Anti-tubulin antibodies in autoimmune thyroid disorders

Syngeneic grafts of liver tissue slices are accepted by normal murine recipients except in the case of male to female grafts in strains which carry the H-2b haplotype. In mouse strains which are known models of autoimmune disease, liver tissue slices are sometimes rejected even when donors and recipients are of the same sex. Although New Zealand Black (NZB) male liver tissue grafts survive in NZB males, female liver tissue grafts are rejected by NZB females. NZB females in which the mouse's own liver has been surgically traumatized accept female liver tissue grafts. In PN females, liver tissue grafts from syngeneic females proliferate. Male to male and male to female grafts show high levels of immunological activity although mostly surviving at 70 days after grafting. MRL male to male, BXSB female to female and NZB male to female grafts all proliferate. Mouse models of autoimmune disease show patterns of liver tissue graft survival which are different from those seen in non-autoimmune mice. These patterns vary among autoimmune strains. Males and females have different antigraft response as well as different cellular lesions controlling their autoimmune disease.     

Anti-thyroid peroxidase antibodies in thyroid disorders and non-thyroid autoimmune diseases.

A new commercial method for measurement of anti-thyroid peroxidase (anti-TPO DYNOtest, Henning, Berlin) was evaluated in normal subjects and in patients with autoimmune thyroid and non-thyroid diseases, and compared to an immune fluorescence method for measurement of anti-microsomal antibodies (MicAb), and a radioimmunological method for quantifying thyroglobulin antibodies (TgAb). The majority of normal subjects had anti-TPO levels below 52 U/ml and patients with Hashimoto's thyroiditis had levels above 200 U/ml, with a good correlation to MicAb. In other autoimmune thyroid diseases the correlation was less pronounced. In non-thyroid autoimmune diseases MicAb showed falsely positive reactions in the presence of other autoantibodies, e.g. mitochondrial antibodies. The present study indicates that the anti-TPO method should probably replace measurements of MicAb for routine clinical use, thus providing a sensitive, precise, antigen specific method with the ability to reveal quantitative fluctuations. The study also indicates that TgAb could be abolished in routine diagnosis of autoimmune thyroid diseases and be reserved for special clinical situations, research purposes as well as measurement in sera before evaluation of serum thyroglobulin levels.     

Clinical epidemiology of autoimmune thyroid disorders--variation of natural history in patients with autoimmune thyroid disorders

Clinical and epidemiological study for autoimmune thyroid disorders was performed in a rural community. Ninety-six of 1,686 subjects had asymptomatic autoimmune thyroiditis and were followed from 1979 to 1988. TRH loading test was carried out in 91 of 96 cases between 1983 and 1984. Each individual was classified into 4 subgroups. Five patients had normal levels of basal plasma TSH and had no increment of peak levels of plasma TSH (Grade G). Twenty-three had normal levels of both basal and peak plasma TSH (Grade I). The peak plasma TSH levels in 53 patients was high, but the basal was within the normal range (Grade II). Ten had high levels of both basal and peak plasma TSH (Grade III). One of the 5 Grade G cases developed overt Graves' disease in 1987 and another Grade III case suffered from goitrous Hashimoto's thyroiditis with primary hypothyroidism. Four of the ten Grade III cases and one Grade II case developed primary myxedema during the observation period. These results show that the natural history of asymptomatic autoimmune thyroiditis is variable and the prevention of overt autoimmune thyroid disorders is difficult.     

Antibodies to species homologous tissue antigens in the rat. II. Circulating antibodies during the development of autoimmune renal disease

Rats were immunized with species-homologous organ homogenates emulsified in Freund's complete adjuvant. Sensitization with kidney and spleen homogenates stimulated in many but not in all animals the formation of circulating antibodies reacting in the complement fixation test with renal and splenic antigens. The observed immune response was probably not consequent on renal tissue damage per se, since it was absent in pyelonephritic rats. On the other hand, in many animals with chronic Masugi's nephritis circulating anti-kidney antibodies were observed.

It can be assumed that the increase in incidence and titre of circulating antibodies following homoimmunization reflects an enhanced formation of naturally occurring anti-tissue antibodies.

     

Measles antibodies and autoantibodies in autoimmune disorders.

Measles CF antibodies have been examined in the sera of patients with a variety of clinical disorders associated with the production of autoantibodies. Previous reports of high-titre reactions in DLE and chronic active hepatitis have been confirmed, the titres in the latter disorder being particularly elevated. Mean antibody titres to measles in patients with rheumatoid arthritis were significantly lower than in matched controls, and an inverse correlation between measles antibody levels and serum globulin levels was found. Measles antibody titres in patients with myasthenia gravis and primary biliary cirrhosis did not differ significantly from those found in controls. However, subdivision of patients with rheumatoid arthritis, myasthenia gravis and primary biliary cirrhosis showed that the presence of anti-nuclear antibody (ANA) was associated with significantly increased measles antibody levels compared with the ANA-negative sera. The presence of gastric parietal cell antibody or thyroid microsomal antibody did not appear to be associated with increased measles antibody levels, whether or not they occurred in association with previous anaemia or thyroid disease. Possible explanations for these findings in terms of immune complex formation and immune hyper-reactivity are discussed.     

An analysis of gastric parietal cell antibodies and thyroid cell antibodies in patients with pernicious anaemia and thyroid disorders

An analysis of immunoglobulins responsible for gastric parietal cell antibodies and for antibodies to thyroid cell has been performed in twenty-four patients with pernicious anaemia and thirteen patients with thyroid disorders. Immunofluorescent technique with conjugated antisera specific to each of the three main immunoglobulins and to β_1c-globulin was used.

IgG-globulin was responsible for gastric parietal cell antibodies in all patients investigated; IgA was found in gastric parietal cell antibodies of four thyroid patients but in none of the pernicious anaemia patients; IgM antibodies were found in two pernicious anaemia patients and in six thyroid patients. With regard to thyroid cell antibodies, IgG and IgA were both found responsible for antibody activity in thirteen cases and IgM in ten cases. In six patients, antibodies to thyroid cell were not β_1c-fixing, whereas all sera with gastric parietal cell antibodies fixed β_1c-globulin.

An obvious relationship could not be found either between the titres of the different types of antibodies within the same category of antibody, or between the titres of gastric parietal cell antibodies and thyroid cell antibodies in the same individual. An occasional relationship was found between the titres of IgG-parietal cell or thyroid cell antibodies and the capacity to bind β_1c-globulin.

These results demonstrate that each of the three main immunoglobulins may contribute to gastric parietal cell antibodies and to antibodies to thyroid cell.

     

Circulating antibodies to the surface antigens on colon epithelial cells in ulcerative colitis.

The fluorescence activated cell sorter (FACS) was used for detecting circulating antibodies to the surface antigens on isolated colon epithelial cells (anti-colon antibodies) by indirect immunofluorescence. Anti-colon antibodies were found in the serum of 30 of 41 (73%) patients with ulcerative colitis. This incidence is much higher than one established in earlier reports by application of indirect immunofluorescence to colon tissue using the fluorescence microscope. The results suggest that FACS analysis is very useful for detecting antibodies to colon specific antigen.     

Preciitating antibodies to mitochondrial antigens in patients with primary biliary cirrhosis.

Sera of patients with primary biliary cirrhosis (PBC) were examined for the presence of precipitating antibodies to sonicated rat liver mitochondrial (M) fraction. Three distinct precipitating systems observed in double immunodiffusion were identified and called M-A, M-B and M-C. Unsonicated mitochondria did not form precipitin lines. Precipitating system M-A was found in nineteen of twenty (95 percent) sera from PBC. The mitochondrial antigen of M-A system had the unusual property of being resistant to enzymatic digestion with deoxyribonuclease (DNase), ribonuclease (RNase) and trypsin under standard conditions. The titres of antibody to M-A antigen correlated (P less than 0.05) with titres of mitochondrial immunofluorescence staining on unfixed mouse kidney sections. Precipitating systems M-B and M-C were present in seven of twenty ribonuclease and trypsin but resistant to ribonuclease indicating that it could be DNA-protein complex. The M-C antigen was destroyed by trypsin suggesting its protein character, but it was difficult to determine if nucleic acids might also be associated with antigenicity. The antibodies to mitochondrial antigens were not present in normals (fifteen health adults), systemic lupus erythematosus (forty patients), rheumatoid arthritis (fifteen patients) and chronic liver diseases (fifteen patients). The antibodies did not show identity with antibodies to ribosomal ribonucleo-protein and other known nuclear antigens previously reported. The data confirm previous reports concerning the heterogeneity of mitochondrial antibodies present in sera of patients with PBC. The antibody to M-A antigen appeared to be a diagnostically useful immunological marker since it was present in the majority of patients with PBC.     

Functional TSH receptor antibodies in children with autoimmune thyroid diseases

Introduction: The diagnostic value of the level of TSH receptor antibodies (TSHR-Ab) in the population of children with autoimmune thyroid diseases (AITDs) is still unknown. The aim of this cross-sectional study was to investigate the prevalence of TSHR-Ab in a paediatric cohort with AITD and healthy controls.

Materials and methods: A total of 240 serum samples were obtained from 205 patients with AITD, type 1 diabetes (T1D), juvenile arthritis (JA), and healthy controls (C). TSHR stimulating (TSI) and -blocking (TBI) immunoglobulins were measured in cell-based bioassays using CHO cells expressing a chimeric TSHR and a c-AMP response-element-dependent luciferase. TSI was reported as percentage of specimen-to-reference ratio (cutoff 140SRR%). Blocking activity was defined as percent inhibition of luciferase expression relative to induction with bovine TSH alone (40% inhibition).

Results: C as well as children with JA and T1D were both TSI and TBI negative. In contrast, children with Graves’ disease (GD) were positive for TSI in 47/53 samples (88.7%) while those with thyroidal and orbital GD showed TSI positivity in 95.8% (23/24 samples). Serum TSI levels were SRR% 320?±?157 and 417?±?135 in GD and GD?+?orbitopathy, respectively (p?=?.02). Children with Hashimoto’s thyroiditis (HT) were TSI positive in 4/83 (4.8%) samples, including two with orbital involvement. TSI levels were increased in HT children with vs. those without eye disease (SRR% 177 vs. 51, p?Conclusions: In conclusion, TSI is prevalent in children with GD while the highest serum TSI levels were noted in children with AITD and orbitopathy.     

Treatment of autoimmune diseases with antibodies to class II major histocompatibility complex antigens

The family of Fc receptors (FcR) for IgG play pivotal roles in affector, effector, and regulatory functions of cells of the immune system. Thus, changes in expression and activation of FcRs may contribute to a variety of disease manifestations that are the consequence of abnormalities in immune system function. Patients with diabetes mellitus are often plagued with recurrent bacterial and mycotic infections, as well as large and small vessel injury which may in part be immune mediated and which lead to organ dysfunction. Hormone-mediated changes in immune system function have been postulated to contribute to a variety of the complications experienced by patients with diabetes mellitus. It is the purpose of this review to summarize current knowledge regarding abnormalities in immune system function in diabetes mellitus with special emphasis on classical hormonal modulation of Fc receptor-mediated phagocytosis.     

Demonstration of IgE antibodies to nucleic acid antigens in patients with SLE.

Using a combination of avidin-biotin microELISA and solid phase radioimmunoassay, we examined sera from 23 patients with systemic lupus erythematosus (SLE), two patients with established sensitivity to ingested shrimp, and 15 healthy normal subjects. In addition to IgG antibodies, varying amounts of IgE antibodies specific for native DNA (nDNA), denatured or single-stranded DNA (dnDNA), RNA, and tRNA were demonstrable in the sera of SLE patients, but not in the sera of normal subjects. A comparison of the specificity of nucleic acid-specific IgE antibodies present in the sera of shrimp-sensitive patients with those present in the sera of seven SLE patients revealed that the IgE antibodies in the sera of shrimp-sensitive patients specifically recognized shrimp tRNA but not yeast tRNA, calf thymus RNA, or calf thymus DNA, while those present in the sera of patients with SLE recognized all these nucleic acid antigens. The IgE antibodies directed against nDNA, dnDNA, RNA, and tRNA may mediate mast cell and basophil degranulation and thus contribute both to immediate-type hypersensitivity phenomena including hives seen in patients with SLE and to the localization of IgE-nucleic acid complexes in target tissues.     

Increased prevalence of antibodies to enteropathogenic Yersinia enterocolitica virulence proteins in relatives of patients with autoimmune thyroid disease

Infections have been implicated in the pathogenesis of a number of autoimmune diseases, and Yersinia enterocolitica (YE) might play a role in the development of autoimmune thyroid disease (AITD). Clinical evidence in support of this hypothesis has been inconclusive. We reasoned that looking earlier in the natural course of AITD might enhance chances of finding evidence for YE infection. Consequently, we determined seroreactivity against YE in subjects at risk of developing AITD, i.e. in 803 female relatives of AITD patients in self-proclaimed good health. As a comparison group we used 100 healthy women who participated in a program for reference values. IgG and IgA antibodies to virulence-associated outer membrane proteins (YOPs) of YE were measured by a specific assay. Serum thyroid peroxidase antibodies (TPO-Ab) as indicators of AITD were considered to be positive at levels of> 100 kU/l. The prevalence of YOP IgG-Ab was higher in AITD relatives than in controls (40.1% vs. 24%, P = 0.002), and the same was true for YOP IgA-Ab (22% vs. 13%, P < 0.05). Of the 803 AITD relatives, 44 had an increased or decreased plasma TSH, and 759 were euthyroid as evident from a normal TSH; the prevalence of YOP-Ab did not differ between these three subgroups. TPO-Ab were present in 10% of controls and in 27% of the AITD relatives (P < 0.001). The prevalence of TPO-Ab in the euthyroid AITD relatives was not different between YOP IgG-Ab positive and negative subjects (23.3% vs. 24.7%, NS), nor between YOP IgA-Ab positive and negative subjects (21.2% vs. 24.9%, NS). In conclusion, healthy female relatives of AITD patients have an increased prevalence of YOP antibodies, which, however, is not related to the higher prevalence of TPO antibodies in these subjects. The findings suggest a higher rate of persistent YE infection in AITD relatives. Susceptibility genes for AITD may also confer a risk for YE infection.     

Circulating Candida antigens and antibodies: useful markers of candidemia.

To investigate the utility of the 48-kDa antigen from Candida albicans in its commercial form (Directigen; Becton Dickinson) and three other serodiagnostic methods (detection of one antigen by Pastorex Candida [Sanofi Diagnostics Pasteur] and detection of immunoglobulin G [IgG] and IgM antibodies to C. albicans blastoconidia [bioMerieux]) for diagnosis of invasive Candida infection, we conducted a prospective clinical trial among 10 patients with candidemia (group 1), 30 patients colonized by C. albicans (group 2), 20 patients with bacteremia (group 3), and 20 subjects without clinical or microbiological evidence of infection. The Directigen system was positive for at least one serum sample each from eight patients in group 1. In groups 2, 3, and 4, it was positive for only three patients. There was no reaction to the Pastorex system in any of the patients infected with or colonized by C. albicans or in the non-Candida-carrying controls. The IgG antibody concentration oscillated between 100 and 800 (mean, 510 +/- 268) IU/ml for the patients in group 1. In this group, eight patients had IgG antibody levels of > 400 IU/ml. The percentages of persons with IgG antibody levels of > 400 IU/ml in groups 2, 3, and 4 were 43.3, 0, and 0, respectively. Specific IgM antibody was present in all group 1 patients but not in those in groups 2, 3, and 4. The sensitivity and specificity of the Directigen test were 65 and 97.1%, respectively. For the Pastorex test, the sensitivity was 0%. The sensitivity of IgG antibodies was 80%, with a specificity of 81.4%, while the IgM antibodies were 100% specific and sensitive. Both the positive and negative predictive values of specific IgM antibodies appeared to be superior to those of the other three tests.     

Prevalence of autoantibodies to thyroperoxidase in patients with various thyroid and autoimmune diseases.

An original radioimmunoassay for quantitation of circulating autoantibodies (aAb) to thyroperoxidase (TPO) proved to be well suited for large scale routine testing. The present study was aimed to assess the prevalence of aAb to TPO in patients with various thyroid and autoimmune disease and, for comparison, in women referred for reproductive disorders and indication of in vitro fertilization. Anti-TPO aAb were measured in sera from 32 healthy subjects and 262 patients thoroughly investigated for thyroid dysfunction. As determined in healthy subjects, the normal level of aAb to TPO in serum ranged from 0.30 to 3.07 mg/l (of affinity-purified) anti-TPO aAb. Anti-TPO and anti-MIC aAb levels were both normal in 115 patients and correlated well (r = 0.835, P less than 0.001) in the remaining 147 patients. Coexistence of normal level of anti-TPO aAb and abnormal level of anti-MIC aAb was found in 4 patients and ascribed to a lack of specificity or sensitivity of the test for anti-MIC aAb. Coexistence of abnormal level of anti-TPO aAb and normal level of anti-MIC aAb was found in 67 patients of whom 62 presented only slightly elevated (3.1 to 10.0 mg/l) anti-TPO aAb concentration; the 5 remaining patients, all with overt thyroid autoimmune disease, showed anti-TPO levels between 10.7 to 100.7 mg/l.(ABSTRACT TRUNCATED AT 250 WORDS)     

Quantification of antineural antibodies in autoimmune neurological disorders

More than 50 different neurological pathologies have a confirmed or suspected autoimmune etiology affecting an estimated number of 75 million people worldwide. Autoantibodies are a useful diagnostic marker for most autoimmune diseases even though their pathological role is not evident, and several tests for their detection are commercially available. However, for autoimmune diseases involving the nervous system, lack of clear information on the identity of antineural antibody targets and the presence of many rare diseases have hampered the development of specific diagnostic assays. This review focuses on the actual knowledge on confirmed and suspected autoimmune diseases that target the CNS and the diagnostic relevance of corresponding antineural autoantibodies.     

Analysis of anti-idiotypic antibodies against anti-microsomal antibodies in patients with thyroid autoimmunity.

Anti-microsomal antibody (AMA) activity was inhibited in 14 of 16 sera and in all 12 IgG preparations from patients with postpartum thyroiditis following incubation with F(ab')2 fragments from normal polyspecific immunoglobulin for therapeutic use (ivIg). Similar results were observed with sera from seven of seven patients with Graves' disease and five of six patients with autoimmune hypothyroidism. Results of these competitive binding assays and affinity chromatography of AMA IgG on Sepharose-bound F(ab'), fragments from ivIg indicated that AMA antibodies reacted with ivIg through idiotypic-anti-idiotypic interactions. Eight out of 10 IgG preparations from patients with autoimmune thyroid disease also showed inhibition of AMA activity when coincubated with autologous IgM at various IgG:IgM molar ratios. These observations suggest that ivIg can inhibit anti-microsomal antibodies through idiotype-anti-idiotype interactions and that such interactions occur with IgM anti-idiotype antibodies in vivo, providing evidence of a role for idiotypic network regulation in the control of thyroid autoimmunity.     

Circulating immune complexes in experimental syphilis: identification of treponemal antigens and specific antibodies to treponemal antigens in isolated complexes.

As a prelude to characterization of the host and treponemal antigens present in purified immune complexes from the sera of rabbits with disseminated syphilis, autoradiographic and immunoenzymatic analyses of solubilized extracts of Treponema pallidum, Treponema phagedenis biotype Reiter, and Treponema refringens were performed on electroblots of polypeptides first separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Electroblots of purified immune complexes were developed with the same panel of antisera so that protein profiles could be compared. Eight treponemal antigens were consistently present in isolated complexes; four of these cross-reacted with antisera prepared against avirulent treponemes. The average molecular weights of these antigens were 87,000, 76,000, 66,000, and 45,000. Antibodies dissociated from isolated immune complexes, when used for the development of T. pallidum electroblots, reacted with four antigens of comparable molecular weight. Antibodies to those polypeptides were also present in the sera of animals immunized with immune complexes. The demonstration of treponemal antigens in purified immune complexes convincingly argues that their occurrence in experimental syphilis is not merely due to tissue destruction and responses to endogenous host antigens.     

Detection of the circulating antibodies to teratocarcinomadefined antigens in patients with testicular tumours.

Sera from twenty-three patients with primary or metastatic testicular tumours of germinal origin were tested for antibodies against teratocarcinoma-associated antigen(s), using an indirect immunofluorescence technique. Human and 129/Sv mouse sperm and mouse teratocarcinoma cell line 402 AX were used as target cells. A total of fifteen sera were identified as positive, six of them when tested against both sperm and tumour cells. Tail staining has been the most prevalent pattern of fluorescence on both human and murine spermatozoa. These observations suggest that antibody to a common teratoma-defined antigen(s) was detected in sera of patients with testicular tumours.     

Increased incidence of autoimmune thyroid disorders in patients with psoriatic arthritis: a longitudinal follow-up study

Contrasting results have been reported about the prevalence of thyroid autoimmunity (AT) and dysfunction (TD) in patients with psoriatic arthritis (PsA). In this study, we pointed to evaluate the incidence of new cases of clinical and subclinical TD in a broad group of patients with PsA versus a control group, matched by age and gender belonging to the same geographic area. PsA patients with TD were excluded firstly, and new cases of thyroid disorders were evaluated in 97 PsA patients and 97 matched controls, who had comparable iodine intake (median follow-up of 74 months in PsA versus 92 in controls). A raised rate of new cases of hypothyroidism, TD, positive antithyroid peroxidase (AbTPO) antibodies, and appearance of a small hypoechoic thyroid pattern in PsA, especially in female gender, compared to controls has been evidenced. Risk factors in female gender for the development of TD are thyroid-stimulating hormone (TSH) within the normal range but at the higher limit, positive AbTPO, and small thyroid volume. To sum up, thyroid function follow-up and suitable treatments should be performed regularly in female patients at high risk (TSH within the normal range but at the higher limit, positive AbTPO, hypoechoic and small thyroid).     

Single-cell approaches to investigate B cells and antibodies in autoimmune neurological disorders

Autoimmune neurological disorders, including neuromyelitis optica spectrum disorder, anti-N-methyl-D-aspartate receptor encephalitis, anti-MOG antibody-associated disorders, and myasthenia gravis, are clearly defined by the presence of autoantibodies against neurological antigens. Although these autoantibodies have been heavily studied for their biological activities, given the heterogeneity of polyclonal patient samples, the characteristics of a single antibody cannot be definitively assigned. This review details the findings of polyclonal serum and CSF studies and then explores the advances made by single-cell technologies to the field of antibody-mediated neurological disorders. High-resolution single-cell methods have revealed abnormalities in the tolerance mechanisms of several disorders and provided further insight into the B cells responsible for autoantibody production. Ultimately, several factors, including epitope specificity and binding affinity, finely regulate the pathogenic potential of an autoantibody, and a deeper appreciation of these factors may progress the development of targeted immunotherapies for patients.