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Infantino M, Manfredi M, Alessio MG, Previtali G, Grossi V, Benucci M, Faraone A, Fortini A, Grifoni E, Masotti L, Russo E, Amedei A, FitzGerald E, Albesa R, Norman GL, Mahler M. Clinical utility of circulating calprotectin to assist prediction and monitoring of COVID-19 severity: An Italian study. J Med Virol 2022; 94:5758-5765. [PMID: 35941084 PMCID: PMC9538954 DOI: 10.1002/jmv.28056] [Citation(s) in RCA: 1] [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] [Received: 03/15/2022] [Revised: 07/23/2022] [Accepted: 08/05/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Calprotectin (S100A8/A9) has been identified as a biomarker that can aid in predicting the severity of disease in COVID-19 patients. This study aims to evaluate the correlation between levels of circulating calprotectin (cCP) and the severity of COVID-19. METHODS Sera from 245 COVID-19 patients and 110 apparently healthy individuals were tested for calprotectin levels using a chemiluminescent immunoassay (Inova Diagnostics). Intensive care unit (ICU) admission and type of respiratory support administered were used as indicators of disease severity, and their correlation with calprotectin levels was assessed. RESULTS Samples from patients in the ICU had a median calprotectin concentration of 11.6 µg/ml as compared to 3.5 µg/ml from COVID-19 patients who were not in the ICU. The median calprotectin concentration in a cohort of healthy individuals collected before the COVID-19 pandemic was 3.0 µg/ml (95% CI: 2.820-2.969 µg/ml). Patients requiring a Venturi mask, continuous positive airway pressure, or orotracheal intubation all had significantly higher values of calprotectin than controls, with the increase of cCP levels proportional to the increasing need of respiratory support. CONCLUSION Calprotectin levels in serum correlate well with disease severity and represent a promising serological biomarker for the risk assessment of COVID-19 patients.
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Affiliation(s)
- Maria Infantino
- Immunology and Allergology Laboratory UnitSan Giovanni di Dio HospitalFlorenceItaly
| | - Mariangela Manfredi
- Immunology and Allergology Laboratory UnitSan Giovanni di Dio HospitalFlorenceItaly
| | | | - Giulia Previtali
- Department of Laboratory MedicineASST Papa Giovanni XXIII HospitalBergamoItaly
| | - Valentina Grossi
- Immunology and Allergology Laboratory UnitSan Giovanni di Dio HospitalFlorenceItaly
| | | | - Antonio Faraone
- Department of Internal MedicineSan Giovanni Di Dio HospitalFlorenceItaly
| | - Alberto Fortini
- Department of Internal MedicineSan Giovanni Di Dio HospitalFlorenceItaly
| | - Elisa Grifoni
- Internal Medicine IISan Giuseppe HospitalEmpoliItaly
| | - Luca Masotti
- Internal Medicine IISan Giuseppe HospitalEmpoliItaly
| | - Edda Russo
- Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
| | - Amedeo Amedei
- Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
| | - Emily FitzGerald
- Headquarters & Technology Center Autoimmunity, WerfenSan DiegoCaliforniaUSA
| | - Roger Albesa
- Headquarters & Technology Center Autoimmunity, WerfenSan DiegoCaliforniaUSA
| | - Gary L. Norman
- Headquarters & Technology Center Autoimmunity, WerfenSan DiegoCaliforniaUSA
| | - Michael Mahler
- Headquarters & Technology Center Autoimmunity, WerfenSan DiegoCaliforniaUSA
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Andalucia C, Albesa R, Mahler M. POS1400 CLINICAL EVIDENCE OF THE DIFFERENCE IN CIRCULATING CALPROTECTIN LEVELS BETWEEN RHEUMATOID ARTHRITIS AND HEALTHY INDIVIDUALS, NON-INFLAMMATORY ARTHRITIS OR OTHER INFLAMMATORY ARTHRITIS: A SYSTEMATIC LITERATURE REVIEW AND META-ANALYSIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundRheumatoid arthritis (RA) is a systemic autoimmune disease mainly characterized by a chronic inflammation of the joints. Early diagnosis and treatment with disease-modifying antirheumatic drugs (DMARDs) is essential to prevent or slow down the structural damage. Diagnosis might be difficult in patients with mild and unspecific clinical signs and symptoms though. A differential diagnosis in patients presenting arthritis is needed for an appropriate patient management.Acute-phase reactants (ESR or CRP) are non-specific inflammatory biomarkers used to aid in the diagnosis of RA and to assess disease activity. In the recent years, studies published have shown that calprotectin may be an alternative biomarker of active inflammatory disorders as well as a prognostic or monitoring biomarker.ObjectivesTo collect all available evidence on the difference between circulating calprotectin (cCalpro) levels in rheumatoid arthritis (RA) patients and other control populations such as healthy individuals (HI), osteoarthritis (OA), psoriatic arthritis (PsA) or spondyloarthritis (SpA).MethodsElectronic databases searches (Scopus, Pubmed and Cochrane Library), complemented by registry and hand searching, were conducted (February 4th, 2021) to identify fully paired studies comparing cCalpro levels in RA and HI, non-inflammatory arthritis (NIA), or other inflammatory arthritis.As recommended by Cochrane, the Hedge´s standardized mean difference (SMD) and its 95% confidence intervals were used to synthetize the difference in cCalpro levels from studies using different matrices (serum or plasma) or laboratory methods. Sample size, mean and standard deviation of each group were extracted from the individual studies to conduct a random-effects model meta-analysis in STATA MP v17.0. When cCalpro levels were reported in median and range or inter-quartile, a formula was used to estimate the mean and standard deviation.Sensitivity analysis, subgroup analyses and meta-regression analyses on matrix type (serum or plasma) and cCalpro commercial test were performed, when feasible, to investigate heterogeneity.ResultsThe systematic review retrieved 27 studies comparing cCalpro levels between RA and controls. One study reported cCalpro levels in three different RA and HI cohorts. Most of RA and controls were age and gender matched. Calprotectin was measured in serum in 72,4% of the comparisons. Thirteen different commercial calprotectin tests and four homemade tests were used.In 21 studies cCalpro levels were measured in 2678 RA and 1096 HI. cCalpro levels were significantly higher in RA than in HI (SMD=2,13;95%CI=1,27-2,98;p<0,0001), and significant heterogeneity was observed. A meta-regression on matrix and assay manufacturer indicated that 22% of the between-study variance might be explained by the type of calprotectin test used.Five studies compared cCalpro levels in 207 RA and 187 NIA (78,57% OA). cCalpro levels were significantly higher in RA than in NIA (SMD=2,914;95% CI=0,957-4,872;p=0,0035), significant heterogeneity was observed.cCalpro levels in 1217 RA and 411 PsA patients were reported in 5 studies. cCalpro levels were slightly higher in RA than in PsA (SMD=0,54; 95%CI=0,424-0,656; p<0,0001), while no significant heterogeneity was observed.A comparison between cCalpro levels in RA and SpA was included in 4 studies. cCalpro levels were slightly higher in RA than in SpA (SMD=0,35; 95%CI=0,129-0,576; p=0,0020), and no significant heterogeneity was observed.ConclusionIn this systematic review and meta-analysis, rheumatoid arthritis patients showed significantly higher circulating calprotectin levels than healthy individuals, non-inflammatory arthritis, psoriatic arthritis and spondyloarthritis. Pooled standardized mean difference between groups should be interpretated with cautious due to substantial heterogeneity or small number of studies.Disclosure of InterestsCarmen Andalucia Employee of: Werfen, Roger Albesa Employee of: Werfen, Michael Mahler Employee of: Werfen
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Infantino M, Manfredi M, Albesa R, Grossi V, Lari B, Benucci M, Gobbi FL, Matucci A, Sarra F, Mahler M. Critical role of pre-analytical aspects for the measurement of circulating calprotectin in serum or plasma as a biomarker for neutrophil-related inflammation. Clin Chem Lab Med 2021; 59:e317-e321. [PMID: 33641273 DOI: 10.1515/cclm-2021-0172] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/11/2021] [Indexed: 12/28/2022]
Affiliation(s)
- Maria Infantino
- Immunology and Allergology Laboratory Unit, S. Giovanni di Dio Hospital, Florence, Italy
| | - Mariangela Manfredi
- Immunology and Allergology Laboratory Unit, S. Giovanni di Dio Hospital, Florence, Italy
| | - Roger Albesa
- Research and Development, Inova Diagnostics, San Diego, CA, USA
| | - Valentina Grossi
- Immunology and Allergology Laboratory Unit, S. Giovanni di Dio Hospital, Florence, Italy
| | - Barbara Lari
- Immunology and Allergology Laboratory Unit, S. Giovanni di Dio Hospital, Florence, Italy
| | - Maurizio Benucci
- Rheumatology Unit, S. Giovanni di Dio Hospital, Medicine Department, Florence, Italy
| | - Francesca Li Gobbi
- Rheumatology Unit, S. Giovanni di Dio Hospital, Medicine Department, Florence, Italy
| | - Alessandra Matucci
- Rheumatology Unit, S. Giovanni di Dio Hospital, Medicine Department, Florence, Italy
| | - Filippo Sarra
- Development Manager Autoimmunity, Werfen, Milan, Italy
| | - Michael Mahler
- Research and Development, Inova Diagnostics, San Diego, CA, USA
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Gatselis NK, Tornai T, Shums Z, Zachou K, Saitis A, Gabeta S, Albesa R, Norman GL, Papp M, Dalekos GN. Golgi protein-73: A biomarker for assessing cirrhosis and prognosis of liver disease patients. World J Gastroenterol 2020; 26:5130-5145. [PMID: 32982114 PMCID: PMC7495033 DOI: 10.3748/wjg.v26.i34.5130] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/19/2020] [Accepted: 08/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Reliable biomarkers of cirrhosis, hepatocellular carcinoma (HCC), or progression of chronic liver diseases are missing. In this context, Golgi protein-73 (GP73) also called Golgi phosphoprotein-2, was originally defined as a resident Golgi type II transmembrane protein expressed in epithelial cells. As a result, GP73 expression was found primarily in biliary epithelial cells, with only slight detection in hepatocytes. However, in patients with acute or chronic liver diseases and especially in HCC, the expression of GP73 is significantly up-regulated in hepatocytes. So far, few studies have assessed GP73 as a diagnostic or prognostic marker of liver fibrosis and disease progression.
AIM To assess serum GP73 efficacy as a diagnostic marker of cirrhosis and/or HCC or as predictor of liver disease progression.
METHODS GP73 serum levels were retrospectively determined by a novel GP73 ELISA (QUANTA Lite® GP73, Inova Diagnostics, Inc., Research Use Only) in a large cohort of 632 consecutive patients with chronic viral and non-viral liver diseases collected from two tertiary Academic centers in Larissa, Greece (n = 366) and Debrecen, Hungary (n = 266). Aspartate aminotransferase (AST)/Platelets (PLT) ratio index (APRI) was also calculated at the relevant time points in all patients. Two hundred and three patients had chronic hepatitis B, 183 chronic hepatitis C, 198 alcoholic liver disease, 28 autoimmune cholestatic liver diseases, 15 autoimmune hepatitis, and 5 with other liver-related disorders. The duration of follow-up was 50 (57) mo [median (interquartile range)]. The development of cirrhosis, liver decompensation and/or HCC during follow-up were assessed according to internationally accepted guidelines. In particular, the surveillance for the development of HCC was performed regularly with ultrasound imaging and alpha-fetoprotein (AFP) determination every 6 mo in cirrhotic and every 12 mo in non-cirrhotic patients.
RESULTS Increased serum levels of GP73 (> 20 units) were detected at initial evaluation in 277 out of 632 patients (43.8%). GP73-seropositivity correlated at baseline with the presence of cirrhosis (96.4% vs 51.5%, P < 0.001), decompensation of cirrhosis (60.3% vs 35.5%, P < 0.001), presence of HCC (18.4% vs 7.9%, P < 0.001) and advanced HCC stage (52.9% vs 14.8%, P = 0.002). GP73 had higher diagnostic accuracy for the presence of cirrhosis compared to APRI score [Area under the curve (AUC) (95%CI): 0.909 (0.885-0.934) vs 0.849 (0.813-0.886), P = 0.003]. Combination of GP73 with APRI improved further the accuracy (AUC: 0.925) compared to GP73 (AUC: 0.909, P = 0.005) or APRI alone (AUC: 0.849, P < 0.001). GP73 levels were significantly higher in HCC patients compared to non-HCC [22.5 (29.2) vs 16 (20.3) units, P < 0.001) and positively associated with BCLC stage [stage 0: 13.9 (10.8); stage A: 17.1 (16.8); stage B: 19.6 (22.3); stage C: 32.2 (30.8); stage D: 45.3 (86.6) units, P < 0.001] and tumor dimensions [very early: 13.9 (10.8); intermediate: 19.6 (18.4); advanced: 29.1 (33.6) units, P = 0.004]. However, the discriminative ability for HCC diagnosis was relatively low [AUC (95%CI): 0.623 (0.570-0.675)]. Kaplan-Meier analysis showed that the detection of GP73 in patients with compensated cirrhosis at baseline, was prognostic of higher rates of decompensation (P = 0.036), HCC development (P = 0.08), and liver-related deaths (P < 0.001) during follow-up.
CONCLUSION GP73 alone appears efficient for detecting cirrhosis and superior to APRI determination. In combination with APRI, its diagnostic performance can be further improved. Most importantly, the simple GP73 measurement proved promising for predicting a worse outcome of patients with both viral and non-viral chronic liver diseases.
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Affiliation(s)
- Nikolaos K Gatselis
- Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa 41110, Greece
- Institute of Internal Medicine and Hepatology, Larissa 41447, Greece
| | - Tamás Tornai
- Department of Internal Medicine, Division of Gastroenterology, University of Debrecen, Faculty of Medicine, Debrecen H-4032, Hungary
| | - Zakera Shums
- Department of Research and Development, Inova Diagnostics, Inc., San Diego, CA 92131, United States
| | - Kalliopi Zachou
- Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa 41110, Greece
- Institute of Internal Medicine and Hepatology, Larissa 41447, Greece
| | - Asterios Saitis
- Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa 41110, Greece
| | - Stella Gabeta
- Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa 41110, Greece
| | - Roger Albesa
- Department of Research and Development, Inova Diagnostics, Inc., San Diego, CA 92131, United States
| | - Gary L Norman
- Department of Research and Development, Inova Diagnostics, Inc., San Diego, CA 92131, United States
| | - Mária Papp
- Department of Internal Medicine, Division of Gastroenterology, University of Debrecen, Faculty of Medicine, Debrecen H-4032, Hungary
| | - George N Dalekos
- Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa 41110, Greece
- Institute of Internal Medicine and Hepatology, Larissa 41447, Greece
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Vázquez-Del Mercado M, Gómez-Bañuelos E, Navarro-Hernández RE, Pizano-Martinez O, Saldaña-Millán A, Chavarria-Avila E, Gonzalez-Rosas L, Andrade-Ortega L, Saavedra MA, Vera-Lastra OL, Jara LJ, Medrano-Ramírez G, Cruz-Reyes C, García-De la Torre I, Escarra-Senmarti M, Anjos LMED, Basu A, Albesa R, Mahler M, Casiano CA. Detection of autoantibodies to DSF70/LEDGFp75 in Mexican Hispanics using multiple complementary assay platforms. Auto Immun Highlights 2017; 8:1. [PMID: 27896669 PMCID: PMC5125105 DOI: 10.1007/s13317-016-0089-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 11/17/2016] [Indexed: 01/13/2023]
Abstract
PURPOSE Antinuclear autoantibodies (ANA) targeting the dense fine speckled antigen DFS70, also known as lens epithelium-derived growth factor p75 (LEDGF/p75), are attracting attention due to their low frequency in systemic rheumatic diseases but increased frequency in clinical laboratory referrals and healthy individuals (HI). These ANA specifically recognize the stress protein DFS70/LEDGFp75, implicated in cancer, HIV-AIDS, and inflammation. While their frequency has been investigated in various ethnic populations, there is little information on their frequency among Hispanics/Latinos. In this study, we determined the frequency of anti-DFS70/LEDGFp75 autoantibodies in Mexican Hispanics using multiple detection platforms. METHODS The frequency of anti-DFS70/LEDGFp75 antibodies was determined in 171 individuals, including 71 dermatomyositis (DM) patients, 47 rheumatoid arthritis (RA) patients, 30 obesity (OB) patients, and 23 HI. Antibody detection was achieved using four complementary assay platforms: indirect immunofluorescence, Western blotting, ELISA, and chemiluminescent immunoassay. RESULTS We detected relatively low frequencies of anti-DFS70/LEDGFp75 antibodies in patients with DM (1.4%), RA (4.3%), and OB (6.6%), and elevated frequency (17.4%) in HI. A strong concordance between the different antibody detection platforms was observed. CONCLUSIONS The low frequency of anti-DFS70/LEDGFp75 antibodies in Mexican patients with rheumatic diseases, but relatively higher frequency in HI, is consistent with previous observations with non-Hispanic populations, suggesting that geographic differences or ethnicity do not influence the frequency of these autoantibodies. Our results also highlight the importance of confirmatory assays for the accurate detection of these autoantibodies. Future studies with larger cohorts of healthy Hispanics/Latinos are needed to confirm if their anti-DFS70/LEDGFp75 antibody frequencies are significantly higher than in non-Hispanics.
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Affiliation(s)
- Mónica Vázquez-Del Mercado
- Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético, CUCS, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
- Servicio de Reumatología, Posgrado 004086 PNPC-CONACyT, División de Medicina Interna, O.P.D., Hospital Civil Dr. Juan I. Menchaca, Guadalajara, Jalisco, Mexico
| | - Eduardo Gómez-Bañuelos
- Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético, CUCS, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Rosa Elena Navarro-Hernández
- Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético, CUCS, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Oscar Pizano-Martinez
- Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético, CUCS, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Adan Saldaña-Millán
- Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético, CUCS, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Efrain Chavarria-Avila
- Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético, CUCS, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Lorena Gonzalez-Rosas
- Servicio de Reumatología, Posgrado 004086 PNPC-CONACyT, División de Medicina Interna, O.P.D., Hospital Civil Dr. Juan I. Menchaca, Guadalajara, Jalisco, Mexico
| | - Lilia Andrade-Ortega
- Servicio de Reumatología, Centro Médico Nacional 20 de Noviembre ISSSTE, Mexico, D.F., Mexico
| | - Miguel Angel Saavedra
- Hospital de Especialidades, Centro Médico Nacional La Raza, IMSS, Mexico, D.F., Mexico
| | | | - Luis Javier Jara
- Hospital de Especialidades, Centro Médico Nacional La Raza, IMSS, Mexico, D.F., Mexico
| | | | - Claudia Cruz-Reyes
- Hospital de Especialidades, Centro Médico Nacional La Raza, IMSS, Mexico, D.F., Mexico
| | | | - Marta Escarra-Senmarti
- Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético, CUCS, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Lisiane Maria Enriconi-Dos Anjos
- Department of Basic Sciences, Center for Health Disparities and Molecular Medicine, Loma Linda University School of Medicine, Mortensen Hall 142, 11085 Campus St., Loma Linda, CA, 92350, USA
| | - Anamika Basu
- Department of Basic Sciences, Center for Health Disparities and Molecular Medicine, Loma Linda University School of Medicine, Mortensen Hall 142, 11085 Campus St., Loma Linda, CA, 92350, USA
| | - Roger Albesa
- Department of Research, Inova Diagnostics, Inc., San Diego, CA, USA
| | - Michael Mahler
- Department of Research, Inova Diagnostics, Inc., San Diego, CA, USA
| | - Carlos A Casiano
- Department of Basic Sciences, Center for Health Disparities and Molecular Medicine, Loma Linda University School of Medicine, Mortensen Hall 142, 11085 Campus St., Loma Linda, CA, 92350, USA.
- Department of Medicine, Division of Rheumatology, Loma Linda University School of Medicine, Loma Linda, CA, USA.
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Mahler M, Albesa R, Zohoury N, Bertolaccini ML, Ateka-Barrutia O, Rodriguez-Garcia JL, Norman GL, Khamashta M. Autoantibodies to domain 1 of beta 2 glycoprotein I determined using a novel chemiluminescence immunoassay demonstrate association with thrombosis in patients with antiphospholipid syndrome. Lupus 2017; 25:911-6. [PMID: 27252269 DOI: 10.1177/0961203316640366] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [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: 12/30/2022]
Abstract
INTRODUCTION Antibodies to the domain 1 of beta 2 glycoprotein I (β2GPI-D1) have been suggested as a risk marker for thrombosis in patients with the antiphospholipid syndrome (APS). This cross-sectional study aimed to analyze the clinical utility of a novel chemiluminescence assay for the detection of anti-β2GPI-D1 antibodies. PATIENTS AND METHODS Sera collected from patients with primary or secondary APS (n = 106; 72 with and 34 without history of thrombosis) and controls (n = 272) were tested for anti-β2GPI-D1 IgG by chemiluminescence assay (QUANTA Flash) and by two anti-β2GPI IgG assays (QUANTA Lite and QUANTA Flash β2GPI IgG). RESULTS Anti-β2GPI-D1 IgG titers were significantly higher in patients with thrombosis (P = 0.0032) than those without. At the cut-off of 20 units, which yielded a 99.5% specificity, 24 of 72 (34.9%) patients with thrombosis and four of 34 (11.8%) without thrombosis were anti-β2GPI-D1 IgG positive (odds ratio, OR = 4.0). By further optimizing the cut-off specifically for correlation with thrombosis, 20.8% of the patients with thrombosis and 2.9% of the patients without thrombosis were positive (OR = 8.7). The ORs were significantly lower for antibodies to the full-length β2GPI by either the chemiluminescence assay or ELISA. Using the anti-β2GPI chemiluminescence assay, the OR was 2.3 (recommended cut-off of 20 CU) or 4.1 (optimal cut-off 164.6 CU). Using the anti-β2GPI ELISA, the OR was 2.7 (recommended cut-off of 20 units) or 3.7 (optimal cut-off 7.6 units). CONCLUSION These data indicate that anti-β2GPI-D1 IgG are present more frequently and in higher titers in APS patients with thrombotic complications than in those without.The novel β2GPI-D1 chemiluminescence assay appears to be superior to full-length β2GPI assays for the risk assessment of thrombotic events in APS patients.
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Affiliation(s)
- M Mahler
- Inova Diagnostics, Inc., San Diego, USA
| | - R Albesa
- Inova Diagnostics, Inc., San Diego, USA
| | - N Zohoury
- Inova Diagnostics, Inc., San Diego, USA
| | - M L Bertolaccini
- Academic Department of Vascular Surgery, King's College London, London, UK
| | - O Ateka-Barrutia
- Graham Hughes Lupus Research Laboratory, King's College London School of Medicine, London, UK
| | - J L Rodriguez-Garcia
- Graham Hughes Lupus Research Laboratory, King's College London School of Medicine, London, UK
| | | | - M Khamashta
- Graham Hughes Lupus Research Laboratory, King's College London School of Medicine, London, UK
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Giudizi MG, Cammelli D, Vivarelli E, Biagiotti R, Ferraro A, Bentow C, Almerigogna F, Albesa R, Mahler M. Anti-HMGCR antibody-associated necrotizing myopathy: diagnosis and treatment illustrated using a case report. Scand J Rheumatol 2016; 45:427-9. [DOI: 10.3109/03009742.2015.1132761] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- MG Giudizi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - D Cammelli
- SOD Immunoallergology, DAI, Medico-Geriatrico, AOU Careggi, Florence, Italy
| | - E Vivarelli
- School of Allergy and Clinical Immunology, University of Florence, Florence, Italy
| | - R Biagiotti
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - A Ferraro
- School of Allergy and Clinical Immunology, University of Florence, Florence, Italy
| | - C Bentow
- Inova Diagnostics, Inc, San Diego, CA, USA
| | - F Almerigogna
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - R Albesa
- Inova Diagnostics, Inc, San Diego, CA, USA
| | - M Mahler
- Inova Diagnostics, Inc, San Diego, CA, USA
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8
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Basu A, Woods-Burnham L, Ortiz G, Rios-Colon L, Figueroa J, Albesa R, Andrade LE, Mahler M, Casiano CA. Specificity of antinuclear autoantibodies recognizing the dense fine speckled nuclear pattern: Preferential targeting of DFS70/LEDGFp75 over its interacting partner MeCP2. Clin Immunol 2015; 161:241-50. [PMID: 26235378 PMCID: PMC4712632 DOI: 10.1016/j.clim.2015.07.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [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: 06/07/2015] [Revised: 07/28/2015] [Accepted: 07/29/2015] [Indexed: 11/26/2022]
Abstract
Human antinuclear autoantibodies (ANAs) targeting the dense fine speckled (DFS) nuclear protein DFS70, commonly known as lens epithelium derived growth factor p75 (LEDGFp75), present a clinical puzzle since their significance remains elusive. While their frequencies are low in ANA-positive autoimmune rheumatic diseases, they are relatively elevated in clinical laboratory referrals, diverse inflammatory conditions, and 'apparently' healthy individuals. We reported previously that DFS70/LEDGFp75 is an autoantigen in prostate cancer that closely interacts with another 70kD DFS nuclear protein, methyl CpG binding protein 2 (MeCP2). This led us to investigate if anti-DFS sera exclusively target DFS70/LEDGFp75 or also recognize MeCP2. Using several complementary autoantibody detection platforms and cellular/molecular approaches we evaluated 65 human sera producing anti-DFS autoantibodies. Our results show that these antibodies are highly specific for DFS70/LEDGFp75 and do not target MeCP2. Establishing the specificity of anti-DFS autoantibodies has implications for increasing our understanding of their biological significance and clinical utility.
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Affiliation(s)
- Anamika Basu
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Leanne Woods-Burnham
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Greisha Ortiz
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Leslimar Rios-Colon
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Johnny Figueroa
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Roger Albesa
- Department of Research, Inova Diagnostics, Inc., San Diego, CA, USA
| | - Luis E Andrade
- Rheumatology Division, Universidade Federal de Sao Paulo, Immunology Division, Fleury Medicine and Health Laboratories, Sao Paulo, Brazil
| | - Michael Mahler
- Department of Research, Inova Diagnostics, Inc., San Diego, CA, USA
| | - Carlos A Casiano
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA; Department of Medicine, Division of Rheumatology, Loma Linda University School of Medicine, Loma Linda, CA, USA.
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Zuily S, de Laat B, Mohamed S, Kelchtermans H, Shums Z, Albesa R, Norman GL, Lamboux-Matthieu C, Rat AC, Ninet J, Magy-Bertrand N, Pasquali JL, Lambert M, Lorcerie B, Kaminsky P, Guillemin F, Regnault V, Wahl D. Validity of the global anti-phospholipid syndrome score to predict thrombosis: a prospective multicentre cohort study. Rheumatology (Oxford) 2015; 54:2071-5. [PMID: 26163690 DOI: 10.1093/rheumatology/kev238] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [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: 01/19/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate the validity of the global APS score (GAPSS) to predict thrombosis in patients with autoimmune diseases. METHODS This prospective cohort study included consecutive patients with aPL or SLE. aPL, aPS-PT and GAPSS were determined. A Cox proportional hazards model assessed the validity of GAPSS and identified other potential independent predictors of thrombosis. RESULTS One hundred and thirty-seven patients [43.5 (s.d. 15.4) years old; 107 women] were followed up for a mean duration of 43.1 (s.d. 20.7) months. Mean GAPSS was significantly higher in patients who experienced a thrombotic event compared with those without [10.88 (s.d. 5.06) vs 8.15 (s.d. 5.31), respectively, P = 0.038]. In univariate analysis, age [hazard ratio (HR) = 1.04 (95% CI 1.01, 1.08)] and GAPSS above 16 [HR = 6.86 (95% CI 1.90, 24.77)] were each significantly associated with thrombosis during follow-up, while history of arterial thrombosis [HR = 2.61 (95% CI 0.87, 7.82)] failed to reach significance. Among aPL assays, IgG aPS/PT--a component of the GAPSS--was significantly associated with thrombosis [HR = 2.95 (95% CI 1.02, 8.51)]. In multivariate analysis, GAPSS above 16 remained the only significant predictor of thrombosis [HR = 6.17 (95% CI 1.70, 22.40)]. CONCLUSION This first external validation study confirmed that GAPSS can predict thrombosis in patients with aPL and associated autoimmune diseases.
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Affiliation(s)
- Stéphane Zuily
- CHU de Nancy, Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Vascular Medicine Division, Inserm, UMRS 1116, Nancy School of Medicine, Université de Lorraine, Nancy, France,
| | - Bas de Laat
- Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Clinical Chemistry and Haematology, University Medical Centre Utrecht, Synapse BV, Maastricht, Department of Plasma Proteins/Blood coagulation, Sanquin Research, Amsterdam, The Netherlands
| | - Shirine Mohamed
- Nancy School of Medicine, Université de Lorraine, Nancy, France, CHU de Nancy, Orphan Disease Unit, Nancy, France
| | - Hilde Kelchtermans
- Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht
| | - Zakera Shums
- Research and Development, Inova Diagnostics, San Diego, CA, USA
| | - Roger Albesa
- Research and Development, Inova Diagnostics, San Diego, CA, USA
| | - Gary L Norman
- Research and Development, Inova Diagnostics, San Diego, CA, USA
| | - Claire Lamboux-Matthieu
- CHU de Nancy, Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Vascular Medicine Division
| | - Anne-Christine Rat
- Université de Lorraine, Paris Descartes University, APEMAC, EA 4360, Inserm, CIC-EC 1433, CHU de Nancy, Clinical Epidemiology and Evaluation Department, CHU de Nancy, Rheumatology Department, Nancy
| | | | | | - Jean-Louis Pasquali
- CHU de Strasbourg, Internal Medicine and Clinical Immunology Department, Strasbourg, F-67000
| | - Marc Lambert
- CHRU de Lille, Department of Internal Medicine, Lille
| | - Bernard Lorcerie
- CHU de Dijon, Internal Medicine and Clinical Immunology Department, Dijon and
| | - Pierre Kaminsky
- Nancy School of Medicine, Université de Lorraine, Nancy, France, CHU de Nancy, Orphan Disease Unit, Nancy, France
| | - Francis Guillemin
- Université de Lorraine, Paris Descartes University, APEMAC, EA 4360, Inserm, CIC-EC 1433, CHU de Nancy, Clinical Epidemiology and Evaluation Department
| | | | - Denis Wahl
- CHU de Nancy, Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Vascular Medicine Division, Inserm, UMRS 1116, Nancy School of Medicine, Université de Lorraine, Nancy, France
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