Molecular and genetic characterizations of five pathogenic and two non-pathogenic monoclonal antiphospholipid antibodies

Antiphospholipid syndrome (APS) is an autoimmune disease that is characterized by thrombosis, recurrent fetal loss and thrombocytopenia. Antiphospholipid antibodies, detected by enzyme-linked immunoabsorbent assays (aCL) and/or in vitro blood clotting assays (LAC) are strongly associated with APS. Both the molecular structures used by pathogenic antiphospholipid antibodies and the genetic mechanisms leading to their production are unknown. We describe here the variable region genes of seven IgG antiphospholipid antibodies derived from two APS patients. Of these, five are pathogenic as defined in a mouse model of thrombosis and two are not. Analyses of the expressed variable region genes show no preferential V gene usage. However, similar to anti-DNA antibodies, pathogenic antiphospholipid antibodies contain an increased number of arginine residues in the third complimentarity-determining region (CDR3) of their H chains. The increased accumulation of arginine residues in the V(H) CDR3 may act to enhance antigen binding, promote disease and point to the importance of the H chain in the pathogenic potential of certain antiphospholipid antibodies.     

Response from lieberman and colleagues

Respond on comments on Lieberman's article: Cyclosiloxanes Produce Fatal Liver and Lung Damage in Mice. Environ Health Perspect 107:161-165     

Optical coherence tomography in interventional cardiology—Research field or future daily routine?

Nowadays, optical coherent tomography (OCT) as the most precise morphologic technique is used in the increasing number of cases, both in routine clinical situations and research projects. Huang and co-workers reported the first clinical use of the 2-dimensional OCT in 1991, suggesting the principle of its use both in ophthalmology and interventional cardiology. The method has developed rapidly since that time. Interventional cardiologists benefit from its detailed intravascular imaging ability, providing real-time information of the intracoronary pathology. Researchers acknowledge the resolution, allowing detailed analysis of vessel structure. Its axial resolution level is approximately 10–15 μm, which is far from any other method used in interventional cardiology. The review will address the principle of the method and the main fields of the relatively short history of the OCT use as a routine clinical imaging method. We will summarize the main OCT milestones in the research field and its possible future as well. The review will describe OCT as the method under rapid development that should be considered as a new “gold” or even “platinum” standard for the coronary vessels imaging.     

Acute coronary syndromes with ongoing myocardial ischemia (ACS with OMI) versus acute coronary syndromes without ongoing ischemia (ACS without OMI): The new classification of acute coronary syndromes should replace old classification based on ST segment elevation presence or absence—Expert consensus statement of the Czech Society of Cardiology

The Czech Society of Cardiology is proposing here the new classification of acute coronary syndromes at the time of the first medical contact. The proposal suggests to remove the terms “ST elevation myocardial infarction” and “non-ST elevation acute coronary syndrome” and to replace these terms by “acute coronary syndrome with ongoing myocardial ischemia” and “acute coronary syndrome without ongoing myocardial ischemia”. The proposed new classification better reflects current treatment approaches and will facilitate the decision making at the first medical contact.