RESUMO
Seropositivity of rheumatoid factor (RF) or anti-cyclic citrullinated peptide antibody (anti-CCP) is one domain of scoring system in new American College of Rheumatology/European League against Rheumatism classification criteria for rheumatoid arthritis (RA). We investigated usefulness of antiperinuclear factor (APF) and autoantibody to microtubule organizing center with microtubule (anti-MTOC-MT), which was detected by autoimmune target (AIT) test, as serological markers for the diagnosis of early RA. The test results of 3,503 patients from the outpatient clinic of The Hospital for Rheumatic Diseases who underwent test for RF, APF, anti-CCP and anti-MTOC-MT simultaneously for the work-up of RA were analyzed. Four kinds of tests showed same results only in 53.1% (1,861/3,503) of all subjects. The kappa coefficient between each test was distributed from -0.011 to 0.622. The agreement was best between RF and anti-CCP (kappa coefficient: 0.622), but the agreement was poor between anti-MTOC-MT and other 3 tests (kappa coefficient: 0.007 to -0.025). In both of RF- and anti-CCP-negative patients, the patients who showed positive result for APF were 4.6% (160/3,503) and for anti-MTOC-MT were 13.2% (464/3,503). RF and anti-CCP positivity could not include all of APF and anti-MTOC-MT positivity. Anti-MTOC-MT detected by AIT test was independent serological marker, and it might be also helpful for the diagnosis of early RA. Therefore, the combined detection of all four serologic markers can be useful for the evaluation of suspected RA patients.
Assuntos
Anticorpos Antinucleares/sangue , Artrite Reumatoide/diagnóstico , Autoanticorpos/sangue , Centro Organizador dos Microtúbulos/imunologia , Microtúbulos/imunologia , Artrite Reumatoide/imunologia , Biomarcadores/sangue , Humanos , Peptídeos Cíclicos/imunologiaRESUMO
We administered both the rapid antigen test and real-time reverse transcriptase polymerase chain reaction (RT-PCR) test to 2154 patients in order to assess the diagnostic value of the rapid antigen test during Korean pandemics of H1N1 2009. The overall sensitivity was 70.0%, specificity was 97.5%, positive predictive value was 97.4%, and negative predictive value was 71.2%. The sensitivity fell and the negative predictive value decreased as the RT-PCR positive rate increased.
Assuntos
Antígenos Virais/análise , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Influenza Humana/diagnóstico , Virologia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Imunoensaio/métodos , Lactente , Recém-Nascido , Vírus da Influenza A Subtipo H1N1/imunologia , Coreia (Geográfico) , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , RNA Viral/genética , RNA Viral/isolamento & purificação , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Sensibilidade e Especificidade , Adulto JovemRESUMO
A single embryonic stem cell (ESC) line can be repetitively cryopreserved, thawed, expanded, and differentiated into various cellular components serving as a potentially renewable and well-characterized stem cell source. Therefore, we determined whether ESCs could be used to reconstitute marrow and blood in major histocompatibility complex (MHC)-mismatched mice. To induce differentiation toward hematopoietic stem cells (HSCs) in vitro, ESCs were cultured in methylcellulose with stem cell factor, interleukin (IL)-3, and IL-6. ESC-derived, cytokine-induced HSCs (c-kit+/CD45+) were isolated by flow cytometry and injected either intra bone marrow or intravenously into lethally irradiated MHC-mismatched recipient mice. From 2 wk to 6 mo after injection, the peripheral blood demonstrated increasing ESC-derived mononuclear cells that included donor-derived T and B lymphocytes, monocytes, and granulocytes without clinical or histologic evidence of graft-versus-host disease (GVHD). Mixed lymphocyte culture assays demonstrated T cell tolerance to both recipient and donor but intact third party proliferative responses and interferon gamma production. ESCs might be used as a renewable alternate marrow donor source that reconstitutes hematopoiesis with intact immune responsiveness without GVHD despite crossing MHC barriers.
Assuntos
Transplante de Células-Tronco Hematopoéticas , Transplante de Células-Tronco , Células-Tronco Totipotentes , Animais , Diferenciação Celular/efeitos dos fármacos , Linhagem Celular , Quimera , Ensaio de Unidades Formadoras de Colônias , Citocinas/farmacologia , Feminino , Doença Enxerto-Hospedeiro/prevenção & controle , Hematopoese/efeitos dos fármacos , Tolerância Imunológica , Imunocompetência , Técnicas In Vitro , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Linfócitos T/citologia , Linfócitos T/imunologiaRESUMO
Embryonic stem cell (ESC)-derived hematopoietic stem cells (HSC), unlike HSC harvested from the blood or marrow, are not contaminated by lymphocytes. We therefore evaluated whether ESC-derived HSC could produce islet cell tolerance, a phenomenon termed graft versus autoimmunity (GVA), without causing the usual allogeneic hematopoietic stem cell transplant complication, graft-versus-host disease (GVHD). Herein, we demonstrate that ESC-derived HSC may be used to prevent autoimmune diabetes mellitus in NOD mice without GVHD or other adverse side effects. ESC were cultured in vitro to induce differentiation toward HSC, selected for c-kit expression, and injected either i.v. or intra-bone marrow (IBM) into sublethally irradiated NOD/LtJ mice. Nine of 10 mice from the IBM group and 5 of 8 from the i.v. group did not become hyperglycemic, in contrast to the control group, in which 8 of 9 mice developed end-stage diabetes. All mice with >5% donor chimerism remained free of diabetes and insulitis, which was confirmed by histology. Splenocytes from transplanted mice were unresponsive to glutamic acid decarboxylase isoform 65, a diabetic-specific autoantigen, but responded normally to third-party antigens. ESC-derived HSC can induce an islet cell tolerizing GVA effect without GVHD. This study represents the first instance, to our knowledge, of ESC-derived HSC cells treating disease in an animal model.
Assuntos
Diabetes Mellitus Tipo 1/prevenção & controle , Células-Tronco Embrionárias/transplante , Transplante de Células-Tronco Hematopoéticas , Animais , Autoimunidade , Linhagem Celular , Diabetes Mellitus Tipo 1/imunologia , Diabetes Mellitus Tipo 1/patologia , Células-Tronco Embrionárias/imunologia , Feminino , Tolerância Imunológica , Ilhotas Pancreáticas/imunologia , Ilhotas Pancreáticas/patologia , Teste de Cultura Mista de Linfócitos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos NOD , Quimera por Radiação/imunologia , Linfócitos T/imunologia , Transplante HomólogoAssuntos
Artrite Reumatoide/sangue , Artrite Reumatoide/imunologia , Autoanticorpos/sangue , Ferritinas/sangue , Peptídeos Cíclicos/imunologia , Especificidade de Anticorpos/imunologia , Artrite Reumatoide/diagnóstico , Autoanticorpos/análise , Biomarcadores/análise , Biomarcadores/sangue , Diagnóstico Diferencial , Ensaio de Imunoadsorção Enzimática/métodos , Ensaio de Imunoadsorção Enzimática/normas , Ferritinas/análise , Humanos , Valor Preditivo dos Testes , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: To find out whether serum level of anti-cyclic citrullinated peptides (anti-CCP) could be useful in the diagnosis of rheumatoid arthritis (RA). METHODS: The study was performed against 1972 patients who visited Hanyang University Medical Center and were tested positive for anti-CCP. RESULTS: When test results were classified into 6 groups according to the anti-CCP level, diagnostic rates of RA in each group were distributed from 73.6% to 77.2%. The increase of serum level did not have any correlation with the diagnostic rate of RA. CONCLUSIONS: The level of serum anti-CCP was not useful in the diagnosis of RA.
Assuntos
Artrite Reumatoide/diagnóstico , Peptídeos Cíclicos/imunologia , Humanos , Peptídeos Cíclicos/sangueRESUMO
BACKGROUND: Irradiated blood is used to prevent transfusion-associated graft-versus host disease in high risk patients. The guidelines for usage of irradiated blood components vary from one country to other according to their needs. But in Korea, little information is available on the current usage of and the guidelines for irradiated blood. Therefore, we analyzed the usage of irradiated blood components in Hanyang University Medical Center. METHODS: Medical records were reviewed for 187 patients who had been transfused with irradiated blood products during the period from January 2004 to June 2005. And we investigated the proportion of irradiated blood products among the total number of blood products that were transfused during a one-year period. RESULTS: Hematologic diseases and solid cancer patients comprised 63.7% and 24.6% respectively. The proportion of irradiated blood products among the total blood components were 25.7% of platelet concentrates, 61.4% of apheresis platelets, and 5.1% of packed red cells. Total transfused amount by disease categories and the average transfused units per patient of irradiated blood components were high in a group of patients with several hematologic diseases such as acute leukemia. CONCLUSIONS: The use of irradiated blood components takes a great proportion in total blood product transfusions and the majority of blood components were transfused to a group of patients with a few hematologic diseases. The proper use of blood should be guided by the promotion and education of a modified usage protocol for irradiated blood products and by a continuous data analysis.