Anti-tumor necrosis factor alpha treatment does not influence serum levels of the markers associated with radiographic progression in ankylosing spondylitis.

Objectives: The study aimed to determine the levels of change of the markers related to radiographic progression, such as Dickkopf-1 (DKK-1), sclerostin (SOST), bone morphogenetic protein (BMP)-2 and -4, and interleukin (IL)-17 and -23, in ankylosing spondyloarthritis (AS) during anti-tumor necrosis factor alpha (TNF-α) treatment. Patients and methods: Fifty-three anti-TNF-α naïve AS patients (34 males, 19 females; median: 38 years; range, 20 to 52 years) refractory to conventional treatments meeting the modified New York criteria or Assessment of SpondyloArthritis International Society classification criteria were enrolled to this cross-sectional, controlled study between October 2015 and January 2017. Fifty healthy volunteers (35 males, 15 females; median: 36 years; range, 18 to 55 years) with similar age and sex characteristics were recruited. Serum DKK-1, BMP-2, BMP-4, SOST, IL-17, and IL-23 levels were measured in both groups. The serum levels of the markers were measured again after about two years (mean follow-up duration of 21.7±6.4 months) in AS patients who started anti-TNF-α treatment. Demographic, clinical characteristics, and laboratory parameters were recorded. The disease activity at the time of inclusion was assessed through the Bath Ankylosing Spondylitis Disease Activity Index. Results: Serum DKK-1, SOST, IL-17, and IL-23 levels in the AS group before anti-TNF-a treatment were significantly higher compared to the control group (p<0.01 for DKK-1, p<0.001 for others). There was no difference regarding serum BMP-4 levels, whereas BMP-2 levels were significantly higher in the control group (p<0.01). Forty (75.47%) AS patients had serum marker levels measured after anti-TNF-α treatment. No significant change was observed in the serum levels of these 40 patients measured 21.7±6.4 months after the initiation of anti-TNF-α treatment (p>0.05 for all). Conclusion: In AS patients, there was no change in DKK-1/SOST, BMP, and IL-17/23 cascade with anti-TNF-α treatment. This finding may suggest that these pathways act independently of each other, and their local effects are not influenced by systemic inflammation.

The Relationship between Plasma Pentraxin 3 and Serum Amyloid P Levels and Disease Activity in Ankylosing Spondylitis.

Background: In clinical practice, it is hard to judge the level of disease activity in some patients with ankylosing spondylitis (AS) who have low traditional acute phase reactant values such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) but have considerable pain and inflammation. The aim of this study is to investigate plasma pentraxin 3 (PTX3) and serum amyloid P (SAP) levels in patients with AS who had normal ESR and CRP but high disease activity. Methods: 100 AS patients and 100 gender- and age-matched controls were included. Epidemiological, clinical, and treatment data and plasma levels of CRP, ESR, PTX3, and SAP were evaluated. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP were used for evaluating disease activity. Plasma levels of PTX3 and SAP were compared between AS patients and controls and also among AS patients with active and inactive disease. Results: AS patients had significantly higher plasma levels of PTX3 and SAP than controls. There were not any significant correlations between PTX3 and SAP with BASDAI, ASDAS-CRP, and ESR. There was a positive correlation between PTX3 and CRP. No significant difference in plasma levels of PTX3 and SAP was observed between patients with active disease and inactive disease, both with normal ESR and CRP levels. Disease duration and treatment did not influence plasma PTX3 levels. Conclusions: In patients with AS, plasma levels of PTX3 and SAP were found to be elevated when compared to healthy controls. No association was observed between these biomarkers and disease activity.

Are the specific and nonspecific ANA staining patterns of Behçet's Disease patients important?

BACKGROUND: The autoinflammatory character of Behçet's Disease has led researchers to investigate the role of autoantibodies. However, no significant positive result has been reported for autoantibody tests for the disease. AIMS: To investigate the specific and nonspecific staining patterns of Behçet's Disease (BD) patients. METHODS: 140 patients (87 females, 53 males) with an average of 41.9±3 years who were being followed up for Behçet's Disease, and a control group consisting of a total of 736 (464 females, 272 males) healthy volunteers made up of blood donors without any disease whose average age was 50.2±4 years were included in the study. Peripheral venous blood was collected from the patients and the sera were separated. Patient sera were studied by indirect immunofluorescence antibody test (IFA) at a dilution of 1/40 and 1/100. RESULTS: A total of 140 (87 females, 53 males) Behçet's Disease patients and 736 (464 females, 272 males) healthy controls were examined. The rate of ANA positivity was 11.6% in the control group and 10.7% in the Behçet's Disease group. In general, no difference was detected between the patients and the healthy controls in terms of autoantibody positivity (p>0.05). However, when examined in terms of patterns, the low detection of DFS70 and the observation of centriole staining type patterns in Behçet's Disease patients was noteworthy (p<0.05). CONCLUSION: Autoantibody tests, which hold an important place in classic autoimmune diseases, are not necessary for Behçet's patients, but they should be examined in terms of nonspecific patterns.

Are the specific and nonspecific ANA staining patterns of Behçet's Disease patients important? / ¿Son importantes los patrones de tinción ANA específicos y no específicos para los pacientes con enfermedad de Behçet?

Background: The autoinflammatory character of Behçet's Disease has led researchers to investigate the role of autoantibodies. However, no significant positive result has been reported for autoantibody tests for the disease. Aims: To investigate the specific and nonspecific staining patterns of Behçet's Disease (BD) patients. Methods: 140 patients (87 females, 53 males) with an average of 41.9±3 years who were being followed up for Behçet's Disease, and a control group consisting of a total of 736 (464 females, 272 males) healthy volunteers made up of blood donors without any disease whose average age was 50.2±4 years were included in the study. Peripheral venous blood was collected from the patients and the sera were separated. Patient sera were studied by indirect immunofluorescence antibody test (IFA) at a dilution of 1/40 and 1/100. Results: A total of 140 (87 females, 53 males) Behçet's Disease patients and 736 (464 females, 272 males) healthy controls were examined. The rate of ANA positivity was 11.6% in the control group and 10.7% in the Behçet's Disease group. In general, no difference was detected between the patients and the healthy controls in terms of autoantibody positivity (p>0.05). However, when examined in terms of patterns, the low detection of DFS70 and the observation of centriole staining type patterns in Behçet's Disease patients was noteworthy (p<0.05). Conclusion: Autoantibody tests, which hold an important place in classic autoimmune diseases, are not necessary for Behçet's patients, but they should be examined in terms of nonspecific patterns.(AU)

Antecedentes: El carácter autoinflamatorio de la enfermedad de Behçet (EB) ha llevado a los investigadores a estudiar el rol de los autoanticuerpos. Sin embargo, no se ha reportado un resultado positivo significativo para las pruebas de autoanticuerpos. Objetivo: Investigar los patrones de tinción específicos y no específicos de los pacientes con EB. Métodos: Se incluyó en el estudio a 140 pacientes (87 mujeres y 53 varones) con una edad media de 41,9±3 años con seguimiento por EB, y un grupo control que incluyó a un total de 736 voluntarios sanos (464 mujeres y 272 varones) integrados por donantes de sangre sin enfermedad alguna, con una edad media de 50,2±4 años. Se extrajo sangre de vena periférica a todos los pacientes, separándose el suero, que se estudió mediante el test de anticuerpos por inmunofluorescencia directa (IFA) a un factor de dilución de 1/40 y 1/100. Resultados: Se examinó a un total de 140 pacientes (87 mujeres y 53 varones) con EB y 736 controles sanos (464 mujeres y 272 varones). La tasa de positividad de ANA fue del 11,6% en el grupo control y del 10,7% en el grupo de EB. En general no se detectó diferencia entre los pacientes y los controles sanos en términos de positividad de autoanticuerpos (p>0,05). Sin embargo, al realizarse el examen en términos de patrones, fue destacable la baja detección de DFS70 y la observación de los patrones tipo tinción de centriolos en los pacientes con EB (p<0,05). Conclusión: Los test de autoanticuerpos, que ocupan una posición importante en las enfermedades autoinmunes clásicas, no son necesarios para los pacientes con EB, aunque deberían examinarse en términos de patrones no específicos.(AU)

Are the Specific and Nonspecific ANA Staining Patterns of Behçet's Disease Patients Important?

BACKGROUND: The autoinflammatory character of Behçet's Disease has led researchers to investigate the role of autoantibodies. However, no significant positive result has been reported for autoantibody tests for the disease. AIMS: To investigate the specific and nonspecific staining patterns of Behçet's Disease (BD) patients. METHODS: 140 patients (87 females, 53 males) with an average of 41.9±3 years who were being followed up for Behçet's Disease, and a control group consisting of a total of 736 (464 females, 272 males) healthy volunteers made up of blood donors without any disease whose average age was 50.2±4 years were included in the study. Peripheral venous blood was collected from the patients and the sera were separated. Patient sera were studied by indirect immunofluorescence antibody test (IFA) at a dilution of 1/40 and 1/100. RESULTS: A total of 140 (87 females, 53 males) Behçet's Disease patients and 736 (464 females, 272 males) healthy controls were examined. The rate of ANA positivity was 11.6% in the control group and 10.7% in the Behçet's Disease group. In general, no difference was detected between the patients and the healthy controls in terms of autoantibody positivity (p>0.05). However, when examined in terms of patterns, the low detection of DFS70 and the observation of centriole staining type patterns in Behçet's Disease patients was noteworthy (p<0.05). CONCLUSION: Autoantibody tests, which hold an important place in classic autoimmune diseases, are not necessary for Behçet's patients, but they should be examined in terms of nonspecific patterns.

Epilepsy and autoimmunity in pediatric patients.

Our aim was to determine the presence and possible role of autoantibodies in epileptic patients with an undetermined etiology. Eighty epilepsy patients, who were referred to the Pediatric Neurology Department at Ankara University between November 2011 and April 2012, were enrolled in the study. Antinuclear antibodies (ANA), anticardiolipin IgG, antiphospholipid, antithyroid peroxidase, paraneoplastic, glutamic acid decarboxylase (GAD), and N-methyl-d-aspartate (NMDA) receptor antibodies were studied in our university laboratory. In addition, NMDA receptor (NMDAR), voltage-gated potassium channel (VGKC)-complex, leucine-rich, glioma inactivated 1 (LGI1) and contactin-associated protein 2 (CASPR2) antibodies were studied at the Oxford University Immunology Laboratory. The study included 35 girls (44%) and 45 boys (56%) with a mean symptom age of 8.6 ± 4.53 years. ANA was detected in 15 (18.8%), antiphospholipid Ab in 3 (3.75%), anticardiolipin Ab in 1 (1.25%), and antithyroid peroxidase in 3 (3.75%) epileptic patients. In addition, anti-GAD Ab was detected in 7 (8.75%), anti-Yo Ab in 3 (3.75%), and anti-Ma2 in 3 (3.75%) epileptic patients. Anti-VGKC was positive in 13 (16.25%) epileptic patients. We performed a pioneer study to investigate the association between autoimmunity and pediatric epilepsy and we conclude that autoimmunity should be considered in epileptic patients with an undetermined etiology.

The association between precancerous gastric lesions and serum pepsinogens, serum gastrin, vascular endothelial growth factor, serum interleukin-1 Beta, serum toll-like receptor-4 levels and Helicobacter pylori Cag A status.

BACKGROUND AND OBJECTIVE: The aim of this study was to investigate the association between serum pepsinogens, serum gastrin, serum vascular endothelial growth factor, serum interleukin-1 Beta, serum toll-like receptor-4 levels and Helicobacter pylori Cag A status in patients with various gastric precancerous lesions. METHODS: One hundred and sixty two consecutive patients with various gastric lesions [38 (23.5%) H. pylori positive chronic non-atrophic gastritis, 45 (27.8%) autoimmune gastritis, 42 intestinal metaplasia and 37 dysplasia] were enrolled into the study. Serum pepsinogen I and II, gastrin 17, vascular endothelial growth factor, interleukin-1 Beta, toll-like receptor-4 levels, H. pylori Cag A status were evaluated. RESULTS: H. pylori was positive in 98 (60.5%) patients and 38 of these patients were Cag A positive. Serum pepsinogen level was significantly lower in patients with autoimmune atrophic gastritis compared to the patients with non-atrophic chronic gastritis (p<0.001), intestinal metaplasia (P<0.001) and dysplasia (P=0.002). Mean serum gastrin was 1209.6±268.48 pg/mL in patients with autoimmune atrophic gastritis and 234.95±184.018 pg/mL in patients with chronic non-atrophic gastritis. Mean toll-like receptor-4 level was 0.56±0.098 ng/mL in patient with dysplasia, and this value was higher compared to patients with chronic non-atrophic gastritis (P=0.007), autoimmune atrophic gastritis (P=0.003) and intestinal metaplasia (P=0.006). Interleukin-1 Beta level was significantly lower in patients with dysplasia compared to patients with chronic non-atrophic gastritis (P=0.034). CONCLUSIONS: Serum pepsinogens, serum gastrin and H. pylori Cag A status are important tests in detecting gastric precancerous lesions. However, toll-like receptor-4 may be a sensitive test to differentiate the patients with dysplasia from the other precancerous gastric lesions. Non-invasive tests are sensitive in the diagnosis of gastric precancerous lesions.

Diagnostic and prognostic role of serum glypican 3 in patients with hepatocellular carcinoma.

α-Feto protein (AFP) is the widely used tumor marker in the diagnosis of hepatocellular carcinoma (HCC). The aim of this study was to assess the diagnostic and prognostic validity of a novel marker, serum Glypican-3 (GPC3) and to compare AFP in patients with HCC. One hundred and twenty-eight patients (75 patients with HCC, 55 patients with cirrhosis, and 28 healthy controls) were included in this study. Cut-off value of GPC3 was 3.9 pg/ml. AFP was divided into four subgroups, according to cut-off values with 13, 20, 100, and 200 ng/ml. Sensitivity, specificity, and positive and negative predictive values of GPC3 and AFP13, AFP20, AFP100, AFP200 subgroups and also GPC3+AFP13, GPC3+AFP20 , GPC3+AFP100 , GPC3+AFP200 combinations were compared. Serum GPC3 levels were significantly higher in patients with HCC and cirrhosis compared with control subjects (P<0.05). The median serum GPC3 levels were 3.9 pg/ml in controls, 5.51 pg/ml in patients with cirrhosis, and 5.13 pg/ml in those with HCC. The median serum AFP levels were 1.37 ng/ml in controls, 2.32 ng/ml in cirrhotics, and 50.65 ng/ml in HCC patients. The sensitivity, specificity, and positive and negative predictive values of GPC3 was 61.33, 41.82, 58.97, and 44.43%, respectively. The values for AFP were 68.57, 94.55, 94.12, and 70.27%, respectively. There was no correlation between GPC3 levels and prognostic parameters. GPC3 is not a useful diagnostic and prognostic marker for HCC.

Diagnostic and prognostic validity of Golgi protein 73 in hepatocellular carcinoma.

BACKGROUND: Golgi protein 73 (GP73) expressions have been detected in hepatocellular carcinoma (HCC) and bile duct carcinoma. AIM: Our purpose was to determine the serum levels of GP73 in patients with HCC and to compare them with α-fetoprotein (AFP) levels. MATERIALS AND METHODS: Seventy-five patients with HCC, 55 patients with cirrhosis and 28 healthy controls were included. RESULTS: The median serum GP73 levels were 0.27 ng/ml (range = 0.078-4.95) in controls, 0.32 ng/ml (range = 0.078-39.63) in cirrhotics and 0.21 ng/ml (range = 0.053-4.98) in those with HCC. The median serum AFP levels were 1.37 ng/ml (range = 0.61-6.89) in controls, 2.32 ng/ml (range = 0.61-85.24) in cirrhotics and 50.65 ng/ml (range = 0.8-37,642) in HCC patients (p < 0.0001 for HCC vs. controls and cirrhotics). The sensitivity, specificity, and positive and negative predictive values of GP73 were 82, 9, 55 and 27%, respectively. Whereas the levels were 68, 94, 94 and 70%, respectively, for AFP(13) and 60, 98, 97 and 64% for AFP(20), respectively. There was no correlation between GP73 levels and other prognostic parameters including tumor size, tumor type, Child-Pugh classification, TNM staging, Cancer of the Liver Italian Program score, portal vein thrombosis and extrahepatic metastasis. CONCLUSIONS: GP73 has a lower diagnostic and prognostic value for HCC. AFP is superior to GP73 for diagnosis of early HCC.

Genetic aspect of venom allergy: association with HLA class I and class II antigens.

Stings from bees and wasps can cause systemic allergic reactions in sensitized patients. However, the mystery of why some cases develop allergic reactions while others do not, remains poorly understood. We investigated whether particular human leukocyte antigen (HLA) class I and class II genes contribute to the development of venom allergy. A total of 21 bee and/or wasp venom sensitive patients who had life-threatening allergic symptoms after a sting, and positive diagnostic tests (Group 1), were included in the study. Thiry-seven healthy subjects without venom allergy (Group 2) were selected as the control group. HLA -class I (A-C) and class II (DR, DQ, DP ) typing was performed by PCR-based techniques. HLA -B*18 and HLA -Cw*07 alleles was found more frequently in Group1 than in Group 2 (14.3 percent vs 2.7 percent, p=0.026, and 31 percent vs 14.9 percent, p=0.036, respectively). Furthermore, HLA -A*01 allele frequency had a trend to be higher in Group 1 than in Group 2 (14.3 percent vs 4.1 percent, p=0.055). However, the frequencies of HLA -A*03 and HLA -Cw*03 alleles were increased in Group 2 compared to Group 1 (20.3 percent vs 7.1 percent, p=0.049 and 10.8 percent vs 0 percent, p=0.024, respectively). Among HLA -class II genotypes, HLA -DQB1*03 allele was significantly increased in Group 2 (60.9 percent vs 38.1 percent, p=0.018), while a higher frequency of HLA -DR B1*03 and HLA -DR B1*14 alleles showed a tendency statistically significant in Group 1 (9.5 percent vs 1.4 percent, p=0.057 and 11.9 percent vs 2.7 percent, p=0.058, respectively). HLA -B*18 and HLA -Cw*07 alleles may probably be associated with susceptibility to venom allergy, whereas HLA -A*03, HLA -Cw*03 and HLA -DQB1*03 seem to be protective markers in a small Turkish population.

Diagnostic accuracy of cytokine levels (TNF-alpha, IL-2 and IFN-gamma) in bronchoalveolar lavage fluid of smear-negative pulmonary tuberculosis patients.

BACKGROUND: The determination of cytokine concentrations in serum and bronchoalveolar lavage fluid (BALF) may contribute to the diagnosis of tuberculosis (TB) since cytokines have been ascribed an important role in TB pathogenesis. OBJECTIVE: To assess the diagnostic accuracy of TNF-alpha, IFN-gamma and IL-2 levels in serum and BALF of smear-negative pulmonary TB patients. METHOD: BALF was obtained from the affected lobe in patients with smear-negative TB or other pulmonary diseases (OPD), and from the right middle lobe in healthy controls. ELISA and a nephelometric method were used to detect cytokine and albumin levels. RESULTS: TNF-alpha levels in BALF were significantly elevated in the TB group (n = 15) compared with the OPD patients (n = 40) and controls (n = 17; p < 0.001). Although these three cytokines correlated well with each other in BALF (p < 0.0001, and r >or= 0.7, respectively), BALF IL-2 and IFN-gamma levels were not significantly different among the groups (p > 0.05). BALF TNF-alpha or IFN-gamma levels were significantly higher in patients with cavitary disease (n = 11) versus those without (n = 61; p < 0.05). However, no significant difference was found between cavitary (n = 7) and non-cavitary TB in cytokine levels (p > 0.05). Neither gender nor smoking status showed any statistical differences in cytokines in the groups (p > 0.05). Sensitivity and specificity of BALF TNF-alpha were found to be 73 and 76%, respectively. The positive and negative predictive values for BALF TNF-alpha were 44 and 91%, respectively. CONCLUSION: In cases of smear-negative TB, BALF TNF-alpha can be a useful tool to identify healthy subjects rather than smear-negative TB patients.

HLA types in Turkish children with celiac disease.

The aim of this study was to assess the distribution of human leukocyte antigen (HLA) groups in Turkish children with celiac disease (CD) and to investigate the association of HLA types and clinical manifestations of CD. Seventy-five children with CD were evaluated in two groups: Group I consisted of 45 classical celiac patients (15 males, 6.7+/-3.8 years); Group II consisted of 30 atypical celiac patients (9 males, 9.3+/-4.3 years). The control group consisted of 100 healthy renal transplantation donors. HLA typing was made serologically using standard lymphocytotoxicity techniques. HLA A29, B51, CW5, DR14, DR16, and DQ1 were the most common antigens in the control group. Frequency of HLA B13, CW7, B8, DR7, DR17 and DQ2 was higher in CD patients than in the control group (p<0.005, <0.05, <0.001, <0.001 and <0.001, respectively). The relative risks for HLA DQ2, B8, DR17 and B13 were 14.9, 13.6, 7.1 and 3.6, respectively. Frequency of HLA B35, DR11 and DQ7 was higher in classical CD than atypical CD, while a positive association was found between HLA B8 and atypical CD. A positive association was found between HLA B13, CW7 and DR17 in Turkish celiac patients in addition to HLA B8, DR7 and DQ2. This study also suggested that a correlation may exist between genotype and clinical manifestations.

Antinucleosome antibodies and systemic lupus erythematosus.

The aim of this study is to investigate the prevalence of antinucleosome antibody in systemic lupus erythematosus (SLE) and their association with disease activity and renal involvement. The study included 131 patients with SLE, 74 rheumatoid arthritis, 26 systemic sclerosis, and 50 healthy individuals. Antinucleosome antibody and anti-dsDNA antibody were measured by an enzyme-linked immunosorbent assay (ELISA). Antinuclear antibody was tested by immunofluorescence using HEp-2 cells. Out of 131 SLE patients, 72 (54.9%) were seropositive for antinucleosome antibody, which was significantly higher than only 3 of 74 (4%) patients with rheumatoid arthritis (chi(2) = 52.82, P < 0.001); none of the patients with systemic sclerosis and 50 healthy individuals were seropositive. The sensitivity and specificity of antinucleosome antibodies in SLE were 83.6% and 70%, respectively. Fifty-one (38.9%) of SLE patients had renal involvement. Among these patients, the rate of antinucleosome positivity and anti-dsDNA were 74.5% and 78.4%, respectively. Antinucleosome antibodies were found to be 31.4% positive in SLE patients lacking anti-dsDNA antibody. Antinucleosome antibodies significantly correlated with disease activity (r = 0.428, P < 0.001) and anti-dsDNA (r = 0518, P < 0.001). The positivity of antinucleosome antibodies was significantly higher in patients with renal disease than the subjects without renal disease (chi(2) = 12.89, P < 0.001). The results of our study have revealed that in SLE patients, antinucleosome antibody could be a useful parameter for the assessment of disease activity or renal involvement.

The significance of serum transforming growth factor beta 1 in detecting of gastric and colon cancers.

BACKGROUND/AIMS: TGF-beta1 is a growth factor with wide ranging effects on proliferation, differentiation, immune suppression, apoptosis and matrix remodeling. We aimed to clarify the clinical significance of circulating levels of TGF-beta1 as a tumor marker in gastrointestinal tract cancers by comparing it to CEA across a range of parameters such as cancer type and severity. METHODOLOGY: Sera collected from patients with gastrointestinal tract cancers (32 gastric, 36 colon) and from 25 healthy volunteers were analyzed for TGF-beta1 and CEA. Relations between serum TGF-beta1 levels and tumor stage and tumor grade were also evaluated. RESULTS: Mean serum TGF-beta1 levels were higher in patients with gastric or colon cancer compared to the control group (p = 0.001). In both types of cancer there were no differences in TGF-beta1 levels associated with serosal involvement, lymph node involvement, vascular invasion, distant metastasis or tumor size. Mean serum TGF-beta1 levels were also not statistically different across histopathological tumor grades in either type of cancer. The sensitivity of TGF-beta1 was higher in patients with gastric cancer than in patients with colon cancer. TGF-beta1 had greater sensitivity than CEA in gastric cancer patients. CONCLUSIONS: TGF-beta1 has higher sensitivity in gastric and colon cancers. Since it may be increased even in cancer without closed and distant metastasis, TGF-beta1 may be used as a tumor marker and combined with CEA particularly in gastric cancers.

Antibodies to beta2-glycoprotein-I: relation of anticardiolipin antibodies with clinical and laboratory parameters in patients with systemic lupus erythematosus.

OBJECTIVES: There are controversial reports on the frequency of antiphospholipid antibodies (aPL) in patients with systemic lupus erythematosus (SLE). Thus, we aimed to determine the frequency and clinical importance of aPL isotypes in Turkish patients with SLE. DESIGN AND METHODS: Fifty-nine patients with SLE and 41 healthy controls were included. Serum aPL levels were measured both in patients and healthy subjects by ELISA. RESULTS: Fifteen of the patients with SLE had the antiphospholipid syndrome (APS) (25.4%). The percentage of anticardiolipin antibody (aCL)-positive SLE patients among all patients was 56%. At least one isotype of anti-beta(2)-glycoprotein I (beta(2)-GPI) antibody was positive in 83% of patients. The positivity rates of aCL and anti-beta(2)-GPI antibodies in patients with or without APS were higher than the healthy controls. There were positive correlations between isotypes of IgM aCL, IgG and IgM anti-beta(2)-GPI and manifestations of APS. CONCLUSION: It seems that the isotypes of IgM aCL, IgG and IgM anti-beta(2)-GPI are correlated with manifestations of APS. They may play a role in pathogenesis and may be helpful in establishing the diagnosis.

Serum-soluble selectin levels in patients with Behçet's disease.

Soluble forms of selectins may play a regulatory role in inflammatory responses. The aim of this study was to examine the levels of serum-soluble (s) selectins in Behçet's disease (BD) patients and to evaluate the associations of these molecules to disease activity, clinical findings, and drugs taken for BD, mainly colchicine. Serum sE-, sL-, and sP-selectins levels were measured by sandwich enzyme-linked immunosorbent assay in 28 BD patients and 22 healthy subjects. The BD patients were classified according to the disease activity, clinical findings, and therapy. Ten patients were newly diagnosed and were not taking any therapy. Remainder were on colchicine (n = 18) and immunosuppressive drugs (n = 5). In BD patients, the levels of sL- and sP-selectins were significantly lower than those of healthy controls, but sE-selectin level was similar to that of the controls. The patients on the therapy had significantly lower levels of sE- and sL-selectins and insignificantly lower level of sP-selectin than the patients not receiving therapy. The BD patients with active disease had significantly higher levels of sE-, sL-, and sP-selectins compared with the patients with inactive disease. There were no significant differences in the levels of selectins between the treated active patients and inactive patients. However, the untreated patients with active disease had significantly higher selectin levels than the inactive patients. There were no significant differences in all selectin levels between the patients with or without vascular involvement. Serum sL-selectin was found to be significantly higher in patients with erythema nodosum. In conclusion, our findings suggest that the levels of soluble selectin molecules in BD patients seem to be modified by the drugs taken for BD. The colchicine therapy is associated with lower selectin levels.