Autoantibodies and Anti-Microbial Antibodies
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Clinical Reasoning
RESIDENT & FELLOW SECTION Clinical Reasoning: Section Editor A 49-year-old woman with progressive Mitchell S.V. Elkind, MD, MS motor deficit Ana Monteiro, MD SECTION 1 strength, and difficulty protruding the tongue, without Amélia Mendes, MD A previously healthy 49-year-old woman presented with fasciculations or atrophy. Symmetrical tetraparesis Fernando Silveira, MD progressive motor deficit. The complaints started the (proximal-greater-than-distal weakness) and increased Lígia Castro, MD year before with weakness of the right arm. Over the tone were noted, with severe pain upon mobilization Goreti Nadais, MD subsequent months, she developed weakness in the left and palpation of joints and muscles. Deep tendon reflexes arm, followed by both legs, and, finally, difficulty speak- were brisk and symmetric, with bilateral flexor plantar ing, with nasal voice, and swallowing. It was increasingly responses. There was atrophy of the interosseous muscles Correspondence to difficult to attend to her chores, and, by the time she of the hands and shoulder girdle muscle wasting. Dr. Monteiro: sought medical attention, she needed help with all daily [email protected] Questions for consideration: activities. In the last few weeks, she also complained of diffuse joint and muscle pain. Medical and family history 1. How do you localize the symptoms: upper motor were unremarkable. neuron (UMN) or lower motor neuron (LMN), Neurologic examination showed bilateral facial weak- neuromuscular junction (NMJ), peripheral nerve, ness, severe dysarthria, dysphonia and dysphagia (nau- or muscle? What is the broad differential? seous reflex preserved), decreased shoulder elevation 2. What findings on examination would be helpful? GO TO SECTION 2 Supplemental data at Neurology.org From the Departments of Neurology (A. -
Supplement 1 Overview of Dystonia Genes
Supplement 1 Overview of genes that may cause dystonia in children and adolescents Gene (OMIM) Disease name/phenotype Mode of inheritance 1: (Formerly called) Primary dystonias (DYTs): TOR1A (605204) DYT1: Early-onset generalized AD primary torsion dystonia (PTD) TUBB4A (602662) DYT4: Whispering dystonia AD GCH1 (600225) DYT5: GTP-cyclohydrolase 1 AD deficiency THAP1 (609520) DYT6: Adolescent onset torsion AD dystonia, mixed type PNKD/MR1 (609023) DYT8: Paroxysmal non- AD kinesigenic dyskinesia SLC2A1 (138140) DYT9/18: Paroxysmal choreoathetosis with episodic AD ataxia and spasticity/GLUT1 deficiency syndrome-1 PRRT2 (614386) DYT10: Paroxysmal kinesigenic AD dyskinesia SGCE (604149) DYT11: Myoclonus-dystonia AD ATP1A3 (182350) DYT12: Rapid-onset dystonia AD parkinsonism PRKRA (603424) DYT16: Young-onset dystonia AR parkinsonism ANO3 (610110) DYT24: Primary focal dystonia AD GNAL (139312) DYT25: Primary torsion dystonia AD 2: Inborn errors of metabolism: GCDH (608801) Glutaric aciduria type 1 AR PCCA (232000) Propionic aciduria AR PCCB (232050) Propionic aciduria AR MUT (609058) Methylmalonic aciduria AR MMAA (607481) Cobalamin A deficiency AR MMAB (607568) Cobalamin B deficiency AR MMACHC (609831) Cobalamin C deficiency AR C2orf25 (611935) Cobalamin D deficiency AR MTRR (602568) Cobalamin E deficiency AR LMBRD1 (612625) Cobalamin F deficiency AR MTR (156570) Cobalamin G deficiency AR CBS (613381) Homocysteinuria AR PCBD (126090) Hyperphelaninemia variant D AR TH (191290) Tyrosine hydroxylase deficiency AR SPR (182125) Sepiaterine reductase -
Supplemental Material
Supplemental Table B ARGs in alphabetical order Symbol Title 3 months 6 months 9 months 12 months 23 months ANOVA Direction Category 38597 septin 2 1557 ± 44 1555 ± 44 1579 ± 56 1655 ± 26 1691 ± 31 0.05219 up Intermediate 0610031j06rik kidney predominant protein NCU-G1 491 ± 6 504 ± 14 503 ± 11 527 ± 13 534 ± 12 0.04747 up Early Adult 1G5 vesicle-associated calmodulin-binding protein 662 ± 23 675 ± 17 629 ± 16 617 ± 20 583 ± 26 0.03129 down Intermediate A2m alpha-2-macroglobulin 262 ± 7 272 ± 8 244 ± 6 290 ± 7 353 ± 16 0.00000 up Midlife Aadat aminoadipate aminotransferase (synonym Kat2) 180 ± 5 201 ± 12 223 ± 7 244 ± 14 275 ± 7 0.00000 up Early Adult Abca2 ATP-binding cassette, sub-family A (ABC1), member 2 958 ± 28 1052 ± 58 1086 ± 36 1071 ± 44 1141 ± 41 0.05371 up Early Adult Abcb1a ATP-binding cassette, sub-family B (MDR/TAP), member 1A 136 ± 8 147 ± 6 147 ± 13 155 ± 9 185 ± 13 0.01272 up Midlife Acadl acetyl-Coenzyme A dehydrogenase, long-chain 423 ± 7 456 ± 11 478 ± 14 486 ± 13 512 ± 11 0.00003 up Early Adult Acadvl acyl-Coenzyme A dehydrogenase, very long chain 426 ± 14 414 ± 10 404 ± 13 411 ± 15 461 ± 10 0.01017 up Late Accn1 amiloride-sensitive cation channel 1, neuronal (degenerin) 242 ± 10 250 ± 9 237 ± 11 247 ± 14 212 ± 8 0.04972 down Late Actb actin, beta 12965 ± 310 13382 ± 170 13145 ± 273 13739 ± 303 14187 ± 269 0.01195 up Midlife Acvrinp1 activin receptor interacting protein 1 304 ± 18 285 ± 21 274 ± 13 297 ± 21 341 ± 14 0.03610 up Late Adk adenosine kinase 1828 ± 43 1920 ± 38 1922 ± 22 2048 ± 30 1949 ± 44 0.00797 up Early -
An Overview of Various Diagnostic Methods to Detect Antinuclear Antibodies of Connective Tissue Diseases
DOI: 10.7860/NJLM/2021/48042:2492 Review Article An Overview of Various Diagnostic Methods to Detect Antinuclear Antibodies of Microbiology Section Microbiology Connective Tissue Diseases SAIKEERTHANA DURAISAMY ABSTRACT Antinuclear Antibodies (ANA) are present in many autoimmune disorders and these disorders are collectively called as Connective Tissue Diseases (CTD). There are various CTDs which include Systemic Lupus Erythematosus (SLE), Sjogren’s syndrome, Systemic Sclerosis (SS), Inflammatory Myositis (IM), Mixed Connective Tissue Disorder (MCTD) and Rheumatoid Arthritis (RA). Detection of ANAs in these CTDs is highly sensitive and is of utmost importance. The ANAs specific to SLE includes antidouble stranded Deoxyribonucleic Acid (antidsDNA), single stranded DNA (ssDNA). Scleroderma or Systemic Sclerosis (SS) is an immune mediated rheumatic disease where autoantibodies like topoisomerase 1, Ribonucleic Acid (RNA) polymerase 1 and fibrillarin are useful in diagnosis. Idiopathic Inflammatory Myositis (IIM) such as polymyositis and dermatomyositis are characterised by the presence of autoantibodies like PM-scl (Polymyositis-Scleromyositis), Mi-1 (Myositis specific autoantibody found in idiopathic inflammatory myositis), Mi-2 and Ku (DNA Binding Protein in dermatomyositis). Antibody titres against polypeptides on the U1 Ribonucleoprotein (U1RNP) is useful in the detection mixed CTD. Sjogren’s syndrome is characterised by the presence of serum autoantibodies against two ribonucleoproteinic complexes like Ro/SSA (Extractable nuclear antigen found in Sjogren's syndrome related antigen A auto antibodies) and La/SSB (Extractable nuclear antigen found in Sjogren's syndrome or lupus erythematous). ANA analysis can be done by techniques like indirect immunofluorescence method, Enzyme Linked Immuno Sorbent Assay (ELISA), Immunoprecipitation in agar and western blotting. All these diagnostic methods give precise identification of these antibodies with high accuracy. -
Attenuation of Ganglioside GM1 Accumulation in the Brain of GM1 Gangliosidosis Mice by Neonatal Intravenous Gene Transfer
Gene Therapy (2003) 10, 1487–1493 & 2003 Nature Publishing Group All rights reserved 0969-7128/03 $25.00 www.nature.com/gt RESEARCH ARTICLE Attenuation of ganglioside GM1 accumulation in the brain of GM1 gangliosidosis mice by neonatal intravenous gene transfer N Takaura1, T Yagi2, M Maeda2, E Nanba3, A Oshima4, Y Suzuki5, T Yamano1 and A Tanaka1 1Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka, Japan; 2Department of Neurobiology and Anatomy, Osaka City University Graduate School of Medicine, Osaka, Japan; 3Gene Research Center, Tottori University, Yonago, Japan; 4Department of Pediatrics, Takagi Hospital, Saitama, Japan; and 5Pediatrics, Clinical Research Center, Nasu Institute for Developmental Disabilities, International University of Health and Welfare, Ohtawara, Japan A single intravenous injection with 4 Â 107 PFU of recombi- ganglioside GM1 was above the normal range in all treated nant adenovirus encoding mouse b-galactosidase cDNA to mice, which was speculated to be the result of reaccumula- newborn mice provided widespread increases of b-galacto- tion. However, the values were still definitely lower in most of sidase activity, and attenuated the development of the the treated mice than those in untreated mice. In the disease including the brain at least for 60 days. The b- histopathological study, X-gal-positive cells, which showed galactosidase activity showed 2–4 times as high a normal the expression of exogenous b-galactosidase gene, were activity in the liver and lung, and 50 times in the heart. In the observed in the brain. It is noteworthy that neonatal brain, while the activity was only 10–20% of normal, the administration via blood vessels provided access to the efficacy of the treatment was distinct. -
Technical Reports
TECHNICAL REPORTS Lipid microarrays identify key mediators of autoimmune brain inflammation Jennifer L Kanter1,2, Sirisha Narayana2, Peggy P Ho2, Ingrid Catz3, Kenneth G Warren3, Raymond A Sobel4,6, Lawrence Steinman2 & William H Robinson5,6 Recent studies suggest that increased T-cell and autoantibody against phospholipids and gangliosides contribute to the pathogenesis reactivity to lipids may be present in the autoimmune in systemic lupus erythematosus and Guillain-Barre´ syndrome, respec- demyelinating disease multiple sclerosis. To perform large-scale tively10. Despite reports of myelin-specific lipid responses in multiple multiplex analysis of antibody responses to lipids in multiple sclerosis, the role of lipid-specific autoimmunity in multiple sclerosis sclerosis, we developed microarrays composed of lipids remains controversial11. Most lipids are presented to T cells bound to 12 http://www.nature.com/naturemedicine present in the myelin sheath, including ganglioside, sulfatide, CD1 molecules and CD1 expression is increased in CNS lesions in cerebroside, sphingomyelin and total brain lipid fractions. Lipid- both multiple sclerosis and experimental autoimmune encephalomye- array analysis showed lipid-specific antibodies against sulfatide, litis (EAE)13–15. These observations led us to hypothesize that myelin sphingomyelin and oxidized lipids in cerebrospinal fluid (CSF) lipids may be target autoantigens in individuals with multiple sclerosis derived from individuals with multiple sclerosis. Sulfatide- and to develop lipid-array technology to investigate this hypothesis. specific antibodies were also detected in SJL/J mice with We developed simple, large-scale lipid microarrays for detection of acute experimental autoimmune encephalomyelitis (EAE). autoantibodies present in biological fluids such as serum and cere- Immunization of mice with sulfatide plus myelin peptide brospinal fluid (CSF). -
Antibody Testing in Peripheral Neuropathies Steven Vernino, MD, Phd*, Gil I
Neurol Clin 25 (2007) 29–46 Antibody Testing in Peripheral Neuropathies Steven Vernino, MD, PhD*, Gil I. Wolfe, MD Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA Causes of peripheral neuropathy (PN) include a wide range of genetic, toxic, metabolic, and inflammatory disorders. Several PNs have an autoim- mune basis, either as a consequence of systemic autoimmune disease, an au- toimmune disorder specifically targeting peripheral nerve or ganglia, or a remote effect of malignancy. Several clinical presentations are distinctive for the autoimmune neuropathies. Subacute progression, asymmetric or multifocal deficits, and selective involvement of motor, sensory, or auto- nomic nerves are clues suggesting an autoimmune, inflammatory cause. The clinical presentation, however, may be indistinguishable from other forms of chronic length-dependent sensorimotor PN. Antibodies against specific glycolipids or glycoproteins, such as anti- GM1 and anti–myelin-associated glycoprotein (MAG), are associated with inflammatory (often demyelinating) peripheral nerve syndromes. In some cases, these antibodies identify motor or sensory neuropathies that are responsive to immunotherapy [1–3] or those with a different prognosis [4,5]. Antineuronal nuclear and cytoplasmic antibodies (such as anti-Hu and CRMP-5) help identify patients who have paraneoplastic neuropathy resulting from remote immunologic effects of malignancy [6,7]. Various other serologic tests, although less specific, can be used to provide clues about the presence of systemic autoimmune disease that can affect the nerves. These include serologic markers for Sjo¨gren’s syndrome (SS), rheu- matoid arthritis, celiac disease, and systemic vasculitides (such as Churg- Strauss syndrome) [8,9]. Because the cause of acquired neuropathies often is obscure, autoanti- body testing can be of great diagnostic value in identifying autoimmune * Corresponding author. -
Improvement of Spontaneous Alternation Behavior Deficit by Activation Ofα4β2 Nicotinic Acetylcholine Receptor Signaling in the Ganglioside GM3-Deficient Mice
Biomedical Research 34 (4) 189-195, 2013 Improvement of spontaneous alternation behavior deficit by activation of α4β2 nicotinic acetylcholine receptor signaling in the ganglioside GM3- deficient mice 1 1 2 1 2 1 Kimie NIIMI , Chieko NISHIOKA , Tomomi MIYAMOTO , Eiki TAKAHASHI , Ichiro MIYOSHI , Chitoshi ITAKURA , 3, 4 and Tadashi YAMASHITA 1 Riken Brain Science Institute, Saitama 351-0198, Japan; 2 Graduate School of Medical Sciences, Nagoya City University, Nagoya 467- 8601, Japan; 3 Graduate School of Veterinary Medicine, Azabu University, Sagamihara 252-5201, Japan; and 4 World Class University Program, Kyungpook National University School of Medicine, Daegu, South Korea (Received 13 May 2013; and accepted 17 June 2013) ABSTRACT We have reported that in ganglioside GM3-deficient (GM3−/−) mice, spontaneous alternation be- havior assessed by a Y-maze task was significantly lower, and total arm entries were significantly higher than in wild-type mice. The objective of the present study was to examine the role of nico- tinic acetylcholine receptor (nAChR) signaling in impairment of spontaneous alternation behavior of GM3−/− mice. Nicotine treatment (0.3, 1.0 mg/kg, s.c.) dose dependently improved the sponta- neous alternation deficit without affecting total arm entries in GM3−/− mice. The nicotine-induced (1.0 mg/kg, s.c.) improvement was significantly abolished by the nAChR antagonist mecamyla- mine (1.0 mg/kg, i.p.). The α4β2 nAChR antagonist dihydro-β-erythroidine (2.5, 10.0 mg/kg, i.p.) dose dependently counteracted the nicotine-induced improvement of spontaneous alternation in GM3−/− mice, whereas the α7 nAChR antagonist methyllycaconitine (2.5, 10.0 mg/kg, i.p.) did not. -
Activated Receptor 4 Ala120thr Variant Alters Platelet Responsiveness to Low‐
Journal of Thrombosis and Haemostasis, 16: 2501–2514 DOI: 10.1111/jth.14318 ORIGINAL ARTICLE The protease-activated receptor 4 Ala120Thr variant alters platelet responsiveness to low-dose thrombin and protease-activated receptor 4 desensitization, and is blocked by non-competitive P2Y12 inhibition M. J. WHITLEY,* D. M. HENKE,† A. GHAZI,† M. NIEMAN,‡ M. STOLLER,§ L. M. SIMON,† E. CHEN,† J. VESCI,* M. HOLINSTAT,¶ S. E. MCKENZIE,* C. A. SHAW,† ** L. C. EDELSTEIN* andP. F. BRAY§ *The Cardeza Foundation for Hematologic Research and the Department of Medicine, Thomas Jefferson University, Jefferson Medical College, Philadelphia, PA; †Department of Human & Molecular Genetics, Baylor College of Medicine, Houston, TX; ‡Department of Pharmacology, Case Western Reserve University, Cleveland, OH; §Program in Molecular Medicine and the Division of Hematology and Hematologic Malignancies, Department of Internal Medicine, University of Utah, Salt Lake City, UT; ¶Department of Pharmacology, University of Michigan, Ann Arbor, MI; and **Department of Statistics, Rice University, Houston, TX, USA To cite this article: Whitley MJ, Henke DM, Ghazi A, Nieman M, Stoller M, Simon LM, Chen E, Vesci J, Holinstat M, McKenzie SE, Shaw CA, Edelstein LC, Bray PF. The protease-activated receptor 4 Ala120Thr variant alters platelet responsiveness to low-dose thrombin and protease- activated receptor 4 desensitization, and is blocked by non-competitive P2Y12 inhibition. J Thromb Haemost 2018; 16: 2501–14. thrombin was assessed without and with antiplatelet antag- Essentials onists. The association of rs773902 alleles with stroke was assessed in the Stroke Genetics Network study. Results: • The rs773902 SNP results in differences in platelet pro- As compared with rs773902 GG donors, platelets from tease-activated receptor (PAR4) function. -
Nicotinic Acetylcholine Receptor Signaling in Neuroprotection
Akinori Akaike · Shun Shimohama Yoshimi Misu Editors Nicotinic Acetylcholine Receptor Signaling in Neuroprotection Nicotinic Acetylcholine Receptor Signaling in Neuroprotection Akinori Akaike • Shun Shimohama Yoshimi Misu Editors Nicotinic Acetylcholine Receptor Signaling in Neuroprotection Editors Akinori Akaike Shun Shimohama Department of Pharmacology, Graduate Department of Neurology, School of School of Pharmaceutical Sciences Medicine Kyoto University Sapporo Medical University Kyoto, Japan Sapporo, Hokkaido, Japan Wakayama Medical University Wakayama, Japan Yoshimi Misu Graduate School of Medicine Yokohama City University Yokohama, Kanagawa, Japan ISBN 978-981-10-8487-4 ISBN 978-981-10-8488-1 (eBook) https://doi.org/10.1007/978-981-10-8488-1 Library of Congress Control Number: 2018936753 © The Editor(s) (if applicable) and The Author(s) 2018. This book is an open access publication. Open Access This book is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made. The images or other third party material in this book are included in the book’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the book’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The use of general descriptive names, registered names, trademarks, service marks, etc. -
Autoantibodies in Systemic Autoimmune Diseases K
umschlag_neutral.qxd 03.10.2007 10:53 Seite 1 2nd edition Karsten Conrad, Werner Schößler, Falk Hiepe, Marvin J. Fritzler Autoantibodies are a very heterogeneous group of antibodies with respect to their specificity, induction, effects, and clinical signifi- cance. Testing for autoantibodies can be helpful or necessary for the diagnosis, differential diagnosis, prognostication, or monitoring of Autoantibodies in Systemic autoimmune diseases. In case of limited (forme fruste) disease or a single disease manifestation, the detection of serum autoantibodies can play an Autoimmune Diseases important role in raising the suspicion of evolving disease and forecasting prog- nosis. This book and reference guide is intended to assist the physician in under- A Diagnostic Reference standing and interpreting the variety of autoantibodies that are being used as diagnostic and prognostic tools for patients with systemic rheumatic diseases. Autoantibodies observed in systemic autoimmune diseases are described in alphabetical order in Part 1 of this reference guide. In Part 2, systemic autoim- mune disorders as well as symptoms that indicate the possible presence of an autoimmune disease are listed. Systemic manifestations of organ-specific autoim- mune diseases will not be covered in this volume. Guide marks were inserted to K. Conrad, W.K. Conrad, Hiepe, M. J. Fritzler F. Schößler, ensure fast and easy cross-reference between symptoms, a given autoimmune disease and associated autoantibodies. Although the landscape of autoantibody testing continues to change, this information will be a useful and valuable refer- ence for many years to come. AUTOANTIGENS, AUTOANTIBODIES, AUTOIMMUNITY Autoantibodies in Systemic Autoimmune Diseases Autoimmune in Systemic Autoantibodies Volume 2, second Edition – 2007 ISBN 978-3-89967-420-0 www.pabst-publishers.com PABST Autoantibodies in Systemic Autoimmune Diseases A Diagnostic Reference Karsten Conrad, Werner Schößler, Falk Hiepe, Marvin J. -
That Are Not Lielu Uutuullittu
THAT ARE NOT LIELUUS009987356B2 UUTUULLITTU (12 ) United States Patent ( 10 ) Patent No. : US 9 ,987 , 356 B2 Reimann et al. ( 45) Date of Patent : Jun . 5 , 2018 (54 ) ANTI -CD40 ANTIBODIES AND METHODS 762 A 12 / 1997 Queen et al. 5 , 801, 227 A 9 / 1998 Fanslow , III et al. OF ADMINISTERING THEREOF 5 , 874 ,082 A 2 / 1999 de Boer 6 ,004 , 552 A 12 / 1999 de Boer et al. ( 75 ) Inventors: Keith A . Reimann , Marblehead , MA 6 ,051 ,228 A 4 / 2000 Aruffo et al. (US ) ; Rijian Wang , Saugus, MA (US ) ; 6 ,054 ,297 A 4 / 2000 Carter et al . Christian P . Larsen , Atlanta , GA (US ) 6 ,056 , 959 A 5 /2000 de Boer et al. 6 , 132 , 978 A 10 /2000 Gelfand et al. 6 , 280 , 957 B18 / 2001 Sayegh et al. ( 73) Assignees : Beth Israel Deaconess Medical 6 , 312 ,693 B1 11/ 2001 Aruffo et al. Center , Inc ., Boston , MA (US ) ; Emory 6 , 315 , 998 B111 / 2001 de Boer et al. University , Atlanta , GA (US ) 6 , 413 ,514 B1 7 / 2002 Aruffo et al. 6 , 632, 927 B2 10 /2003 Adair et al. ( * ) Notice : Subject to any disclaimer , the term of this 7 ,063 , 845 B2 6 / 2006 Mikayama et al. patent is extended or adjusted under 35 7 , 193 , 064 B2 3 / 2007 Mikayama et al. 7 , 288 , 251 B2 10 / 2007 Bedian et al . U . S . C . 154 ( b ) by 464 days . 7 , 361 , 345 B2 4 /2008 de Boer et al. 7 , 445 , 780 B2 11/ 2008 Chu et al. (21 ) Appl . No.