妊娠期高血压患者血清热休克蛋白70水平与心功能及免疫球蛋白的关系研究

目的:探究妊娠期高血压患者血清热休克蛋白70(HSP70)水平与心功能及免疫球蛋白的关系。方法:选择2017年4月至2018年4月在陕西省人民医院诊治的200例妊娠期高血压患者作为妊娠期高血压组,同时选择同期在我院进行孕检的200名健康孕妇作为对照组。采用酶联免疫吸附法检测血清HSP70水平,采用全自动生化分析仪检测免疫球蛋白G(Ig G)、免疫球蛋白M(Ig M)、免疫球蛋白A(Ig A)、免疫球蛋白D(Ig D)和免疫球蛋白E(Ig E)水平,采用多普勒超声心动图监测两组的左心室后壁厚度(LVPWT)、左心室舒张末期内径(LVEDD)和室间隔厚度(IVST)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)和每搏指数(SVI),计算左心室质量(LVM)、二尖瓣舒张早期血流速度峰值与二尖瓣环侧壁舒张早期运动峰速度的比值(E/Em)、舒张早期与舒张晚期血流速度峰值的比值(E/A)。采用spearman相关性分析血清HSP70水平与血清免疫球蛋白水平及心功能指标的相关性。结果:与对照组相比,妊娠期高血压组的血清HSP70水平明显升高,而Ig G和Ig M水平明显下降,并且LVESD、LVEF、E/A也明显下降(P0.05)。血清HSP70水平与Ig G、Ig M、LVESD、LVEF、E/A均呈负相关性(P0.05)。结论:妊娠期高血压患者的血清HSP70水平明显升高,并且血清HSP70水平与妊娠期高血压患者免疫功能和心功能下降存在相关性,在妊娠期高血压患者的诊断和治疗中具有一定临床价值。     

Serum BAFF and APRIL levels in patients with IgG4-related disease and their clinical significance

Introduction

B cell-activating factor of the tumor necrosis factor family (BAFF) and a proliferation-inducing ligand (APRIL) play a crucial role in B cell development, survival, and antibody production. Here we analyzed the serum levels of BAFF and APRIL and their respective clinical associations in patients with an immunoglobulin (Ig) G4-related disease (IgG4-RD).

Methods

We measured serum levels of BAFF and APRIL in patients with IgG4-RD, primary Sjögren''s syndrome (pSS), and healthy individuals. Serum BAFF and APRIL levels in IgG4-RD were assessed for correlations with serological parameters, including Ig, particularly IgG4, and the number of affected organs. Serum BAFF and APRIL levels in IgG4-RD were monitored during glucocorticoid (GC) therapy.

Results

Serum BAFF and APRIL levels in patients with IgG4-RD were significantly higher (P < 0.01) than in healthy individuals. The BAFF levels of patients with IgG4-RD were comparable to those of patients with pSS. Although clinical parameters, such as serum IgG4 and the number of affected organs, were not correlated with the levels of BAFF, serum APRIL levels were inversely correlated with serum IgG4 levels (r = -0.626, P < 0.05). While serum BAFF levels decreased following GC therapy, serum APRIL levels increased during follow-up.

Conclusion

These results indicate that BAFF and APRIL might be useful markers for predicting disease activity in IgG4-RD. Further studies are needed to elucidate the role of BAFF and APRIL in the pathogenesis of IgG4-RD.     

Serum immunoglobulins in patients with carcinoma of the oral cavity,uterine cervix and breast

Summary Serum immunoglobulin levels (IgG, IgA, IgM, IgD and IgE) were estimated in 196 patients with carcinoma of the oral cavity, 172 patients with cervical cancer and 166 patients with breast cancer. The values were compared with those of 50 patients with benign lesions of the breast and cervix and 100 healthy adult controls. Only the serum IgE levels were found to be elevated in the benign group. Serum IgA, IgD and IgE levels were found to be elevated in all the three types of cancers and the levels were found to increase with clinical stage. In carcinoma of uterine cervix IgG levels were also found to be elevated. Immunoglobulins A and D returned to normal after clinical cure whereas IgE remained slightly elevated. IgD and IgE remained high in patients who had residual cancer.     

Changes in serum immunoglobulins in subjects with acute myocardial infarct and essential hypertension

20 (12 men and 8 women) acute myocardial infarction (AMI) patients and 17 (14 men and 3 women) patients with arterial hypertension (II degrees stage according to OMS) in comparison to controls age and sex matched, were studied, serum IgA, IgG, IgM were evaluated with radial immunodiffusion and serum IgE with RIA. Ho significant changes ef immunoglobulins were observed between hypertensive patients and controls; whereas a significant increase of IgM, IgG and IgE, with out changes of IgA, were shown in AMI patients. Serum Ig and IgM were significantly augmented in AMI patients in comparison to hypertensive patients.     

脑梗死复发患者血清同型半胱氨酸、白蛋白和尿微量白蛋白的变化及其影响因素分析

目的:研究脑梗死复发患者血清同型半胱氨酸(Hcy)、白蛋白(ALB)和尿微量白蛋白的变化及脑梗死复发的影响因素。方法:将2013年2月至2016年2月我院收治的脑梗死复发患者63例记为复发组,另取同期住院治疗的未复发脑梗死患者57例记为非复发组。比较两组患者血清Hcy、ALB、尿微量白蛋白水平和基本资料,并采用多因素Logistic回归分析脑梗死复发的影响因素。结果:复发组血清Hcy、尿微量白蛋白水平高于非复发组,复发组血清ALB水平低于非复发组(P0.05)。经Pearson相关性分析可得:脑梗死复发患者血清Hcy与尿微量白蛋白水平呈正相关关系,ALB与Hcy、尿微量白蛋白水平呈负相关关系(P0.05)。复发组高血压、脑白质疏松、脑血管病家族史人数占比高于非复发组(均P0.05)。经多因素Logistic回归分析可得:血清Hcy、尿微量白蛋白水平以及高血压均是脑梗死复发的独立危险因素(P0.05),而血清ALB水平是脑梗死复发的保护性因素(P0.05)。结论:脑梗死复发患者的血清Hcy、尿微量白蛋白水平升高,而血清ALB水平降低,上述三项指标的异常改变可能共同促进了脑梗死的复发,值得临床重点关注。     

Serum Biomarkers in Patients with Relapsing Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss)

Introduction

Previous studies suggest a role for eotaxin-3, TARC/CCL17 and IgG4 in newly- diagnosed patients with eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss) with highly active disease. The role of these biomarkers in relapsing disease is unclear.

Methods

Serum levels of TARC/CCL17, eotaxin-3, IgG4, and IgG4/IgG ratio were determined in serum samples from a longitudinal cohort of patients with EGPA (105 visits of 25 patients). Epidemiological, clinical and laboratory data were available for all visits.

Results

At the first visit, 80% of patients were using glucocorticoids and 68% additional immunosuppressive drugs. Disease flares were seen at 18 visits. The median BVAS and BVAS/WG scores at time of relapse were 4 and 2, respectively. None of the biomarkers tested were useful to discriminate between active disease and remission. Patients treated with prednisone had lower eotaxin-3 and eosinophil levels compared to patients not taking glucocorticoids irrespective of disease activity. Use of immunosuppressive agents was not associated with biomarker levels.

Conclusions

Serum levels of TARC/CCL17, eotaxin-3, IgG4, and IgG4/IgG ratio do not clearly differentiate active and inactive disease in established EGPA. Defining biomarkers in EGPA remains a challenge especially during times of glucocorticoid use.     

Detection of Serum IgG4 Levels in Patients with IgG4-Related Disease and Other Disorders

Objective

Elevated serum IgG4 levels are an important hallmark for diagnosing IgG4-related disease (IgG4-RD), but can also be observed in other diseases. This study aimed to compare two different testing methods for IgG4: ELISA and nephelometric assay. Both assays were used to measure serum IgG4 concentrations, and to assess the prevalence of high serum IgG4 levels in both IgG4-RD and non-IgG4-RD diseases.

Methods

A total of 80 serum samples were tested using the nephelometric assay and ELISA method that we established. Serum IgG4 concentrations were determined by ELISA for 957 patients with distinct diseases, including 12 cases of IgG4-RD and 945 cases of non-IgG4-RD.

Results

IgG4 levels from 80 selected serum samples examined by ELISA were in agreement with those detected using the nephelometry assay. Meanwhile, the serum IgG4 concentrations measured by ELISA were also consistent with the clinical diagnoses of patients with IgG4-RD during the course of disease. The Elevated levels of serum IgG4 (>1.35 g/L) were detected in all IgG4-RD (12/12) patients, and the prevalence of high IgG4 serum levels was 3.39% in non-IgG4-RD cases. Among them, the positive rates of serum IgG4 were 2.06% in patients with carcinoma and 6.3% in patients with other non-IgG4 autoimmune diseases.

Conclusion

Our established ELISA method is a reliable and convenient technique, which could be extensively used in the clinic to measure serum IgG4 levels. High levels of IgG4 were observed in IgG4-RD. However, this phenomenon could also be observed in other diseases, such as carcinomas and other autoimmune diseases. Thus, a diagnosis of IgG4 disease cannot only be dependent on the detection of elevated serum IgG4 levels.     

血清PTH及肿瘤标志物在类风湿关节炎患者合并骨质疏松症诊断价值分析

摘要 目的：研究血清甲状旁腺激素（PTH）和肿瘤标志物对类风湿性关节炎合并骨质疏松症（RAOP）的诊断价值。方法：选取2019年1月-2021年12月在我院就诊的60例RAOP患者为研究对象,并选取同期在我院就诊的类风湿性关节炎（RA）患者作为对照。比较两组患者血清PTH、甲胎蛋白（AFP）、癌胚抗原（CEA）、癌抗原125（CA125）、癌抗原199（CA199）和癌抗原724（CA724）。通过pearsonr相关系数分析各指标的相关性,通过Logistic回归分析RAOP的影响因素和通过受试者工作特征（ROC）曲线分析各指标对RAOP的诊断价值。结果：（1）RAOP患者血清PTH、CA125和CA199水平均显著高于RA患者（P<0.05）,而血清CA724水平显著低于RA患者（P<0.05）,并且血清AFP和CEA水平与RA患者比较无差异（P>0.05）;（2）RAOP患者血清PTH与血清PTH水平与血清CA125和CA199水平呈正相关（P<0.05）,与血清CA724水平呈负相关（P<0.05）,与血清AFP和CEA水平不相关（P>0.05）;（3）Logistic回归分析显示：血清PTH、CA125、CA199、CA724是影响类风湿性关节炎合并骨质疏松症的独立影响因素（P<0.05）;（4）ROC曲线分析显示：血清PTH、CA125、CA199对RAOP具有诊断价值,诊断敏感性和特异性分别为90.00%和86.97%、80.36 %和78.97 %、75.62 %和75.12 %。结论：血清PTH、CA125和CA199在RAOP患者含量升高,是影响RAOP的独立危险因素,可作为诊断RAOP的指标。     

血清尿酸水平与老年轻度高血压患者的内皮功能相关性分析

目的:探讨血清尿酸水平与老年轻度高血压患者的内皮功能相关性。方法:选取我院2020年1月到2020年12月共收治的200例老年轻度高血压患者作为研究对象,所有患者均为未使用过降压药物治疗,将其分为轻度高血压组。另选取同期收治的200例高血压常规药物治疗患者作为重度高血压组与200名健康者作为对照组,对比三组患者血清尿酸水平与血管内皮功能。对观察组所有患者依照血清尿酸水平进行分组,将血清尿酸水平208-360μmol/L的患者分为低尿酸组,共计136例,将血清尿酸水平≥360μmol/L的患者分为高尿酸组,共计64例。对比两组患者的一般临床指标、血管内皮功能与氧化应激指标,并分析血清尿酸水平与老年轻度高血压患者的内皮功能相关性。结果:重度、轻度高血压组与对照组患者NO、ET-1、SUA水平对比差异显著,具有统计学意义(P<0.05);高尿酸组与低尿酸组患者TG、TC、DBP、SBP水平对比无明显差异(P>0.05),高尿酸组患者Cr水平高于低尿酸组,组间对比,差异具有统计学意义(P<0.05);高尿酸组与低尿酸组患者T-AOC、GSH-Px、LHP、MDA、NO、ET-1水平对比差异显著,高尿酸组患者LHP、MDA和ET-1水平明显高于低尿酸组,高尿酸组患者T-AOC、GSH-Px、NO水平明显低于低尿酸组,组间对比,差异具有统计学意义(P>0.05);Spearman相关分析结果显示:TG、TC、Cr、DBP、SBP与血尿酸水平无明显相关性(P>0.05),T-AOC、GSH-Px、NO与血清尿酸水平呈负相关(P<0.05),LHP、MDA、ET-1与血清尿酸水平呈正相关(P<0.05)。结论:血清尿酸水平与老年轻度高血压患者的内皮功能具有明显相关性,而且证明血尿酸水平的升高可能由患者氧化应激导致,因此氧化应激水平也是引起血管内皮功能障碍的一种潜在机制,希望本研究结果能够为高血压患者的疾病控制提供参考意见。     

Serum levels of FGF-21 are increased in coronary heart disease patients and are independently associated with adverse lipid profile

Background

Fibroblast growth factor 21 (FGF-21) is a metabolic regulator with multiple beneficial effects on glucose homeostasis and lipid metabolism in animal models. The relationship between plasma levels of FGF-21 and coronary heart disease (CHD) in unknown.

Methodology/Principal Findings

This study aimed to investigate the correlation of serum FGF-21 levels and lipid metabolism in the patients with coronary heart disease. We performed a logistic regression analysis of the relation between serum levels of FGF-21 and CHD patients with and without diabetes and hypertension. This study was conducted in the Departments of Endocrinology and Cardiovascular Diseases at two University Hospitals. Participants consisted of one hundred and thirty-five patients who have been diagnosed to have CHD and sixty-one control subjects. Serum FGF-21 level and levels of fasting blood glucose; triglyceride; apolipoprotein B100; HOMA-IR; insulin; total cholesterol; HDL-cholesterol; LDL-cholesterol; and C-reactive protein were measured. We found that median serum FGF-21 levels were significantly higher in CHD than that of control subjects (P<0.0001). Serum FGF-21 levels in CHD patients with diabetes, hypertension, or both were higher than that of patients without these comorbidities. Serum FGF-21 levels correlated positively with triglycerides, fasting blood glucose, apolipoprotein B100, insulin and HOMA-IR but negatively with HDL-C and apolipoprotein A1 after adjusting for BMI, diabetes and hypertension. Logistic regression analysis demonstrated that FGF-21 showed an independent association with triglyceride and apolipoprotein A1.

Conclusions/Significance

High levels of FGF-21 are associated with adverse lipid profiles in CHD patients. The paradoxical increase of serum FGF-21 in CHD patients may indicate a compensatory response or resistance to FGF-21.     

Serum immunoglobulins IgG, IgA and IgM in patients with oral lichen ruber

The aim of this study was to determine level of serum IgA, IgG and IgM in patients with OLR as indicators of humoral immunity which might reflect cell-mediated immunity. This study was conducted on 30 patients (age 60.17 +/- 11.75) with clinically and histopathologically confirmed diagnosis of OLR and 30 healthy controls (age 56.16 +/- 11.82) Determination of serum IgA, IgG and IgM was performed by use of standard laser nephelometry in both patients and controls. Statistical analysis was done using Mann-Whitney U test and the level of significance was determined as p values lower than 0.05. Serum IgA and IgM in patients with OLR were significantly increased in comparison to the control group, while serum IgG levels were higher in patients with OLR but they did not reach significance. We might conclude that elevated levels of serum IgA and IgM show that humoral immunity is implicated in the pathogenesis of OLR.     

Serum immunoglobulin levels in human hydatidosis

Serum IgG, IgM, IgA and IgD levels of 83 patients with hepatic or pulmonary hydatidosis and 15 postoperative individuals with no cysts were compared with the mean values of 80 healthy Lebanese controls. A significant increase of IgG was present in all patients. An increase in the mean IgM and IgA levels was significant only in pulmonary cases. There was no significant correlation between the titres of antibodies as detected by haemagglutination and complement-fixation tests and the respective serum IgG and IgM immunoglobin levels. Mean IgD levels were not different between patients and controls. Elevated IgE levels were detected in 77% of 21 hydatid patients. A persistent hyperglobulinemia was observed in postoperative follow-ups.     

中药熏蒸对挂线引流术后肛瘘患者血清免疫球蛋白水平及预后的影响

目的:探讨中药熏蒸对经挂线引流术后肛瘘患者血清免疫球蛋白水平及预后的影响。方法:收集我院治疗的94例肛瘘患者,随机分为实验组和对照组,每组47例。所有患者行肛瘘挂线术,对照组患者术后采用左氧氟沙星注射液治疗,实验组患者在对照组基础上给予中药熏洗治疗。观察并比较两组患者治疗前后血清IgA及IgG水平,疼痛持续时间及恢复时间以及临床疗效。结果:与治疗前相比,两组患者治疗后血清IgA及IgG水平均下降,差异具有统计学意义(P0.05);与对照组相比,实验组患者治疗后血清IgA及IgG水平较低,差异具有统计学意义(P0.05);实验组患者疼痛持续时间及恢复时间均少于对照组,差异具有统计学意义(P0.05);实验组临床治疗有效率高于对照组,差异具有统计学意义(P0.05)。结论:中药熏蒸能够降低经挂线引流术后肛瘘患者血清IgA及IgG水平,缩短术后疼痛时间,促进术后康复,临床疗效较好。     

乌司他丁对毒蛇咬伤并急性肾功能损伤患者肾功能和血TNF-α的影响

目的探讨乌司他丁对毒蛇咬伤合并急性肾功能损伤患者的肾功能和血TNF-α、IL-6的影响及疗效。方法将45例毒蛇咬伤并急性肾功能损伤患者随机分为治疗组(n=25)和对照组(n=20),两组均给予综合治疗,治疗组在综合治疗的基础上静脉注射乌司他丁。观察治疗后两组血尿素氮、血肌酐、TNF-α和IL-6水平变化,同时观察两组的治愈率和平均进入多尿期时间。结果治疗组的血尿素氮、血肌酐、TNF-α和IL-6水平均较对照组下降明显(P0.05),同时治疗组平均进入多尿期时间也短于对照组(P0.05),但两组的治愈率无统计学差异(P0.05)。结论乌司他丁能改善毒蛇咬伤合并急性肾功能损伤患者的肾功能和TNF-α和IL-6指标,明显缩短病程,减少住院时间。     

Impact of interleukin-21 in the pathogenesis of primary Sjogren's syndrome: increased serum levels of interleukin-21 and its expression in the labial salivary glands

Introduction

Interleukin (IL)-21 is a cytokine that controls the functional activity of effector T helper cells and the differentiation of Th17 cells, and promotes B-cell differentiation. To test whether IL-21 participates in the pathogenesis of primary Sjögren''s syndrome (SS), serum IL-21 level was measured and IL-21 expression in the labial salivary glands (LSG) was examined.

Methods

Serum IL-21 levels in 40 primary SS, 40 rheumatoid arthritis (RA), and 38 systemic lupus erythematosus (SLE) patients and 20 healthy controls were measured. Serum IL-21 levels of SS patients were assessed for correlations with laboratory data, including anti-nuclear antibody, anti-Ro/La antibodies, globulin, immunoglobulin (Ig) class, and IgG subclass. LSGs from 16 primary SS and 4 controls with sicca symptoms were evaluated for IL-21 and IL-21 receptor (IL-21R) expression by immunohistochemistry. Confocal microscopy was performed to further characterize the IL-21 positive cells.

Results

Primary SS patients had significantly higher serum IL-21 levels than controls, and these increments correlated positively with levels of IgG, IgG1. Serum IgG1 levels correlated with anti-Ro antibody titers. Immunohistochemical analyses showed that lymphocytic foci and the periductal area of the LSGs from SS patients expressed high levels of IL-21 and lower levels of IL-21R, whereas the control LSGs showed minimal expression of both antigens. The more the lymphocyte infiltrated, IL-21expression in LSGs showed a tendency to increase. Confocal microscopic analyses revealed that IL-21 expressing infiltrating lymphocytes in the LSGs of SS patients also expressed CXCR5.

Conclusions

Primary SS is associated with high serum IL-21 levels that correlate positively with serum IgG, especially IgG1, levels. The expression of IL-21 is increased as more lymphocytes infiltrated in LSGs. These observations suggest that IL-21 may play an important role in primary SS pathogenesis.     

A Panel of Serum Biomarkers Differentiates IgA Nephropathy from Other Renal Diseases

Background and Objectives

There is increasing evidence that galactose-deficient IgA1 (Gd-IgA1) and Gd-IgA1-containing immune complexes are important for the pathogenesis of IgA nephropathy (IgAN). In the present study, we assessed a novel noninvasive multi-biomarker approach in the diagnostic test for IgAN.

Materials and Methods

We compared serum levels of IgA, IgG, Gd-IgA1, Gd-IgA1-specific IgG and Gd-IgA1-specific IgA in 135 IgAN patients, 79 patients with non-IgAN chronic kidney disease (CKD) controls and 106 healthy controls. Serum was collected at the time of kidney biopsy from all IgAN and CKD patients.

Results

Each serum marker was significantly elevated in IgAN patients compared to CKD (P<0.001) and healthy controls (P<0.001). While 41% of IgAN patients had elevated serum Gd-IgA1 levels, 91% of these patients exhibited Gd-IgA1-specific IgG levels above the 90th percentile for healthy controls (sensitivity 89%, specificity 92%). Although up to 25% of CKD controls, particularly those with immune-mediated glomerular diseases including lupus nephritis, also had elevated serum levels of Gd-IgA1-specific IgG, most IgAN patients had elevated levels of Gd-IgA1-specific antibody of both isotypes. Serum levels of Gd-IgA1-specific IgG were associated with renal histological grading. Furthermore, there was a trend toward higher serum levels of Gd-IgA1-specific IgG in IgAN patients with at least moderate proteinuria (≥1.0 g/g), compared to patients with less proteinuria.

Conclusions

Serum levels of Gd-IgA1-specific antibodies are elevated in most IgAN patients, and their assessment, together with serum levels of Gd-IgA1, improves the specificity of the assays. Our observations suggest that a panel of serum biomarkers may be helpful in differentiating IgAN from other glomerular diseases.     

Clinicopathological characteristics of immunoglobulin G4-related sialadenitis

IntroductionImmunoglobulin G4-related disease (IgG4-RD) is a newly recognized fibro-inflammatory condition. Forty-two cases with immunoglobulin G4-related sialadenitis (IgG4-RS) confirmed by histopathological and immunohistochemical assessment were studied to clarify the clinicopathologic characteristics of the salivary glands involved in IgG4-RS, especially the relationship between the histopathologic features and function of salivary glands or serum levels of IgG4.MethodsClinical, serologic, imaging and histopathological data of these cases were analyzed. CT volumes of submandibular, parotid, and lacrimal glands were calculated. The saliva flow rate was measured. Scintigraphy with 99mTc-pertechnetate was undertaken in 31 cases, and the concentration index (CI) and secretion index (SI) was calculated. Relationships between fibrosis severity and salivary gland function or serum IgG4 levels were analyzed.ResultsThe first symptom was swelling of bilateral submandibular or lacrimal glands. Physical examination showed multiple bilateral major salivary glands (including sublingual and accessory parotid glands) and lacrimal glands were enlarged in IgG4 RS. Multiple enlarged cervical lymph nodes were noted in 30 patients. Saliva flow at rest was lower than normal in 34 cases; stimulated saliva flow was lower than normal in 15 cases. Secretory function was reduced more severely in the submandibular glands than in the parotid glands. Serum levels of IgG4 were elevated in 95.2% of cases and 78.6% patients had increased IgE levels. Serum IgG4 level was higher and saliva secretion lower as glandular fibrosis increased.ConclusionsProminent changes in the morphology, histology, immunohistochemistry and secretion of the major salivary glands of IgG4-RS patients were accompanied by involvement of the lacrimal glands and cervical lymph nodes. Elevated IgE, allergic history, eosinophil infiltration suggest allergic reactions as a potential pathogenesis of IgG4-RS. Severity of glandular fibrosis correlated with salivary function and serum levels of IgG4.     

Clinical Experience with an Oral Diuretic,Trichlormethiazide

The main objective of this study was to observe the long-term effects of the administration of trichlormethiazide on the urine and blood. Fourteen patients suffering from essential hypertension or edema requiring diuretic therapy were treated for periods of one to 12 months (mean 5.4 months). There were no significant changes in urine values, blood counts, or serum sodium or potassium levels. Additional nitrogen retention occurred in two patients with renal failure, but no significant changes in blood urea nitrogen occurred in the remainder. Serum uric acid levels were lower at the end of treatment than before. The blood pressure fell in nine patients. No toxic effects were observed.     

Humoral components of immunological response in nephrotic syndrome

Serum and urine were collected from 58 patients with nephrotic syndrome. Immunoglobulins (IgA, IgG and IgM), complement (C3) and transferrin levels were measured by single radial immunodiffusion. The extent of glomerular injury was estimated by determining the selectivity of proteinuria. The relationship between the severity of glomerular damage and serum concentrations of immunoglobulins and complement was assessed. Higher IgM and lower IgG serum concentrations were found in nephrotic patients than in normal controls (157 +/- 108 mg+ vs 127 +/- 38 mg% for IgM, 929 +/- 537 mg% for IgG). The difference was statistically significant (p less than 0.05 for IgM, p less than 0.001 for IgG). No correlation was present between the selectivity of proteinuria and serum levels of IgA, IgM, IgG or C3. The results indicate that abnormalities in humoral components of the immune system are present in nephrotic patients and are probably related to a basic immunological defect in the patients rather than to the severity of glomerular damage.     

Co-Positivity for Anti-dsDNA, -Nucleosome and -Histone Antibodies in Lupus Nephritis Is Indicative of High Serum Levels and Severe Nephropathy

ObjectiveTo characterize the significance of correlated autoantibodies in systemic lupus erythematosus (SLE) and its complication lupus nephritis (LN) in a large cohort of patients.MethodsClinical data were statistically analyzed in 1699 SLE patients with or without nephritis who were diagnosed and treated during 2002–2013 in the northeast region of China. Reactivity to a list of 16 autoantibodies was detected by the serum test Euroline ANA profile (IgG). Serum titers of the anti-nucleosome autoantibodies were measured by ELISA assays. Kidney biopsies were examined by pathologists. Immune complex deposition was identified by immunohistochemistry stain.ResultsSimultaneous positivity of anti-dsDNA, -nucleosome and -histone antibodies (3-pos) was prevalent in SLE patients with LN compared to Non-renal SLE patients (41% vs 11%, p< 0.001). Significant correlations were found between any two of the above three anti-nucleosome antibodies in LN patients. In comparison to non-3-pos cohorts, 3-pos patients with LN had significantly higher serum levels of the three antibodies and more active disease; was associated with type IV disease; suffered from more severe renal damages; received more intensive treatment and had worse disease outcome. The serum levels of these three autoantibodies in 3-pos LN patients were significantly decreased when they underwent clinical recovery.ConclusionsSimultaneous reactivity to anti-dsDNA, -nucleosome and -histone antibodies by Euroline ANA profile (IgG) may indicate severe nephropathy in patients with SLE.