Antinuclear antibodies in the oldest-old women and men

The aim of this study was to compare the prevalence of antinuclear antibodies (ANA) in very old individuals (≥86 years of age) with healthy younger (18–68 years) blood donors (n = 200) regarding gender, health status, ratio of circulating CD4/CD8 cells and cytomegalovirus (CMV) serology. Frozen plasma was used for ANA detection in two study groups, i.e. ‘OCTO’ (97 persons aged 86–92 years, 65% women) and ‘NONA’ (136 persons aged 86–95 years, 70% women). OCTO participants were recruited on the basis that they were healthy or moderately healthy according to a selection protocol. No exclusion criteria regarding health status were applied in the NONA sample. The prevalence of ANA was significantly higher in the oldest-old samples compared to blood donors. There was no association between health status and the presence of ANA in the oldest-old. The difference across age was most pronounced in men, with low levels at younger age, whereas the prevalence among the oldest-old men reached similar levels as in women. There were no associations between the presence of ANA and CD4/CD8 ratio or with CMV status in the oldest-old. Our findings confirm an increased prevalence of ANA in the oldest-old, and emphasize the importance of taking gender and age into consideration when evaluating ANA.     

Antinuclear Autoantibodies in Women with Recurrent Pregnancy Loss

Citation Ticconi C, Rotondi F, Veglia M, Pietropolli A, Bernardini S, Ria F, Caruso A, Di Simone N. Antinuclear autoantibodies in women with recurrent pregnancy loss. Am J Reprod Immunol 2010; 64: 384–392 Problem To investigate the possibility that antinuclear antibodies (ANA) are involved in recurrent pregnancy loss (RPL). Methods Case–control study carried out on 294 women (194 cases and 100 controls) in two University hospitals. The presence, the serum titers and the indirect immunofluorescence (IIF) patterns of ANA were determined in women with RPL and in control women. Results Antinuclear antibodies at titers ≥ 1:80 were detected in 97 (50%) women with RPL and in 16 (16%) control women. Elevated ANA titers (≥1:180) were detected only in RPL women, whereas all control women had ANA titers no greater than 1:80. No differences could be detected in the IIF patterns between RPL and control women. No differences in ANA positivity could be detected according to the type (primary or secondary) or number (>2 versus ≥3) of losses. Conclusions ANA could be of some value in identifying women with RPL with potential, although still not fully defined, immune abnormalities.     

Analyses of CD27<Superscript>++</Superscript> Plasma Cells in Peripheral Blood from Patients with Bacterial Infections and Patients with Serum Antinuclear Antibodies

The number of CD27⁺⁺ plasma cells (PCs) in peripheral blood may be a valuable biomarker for systemic lupus erythematosus (SLE) disease management. More insights into the behavior of the PC population are, however, required to validate CD27 as a reliable biomarker. In the current study, we have monitored the PC compartment of patients with acute bacterial infections and patients with SLE and, in addition, examined the relationship between the presence of serum antinuclear antibodies (ANAs) and the number of peripheral PCs. Kinetic analyses in patients with bacterial infection revealed a 10–60-fold expansion of the CD27⁺⁺ PC compartment that peaked at day 2–5 and returned toward normal values at day 7–9 after hospital admission. The transient expansion of the PC population appeared to be a late phenomenon in the process of recovering from a bacterial infection. SLE subjects had significantly increased frequencies of PCs compared with patients suspected of a connective tissue disease and healthy controls. In patients suspected of a connective tissue disease, no relationship was found between the presence of serum ANAs and the number of CD27⁺⁺ PCs. Additionally, the presence of serum ANAs was not associated with abnormalities in other peripheral B-cell subsets. It remains to be established at which stage of SLE development the expansion of the PC compartment is initiated. An erratum to this article can be found at     

Morbidity does not influence the T-cell immune risk phenotype in the elderly: findings in the Swedish NONA Immune Study using sample selection protocols

A critical issue in our understanding of ageing and the immune system refers to the health status of the population from which inferences are drawn. The commonly used SENIEUR protocol, selecting individuals representing 'normal ageing' has recently been under debate because a substantial amount of individuals with various health problems are excluded. The aim of the present study was to investigate the influence of morbidity on immune parameters and to evaluate the associations with the T-cell immune risk phenotype (IRP), related to cytomegalovirus (CMV) seropositivity by applying the SENIEUR protocol and the OCTO-Immune protocol in the unselected population based sample (n=138) of oldest-olds, participating in the Swedish NONA Immune Study. The SENIEUR protocol excluded over 90% of the sample whereas the OCTO-Immune protocol excluded almost 65% of the sample. Three independent groups, very healthy (SENIEUR), moderately healthy (OCTO-Immune) and frail (non-SENIEUR/non-OCTO-Immune) were created. Flow cytometry studies on lymphocyte sub-populations revealed no significant difference in CD4/CD8 ratio, CD3+CD4-CD8+, CD3+CD4+CD8-, CD8+CD57+CD28-, CD8+CD56+CD57- or CD8+CD56+CD57+ between the very healthy, moderately healthy and the frail subsamples. Our findings indicate that morbidity does not significantly influence the T-cell immune risk profile in the elderly, and we suggest the inclusion of broader samples in future immunogerontological studies.     

Antinuclear autoantibodies in healthy nonpregnant and pregnant women and their offspring.

Antinuclear autoantibodies have previously been detected in sera of healthy women although less frequently than in sera of women with autoimmune disorders. The effect of pregnancy on antinuclear autoantibody production in healthy women is as yet debatable. We present four studies in which, by employing the ELISA method, we evaluated the presence of six antinuclear autoantibodies (anti-ds DNA, anti-ss DNA, anti-poly(I), anti-cardiolipin, anti-Sm, and anti-RNP) in the sera of more than 1,000 healthy pregnant and nonpregnant women, including 196 pairs of matched maternal and cord blood sera. In all four studies healthy pregnant women did not demonstrate significantly higher prevalence rates of various serum antinuclear autoantibodies as compared to healthy non-pregnant women. All detected autoantibodies were of the IgM isotype. In only one infant (born to a healthy seronegative mother) was an autoantibody (IgM anti-ss DNA) detected. This may indicate that in certain circumstances the fetus is capable of self-production of autoantibodies.     

Anticardiolipin,glutamic acid decarboxylase,and antinuclear antibodies in epileptic patients

To explore the hypothesis that raised anticardiolipin antibodies, glutamic acid decarboxylase, and antinuclear antibodies may be associated with epilepsy and/or pharmacoresistance, we studied titers in 74 epileptic patients and 50 controls. Epileptic patients were divided into two groups according to their response to anticonvulsant therapy. Group I included 52 children (30 females and 22 males with a mean age±SD of 7.0±2.4 years) suffering from different types of epilepsy who were treated with various anticonvulsants. Group II included 22 children (10 females and 12 males with a mean age of 6.2±3.6 years) suffering from therapy resistant epilepsy. We found that the prevalence of anticardiolipin antibodies was significantly higher in epileptic patients than in controls, while there was no significant difference between patients who were seizure free and those with uncontrolled epilepsy. No significant difference was found in glutamic acid decarboxylase antibodies between epileptic children and controls, and between patients who were seizure free and those with uncontrolled epilepsy. A significant difference in the incidence of antinuclear antibodies was found between epileptic children and controls, while no difference was found between well-controlled and drug-resistant epilepsy. In conclusion, the prevalence of anticardiolipin and antinuclear antibodies was higher in patients with epilepsy than in controls. There was no significant difference in serum glutamic acid decarboxylase antibodies between epileptic children and controls, and between patients who were seizure free and those with uncontrolled epilepsy. Received: 10 October 2002 / Accepted: 18 February 2003 Correspondence to A. Verrotti     

抗核抗体与抗核抗体谱联合检测在自身免疫性疾病诊断上的应用

目的探讨抗核抗体(antinuclear antibody,ANA)和抗核抗体谱(antinuclear antibodies spectrum,ANAs)联合检测在自身免疫性疾病(autoimmune diseases,AID)诊断上的应用方案及价值,从而降低现症及潜在AID患者的漏检率。方法对1 231份本院门诊和住院疑似AID患者的血清标本分别采用间接免疫荧光法(indirect immunofluorescence,IIF)和免疫印迹法(immumoblottest,IBT)检测ANA和ANAs,对其中IIF-ANA1∶100(-)/IBT-ANAs(+)标本分别进行1∶10及1∶32稀释后采用IIF检测ANA,最后对上述检测结果进行统计分析。结果 1 231份血清标本中ANA阳性414份,占33.63%,ANAs阳性429份,占34.85%。按不同检测方案进行分组,发现同时检测IIF-ANA与IBT-ANAs的方案对确诊/疑似AID病人检出率最高(43.05%),分别与应用IIF-ANA进行AID的初筛的方案、仅检测IBT-ANAs的方案相比均有统计学意义(χ2=23.12,P<0.05,χ2=17.42,P<0.05)。对116份(9.42%)IIF-ANA 1∶100(-)/IBT-ANAs(+)的标本分别进行1∶32及1∶10稀释后再采用IIF检测ANA,发现其中103份标本ANA荧光结果≥1∶32,10份标本ANA荧光结果<1∶32而≥1∶10,3份标本ANA荧光结果<1∶10;将标本增加1∶32和1∶10稀释度可将AID确诊/疑似病例检出率分别提高8.37%(χ2=20.84,P<0.05)与9.18%(χ2=24.70,P<0.05),但二者之间相比则无统计学意义(χ2=0.17,P>0.5)。结论 IIF-ANA可应用于大范围AID病人初筛以减轻病人经济负担及实验室工作量压力。但是仅检测IIF-ANA或IBT-ANAs均可导致临床上患有AID或潜在的AID病人的漏检。联合检测IIF-ANA和IBT-ANAs,尤其是对临床高度怀疑AID、且ANA荧光结果≥1:32的标本进行IBT-ANAs的检测可显著提高检出率,从而降低现症及潜在AID患者的漏检率。     

D-penicillamine- and quinidine-induced antinuclear antibodies in A.SW (H-2s) mice: similarities with autoantibodies in spontaneous and heavy metal-induced autoimmunity

Ten percent of human lupus syndromes occur in patients as a result of treatment with certain medications. H-2^s mice can produce autoantibodies following treatment with various drugs or heavy metals and they are a potential animal model of drug-induced lupus. We have examined nine anti-chromatin monoclonal antibodies (mAb) from A.SW mice that had been treated with either D -penicillamine or quinidine, two lupus-inducing drugs in humans. These mAb are specific either for DNA or histone-DNA complexes corresponding to nucleosomes or subnucleosome particles. Only one mAb reacts with an unknown chromatin antigen. The V region sequences of six of these mAb were studied and are notable by several features. As previously observed in spontaneous autoantibodies to DNA or histone-DNA complexes, arginine or asparagine residues are found at critical locations throughout the V regions. Many of these residues, potentially important for binding to DNA or DNA-histone complexes, result either from somatic mutations or atypical V_H-D-J_H rearrangements. Another significant characteristic is that the V_H genes of several D -penicillamine- or quinidine-induced mAb are most similar to those of anti-nucleolar mAb obtained from mercury-injected A.SW mice. The implications of these findings for the pathogenesis of spontaneous or induced autoimmunity are discussed.     

Antinuclear Antibodies Detected by Indirect Immunofluorescence on HEp2 Cells and by Immunoblotting in Patients with Systemic Sclerosis

The HEp2 cell cultures appeared highly sensitive in detecting the antinuclear antibodies (ANAb) in systemic sclerosis, principally anticentromere antibodies of the CREST syndrome. The immunoblotting used with either complex cellular extracts from HeLa and rabbit thymus or purified nuclear components (high mobility group (HMG) proteins and histones) is able to identify precisely the ANAb targets and to contribute to diagnosis. With nuclear extracts of HeLa cells, the sera from 75.8% of CREST syndrome subjects stained 18 and 22 kD proteins. Corresponding antibodies were also detected in 72.7% of these patients, on HEp2 centromeres by indirect immunofluorescence. With the same extracts, 33.3% of sera from diffuse sclerosis/acrosclerosis patients contain antibodies staining 86, 73, 32 and 30kD. These sera also stain 77, 66 and 63kD from thymus extracts. Corresponding antibodies will be the anti-SCL-70 antibodies defined by double immunodiffusion. The anti-HMG antibodies were infrequent in systemic sclerosis, rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) and consequently without interest for diagnosis. The anti-whole histones antibodies which are less frequent in diffuse sclerosis/acrosclerosis (35.7%) than in SLE (41.3%) recognize especially HI and H2A in the first diseases, HI and H2B in SLE and HI and H3 in RA.     

Seven antiphospholipid antibodies in HIV-positive patients: correlation with clinical course and laboratory findings

OBJECTIVE: To compare the clinical course of HIV-1-infected patients, their CD4+, CD8+ T lymphocytes, and viral loads (VL) with the levels of seven antiphospholipid antibodies (aPLs) before, during, and after the highly active antiretroviral therapy (HAART). PATIENTS AND METHODS: aPLs were examined in patients (20 men, 10 women, aged 12-64 years, median 33 years) from the AIDS center of Western Bohemia before the initiation of HAART, and two (23 patients), and five (20 patients) years later. Flow-cytometry was used for CD4+ and CD8+ T lymphocytes analysis, commercial kits were used for VL-measurements, and commercial enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of anti-beta2-glycoprotein I (GPI) of immunoglobulin G (IgG) and IgA isotypes, and anticardiolipin levels (ACA) of IgG and IgM isotypes. APLs screening also included L-alpha-phosphatidic (ph) acid, L-alpha-phosphatidylethanolamine, L-alpha-phosphatidyl-DL-glycerol, L-alpha-phosphatidylinositol, and L-alpha-phosphatidylserine of IgG and IgM autoantibodies. Statistical analysis was performed using cut-off levels for immunoglobulin-isotypes of aPLs using 3 S.D. or 95th percentile calculated using Statgraphics-software. RESULTS: In 14 of 21 patients treated by HAART an increased number of CD4+ T lymphocytes was detected, and in 14 of 21 patients VL decreased below detection threshold during the 5 years of observation. We did not observe correlations of aPLs with age, the initial low CD4+ and high number of CD8+ T lymphocytes, and the viremic levels over the entire observation period. We did not find the elevation of aPLs in 2 of 5 patients in stage C (AIDS). Ten of 11 HIV-positive homosexuals had positive aPLs, and the same result was seen in 7 of 10 patients infected through heterosexual intercourse. aPLs levels were significantly increased in 18 of 30 patients at the beginning of HAART. ACA IgG was elevated in 14 of 30 cases, IgG antibodies against L-alpha-ph-acid in 5 of 30, ph-ethanolamine in 10 of 30, ph-inositol in 9 of 30, and L-serine in 14 of 30, combined positivity of six aPLs together was detected in 10 HIV positive patients. Significantly decreased levels of aPLs because of HAART were found in eight patients. APLs were still present in only four patients after 5 years of the treatment. Abnormalities in blood clotting were not present in any of our patients. CONCLUSION: Results of screening for seven aPLs in HIV-positive patients suggest that HAART also positively influences the autoimmune response represented by aPLs levels, but individual differences in aPLs levels were observed.     

Anti-IgG Antibodies and Antinuclear Antibodies in Allergic Patients

With an indirect immunofluorescencc technique 77 % of 96 patients with type I allergy and 40% of 20 patients with intrinsic bronchial asthma showed positive reactions for IgG ami-IgG antibodies in serum. They were present partly in an aggregated state not directly detectable before treatment with dithiothreitol. The aggregates could be removed by precipitation with polyethylene glycol. The IgG ami-IgG in hyposensitized patients were directed against both F(ab')² and Fe fragments of rabbit IgG. Thirty of the type I allergic patients were examined once during hyposensitization as well. Before treatment 87% and IgG anti-IgG (titres 9–72). After ≥ 13 months of treatment 100% were positive (titres 35–288), Fight patterns were also examined after hyposensitzation had been discontinued for at least 12 months. The titres of IgG ami-IgG had then reverted lo the levels obtained before hyposensitization. Of 116 controls matched for sex and age, 79r had IgG ami-IgG anybodies, is suggested that the production of IgG anti-IgG may be stimulated by the presence of immune complexes and that purity, amount and/or combination of allergens administered during hyposensitization may influence the production of anti-JgG antibodies. Neither IgK anti-IgG nor antinuclear antibodies seem to be of particular significance in allergic patients.     

Antinuclear Antibodies and Anti-DNA Antibodies in Scleroderma

Antinuclear antibodies (ANA), including anti-DNA antibodies, and rheumatoid factors (RAT, Waaler-Rose) were determined prospectively during a 3-year period in 40 patients with localized scleroderma (LS) compared with 77 patients with generalized scleroderma (GS). ANA were increased in 26% of patients with LS, and in 47% with GS, anti-DNA antibodies in 23% of patients with LS, and in 34% with GS. Thus, the anti-DNA antibody level was lower compared with the known level in systemic lupus erythematosus. Rheumatoid factors were present in 6-7% of patients with LS, and in 14-15% of patients with GS. Increased antinuclear antibodies were not associated with any specific type of localized scleroderma, nor with internal disorders, and no case of clinical overlap to discoid or systemic lupus erythematosus was observed. However, six patients with localized scleroderma and complaints of arthralgia all presented increased antibodies, and one patient showed overlap to rheumatoid arthritis. It is suggested that increased ANA and anti-DNA antibodies in localized scleroderma, associated with joint manifestations, represents a systemic component in this type of scleroderma, with activation of the immune system and similarities with generalized collagen diseases.     

Antinuclear autoantibodies, complement level, hypergammaglobulinemia and spontaneous intrauterine hematoma in pregnant women

PROBLEM: To examine the associative relationship among autoantibodies, C4 levels and intrauterine hematomas (IUH) in more detail than in the studies published earlier. METHOD OF STUDY: We performed a retrospective study of 54 women with poor obstetric outcomes. Sera were screened for antinuclear antibodies (ANA), anti-DNA antibodies, antiphospholipid antibodies (aPL), and antithyroid antibodies. C4-complement and gammaglobulin levels were also monitored. We compared the main variables in IUH complicated pregnancy group with the risk pregnancy group without IUH. We also compared these variables in the IUH cases before and during IUH. RESULTS: Eight IUH were detected. The average number of spontaneous losses for these eight women was 3.3 +/- 2.1 (range: 1-8). aPL was present in 100% of cases. ANAs and hypergammaglobulinemia were present in 50% of cases and low C4 in 87.5% of cases. After comparing these variables apart from C4 before and during IUH, we found no statistical differences. However, C4 was low in four patients before IUH and in seven patients during IUH (OR: 7.0; 95% CI: 0.57-86.33). When we compared autoantibodies apart from lupus anticoagulant (LAC) between the two groups, no differences were observed. However, seven of the eight (87.5%) patients with IUH were LAC positive whereas only 24 of the 46 patients (52.1%) were positive in the non-IUH group (OR: 6.42; 95% CI: 0.73-56.41). Rapid plasma reagin was present in 8/46 in the non-IUH group (16.7%) and 5/8 in the IUH group (62.5%) P < 0.015). CONCLUSIONS: In women with poor obstetric histories, autoantibodies, especially antiphospholid antibodies, may play a role in the IUH development especially if low C4 and/or hypergammaglobulinemia are present.     

87例抗核抗体斑点型阳性患者血清特异性抗核抗体谱分析

目的探讨血清斑点型抗核抗体（ANA）与特异性抗核抗体谱（ANAS）中不同项目阳性组合之间的相关性。方法分析87例斑点型ANA阳性病例的抗ANAS（抗Ul-nRNP、Sm、SS-A、SS—B、Scl-70、Jo-1、SCL-70、PM—Scl、centromereB、nukleosome、PCNA、ds—DNA、histones、ribosomal—Pprotein、AMA-M2抗体）多肽谱类型。结果斑点型ANA的特异性ANAS不同项目阳性组合类型达到23种,除SCL-70、PM—Scl外,其他13种特异性ANAS成分均见阳性。ds—DNA阴性的histone、Sm、nukleosome、PCNA、Rib-P．P单独阳性或合并其他抗体阳性率高达19．5％（17／87）,联合检测这些抗体能提高系统性红斑狼疮（SLE）诊断的敏感性。ANAS阳性率与ANA滴度之间没有绝对关系。结论不能简单地依据荧光核型来推断抗ANAS抗体的具体类型;多项指标联合检测能提高诊断疾病的敏感性和特异性;斑点型ANA低滴度时也应作特异性ANAS检测。     

A simple guide to the terminology and application of leucocyte monoclonal antibodies

This review aims to provide a simple guide and quick reference to the terminology and diagnostic applications of leucocyte monoclonal antibodies. The differentiation cluster terminology, where applicable, is used throughout.     

高校离退休老人躯体健康与家庭特征的相关性研究

老龄问题已成为全球关注的课题 ,老人生活质量的研究是当今的热点之一。已证实老人的健康、家庭生活等是影响其生活质量的重要因素 ,老人的躯体健康和家庭生活特征是密切相关的 ,但老人的家庭特征与躯体各系统的健康状况的相互关系国内外的研究甚少。为此 ,本研究对广州地区的高校离退休老人的躯体健康和家庭特征进行了调查 ,并对这两组变量进行典则相关分析 ,以探讨两者之间的关系。1　对象与方法1 .1　对象对广州地区的高校进行整群抽样 ,抽取中山医科大学、华南理工大学、华南师范大学、广东外国语大学等四所大学 ,对参加 1994年离退休职…     

男性不明原因不育症患者血浆中AcrAb及Sp17Ab水平变化的研究

目的探讨抗精子蛋白17抗体(Sp17Ab)、抗顶体蛋白酶抗体(AcrAb)在男性不育症发病中的作用。方法采用酶联免疫吸附(ELISA)对12例不明原因不育患者,20例其它原因引起不育的患者及25名正常的生育者的血浆中AcrAb、Sp17Ab进行检测并分析不明原因不育患者血浆中AcrAb和Sp17Ab的水平及其相关性。结果(1)血浆AcrAb水平:不明原因不育患者血浆中顶体蛋白酶抗体(4.15±1.18)μg/L,明显高于对照组的(1.49±0.51)μg/L及其它原因引起的不育(1.56±0.40)μg/L,差异有统计学意义(P0.01);对照组和其它原因引起的不育两者比较,差异无统计学意义(P0.05);(2)血浆Sp17Ab水平:不明原因不育患者血浆中精子蛋白17抗体(8.34±1.88)μg/L,明显高于对照组(4.17±1.07)μg/L及其他原因引起的不育(4.10±0.95)μg/L,差异具有统计学意义(P0.01);对照组和其它原因引起的不育两者比较,差异无统计学意义(P0.05);(3)相关性分析:血浆中顶体蛋白酶抗体与精子蛋白17抗体水平无相关性(r=0.125,P0.05)。结论血浆中顶体蛋白酶抗体、精子蛋白17抗体水平变化与不明原因不育患者发病有关。