BACKGROUND： Humoral autoimmunity in patients with multiple sclerosis is often asymptomatic and transient during interferon therapy. OBJECTIVE： To analyze the frequency of positivity to autoantibodies in multiple scl...BACKGROUND： Humoral autoimmunity in patients with multiple sclerosis is often asymptomatic and transient during interferon therapy. OBJECTIVE： To analyze the frequency of positivity to autoantibodies in multiple sclerosis patients and to clarify whether it is modified by immunomodulating therapy. DESIGN： A retrospective study.TIME AND SE＇rrlNG： The study was performed at the Multiple Sclerosis Center, Department of Neurosciences, Salerno Hospital, Italy, between 2005 and 2007. PARTICIPANTS： A total of 169 multiple sclerosis patients were included, 57 males and 112 females Individuals were mainly outpatients and were usually tested yearly for autoantibodies. Patients with previous immunological diseases were excluded from statistical evaluation. METHODS： The frequency of positivity was calculated in patients grouped for gender, multiple sclerosis clinical parameters, magnetic resonance imaging features and disease modifying therapy. A total of 113 patients were treated with beta interferons. MAIN OUTCOME MEASURES： Frequency of positivity to any autoantibody. Prevalences and incidences were calculated.RESULTS： The overall prevalence of autoantibodies within 3 years was 47.3%. In multiple sclerosis patients who were untreated or treated with drugs other than interferons, the prevalence was higher, and greater positivity to autoantibodies was seen in patients treated with interferons [odds ratio （95% confidence interval）, 2.87 （1.5 - 5.2）, P 〈 0.05 - 0.01]. Multiple regression analysis showed a significant association of the positivity to autoantibodies with interferon therapy, rather than gender, relapse or magnetic resonance imaging. CONCLUSION： Interferon therapy is associated with significantly higher frequency of autoantibodies in patients with multiple sclerosis. The differences among the therapies are not influenced by other variables such as gender or clinical pattern.展开更多
Background: Low-dose computed tomography (CT) screening reduces lung cancer mortality but costs are prohibitive for most healthcare budgets due to high false positive rates. An adjunctive test able to distinguish mali...Background: Low-dose computed tomography (CT) screening reduces lung cancer mortality but costs are prohibitive for most healthcare budgets due to high false positive rates. An adjunctive test able to distinguish malignant from benign pulmonary nodules would be hugely beneficial. EarlyCDT-Lung measures serum autoantibodies to tumor-associated antigens and has found clinical acceptance to aid early detection of lung cancer for high risk patients. However performance was optimized for screening. The construction of a receiver-operating characteristic (ROC) curve would enable optimization of performance for alternative settings, including nodule malignancy. Methods: A Monte-Carlo search method was used to construct a ROC curve using a case-control cohort, enabling high and low specificity versions of EarlyCDT-Lung to be determined. These were used for a theoretical evaluation of a nodule cohort, and positive predictive value (PPV) was calculated under the assumption of independence of risk source. Patients or their nodules are typically classified into three risk groups: low (0% - 10%), intermediate (10% - 65%) and high (>65%) risk of malignancy. The predicted shift in risk group by application of the high and low specificity versions, along with the current commercial EarlyCDT-Lung, was then estimated. Results: The ROC curve, with an area under the curve of 0.743, was constructed. The high specificity (98%), low specificity (49%) and current commercial (91% specificity) versions of EarlyCDT-Lung re-classified 27%, 23% and 26% of intermediate nodules, respectively, to either a higher (10%, 8% and 10%) or lower (17%, 15% and 16%) risk group. Conclusion: A ROC curve was constructed to allow performance prediction of EarlyCDT-Lung at different specificities in the indeterminate nodule setting. This enabled risk re-classification of intermediate risk nodules, and could therefore facilitate alternative more appropriate intervention. We have shown how a multivariate biomarker test can add to the interpretation of pulmonary nodules and therefore aid patient management.展开更多
Neuromyelitis optica is an inflammatory demyelinating disease of the central nervous system that differs from multiple sclerosis.Over the past 20 years,the search for biomarke rs for neuromyelitis optica has been ongo...Neuromyelitis optica is an inflammatory demyelinating disease of the central nervous system that differs from multiple sclerosis.Over the past 20 years,the search for biomarke rs for neuromyelitis optica has been ongoing.Here,we used a bibliometric approach to analyze the main research focus in the field of biomarkers for neuromyelitis optica.Research in this area is consistently increasing,with China and the United States leading the way on the number of studies conducted.The Mayo Clinic is a highly reputable institution in the United States,and was identified as the most authoritative institution in this field.Furthermore,Professor Wingerchuk from the Mayo Clinic was the most authoritative expe rt in this field.Keyword analysis revealed that the terms "neuro myelitis optica"(261 times), "multiple sclerosis"(220 times), "neuromyelitis optica spectrum disorder"(132 times), "aquaporin4"(99 times),and "optical neuritis"(87 times) were the most frequently used keywords in literature related to this field.Comprehensive analysis of the classical literature showed that the majority of publications provide conclusive research evidence supporting the use of aquaporin-4-IgG and neuromyelitis optica-IgG to effectively diagnose and differentiate neuromyelitis optica from multiple sclerosis.Furthermore,aquaporin-4-IgG has emerged as a highly specific diagnostic biomarker for neuromyelitis optica spectrum disorder.Myelin oligodendrocyte glycoprotein-IgG is a diagnostic biomarke r for myelin oligodendrocyte glycoprotein antibody-associated disease.Recent biomarkers for neuromyelitis optica in clude cerebrospinal fluid immunological biomarkers such as glial fibrillary acidic protein,serum astrocyte damage biomarkers like FAM19A5,serum albumin,and gammaaminobutyric acid.The latest prospective clinical trials are exploring the potential of these biomarkers.Preliminary results indicate that glial fibrillary acidic protein is emerging as a promising candidate biomarker for neuromyelitis optica spectrum disorder.The ultimate goal of future research is to identify non-invasive biomarkers with high sensitivity,specificity,and safety for the accurate diagnosis of neuro myelitis optica.展开更多
In this study, we recruited 10 neuromyelitis optica patients, two multiple sclerosis patients and two myelitis patients. Chinese hamster lung fibroblast （V79） cells transfected with a human aquaporin-4-mCherry fusio...In this study, we recruited 10 neuromyelitis optica patients, two multiple sclerosis patients and two myelitis patients. Chinese hamster lung fibroblast （V79） cells transfected with a human aquaporin-4-mCherry fusion protein gene were used to detect anti-aquaporin-4 antibody in neuromyelitis optica patient sera by immunofluorescence. Anti-aquaporin-4 autoantibody was stably detected by immunofluorescence in neuromyelitis optica patient sera exclusively. The sensitivity of the assay for neuromyelitis optica was 90% and the specificity for neuromyelitis optica was 100%. The anti-aquaporin-4 antibody titers in sera were tested with serial dilutions until the signal disappeared. A positive correlation was detected between Expanded Disability Status Scale scores and serum anti-aquaporin-4 antibody titers. The anti-aquaporin-4 antibody assay is highly sensitive and specific in the sera of Chinese neuromyelitis optica patients. Detection of aquaporin-4 autoantibody is important for the diagnosis and treatment of neuromyelitis optica.展开更多
Autoantibodies and inflammation are the hallmarks of autoimmune diseases(ADs).Organ-specific and nonorgan-specific ADs are divided according to whether the autoimmune reaction is directed against a specific tissue(e.g...Autoantibodies and inflammation are the hallmarks of autoimmune diseases(ADs).Organ-specific and nonorgan-specific ADs are divided according to whether the autoimmune reaction is directed against a specific tissue(e.g.,thyroid in Hashimoto's thyroiditis)or widely expressed antigens(e.g.,cell nuclei in systemic lupus erythematosus[SLE]).SLE is distinguished by the presence of circulating autoantibodies and immune complex deposition,both of which can induce inflammatory damage to many organs.Rheumatoid arthritis(RA),sometimes called inflammatory arthritis,is a systemic AD that affects the joints and causes synovitis.Multiple sclerosis(MS)is a central nervous system inflammatory disease with various neurological and autoimmune symptoms.Links have been reported between RA and SLE as well as between Type 1 diabetes mellitus and MS.Identification of shared genes and biological processes could aid in the discovery of possible treatment targets in these dual ADs.This review article explores the molecular nature and familial inheritance of dual ADs.展开更多
Background:Clinically amyopathic dermatomyositis(CADM)is a unique sub-type of idiopathic inflammatory myopathies with a high prevalence of interstitial lung disease(ILD).Poor prognosis of the patients was strongly ass...Background:Clinically amyopathic dermatomyositis(CADM)is a unique sub-type of idiopathic inflammatory myopathies with a high prevalence of interstitial lung disease(ILD).Poor prognosis of the patients was strongly associated with rapid progressive ILD.The aim of this study was to identify risk factors for prediction of different types of ILD in CADM.Methods:In this study,data of 108 inpatients with CADM were collected,including 87 with ILD.The baseline clinical data and laboratory parameters,including myositis-specific and associated antibodies and tumor-associated antigens were analyzed to identify risk factors for acute or subacute interstitial pneumonitis(A/SIP)and chronic interstitial pneumonitis(CIP).Results:In 87 patients with CADM-ILD,39(36.1%)were A/SIP,and 48(44.4%)were CIP.There were 22(20.4%)patients with asymptomatic ILD who were detected by routine high resolution computed tomography.Cytokeratin-19 fragment(CYFRA21-1)was significantly higher in CADM-ILD than that in CADM patients without ILD;carcinoembryonic antigen and neuron-specific enolase were significantly elevated in A/SIP than that in CIP.Patients with A/SIP had a higher positive rate of anti-melanoma differentiation-associated gene 5(MDA5),while patients with CIP had a higher positive rate of anti PL-12 and anti-Ro-52.Logistic regression analysis indicated that elevation of CYFRA21-1 was a risk factor for ILD,higher titer of anti-MDA5 indicated increased likelihood for A/SIP,and higher titer of anti-Ro-52 was also clearly associated with CIP.Conclusions:This study indicated that the prevalence of ILD was high in CADM.Asymptomatic ILD has been previously underestimated.Anti-MDA5 was a risk factor for the presence of A/SIP,and CYFRA21-1 was a risk factor for ILD.展开更多
文摘BACKGROUND： Humoral autoimmunity in patients with multiple sclerosis is often asymptomatic and transient during interferon therapy. OBJECTIVE： To analyze the frequency of positivity to autoantibodies in multiple sclerosis patients and to clarify whether it is modified by immunomodulating therapy. DESIGN： A retrospective study.TIME AND SE＇rrlNG： The study was performed at the Multiple Sclerosis Center, Department of Neurosciences, Salerno Hospital, Italy, between 2005 and 2007. PARTICIPANTS： A total of 169 multiple sclerosis patients were included, 57 males and 112 females Individuals were mainly outpatients and were usually tested yearly for autoantibodies. Patients with previous immunological diseases were excluded from statistical evaluation. METHODS： The frequency of positivity was calculated in patients grouped for gender, multiple sclerosis clinical parameters, magnetic resonance imaging features and disease modifying therapy. A total of 113 patients were treated with beta interferons. MAIN OUTCOME MEASURES： Frequency of positivity to any autoantibody. Prevalences and incidences were calculated.RESULTS： The overall prevalence of autoantibodies within 3 years was 47.3%. In multiple sclerosis patients who were untreated or treated with drugs other than interferons, the prevalence was higher, and greater positivity to autoantibodies was seen in patients treated with interferons [odds ratio （95% confidence interval）, 2.87 （1.5 - 5.2）, P 〈 0.05 - 0.01]. Multiple regression analysis showed a significant association of the positivity to autoantibodies with interferon therapy, rather than gender, relapse or magnetic resonance imaging. CONCLUSION： Interferon therapy is associated with significantly higher frequency of autoantibodies in patients with multiple sclerosis. The differences among the therapies are not influenced by other variables such as gender or clinical pattern.
文摘Background: Low-dose computed tomography (CT) screening reduces lung cancer mortality but costs are prohibitive for most healthcare budgets due to high false positive rates. An adjunctive test able to distinguish malignant from benign pulmonary nodules would be hugely beneficial. EarlyCDT-Lung measures serum autoantibodies to tumor-associated antigens and has found clinical acceptance to aid early detection of lung cancer for high risk patients. However performance was optimized for screening. The construction of a receiver-operating characteristic (ROC) curve would enable optimization of performance for alternative settings, including nodule malignancy. Methods: A Monte-Carlo search method was used to construct a ROC curve using a case-control cohort, enabling high and low specificity versions of EarlyCDT-Lung to be determined. These were used for a theoretical evaluation of a nodule cohort, and positive predictive value (PPV) was calculated under the assumption of independence of risk source. Patients or their nodules are typically classified into three risk groups: low (0% - 10%), intermediate (10% - 65%) and high (>65%) risk of malignancy. The predicted shift in risk group by application of the high and low specificity versions, along with the current commercial EarlyCDT-Lung, was then estimated. Results: The ROC curve, with an area under the curve of 0.743, was constructed. The high specificity (98%), low specificity (49%) and current commercial (91% specificity) versions of EarlyCDT-Lung re-classified 27%, 23% and 26% of intermediate nodules, respectively, to either a higher (10%, 8% and 10%) or lower (17%, 15% and 16%) risk group. Conclusion: A ROC curve was constructed to allow performance prediction of EarlyCDT-Lung at different specificities in the indeterminate nodule setting. This enabled risk re-classification of intermediate risk nodules, and could therefore facilitate alternative more appropriate intervention. We have shown how a multivariate biomarker test can add to the interpretation of pulmonary nodules and therefore aid patient management.
文摘Neuromyelitis optica is an inflammatory demyelinating disease of the central nervous system that differs from multiple sclerosis.Over the past 20 years,the search for biomarke rs for neuromyelitis optica has been ongoing.Here,we used a bibliometric approach to analyze the main research focus in the field of biomarkers for neuromyelitis optica.Research in this area is consistently increasing,with China and the United States leading the way on the number of studies conducted.The Mayo Clinic is a highly reputable institution in the United States,and was identified as the most authoritative institution in this field.Furthermore,Professor Wingerchuk from the Mayo Clinic was the most authoritative expe rt in this field.Keyword analysis revealed that the terms "neuro myelitis optica"(261 times), "multiple sclerosis"(220 times), "neuromyelitis optica spectrum disorder"(132 times), "aquaporin4"(99 times),and "optical neuritis"(87 times) were the most frequently used keywords in literature related to this field.Comprehensive analysis of the classical literature showed that the majority of publications provide conclusive research evidence supporting the use of aquaporin-4-IgG and neuromyelitis optica-IgG to effectively diagnose and differentiate neuromyelitis optica from multiple sclerosis.Furthermore,aquaporin-4-IgG has emerged as a highly specific diagnostic biomarker for neuromyelitis optica spectrum disorder.Myelin oligodendrocyte glycoprotein-IgG is a diagnostic biomarke r for myelin oligodendrocyte glycoprotein antibody-associated disease.Recent biomarkers for neuromyelitis optica in clude cerebrospinal fluid immunological biomarkers such as glial fibrillary acidic protein,serum astrocyte damage biomarkers like FAM19A5,serum albumin,and gammaaminobutyric acid.The latest prospective clinical trials are exploring the potential of these biomarkers.Preliminary results indicate that glial fibrillary acidic protein is emerging as a promising candidate biomarker for neuromyelitis optica spectrum disorder.The ultimate goal of future research is to identify non-invasive biomarkers with high sensitivity,specificity,and safety for the accurate diagnosis of neuro myelitis optica.
基金supported by a grant from the China-Italy Bilateral Cooperation in Science and Technology Committee,No.PGR00011
文摘In this study, we recruited 10 neuromyelitis optica patients, two multiple sclerosis patients and two myelitis patients. Chinese hamster lung fibroblast （V79） cells transfected with a human aquaporin-4-mCherry fusion protein gene were used to detect anti-aquaporin-4 antibody in neuromyelitis optica patient sera by immunofluorescence. Anti-aquaporin-4 autoantibody was stably detected by immunofluorescence in neuromyelitis optica patient sera exclusively. The sensitivity of the assay for neuromyelitis optica was 90% and the specificity for neuromyelitis optica was 100%. The anti-aquaporin-4 antibody titers in sera were tested with serial dilutions until the signal disappeared. A positive correlation was detected between Expanded Disability Status Scale scores and serum anti-aquaporin-4 antibody titers. The anti-aquaporin-4 antibody assay is highly sensitive and specific in the sera of Chinese neuromyelitis optica patients. Detection of aquaporin-4 autoantibody is important for the diagnosis and treatment of neuromyelitis optica.
文摘Autoantibodies and inflammation are the hallmarks of autoimmune diseases(ADs).Organ-specific and nonorgan-specific ADs are divided according to whether the autoimmune reaction is directed against a specific tissue(e.g.,thyroid in Hashimoto's thyroiditis)or widely expressed antigens(e.g.,cell nuclei in systemic lupus erythematosus[SLE]).SLE is distinguished by the presence of circulating autoantibodies and immune complex deposition,both of which can induce inflammatory damage to many organs.Rheumatoid arthritis(RA),sometimes called inflammatory arthritis,is a systemic AD that affects the joints and causes synovitis.Multiple sclerosis(MS)is a central nervous system inflammatory disease with various neurological and autoimmune symptoms.Links have been reported between RA and SLE as well as between Type 1 diabetes mellitus and MS.Identification of shared genes and biological processes could aid in the discovery of possible treatment targets in these dual ADs.This review article explores the molecular nature and familial inheritance of dual ADs.
基金This work was supported by grants from the National Natural Science Foundation of China(Nos.81801615 and 81871289).
文摘Background:Clinically amyopathic dermatomyositis(CADM)is a unique sub-type of idiopathic inflammatory myopathies with a high prevalence of interstitial lung disease(ILD).Poor prognosis of the patients was strongly associated with rapid progressive ILD.The aim of this study was to identify risk factors for prediction of different types of ILD in CADM.Methods:In this study,data of 108 inpatients with CADM were collected,including 87 with ILD.The baseline clinical data and laboratory parameters,including myositis-specific and associated antibodies and tumor-associated antigens were analyzed to identify risk factors for acute or subacute interstitial pneumonitis(A/SIP)and chronic interstitial pneumonitis(CIP).Results:In 87 patients with CADM-ILD,39(36.1%)were A/SIP,and 48(44.4%)were CIP.There were 22(20.4%)patients with asymptomatic ILD who were detected by routine high resolution computed tomography.Cytokeratin-19 fragment(CYFRA21-1)was significantly higher in CADM-ILD than that in CADM patients without ILD;carcinoembryonic antigen and neuron-specific enolase were significantly elevated in A/SIP than that in CIP.Patients with A/SIP had a higher positive rate of anti-melanoma differentiation-associated gene 5(MDA5),while patients with CIP had a higher positive rate of anti PL-12 and anti-Ro-52.Logistic regression analysis indicated that elevation of CYFRA21-1 was a risk factor for ILD,higher titer of anti-MDA5 indicated increased likelihood for A/SIP,and higher titer of anti-Ro-52 was also clearly associated with CIP.Conclusions:This study indicated that the prevalence of ILD was high in CADM.Asymptomatic ILD has been previously underestimated.Anti-MDA5 was a risk factor for the presence of A/SIP,and CYFRA21-1 was a risk factor for ILD.
