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Chougule A, Iyengar VV, Gowri V, Taur P, Madkaikar MR, Bodhanwala M, Desai MM. Cleavage-resistant RIPK1-induced autoinflammatory syndrome-A report of three generations with periodic fever and clinical response to colchicine. Int J Rheum Dis 2024; 27:e14837. [PMID: 37452601 DOI: 10.1111/1756-185x.14837] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 06/30/2023] [Accepted: 07/02/2023] [Indexed: 07/18/2023]
Abstract
The clinical syndrome caused by cleavage-resistant RIPK1 is known as CRIA (Cleavage-resistant RIPK1-induced autoinflammatory) syndrome. We present a family with three generations affected by CRIA syndrome. Our index patient (P1), a boy born of a non-consanguineous marriage, developed recurrent episodes of fever after 5 months of age, with variable periodicity. His father (P2) and paternal grandmother also had periodic fever. At 23 months of age, P1 was diagnosed with renal biopsy-proven steroid-responsive nephrotic syndrome. His first visit to our center was at 2 years of age. At presentation, he had failure to thrive, microcytic hypochromic anemia, and elevated inflammatory markers and interleukin-6 levels. Amyloid A protein was elevated, serum creatinine was normal, and proteinuria resolved after addition of steroids. Next-generation sequencing showed heterozygous mutation (c.970G>A, p.Asp324His) in RIPK1. This mutation has been reported to cause CRIA syndrome. P2 and P1's asymptomatic younger brother had the same mutation. All the affected members showed variability with respect to frequency and duration of periodic fever as well as the age of onset. Both P1 and P2 had elevated amyloid A, with no evidence of renal dysfunction. P1 and P2 showed improvement in the intensity of fever spikes with colchicine treatment; however, both continue to have periodic fever.
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Affiliation(s)
- Akshaya Chougule
- Department of Pediatric Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Vaishnavi V Iyengar
- Department of Pediatric Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Vijaya Gowri
- Department of Pediatric Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Prasad Taur
- Department of Pediatric Immunology, B. J. Wadia Hospital for Children, Mumbai, India
| | - Manisha R Madkaikar
- Department of Pediatric Immunology and Leukocyte Biology, ICMR NIIH, Mumbai, India
| | - Minnie Bodhanwala
- Department of Paediatrics, B. J. Wadia Hospital for Children, Mumbai, India
| | - Mukesh M Desai
- Department of Pediatric Immunology, B. J. Wadia Hospital for Children, Mumbai, India
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Gowri V, Chougule A, Gupta M, Taur P, Iyengar VV, Sivasankaran M, Munirathnam D, Krishna S, Bargir UA, Dalvi A, Setia P, Jodhawat N, Shinde S, Prabhu SS, Bodhanwala M, Madkaikar MR, Desai MM. Clinical, immunological and molecular findings of patients with DOCK-8 deficiency from India. Scand J Immunol 2023:e13276. [PMID: 37114940 DOI: 10.1111/sji.13276] [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: 11/19/2022] [Revised: 04/08/2023] [Accepted: 04/25/2023] [Indexed: 04/29/2023]
Abstract
DOCK8 deficiency affects various cell subsets belonging to both innate and adaptive immune systems. Clinical diagnosis is challenging as many cases present with severe atopic dermatitis as the only initial manifestation. Though flow cytometry helps in presumptive diagnosis of DOCK8 deficient patients by evaluating their DOCK8 protein expression, it requires subsequent confirmation by molecular genetic analysis. Currently, hematopoietic stem cell transplantation (HSCT) is the only curative treatment option available for these patients. There is paucity of data from India on clinical diversity and molecular spectrum of DOCK8 deficiency. In the present study we report the clinical, immunological and molecular findings in 17 DOCK8-deficient patients from India diagnosed over last 5 years.
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Affiliation(s)
- Vijaya Gowri
- Bai Jerbai Wadia Hospital for Children, Parel, Mumbai
| | | | - Maya Gupta
- ICMR- National Institute of Immunohematology, Parel, Mumbai
| | - Prasad Taur
- Bai Jerbai Wadia Hospital for Children, Parel, Mumbai
| | | | | | | | | | - Umair A Bargir
- ICMR- National Institute of Immunohematology, Parel, Mumbai
| | - Aparna Dalvi
- ICMR- National Institute of Immunohematology, Parel, Mumbai
| | - Priyanka Setia
- ICMR- National Institute of Immunohematology, Parel, Mumbai
| | - Neha Jodhawat
- ICMR- National Institute of Immunohematology, Parel, Mumbai
| | - Shweta Shinde
- ICMR- National Institute of Immunohematology, Parel, Mumbai
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3
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Chougule A, Taur P, Iyengar VV, Gowri V, Kulkarni BP, Madkaikar MR, Bodhanwala M, Desai MM. Clinical features, laboratory and molecular findings of children with leukocyte adhesion deficiency type-III from a single center in India. Pediatric Hematology Oncology Journal 2022. [DOI: 10.1016/j.phoj.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Warang PP, Shinde NS, Umare VD, Deshmukh PV, Ghosh K, Madkaikar MR, Colah RB, Mukherjee MB. Role of Oxidative Stress and the Protective Effect of Fermented Papaya Preparation in Sickle Cell Disease. Hemoglobin 2022; 46:260-264. [PMID: 36073153 DOI: 10.1080/03630269.2022.2118603] [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] [Indexed: 11/04/2022]
Abstract
Fermented papaya preparation (FPP) is the source of antioxidants that may help in reducing the complications associated with oxidative stress and may improve the quality of life in sickle cell disease patients. In this study, we assessed the in vitro effect of FPP on sickled red blood cells (RBCs) using oxidative stress markers and observed that FPP has the potential to reduce the oxidative stress. Scanning electron microscopy (SEM) and eosin 5' malaemide (E5'M) dye test showed that FPP protects red cell morphology against the oxidative stress. Liquid chromatography mass spectrometry (LCMS) analysis of FPP suggests the presence of essential amino acids, vitamin D3, and its derivatives. Fermented papaya preparation can be of benefit either in reducing oxidative stress parameters or in preventing pathophysiological events in the sickle cell disease patients.
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Affiliation(s)
- Prashant P Warang
- Department of Haematogenetics, Indian Council of Medical Research, National Institute of Immunohaematology, Mumbai, Maharashtra, India
| | - Nikhil S Shinde
- Department of Haematogenetics, Indian Council of Medical Research, National Institute of Immunohaematology, Mumbai, Maharashtra, India
| | - Vinod D Umare
- Department of Haematogenetics, Indian Council of Medical Research, National Institute of Immunohaematology, Mumbai, Maharashtra, India
| | - Prajyot V Deshmukh
- Department of Haematogenetics, Indian Council of Medical Research, National Institute of Immunohaematology, Mumbai, Maharashtra, India
| | - Kanjaksha Ghosh
- Department of Haematogenetics, Indian Council of Medical Research, National Institute of Immunohaematology, Mumbai, Maharashtra, India
| | - Manisha R Madkaikar
- Department of Haematogenetics, Indian Council of Medical Research, National Institute of Immunohaematology, Mumbai, Maharashtra, India
| | - Roshan B Colah
- Department of Haematogenetics, Indian Council of Medical Research, National Institute of Immunohaematology, Mumbai, Maharashtra, India
| | - Malay B Mukherjee
- Department of Haematogenetics, Indian Council of Medical Research, National Institute of Immunohaematology, Mumbai, Maharashtra, India
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5
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Kelkar MG, Bargir UA, Malik-Yadav R, Gupta M, Dalvi A, Jodhawat N, Shinde S, Madkaikar MR. CD8 + T Cells Exhibit an Exhausted Phenotype in Hemophagocytic Lymphohistiocytosis. J Clin Immunol 2021; 41:1794-1803. [PMID: 34389889 DOI: 10.1007/s10875-021-01109-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 07/22/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome mainly caused by uncontrolled activation of antigen presenting cells and CD8 T cells. CD8 T cell exhaustion is a known phenomenon in chronic viral infections and cancer. However, the role of T cell exhaustion is not yet identified in HLH in the background of persistent inflammation. So, currently, we have characterized the CD8 T cells using flow cytometry to understand the phenomenon of exhaustion in these cells in HLH. METHODS We have comprehensively evaluated lymphocyte subsets and characterized CD8 T cells using immunophenotypic markers like PD1, TIM3, LAG3, Ki67, Granzyme B, etc. in a cohort of 21 HLH patients. Effector cytokine secretion and degranulation by CD8 T cells are also studied. RESULTS Our findings indicate skewed lymphocyte subsets and aberrantly activated CD8 T cells in HLH. CD8 T cells exhibit significantly increased expression of PD1, TIM3, and LAG3 prominently in primary HLH as compared to controls. PD1 + CD8 T cells express elevated levels of Granzyme B and Ki67. Moreover, CD8 T cells are hypofunctional as evidenced by significantly reduced cytokine secretion and compromised CD107a degranulation. CONCLUSION The study has revealed that CD8 + cytotoxic T lymphocytes from HLH patients exhibited high expression of exhaustion markers with overall impaired function. To the best of our understanding, this is the first report suggesting functional exhaustion of CD8 T cells in both primary and secondary HLH. Future studies to understand the association of exhaustion with disease outcome are needed for its probable therapeutic implementation.
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Affiliation(s)
- Madhura G Kelkar
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India
| | - Umair Ahmad Bargir
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India
| | - Reetika Malik-Yadav
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India
| | - Maya Gupta
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India
| | - Aparna Dalvi
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India
| | - Neha Jodhawat
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India
| | - Shweta Shinde
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India
| | - Manisha R Madkaikar
- Department of Pediatric Immunology and Leukocyte Biology, ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, NMS Building, KEM Hospital Campus, Parel, , Mumbai, 400012, India.
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6
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Suri D, Rikhi R, Jindal AK, Rawat A, Sudhakar M, Vignesh P, Gupta A, Kaur A, Sharma J, Ahluwalia J, Bhatia P, Khadwal A, Raj R, Uppuluri R, Desai M, Taur P, Pandrowala AA, Gowri V, Madkaikar MR, Lashkari HP, Bhattad S, Kumar H, Verma S, Imai K, Nonoyama S, Ohara O, Chan KW, Lee PP, Lau YL, Singh S. Wiskott Aldrich Syndrome: A Multi-Institutional Experience From India. Front Immunol 2021; 12:627651. [PMID: 33936041 PMCID: PMC8086834 DOI: 10.3389/fimmu.2021.627651] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/18/2021] [Indexed: 12/21/2022] Open
Abstract
Background Wiskott Aldrich syndrome (WAS) is characterized by bleeding manifestations, recurrent infections, eczema, autoimmunity, and malignancy. Over the last decade, improved awareness and better in-house diagnostic facilities at several centers in India has resulted in increased recognition of WAS. This study reports collated data across major primary immunodeficiency diseases (PID) centers in India that are involved in care of children with WAS and highlights the varied clinical presentations, genetic profile, and outcomes of patients in India. Methods Request to share data was sent to multiple centers in India that are involved in care and management of patients with PID. Six centers provided requisite data that were compiled and analyzed. Results In this multi-institutional cohort, clinical details of 108 patients who had a provisional diagnosis of WAS were received. Of these, 95 patients with 'definite WAS' were included Fourteen patients were classified as XLT and 81 patients as WAS. Median age at onset of symptoms of patients was 3 months (IQR 1.6, 6.0 months) and median age at diagnosis was 12 months (IQR 6,48 months). Clinical profile included bleeding episodes (92.6%), infections (84.2%), eczema (78.9%), various autoimmune manifestations (40%), and malignancy (2.1%). DNA analysis revealed 47 variants in 67 cases. Nonsense and missense variants were the most common (28.4% each), followed by small deletions (19.4%), and splice site defects (16.4%). We also report 24 novel variants, most of these being frameshift and nonsense mutations resulting in premature termination of protein synthesis. Prophylactic intravenous immunoglobulin (IVIg) was initiated in 52 patients (54.7%). Hematopoietic stem cell transplantation (HSCT) was carried out in 25 patients (26.3%). Of those transplanted, disease-free survival was seen in 15 patients (60%). Transplant related mortality was 36%. Outcome details were available for 89 patients. Of these, 37% had died till the time of this analysis. Median duration of follow-up was 36 months (range 2 weeks- 12 years; IQR 16.2 months- 70 months). Conclusions We report the first nationwide cohort of patients with WAS from India. Bleeding episodes and infections are common manifestations. Mortality continues to be high as curative therapy is not accessible to most of our patients.
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Affiliation(s)
- Deepti Suri
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rashmi Rikhi
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ankur K. Jindal
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Amit Rawat
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Murugan Sudhakar
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Pandiarajan Vignesh
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Anju Gupta
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Anit Kaur
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Jyoti Sharma
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Jasmina Ahluwalia
- Department of Haematology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Prateek Bhatia
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Alka Khadwal
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Revathi Raj
- Department of Paediatric Haematology and Oncology, Apollo Speciality Hospitals, Chennai, India
| | - Ramya Uppuluri
- Department of Paediatric Haematology and Oncology, Apollo Speciality Hospitals, Chennai, India
| | - Mukesh Desai
- Division of Immunology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Prasad Taur
- Division of Immunology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | | | - Vijaya Gowri
- Division of Immunology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Manisha R. Madkaikar
- Department of Paediatric Immunology and Leukocyte Biology, National Institute of Immunohematology, Mumbai, India
| | - Harsha Prasada Lashkari
- Department of Pediatrics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Sagar Bhattad
- Pediatric Immunology and Rheumatology, Aster CMI Hospital, Bengaluru, India
| | - Harish Kumar
- Pediatric Immunology and Rheumatology, Aster CMI Hospital, Bengaluru, India
| | - Sanjeev Verma
- Department of King George Medical University, Lucknow, India
| | - Kohsuke Imai
- Department of Pediatrics, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Shigeaki Nonoyama
- Department of Pediatrics, National Defense Medical College, Saitama, Japan
| | - Osamu Ohara
- Department of Applied Genomics, Kazusa DNA Research Institute, Kisarazu, Chiba, Japan
| | - Koon W. Chan
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong
| | - Pamela P. Lee
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong
| | - Yu Lung Lau
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong
| | - Surjit Singh
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Korgaonkar SA, Chougule DA, Khopkar US, Kharkar VD, Lahoria V, Khadilkar PV, Madkaikar MR, Pradhan VD. Quantitative Estimation of Antidesmoglein Autoantibodies by ELISA in Pemphigus Patients and its Correlation with Disease Activity. Indian J Dermatol 2021; 66:98-99. [PMID: 33911304 PMCID: PMC8061489 DOI: 10.4103/ijd.ijd_723_18] [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: 01/19/2023] Open
Affiliation(s)
- Seema A Korgaonkar
- National Institute of Immunohaematology, 13th Floor, King Edward Memorial Hospital Campus, Parel, Mumbai, Maharashtra, India E-mail:
| | - Durga A Chougule
- National Institute of Immunohaematology, 13th Floor, King Edward Memorial Hospital Campus, Parel, Mumbai, Maharashtra, India E-mail:
| | - Uday S Khopkar
- Department of Skin, King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - Vidya D Kharkar
- Department of Skin, King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - Vikram Lahoria
- Department of Skin, King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - Prasad V Khadilkar
- National Institute of Immunohaematology, 13th Floor, King Edward Memorial Hospital Campus, Parel, Mumbai, Maharashtra, India E-mail:
| | - Manisha R Madkaikar
- National Institute of Immunohaematology, 13th Floor, King Edward Memorial Hospital Campus, Parel, Mumbai, Maharashtra, India E-mail:
| | - Vandana D Pradhan
- National Institute of Immunohaematology, 13th Floor, King Edward Memorial Hospital Campus, Parel, Mumbai, Maharashtra, India E-mail:
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Chawla SS, Gorakshakar AC, Ghosh KK, Madkaikar MR, Devarajan PV. Fabrication of gelatin functionalized silver nanoparticles for blood group profiling. Nanotechnology 2020; 31:295102. [PMID: 32213681 DOI: 10.1088/1361-6528/ab83b9] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We report the fabrication of silver nanoparticles (AgNPs) surface functionalized with gelatin at different concentrations (G10/G20/G40 AgNPs) with an average particle size of ∼200 nm, bioconjugated with antisera antibodies (AsAbs) of the major and clinically significant blood groups (CSBGs) at different titres from neat to 1:128. Bioconjugation using ionic interaction at pH 7.4 enabled 'end-on' configuration, with the -NH2 group of the antibody free for interaction with the red blood cell antigen, as confirmed by Fourier transform infrared spectroscopy. The tube agglutination test (TAT) revealed optimum agglutination with G20NPs, while SDS PAGE confirmed the optimal titre as 1:8 for the major blood groups A, B, AB and O. Bioconjugated AgNPs coated onto microtitre assay plates with the major blood groups and CSBGs to enable simultaneous identification, were validated against the TAT on 400 random blood samples for the major blood groups and revealed high accuracy (95%). While similar accuracy was seen for most of the CSBGs with only false negatives, the method was not found to be suitable for the Kell, Kidd and Duffy groups. The absence of false positives reflects high safety, and eliminates the risk of a mismatched blood transfusion. The method uses diluted blood and hence could enable point-of-care detection. The significantly lower AsAb requirement also provides a cost advantage.
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Affiliation(s)
- Shweta S Chawla
- Department of Pharmaceutical Sciences, Institute of Chemical Technology, Mumbai, India
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9
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Bargir UA, Hule GP, Kambli P, Kulkarni M, Donta AK, Taur P, Gorakshakar A, Desai M, Madkaikar MR. "FUT2" a potential genetic modifier in NCF1 deficiency. J Allergy Clin Immunol Pract 2020; 8:1097-1099. [PMID: 31494296 DOI: 10.1016/j.jaip.2019.08.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/16/2019] [Accepted: 08/18/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Umair Ahmed Bargir
- Department of Paediatric Immunology and Leukocyte Biology, National Institute of Immunohaematology (ICMR), Mumbai, India
| | - Gouri P Hule
- Department of Paediatric Immunology and Leukocyte Biology, National Institute of Immunohaematology (ICMR), Mumbai, India
| | - Priyanka Kambli
- Department of Paediatric Immunology and Leukocyte Biology, National Institute of Immunohaematology (ICMR), Mumbai, India
| | - Manasi Kulkarni
- Department of Paediatric Immunology and Leukocyte Biology, National Institute of Immunohaematology (ICMR), Mumbai, India
| | - Ajay Kumar Donta
- Department of Transfusion Medicine, National Institute of Immunohaematology (ICMR), Mumbai, India
| | - Prasad Taur
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Ajit Gorakshakar
- Department of Transfusion Medicine, National Institute of Immunohaematology (ICMR), Mumbai, India
| | - Mukesh Desai
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Manisha R Madkaikar
- Department of Paediatric Immunology and Leukocyte Biology, National Institute of Immunohaematology (ICMR), Mumbai, India.
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10
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Khadilkar PV, Khopkar US, Nadkar MY, Rajadhyaksha AG, Chougule DA, Deshpande SD, Madkaikar MR, Pradhan VD. Fibrotic Cytokine Interplay in Evaluation of Disease Activity in Treatment Naïve Systemic Sclerosis Patients from Western India. J Assoc Physicians India 2019; 67:26-30. [PMID: 31562712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND : Systemic sclerosis (SSc) is a demyelinating disease of skin, subcutaneous tissue, muscles and internal organs, with fibrosis as an important pathological event. AIM : To understand cytokine interplay of IL-1β, IL-4 and IL-6 and their association with disease activity in treatment naïve active cases of systemic sclerosis from Western India. METHODS Twenty-five SSc patients as per ACR-EULAR 2013 criteria (classified based on pulmonary fibrosis and generalized fibrosis) and 25 age-sex matched controls were enrolled. Serum cytokine levels of IL-1β, IL-4 and IL-6 were assessed by multiplex bead based immunoassay. RESULTS Ten patients had Interstitial lung disease (ILD), whereas, 16 patients had generalized fibrosis. Anti-nuclear antibodies were seen in 22 patients (88%); antiScl70 in 15 patients (60%) and anti-Centromere antibodies in 5 patients (20%). Serum levels of IL-1β in patients were significantly higher than healthy controls (p=0.0006). IL-4 levels in all SSc patients were marginally raised (p=0.0102), while IL-6 levels were significantly raised (p<0.0001). IL-4 was found to be significantly raised in SSc patients with ILD (p=0.021) as compared to patients without ILD. IL-1β (p=0.0293) and IL-4 (p<0.0001) were significantly higher in SSc patients with fibrosis. On the contrary, IL-6 levels in patients with fibrosis were found to be lower than in patients without fibrosis. CONCLUSION Significantly raised cytokine levels among treatment naïve systemic sclerosis patients were found to be associated with higher disease severity in our study. Higher levels of IL-1β and IL-6 indicated an active inflammatory status, whereas significantly raised IL-4 levels indicated at higher fibrotic activity.
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Affiliation(s)
- Prasad V Khadilkar
- Doctoral Student, Department of Clinical Pathology, Haffkine Institute for Training, Research and Testing, Mumbai, Maharashtra
| | | | - Milind Y Nadkar
- Professor, Department of Medicine, Head EMS and Rheumatology Clinic
| | - Anjali G Rajadhyaksha
- Professor, Department of Medicine, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra
| | - Durga A Chougule
- M.Sc. Doctoral Student, Department of Clinical and Experimental Immunology, NIIH-ICMR, KEM Hospital Campus, Mumbai, Maharashtra
| | - Sunita D Deshpande
- National Professor and Emeritus Scientist, Department of Clinical Pathology, Haffkine Institute for Training, Research and Testing, Mumbai, Maharashtra
| | | | - Vandana D Pradhan
- Scientist. Department of Clinical and Experimental Immunology, NIIH-ICMR, KEM Hospital Campus, Mumbai, Maharashtra
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Dongerdiye R, Kamat P, Jain P, Warang P, Devendra R, Wasekar N, Sharma R, Mhaskar K, Madkaikar MR, Manglani MV, Kedar PS. Red cell adenylate kinase deficiency in India: identification of two novel missense mutations (c.71A>G and c.413G>A). J Clin Pathol 2019; 72:393-398. [PMID: 30918013 DOI: 10.1136/jclinpath-2019-205718] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 01/16/2019] [Revised: 02/21/2019] [Accepted: 02/25/2019] [Indexed: 02/03/2023]
Abstract
Adenylate kinase (AK) deficiency is a rare erythroenzymopathy associated with hereditary nonspherocytic haemolytic anaemia along with mental/psychomotor retardation in few cases. Diagnosis of AK deficiency depends on the decreased level of enzyme activity in red cell and identification of a mutation in the AK1 gene. Until, only eight mutations causing AK deficiency have been reported in the literature. We are reporting two novel missense mutation (c.71A > G and c.413G > A) detected in the AK1 gene by next-generation sequencing (NGS) in a 6-year-old male child from India. Red cell AK enzyme activity was found to be 30% normal. We have screened a total of 32 family members of the patient and showed reduced red cell enzyme activity and confirm mutations by Sanger's sequencing. On the basis of Sanger sequencing, we suggest that the proband has inherited a mutation in AK1 gene exon 4 c.71A > G (p.Gln24Arg) from paternal family and exon 6 c.413G > A (p.Arg138His) from maternal family. Bioinformatics tools, such as SIFT, Polymorphism Phenotyping v.2, Mutation Taster, MutPred, also confirmed the deleterious effect of both the mutations. Molecular modelling suggests that the structural changes induced by p.Gln24Arg and p.Arg138His are pathogenic variants having a direct impact on the structural arrangement of the region close to the active site of the enzyme. In conclusion, NGS will be the best solution for diagnosis of very rare disorders leading to better management of the disease. This is the first report of the red cell AK deficiency from the Indian population.
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Affiliation(s)
- Rashmi Dongerdiye
- Department of Haematogenetics, National Institute of Immunohaematology, Mumbai, India
| | - Pranoti Kamat
- MCGM Comprehensive Thalassemia Care Pediatric Hematology-Oncology and Bone Marrow Transplantation Centre, Mumbai, India
| | - Punit Jain
- MCGM Comprehensive Thalassemia Care Pediatric Hematology-Oncology and Bone Marrow Transplantation Centre, Mumbai, India
| | - Prashant Warang
- Department of Haematogenetics, National Institute of Immunohaematology, Mumbai, India
| | - Rati Devendra
- Department of Haematogenetics, National Institute of Immunohaematology, Mumbai, India
| | - Nilesh Wasekar
- MCGM Comprehensive Thalassemia Care Pediatric Hematology-Oncology and Bone Marrow Transplantation Centre, Mumbai, India
| | - Ratna Sharma
- MCGM Comprehensive Thalassemia Care Pediatric Hematology-Oncology and Bone Marrow Transplantation Centre, Mumbai, India
| | - Ketaki Mhaskar
- MCGM Comprehensive Thalassemia Care Pediatric Hematology-Oncology and Bone Marrow Transplantation Centre, Mumbai, India
| | | | - Mamta V Manglani
- MCGM Comprehensive Thalassemia Care Pediatric Hematology-Oncology and Bone Marrow Transplantation Centre, Mumbai, India
| | - Prabhakar S Kedar
- Department of Haematogenetics, National Institute of Immunohaematology, Mumbai, India
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Kedar PS, Gupta V, Dongerdiye R, Chiddarwar A, Warang P, Madkaikar MR. Molecular diagnosis of unexplained haemolytic anaemia using targeted next-generation sequencing panel revealed (p.Ala337Thr) novel mutation in GPI gene in two Indian patients. J Clin Pathol 2018; 72:81-85. [PMID: 30337328 DOI: 10.1136/jclinpath-2018-205420] [Citation(s) in RCA: 11] [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] [Received: 08/07/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 01/19/2023]
Abstract
Glucose-6-phosphate isomerase (GPI) deficiency is an autosomal recessive genetic disorder causing congenital haemolytic anaemia (CHA). Diagnosis of GPI deficiency by the biochemical method is unpredicted. Molecular diagnosis by identifying genetic mutation is the gold standard method for confirmation of disease, but causative genes involved in CHA are numerous, and identifying a gene-by-gene approach using Sanger sequencing is also cumbersome, expensive and labour intensive. Recently, next-generation targeted sequencing is more useful in the diagnosis of unexplained haemolytic anaemia. We used targeted next-generation sequencing (NGS) clinical panel for diagnosis of unexplained haemolytic anaemia in two Indian patients which were pending for a long time. All possible causes of haemolytic anaemia were found within normal limit. NGS by clinical exome panel revealed homozygous novel missense mutation in exon 12, c.1009G>A (p.Ala337Thr) in both patients. We further confirm by measuring red blood cell GPI activity in the patients and showed deficiency whereas parents were having intermediate activity. c.1009G>A mutation was also confirmed by Sanger sequencing of exon 12 of GPI gene. The structural-functional analysis by bioinformatics software like Swiss PDB, PolyPhen-2 and PyMol suggested that this pathogenic variant has a direct impact on the structural rearrangement at the region near the active site of the enzyme. This rapid and high-performance targeted NGS assay can be configured to detect specific CHA mutations unique to an individual defect, making it a potentially valuable method for diagnosis of unexplained haemolytic anaemia.
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Affiliation(s)
- Prabhakar S Kedar
- Department of Hematogenetics, National Institute of Immunohematology (Indian Council of Medical Research), Mumbai, India
| | - Vinod Gupta
- Department of Hematogenetics, National Institute of Immunohematology (Indian Council of Medical Research), Mumbai, India
| | - Rashmi Dongerdiye
- Department of Hematogenetics, National Institute of Immunohematology (Indian Council of Medical Research), Mumbai, India
| | - Ashish Chiddarwar
- Department of Hematogenetics, National Institute of Immunohematology (Indian Council of Medical Research), Mumbai, India
| | - Prashant Warang
- Department of Hematogenetics, National Institute of Immunohematology (Indian Council of Medical Research), Mumbai, India
| | - Manisha R Madkaikar
- Department of Hematogenetics, National Institute of Immunohematology (Indian Council of Medical Research), Mumbai, India
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Hule GP, Kanvinde PR, Kulkarni MA, van Leeuwen K, de Boer M, Bargir UA, Taur PD, Desai MM, Madkaikar MR. p47 phox-/- Chronic Granulomatous Disease Patient with Incomplete Kawasaki Disease. J Clin Immunol 2018; 38:638-641. [PMID: 30091057 DOI: 10.1007/s10875-018-0532-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 07/09/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Gouri P Hule
- Department of Pediatric Immunology and Leukocyte Biology, National Institute of Immunohaematology (ICMR), 13th Floor, NMS Building, KEM Hospital Campus, Parel, Mumbai, 400012, India
| | - Purva R Kanvinde
- Bai Jerbai Wadia Hospital for Children, Parel, Mumbai, 400012, India
| | - Manasi A Kulkarni
- Department of Pediatric Immunology and Leukocyte Biology, National Institute of Immunohaematology (ICMR), 13th Floor, NMS Building, KEM Hospital Campus, Parel, Mumbai, 400012, India
| | - Karin van Leeuwen
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory of the Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - Martin de Boer
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory of the Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - Umair Ahmed Bargir
- Department of Pediatric Immunology and Leukocyte Biology, National Institute of Immunohaematology (ICMR), 13th Floor, NMS Building, KEM Hospital Campus, Parel, Mumbai, 400012, India
| | - Prasad D Taur
- Bai Jerbai Wadia Hospital for Children, Parel, Mumbai, 400012, India
| | - Mukesh M Desai
- Bai Jerbai Wadia Hospital for Children, Parel, Mumbai, 400012, India
| | - Manisha R Madkaikar
- Department of Pediatric Immunology and Leukocyte Biology, National Institute of Immunohaematology (ICMR), 13th Floor, NMS Building, KEM Hospital Campus, Parel, Mumbai, 400012, India.
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