with a transcriptional profile distinct from Th1 and Th2 cells. The role of Tfh cells and its primary product, IL-21, on B-cell activation and differentiation is essential for humoral immunity against infectious agents. However, when deregulated, Tfh cells could represent an important mechanism contributing to exacerbated humoral response and autoantibody production in autoimmune diseases. This review highlights the importance of Tfh cells by focusing on their biology and differentiation processes in the context of normal immune response to infectious microorganisms and their role in the pathogenesis of autoimmune diseases.
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Affiliation(s)
- D Mesquita
- Divisão de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - W M Cruvinel
- Divisão de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - L S Resende
- Divisão de Farmacologia, Instituto de Ciências Biológicas, Universidade de São Paulo, São Paulo, SP, Brasil
| | - F V Mesquita
- Divisão de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - N P Silva
- Divisão de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - N O S Câmara
- Divisão de Imunologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - L E C Andrade
- Divisão de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
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Cruvinel WDM, Mesquita Júnior D, Araújo JAP, Samazi KC, Kállas EG, Cendoroglo MS, Andrade LEC. Abnormal phenotypic distribution of regulatory and effector T cells in octogenarian and nonagenarian women. Rev Assoc Med Bras (1992) 2016; 61:329-35. [PMID: 26466214 DOI: 10.1590/1806-9282.61.04.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 10/21/2014] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION aging is associated with several immunologic changes. Regulatory (Treg) and effector T cells are involved in the pathogenesis of infectious, neoplastic, and autoimmune diseases. Little is known about the effects of aging on the frequency and function of these T cell subpopulations. METHODS peripheral blood mononuclear cells (PBMC) were obtained from 26 young (under 44 years old) and 18 elderly (above 80 years old) healthy women. T cell subpopulations were analyzed by flow cytometry. RESULTS elderly individuals had lower frequency of several activated effector T cell phenotypes as compared with young individuals: CD3+CD4+CD25+ (3.82±1.93 versus 9.53±4.49; p<0.0001); CD3+CD4+CD25+CD127+(2.39±1.19 versus 7.26±3.84; p<0.0001); CD3+CD4+CD25+ (0.41±0.22 versus 1.86±0.85, p<0.0001); and CD3+CD4+CD25highCD127+(0.06±0.038 versus 0.94±0.64, p<0.0001). Treg (CD3+CD4+CD25+CD127øFoxp3+) presented lower frequency in elderly individuals as compared to young adults (0.34±0.18 versus 0.76±0.48; p=0.0004) and its frequency was inversely correlated with age in the whole group (r=-0.439; p=0.013). The elderly group showed higher frequency of two undefined CD25øFoxp3+ phenotypes: CD3+CD4+CD25øFoxp3+(15.05±7.34 versus 1.65±1.71; p<0.0001) and CD3+CD4+CD25øCD127øFoxp3+(13.0±5.52 versus 3.51±2.87; p<0.0001). CONCLUSIONS the altered proportion of different T cell subsets herein documented in healthy elderly women may be relevant to the understanding of the immunologic behavior and disease susceptibility patterns observed in geriatric patients.
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Affiliation(s)
- Wilson de Melo Cruvinel
- School of Medical, Pharmaceutical and Biomedical Sciences, Pontifícia Universidade Católica de Goiás, Goiás, GO, BR
| | | | | | - Karina Carvalho Samazi
- Division of Clinical Immunology and Allergy, Universidade de São Paulo, São Paulo, SP, BR
| | - Esper Georges Kállas
- Division of Clinical Immunology and Allergy, Universidade de São Paulo, São Paulo, SP, BR
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Santos VC, Grecco M, Pereira KMC, Terzian CCN, Andrade LEC, Silva NP. Fc gamma receptor IIIb polymorphism and systemic lupus erythematosus: association with disease susceptibility and identification of a novel FCGR3B*01 variant. Lupus 2016; 25:1237-43. [PMID: 26946294 DOI: 10.1177/0961203316636952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 06/29/2015] [Accepted: 02/11/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the association between Fc gamma receptor IIIb polymorphism and susceptibility to systemic lupus erythematosus and clinical traits of the disease. METHODS Genomic DNA was obtained from 303 consecutive systemic lupus erythematosus patients and 300 healthy blood donors from the southeastern region of Brazil. The polymorphic region of the FCGR3B gene was sequenced and the alleles FCGR3B*01, FCGR3B*02 and FCGR3B*03 were analyzed. RESULTS The FCGR3B*01 allele was more frequent in systemic lupus erythematosus patients (43.1%) while the FCGR3B*02 allele prevailed among controls (63.7%) (P = 0.001). The FCGR3B*03 allele was found equally in both groups. The FCGR3B*01/*01 (20.7%) and FCGR3B*01/*02 (41.1%) genotypes were more frequent among systemic lupus erythematosus patients (P = 0.028 and P = 0.012, respectively) while the FCGR3B*02/*02 genotype was more frequent in controls (45.5%) (P < 0.001). One variant of the FCGR3B*01 allele previously described in Germany was found in only one control. A new variant of the FCGR3B*01 allele with two substitutions (A227G/G277A) was found in one control. Three variants of the FCGR3B*02 allele previously described in African-Americans, Brazilians, Chinese and Japanese were found in ten 10 patients and two controls. In addition, several single nucleotide polymorphisms at non-polymorphic positions were identified in both patients and controls. CONCLUSION Susceptibility to systemic lupus erythematosus was associated with the FCGR3B*01 allele, as well as with the FCGR3B*01/*01 and FCGR3B*01/*02 genotypes. No association was found between FCGR3B genotypes and clinical manifestations, disease severity or the presence of autoantibodies.
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Affiliation(s)
- V C Santos
- Disciplina de Reumatologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - M Grecco
- Disciplina de Reumatologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - K M C Pereira
- Disciplina de Reumatologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - C C N Terzian
- Disciplina de Hematologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - L E C Andrade
- Disciplina de Reumatologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - N P Silva
- Disciplina de Reumatologia, Universidade Federal de São Paulo, São Paulo, Brazil
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Rezende RPV, Ribeiro FM, Albuquerque EMN, Gayer CR, Andrade LEC, Klumb EM. Immunogenicity of pneumococcal polysaccharide vaccine in adult systemic lupus erythematosus patients undergoing immunosuppressive treatment. Lupus 2016; 25:1254-9. [PMID: 26923283 DOI: 10.1177/0961203316636472] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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: 10/27/2015] [Accepted: 01/25/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the immunogenicity of the 23-valent pneumococcal polysaccharide vaccine (PPSV23) in adult systemic lupus erythematosus patients undergoing (IS group) and not undergoing (non-IS group) immunosuppressive treatment. METHODS In this prospective open-label study from February 2013 to April 2014, 54 patients had blood samples collected immediately before PPSV23 immunization and 4-6 weeks thereafter for the ELISA measurement of IgG antibody levels against seven pneumococcal serotypes. Positive vaccine response for each serotype was defined as a four-fold or greater antibody response over baseline levels or as a post-vaccine anti-pneumococcal IgG level ≥1.3 µg/ml when baseline values were <1.3 µg/ml. Patients should have responded appropriately to ≥70% of the tested serotypes. We also calculated the mean ratio of post- to pre-vaccination anti-pneumococcal IgG levels. RESULTS Twenty-eight patients were classified into the IS group and 26 into non-IS group. The median dose of prednisone at baseline was ≤5 mg/day in both groups. Serotype-specific vaccine response rates were not significantly different between the groups. Less than 40% of patients responded adequately by both vaccine response criteria, being numerically lower among IS patients. The mean ratio of increase in anti-pneumococcal levels was 6.4 versus 4.7 (p = 0.001) in non-IS and IS groups, respectively. CONCLUSION The vaccine was poorly immunogenic, especially among adult systemic lupus erythematosus patients under immunosuppressive therapy.
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Affiliation(s)
- R P V Rezende
- Department of Rheumatology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - F M Ribeiro
- Department of Rheumatology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - E M N Albuquerque
- Department of Rheumatology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - C R Gayer
- Department of Biochemistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | - E M Klumb
- Department of Rheumatology, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Araújo JAP, Mesquita D, Cruvinel WDM, Salmazi KI, Kallás EG, Andrade LEC. Linfócitos Th17 e linfócitos T CD4+ multifuncionais em pacientes com lúpus eritematoso sistêmico. Revista Brasileira de Reumatologia 2016. [DOI: 10.1016/j.rbr.2015.08.008] [Citation(s) in RCA: 3] [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: 10/22/2022] Open
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Araújo JAP, Mesquita D, de Melo Cruvinel W, Salmazi KI, Kallás EG, Andrade LEC. Th17 cells and CD4(+) multifunctional T cells in patients with systemic lupus erythematosus. Rev Bras Reumatol Engl Ed 2015; 56:28-36. [PMID: 27267331 DOI: 10.1016/j.rbre.2015.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 04/04/2014] [Accepted: 08/22/2015] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION/OBJECTIVE Recent evidence suggests that abnormalities involving Th17 lymphocytes are associated with the pathophysiology of systemic lupus erythematosus (SLE). In addition, multifunctional T cells (MFT), i.e., those producing multiple cytokines simultaneously, are present in the inflammatory milieu and may be implicated in the autoimmune process observed in SLE. In the present study, we aimed to characterize the functional status of CD4(+) T cells in SLE by simultaneously determining the concentration of IL-2, IFN-γ and IL-17 in lymphocyte cultures under exogenous and self-antigenic stimuli. PATIENTS AND METHODS Eighteen patients with active disease, 18 with inactive disease, and 14 healthy controls had functional status of CD4(+) T cells analyzed. RESULTS We found that SLE patients presented a decreased number of total CD4(+) cells, an increased number of activated T cells, and an increased frequency of Th17 cells compared to healthy controls (HC). MFT cells had increased frequency in SLE patients and there was an increased frequency of tri-functional MFT in patients with active SLE compared with those with inactive SLE. Interestingly, MTF cells produced larger amounts of IFNγ than mono-functional T cells in patients and controls. CONCLUSION Taken together these data indicate the participation of recently activated Th17 cells and MTF cells in the SLE pathophysiology.
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Affiliation(s)
| | - Danilo Mesquita
- Department of Rheumatology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Wilson de Melo Cruvinel
- Department of Rheumatology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Department of Biomedicine, Pontifícia Universidade Católica de Goiás (PUC-GO), Goiânia, GO, Brazil
| | - Karina Inácio Salmazi
- Department of Clinical Immunology and Allergy, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Esper Georges Kallás
- Department of Clinical Immunology and Allergy, Universidade de São Paulo (USP), São Paulo, SP, Brazil
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Errante PR, Perazzio SF, Frazão JB, da Silva NP, Andrade LEC. Primary immunodeficiency association with systemic lupus erythematosus: review of literature and lessons learned by the Rheumatology Division of a tertiary university hospital at São Paulo, Brazil. Rev Bras Reumatol Engl Ed 2015; 56:58-68. [PMID: 27267335 DOI: 10.1016/j.rbre.2015.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 03/12/2014] [Accepted: 03/08/2015] [Indexed: 01/02/2023] Open
Abstract
Primary immunodeficiency disorders (PID) represent a heterogeneous group of diseases resulting from inherited defects in the development, maturation and normal function of immune cells; thus, turning individuals susceptible to recurrent infections, allergy, autoimmunity, and malignancies. In this retrospective study, autoimmune diseases (AIDs), in special systemic lupus erythematosus (SLE) which arose associated to the course of PID, are described. Classically, the literature describes three groups of PID associated with SLE: (1) deficiency of Complement pathway components, (2) defects in immunoglobulin synthesis, and (3) chronic granulomatous disease (CGD). Currently, other PID have been described with clinical manifestation of SLE, such as Wiskott-Aldrich syndrome (WAS), autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED), autoimmune lymphoproliferative syndrome (ALPS) and idiopathic CD4(+) lymphocytopenia. Also we present findings from an adult cohort from the outpatient clinic of the Rheumatology Division of Universidade Federal de São Paulo. The PID manifestations found by our study group were considered mild in terms of severity of infections and mortality in early life. Thus, it is possible that some immunodeficiency states are compatible with survival regarding infectious susceptibility; however these states might represent a strong predisposing factor for the development of immune disorders like those observed in SLE.
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Affiliation(s)
- Paolo Ruggero Errante
- Department of Immunology, Institute of Biomedical Sciences, Universidade de São Paulo (USP), São Paulo, SP, Brazil; Department of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Sandro Félix Perazzio
- Department of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Josias Brito Frazão
- Department of Immunology, Institute of Biomedical Sciences, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Neusa Pereira da Silva
- Department of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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Mota LMHD, Cruz BA, Brenol CV, Pollak DF, Pinheiro GDRC, Laurindo IMM, Pereira IA, Carvalho JFD, Bertolo MB, Pinheiro MDM, Freitas MVC, Silva NAD, Louzada‐Júnior P, Sampaio‐Barros PD, Giorgi RDN, Lima RAC, Andrade LEC. Segurança do uso de terapias biológicas para o tratamento de artrite reumatoide e espondiloartrites. Revista Brasileira de Reumatologia 2015; 55:281-309. [DOI: 10.1016/j.rbr.2014.06.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 05/25/2014] [Accepted: 06/30/2014] [Indexed: 02/07/2023] Open
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Mesquita D, Cruvinel WM, Araujo JAP, Salmazi KC, Kallas EG, Andrade LEC. Imbalanced expression of functional surface molecules in regulatory and effector T cells in systemic lupus erythematosus. ACTA ACUST UNITED AC 2014; 47:662-9. [PMID: 25098715 PMCID: PMC4165293 DOI: 10.1590/1414-431x20143483] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 06/09/2014] [Indexed: 01/09/2023]
Abstract
Regulatory T (TREG) cells play an important role in maintaining immune tolerance and
avoiding autoimmunity. We analyzed the expression of membrane molecules in TREG and
effector T cells in systemic lupus erythematosus (SLE). TREG and effector T cells
were analyzed for the expression of CTLA-4, PD1, CD28, CD95, GITR, HLA-DR, OX40,
CD40L, and CD45RO in 26 patients with active disease, 31 with inactive disease, and
26 healthy controls. TREG cells were defined as
CD25+/highCD127Ø/lowFoxP3+, and effector T cells
were defined as CD25+CD127+FoxP3Ø. The ratio of TREG
to effector T cells expressing GITR, PD1, HLA-DR, OX40, CD40L, and CD45RO was
determined in the three groups. The frequency of TREG cells was similar in patients
with SLE and controls. However, SLE patients had a decreased frequency of
CTLA-4+TREG and CD28+TREG cells and an increased frequency
of CD40L+TREG cells. There was a decrease in the TREG/effector-T ratio for
GITR+, HLA-DR+, OX40+, and CD45RO+
cells, and an increased ratio of TREG/effector-T CD40L+ cells in patients
with SLE. In addition, CD40L+TREG cell frequency correlated with the SLE
disease activity index (P=0.0163). In conclusion, our findings showed several
abnormalities in the expression of functionally critical surface molecules in TREG
and effector T cells in SLE that may be relevant to the pathogenesis of this
disease.
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Affiliation(s)
- D Mesquita
- Disciplina de Reumatologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - W M Cruvinel
- Disciplina de Reumatologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - J A P Araujo
- Disciplina de Reumatologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - K C Salmazi
- Disciplina de Imunologia Clínica e Alergia, Departamento de Clínica Médica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - E G Kallas
- Disciplina de Imunologia Clínica e Alergia, Departamento de Clínica Médica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - L E C Andrade
- Disciplina de Reumatologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
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Francescantonio PLC, Cruvinel WDM, Dellavance A, Andrade LEC, HurTaliberti B, Mühlen CAV, Bichara CDA, Bueno C, Mangueira CLP, Carvalho DG, Bonfá ESDO, Brito FDA, Araújo FIE, Rêgo J, Pereira KMC, Anjos LMED, Bissoli MDF, Santiago MB, Maluf NZ, Alvarenga RR, Neves SPF, Valim V, Santos WSD. IV Brazilian Guidelines for autoantibodies on HEp-2 cells. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.rbre.2014.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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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Francescantonio PLC, Cruvinel WDM, Dellavance A, Andrade LEC, HurTaliberti B, Mühlen CAV, Bichara CDA, Bueno C, Mangueira CLP, Carvalho DG, Bonfá ESDO, Brito FDA, Araújo FIE, Rêgo J, Pereira KMC, Anjos LMED, Bissoli MDF, Santiago MB, Maluf NZ, Alvarenga RR, Neves SPF, Valim V, Santos WSD. IV Consenso Brasileiro para pesquisa de autoanticorpos em células HEp-2. Revista Brasileira de Reumatologia 2014. [DOI: 10.1016/j.rbr.2013.10.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Francescantonio PLC, Cruvinel WDM, Dellavance A, Andrade LEC, Taliberti BH, von Mühlen CA, Bichara CDA, Bueno C, Mangueira CLP, Carvalho DG, Bonfá ESDDO, Brito FDA, Araújo FIE, Rêgo J, Pereira KMC, dos Anjos LME, Bissoli MDF, Santiago MB, Maluf NZ, Alvarenga RR, Neves SPF, Valim V, dos Santos WS. IV Brazilian guidelines for autoantibodies on HEp-2 cells. Rev Bras Reumatol 2014; 54:44-50. [PMID: 24878791] [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] [Received: 09/04/2013] [Accepted: 10/13/2013] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE The Fourth Brazilian Consensus for Autoantibodies Screening in HEp-2 Cells (ANA) was held in Vitória, Espírito Santo, and aimed to discuss strategies and recommendations about the technique, standardization, interpretation and quality control of the indirect immunofluorescence reaction on HEp-2 cells. METHODS Twenty three ANA experts from university centers and private laboratories in different areas from Brazil discussed and agreed upon recommendations for the fourth edition of the Brazilian Consensus for Autoantibodies Screening in HEp-2 Cells. RESULTS AND CONCLUSION The 4th ANA Consensus included three novel patterns into the existing algorithm (cytoplasmic Rods and Rings, nuclear Quasi-homogeneous, and CENP-F). Emphasis was given to the need of attention in describing the peculiar mixed pattern elicited by anti-DNA topoisomerase I (Scl-70) autoantibodies, comprising nuclear fine specked, nucleolar homogeneous pattern, NOR staining in metaphase plates, and cytoplasmic fine speckled patterns. The group also emphasized the need for continuous quality control in indirect immunofluorescence assays, the establishment of screening dilutions, as well as conjugate titration. An alert was made regarding the heterogeneity of commercial kits in defining patterns and the use of solid phase methodologies to determine the presence of autoantibodies.
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Affiliation(s)
| | | | | | | | - Ben Hur Taliberti
- Serviço de Reumatologia, Hospital das Clínicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil
| | - Carlos Alberto von Mühlen
- Centro de Diagnósticos Médicos e Rheuma Clínica de Doenças Reumáticas de Porto Alegre, Porto Alegre, RS, Brasil
| | | | - Cleonice Bueno
- Laboratórios de Investigação Médica, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | | | | | | | | | | | - Jozelia Rêgo
- Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, GO, Brasil
| | | | | | | | | | | | | | | | - Valeria Valim
- Universidade Federal do Espírito Santo, Vitória, ES, Brasil
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Agmon-Levin N, Damoiseaux J, Kallenberg C, Sack U, Witte T, Herold M, Bossuyt X, Musset L, Cervera R, Plaza-Lopez A, Dias C, Sousa MJ, Radice A, Eriksson C, Hultgren O, Viander M, Khamashta M, Regenass S, Andrade LEC, Wiik A, Tincani A, Rönnelid J, Bloch DB, Fritzler MJ, Chan EKL, Garcia-De La Torre I, Konstantinov KN, Lahita R, Wilson M, Vainio O, Fabien N, Sinico RA, Meroni P, Shoenfeld Y. International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti-nuclear antibodies. Ann Rheum Dis 2013; 73:17-23. [PMID: 24126457 DOI: 10.1136/annrheumdis-2013-203863] [Citation(s) in RCA: 382] [Impact Index Per Article: 34.7] [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: 01/20/2023]
Abstract
Anti-nuclear antibodies (ANA) are fundamental for the diagnosis of autoimmune diseases, and have been determined by indirect immunofluorescence assay (IIFA) for decades. As the demand for ANA testing increased, alternative techniques were developed challenging the classic IIFA. These alternative platforms differ in their antigen profiles, sensitivity and specificity, raising uncertainties regarding standardisation and interpretation of incongruent results. Therefore, an international group of experts has created recommendations for ANA testing by different methods. Two groups of experts participated in this initiative. The European autoimmunity standardization initiative representing 15 European countries and the International Union of Immunologic Societies/World Health Organization/Arthritis Foundation/Centers for Disease Control and Prevention autoantibody standardising committee. A three-step process followed by a Delphi exercise with closed voting was applied. Twenty-five recommendations for determining ANA (1-13), anti-double stranded DNA antibodies (14-18), specific antibodies (19-23) and validation of methods (24-25) were created. Significant differences between experts were observed regarding recommendations 24-25 (p<0.03). Here, we formulated recommendations for the assessment and interpretation of ANA and associated antibodies. Notably, the roles of IIFA as a reference method, and the importance of defining nuclear and cytoplasmic staining, were emphasised, while the need to incorporate alternative automated methods was acknowledged. Various approaches to overcome discrepancies between methods were suggested of which an improved bench-to-bedside communication is of the utmost importance. These recommendations are based on current knowledge and can enable harmonisation of local algorithms for testing and evaluation of ANA and related autoantibodies. Last but not least, new more appropriate terminologies have been suggested.
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Affiliation(s)
- Nancy Agmon-Levin
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, , Tel Aviv, Israel
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Dellavance A, Cruvinel WDM, Francescantonio PLC, Mangueira CLP, Drugowick IC, Rodrigues SH, Andrade LEC. Variability in the recognition of distinctive immunofluorescence patterns in different brands of HEp-2 cell slides. J Bras Patol Med Lab 2013. [DOI: 10.1590/s1676-24442013000300005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Dellavance A, Alvarenga RR, Rodrigues SH, Barbosa SH, Camilo ACP, Shiguedomi HSO, Rodrigues SS, Silva CG, Andrade LEC. Autoantibodies to 60kDa SS-A/Ro yield a specific nuclear myriad discrete fine speckled immunofluorescence pattern. J Immunol Methods 2013; 390:35-40. [DOI: 10.1016/j.jim.2013.01.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 01/18/2013] [Accepted: 01/18/2013] [Indexed: 10/27/2022]
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Oliveira EMG, Oliveira PM, Becker V, Dellavance A, Andrade LEC, Lanzoni V, Silva AEB, Ferraz MLG. Overlapping of primary biliary cirrhosis and small duct primary sclerosing cholangitis: first case report. J Clin Med Res 2012; 4:429-33. [PMID: 23226177 PMCID: PMC3513426 DOI: 10.4021/jocmr1060w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2012] [Indexed: 12/27/2022] Open
Abstract
Primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) are both autoimmune cholestatic liver disease and the association of these two conditions in the same patient is very rare. We report the case of a female patient presenting with a cholestatic liver disease and a panel of autoantibodies specific for PBC, including antibodies to mitochondrial E2-pyruvate dehydrogenase, gp-210 and Sp-100. Beside these findings, the liver biopsy revealed concentric fibrosis of small biliary ducts and the magnetic resonance cholangiography presented no abnormal findings. Diagnosis of small duct PSC/PBC overlapping was done. No description of this association was found in the literature. Clinical and serological features of this unusual finding are discussed.
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Keusseyan SP, da Silva NP, Hilário MOE, Okuda EM, Terreri MTSLRA, Andrade LEC. Diagnostic performance and clinical associations of antibodies to the chromatin antigenic system in juvenile systemic lupus erythematosus. Rev Bras Reumatol 2012; 52:695-712. [PMID: 23090370] [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] [Received: 09/28/2011] [Accepted: 06/27/2012] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVES To determine the frequency of antibodies to chromatin components in juvenile systemic lupus erythematosus (JSLE), and to correlate the presence of these autoantibodies with clinical manifestations and disease activity. METHODS Anti-chromatin (anti-CHR), anti-nucleosome core particle (anti-NCS) and anti-dsDNA antibodies were measured in 175 individuals, including 37 patients with active JSLE and 41 with inactive disease, 47 non-lupus autoimmune disease patients (non-lupus AD), and 50 healthy children. An in-house ELISA was developed with purified nucleosome core particles from calf thymus to determine IgG and IgG3 anti-NCS antibodies. Anti-CHR and anti-dsDNA antibodies were detected by commercial ELISA kits (INOVA). RESULTS Anti-NCS and anti-CHR antibodies exhibited high specificity for JSLE and similar frequency in active and inactive JSLE. Anti-CHR and IgG/IgG3 anti-NCS serum levels did not differ between active and inactive JSLE. SLEDAI correlated with anti-dsDNA antibodies but not with antibodies to other chromatin components. There was association of anti-dsDNA, anti-CHR and IgG/IgG3 anti-NCS antibodies with proteinuria and low C4 serum levels. Anti-NCS antibodies in the absence of anti-dsDNA were observed in 14% of the JSLE patients. CONCLUSIONS Our data indicate that anti-NCS and anti-CHR antibodies are relevant diagnostic markers for JSLE and appear to be correlated with JSLE lupus nephritis activity. IgG3 isotype anti-NCS antibodies do not seem to be more relevant than IgG anti-NCS antibodies as markers of disease activity or active nephritis in JSLE.
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Keusseyan SP, Silva NPD, Hilário MOE, Okuda EM, Terreri MTSLRA, Andrade LEC. Desempenho diagnóstico e associações clínicas dos anticorpos contra componentes da cromatina no lúpus eritematoso sistêmico juvenil. Rev Bras Reumatol 2012. [DOI: 10.1590/s0482-50042012000500005] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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