467 results on '"Antinuclear antibodies"'
Search Results
2. Prevalence and gender - specific analysis of a systemic sclerosis cohort in Latvia.
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Ivanova, Kristine, Ribakova, Olga, Mihailova, Anna, Mozeitovica, Evelina, Kadisa, Anda, Zepa, Julija, Kenina, Viktorija, Kurjane, Natalja, and Bulina, Inita
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SYSTEMIC scleroderma , *AGE groups , *INTERSTITIAL lung diseases , *RHEUMATISM , *AUTOIMMUNE diseases - Abstract
Background: Systemic sclerosis (SSc) is considered by many to be one of the most severe autoimmune rheumatic diseases with lower prevalence observed in Northern Europe. No previous studies on the prevalence of SSc in Latvia have been conducted and the aim was to study the demographic and clinical data of patients with SSc in northeastern Europe country. Methods: This study was conducted in two main Latvian hospitals for adults and includes patients with SSc who were consulted between 2016 and 2021. Results: During the study period, 159 patients with SSc were consulted. The point prevalence on 1 January 2021 was 84.0 per million. Female to male ratio was 4.67:1, and highest gender ratio was observed in the age group 70–79-year (6.75:1). Antinuclear antibodies were present in 82.58% of patients, without gender difference. Centromere pattern was more frequently observed in females (40.19% vs. 19.04%), in contrast to speckled pattern (50.98% vs. 57.14%). At disease onset females tended to be younger (46.51 ± 13.52) than males (50.5 ± 16.64). Males had more diffuse cutaneous subtype, interstitial lung disease, pulmonary hypertension and esophageal dysmotility. More than half of patients received treatment with glucocorticoids at any point of the disease (68.31%), without gender difference. Conclusions: Systemic sclerosis is less common in Latvia than in other countries and regions. Due to its location, the data from Latvia are consistent with a north-south gradient in Europe. Gender ratio differences persisted in older age groups as well. Antinuclear antibodies presence did not differ between genders, but in female's centromere pattern was much more likely to be present. Males had more severe disease course, but in both genders more than half of patients received treatment with GCs at any point of the disease. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Association of focus score and extraglandular involvement in Sjögren's syndrome: A study on antinuclear antibodies and minor salivary gland pathology.
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Ergün, Mustafa Çağrı, Yılmaz, Okancan, Bilgen, Hakan, Oltulu, Pembe, Kılınç, Fahriye, and Tunç, Recep
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RISK assessment , *HYDROXYCHLOROQUINE , *MONONUCLEAR leukocytes , *T-test (Statistics) , *AUTOANTIBODIES , *LOGISTIC regression analysis , *RETROSPECTIVE studies , *DESCRIPTIVE statistics , *AGE distribution , *CHI-squared test , *MANN Whitney U Test , *ANTIGENS , *LONGITUDINAL method , *MEDICAL records , *ACQUISITION of data , *SJOGREN'S syndrome , *SALIVARY glands , *COMPARATIVE studies , *DATA analysis software , *DISEASE complications - Abstract
Objectives: This study aimed to investigate the relationship between patients with and without extraglandular involvement in Sjögren's syndrome (SS) by analyzing ANA (antinuclear antibody) and ENA (extractable nuclear antigen) results and minor salivary gland pathology findings. Patients and methods: A total of 265 (245 females; 20 males; mean age: 50.4±12.4 years; range, 19 to 79 years) patients diagnosed with SS were included in the retrospective cohort study between March 1, 2011, and December 1, 2021. Detailed documentation was performed, capturing demographic characteristics, clinical information, laboratory findings, medication usage, and manifestations of the syndrome. The patients were divided into two groups, with (78 females; 8 males; mean age: 52.7±11.5; range, 22 to 78 years or without (167 females; 12 males; mean age: 49.3±12.8; range, 19 to 79 years extraglandular involvement. Results: The mean follow-up duration was 63.1±31.9 months. Extraganular involvement, including joint involvement, lung involvement, central nervous system involvement, hematological involvement, hepatitis, and lymphoma, was observed in 32.5% of the patients. Patients with extraglandular involvement required multiple medications, while those with only glandular involvement predominantly used hydroxychloroquine. The mean duration from SS diagnosis to extraglandular involvement was 15.2±27.8 months. The comparison between patients with and without extraglandular involvement revealed a significant association between higher focus scores (FS) and extraglandular manifestations. However, no significant differences were observed in terms of ANA positivity, ANA titers, or ENA positivity. Regression analysis indicated that age and FS were linked to systemic involvement. Conclusion: This study highlights the importance of FS as a predictive indicator for extraglandular manifestations in SS. Advanced age was found to be associated with an increased likelihood of extraglandular involvement. Assessing FS and age can aid in predicting extraglandular manifestations. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Clinical Significance of Antibodies to DFS70 in Immunoinflammatory Rheumatic Diseases.
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Panafidina, T. A., Verizhnikova, Zh. G., Avdeeva, A. S., Popkova, T. V., and Nasonov, E. L.
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RHEUMATISM , *ANTINUCLEAR factors , *IMMUNOGLOBULINS , *IMMUNOFLUORESCENCE , *PROGNOSIS - Abstract
The relevance of the problem of immunoinflammatory rheumatic diseases (IIRD) for modern medicine is determined by their high prevalence in the population, the difficulty of early diagnosis, the rapid development of disability and poor life prognosis. Recent data on the significance of anti-DFS70 have opened up new possibilities for optimizing the step-by-step diagnosis of IIRD. The detection of these antibodies can help in the interpretation of a positive result for antinuclear antibodies (ANA) by indirect immunofluorescence assay on HEp-2 cells (IIFA-HEp-2) in the absence of autoantibodies specific for IIRD. Detection of anti-DFS70 in antinuclear factor (ANF) seropositive patients without clinical and/or serological markers characteristic of a certain disease from the IIRD group can be considered as a potential marker that excludes this group of diseases. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Assessing serum anti-nuclear antibodies HEp-2 patterns in synucleinopathies
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Jonas Folke, Marie Skougaard, Trine-Line Korsholm, Anne-Line Strange Laursen, Lisette Salvesen, Anne-Mette Hejl, Sara Bech, Annemette Løkkegaard, Tomasz Brudek, Sisse Bolm Ditlev, and Susana Aznar
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Autoantibodies ,Synucleinopathies ,Movement disorders ,Antinuclear antibodies ,Immunologic diseases. Allergy ,RC581-607 ,Geriatrics ,RC952-954.6 - Abstract
Abstract This study investigates the presence of antinuclear antibodies (ANA) in three primary synucleinopathies – Parkinson’s disease (PD), multiple system atrophy (MSA), and dementia with Lewy bodies (DLB), compared to healthy controls. Autoinflammatory disorders typically involve the immune system mistakenly attacking the body’s own cells and start producing ANA. There is an increasing body of evidence that immune-mediated inflammation is a pathological feature linked to synucleinopathies. To investigate whether this could be autoimmune mediated we analyzed for ANA in the plasma of 25 MSA, 25 PD, and 17 DLB patients, along with 25 healthy controls, using the ANA HEp-2 indirect immunofluorescence antibody assay (ANA HEp-2 IFA). Contrary to initial expectations, results showed ANA HEp-2 positivity in 12% of PD, 8% of MSA patients, 18% of DLB patients, and 17% of healthy controls, indicating no increased prevalence of ANA in synucleinopathies compared to age-matched healthy individuals. Various ANA HEp-2 patterns were identified, but no specific pattern was associated with individual synucleinopathies. We conclude hereby that synucleinopathies are not associated with detectable presence of ANA in plasma.
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- 2024
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6. Assessing serum anti-nuclear antibodies HEp-2 patterns in synucleinopathies.
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Folke, Jonas, Skougaard, Marie, Korsholm, Trine-Line, Laursen, Anne-Line Strange, Salvesen, Lisette, Hejl, Anne-Mette, Bech, Sara, Løkkegaard, Annemette, Brudek, Tomasz, Ditlev, Sisse Bolm, and Aznar, Susana
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ANTINUCLEAR factors , *LEWY body dementia , *MULTIPLE system atrophy , *PARKINSON'S disease , *IMMUNE system - Abstract
This study investigates the presence of antinuclear antibodies (ANA) in three primary synucleinopathies – Parkinson's disease (PD), multiple system atrophy (MSA), and dementia with Lewy bodies (DLB), compared to healthy controls. Autoinflammatory disorders typically involve the immune system mistakenly attacking the body's own cells and start producing ANA. There is an increasing body of evidence that immune-mediated inflammation is a pathological feature linked to synucleinopathies. To investigate whether this could be autoimmune mediated we analyzed for ANA in the plasma of 25 MSA, 25 PD, and 17 DLB patients, along with 25 healthy controls, using the ANA HEp-2 indirect immunofluorescence antibody assay (ANA HEp-2 IFA). Contrary to initial expectations, results showed ANA HEp-2 positivity in 12% of PD, 8% of MSA patients, 18% of DLB patients, and 17% of healthy controls, indicating no increased prevalence of ANA in synucleinopathies compared to age-matched healthy individuals. Various ANA HEp-2 patterns were identified, but no specific pattern was associated with individual synucleinopathies. We conclude hereby that synucleinopathies are not associated with detectable presence of ANA in plasma. [ABSTRACT FROM AUTHOR]
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- 2024
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7. TNF-α-positive patients with recurrent pregnancy loss: The etiology and management.
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Cai, Zhuhua, Guo, Xueke, Zheng, Ge, Xiang, Junmiao, Liu, Lingyun, Lin, Dongmei, and Deng, Xiaohui
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RECURRENT miscarriage , *ECULIZUMAB , *COMPLEMENT (Immunology) , *PREGNANCY outcomes , *TUMOR necrosis factors , *ANTINUCLEAR factors , *IMMUNOGLOBULIN M - Abstract
Elevated levels of tumor necrosis factor-alpha (TNF-α) have been associated with adverse pregnancy outcomes, specifically recurrent pregnancy loss (RPL). These elevated levels may be associated with the presence of autoantibodies. Although TNF-α inhibitors have shown promise in improving pregnancy rates, further research is needed to comprehend their impact and mechanisms in RPL patients. This study aims to investigate the association between elevated TNF-α levels and autoantibodies in RPL patients, as well as evaluate the effect of TNF-α inhibition on pregnancy outcomes. A total of 249 RPL patients were included in this study. Serum levels of TNF-α, autoantibodies, and complement were measured and monitored. Among these patients, 138 tested positive for TNF-α, while 111 tested negative. The medical records of these patients were retrospectively evaluated. Additionally, 102 patients with elevated TNF-α levels were treated with TNF-α inhibitors, and their pregnancy outcomes were assessed.TNF-α-positive RPL patients had higher levels of complement C1q, anti-cardiolipin (ACL)-IgA, ACL-IgM ,ACL-IgG, thyroglobulin antibody, and Anti-phosphatidylserine/prothrombin IgM antibody, as well as a higher positive rate of antinuclear antibodies compared to TNF-α-negative patients (23.19% vs. 12.6%, P< 0.05). Conversely, complement C3 were lower in TNF-α-positive patients (t test, P< 0.05). The use of TNF-α inhibitors led to a reduction in the early abortion rate (13.7% vs. 44.4%, P< 0.001) and an improvement in term delivery rate (52.0% vs. 27.8%, P= 0.012). Furthermore, patients who used TNF-α inhibitors before 5 weeks of pregnancy had a lower early abortion rate (7.7% vs. 24.3%, P= 0.033) and a higher term delivery rate (69.2% vs. 48.6%, P= 0.033).TNF-α plays a role in the occurrence and development of RPL, and its expression is closely associated with autoantibodies and complements. TNF-α inhibitors increase the term delivery rate in TNF-α-positive RPL patients, and their use before 5 weeks of pregnancy may more beneficial. [ABSTRACT FROM AUTHOR]
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- 2024
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8. Clinical significance of the anti-Nucleolar Organizer Region 90 antibodies (NOR90) in systemic sclerosis: Analysis of the European Scleroderma Trials and Research (EUSTAR) cohort and a systematic literature review.
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Dima, A, Vonk, MC, Garaiman, A, Kersten, BE, Becvar, R, Tomcik, M, Hoffmann-Vold, A-M, Castellvi, I, Jaime, JL Tandaipan, Brzosko, M, Milchert, M, Krasowska, D, Michalska-Jakubus, M, Airo, P, Matucci-Cerinic, M, Bruni, C, Iudici, M, Distler, JHW, Gheorghiu, AM, and Poormoghim, H
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SYSTEMIC scleroderma , *ANTINUCLEAR factors , *IMMUNOGLOBULINS , *DATABASES , *GASTROINTESTINAL hemorrhage - Abstract
The anti-Nucleolar Organizer Region 90 antibodies (NOR90) are rare antinuclear antibodies (ANA) reported in systemic sclerosis (SSc). Especially due to low prevalence, the clinical relevance of NOR90 in SSc remains uncertain. To analyze the clinical associations of NOR90 in patients with SSc in a multicentric cohort. Post-hoc, cross-sectional study of prospectively collected data from the European Scleroderma Trials and Research (EUSTAR) database, with additional information on NOR90. Further, we performed a systematic literature search, using the terms "systemic sclerosis" and "NOR90" across three databases: Medline via PubMed, Scopus, and Thomson Reuters' Web of Science Core Collection, from inception to November 1st, 2023. Overall, 1318 patients with SSc were included (mean age 58.3 ± 13.7 years, 81.3 % female), of whom 44 (3.3 %) were positive for NOR90. Of these, 32 were also positive for one of the SSc-criteria antibodies: 9/44 (20.5 %) for anti-topoisomerase I, 18/42 (42.9 %) for anti-centromere, and 5/40 (12.5 %) for anti-RNA polymerase III. NOR90-positive patients were more frequently female, had lower modified Rodnan skin score (mRSS), and lower prevalence of upper and lower gastrointestinal (GI) symptoms compared to NOR90-negative patients. In multivariable analysis, NOR90 remained significantly associated with lower mRSS and less frequent GI symptoms. The literature search identified 17 articles, including a total number of 87 NOR90-positive out of 3357 SSc patients, corresponding to an overall prevalence of 2.6 %. To our best knowledge, this is the largest SSc cohort tested for NOR90 to date, confirming the NOR90 prevalence in SSc patients is around 3 %. [ABSTRACT FROM AUTHOR]
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- 2024
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9. Clinical characteristics of systemic lupus erythematosus in Al Qassim region of Saudi Arabia.
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AlShomar, Ahmad, Sula, Idris, Alsulmi, Hussam A., and Mahmoud Bakr, Mohamed
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The aim of the study is to explore the clinical manifestations, laboratory findings, and management of systemic lupus erythematosus (SLE) patients in Al Qassim region of Saudi Arabia. The clinical data, laboratory investigations, medications received and co-morbidities from SLE patients in Al Qassim region of Saudi Arabia were recorded. The 96 SLE patients were 87 (90.63 %) Saudi. 83 (86.5 %) were females and 13 (13.5 %) males (F:M 6.3:1). The mean age of the patients was 37.4 ± 11.9 years; at time of diagnosis was 32.3 ± 11.1 years, disease duration 5.1 ± 5.8 years. 9.3 % were hypertensive. The most common clinical manifestations were musculoskeletal (79 %) and constitutional (77 %) followed by mucocutaneous (42 %). Lupus nephritis was diagnosed in 25 % of patients and was confirmed by renal biopsy in 13.5 %. 4.2 % had thromboembolic disorders. Co-morbidities were present in 25 % and pregnancy complications were reported in 18 % of the females. Anemia was present in 63.5 %, leukopenia in 20 % and thrombocytopenia in 15 %. All patients tested positive for antinuclear antibodies, 80 % positive for anti-double-stranded deoxyribonucleic acid and 42.7 % anti-Smith. Antiphospholipid antibodies were detected in 46 % of patients and rheumatoid factor in 15.6 %. 93.8 % of patients received hydroxychloroquine, 76 % received steroids, 29.2 % mycophenolate mofetil, 4 patients received rituximab and 3 belimumab. The most common clinical disease profile in SLE patients from AlQassim was musculoskeletal and constitutional symptoms. 25 % of the patients had LN and 25 % had co-morbidities. Anemia is a common laboratory finding, and hydroxychloroquine is the most common treatment. [ABSTRACT FROM AUTHOR]
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- 2024
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10. The Onset of Antinuclear Antibodies (ANAs) as a Potential Risk Factor for Mortality and Morbidity in COVID-19 Patients: A Single-Center Retrospective Study.
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Netti, Giuseppe Stefano, Soccio, Piera, Catalano, Valeria, De Luca, Federica, Khalid, Javeria, Camporeale, Valentina, Moriondo, Giorgia, Papale, Massimo, Scioscia, Giulia, Corso, Gaetano, Foschino, Maria Pia, Lo Caputo, Sergio, Lacedonia, Donato, and Ranieri, Elena
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COVID-19 ,ANTINUCLEAR factors ,MORTALITY risk factors ,AUTOIMMUNE diseases ,SURVIVAL rate - Abstract
The immune system's amplified response to SARS-CoV-2 may lead to the production of autoantibodies, but their specific impact on disease severity and outcome remains unclear. This study aims to assess if hospitalized COVID-19 patients face a worse prognosis based on ANA presence, even without autoimmune diseases. We performed a retrospective, single-center, observational cohort study, enrolling 638 COVID-19 patients hospitalized from April 2020 to March 2021 at Hospital "Policlinico Riuniti" of Foggia (Italy). COVID-19 patients with a positive ANA test exhibited a significantly lower 30-day survival rate (64.4% vs. 83.0%) and a higher likelihood of severe respiratory complications during hospitalization than those with negative ANA screening (35.4% vs. 17.0%) (p < 0.001). The association between poor prognosis and ANA status was identified by calculating the HALP score (Hemoglobin-Albumin-Lymphocyte-Platelet), which was lower in COVID-19 patients with a positive ANA test compared to ANA-negative patients (108.1 ± 7.4 vs. 218.6 ± 11.2 AU; p < 0.011). In detail, COVID-19 patients with a low HALP showed a lower 30-day survival rate (99.1% vs. 83.6% vs. 55.2% for high, medium, and low HALP, respectively; p < 0.001) and a higher incidence of adverse respiratory events compared to those with high and medium HALP (13.1% vs. 35.2% vs. 64.6% for high, medium, and low HALP, respectively; p < 0.001). In summary, ANA positivity in COVID-19 patients appears to be linked to a more aggressive disease phenotype with a reduced survival rate. Furthermore, we propose that the HALP score could serve as a valuable parameter to assess prognosis for COVID-19 patients. [ABSTRACT FROM AUTHOR]
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- 2024
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11. Systemic lupus erythematosus (SLE) associated uveitis in India - A case series.
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Magesan, Kowsigan, Nangia, Purna, Manoharan, Anitha, Sitaula, Ranju K., Srikantiah, Chandrashekara, and Biswas, Jyotirmay
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SYSTEMIC lupus erythematosus , *ANTINUCLEAR factors , *UVEITIS , *IRIDOCYCLITIS , *OCULAR manifestations of general diseases , *IMMUNOSUPPRESSIVE agents - Abstract
Purpose: To report the uveitic manifestations of patients with systemic lupus erythematosus (SLE). Methods: This was a retrospective analysis of all SLE cases with ocular manifestations seen by a single ophthalmologist between 2015 and December 2021. Results: In total, seven patients with a median age of 40 (range 18-50) years were included in the study. Female (85.7%) predominance was noted. Ocular findings were bilateral in 71% (five patients) of cases. Majority (10 eyes, 83%) of the patients had retinal vasculitis as the common finding. Antinuclear antibodies were positive in all the patients. The vision improved in two (16.6%) eyes, was stable in eight (66%) eyes, and worsened in one (8%) eye. All the patients were treated with oral steroids along with immunosuppressive agents. Conclusion: Though SLE is rare cause of uveitis, it can be associated with significant ocular morbidity. Hence, early diagnosis and treatment can salvage vision in many cases. [ABSTRACT FROM AUTHOR]
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- 2024
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12. Clinical features and visual prognosis of very late-onset neuromyelitis optica spectrum disorder–related optic neuritis.
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Yang, Qinglin, Lai, Chuntao, Meng, Chao, Chang, Qinglin, Wei, Na, and Wang, Jiawei
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NEUROMYELITIS optica , *OPTIC neuritis , *ANTINUCLEAR factors , *LOGISTIC regression analysis - Abstract
Background: Very late-onset neuromyelitis optica spectrum disorder–related optic neuritis is limited to a few case reports. Objective: To investigate the clinical features and visual prognosis of very late-onset neuromyelitis optica spectrum disorder–related optic neuritis. Methods: This study evaluated 22 patients with first-onset optic neuritis and fulfilled the 2015 diagnosis criteria for neuromyelitis optica spectrum disorders. Results: The mean age at optic neuritis onset was 73.91 ± 4.71 (range: 70–82) years with a female predominance (81.8%; ratio: 4.5:1). Antinuclear antibody seropositivity and seronegativity were identified in 12 (55.5%) and 10 (45.5%) patients, respectively. Severe visual loss persisted in 19 (19/42, 45.3%) eyes at the last follow-up. Although patients with antinuclear antibody seropositivity had a significantly higher frequency of attacks (P = 0.015), but they had a longer median time to reach severe visual loss (37 vs. 26 months; log-rank test, P = 0.023). Multivariate logistic regression analysis revealed antinuclear antibody seropositivity (hazard ratio = 4.849, 95% confidence interval: 1.309–17.965, P = 0.018) as a good predictor of visual acuity improvement. Conclusion: Patients with very late-onset neuromyelitis optica spectrum disorder–related optic neuritis may develop severe optic neuritis, and those with antinuclear antibody seronegativity have a similar clinical presentation but worse outcome than those with seropositivity. [ABSTRACT FROM AUTHOR]
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- 2024
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13. Les anticorps antinucléaires : spectateurs ou acteurs ? Exemple de la sclérodermie systémique.
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Chépy, Aurélien, Collet, Aurore, Sobanski, Vincent, and Dubucquoi, Sylvain
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Les anticorps antinucléaires (ANA pour Anti-nuclear antibodies) sont en première ligne dans le diagnostic des connectivites dans notre pratique. Au-delà de leur utilité diagnostique et pronostique, ces biomarqueurs pourraient également avoir un rôle direct pathogénique. Ainsi, dans la sclérodermie systémique (ScS) les trois spécificités les plus fréquentes que sont les auto-anticorps (aAc) anti-topoisomérase-I (anti-TOPO-I ou Scl70), anti-centromères et anti-ARN polymérase-III sont intégrées dans la classification de la maladie. De nouvelles spécificités antigéniques sont également associées au diagnostic de la ScS. La chronologie d'apparition de ces auto-anticorps, leur corrélation à des phénotypes et/ou leur valeur pronostique, ainsi que l'efficacité de certaines biothérapies, plaident en faveur d'un rôle pathogénique de ces aAc au-delà de leur rôle de marqueur diagnostique. L'implication des ANA dans la physiopathologie de la ScS ouvre la voie à de nouveaux champs de recherche dans ce domaine. Anti-nuclear antibodies (ANA) are on the front line of diagnosing connective tissue disease. Beyond their diagnostic and prognostic utility, these biomarkers could also have a direct pathogenetic role. Thus, in systemic sclerosis the three most frequent specificities which are anti-topoisomerase-I aAb (anti-TOPO-I or Scl70), anti-centromeres and anti-RNA polymerase-III are integrated into the classification of the disease. New antigenic specificities are also associated with the diagnosis of systemic sclerosis. The time frame for theses autoantibodies appearance, their correlation with phenotypes and/or prognoses as well as the therapeutic efficacy of certain biotherapies argue in favor of a pathogenetic role of these aAb beyond their role as diagnostic marker. The involvement of ANA in the pathophysiology of SSc opens the way to new fields of research in this area. [ABSTRACT FROM AUTHOR]
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- 2024
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14. Antinuclear Antibodies in Systemic Lupus Erythematous – Their Complex Role and Clinical Significance in Diagnosis
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Natalia Kucy, Paula Kula, Alicja Kotula, Olga Grelewicz, Adrianna Czachor, Elwira Servaas, Adam Juśkiewicz, and Mateusz Haber
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Systemic Lupus Erythematosus ,Antinuclear antibodies ,autoimmune diseases ,rheumatology ,dermatology ,assay ,Sports ,GV557-1198.995 ,Sports medicine ,RC1200-1245 - Abstract
Antinuclear antibodies (ANA) are a wide group of proteins directed against autologous cellular components, primarily nucleic acids and histones. Their levels are assessed using immunofluorescence on Hep-2 cells or a solid-phase ANA screening immunoassay to subsequently obtain titer value with positive cut-point of ≥1:80. Studies show that ANA can be found in 13% of general population, but typically they are associated with autoimmune conditions and inflammatory connective tissue diseases for example: systemic lupus erythematosus (SLE), sjögren's syndrome, rheumatoid arthritis, mixed connective tissue disease, juvenile idiopathic arthritis, systemic sclerosis, inflammatory myopathies. ANA detection is especially important for SLE, where 2 antibody types - anti-Sm and anti-dsDNA - serve as an entry diagnostic criterion. With increasing patient screening for those antibodies, it is important to determine that alone, positive ANA assays cannot confirm nor deny any disease and to classify their presence as a marker of a disease it is required to satisfy additional additive criteria approved in 2019 by European League Against Rheumatism/American College of Rheumatology. SLE diagnosis can be made when patient collects 10 points from clinical or immunologic domains described by EULAR/ACR, which makes SLE diagnosis challenging and therefore, describing the guidelines is vital to remain cautious about overestimation of the position positive ANA values hold in clinical practice. In conclusion the positive ANA test may be a basis for diagnosis, when additional symptoms occur, but alone does not hold any diagnostic significance and may lead to unnecessary stress for patient.
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- 2024
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15. Comprehensive Insights into Neuropsychiatric Systemic Lupus Erythematosus
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Monika Turek, Klara Wojciechowska, Karolina Piątkowska, Aleksandra Jaroń, Katarzyna Jastrzębska, Iwona Chaberska, Aleksandra Feruś, and Julia Lipska
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Neuropsychiatric systemic lupus erythematosus ,cognitive dysfunction ,antinuclear antibodies ,Sports ,GV557-1198.995 ,Sports medicine ,RC1200-1245 - Abstract
Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, often affecting women of childbearing age, with periods of exacerbations and remissions. SLE can impact multiple organs, causing a range of clinical symptoms. Neuropsychiatric systemic lupus erythematosus (NPSLE) includes symptoms like headaches, seizures, anxiety disorders, cognitive dysfunctions, psychosis, and neuropathies. Its diagnosis is challenging, and treatment is complex. Purpose: This study aims to explain the pathophysiology of NPSLE, describe diagnostic methods, and summarize current treatment methods based on recent research. Methods: Databases such as PubMed, Medline, and ResearchGate were used. State of current knowledge: Early and accurate diagnosis of SLE is crucial for optimal patient management. The 2019 EULAR/ACR classification criteria have improved diagnostic precision with a weighted scoring system for diverse disease manifestations. Therapy of neuropsychiatric lupus focuses on symptom control and causal treatment, considering anti-inflammatory action or counteracting ischemic incidents. It involves immunosuppressive agents and antiplatelet or anticoagulant substances. Non-pharmacological interventions and lifestyle modifications are also important. The dynamic criteria reflect ongoing advancements in understanding SLE, emphasizing continuous research and collaboration. Conclusions: The diagnosis of NPSLE requires excluding other causes of neuropsychiatric symptoms, such as infections, endocrine disorders, or drug reactions. Diagnostic methods vary based on symptoms, including lumbar puncture, CSF analysis, EEG, cognitive function assessment, and MRI. The treatment of NPSLE focuses on symptom control and causal treatment, with therapy individualized based on symptom severity and patient burden.
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- 2024
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16. Fully automated chemiluminescence microarray immunoassay for detection of antinuclear antibodies in systemic autoimmune rheumatic diseases
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Yuan Dandan, Yang Xue, Ji Chen, Sun Guo, Xu Yang, Cao Ye, Ye Yan, Wang Tingting, and Hu Zhigang
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antinuclear antibodies ,clmia ,systemic autoimmune rheumatic diseases ,Medical technology ,R855-855.5 - Abstract
Detection of specific antinuclear antibodies is very important in term of diagnosis, prognosis and management of patients with systemic autoimmune rheumatic diseases. Chemiluminescence microarray immunoassay (CLMIA) is a microdot array-based method that allows simultaneous detection of multiple antinuclear antibodies, which received increasing attention.
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- 2024
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17. Diez puntos de ayuda para la clasificación de pacientes con lupus eritematoso sistémico.
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Mercado, Ulises
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In 2019, the American College of Rheumatology (ACR)/European League against Rheumatism (EULAR) proposed new criteria to aid classify a patient with systemic lupus erythematosus. These criteria use a point-based system ranging from 2-10 points. The presence of antinuclear antibody is an entry criterion for classification. Sensitivity and specificity are 93% and 96%, respectively. Non-infectious fever was added as the new criterion. VDRL and LE cell tests and photosensitivity have been removed. [ABSTRACT FROM AUTHOR]
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- 2024
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18. Systemic lupus erythematosus associated with erythema multiforme: A rare case report of Rowell's syndrome.
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Bhattarai, Madhur, Sharma, Niraj Kumar, Paudel, Shreeram, Bhandari, Sujata, Bhusal, Amrit, Dhonju, Kiran, Kuikel, Sandip, Jha, Shivendra Kumar, Aryal, Egesh, and Subedi, Deepak
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ERYTHEMA multiforme , *SYSTEMIC lupus erythematosus , *RHEUMATOID factor , *ANTINUCLEAR factors , *HERPES simplex virus , *CONNECTIVE tissues - Abstract
Key Clinical Message: Although it is very uncommon, SLE may initially present with recurrent episodes of EM‐like rash. Despite the various possibilities underlying their association, prompt identification, and treatment of SLE in patients presenting with EM is important to prevent death or serious organ damage. Rowell's syndrome (RS) is an uncommon presentation of systemic lupus erythematosus (SLE) with erythema multiforme (EM)‐like lesions associated with specific serological changes, including positive rheumatoid factor (RF), speckled antinuclear antibody (ANA), positive rheumatoid factor, or anti‐La antibodies in the serum. Our case, a 41‐year‐old male, presented with features of EM. Upon investigation, we identified underlying systemic lupus erythematosus, marking a rare instance of SLE presenting for the first time as EM. Classical or true EM is precipitated by trigger factors such as infective agents like the herpes simplex virus, Mycoplasma pneumoniae, drugs like anticonvulsants, antibiotics, and non‐steroid anti‐inflammatory drugs, any underlying malignancy, or connective tissue disorders, and is not associated with any specific serological abnormalities. EM cases associated with LE lesions where an EM trigger factor is missing are considered an RS diagnostic criterion. In this case report, the importance of considering SLE in patients presenting initially with recurrent episodes of EM‐like rash is emphasized. RS should be considered, especially when there is no evidence of triggering factors. Early diagnosis and prompt treatment of SLE are crucial to preventing death and irreversible organ damage. [ABSTRACT FROM AUTHOR]
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- 2024
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19. Rekomendacje EFLM, EASI oraz ICAP: Detekcja przeciwciał przeciwjądrowych Publikacja EFLM.
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Bonroy, Carolien, Vercammen, Martine, Fierz, Walter, Andrade, Luis E. C., Van Hoovels, Lieve, Infantino, Maria, Fritzler, Marvin J., Bogdanos, Dimitrios, Kozmar, Ana, Nespola, Benoit, Broeders, Sylvia, Patel, Dina, Herold, Manfred, Zheng, Bing, Chan, Eric Y. T., Uibo, Raivo, Haapala, Anna-Maija, Musset, Lucile, Sack, Ulrich, and Nagy, Gabor
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COMPUTER-aided diagnosis ,ANTINUCLEAR factors ,CLINICAL chemistry ,EUROPEAN integration ,CHEMICAL laboratories - Abstract
Copyright of Journal of Laboratory Diagnostics / Diagnostyka Laboratoryjna is the property of Index Copernicus International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2024
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20. Identifying antinuclear antibody positive individuals at risk for developing systemic autoimmune disease: development and validation of a real-time risk model.
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Barnado, April, Moore, Ryan P., Domenico, Henry J., Green, Sarah, Camai, Alex, Suh, Ashley, Han, Bryan, Walker, Katherine, Anderson, Audrey, Caruth, Lannawill, Katta, Anish, McCoy, Allison B., and Byrne, Daniel W.
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ANTINUCLEAR factors ,AUTOIMMUNE diseases ,MACHINE learning ,ELECTRONIC health records ,SYSTEMIC risk (Finance) ,PLATELET count - Abstract
Objective: Positive antinuclear antibodies (ANAs) cause diagnostic dilemmas for clinicians. Currently, no tools exist to help clinicians interpret the significance of a positive ANA in individuals without diagnosed autoimmune diseases. We developed and validated a risk model to predict risk of developing autoimmune disease in positive ANA individuals. Methods: Using a de-identified electronic health record (EHR), we randomly chart reviewed 2,000 positive ANA individuals to determine if a systemic autoimmune disease was diagnosed by a rheumatologist. A priori, we considered demographics, billing codes for autoimmune disease-related symptoms, and laboratory values as variables for the risk model. We performed logistic regression and machine learning models using training and validation samples. Results: We assembled training (n = 1030) and validation (n = 449) sets. Positive ANA individuals who were younger, female, had a higher titer ANA, higher platelet count, disease-specific autoantibodies, and more billing codes related to symptoms of autoimmune diseases were all more likely to develop autoimmune diseases. The most important variables included having a diseasespecific autoantibody, number of billing codes for autoimmune disease-related symptoms, and platelet count. In the logistic regression model, AUC was 0.83 (95% CI 0.79-0.86) in the training set and 0.75 (95% CI 0.68-0.81) in the validation set. Conclusion: We developed and validated a risk model that predicts risk for developing systemic autoimmune diseases and can be deployed easily within the EHR. The model can risk stratify positive ANA individuals to ensure high-risk individuals receive urgent rheumatology referrals while reassuring low-risk individuals and reducing unnecessary referrals. [ABSTRACT FROM AUTHOR]
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- 2024
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21. Recognition of rare antinuclear antibody patterns based on a novel attention-based enhancement framework.
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Zeng, Junxiang, Gao, Xiupan, Gao, Limei, Yu, Youyou, Shen, Lisong, and Pan, Xiujun
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PATTERN recognition systems , *MEDICAL technologists , *IMMUNOGLOBULINS , *DEEP learning , *MEDICAL assistants , *ANTINUCLEAR factors , *ARTIFICIAL intelligence - Abstract
Rare antinuclear antibody (ANA) pattern recognition has been a widely applied technology for routine ANA screening in clinical laboratories. In recent years, the application of deep learning methods in recognizing ANA patterns has witnessed remarkable advancements. However, the majority of studies in this field have primarily focused on the classification of the most common ANA patterns, while another subset has concentrated on the detection of mitotic metaphase cells. To date, no prior research has been specifically dedicated to the identification of rare ANA patterns. In the present paper, we introduce a novel attention-based enhancement framework, which was designed for the recognition of rare ANA patterns in ANA-indirect immunofluorescence images. More specifically, we selected the algorithm with the best performance as our target detection network by conducting comparative experiments. We then further developed and enhanced the chosen algorithm through a series of optimizations. Then, attention mechanism was introduced to facilitate neural networks in expediting the learning process, extracting more essential and distinctive features for the target features that belong to the specific patterns. The proposed approach has helped to obtained high precision rate of 86.40%, 82.75% recall, 84.24% F1 score and 84.64% mean average precision for a 9-category rare ANA pattern detection task on our dataset. Finally, we evaluated the potential of the model as medical technologist assistant and observed that the technologist's performance improved after referring to the results of the model prediction. These promising results highlighted its potential as an efficient and reliable tool to assist medical technologists in their clinical practice. [ABSTRACT FROM AUTHOR]
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- 2024
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22. The Binding Properties of Antibodies to Z-DNA in the Sera of Normal Healthy Subjects.
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Pisetsky, David S., Gedye, Matthew J., David, Lawrence A., and Spencer, Diane M.
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DNA antibodies , *IMMUNOGLOBULINS , *IONIC strength , *ELECTROSTATIC interaction , *IMMUNOGLOBULIN A , *IMMUNOGLOBULIN G , *SERUM , *UREA - Abstract
Antibodies to DNA are a diverse set of antibodies that bind sites on DNA, a polymeric macromolecule that displays various conformations. In a previous study, we showed that sera of normal healthy subjects (NHS) contain IgG antibodies to Z-DNA, a left-handed helix with a zig-zig backbone. Recent studies have demonstrated the presence of Z-DNA in bacterial biofilms, suggesting a source of this conformation to induce responses. To characterize further antibodies to Z-DNA, we used an ELISA assay with brominated poly(dGdC) as a source of Z-DNA and determined the isotype of these antibodies and their binding properties. Results of these studies indicate that NHS sera contain IgM and IgA as well as IgG anti-Z-DNA antibodies. As shown by the effects of ionic strength in association and dissociation assays, the anti-Z-DNA antibodies bind primarily by electrostatic interactions; this type of binding differs from that of induced anti-Z-DNA antibodies from immunized animals which bind by non-ionic interactions. Furthermore, urea caused dissociation of NHS anti-Z-DNA at molar concentrations much lower than those for the induced antibodies. These studies also showed IgA anti-Z-DNA antibodies in fecal water. Together, these studies demonstrate that antibodies to Z-DNA occur commonly in normal immunity and may arise as a response to Z-DNA of bacterial origin. [ABSTRACT FROM AUTHOR]
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- 2024
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23. New-onset autoimmune disease after COVID-19.
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Hileman, Corrilynn O., Malakooti, Shahdi K., Patil, Nirav, Singer, Nora G., and McComsey, Grace A.
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POLYARTERITIS nodosa ,AUTOIMMUNE diseases ,SARS-CoV-2 ,COVID-19 ,SARS-CoV-2 Omicron variant ,TYPE 1 diabetes ,LEUKOCYTOCLASTIC vasculitis - Abstract
Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may trigger autoimmune disease (AD) through initial innate immune activation with subsequent aberrations in adaptive immune cells leading to AD. While there are multiple reports of incident AD diagnosed after COVID-19, the risk in the context of key circulating strains is unknown. Methods: TriNetX, a global, federated, health research network providing access to electronic medical records across 74 healthcare organizations, was utilized to define an adult cohort between January 1, 2020, and March 3, 2023. Exposure was defined as COVID-19 diagnosis (ICD-10 code or positive laboratory test). Age- and sex-propensity score-matched controls never had COVID-19 diagnosed. Outcomes were assessed 1 month to 1 year after the index date. Patients with AD prior to or within 1 month after the index date were excluded from the primary analysis. Incidence and risk ratios of each AD were assessed. Results: A total of 3,908,592 patients were included. Of 24 AD patients assessed, adjusted risk ratios for eight AD patients who had COVID-19 were higher compared to those who had no COVID-19. Cutaneous vasculitis (adjusted hazard ratio (aHR): 1.82; 95% CI 1.55-2.13), polyarteritis nodosa (aHR: 1.76; 95% CI 1.15-2.70), and hypersensitivity angiitis (aHR: 1.64; 95% CI 1.12-2.38) had the highest risk ratios. Overall, psoriasis (0.15%), rheumatoid arthritis (0.14%), and type 1 diabetes (0.13%) had the highest incidence during the study period, and of these, psoriasis and diabetes were more likely after COVID-19. The risk of any AD was lower if COVID-19 was diagnosed when Omicron variants were the predominant circulating strains. A positive antinuclear antibody was more likely and predictive of AD after COVID-19. Discussion: SARS-CoV-2 may be a potential trigger for some AD, but the risk for AD may decrease with time given the apparent lower risk after infection with Omicron variants. [ABSTRACT FROM AUTHOR]
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- 2024
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24. The titers of antinuclear antibodies are associated with the degree of inflammation and organ damage in Primary Sjögren's Syndrome.
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Shao, Huijun, Wu, Yue, Tao, Xinyu, Liu, Qun, Ran, Chenyu, Jin, Li, and Tao, Jinhui
- Abstract
Primary Sjögren’s Syndrome (pSS) falls within the category of connective tissue diseases, characterized by the presence of autoantibodies such as antinuclear antibodies (ANA). However, according to the classification criteria for pSS, some patients may exhibit a negative result for autoantibodies. Patients with a negative result for autoantibodies may lack typical features of connective tissue diseases, and the immunological state as well as the extent of organ involvement and damage may differ from those with positive autoantibodies. This study aims to compare the clinical phenotypes of patients with positive and negative autoantibodies, providing insights for disease classification and treatment selection for clinicians. Patients with pSS were grouped based on the presence and titers of their autoantibodies. Subsequently, differences in organ damage and laboratory indicators were compared between these groups, aiming to analyze the value of autoantibody titers in assessing the condition of pSS. (1) Patients with positive ANA exhibited elevated levels of inflammatory indicators, including ESR, IgG levels, lip gland biopsy pathology grade, and overall organ involvement, in comparison with patients with negative ANA (P < 0.05). Furthermore, ANA-positivity correlated with a higher occurrence of multi-organ damage, particularly affecting the skin, mucous membranes, and the hematological system (P < 0.05). (2) As ANA titers increased, patients demonstrated elevated levels of IgG and an escalation in organ involvement (P < 0.05). (3) Patients in the positive autoantibody group (positive for antinuclear antibodies, anti-SSA, or anti-SSB antibodies) had higher IgG levels compared to the negative group (P < 0.05). (4) Patients with positive anti-SSA and anti-SSB antibodies exhibited higher levels of inflammatory indicators and IgG compared to other patients (P < 0.05); however, no significant differences were observed in terms of organ involvement and organ damage. Patients with positive ANA in pSS typically exhibit higher levels of inflammation and an increased likelihood of experiencing multi-organ damage. Furthermore, as the ANA titers increase, both inflammation levels and the risk of multi-organ damage also escalate. Additionally, the presence of anti-SSA and anti-SSB antibodies may contribute to an elevated risk of increased inflammation levels, but does not increase the risk of organ damage. [ABSTRACT FROM AUTHOR]
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- 2024
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25. Comprehensive Exploration of Antinuclear Antibodies (ANAs): Unveiling Clinical Significance, Associations with Cancer, and the Nuances of Differential Diagnosis in Positive ANA Patients.
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Kraev, Krasimir, Hristov, Bozhidar, Uchikov, Petar, Kraeva, Maria, Basheva-Kraeva, Yordanka, Valova, Siyana, Koleva-Ivanova, Maria, Popova-Belova, Stanislava, Sandeva, Milena, Chakarov, Dzhevdet, and Geneva-Popova, Mariela
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ANTINUCLEAR factors , *LUPUS erythematosus , *AUTOIMMUNE diseases , *DIFFERENTIAL diagnosis , *INDIVIDUALIZED medicine - Abstract
This comprehensive review delves into the complex realm of antinuclear antibodies (ANAs), expanding beyond their traditional involvement in autoimmune rheumatic disorders. By digging into historical changes, diagnostic complexity, and clinical significance, the debate reveals the shifting relationships between ANAs, particularly with cancer. Specialized studies provide practical insights on ANA testing processes, standardization, and upcoming challenges. Examining prevalence trends in the United States provides a time dimension to ANA dynamics, linking autoimmune and oncological considerations. The debate delves into the complexity of lupus erythematosus, emphasizing ANAs' diverse presentations and their potential as flexible diagnostic and prognostic indicators. The complex relationship between ANAs and cancer is highlighted, demonstrating their potential as early markers or indicators of malignancies. Looking ahead, this synthesis anticipates advances in personalized medicine and collaborative research, putting ANAs at the forefront of advanced diagnostics and treatments for autoimmune disorders and cancer. This synthesis envisions a future for ANA research in which these antibodies play a critical role in promoting personalized treatment, enhancing diagnostics, and fostering collaborative initiatives that cross traditional boundaries. As ANAs grow more prominent at the junction of autoimmune illnesses and cancer, this synthesis lays the path for further research and novel advances in understanding, diagnosing, and treating complicated medical conditions. [ABSTRACT FROM AUTHOR]
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- 2024
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26. Systemic lupus erythematosus (SLE) associated uveitis in India – A case series
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Kowsigan Magesan, Purna Nangia, Anitha Manoharan, Ranju K Sitaula, Chandrashekara Srikantiah, and Jyotirmay Biswas
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anterior uveitis ,antinuclear antibodies ,immunosuppressants ,retinal vasculitis ,rituximab ,systemic lupus erythematosus ,Ophthalmology ,RE1-994 - Abstract
Purpose: To report the uveitic manifestations of patients with systemic lupus erythematosus (SLE). Methods: This was a retrospective analysis of all SLE cases with ocular manifestations seen by a single ophthalmologist between 2015 and December 2021. Results: In total, seven patients with a median age of 40 (range 18–50) years were included in the study. Female (85.7%) predominance was noted. Ocular findings were bilateral in 71% (five patients) of cases. Majority (10 eyes, 83%) of the patients had retinal vasculitis as the common finding. Antinuclear antibodies were positive in all the patients. The vision improved in two (16.6%) eyes, was stable in eight (66%) eyes, and worsened in one (8%) eye. All the patients were treated with oral steroids along with immunosuppressive agents. Conclusion: Though SLE is rare cause of uveitis, it can be associated with significant ocular morbidity. Hence, early diagnosis and treatment can salvage vision in many cases.
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- 2023
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27. Hydrolysis of Oligodeoxyribonucleotides on the Microarray Surface and in Solution by Catalytic Anti-DNA Antibodies in Systemic Lupus Erythematosus
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Tatiana S. Novikova, Evgeny A. Ermakov, Elena V. Kostina, Alexander N. Sinyakov, Alexey E. Sizikov, Georgy A. Nevinsky, and Valentina N. Buneva
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systemic lupus erythematosus ,SLE ,anti-DNA antibodies ,antinuclear antibodies ,natural catalytic antibodies ,abzymes ,Biology (General) ,QH301-705.5 - Abstract
Anti-DNA antibodies are known to be classical serological hallmarks of systemic lupus erythematosus (SLE). In addition to high-affinity antibodies, the autoantibody pool also contains natural catalytic anti-DNA antibodies that recognize and hydrolyze DNA. However, the specificity of such antibodies is uncertain. In addition, DNA binding to a surface such as the cell membrane, can also affect its recognition by antibodies. Here, we analyzed the hydrolysis of short oligodeoxyribonucleotides (ODNs) immobilized on the microarray surface and in solution by catalytic anti-DNA antibodies from SLE patients. It has been shown that IgG antibodies from SLE patients hydrolyze ODNs more effectively both in solution and on the surface, compared to IgG from healthy individuals. The data obtained indicate a more efficient hydrolysis of ODNs in solution than immobilized ODNs on the surface. In addition, differences in the specificity of recognition and hydrolysis of certain ODNs by anti-DNA antibodies were revealed, indicating the formation of autoantibodies to specific DNA motifs in SLE. The data obtained expand our understanding of the role of anti-DNA antibodies in SLE. Differences in the recognition and hydrolysis of surface-tethered and dissolved ODNs need to be considered in DNA microarray applications.
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- 2023
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28. Clinical research on progress of antinuclear antibody in rheumatoid arthritis
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LI Yuan, ZHANG Le, YIN Hanlin, ZHENG Bing, LÜ Liangjing
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rheumatoid arthritis ,antinuclear antibodies ,tumor necrosis factor-α inhibitor ,Medicine - Abstract
Rheumatoid arthritis (RA) is a common chronic, systemic autoimmune disease characterized by erosive arthritis, with a global prevalence of 0.25% to 1.00%, which may ultimately lead to joint deformity and loss of function. Antinuclear antibody (ANA) refers to auto-antibodies that target various components of eukaryotic cells. Although ANA may be frequently detected in RA patients, with a positive rate of 30% to 60%, the significance of ANA in the diagnosis and treatment of RA remains unclear. Nuclear patterns in RA population are dominated by speckled and homogeneous patterns, mainly at low titres. The detection rate of extractable nuclear antibodies is usually lower than that of ANA. The serum levels of rheumatoid factor and anti-cyclic citrullinated peptide antibody in ANA-positive RA patients are much higher than ANA-negative ones, and joint erosion of ANA-positive RA patients had more severe joint erosion on imaging as well. Therefore, ANA is a potential predictor of severe joint injury. ANA-positive RA patients are more likely to have extra-articular manifestations [such as subcutaneous nodules(82% vs 46%), ocular lesions(38% vs 6%), and infections(38% vs 12%)].In terms of RA comorbidities, compared to the ANA negative group, the ANA positive group had higher levels of moderate and severe anemia (16.04% vs 6.9%; 6.6% vs 0.07%), Sjogren's syndrome (19.5% vs 4.1%), and vasculitis (29% vs 7%). In addition, ANA positivity is an independent risk factor for elderly RA patients with carotid intimal thickening (HR=4.089) and adverse pregnancy outcomes in female RA (OR=3.268, P=0.045), respectively. Attention should be paid to high-titre ANA-positive RA patients for preventive measures. In terms of treatment, RA patients who are ANA-positive when given tumour necrosis factor-α inhibitor (TNFi) treatment got much poorer therapeutic response than ANA-negative ones, especially those with high titres were more prone to generating anti-drug antibodies. Increase of ANA titer induced by TNFi is associated with no response to TNFi treatment, thus monitoring the change of ANA may predict the long-term efficacy of TNFi. The most common adverse event of TNFi is drug-induced lupus. Although it has been confirmed that the induction of anti-double-stranded DNA antibodies is associated with poor efficacy of TNFi, large-scale studies are still needed to confirm the correlation between the increase of ANA titer or ocurence of dsDNA antibody and the induction of drug-induced lupus. In conclusion, this paper reviews the research progress on ANA characteristics in RA population, clinical manifestations of ANA-positive RA, and the association between ANA and TNFi prognosis. The potential of ANA as a new biomarker of RA needs to be further studied.
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- 2023
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29. Pediatric Primary Raynaud's Phenomenon: A Comprehensive Cardiovascular Analysis
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Özpınar, Şeyma, Bornaun, Helen, Sönmez, Hafize Emine, Doğan, Sümeyra, Sönmez, Süleyman, and Harman, Halil
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- 2024
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30. Complex patterns on HEp-2 indirect immunofluorescence assay in a large sample referred for anti-cell autoantibodies detection.
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Santos, Wilton Ferreira S., de Castro Cantuária, Ana Paula, de Castro Félix, Daniele, Carvalho Guimarães, Natália, and Santos de Melo, Igor Cabral
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AUTOANTIBODIES ,ANTINUCLEAR factors ,IMMUNOFLUORESCENCE ,CHILD patients ,AGE groups - Abstract
Introduction: The combination of patterns is a frequent and challenging situation in the daily laboratory routine of autoantibodies testing using HEp-2 cells indirect immunofluorescence assay (HEp-2-IFA). Recently, the Brazilian Consensus on Autoantibodies (BCA) named these combinations as complex patterns (CPs) and organized them into 3 subtypes: multiple, mixed, and composite. This study aimed to describe the most frequent combinations of HEp-2-IIF patterns according to this new nomenclature. Methods: Routine HEp-2-IFA results reported in January and June 2017 were reviewed using the new BCA classification. Visual pattern recognition was performed by experts on HEp-2-IFA readings, using the International Consensus on Antinuclear Antibodies (ANA) Patterns (ICAP) and BCA recommendations. Results: 54,990 serum samples from different patients were tested for ANAHEp-2, and 11,478 (20.9%) were positive at a titer ≥ 1/80. Among these positive samples, 1,111 (9.7%) displayed CPs, divided into 95 different combinations. A higher proportion of CPs was observed in the pediatric age group. Multiple, mixed, and composite patterns were present in 85.3, 5.4, and 9.5% of the samples, respectively. In the multiple/mixed pattern group (n=1,005), double, triple, and quadruple combinations (ICAP/BCA codes) were observed in 97.7%, 2.2%, and 0.1%, respectively. The double nuclear pattern was the most prevalent combination observed (67.6%). The most common CPs registered were AC-4 (nuclear fine speckled) + AC-6,7 (nuclear discrete dots) (n=264); AC-2 (nuclear dense fine speckled) + AC-6,7 (n=201); AC-4+AC-8,9,10 (nucleolar) (n=129); and AC-3 (centromere)+AC-4 (n=124). All of these combinations were in the multiple subgroup. Conclusion: Almost 10% of positive results in the HEp-2 procedure displayed CPs. Among the 3 subtypes of CPs proposed, the multiple pattern was the most prevalent, especially in the pediatric population. The AC-4, AC-2, and AC-6,7 were the most prevalent single patterns observed in the combinations described in this study. There was a significant association between age and the prevalence of most combined patterns. The AC-4+AC-6,7 combination was the most prevalent complex pattern detected regardless of the age group. The AC-2 +AC-6,7 was more prevalent in younger individuals. The concepts involved in the CPs definition should add value to the reading and interpretation of the HEp-2-IIF assay. [ABSTRACT FROM AUTHOR]
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- 2024
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31. 广东地区人群抗核抗体检测滴度及核型特征 分析.
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闻向晖, 杜凯伟, 周刘忠, 魏秋静, 姚纯, 古洁若, and 张鹏
- Abstract
Objective To investigate the clinical characteristics of ANA-positive individuals, by analyzing the titers of ANA and the positive detection of nuclear patterns in subjects from Guangdong; providing scientific basis for health management of the Guangdong population and offers early health guidance and reference for potential patients with autoimmune diseases (AID) . Methods A retrospective analysis was conducted on 23 771 patients from 22 hospitals in Guangdong who underwent routine ANA testing using indirect immunofluorescence (IIF) from April 2021 to July 2023. ANA titers, positive detection rates of nuclear patterns, and demographic characteristics such as gender and age were statistically analyzed. Results The positive detection rate of ANA in the 23 771 tested patients was 14.21% (3 378/23 771) . The number of ANA-positive patients increased with age, with the highest number (1 440 cases, 42.63%) occurring in individuals aged 60 and above. The ANA-positive detection rates for females were higher than those for males in different age groups. The majority of cases had low titers of 1∶80 antibodies (2 662 cases, 78.81%), while the positive rates for high titers of 1∶1 000 and 1∶1 280 were relatively low. Granular pattern positivity was the most common (2 288 cases, 67.73%), with the highest occurrence (879 cases, 46.31%) in individuals aged 60 and above. However, the gender gap in granular pattern positivity gradually narrowed with increasing age. Conclusion The high prevalence of ANA positivity, especially with a granular pattern at 1:80 titer, in females in the Guangdong region suggests a significant risk of diseases such as systemic lupus erythematosus (SLE), mixed connective tissue disease (MCTD), Sj9 gren′s syndrome (SS), or polymyositis (PM) . This risk is particularly noteworthy in postmenopausal middle-aged and elderly women. Men aged 60 and above should also be vigilant about the risk of developing immune-related diseases. [ABSTRACT FROM AUTHOR]
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- 2024
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32. The contemporary role of antinuclear antibodies in early diagnosis of autoimmune rheumatic diseases.
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Kozak, N. P. and Krasnenkova, T. V.
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ANTINUCLEAR factors , *AUTOIMMUNE diseases , *IMMUNOGLOBULINS , *RHEUMATISM , *SERUM - Abstract
Antinuclear antibodies (ANA) in blood serum remain the primary diagnostic screening test for systemic connective tissue diseases. This article presents recent literature findings concerning the utilization of ANA in clinical practice. Specifically, it focuses on interpreting analysis positivity, identifying clinically significant types of fluorescence, and categorizing ANA patterns according to specific nosologies. Recommendations for using the name HEp-2-IIF instead of ANA and reporting the results of indirect immunofluorescence analysis for antinuclear antibodies on HEp-2 cell substrates are described in a standardized way, presenting immunofluorescence patterns together with the nomenclature of antibodies and informing about the subsequent management of the patient. Changes made to pattern classification to distinguish between competent and expert level patterns and to improve the visual separation between nuclear and cytoplasmic HEp-2 patterns are discussed. The need for further study of the prevalence and clinical significance of rare ANA patterns, particularly those directed at the mitotic spindle apparatus (NuMA and MSA-2), is emphasized. Prospects for the study and use of autoantibodies against double-stranded DNA not only in diagnosis but also in the treatment of patients with SLE are noted. It was concluded that there is a need for further clinical research, collection, and arrangement of various models of HEp-2 IIF to facilitate the accurate determination of «criterion level» patterns, increase the possibilities of early diagnosis of rheumatological diseases, and improve the management tactics of patients in this category. [ABSTRACT FROM AUTHOR]
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- 2024
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33. Antinuclear Antibodies Are Associated with an Increased Risk of Diffuse Large B-Cell Lymphoma.
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Frost, Eleanor, Hofmann, Jonathan N., Huang, Wen-Yi, Parks, Christine G., Frazer-Abel, Ashley A., Deane, Kevin D., and Berndt, Sonja I.
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AUTOANTIBODIES , *BIOMARKERS , *CONFIDENCE intervals , *B cell lymphoma , *CASE-control method , *RISK assessment , *RESEARCH funding , *DESCRIPTIVE statistics , *LOGISTIC regression analysis , *ODDS ratio , *NON-Hodgkin's lymphoma , *DISEASE risk factors - Abstract
Simple Summary: Some autoimmune diseases have been linked to an increased risk of non-Hodgkin lymphoma (NHL), but the evidence varies across different subtypes of NHL, and few studies have examined whether autoimmunity is more generally associated with disease risk. Given the rise in autoimmunity, as measured by antinuclear antibodies (ANA) over time in the U.S., it is important to evaluate its potential association with NHL risk. In this nested case-control study, we measured ANA and other autoimmune biomarkers in serum collected years prior to diagnosis for cases and controls. We demonstrate that the presence of ANA is associated with an increased risk of diffuse large B-cell lymphoma, a common subtype of non-Hodgkin lymphoma. We further show that specific autoimmune biomarkers are associated with an increased risk of NHL, especially diffuse large B-cell and marginal zone lymphoma. Our study establishes autoimmunity as a risk factor for diffuse large B-cell lymphoma. Immune dysregulation is thought to increase the risk of non-Hodgkin lymphoma (NHL), but the evidence varies by subtype. We evaluated whether antinuclear antibodies (ANA), double-stranded DNA antibodies (anti-dsDNA), and extractable nuclear antigen antibodies (anti-ENA) were associated with the risk of common NHL subtypes in a nested case-control study. The autoantibodies were tested in serum collected years prior to NHL diagnosis in 832 cases and 809 controls from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Logistic regression was used to determine odds ratios (ORs) and 95% confidence intervals (95% CI) for the association with NHL risk. No association was observed between ANA positivity and NHL risk overall (OR: 1.18, 95% CI: 0.88–1.58); however, ANA positivity was associated with an increased risk of diffuse large B-cell lymphoma (DLBCL) (OR: 1.83, 95% CI: 1.15–2.91), with 19.7% of cases and 12.2% of controls testing positive. The presence of either anti-ENA or anti-dsDNA was associated with an increased risk of NHL (OR: 2.93, 95% CI: 1.18–7.28), particularly DLBCL (OR: 3.51, 95% CI: 1.02–12.0) and marginal zone lymphoma (OR: 8.86, 95% CI: 1.26–62.0). Our study demonstrates that autoantibodies are associated with an elevated risk of DLBCL, providing support for autoimmunity as a risk factor. [ABSTRACT FROM AUTHOR]
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- 2023
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34. Mild‐to‐moderate COVID‐19 does not predispose to the development of autoimmune rheumatic diseases or autoimmune‐based thrombosis.
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Kozłowski, Paweł, Lulek, Michalina, Skwarek, Agata, Śmiarowski, Marcin, Małecka‐Giełdowska, Milena, and Ciepiela, Olga
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CORONAVIRUS diseases , *RHEUMATISM , *AUTOIMMUNE diseases , *COVID-19 , *ANTINUCLEAR factors , *AUTOIMMUNITY - Abstract
An infection with severe acute respiratory syndrome coronavirus (SARS‐CoV‐2) may have a significant impact on the human immune system. Interactions between the virus and defence mechanisms may promote the development of autoimmune processes which manifest as antinuclear antibody (ANA) synthesis. Since many different viruses are suspected to take part in the pathogenesis of different systemic autoimmune rheumatic diseases (SARDs), we examined whether coronavirus disease 2019 convalescents who suffer from mild to moderate disease have a higher risk of developing ANA and anti‐β2‐glicoprotein I IgG antibodies (β2 GPI). In a retrospective study, we examined 294 adults among volunteer blood donors divided into convalescents (N = 215) and healthy controls (N = 79). For ANA detection, we used line‐blotting, a type of indirect immunofluorescence assay (IF), to determine antigenic specificity and ELISA for β2 GPI. We found a lower incidence of ANA in convalescents than in healthy controls, with the majority of these antibodies directed to antigens with no known clinical significance. Additionally, no participants were positive for β2 GPI in either group. Our results show that COVID‐19 with mild to moderate symptoms in the generally healthy population does not induce the development of ANA or anti‐β2 GPI antibodies for at least 6 months following the disease. [ABSTRACT FROM AUTHOR]
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- 2023
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35. Systemic lupus erythematosus associated with erythema multiforme: A rare case report of Rowell's syndrome
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Madhur Bhattarai, Niraj Kumar Sharma, Shreeram Paudel, Sujata Bhandari, Amrit Bhusal, Kiran Dhonju, Sandip Kuikel, Shivendra Kumar Jha, Egesh Aryal, and Deepak Subedi
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antinuclear antibodies ,erythema multiforme ,rheumatoid factor ,rowell syndrome ,systemic lupus erythematosus ,Medicine ,Medicine (General) ,R5-920 - Abstract
Key Clinical Message Although it is very uncommon, SLE may initially present with recurrent episodes of EM‐like rash. Despite the various possibilities underlying their association, prompt identification, and treatment of SLE in patients presenting with EM is important to prevent death or serious organ damage. Abstract Rowell's syndrome (RS) is an uncommon presentation of systemic lupus erythematosus (SLE) with erythema multiforme (EM)‐like lesions associated with specific serological changes, including positive rheumatoid factor (RF), speckled antinuclear antibody (ANA), positive rheumatoid factor, or anti‐La antibodies in the serum. Our case, a 41‐year‐old male, presented with features of EM. Upon investigation, we identified underlying systemic lupus erythematosus, marking a rare instance of SLE presenting for the first time as EM. Classical or true EM is precipitated by trigger factors such as infective agents like the herpes simplex virus, Mycoplasma pneumoniae, drugs like anticonvulsants, antibiotics, and non‐steroid anti‐inflammatory drugs, any underlying malignancy, or connective tissue disorders, and is not associated with any specific serological abnormalities. EM cases associated with LE lesions where an EM trigger factor is missing are considered an RS diagnostic criterion. In this case report, the importance of considering SLE in patients presenting initially with recurrent episodes of EM‐like rash is emphasized. RS should be considered, especially when there is no evidence of triggering factors. Early diagnosis and prompt treatment of SLE are crucial to preventing death and irreversible organ damage.
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- 2024
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36. Identifying antinuclear antibody positive individuals at risk for developing systemic autoimmune disease: development and validation of a real-time risk model
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April Barnado, Ryan P. Moore, Henry J. Domenico, Sarah Green, Alex Camai, Ashley Suh, Bryan Han, Katherine Walker, Audrey Anderson, Lannawill Caruth, Anish Katta, Allison B. McCoy, and Daniel W. Byrne
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antinuclear antibodies ,electronic health record ,risk model ,autoimmune disease ,rheumatology ,Immunologic diseases. Allergy ,RC581-607 - Abstract
ObjectivePositive antinuclear antibodies (ANAs) cause diagnostic dilemmas for clinicians. Currently, no tools exist to help clinicians interpret the significance of a positive ANA in individuals without diagnosed autoimmune diseases. We developed and validated a risk model to predict risk of developing autoimmune disease in positive ANA individuals.MethodsUsing a de-identified electronic health record (EHR), we randomly chart reviewed 2,000 positive ANA individuals to determine if a systemic autoimmune disease was diagnosed by a rheumatologist. A priori, we considered demographics, billing codes for autoimmune disease-related symptoms, and laboratory values as variables for the risk model. We performed logistic regression and machine learning models using training and validation samples.ResultsWe assembled training (n = 1030) and validation (n = 449) sets. Positive ANA individuals who were younger, female, had a higher titer ANA, higher platelet count, disease-specific autoantibodies, and more billing codes related to symptoms of autoimmune diseases were all more likely to develop autoimmune diseases. The most important variables included having a disease-specific autoantibody, number of billing codes for autoimmune disease-related symptoms, and platelet count. In the logistic regression model, AUC was 0.83 (95% CI 0.79-0.86) in the training set and 0.75 (95% CI 0.68-0.81) in the validation set.ConclusionWe developed and validated a risk model that predicts risk for developing systemic autoimmune diseases and can be deployed easily within the EHR. The model can risk stratify positive ANA individuals to ensure high-risk individuals receive urgent rheumatology referrals while reassuring low-risk individuals and reducing unnecessary referrals.
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- 2024
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37. New-onset autoimmune disease after COVID-19
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Corrilynn O. Hileman, Shahdi K. Malakooti, Nirav Patil, Nora G. Singer, and Grace A. McComsey
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autoimmune diseases ,COVID-19 ,autoantibodies ,risk factors ,antinuclear antibodies ,Immunologic diseases. Allergy ,RC581-607 - Abstract
IntroductionSevere acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may trigger autoimmune disease (AD) through initial innate immune activation with subsequent aberrations in adaptive immune cells leading to AD. While there are multiple reports of incident AD diagnosed after COVID-19, the risk in the context of key circulating strains is unknown.MethodsTriNetX, a global, federated, health research network providing access to electronic medical records across 74 healthcare organizations, was utilized to define an adult cohort between January 1, 2020, and March 3, 2023. Exposure was defined as COVID-19 diagnosis (ICD-10 code or positive laboratory test). Age- and sex-propensity score-matched controls never had COVID-19 diagnosed. Outcomes were assessed 1 month to 1 year after the index date. Patients with AD prior to or within 1 month after the index date were excluded from the primary analysis. Incidence and risk ratios of each AD were assessed.ResultsA total of 3,908,592 patients were included. Of 24 AD patients assessed, adjusted risk ratios for eight AD patients who had COVID-19 were higher compared to those who had no COVID-19. Cutaneous vasculitis (adjusted hazard ratio (aHR): 1.82; 95% CI 1.55–2.13), polyarteritis nodosa (aHR: 1.76; 95% CI 1.15–2.70), and hypersensitivity angiitis (aHR: 1.64; 95% CI 1.12–2.38) had the highest risk ratios. Overall, psoriasis (0.15%), rheumatoid arthritis (0.14%), and type 1 diabetes (0.13%) had the highest incidence during the study period, and of these, psoriasis and diabetes were more likely after COVID-19. The risk of any AD was lower if COVID-19 was diagnosed when Omicron variants were the predominant circulating strains. A positive antinuclear antibody was more likely and predictive of AD after COVID-19.DiscussionSARS-CoV-2 may be a potential trigger for some AD, but the risk for AD may decrease with time given the apparent lower risk after infection with Omicron variants.
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- 2024
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38. Serological abnormalities that predict progression to systemic autoimmune rheumatic diseases in antinuclear antibody-positive individuals.
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Muñoz-Grajales, Carolina, Prokopec, Stephenie D, Johnson, Sindhu R, Touma, Zahi, Ahmad, Zareen, Bonilla, Dennisse, Hiraki, Linda, Bookman, Arthur, Boutros, Paul C, Chruscinski, Andrzej, and Wither, Joan
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Biomedical and Clinical Sciences ,Clinical Sciences ,Autoimmune Disease ,Prevention ,Clinical Research ,Detection ,screening and diagnosis ,4.1 Discovery and preclinical testing of markers and technologies ,Aetiology ,4.2 Evaluation of markers and technologies ,2.1 Biological and endogenous factors ,Inflammatory and immune system ,Adult ,Antibodies ,Antinuclear ,Autoimmune Diseases ,Disease Progression ,Female ,Humans ,Male ,Middle Aged ,Predictive Value of Tests ,Rheumatic Diseases ,Young Adult ,antinuclear antibodies ,microarray analysis ,SLE ,rheumatic diseases ,Ro52 antigen ,Immunology ,Public Health and Health Services ,Arthritis & Rheumatology ,Clinical sciences - Abstract
ObjectiveWe investigated the autoantibody (autoAb) profiles in ANA+ individuals lacking systemic autoimmune rheumatic disease (SARD) and early SARD patients to determine the key differences between these groups and identify factors that are associated with an increased risk of symptomatic progression within the next 2 years in ANA+ individuals.MethodsUsing custom antigen (Ag) microarrays, 144 IgM and IgG autoAbs were surveyed in 84 asymptomatic and 123 symptomatic (48 UCTD and 75 SARD patients) ANA+ individuals. AutoAbs were compared in ANA+ individuals lacking a SARD diagnosis with ≥2 years follow-up (n = 52), including all those who demonstrated progression (n = 14) during this period, with changes over time assessed in a representative subset.ResultsWe show that ANA+ individuals have autoAb to many self-Ags that are not being captured by current screening techniques and very high levels of these autoAbs are predominantly restricted to early SARD patients, with SLE patients displaying reactivity to many more autoAgs than the other groups. In general, the symptoms that developed in progressors mirrored those seen in SARD patients with similar patterns of autoAbs. Only anti-Ro52 Abs were found to predict progression (positive predictive value 46%, negative predictive value 89%). Surprisingly, over 2 years of follow-up the levels of autoAbs remained remarkably stable regardless of whether individuals progressed or not.ConclusionOur findings strongly argue that development of assays with an expanded set of auto-Ags and enhanced dynamic range would improve the diagnostic and prognostic ability of autoAb testing.
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- 2022
39. Clinical diagnoses associated with a positive antinuclear antibody test in patients with and without autoimmune disease
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Jacy T. Zanussi, Juan Zhao, Wei-Qi Wei, Gul Karakoc, Cecilia P. Chung, QiPing Feng, Nancy J. Olsen, C. Michael Stein, and Vivian K. Kawai
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Antinuclear antibodies ,PheWAS ,Disease risk ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Antinuclear antibodies (ANA) are antibodies present in several autoimmune disorders. However, a large proportion of the general population (20%) also have a positive test; very few of these individuals will develop an autoimmune disease, and the clinical impact of a positive ANA in them is not known. Thus, we test the hypothesis that ANA + test reflects a state of immune dysregulation that alters risk for some clinical disorders in individuals without an autoimmune disease. Methods We performed high throughput association analyses in a case–control study using real world data from the de-identified electronic health record (EHR) system from Vanderbilt University Medical Center. The study population included individuals with an ANA titer ≥ 1:80 at any time (ANA +) and those with negative results (ANA-). The cohort was stratified into sub-cohorts of individuals with and without an autoimmune disease. A phenome-wide association study (PheWAS) adjusted by sex, year of birth, race, and length of follow-up was performed in the study cohort and in the sub-cohorts. As secondary analyses, only clinical diagnoses after ANA testing were included in the analyses. Results The cohort included 70,043 individuals: 49,546 without and 20,497 with an autoimmune disease, 26,579 were ANA + and 43,464 ANA-. In the study cohort and the sub-cohort with autoimmune disease, ANA + was associated (P ≤ 5 × 10–5) with 88 and 136 clinical diagnoses respectively, including lupus (OR ≥ 5.4, P ≤ 7.8 × 10–202) and other autoimmune diseases and complications. In the sub-cohort without autoimmune diseases, ANA + was associated with increased risk of Raynaud’s syndrome (OR ≥ 2.1) and alveolar/perialveolar-related pneumopathies (OR ≥ 1.4) and decreased risk of hepatitis C, tobacco use disorders, mood disorders, convulsions, fever of unknown origin, and substance abuse disorders (OR ≤ 0.8). Analyses including only diagnoses after ANA testing yielded similar results. Conclusion A positive ANA test, in addition to known associations with autoimmune diseases, Raynaud’s phenomenon, and idiopathic fibrosing alveolitis related disorders, is associated with decreased prevalence of several non-autoimmune diseases.
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- 2023
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40. The Onset of Antinuclear Antibodies (ANAs) as a Potential Risk Factor for Mortality and Morbidity in COVID-19 Patients: A Single-Center Retrospective Study
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Giuseppe Stefano Netti, Piera Soccio, Valeria Catalano, Federica De Luca, Javeria Khalid, Valentina Camporeale, Giorgia Moriondo, Massimo Papale, Giulia Scioscia, Gaetano Corso, Maria Pia Foschino, Sergio Lo Caputo, Donato Lacedonia, and Elena Ranieri
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COVID-19 ,SARS-CoV-2 ,ANA ,antinuclear antibodies ,HALP score ,Biology (General) ,QH301-705.5 - Abstract
The immune system’s amplified response to SARS-CoV-2 may lead to the production of autoantibodies, but their specific impact on disease severity and outcome remains unclear. This study aims to assess if hospitalized COVID-19 patients face a worse prognosis based on ANA presence, even without autoimmune diseases. We performed a retrospective, single-center, observational cohort study, enrolling 638 COVID-19 patients hospitalized from April 2020 to March 2021 at Hospital “Policlinico Riuniti” of Foggia (Italy). COVID-19 patients with a positive ANA test exhibited a significantly lower 30-day survival rate (64.4% vs. 83.0%) and a higher likelihood of severe respiratory complications during hospitalization than those with negative ANA screening (35.4% vs. 17.0%) (p < 0.001). The association between poor prognosis and ANA status was identified by calculating the HALP score (Hemoglobin-Albumin-Lymphocyte-Platelet), which was lower in COVID-19 patients with a positive ANA test compared to ANA-negative patients (108.1 ± 7.4 vs. 218.6 ± 11.2 AU; p < 0.011). In detail, COVID-19 patients with a low HALP showed a lower 30-day survival rate (99.1% vs. 83.6% vs. 55.2% for high, medium, and low HALP, respectively; p < 0.001) and a higher incidence of adverse respiratory events compared to those with high and medium HALP (13.1% vs. 35.2% vs. 64.6% for high, medium, and low HALP, respectively; p < 0.001). In summary, ANA positivity in COVID-19 patients appears to be linked to a more aggressive disease phenotype with a reduced survival rate. Furthermore, we propose that the HALP score could serve as a valuable parameter to assess prognosis for COVID-19 patients.
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- 2024
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41. Interpretation of Immunofluorescence Slides by Deep Learning Techniques: Anti-nuclear Antibodies Case Study
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Khlelfa, Oumar, Yahyaoui, Aymen, Azaiz, Mouna Ben, Ncibi, Anwer, Gazouani, Ezzedine, Ammar, Adel, Boulila, Wadii, Filipe, Joaquim, Editorial Board Member, Ghosh, Ashish, Editorial Board Member, Prates, Raquel Oliveira, Editorial Board Member, Zhou, Lizhu, Editorial Board Member, Nguyen, Ngoc Thanh, editor, Botzheim, János, editor, Gulyás, László, editor, Nunez, Manuel, editor, Treur, Jan, editor, Vossen, Gottfried, editor, and Kozierkiewicz, Adrianna, editor
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- 2023
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42. Complex patterns on HEp-2 indirect immunofluorescence assay in a large sample referred for anti-cell autoantibodies detection
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Wilton Ferreira S. Santos, Ana Paula de Castro Cantuária, Daniele de Castro Félix, Natália Carvalho Guimarães, and Igor Cabral Santos de Melo
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antinuclear antibodies ,autoantibodies ,autoimmunity ,HEp-2 cells ,ANA patterns ,indirect immunofluorescence ,Immunologic diseases. Allergy ,RC581-607 - Abstract
IntroductionThe combination of patterns is a frequent and challenging situation in the daily laboratory routine of autoantibodies testing using HEp-2 cells indirect immunofluorescence assay (HEp-2-IFA). Recently, the Brazilian Consensus on Autoantibodies (BCA) named these combinations as complex patterns (CPs) and organized them into 3 subtypes: multiple, mixed, and composite. This study aimed to describe the most frequent combinations of HEp-2-IIF patterns according to this new nomenclature.MethodsRoutine HEp-2-IFA results reported in January and June 2017 were reviewed using the new BCA classification. Visual pattern recognition was performed by experts on HEp-2-IFA readings, using the International Consensus on Antinuclear Antibodies (ANA) Patterns (ICAP) and BCA recommendations.Results54,990 serum samples from different patients were tested for ANA-HEp-2, and 11,478 (20.9%) were positive at a titer ≥ 1/80. Among these positive samples, 1,111 (9.7%) displayed CPs, divided into 95 different combinations. A higher proportion of CPs was observed in the pediatric age group. Multiple, mixed, and composite patterns were present in 85.3, 5.4, and 9.5% of the samples, respectively. In the multiple/mixed pattern group (n=1,005), double, triple, and quadruple combinations (ICAP/BCA codes) were observed in 97.7%, 2.2%, and 0.1%, respectively. The double nuclear pattern was the most prevalent combination observed (67.6%). The most common CPs registered were AC-4 (nuclear fine speckled) + AC-6,7 (nuclear discrete dots) (n=264); AC-2 (nuclear dense fine speckled) + AC-6,7 (n=201); AC-4+AC-8,9,10 (nucleolar) (n=129); and AC-3 (centromere)+AC-4 (n=124). All of these combinations were in the multiple subgroup.ConclusionAlmost 10% of positive results in the HEp-2 procedure displayed CPs. Among the 3 subtypes of CPs proposed, the multiple pattern was the most prevalent, especially in the pediatric population. The AC-4, AC-2, and AC-6,7 were the most prevalent single patterns observed in the combinations described in this study. There was a significant association between age and the prevalence of most combined patterns. The AC-4+AC-6,7 combination was the most prevalent complex pattern detected regardless of the age group. The AC-2+AC-6,7 was more prevalent in younger individuals. The concepts involved in the CPs definition should add value to the reading and interpretation of the HEp-2-IIF assay.
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- 2024
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43. Clinical significance of antinuclear antibodies in primary immune thrombocytopenia.
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Moulis, Guillaume, Aladjidi, Nathalie, and Godeau, Bertrand
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ANTINUCLEAR factors , *IDIOPATHIC thrombocytopenic purpura - Abstract
Summary: There are discrepancies across guidelines about whether the dosage of antinuclear antibodies (ANAs) is of use at the diagnosis of primary immune thrombocytopenia (ITP). This review describes the current knowledge about ANA prevalence in patients with primary ITP, and their potential usefulness as biomarkers for ITP evolution, response to treatments and increased risk of subsequent development of systemic lupus and thrombosis. [ABSTRACT FROM AUTHOR]
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- 2023
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44. Distribution of titer and karyotype of antinuclear antibodies in a healthy population and its relationship with gastrointestinal lesions.
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Rao, Yuan, Tu, Liudan, Wei, Qiujing, Yang, Mingcan, Gu, Jieruo, and Liu, Huafeng
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ANTINUCLEAR factors , *AUTOIMMUNE diseases , *CARDIOVASCULAR diseases , *KARYOTYPES - Abstract
A total of 119 subjects were found to have intestinal polyps, including 61 cases of hyperplastic polyps and 58 cases of adenomas, and no significant difference was found in ANA positivity rate between intestinal polyp and polyp-free participants. Keywords: antinuclear antibodies; autoimmune diseases; gastrointestinal lesions; healthy population EN antinuclear antibodies autoimmune diseases gastrointestinal lesions healthy population 1849 1852 4 09/06/23 20230901 NES 230901 INTRODUCED Antinuclear antibodies (ANA), as an important marker of autoimmune diseases, is widely used in the screening, diagnosis and follow-up of autoimmune diseases. In summary, ANA may be associated with gastrointestinal tract tumors, cardiovascular events and all-cause mortality, in addition to being a warning sign of autoimmune diseases. DISCUSSION ANA is an important marker of autoimmune diseases and can be positive several years before the onset of autoimmune diseases. [Extracted from the article]
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- 2023
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45. Dense fine speckled nuclear immunofluorescence: A mildly reassuring antinuclear antibody pattern meriting consideration.
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Fijałkowska, Aleksandra, Schwartz, Robert A., and Woźniacka, Anna
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ANTINUCLEAR factors , *CONNECTIVE tissue diseases , *SPECKLE interference , *IMMUNOFLUORESCENCE , *PROGNOSIS - Abstract
Introduction: Antinuclear antibodies (ANAs) are regarded as a hallmark of connective tissue diseases (CTDs) and play a key role in their diagnosis, but the value of some particular antibodies in management of patients and the disease prognosis is controversial. The mechanism underlying the production of ANAs in CTDs, other chronic inflammatory conditions and even in healthy people, is not completely elucidated. Anti‐DFS70 antibodies connected with the dense fine speckled autoantigen of 70 kD, known as the lens epithelium‐derived growth factor p75, are a subgroup of ANAs. Their presence and coexistence with other antibodies and their clinical significance are the matter of debate. Methods: Based on literature data, the authors focused on current knowledge explaining the role of anti‐DFS70 antibodies in selected CTDs. Results: However, the literature data is ambiguous and does not fully support the validity of the anti‐DFS70 assay for a specific CTD diagnosis. Most researchers claim that the presence of anti‐DFS70 as the only one usually exclude the diagnosis of CTD. Nevertheless, its coexistence with other ANAs is not an excluding factor but has predictive value due to more favorable course of CTD. Such situations may also suggest an enhanced risk of the development of a CTD in the future. Conclusions: Although more studies are needed in this field, it seems reasonable to ascertain the presence of anti‐DFS70 in routine clinical practice. [ABSTRACT FROM AUTHOR]
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- 2023
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46. Frequency of Autoantibodies on Non-Hodgkin Lymphoma.
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Barreno-Rocha, Sonia Guadalupe, Guzmán-Silahua, Sandra, Cardona-Muñoz, Ernesto Germán, Zavala-Cerna, Maria Guadalupe, Muñoz Gaytan, David Eduardo, Riebeling-Navarro, Carlos, Rubio-Jurado, Benjamín, and Nava-Zavala, Arnulfo Hernán
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AUTOANTIBODIES ,RETROSPECTIVE studies ,MANN Whitney U Test ,CHI-squared test ,DATA analysis software ,NON-Hodgkin's lymphoma ,LONGITUDINAL method - Abstract
(1) Background: Non-Hodgkin Lymphoma is a neoplasm that can significantly compromise the immune system, but timely assessment can change the patient outcome. In cancer, the activation of the immune system could lead to the secretion of autoantibodies. (2) Methods: A retrospective cohort study was performed from 2017 to 2019 in patients with Non-Hodgkin Lymphoma diagnosed with a biopsy. (3) Results: We included 39 patients who were newly diagnosed, untreated, and without any autoimmune disease previously reported. Thirty patients had the presence of autoantibodies (antiphospholipid antibodies, anti-cytoplasmic neutrophils antibodies, antinuclear antibodies), and nine were without autoantibodies. There were no statistical differences among groups regarding clinical, demographic, staging, and prognosis characteristics. Also, there were no differences in the outcomes of the patients after finishing chemotherapy and one year after initiating treatment. (4) Conclusions: Further investigations must be conducted regarding an extended panel of autoantibodies because the panel of autoantibodies in this study did not show a relationship between the presence and the clinical outcome of the patients. [ABSTRACT FROM AUTHOR]
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- 2023
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47. Clinical and serological characterization of acute pleuropericarditis suggests an autoinflammatory pathogenesis and highlights risk factors for recurrent attacks
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Kaudewitz, Dorothee, John, Lukas, Meis, Jan, Frey, Norbert, Lorenz, Hanns-Martin, Leuschner, Florian, and Blank, Norbert
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- 2024
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48. Clinical significance of antiDFS70 in immunoinflammatory rheumatic diseases (review)
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T. A. Panafidina, Zh. G. Verizhnikova, A. S. Avdeeva, T. V. Popkova, and E. L. Nasonov
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immunoinflammatory rheumatic diseases ,anti-dfs70 ,antinuclear antibodies ,indirect immunofluorescence assay on hep-2 cells ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
The relevance of the problem of immunoinflammatory rheumatic diseases (IIRD) for modern medicine is determined by their high prevalence in the population, the difficulty of early diagnosis, the rapid development of disability and poor life prognosis. Recent data on the significance of anti-DFS70 have opened up new possibilities for optimizing the step-by-step diagnosis of IIRD. The detection of these antibodies can help in the interpretation of a positive result for antinuclear antibodies (ANA) by indirect immunofluorescence assay on HEp-2 cells (IIFA-HEp-2) in the absence of autoantibodies specific for IIRD. Detection of anti-DFS70 in antinuclear factor (ANF) seropositive patients without clinical and/or serological markers characteristic of a certain disease from the IIRD group can be considered as a potential marker that excludes this group of diseases.
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- 2023
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49. The Binding Properties of Antibodies to Z-DNA in the Sera of Normal Healthy Subjects
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David S. Pisetsky, Matthew J. Gedye, Lawrence A. David, and Diane M. Spencer
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DNA ,antibodies ,anti-DNA ,antinuclear antibodies ,B-DNA ,Z-DNA ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Antibodies to DNA are a diverse set of antibodies that bind sites on DNA, a polymeric macromolecule that displays various conformations. In a previous study, we showed that sera of normal healthy subjects (NHS) contain IgG antibodies to Z-DNA, a left-handed helix with a zig-zig backbone. Recent studies have demonstrated the presence of Z-DNA in bacterial biofilms, suggesting a source of this conformation to induce responses. To characterize further antibodies to Z-DNA, we used an ELISA assay with brominated poly(dGdC) as a source of Z-DNA and determined the isotype of these antibodies and their binding properties. Results of these studies indicate that NHS sera contain IgM and IgA as well as IgG anti-Z-DNA antibodies. As shown by the effects of ionic strength in association and dissociation assays, the anti-Z-DNA antibodies bind primarily by electrostatic interactions; this type of binding differs from that of induced anti-Z-DNA antibodies from immunized animals which bind by non-ionic interactions. Furthermore, urea caused dissociation of NHS anti-Z-DNA at molar concentrations much lower than those for the induced antibodies. These studies also showed IgA anti-Z-DNA antibodies in fecal water. Together, these studies demonstrate that antibodies to Z-DNA occur commonly in normal immunity and may arise as a response to Z-DNA of bacterial origin.
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- 2024
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50. Comprehensive Exploration of Antinuclear Antibodies (ANAs): Unveiling Clinical Significance, Associations with Cancer, and the Nuances of Differential Diagnosis in Positive ANA Patients
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Krasimir Kraev, Bozhidar Hristov, Petar Uchikov, Maria Kraeva, Yordanka Basheva-Kraeva, Siyana Valova, Maria Koleva-Ivanova, Stanislava Popova-Belova, Milena Sandeva, Dzhevdet Chakarov, and Mariela Geneva-Popova
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antinuclear antibodies ,autoimmune rheumatic diseases ,cancer associations ,Medicine (General) ,R5-920 - Abstract
This comprehensive review delves into the complex realm of antinuclear antibodies (ANAs), expanding beyond their traditional involvement in autoimmune rheumatic disorders. By digging into historical changes, diagnostic complexity, and clinical significance, the debate reveals the shifting relationships between ANAs, particularly with cancer. Specialized studies provide practical insights on ANA testing processes, standardization, and upcoming challenges. Examining prevalence trends in the United States provides a time dimension to ANA dynamics, linking autoimmune and oncological considerations. The debate delves into the complexity of lupus erythematosus, emphasizing ANAs’ diverse presentations and their potential as flexible diagnostic and prognostic indicators. The complex relationship between ANAs and cancer is highlighted, demonstrating their potential as early markers or indicators of malignancies. Looking ahead, this synthesis anticipates advances in personalized medicine and collaborative research, putting ANAs at the forefront of advanced diagnostics and treatments for autoimmune disorders and cancer. This synthesis envisions a future for ANA research in which these antibodies play a critical role in promoting personalized treatment, enhancing diagnostics, and fostering collaborative initiatives that cross traditional boundaries. As ANAs grow more prominent at the junction of autoimmune illnesses and cancer, this synthesis lays the path for further research and novel advances in understanding, diagnosing, and treating complicated medical conditions.
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- 2024
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