RESUMO
Our objective was to evaluate the frequency of antinucleosome antibodies (anti-Ncs) in juvenile systemic lupus erythematosus (JSLE) comparing it to that observed for anti-DNA and to correlate the presence of these antibodies with clinical manifestations and disease activity. Anti-Ncs and anti-DNA were detected by ELISA in 74 patients with JSLE and 64 normal controls. Clinical records were reviewed. Disease activity was assessed by SLEDAI score. Anti-Ncs and anti-DNA showed sensitivity of 52.7% and 54% and specificity of 98.4% and 95.3%, respectively. Disagreement between the two assays was found in 25.7% of the cases: isolated positive Anti-Ncs in nine cases (12.2%) and isolated positive anti-DNA in 10 cases (13.5%). Agreement was found in 74.3%: both positive antibodies in 30 cases and both negative in 25. The presence of anti-Ncs was significantly associated with malar erythema, hemolytic anemia, anti-DNA and low complement levels, but not with renal manifestations. The presence of anti-Ncs was associated with a higher SLEDAI median (P < 0.001) and its titers correlated with the SLEDAI score (r = 0.504; P < 0.001). The frequency, sensitivity and specificity values were similar between anti-Ncs and anti-DNA antibodies in patients with JSLE. Nevertheless, the discordance of 25.7% between the two assays suggests that both antibodies may have a complementary diagnostic role. The association and correlation between anti-Ncs and several disease activity parameters demonstrated its usufulness in the follow-up of these patients.
Assuntos
Anticorpos Antinucleares/imunologia , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/imunologia , Nucleossomos/imunologia , Adolescente , Anticorpos Antinucleares/sangue , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Lúpus Eritematoso Sistêmico/fisiopatologia , Masculino , Estatística como AssuntoRESUMO
OBJECTIVES: To investigate the serum levels of VEGF in patients with rheumatoid arthritis of long duration. METHODS: Serum VEGF levels were measured in 118 patients with long-standing rheumatoid arthritis according to the ACR criteria (mean duration 12 years). The disease activity score was evaluated by the method of van der Heijde et al. RESULTS: Serum levels of VEGF in patients with RA were significantly higher than in healthy controls. VEGF levels showed no correlation with CRP, SAA amyloid protein, or the disease activity score. CONCLUSIONS: Our findings suggest that, contrary to the results reported in patients with early onset RA, where VEGF appears to play an active part in joint inflammation, in long-standing RA elevated VEGF serum levels may be an independent marker although its significance remain to be established.
Assuntos
Artrite Reumatoide/sangue , Fatores de Crescimento Endotelial/sangue , Linfocinas/sangue , Adulto , Amiloide/sangue , Artrite Reumatoide/fisiopatologia , Biomarcadores/sangue , Proteína C-Reativa/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Fator A de Crescimento do Endotélio Vascular , Fatores de Crescimento do Endotélio VascularAssuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Farmacorresistência Viral , HIV-1/genética , Síndrome da Imunodeficiência Adquirida/virologia , Brasil , Genótipo , Protease de HIV/genética , Transcriptase Reversa do HIV/genética , HIV-1/classificação , Humanos , Mutação , Falha de TratamentoAssuntos
Artroscopia , Cartilagem/metabolismo , Glicoproteínas/sangue , Osteoartrite do Joelho/sangue , Adipocinas , Adulto , Biomarcadores/sangue , Cartilagem/patologia , Proteína 1 Semelhante à Quitinase-3 , Condrócitos/metabolismo , Diagnóstico Diferencial , Feminino , Fibroblastos/metabolismo , Glicoproteínas/metabolismo , Humanos , Lectinas , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/patologia , Osteoartrite do Joelho/cirurgia , Líquido Sinovial/citologiaAssuntos
Centros Médicos Acadêmicos/legislação & jurisprudência , Indigência Médica/legislação & jurisprudência , Programas Nacionais de Saúde/legislação & jurisprudência , Garantia da Qualidade dos Cuidados de Saúde/legislação & jurisprudência , Centros Médicos Acadêmicos/economia , Brasil , Economia Hospitalar/legislação & jurisprudência , Financiamento Governamental/legislação & jurisprudência , Humanos , Indigência Médica/economia , Programas Nacionais de Saúde/economiaRESUMO
OBJECTIVE: Adult onset Still's disease (AOSD) is an inflammatory disorder with elevated serum acute phase proteins. Interleukin-6 is a major contributor to the acute phase response. We therefore examined the serum levels of CRP, SAA and interleukin-6 in active and inactive AOSD. RESULTS: Active patients had significantly elevated CRP, SAA, and interleukin-6 values. After steroid treatment a marked reduction was observed in all three parameters. There was a close kinetics on the fluctuations of CRP and SAA, but not on IL-6. CONCLUSION: Acute phase proteins and IL-6 are useful markers of disease activity in AOSD.
Assuntos
Biomarcadores/sangue , Interleucina-6/sangue , Doença de Still de Início Tardio/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Apolipoproteínas/metabolismo , Proteína C-Reativa/metabolismo , Ensaio de Imunoadsorção Enzimática , Humanos , Pessoa de Meia-Idade , Proteína Amiloide A Sérica/metabolismoRESUMO
Recent data suggest that the clinical course of reactional states in leprosy is closely related to the cytokine profile released locally or systemically by the patients. In the present study, patients with erythema nodosum leprosum (ENL) were grouped according to the intensity of their clinical symptoms. Clinical and immunological aspects of ENL and the impact of these parameters on bacterial load were assessed in conjunction with patients' in vitro immune response to mycobacterial antigens. In 10 out of the 17 patients tested, BI (bacterial index) was reduced by at least 1 log from leprosy diagnosis to the onset of their first reactional episode (ENL), as compared to an expected 0.3 log reduction in the unreactional group for the same MDT (multidrug therapy) period. However, no difference in the rate of BI reduction was noted at the end of MDT among ENL and unreactional lepromatous patients. Accordingly, although TNF-alpha (tumor necrosis factor) levels were enhanced in the sera of 70.6% of the ENL patients tested, no relationship was noted between circulating TNF-alpha levels and the decrease in BI detected at the onset of the reactional episode. Evaluation of bacterial viability of M. leprae isolated from the reactional lesions showed no growth in the mouse footpads. Only 20% of the patients demonstrated specific immune response to M. leprae during ENL. Moreover, high levels of soluble IL-2R (interleukin-2 receptor) were present in 78% of the patients. Circulating anti-neural (anti-ceramide and anti-galactocerebroside antibodies) and anti-mycobacterial antibodies were detected in ENL patients' sera as well, which were not related to the clinical course of disease. Our data suggest that bacterial killing is enhanced during reactions. Emergence of specific immune response to M. leprae and the effective role of TNF-alpha in mediating fragmentation of bacteria still need to be clarified.
Assuntos
Eritema Nodoso/imunologia , Hanseníase Virchowiana/imunologia , Mycobacterium leprae/crescimento & desenvolvimento , Receptores de Interleucina-2/sangue , Adolescente , Adulto , Idoso , Animais , Contagem de Colônia Microbiana , Eritema Nodoso/sangue , Eritema Nodoso/microbiologia , Feminino , Humanos , Interferon gama/sangue , Hanseníase Virchowiana/sangue , Hanseníase Virchowiana/microbiologia , Masculino , Camundongos , Pessoa de Meia-Idade , Fator de Necrose Tumoral alfa/análiseRESUMO
Our objective was to assess the prevalence of autoantibodies in patients with leprosy. Forty-one cases of lepromatous leprosy were studied. For the detection of autoantibodies we used the Elisa technique using the following purified antigens in an Elisa assay: dsDNA, ssDNA, histone, mitochondria, RNA, RNP, SS-A, SS-B, Sm, Scl-70, Anca C, Anca P and the cardiolipin complex. As a "cut off" point we used values shown on previous studies to differentiate normal from elevated values. Antibodies to SS-B, mitochondria and cardiolipin were the most prevalent in our study. Antimitochondrial antibodies distinct from those seen in primary biliary cirrhosis and antiphospholipid antibodies with variable ligand activity to B2GIP are frequent in the sera of leprosy patients.