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Diagnosis of autoimmune central diabetes insipidus (CDI) is based on the presence of autoantibodies to AVP-secreting cells (AVPcAb) or the coexistence of other autoimmune polyendocrine syndromes; moreover, it can be also suggested by the presence of lymphocytic infundibulo-neurohypophysitis, evidenced by biopsy of pituitary stalk and/or by pituitary stalk thickening on magnetic resonance imaging (MRI). However, so far, in clinical CDI patients with lymphocytic infundibulo-neurohypophysitis, AVPcAb have not been investigated and in those with or without autoimmune polyendocrine syndromes (APS), longitudinal studies on the behavior of AVPcAb alone, or of both AVPcAb and hypothalamic pituitary imaging on MRI are lacking. Aim of this work was to investigate in these patients the occurrence of AVPcAb (by indirect immunofluorescence) and of pituitary stalk thickening (by MRI) and their longitudinal changes during a follow-up period. We studied 22 patients, aged 29-53, with APS and complete CDI, grouped as follows: 10 with recent onset (< or =1.5 yr) of CDI (group 1a) and 12 with CDI of long-term duration (> or = 7 yr) (group 1b); moreover, a group of 13 patients with apparent idiopathic CDI of recent onset (

In patients with type 2 diabetes, reduced levels of circulating endothelial progenitor cells have been reported and these have been correlated with disease severity. In this study, we examined a panel of markers widely used to identify progenitor and/or stem cells, and determined their association with disease severity in diabetic patients. Since expression of chemokine (C-X-C motif) receptor 4 (CXCR4) has been associated with mobilisation and recruitment of progenitor cells, CXCR4 expression was also analysed.Peripheral blood mononuclear cells (PBMCs) from 98 patients with type 2 diabetes and 39 control individuals were analysed by flow cytometry for surface marker expression.Cells expressing different combinations of progenitor and/or stem cell markers were severely reduced in PBMCs of diabetic patients compared with those of control participants. Moreover, a number of these putative progenitor cell populations were negatively associated with disease severity. Reduced expression of CXCR4 and CD34/CXCR4-positive cells was also observed in diabetic patients. PBMCs expressing CXCR4 positively correlated with levels of progenitor cells in control participants but not in diabetic patients. Levels of putative progenitor and CXCR4-positive cells were further decreased in patients with diabetic complications, including cardiovascular and microvascular diseases.A generalised decrease in a range of progenitor cell populations was observed in type 2 diabetic patients. This reduction was also negatively associated with disease severity.

To investigate whether the serological markers of autoimmunity and the clinical features of autoimmune disease which occur in hepatitis C virus (HCV)-infected subjects are correlated to each other and/or to the clinical pattern of the disease.Seventeen symptom-free, anti-HCV antibody positive subjects, 17 patients with chronic hepatitis C, 21 patients with mixed cryoglobulinemia (MC), and as controls 17 anti-HCV negative patients with dyspepsia were enrolled in a prospective study. A patient history, clinical examination, self-administered questionnaire and laboratory investigations (hepatic enzyme levels, serum HCV-RNA and anti-HCV antibody testing, and serum autoantibody profile) were performed to detect liver and/or autoimmune disease.Serological markers of autoimmunity and clinical findings of autoimmune disease were found to be more frequent in the HCV-infected patients considered as a whole than in controls. However, rheumatoid factor and clinical findings of autoimmune disease were more frequent in MC patients, while anti-smooth muscle antibodies not linked to symptoms or signs of autoimmune disease were detected in all groups of HCV-infected individuals, including healthy carriers and subjects who had recovered from a previous HCV infection.Anti-smooth muscle antibodies, a serological marker of autoimmunity, are detectable in HCV-infected subjects whatever their clinical status. Clinical findings of autoimmune disease prevalently occur in patients with mixed cryoglobulinemia.

The antiphospholipid antibody syndrome is characterized by the association between recurrent arterial or venous thrombosis and the presence of circulating antiphospholipid antibodies. Antiphospholipid antibody-related thrombosis seems to constitute a significant proportion of childhood thromboses. About one third of children suffering a thrombotic event have circulating antiphospholipid antibodies, and more than two thirds of children with idiopathic cerebral ischemia meet the criteria for the diagnosis of antiphospholipid antibody syndrome. Because the other risk factors for thrombosis commonly found in adults have no impact on the pediatric patient, the risk for thrombosis and thrombotic recurrences and the optimal anticoagulation therapy may differ from adults.

The authors point out the possible relationship between the biochemical and immunological components of nasal mucus in subjects affected by allergic rhinitis and/or olfactory disorders. Fifty seven subjects (33 F, 24 M) aged between 19 and 73 years, (median age 65 SD 14.60) were studied. Twenty seven of them were normosmic affected by allergic rhinitis and taken as control group, (14 were positive to allergometric tests and/or RAST, while the other 13 were negative), 30 were dysosmic, and subdivided into parosmic (n = 6), anosmic (n = 15) and hyposmic (n = 9) (only one was negative both to allergometric tests and to RAST). In all patients we assessed: nasal mucus (it was analysed for: mucus quantity, pH, protein concentration, K+ concentration and the SIgA antibodies, tested both by radian immunodiffusion and by ELISA), allergometric tests, PRIST, RAST, anterior rhinomanometry, evoked olfactory potential. As regard to allergometric tests, we have no observed statistically significant differences between the control and the dysosmic group, although all the dysosmic patients (except one) were positive both to allergometric tests and to RAST. Total (PRIST) and specific (RAST) IgE values (except for the anosmic subjects who had IgE values moderately higher) were similar to the results obtained by allergometric tests. As regards to nasal secretion quantity, it was reduced (p: n.s.), like the pH (p: n.s.), in the parosmic subjects. On the other hand, proteins concentration of nasal secretion was lowered in hyposmic (p: n.s.) and anosmic (p = 0.05) subjects, while there were no differences between parosmic subjects and control group. The values of SIgA in controls and hyposmic subjects were not too different and similar to those observed by other authors; however they were slightly increased in controls affected by allergic rhinitis with positivity both to RAST and/or allergometric tests (p: n.s.), while they were reduced in the parosmic and significantly in the anosmic patients (p0.01). On the basis of that data, the authors conclude that, (though related to a limited case reports) being the secretory IgA values inversely proportional to the gravity of olfactory pathology, a their protective role (if the anatomic-functional substratum is efficient), in the pathologies examined, can be easily hypothesized. Besides, that data highlight that their concentration is slightly decreased in those patients affected by allergic rhinitis, without olfactory disorders (p: n.s.).

Encephalitogenic activity of myelin basic protein (MBP) isolated in a form retaining binding to all myelin lipids was tested in Lewis rats. Immunization with this new stable lipid-bound and native-like preparation (LB-MBP), induced experimental autoimmune encephalomyelitis (EAE) as intensively as the classical lipid free MBP (LF-MBP). During the course of the disease, high affinity specific response to LB-MBP and high frequency of LB-MBP specific precursors was observed in peripheral lymphoid organs, indicating that the disease occurred in presence of anti LB-MBP specific T-cell responsivity. Short term lines, generated from lymphocytes collected at the onset of the disease from LB-MBP immunized rats, showed a strong dose-dependent response to LB-MBP, but not to LF-MBP. The present data indicate that in rat, LB-MBP maintains encephalitogenic activity and induces expansion of a specific T-cell population. These data suggest also that LB-MBP is a new autoantigen that may be relevant in human diseases.

Circulating immune complexes (CIC) were found in 47% of 71 patients before treatment, in a horizontal study of the presence of CIC in primary lung cancer (PLC). The precipitation technique in PEG was used, and C1q, IgG and IgM fractions in the precipitate were assayed. Especially in epidermoid carcinoma, CIC were found in 1/6 cases with stage 1, 2/9 with stage II and 21/34 with stage III. The frequency was significantly higher in stage III cases, and showed a significant tendency to increase with progression of the clinical stage. If stage parameters are considered separately, this tendency correlates significantly (p less than 0.002) with the amount of lymph node involvement (N) but not to the tumor (T) size nor to the presence of metastases (M). Analysis of CIC behavior in comparison with the single fractions showed that C1q and/or IgG were elevated in 40% of cases. The presence of C1q and/or IgG associated with IgM is more characteristic of stage N2, while the presence of CIC with the fractions C1q and/or IgG not associated with IgM is more frequent in stage N1. There was a lower survival rate at 12 months in patients with CIC as compared to those without (p less than 0.05).