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1.
Rev Alerg Mex ; 69 Suppl 1: s69-s80, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-34998312

RESUMO

Chronic spontaneous urticaria is a condition that persists for more than six weeks, it occurs in the absence of an identifiable triggering factor and from the pathogenic activation of mast cells and basophils. The possibility of autoimmune etiology in up to 40 % of patients is presented, followed by subclinical infections and psychological factors. Two main mechanisms of the pathogenesis of chronic urticaria have been proposed: the former is the dysregulation of intracellular signaling pathways within mast cells and basophils, which leads to defects in the traffic or function of these cells. The latter is the development of autoantibodies against FcεRIα or IgE, in both mast cells and basophils. Numerous autoimmune diseases such as systemic lupus erythematosus, polymyositis, dermatomyositis, and rheumatoid arthritis have been associated with chronic urticaria; however, autoimmune thyroid disease deserves a special mention. A higher prevalence of antithyroid antibodies has been found, regardless of thyroid function (euthyroidism, hypo and hyperthyroidism) in patients with chronic spontaneous urticaria. Several infections have been linked to chronic urticaria. The best evidence is for Helicobacter pylori infection. Finally, stress is associated with the onset of the disease through the activation of the sympathetic and adrenomedullary system and the hypothalamic-pituitary- adrenal axis. Diagnosis may vary in different regions of the world, but the common feature is the completion of a thorough medical history.


La urticaria crónica espontánea es una afección que persiste durante más de seis semanas y ocurre en ausencia de un factor desencadenante identificable y resulta de la activación patógena de células cebadas y basófilos. Se plantea la posible etiología autoinmune hasta en 40 % de los pacientes, seguida de infecciones subclínicas y factores psicológicos. Se han propuesto dos mecanismos principales de la patogénesis de la urticaria crónica: la desregulación de las vías de señalización intracelular dentro de las células cebadas y basófilos que conduce a defectos en el tráfico o la función de estas células, así como el desarrollo de autoanticuerpos contra FcεRIα o IgE, tanto en células cebadas como en basófilos. Numerosas enfermedades autoinmunes como lupus eritematoso sistémico, polimiositis, dermatomiositis y artritis reumatoide se han asociado a urticaria crónica; sin embargo, la enfermedad tiroidea autoinmune merece una mención especial. Se ha encontrado una mayor prevalencia de anticuerpos antitiroideos, independientemente de la función tiroidea (eutiroidismo, hipo e hipertiroidismo), en pacientes con urticaria crónica espontánea. Varias infecciones se han relacionado a urticaria crónica. Existe la mejor evidencia de infección por Helicobacter pylori. Por último, el estrés está asociado al inicio de la enfermedad mediante la activación del sistema simpático y adrenomedular y el eje hipotálamo hipófisis suprarrenal. El diagnóstico puede variar en las diferentes regiones del mundo, pero el rasgo común es la realización de una historia clínica completa.


Assuntos
Doenças Autoimunes , Urticária Crônica , Infecções por Helicobacter , Helicobacter pylori , Urticária , Autoanticorpos , Doenças Autoimunes/epidemiologia , Autoimunidade , Doença Crônica , Humanos , Imunoglobulina E , Receptores de IgE , Urticária/epidemiologia , Urticária/etiologia
2.
Clin Lab ; 68(1)2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35023669

RESUMO

BACKGROUND: Identification of validated peripheral biomarkers for Alzheimer's Disease, leading to an early diagnosis of the disease, would be valuable for predicting progression and targeted therapeutics. In this regard, serum levels of GADA, ZnT8A, Zn, vitamin D, and leukocyte expression of brain-derived neurotrophic factor (BDNF) gene were investigated in Alzheimer's patients and control group. METHODS: Serum levels of GADA, ZnT8A, Zn, and vitamin D and leukocyte expression of the BDNF gene were evaluated in 40 AD patients and 40 control cases. The diagnostic value of investigated factors was examined with the receiver operating characteristic (ROC). RESULTS: The results showed significant differences of p < 0.0001, p < 0.0001, and p = 0.0006 between AD patients and control individuals in GADA, Zn, and ZnT8A serum levels, respectively. No significant difference was observed in the serum concentration of vitamin D between AD patients and control cases (p = 0.2993). The expression level of the BDNF gene in AD patients was different from control cases, but it was not statistically significant (p > 0.05). Moreover, ROC curve analysis disclosed a diagnostic potency for serum levels of GADA, Zn, and ZnT8A for AD with an area under the ROC curve of > 0.7 (p < 0.0001, p < 0.0001, and p = 0.0007, respectively). CONCLUSIONS: The results demonstrated the higher serum levels of GADA and ZnT8A and lower serum concentrations of Zn in the patient group. Therefore, these parameters can be discussed as possibly diagnostic in AD cases.


Assuntos
Doença de Alzheimer , Diabetes Mellitus Tipo 1 , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/genética , Autoanticorpos , Biomarcadores , Glutamato Descarboxilase , Humanos , Transportador 8 de Zinco
3.
BMJ Case Rep ; 15(1)2022 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-35027384

RESUMO

Type 1 diabetes is typically a disease of young but can present at any age. We present a case of a 93-year-old woman who presented with 10 days history of feeling lethargic, polydipsia and decreased appetite. Her capillary blood glucose was raised at 25 mmol/L with significant ketonaemia and venous blood gas showing metabolic acidosis. She had a background of primary hypothyroidism and vitamin B12 deficiency with weakly positive parietal cell antibodies. Laboratory investigations confirmed diabetes with HbA1c of 117 mmol/mol (12.9%). In view of high clinical suspicion of type 1 diabetes, her diabetes autoantibodies were checked which showed strongly positive anti-GAD antibody with titre of >2000 IU/mL (range<10) confirming our diagnosis. She was treated with diabetic ketoacidosis protocol with intravenous fluids and intravenous insulin. On recovery, she was discharged home on once daily insulin with aim to self-manage diabetes with support from district nurses and to avoid hypoglycaemia.


Assuntos
Diabetes Mellitus Tipo 1 , Cetoacidose Diabética , Hipoglicemia , Idoso de 80 Anos ou mais , Autoanticorpos , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/tratamento farmacológico , Cetoacidose Diabética/diagnóstico , Cetoacidose Diabética/tratamento farmacológico , Feminino , Humanos , Insulina
4.
BMJ Case Rep ; 15(1)2022 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-35027392

RESUMO

An 81-year-old woman presented with neck weakness, dysarthria, dysphasia and left-sided ptosis. Myasthenia gravis (MG) was strongly suspected. Voltage gated calcium channel (VGCC) antibodies, associated with Lambert-Eaton myasthenic syndrome (LEMS), were negative. Acetylcholine receptor (AChR) antibody level was 536 nmol/L and diagnosis of MG was confirmed. Imaging revealed a pelvic mass and subsequent biopsy confirmed a pelvic follicular lymphoma. Our searches revealed this to be the first documented case of MG associated with a pelvic follicular lymphoma. She underwent radiotherapy to treat the lymphoma and received both pyridostigmine and immunosuppression to treat the MG. Her AChR antibody level decreased to 38 nmol/L and her MG symptoms resolved aside from head drop which is continuing to improve. Her lymphoma is now in remission. We have presented a case with a successful outcome, which highlights the importance of screening for lymphoma and thymoma in new presentations of MG.


Assuntos
Síndrome Miastênica de Lambert-Eaton , Linfoma Folicular , Miastenia Gravis , Neoplasias do Timo , Idoso de 80 Anos ou mais , Autoanticorpos , Feminino , Humanos , Linfoma Folicular/complicações , Linfoma Folicular/diagnóstico , Miastenia Gravis/complicações , Miastenia Gravis/diagnóstico
5.
J Med Case Rep ; 16(1): 3, 2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-34980241

RESUMO

CONTEXT: Dermatomyositis is a rare autoimmune disease characterized by noninfectious inflammatory damage of skin and predominant muscles in the belts. It is believed to be associated with about 1 in 1000 cases of nasopharyngeal carcinoma. This association has been described for locally advanced stages II and III nasopharyngeal carcinoma. It has rarely been described in the early stages (stage I). CASE PRESENTATION: A 65-year-old Moroccan patient residing in Casablanca, with no particular history was referred to the Mohamed VI Center for the treatment of cancers of the University Hospital Center IBN ROCHD in Casablanca, for treatment of nasopharyngeal cancer. He was admitted in poor general condition, performance status 3, with erythema on the face, neck, and extremities. The diagnosis of paraneoplastic dermatomyositis was made owing to progressive muscle weakness and elevation of muscle enzymes associated with the typical rash of the face and hands. He received corticosteroid therapy and then radiotherapy to the nasopharynx with good clinical outcome, disappearance of skin lesions, and recovery of muscle strength. CONCLUSIONS: We report this case of dermatomyositis in early-stage nasopharyngeal carcinoma, which is a rarely described entity. Rapid treatment of dermatomyositis improved the patient's quality of life and enabled him to support specific cancer treatments. This can be used as an element of early diagnosis and monitoring after treatment.


Assuntos
Dermatomiosite , Neoplasias Nasofaríngeas , Síndromes Paraneoplásicas , Idoso , Autoanticorpos , Dermatomiosite/diagnóstico , Humanos , Masculino , Carcinoma Nasofaríngeo , Neoplasias Nasofaríngeas/complicações , Neoplasias Nasofaríngeas/diagnóstico , Síndromes Paraneoplásicas/diagnóstico , Síndromes Paraneoplásicas/etiologia , Qualidade de Vida
6.
Saudi Med J ; 43(1): 45-52, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35022283

RESUMO

OBJECTIVES: To investigate the possible effects of wet-cupping therapy (hijama) on autoimmune activity and thyroid hormonal profiles of Hashimoto's disease (HD) patients. METHODS: A prospective pilot controlled trial was carried out among adult females following HD at the Endocrinology Clinic of King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from February 2014 until March 2017. A total of 13 patients (intervention group) underwent 3 hijama sessions at 3-week interval with a 6-month follow-up. Blood tests were carried out for both pre- and post-hijama, including: thyroid peroxidase antibody (TPO), thyroglobulin antibody (TG), thyroid stimulating hormone (TSH), thyroxine-4 (T4), and prolactin. Control group included 13 randomly selected HD patients following usual care with 2 consecutive measurements of TPO and TG at 2-3 months interval. RESULTS: Changes in anti-TPO and anti-TG showed a decrease in hijama group versus an increase in control group, and intervention group comparison was statistically significant. On a fixed thyroxine supplement for each patient, significant decrease in levels of anti-TPO, anti-TG, TSH, prolactin, and erythrocyte sedi-mentation rate (ESR) occurred. CONCLUSION: These findings are presumptive to the efficacy of hijama on the pathogenesis of HD in modulating the immune inflammatory process demonstrated by the reduction in ESR, TPO, and TSH levels on a fixed thyroxin supplementation dose, along with patient-reported clinical improvement and positive changes in ultrasound including regaining of gland physiological size, echogenicity, and vascularity.


Assuntos
Ventosaterapia , Doença de Hashimoto , Adulto , Autoanticorpos , Feminino , Doença de Hashimoto/tratamento farmacológico , Humanos , Estudos Prospectivos , Tiroxina
7.
BMC Musculoskelet Disord ; 23(1): 46, 2022 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-35027028

RESUMO

OBJECTIVE: Rheumatoid arthritis (RA) is often complicated with chronic lung diseases (CLD), including interstitial lung disease (ILD) and airway disease, which occur as extra-articular manifestations. CLD in RA have been associated with the production of rheumatoid factor (RF), anti-citrullinated peptide antibody (ACPA), or anti-carbamylated protein (CarP) antibody. However, few validation studies have been performed thus far. In the present study, we investigated the association of RF, ACPA, and anti-CarP antibodies with RA complicated with CLD. METHODS: Sera from RA patients with or without CLD were collected. The levels of serum RF, RF immunoglobulin A (IgA), ACPA IgG, ACPA IgA, and ACPA secretory component (SC) were measured using enzyme-linked immunosorbent assay. RESULTS: The comparison of RA patients with and without CLD showed that RF IgA was associated with ILD (mean ± standard deviation: 206.6 ± 400.5 vs. 95.0 ± 523.1 U/ml, respectively, P = 1.13 × 10- 8), particularly usual interstitial pneumonia (UIP) (263.5 ± 502.0 U/ml, P = 1.00 × 10- 7). ACPA SC was associated with RA complicated with ILD (mean ± standard deviation: 8.6 ± 25.1 vs. 2.3 ± 3.4 U/ml, respectively, P = 0.0003), particularly nonspecific interstitial pneumonia (NSIP) (10.7 ± 31.5 U/ml, P = 0.0017). Anti-CarP antibodies were associated with RA complicated with ILD (0.042 ± 0.285 vs. 0.003 ± 0.011 U/ml, respectively, P = 1.04X10- 11). CONCLUSION: RF IgA and ACPA SC in RA were associated with UIP and NSIP, respectively, suggesting different specificities in patients with RA. Anti-CarP antibodies were associated with ILD in RA. These results may help elucidate the different pathogeneses of UIP and NSIP in RA.


Assuntos
Artrite Reumatoide , Doenças Pulmonares Intersticiais , Anticorpos Anti-Proteína Citrulinada , Artrite Reumatoide/diagnóstico , Autoanticorpos , Humanos , Doenças Pulmonares Intersticiais/diagnóstico , Fator Reumatoide , Componente Secretório
8.
Zhonghua Er Ke Za Zhi ; 60(1): 46-50, 2022 Jan 02.
Artigo em Chinês | MEDLINE | ID: mdl-34986623

RESUMO

Objective: To analyze the clinical characteristics, treatment and prognosis of Hashimoto's encephalopathy presenting with isolated cerebellar ataxia in children. Methods: A retrospective analysis was performed on the clinical features, laboratory tests, neuroelectrophysiological examination, imaging, treatment and outcomes of 13 patients with Hashimoto's encephalopathy presenting with isolated cerebellar ataxia, who were admitted to the Department of Pediatric Neurology of Guangzhou Women and Children's Medical Center from January 2016 to May 2021. Results: Among the 13 cases, 6 were males and 7 were females. The onset age was 2.6 (2.0,3.3) years, 9 children had precursor infection or vaccination before the first course of disease. All the 13 children had gait abnormalities or unsteady sitting, 10 had intentional tremor, 6 had dysarthria, 3 had body tremor, 2 had nystagmus, 3 had fatigue, 3 had hypotonia, 2 had vomiting and 1 had irritability. Thyroglobulin antibody (TgAb) was 500.0 (298.9,587.2) kU/L and thyroid peroxidase antibody (TPOAb) was 621.9 (449.6,869.4) kU/L in 13 cases. Autoantibodies were positive in 9 cases, and cerebrospinal fluid leukocytosis was seen in 4 cases. Regarding electroencephalography result, 4 cases had background slowing and 1 case had occasional sharp waves. Among the 3 patients who had relapses, 1 had cerebellar atrophy shown on cranial magnetic resonance imaging (MRI) during the recurrence. All the patients received intravenous immunoglobulin (IVIG) and intensive methylprednisolone therapy during the first onset, followed by the disappearance of the symptoms, 1 patient had repeated episodes which was decreased after immunosuppressive treatment with Rituximab.Followed up for 25.0 (22.5,33.3) months after the last episode, 12 achieved complete remission and 1 had a wide base gait. Conclusions: Trunk ataxia is the common symptom of Hashimoto's encephalopathy presenting with isolated cerebellar ataxia in children.Children with cerebellar ataxia should be tested for TgAb and TPOAb to detect Hashimoto's encephalopathy, avoiding missed diagnosis and treatment delays; IVIG and intensive steroid therapy is effective, and immunosuppressive therapy for patients with multiple relapses could reduce the recurrence.


Assuntos
Ataxia Cerebelar , Encefalite , Doença de Hashimoto , Autoanticorpos , Criança , Feminino , Humanos , Masculino , Estudos Retrospectivos
9.
Neurosciences (Riyadh) ; 27(1): 16-23, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35017286

RESUMO

OBJECTIVES: To report demographic and clinical data on 98 myasthenia gravis (MG) patients, seen over 5 years (January 2014-December 2018). METHODS: This was a retrospective, observational cohort study carried out at 3 hospitals in Bahrain. MG was classified into ocular or generalized types. We subdivided MG into early-onset (EOMG, ≤ 49 years) or late-onset (LOMG, > 49 years). Demographic and clinical data were recorded. The data was entered and analyzed using SPSS version 26.0. RESULTS: 61.2% were females. The mean age at onset was 43.8±17.7 years in males and 43.1±15.7 years in females. 72.4% had EOMG. A pure ocular presentation was most common (51%). Limb weakness was more prevalent in AChR-positive patients. The MuSK group had more severe presentation. 57.1% of patients were AChR-positive, 3.1% MuSK-positive, and 39.8% double-seronegative. Generalized disease onset was more likely with AChR. Abnormal CT chest was seen in 24/69 (35%) including thymic hyperplasia, thymoma, and thymic atrophy. Pathology findings were thymic hyperplasia (55.0%), thymoma (30%), thymolipoma (10%), and normal thymus (5%). Treatment outcomes were favorable. CONCLUSION: The present study revealed that MG was more common in females, with similar age at onset between males and females. The majority of patients had EOMG with ocular disease and AChR positivity. The clinical outcomes were favorable. Following a standardized protocol for MG diagnosis and workup is recommended.


Assuntos
Miastenia Gravis , Neoplasias do Timo , Idade de Início , Autoanticorpos , Barein/epidemiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Miastenia Gravis/diagnóstico , Miastenia Gravis/epidemiologia
10.
J Med Virol ; 94(1): 54-62, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34427929

RESUMO

Coronavirus disease 2019 (COVID-19) is still propagating a year after the start of the pandemic. Besides the complications patients face during the COVID-19 disease period, there is an accumulating body of evidence concerning the late-onset complications of COVID-19, of which autoimmune manifestations have attracted remarkable attention from the first months of the pandemic. Autoimmune hemolytic anemia, immune thrombocytopenic purpura, autoimmune thyroid diseases, Kawasaki disease, Guillain-Barre syndrome, and the detection of autoantibodies are the cues to the discovery of the potential of COVID-19 in inducing autoimmunity. Clarification of the pathophysiology of COVID-19 injuries to the host, whether it is direct viral injury or autoimmunity, could help to develop appropriate treatment.


Assuntos
Doenças Autoimunes/epidemiologia , Doenças Autoimunes/imunologia , Autoimunidade/imunologia , COVID-19/patologia , SARS-CoV-2/imunologia , Autoanticorpos/sangue , Autoanticorpos/imunologia , Doenças Autoimunes/virologia , COVID-19/imunologia , Humanos
11.
J Clin Rheumatol ; 28(1): e240-e244, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34941621

RESUMO

BACKGROUND: The epidemiology of Sjögren syndrome (SS) has been extensively studied in America, Europe, and Asia. OBJECTIVE: To summarize available data on the epidemiology of SS in Africa. METHODS: MEDLINE, EMBASE, and African Journals Online were searched from inception up to May 17, 2020, to identify relevant articles. Data gleaned from these reports have been summarized narratively in this review. RESULTS: Twenty-one hospital-based studies were included. These studies reported 744 cases of SS. The mean age at diagnosis varied between 28 and 73.6 years, and the female proportion ranged from 83.3% to 100%. There was no population-based incidence or prevalence. Among people with autoimmune and other rheumatic conditions, the frequency of primary SS was in the range 1.9% to 47.6%, whereas that of rheumatoid arthritis-associated secondary SS was in the range 4.3% to 100%. Sicca symptoms were the commonest features, with most frequently involved organs being joints, lungs, and neurological structures. Main autoantibodies were anti-Ro/SS antigen A, anti-La/SS antigen B, and antinuclear antibodies. CONCLUSIONS: The epidemiology of SS is poorly characterized in Africa. Available data are broadly consistent with those from other populations. Extensive and high-quality research is urgently needed.


Assuntos
Artrite Reumatoide , Síndrome de Sjogren , Adulto , Idoso , Anticorpos Antinucleares , Autoanticorpos , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/epidemiologia
12.
Cancer Lett ; 524: 1-14, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34637844

RESUMO

Glucose-related protein 78 (GRP78) is a chaperone protein localized primarily in the endoplasmic reticulum (ER) lumen, where it helps in proper protein folding by targeting misfolded proteins and facilitating protein assembly. In stressed cells, GRP78 is translocated to the cell surface (csGRP78) where it binds to various ligands and triggers different intracellular pathways. Thus, csGRP78 expression is associated with cancer, involved in the maintenance and progression of the disease. Extracellular exposition of csGRP78 leads to the production of autoantibodies as observed in patients with prostate or ovarian cancer, in which the ability to target csGRP78 affects the tumor development. Present on the surface of cancer cells and not normal cells in vivo, csGRP78 represents an interesting target for therapeutic antibody strategies. Here we give an overview of the csGRP78 function in the cell and its role in oncogenesis, thereby providing insight into the clinical value of GRP78 monoclonal antibodies for cancer prognosis and treatment.


Assuntos
/genética , Neoplasias Ovarianas/genética , Neoplasias da Próstata/genética , Autoanticorpos/imunologia , Retículo Endoplasmático/genética , Retículo Endoplasmático/imunologia , Feminino , Humanos , Masculino , Proteínas de Membrana/genética , Proteínas de Membrana/imunologia , Neoplasias Ovarianas/imunologia , Neoplasias Ovarianas/patologia , Neoplasias da Próstata/imunologia , Neoplasias da Próstata/patologia , Transdução de Sinais
13.
Methods Mol Biol ; 2343: 203-213, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34473324

RESUMO

Dietary interventions and physical exercise may improve some symptoms in mental illnesses such as major depression and schizophrenia. Hashimoto's thyroiditis is a known risk factor for these conditions and is marked by the presence of circulating antibodies to thyroid peroxidase (TPO) and thyroglobulin (TG). This chapter presents a protocol to determine if patients with major depression or schizophrenia contain high circulating levels of these antibodies relative to healthy controls. We also describe a procedure testing for the presence of other circulating biomarkers related to brain function, including antibodies directly related to neuronal function. This analysis was performed by screening biochip mosaics of frozen tissue sections and transfected HEK293 cells expressing target antigens using patient and control sera. Finally, we describe a correlation analysis of these markers with symptom scores at baseline and after 6 weeks treatment of the patients using antipsychotics or antidepressants as appropriate.


Assuntos
Depressão , Iodeto Peroxidase , Esquizofrenia , Autoanticorpos , Estudos de Casos e Controles , Depressão/diagnóstico , Depressão/enzimologia , Células HEK293 , Humanos , Esquizofrenia/diagnóstico , Esquizofrenia/enzimologia
14.
Eur J Radiol ; 146: 110063, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34922119

RESUMO

PURPOSE: To compare the diagnostic performance of imaging criteria that differentiate AQP4+ Neuromyelitis Optica Spectrum Disorders (NMOSD) and Multiple Sclerosis (MS) at disease onset (DO) and follow-up (FU). METHODS: We retrospectively analyzed MRI scans at DO (defined as the first 60 days of patient-reported symptom onset) in 10 AQP4+NMOSD and 25 (time to MRI matched) relapsing-remitting MS patients from a monocentric cohort. RESULTS: The Matthews criteria were met in 20% of AQP4+NMOSD patients at DO vs. 33% at FU, and in 96% of RRMS patients vs.100% at FU. Specificity (SP) and sensitivity (SE) were thus high at both time-points: SP-DO: 96%; SP-FU:100%; and SE-DO: 80%; SE-FU: 67%, with similar area under the curve (AUC) values at DO: 88% [95% CI 74%-100%] and FU: 83% [95% CI 67%-100%]. The Cacciaguerra criteria were met in 90% of AQP4+NMOSD patients at DO vs. 88.9% at FU and in 24% of RRMS patients vs. 14% at FU; SP-DO: 87%; SP-FU: 86%; and SE-DO: 90%; SE-FU: 89%, with similar AUC values at DO: 88% [95% CI 76%-98%] and FU: 87% [95% CI 74%-98%]. CONCLUSIONS: While diagnostic MRI criteria were developed on data acquired years after disease onset, our study demonstrates their high applicability at the earliest disease stages, thus emphasising their valuable use in clinical practice.


Assuntos
Esclerose Múltipla , Neuromielite Óptica , Aquaporina 4 , Autoanticorpos , Humanos , Neuromielite Óptica/diagnóstico por imagem , Estudos Retrospectivos
15.
Indian J Ophthalmol ; 70(1): 310-316, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34937266

RESUMO

Neuroophthalmic manifestations are very rare in corona virus disease-19 (COVID-19) infection. Only few reports have been published till date describing COVID-19-associated neuroophthalmic manifestations. We, hereby, present a series of three cases who developed optic neuritis during the recovery period from COVID-19 infection. Among the three patients, demyelinating lesions were identified in two cases, while another case was associated with serum antibodies against myelin oligodendrocyte glycoprotein. All three patients received intravenous methylprednisolone followed by oral steroids according to the Optic Neuritis Treatment Trail ptotocol. Vision recovery was noted in all three patients, which was maintained at 2 months of the last follow up visit.


Assuntos
COVID-19 , Neurite Óptica , Autoanticorpos , Humanos , Glicoproteína Mielina-Oligodendrócito , Neurite Óptica/diagnóstico , Neurite Óptica/tratamento farmacológico , SARS-CoV-2
16.
Indian J Ophthalmol ; 70(1): 194-200, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34937238

RESUMO

Purpose: To analyze clinical profile, imaging features, and short-term visual outcomes of optic neuritis patients in Indian population with and without seromarkers for myelin oligodendrocyte glycoprotein (MOG)/neuromyelitis optica (NMO). Methods: Electronic medical records of 203 optic neuritis patients who presented between June 2018 and December 2019 to the Neuro-ophthalmology services of a tertiary care center in India were retrospectively analyzed. Results: Of 203 patients, 57 patients (28.08%) were positive for MOG-antibody and 20 patients (9.85%) were positive for NMO antibody. 114 patients (56.16%) were double-negative (negative for both antibodies) and 12 patients (5.91%) were diagnosed as multiple sclerosis (MS). None of the patients had both antibodies. Mean age of presentation was 31.29 ± 1.035 years. There was female preponderance in NMO-optic neuritis (NMO-ON) and MS-optic neuritis (MS-ON) groups (1:5). Mean vision on presentation was worse (logMAR 1.570 ± 0.863) in NMO-ON group. The mean visual acuity showed statistically significant recovery (logMAR 0.338 ± 0.639) in the final follow-up in MOG-optic neuritis (MOG-ON) group. Multivariate logistic regression analysis revealed poor visual outcome in patients presenting with retrobulbar neuritis, optic disc pallor, bilateral sequential optic nerve involvement, and with positive NMO antibody. Optic neuritis patients presenting with disc edema associated with pain and positive for MOG antibody were found to have a better visual outcome. Conclusion: In this Indian optic neuritis cohort, the prevalence of MOG-ON was higher than NMO-ON. MOG-ON had a better visual outcome than NMO-ON. The incidence of MS-ON was less compared to the western literature. A significant number of patients (114 patients, 56.16%) were double negative for both seromarkers and yet had presented with optic neuritis with no clinical or imaging features suggestive of MS/MOG associated disease (MOG AD)/NMO spectrum disorder (NMO SD).


Assuntos
Neuromielite Óptica , Neurite Óptica , Adulto , Autoanticorpos , Feminino , Humanos , Glicoproteína Mielina-Oligodendrócito , Neuromielite Óptica/complicações , Neuromielite Óptica/diagnóstico , Neuromielite Óptica/epidemiologia , Neurite Óptica/diagnóstico , Neurite Óptica/epidemiologia , Estudos Retrospectivos
17.
J Clin Neurosci ; 95: 75-80, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34929655

RESUMO

BACKGROUND: Interleukin 35 (IL-35) plays an anti-inflammatory in numerous autoimmune diseases. However, the potential roles of IL-35-producing T and B cells and serum IL-35 levels in the pathogenesis of myasthenia gravis (MG) and its association with disease activity in patients with MG remain unclear. METHODS: The percentages of IL-35-producing CD4 + CD25 + T cells and CD19 + B cells among peripheral blood mononuclear cells were determined in 37 patients with anti-acetylcholine receptor (AChR) antibody-positive MG and 35 healthy controls (HCs) by performing a flow cytometry analysis. Serum IL-35 levels in participants were determined using an enzyme-linked immunosorbent assay. Further, the correlations between IL35 levels and disease activity were analysed. RESULTS: The percentages of IL-35-producing CD4 + CD25 + T cells and CD19 + B cells were significantly lower in patients with anti-AChR antibody-positive MG than in HCs (p = 0.001 and p = 0.002, respectively). Furthermore, patients with thymoma and patients with generalized MG had lower percentages of IL-35-producing CD4 + CD25 + T cells and CD19 + B cells than those without thymoma and those with ocular MG (p = 0.001 and p = 0.003; p = 0.008 and p = 0.001, respectively). Interestingly, the suppression of IL-35 secretion correlated negatively with the activities of daily living scores of patients with MG (r = -0.4774, p = 0.0028) and the quantitative MG scores (r = -0.4656, p = 0.0037). The proportions of IL-35-producing T cells and B cells and serum levels of IL-35 increased after treatment. CONCLUSIONS: IL-35 may represent a potential biomarker for the clinical evaluation of MG.


Assuntos
Linfócitos B , Interleucinas , Leucócitos Mononucleares , Miastenia Gravis , Linfócitos T , Atividades Cotidianas , Autoanticorpos , Linfócitos B/imunologia , Humanos , Receptores Colinérgicos , Linfócitos T/imunologia
18.
Biol Trace Elem Res ; 200(1): 59-66, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33650064

RESUMO

The current study aimed to identify correlative and regressive dependencies between the water iodine concentration and the levels of TSH (thyroid-stimulating hormone), thyroglobulin antibodies (TgAbs), and thyroid peroxidase (TPOAb) in the serum of 168 in patients (34 men and 134 women) with a hypothyroid form of Hashimoto's thyroiditis who use water from the supply network and individual wells. Based on the water iodine concentration, low and moderate degrees of iodine endemia in the location of the patients were determined. In the groups of men and women using water from different water supply sources, there were direct correlations between the water iodine concentrations and the TgAbs and TPOAb titers as well as an inverse dependence between iodine and TSH levels. Multivariate regressive analysis indicated that TgAb and TSH in the group of women using water from a supply network and TPOAb titers in the group of women using well water were independent factors associated with water iodine concentrations. Statistically significant correlations and regressive dependencies between the water iodine concentrations and the biomarkers of the thyroid status of the patients indicate the risk of Hashimoto's thyroiditis progression, especially among women with additional iodine intake.


Assuntos
Água Potável , Doença de Hashimoto , Hipotireoidismo , Iodo , Autoanticorpos , Feminino , Humanos , Masculino
19.
Curr Drug Deliv ; 18(7): 1027-1040, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34911421

RESUMO

AIMS: This study aims to investigate the role of glyoxal modified LDL in the immunopathology of diabetes and cardiovascular disease. BACKGROUND: Glycoxidation of proteins is widely studied in relation to diabetes and cardiovascular disease. OBJECTIVE: This study probed the glyoxal mediated modifications in LDL, analyzed the immunogenicity of the glycated LDL and ascertained the presence of circulating antibodies against modified LDL in patients with type 2 diabetes mellitus (T2DM), coronary artery disease (CAD) and patients with both (T2DM+CAD). METHODS: Glyoxal mediated modifications in LDL were studied by multiple spectroscopic techniques, high-performance liquid chromatography and electron microscopy. Immunization studies were carried in New Zealand rabbits. The presence of antibodies against glyoxal modified LDL in immunized rabbits and human subjects was analyzed by ELISA. RESULTS: Glyoxal altered the structural integrity of LDL and led to the formation of AGEs. It decreased the alpha-helix content of LDL; increased ß sheet formation, increased carbonyl content and decreased free lysine and arginine content. Modified LDL showed aggregation, generation of of Nε- (Carboxymethyl) lysine and the formation of amorphous type aggregates. It exhibited high antigenicity and generated a specific immune response that shared common antigenic determinants with other glycated proteins. Direct binding data showed the presence of anti-glyoxal modified LDL antibodies in patients with T2DM, CAD and patients with both T2DM and CAD. Further analysis in competitive binding assay revealed specific binding characteristics of auto-antibodies. Sera from patients with T2DM+CAD exhibited the highest binding with glyoxal modified LDL. CONCLUSION: Glyoxal-modified LDL has neo-antigenic determinants that cause the generation of circulating antibodies in diabetes and coronary artery disease. The study might have potential relevance in biomarker development.


Assuntos
Doença da Artéria Coronariana , Diabetes Mellitus Tipo 2 , Animais , Autoanticorpos , Epitopos , Glioxal , Humanos , Coelhos
20.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(12): 1426-1434, 2021 Dec 06.
Artigo em Chinês | MEDLINE | ID: mdl-34963239

RESUMO

Objective: To investigate the auxiliary diagnostic value of seven tumor-associated autoantibodies (AABs) P53, PGP9.5, SOX2, GAGE7, GBU4-5, MAGEA1 and CAGE in early non-small cell lung cancer (NSCLC). Methods: The case-control study enrolled 195 patients with early NSCLC [71 males and 124 females, aged (55.70±11.78) years old], 114 patients with benign lung disease [44 males and 70 females, aged (52.85±12.31) years old] and 100 healthy subjects [39 males and 61 females, aged (53.62±9.97) years old] from the First Affiliate Hospital of Nanjing Medical University from June 2020 to December 2020. AABs were detected by enzyme-linked-immunosorbent serologic assay (ELISA), and carcinoembryonic antigen (CEA),cytokeratin 19-fragments (CYFRA21-1) and neuron specific enolase (NSE) were detected by electrochemiluminescence. The levels of AABs,CEA,CYFRA21-1 and NSE in the 3 groups were compared. Patients with benign lung diseases and healthy subjects were combined into the control group, and the positive rate of each indicator in the NSCLC group and the control group was compared. The diagnostic efficacy of single and combined tests for NSCLC were obtained using receiver operating characteristic (ROC) curves. Besides, the relationship between the levels of AABs, CEA, CYFRA21-1 and NSE and their clinicopathological features and preoperative imaging parameters in NSCLC patients was assessed. Results: The levels of SOX2 [0.70 (0.10, 2.40) U/mL] and GBU4-5 [1.30 (0.30, 8.90) U/mL] in NSCLC group were higher than those in benign disease group [SOX2: 0.50 (0.10, 1.60) U/mL, GBU4-5: 0.80 (0.10, 2.30) U/mL, Z values were 27.258 and 45.797; P values were all<0.05] and health control group [SOX2: 0.45 (0.10, 1.08) U/mL, GBU4-5: 0.75 (0.20, 1.78) U/mL, Z values were 32.551 and 40.456; P values were all<0.05], and there was no significant difference between benign disease group and health control group (Z values were 5.293 and 5.340, P values were all>0.05). The levels of CEA [1.75 (1.08, 2.72) U/mL] and CYFRA21-1 [1.81 (1.41, 2.36) U/mL] in NSCLC group were higher than those in healthy control group [CEA: 1.22 (0.68, 1.81) U/mL, CYFRA21-1: 1.43 (1.14, 1.74) U/mL, Z values were 64.100 and 37.597; P values were all<0.05], but there was no significant difference between NSCLC group and benign group [CEA: 1.74 (1.01, 2.51) U/mL, CYFRA21-1: 1.82 (1.45, 2.46) U/mL, Z values were 7.275 and 10.621; P values were all>0.05]. The positive rates of P53, SOX2, GAGE7, GBU4-5 and CEA in NSCLC group were higher than those in the control group [P53: 10.3% vs 0.9%, SOX2: 11.3% vs 2.3%, GAGE7: 11.3% vs 0.5%, GBU4-5: 30.1% vs 5.6%, CEA: 9.7% vs 0.9%, χ2 values were 17.420, 13.242, 22.485, 43.211, 16.255, respectively; P values were all<0.05]. The diagnostic efficiency of the combined detection of seven AABs was better than that of single detection. Seven AABs combined with CEA [area under curve (AUC): 0.732, sensitivity: 64.10%] and with CYFRA21-1 (AUC: 0.737, sensitivity: 58.97%) greatly improved the diagnostic efficiency and sensitivity of CEA (AUC: 0.583, sensitivity: 50.77%) and CYFRA21-1 (AUC: 0.552, sensitivity: 44.10%). The levels of SOX2 and CEA in NSCLC patients were correlated with the degree of tumor invasion (H values were 6.436 and 14.071; P values were all<0.05); the levels of GAGE7 and CEA were correlated with the nodule density (H values were 7.643 and 12.268; P values were all<0.05); and the levels of SOX2, GAGE7, CEA and CYFRA21-1 were all correlated with the nodule size (H values were 10.837, 11.528, 31.835, 20.338; P values were all<0.05). Conclusion: The detection of AABs combined with CEA and CYFRA21-1 is helpful for the early auxiliary diagnosis of NSCLC, and plays an important role in prevention and screening for early lung cancer.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Adulto , Idoso , Antígenos de Neoplasias , Autoanticorpos , Biomarcadores Tumorais , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Estudos de Casos e Controles , Feminino , Humanos , Queratina-19 , Neoplasias Pulmonares/diagnóstico , Masculino , Pessoa de Meia-Idade
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