1.Measurement of serum IgG4 levels by an established ELISA system and its clinical applications in autoimmune diseases.
Wei SUN ; Rong-fen GAO ; Yu CHEN ; Yu-ying SU ; Ling-li DONG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2013;33(4):611-614
IgG4-related disease (IgG4-RD) is a novel and rare autoimmune disease entity. Elevated serum IgG4 level is strongly suggestive of IgG4-RD. But it is still unknown whether serum IgG4 elevation commonly occurs in other autoimmune diseases. In this study, the serum IgG4 levels were detected by an established enzyme-linked immunosorbent assay (ELISA) in a variety of autoimmune diseases including systemic lupus erythematosus (SLE), Sjogren's syndrome (SS), polymyositis or dermatomyositis (PM/DM) and IgG4-RD. To evaluate the reliability of this ELISA system, some of our samples were sent to a lab in Kanazawa Medical University, Japan, and detected by using the nephelometric assay. The results showed that our findings were consistent with theirs. Moreover, it was found that the serum IgG4 levels were 0.23±0.16 g/L in 53 healthy controls, 0.16±0.15 g/L in 103 SLE patients, 0.22±0.18 g/L in 41 SS patients and 0.40±0.32 g/L in 21 PM/DM patients. No significant difference in the serum IgG4 level was observed among these groups (P>0.05). The serum IgG4 levels of two cases of IgG4-RD were 1.63 and 4.65 g/L respectively, and both decreased markedly after treatment with glucocorticoids. These data indicated that this established ELISA system can be used for detecting serum IgG4 levels. Elevated serum IgG4 levels help diagnose IgG4-RD and evaluate the curative effect of this condition rather than other autoimmune diseases.
Autoimmune Diseases
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blood
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diagnosis
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immunology
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Enzyme-Linked Immunosorbent Assay
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methods
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Humans
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Immunoglobulin G
;
blood
2.Basophil Markers for Identification and Activation in the Indirect Basophil Activation Test by Flow Cytometry for Diagnosis of Autoimmune Urticaria.
Zehwan KIM ; Bong Seok CHOI ; Jong Kun KIM ; Dong Il WON
Annals of Laboratory Medicine 2016;36(1):28-35
BACKGROUND: The indirect basophil activation test using flow cytometry is a promising tool for autoimmune urticaria diagnosis. We aimed to identify better donor basophils (from atopic vs. non-atopic donors and interleukin-3 primed vs. unprimed basophils) and improve basophil identification and activation markers (eotaxin CC chemokine receptor-3 [CCR3] vs. CD123 and CD63 vs. CD203c). METHODS: Donor basophils were obtained from non-atopic and atopic group O donors. Positive control sera were artificially prepared to simulate autoimmune urticaria patients' sera. Patient sera were obtained from nine children with chronic urticaria. Assay sensitivity was compared among each variation by using positive control sera (n=21), applying cutoff values defined from negative control sera (n=20). RESULTS: For basophil identification, a combination of CCR3 and CD123 markers revealed a higher correlation with automated complete blood count (r=0.530) compared with that observed using CD123 (r=0.498) or CCR3 alone (r=0.195). Three activation markers on the atopic donor basophils attained 100% assay sensitivity: CD203c on unprimed basophils, CD63+CD203+ or CD63 alone on primed basophils; however, these markers on the non-atopic donor basophils attained lower assay sensitivity. CONCLUSIONS: For basophil identification markers, a combination of CD123 and CCR3 is recommended, while CD123 alone may be used as an alternative. Donor basophils should be obtained from an atopic donor. For basophil activation markers, either CD203c alone on unprimed basophils or CD203c and CD63 on primed basophils are recommended, while CD63 alone on primed basophils may be used as an alternative.
Autoimmune Diseases/blood/*diagnosis/immunology
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Basophils/*immunology/metabolism
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Biomarkers/blood
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Child
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Flow Cytometry
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Humans
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Interleukin-3 Receptor alpha Subunit/blood
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Male
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Receptors, CCR3/blood
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Urticaria/blood/*diagnosis/immunology
3.Seroprevalence and diagnostic value of aquaporin-4 antibody in patients with inflammatory central nervous system demyelinating diseases.
Lei WU ; Yang YANG ; De-Hui HUANG ; Wei-Ping WU
Journal of Southern Medical University 2011;31(2):350-352
OBJECTIVETo assess the seroprevalence and diagnostic value of aquaporin-4 antibody (AQP4-Ab) in patients with inflammatory central nervous system demyelinating diseases.
METHODSSeventy-two patients with neuromyelitis optica (NMO), 68 with multiple sclerosis (MS), 4 with optic neuritis (ON), and 41 with transverse myelitis (TM) were included in this study. The TM group comprised 19 patients with non-longitudinally extensive transverse myelitis (nLETM), 14 with monophasic longitudinally extensive transverse myelitis (mLETM), and 8 with recurrent longitudinally extensive transverse myelitis (rLETM). The serum levels of AQP4-Ab was detected by indirect immunofluorence assay in these patients.
RESULTSAQP4-Ab was detected in 72.2% (52/72) patients with NMO, 5.9% (4/68) patients with MS, 25.0% (1/4) patients with ON, and 17.1% (7/41) patients with TM, showing a significant difference in the positivity between NMO and MS groups (P<0.01). AQP4-Ab seropositivity rate was 5.3% (1/19) in nLETM patients, 62.5% (5/8) in rLETM patients and 7.1% (1/14) in mLETM patients, significantly higher in rLETM than in nLETM (P<0.01) and mLETM groups (P<0.05), but no statistical difference was found between rLETM and NMO groups.
CONCLUSIONSA high seroprevalence of AQP4-Ab is observed in patients with NMO and rLETM, which support the hypothesis that NMO and rLETM belong to NMO spectrum disorders. AQP4-Ab can serve as a useful index for diagnosing NMO and differential diagnosis from MS. More attention and effective immunosuppressive treatments should be given to patients positive for AQP4-Ab.
Aquaporin 4 ; immunology ; Autoantibodies ; blood ; Demyelinating Autoimmune Diseases, CNS ; diagnosis ; immunology ; Female ; Humans ; Male ; Multiple Sclerosis ; diagnosis ; immunology ; Neuromyelitis Optica ; diagnosis ; immunology ; Seroepidemiologic Studies
4.Relation between insulin resistance and glutamic acid decarboxylase antibody titers in latent autoimmune diabetes in adults.
Xia LI ; Gan HUANG ; Xiang YAN ; Lin YANG ; Zhi-guang ZHOU
Journal of Southern Medical University 2010;30(6):1247-1249
OBJECTIVETo investigate the relation between insulin resistance and glutamic acid decarboxylase antibody (GAD-Ab) titers in latent autoimmune diabetes in adults (LADA).
METHODSThe patients with phenotypic type 2 diabetes were screened for GAD-Ab positivity, and the 141 positive patients were divided into two subgroups according to the GAD-Ab titer, namely the high-titer group (LADA-1 subtype) and low-titer group (LADA-2 subgroup). The clinical features and insulin resistance were compared between the two groups. Insulin resistance was calculated by HOMA 2 software, and GAD-Ab and C peptide were determined with radioligand and radioimmune assay, respectively.
RESULTSCompared with low-titer LADA patients, the patients with high titers had younger age of onset, lower BMI, higher HbA1c level, and worse fasting and postprandial C peptide levels. The insulin resistance index by HOMA 2 was significantly lower in LADA-1 group than in LADA-2 group (1.6-/+1.1 vs 2.1-/+1.1, P=0.001). The HOMA2-IR index showed a negative correlation to GAD-Ab titer.
CONCLUSIONThe degree of insulin resistance is correlated to GAD-Ab titers in LADA, and low titer patients have higher insulin resistance level.
Adult ; Aged ; Autoantibodies ; blood ; Autoimmune Diseases ; diagnosis ; immunology ; Diabetes Mellitus, Type 2 ; diagnosis ; immunology ; Female ; Glutamate Decarboxylase ; immunology ; Humans ; Insulin Resistance ; Islets of Langerhans ; immunology ; physiology ; Male ; Middle Aged
5.Clinical Usefulness of Serum Immunoglobulin G and G4 Level in the Diagnosis of Autoimmune Pancreatitis.
Pung KANG ; Kyu Taek LEE ; Dong Hyunn SINN ; Beom Jin KIM ; Jae Seung LEE ; Jong Kyun LEE ; Jong Chul RHEE
The Korean Journal of Gastroenterology 2008;52(5):304-309
BACKGROUND/AIMS: To diagnose autoimmune pancreatitis (AIP), serum IgG and IgG4 concentration are significant serologic markers. The purpose of this study was to assess the utility of serum IgG and IgG4 for the diagnosis of AIP. METHODS: We divided enrolled patients into 2 groups: autoimmune pancreatitis and other pancreatic disease. We measured serum IgG and IgG4 levels in patients including 12 AIP and 23 other pancreatic disease. RESULTS: Among AIP patients, 10 cases (83%) showed elevated IgG4 levels of more than 135 mg/dL and 4 cases (33%) showed elevated IgG levels of more than 1,800 mg/dL, the current cutoff value applied in Japan. Only one patient showed elevated serum IgG level, despite having normal IgG4 level. Sensitivity and specificity for AIP of elevated serum IgG4 (>135 mg/dL) were 91% and 92%, and for elevated serum IgG (>1,800 mg/dL) 67% and 92%, respectively. The optimal cut-off level of IgG4 using receiver operation characteristic (ROC) was 127 mg/dL, at which the sensitivity and specificity were 83% and 96%, respectively, for the diagnosis of AIP. Serum IgG at 1,520 mg/dL showed the sensitivity and specificity of 83% and 87%, respectively. CONCLUSONS: The measurement of serum IgG and IgG4 are helpful to diagnose AIP. Serum IgG and IgG4 are complementary to each other in the diagnosis of AIP.
Adult
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Aged
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Autoimmune Diseases/*diagnosis/immunology
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Biological Markers/blood
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Diagnosis, Differential
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Female
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Humans
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Immunoglobulin G/*blood
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Male
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Middle Aged
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Pancreatitis, Chronic/*diagnosis/etiology/immunology
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ROC Curve
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Sensitivity and Specificity
6.Autoimmune pancreatitis: report of a case.
Ke SUN ; Hong-tian YAO ; Mei KONG ; Xiao-dong TENG
Chinese Journal of Pathology 2012;41(2):140-141
Autoimmune Diseases
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diagnosis
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immunology
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pathology
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surgery
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Humans
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Immunoglobulin G
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blood
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Magnetic Resonance Imaging
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Male
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Middle Aged
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Pancreatectomy
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Pancreatitis
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diagnosis
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immunology
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pathology
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surgery
7.Autoantibodies against thyroid hormones and their influence on thyroxine determination with chemiluminescence immunoassay in dogs.
Marion PIECHOTTA ; Michael ARNDT ; Hans Otto HOPPEN
Journal of Veterinary Science 2010;11(3):191-196
Autoantibodies against thyroxin (T4AA) and triiodothyronine (T3AA) are present in dogs with autoimmune thyroiditis and have been reported to interfere with immunoassays. The objectives of this study were to determine the frequency of autoantibodies and to determine whether interference occurs by T4AA, using a non-immunological method (high performance liquid chromatography, HPLC) for thyroxin (T4) measurement. Based on clinical symptoms, T4 and thyroid stimulating hormone (TSH) concentration, 1,339 dogs were divided into six groups: Group 1: hypothyroid (n = 149); Group 2: subclinical thyroiditis (n = 110); Group 3: suspicious for non thyroidal illness (n = 691); Group 4: biochemical euthyroid (n = 138); Group 5: hypothyroid dogs under substitution therapy (n = 141); Group 6: healthy dogs (n = 110). The incidence of T4AA and T3AA, determined using radiometric assay, was low (0.5% and 3.8%) and higher in hypothyroid dogs compared to dogs suspicious for hypothyroidism (Group 2-4) (p<0.05). T4AA was not detected in dogs with normal T4 and elevated TSH. T4 concentrations of T4AA positive samples determined using HPLC were comparable to results obtained by chemiluminescence immunoassay. These findings indicate that the probability of interference of T4AA leading to falsely elevated T4 concentration in the T4 assay seems to be low.
Animals
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Autoantibodies/*immunology
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Chemiluminescent Measurements/methods/*veterinary
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Chromatography, High Pressure Liquid/veterinary
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Dog Diseases/*diagnosis/*immunology
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Dogs
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Immunoassay/methods/*veterinary
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Thyroid Hormones/*immunology
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Thyroiditis, Autoimmune/diagnosis/immunology/*veterinary
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Thyroxine/*blood
8.Clinical characteristics of patients with juvenile localized scleroderma.
Qiu-Ning SUN ; Wei DU ; Bin HU ; Pai LIU ; Xie YUAN
Acta Academiae Medicinae Sinicae 2009;31(1):48-50
OBJECTIVETo investigate the clinical characteristics of juvenile localized scleroderma (JLS).
METHODSThe clinical data of 100 outpatients with JLS who were admitted to PUMC Hospital from 2000 to 2008 were retrospectively analyzed.
RESULTSOf a total of 100 cases, 51 (51%) were confirmed as linear scleroderma, 26 (26%) as plaque morphea, 26 (26%) as deep morphea, 12 (12%) as generalized morphea, and 15 (15%) as a mixed subtype. Nine patients (9%) had family histories of rheumatic or autoimmune diseases, while 16 (16%) might be triggered by unknown factors. Totally 84 patients underwent antinuclear antibody tests and 38 patients (45.2%) had positive results.
CONCLUSIONSLinear scleroderma are the most frequent subtype of JLS. Localized scleroderma may be associated with some autoimmune-related causes.
Adolescent ; Antibodies, Antinuclear ; blood ; Autoimmune Diseases ; complications ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Scleroderma, Localized ; diagnosis ; immunology ; pathology
9.Incidentally Detected Autoimmune Pancreatitis in a Patient with Retroperitoneal Fibrosis.
The Korean Journal of Gastroenterology 2008;51(5):271-273
No abstract available.
Anti-Inflammatory Agents/therapeutic use
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Autoimmune Diseases/complications/*diagnosis/drug therapy
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Humans
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Immunoglobulin G/blood
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Male
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Middle Aged
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Pancreatitis/complications/*diagnosis/immunology
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Prednisolone/therapeutic use
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Retroperitoneal Fibrosis/complications/*diagnosis/immunology
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Tomography, X-Ray Computed
10.Imaging features of autoimmune pancreatitis.
Guan-ning CONG ; Ming-wei QIN ; Hui YOU ; Wei LIU ; Kai XU
Acta Academiae Medicinae Sinicae 2008;30(4):479-484
OBJECTIVETo explore the clinical, pathological, and imaging features of autoimmune pancreatitis (AlP).
METHODSThe clinical data of 10 patients (all men; aged 47-80 years, mean 61.3 years) with AlP in our hospital between March 2000 and August 2007 were retrospectively analyzed. gamma-globulin, immunoglobulin C (IgG), rheumatoid factors, and autoantibodies were examined for all cases. The imaging findings were reviewed, which included helical computed tomography (CT), endoscopic ultrasonography (EUS), and B-mode ultrasound in all patients, magnetic resonance cholangiopancreatography (MRCP) in 9 patients, and endoscopic retrograde cholangiopancreatography (ERCP) in 7 patients. Follow-up imaging results were available in 5 patients.
RESULTSClinically, the most common early symptoms included obstructive jaundice (9/10) and non-specific abdominal pain (1/10), accompanied by the elevated levels of serum gamma-globulin, IgG or the presence of autoantibodies. Diabetes mellitus was detected at presentation in 2 patients. imaging findings included: CT showed diffuse (n=9) and focal (n=1) enlargement of pancreas. Minimal peripancreatic stranding was found in 7 patients, with no pancreatic pseudocyst and calcification. Six patients had enlarged peripancreatic lymph nodes. After contrast injection for 4 patients, delayed enhancement of the pancreatic parenchyma was observed, along with low-density capsule-like rim surrounding the pancreas. Magnetic resonance imaging showed diffuse enlargement of pancreas in 9 patients. MRCP showed diffuse (n=6) and segmental (n=3) irregular narrowing of the main pancreatic duct. B-mode ultrasound showed diffuse (n=9) and focal (n=1) enlargement of the pancreas. EUS showed diffuse (n=9) and focal (n=1) enlargement with hypoecho. ERCP showed stricture of distal common bile duct and irregular dilation of proximal bile ducts in 7 patients, diffuse stricture in main pancreatic duct in 4 patients, and segmental stricture in 3 patients. During the follow-up, abnormalities of imaging and serum markers were resolved after steroid therapy in 5 patients.
CONCLUSIONAIP is a distinctive type of chronic pancreatitis that shows specific imaging features.
Aged ; Aged, 80 and over ; Autoantibodies ; blood ; Autoimmune Diseases ; diagnosis ; diagnostic imaging ; immunology ; Endosonography ; Female ; Humans ; Male ; Middle Aged ; Pancreatitis ; diagnosis ; diagnostic imaging ; immunology ; Retrospective Studies ; Tomography, X-Ray Computed