RESUMEN

BACKGROUND/AIM: Multiple sclerosis (MS) is an inflammatory demyelinating central nervous system (CNS) disease. Among the paraclinical tests, brain and spinal Magnetic Resonance Imaging (MRI) is primarily involved in the diagnosis process, and cerebrospinal fluid (CSF) analysis is fundamental in diagnosing MS and the differential diagnosis. A positive relationship was demonstrated between oligoclonal band (OCB) positivity, CSF band number and immunoglobulin G(IgG) index. The study aimed to evaluate whether the number of OCB can predict disease activity and determine a correlation with the IgG index. METHODS: Our study included 401 MS patients who had relapsing-remitting multiple sclerosis (RRMS), primary progressive multiple sclerosis (PPMS), secondary progressive multiple sclerosis (SPMS), clinic isolated syndrome (CIS), radiologic isolated syndrome (RIS), Neuromyelitis optica spectrum disorder (NMOSD) and Acute disseminated encephalomyelitis (ADEM) with OCB number groups of 2-4, 4-8, 8-12, and 12 and above. RESULTS: No significant correlation was observed between IgG index, pre-and post-treatment EDSS (Expanded Disability Status Scale Scores) and disease-modifying therapies (DMT). Drug response was better in the patient group with band number between 2 and 8 and post-treatment EDSS scores were lower (1.62±0.44). CONCLUSION: The study results suggested that band number may be as valuable as the IgG index and a predictive biomarker for disease activity.

Asunto(s)

RESUMEN

Streptococcus pyogenes, or Group A Streptococcus, is an exclusively human pathogen that causes a wide variety of diseases ranging from mild throat and skin infections to severe invasive disease. The pathogenesis of S. pyogenes infection has been extensively studied, but the pathophysiology, especially of the more severe infections, is still somewhat elusive. One key feature of S. pyogenes is the expression of secreted, surface-associated, and intracellular enzymes that directly or indirectly affect both the innate and adaptive host immune systems. Undoubtedly, S. pyogenes is one of the major bacterial sources for immunomodulating enzymes. Major targets for these enzymes are immunoglobulins that are destroyed or modified through proteolysis or glycan hydrolysis. Furthermore, several enzymes degrade components of the complement system and a group of DNAses degrade host DNA in neutrophil extracellular traps. Additional types of enzymes interfere with cellular inflammatory and innate immunity responses. In this review, we attempt to give a broad overview of the functions of these enzymes and their roles in pathogenesis. For those enzymes where experimentally determined structures exist, the structural aspects of the enzymatic activity are further discussed. Lastly, we also discuss the emerging use of some of the enzymes as biotechnological tools as well as biological drugs and vaccines.

RESUMEN

The European Liver and Intestine Transplant Association, ELITA, promoted a Consensus Conference involving 20 experts across the world which generated updated guidelines on HBV prophylaxis in liver transplant candidates and recipients. This study explores the economic impact associated with the implementation of the new ELITA guidelines. To this aim, a condition-specific cohort simulation model has been developed to compare new and historical prophylaxis, including only pharmaceutical cost and using the European perspective. The target population simulated in the model included both prevalent and incident cases, and consisted of 6,133 patients after the first year, that increased to 7,442 and 8,743 patents after 5 and 10 years from its implementation. The ELITA protocols allowed a cost saving of around € 235.65 million after 5 years and € 540.73 million after 10 years; which was mainly due to early HIBG withdrawal either after the first 4 weeks or after the first year post Liver Transplantation (LT) depending on the virological risk at transplantation. Results were confirmed by sensitivity analyses. The money saved by the implementation of the ELITA guidelines would allow healthcare decision makers and budget holders to understand where costs could be reduced and resources re-allocated to different needs.

Asunto(s)

RESUMEN

Introducción y objetivos: La enfermedad relacionada con IgG4 (ER-IgG4) es un trastorno sistémico autoinmune caracterizado por la infiltración tisular por células plasmáticas positivas para IgG4, aparición de fibrosis y disfunción orgánica. Puede dar afectación a muchos niveles del organismo. El objetivo de este trabajo es identificar las posibles manifestaciones de esta enfermedad a nivel laríngeo. Material y métodos: Se realizó una revisión sistemática de la literatura médica publicada entre 2003 y abril de 2021, en busca de los casos descritos de ER-IgG4 con afectación laríngea. La búsqueda se realizó a través de las bases de datos Pubmed, Web of Science y Scopus. Se seleccionaron 23 casos, todos ellos con demostración histológica de la enfermedad a ese nivel. Resultados: La mayoría de los pacientes eran varones, con edades comprendidas entre los 41 y los 60 años. Las lesiones a nivel de la laringe mayoritarimaente tenían un aspecto pseudotumor. La zona de aparición preferente de estas fue la supraglotis. Con tratamiento corticoideo los pacientes suelen evolucionar favorablemente. Sin embargo, gran parte de estos sufrió importantes retrasos en el diagnóstico, así como cirugías agresivas. Conclusiones: La afectación laríngea es infrecuente en la ER-IgG4. Se debe tener en mente esta entidad ante lesiones pseudotumorales con biopsias negativas para malingnidad, dado que un diagnóstico temprano y un tratamiento adecuado son efectivos para prevenir secuelas importantes a largo plazo. (AU)

Introduction and objectives: IgG4-Related disease (IgG4-RD) is a systemic autoimmune disorder characterized by tissue infiltration with IgG4-secreting plasma cells, fibrosis and organic disfunc-tion. It can involve multiple sites. The objectives in this article are to identify the laryngeal involvement of this disease. Methods: A systematic review was conducted by collecting the literature published between 2003 and February 2021, seeking for case reports of IgG4-RD with laryngeal involvement. The bibliographic databases utilized were Pubmed, Web of Science and Scopus. 22 cases were selected, all of them including histological findings in the larynx. Results: Most of the patients were male, between 41 and 60 years old. The most common laryngeal manifestations were pseudotumoral neoformations. The supraglottis was the area were most of these lesions appeared. In this disease the standard treatment involves glucocorticoids, often with an optimal clinical response. However, a great part of the patients included in the review got a delayed diagnosis, some of them leading to aggressive surgical procedures. Conclusions: Laryngeal mani-festations in the IgG4-Related disease are unusual. That ́s why it should be considered when considering the differential diagnosis of malignant tumors. This is an illness that needs to be suspected in some cases, to ensure a prompt diagnosis and a proper treatment, thus avoiding long-term sequelae. (AU)

Asunto(s)

RESUMEN

We compared plasma and dried blood spots for detection of SARS-CoV-2 IgG antibodies. There was a good correlation between IgG values measured by both sampling methods, r = 0.935 and 0.965 for Receptor Binding Domain and full-length spike protein of SARS-CoV-2. Bland-Altman assessment showed good agreement between two sampling methods. Dried blood spots is a more pragmatic method for collecting samples for sero-epidemiological surveys of SARS-CoV-2 infection.

Asunto(s)

RESUMEN

A new coronavirus disease (COVID-19) has already affected millions of people in 213 countries. The possibilities of treatment have been reviewed in recent publications but there are many controversial results and conclusions. An analysis of the studies did not reveal a difference in mortality level between people treated with standard therapy, such as antiviral drugs and dexamethasone, and new antiviral drugs/additional immune therapy. However, most studies describe clinical improvement and a decrease in mortality among patients with severe and critical conditions, with the early initiation of additional immune therapy. Possible new targets based on viral life cycles were considered. Unfortunately, the data analysis on the efficacy of different medicine and therapy regimens among patients with COVID-19, showed little success in decreasing the mortality rate in all treatment methods. Some efficacy has been shown with an immunosuppressive therapy in small patient samples, but when a larger number of patients were analyzed the data did not differ significantly from the control groups.

Asunto(s)

RESUMEN

Objectives Clinical laboratories plays a key role in screening, diagnosis and containment of the Coronavirus 2019 infection epidemic. The etiological diagnosis presupposes the isolation of virus genetic material in the patient's biological sample but laboratory diagnostics also make use of searching possibility for immunoglobulin (Ig)G, IgM classes antibodies. The characteristics of the antibody response are not yet completely clear. Methods This study describes a serological monitoring of subjects, elderly nursing care residence guests, interested by a very large infection outbreak. After first nasopharyngeal swab, all the positive subjects (43) were monitored for the persistence of the virus infection through nasopharyngeal swab after 20 days (16-24), 32 days (28-36) and after 49 days (47-50). At the same time, during the second (day 32) and third (day 49) follow up, all the guests were investigated for IgM and IgG anti SARS-CoV-2 antibodies, by using a quantitative chemiluminescence method. Results Thirty two days after performing the first diagnostic swab, 39 of 43 patients (90%) had IgG higher than the cut off value. After 49 days the four patients with negative IgG were still negative. The comparison of the levels of IgG-Ab between the controls shows a significant decrease in concentrations (-10%). Conclusions Our study confirms that in most patients affected by COVID-19 there is a typical antibody response with IgG-Ab present in 90% of nursing care COVID-19 positive residence guests. For IgM-Ab only 23% of tested subjects were positive on the 32nd and 49th day of illness, always in parallel with the IgG-Ab positivity.

Asunto(s)

RESUMEN

Neonatal γ-immunoglobulin (IgG) Fc receptor (FcγRn) is a receptor that transports IgG across the intestinal mucosa, placenta, and mammary gland, ensuring the balance of IgG and albumin in the body. These functions of FcγRn depend on the intracellular signal transduction and activation caused by the combination of its extracellular domain and IgG Fc domain. Nevertheless, there are still no kinetic studies on this interaction. Consequently, in the present study, we successfully constructed the human FcγRn (hFcγRn) electrochemical receptor sensor. The signal amplification system formed by chitosan nanogold-hFcγRn protein and horseradish peroxidase was used to simulate the cell signal amplification system in vivo, and the kinetic effects between seven IgG and hFcγRn receptors from different species were quantitatively measured. The results showed that the interaction of these seven IgGs with hFcγRn was similar to the catalytic kinetics of enzyme and substrate, and there was a ligand-receptor saturation effect. The order of the interconnect allosteric constants (Ka), which is similar to the Michaelis constant (Km), was human IgG < bovine IgG < horse IgG < rabbit IgG < sheep IgG < donkey IgG < quail IgY. The results showed that hFcγRn had the strongest ability to transport human IgG, which was consistent with the evolution of the system. Therefore, our hFcγRn electrochemical receptor sensor can be used to measure and evaluate the interconnected allosteric network. It is also an essential parameter of the interaction between hFcγRn and different IgGs and, thus, provides a new detection and evaluation method for immunoemulsion, therapeutic monoclonal antibody therapy, heteroantibody treatment, and half-life research.

Asunto(s)

RESUMEN

Introducción: El dengue se ha convertido en una de las enfermedades de mayor impacto epidemiológico, social y económico para la salud pública a nivel mundial. Objetivo: Determinar la seroprevalencia de dengue en cinco municipios del Valle del Cauca con transmisión hiperendémica y mesoendémica de la enfermedad. Métodos: Estudio de prevalencia mediante muestreo probabilístico por conglomerados multietápico. Se evaluaron 822 personas. Resultados: La seroprevalencia de dengue fue del 91,36 por ciento obtenida a partir de la aplicación de la prueba de ensayo por inmunoabsorción ligado a enzimas para dengue indirecta IgG. Al aplicar la prueba de captura para IgM para dengue, la seroprevalencia fue de un 21,41 por ciento. La seropositividad conjunta de anticuerpos IgM e IgG fue del 20,3 por ciento. Conclusiones: La alta seroprevalencia de dengue en el Valle del Cauca muestra el impacto de esta enfermedad en la historia de vida de sus residentes. Su reemergencia impacta negativamente en los que tienen como antecedentes haber padecido la enfermedad provocando un desarrollo de su variante más grave, lo que se puede evitar con la administración de una vacuna tetravalente contra el dengue(AU)

Introduction: Dengue has become one of the largest epidemiological, social, and economic impacts for global public health. Objective: To determine the seroprevalence of dengue in five municipalities of Valle del Cauca with hyperendemic and mesoendemic transmission of the disease. Methods: Prevalence study through multistage probability sampling by clusters. 822 people were assessed. Results: Seroprevalence of dengue was of 91.36 percent, it was obtained from the implementation of the enzyme-linked immunosorbent´s trial test for indirect dengue IgG. When applying the capture test IgM for dengue, seroprevalence was of 21.41 percent. The joint seropositivity of IgM and IgG antibodies was 20.3 percent. Conclusions: The high seroprevalence of dengue in Valle del Cauca shows the impact of this disease in the life history of the residents. Dengue re-emergence impacts negatively on those who have a background of having suffered from the disease which caused a development of its most severe variant that can be avoided with the administration of a quadrivalent vaccine against dengue(AU)

Asunto(s)

RESUMEN

La policondritis recidivante (RP) es un trastorno autoinmune sistémico poco frecuente que se caracteriza por episodio y deterioro progresivo de la inflamación del cartílago. Aproximadamente el 30% de los pacientes con RP tienen enfermedad concurrente. Sin embargo, hay tres casos previos reportados de RP relacionado con enfermedad relacionada con la inmunoglobulina G4 (IgG4-RD). Nosotros presentamos otro caso de una mujer de 37 años que desarrolló RP aproximadamente 1 año antes del diagnóstico de IgG4-RD. La asociación entre ER-IgG4 y RP sigue sin estar clara.

Relapsing polychondritis (RP) is a rare systemic autoimmune disorder characterized by the episodic and progressive deterioration of cartilage inflammation. Approximately 30% patients with RP have concurrent disease. However, there are three cases reports of RP complicated by immunoglobulin G4-related disease (IgG4-RD). Here we report another case of a 37-year-old female who developed RP approximately 1 years before IgG4-RD diagnosis. The association between IgG4-RD and RP remains unclear.

Asunto(s)

RESUMEN

Antibody-like biopharmaceuticals cross the placenta by utilizing existing transport pathways (e.g., FcRn receptor). There are limited data evaluating this transfer during organogenesis in any species. Understanding placental transfer of antibody-like biopharmaceuticals can help to predict risk of developmental toxicity across species, including humans. To complement previously published placental transfer data in the rat with humanized IgGΔ2 (hIgG2), the timing and magnitude of transfer in the cynomolgus monkey and embryo/fetal biodistribution of maternally administered 125 I-radiolabeled hIgG2 was quantified on gestation days (GD) 35, 40, 50, 70, and 140 using gamma counting and whole body autoradiography 24 hr following intravenous injection. Chorioallantoic placental tissues were collected at all time points for Western Blot analysis with anti-FcRn antibody. Maternally administered 125 I-hIgG2 was found in embryo/fetal tissues at all time points, including organogenesis. Embryo/fetal plasma 125 I-hIgG2 concentration increased during gestation, but only slightly up to GD 70 in embryo/fetal tissues, with hIgG2 tissue concentrations generally similar between GD70 and 140. The embryo/fetal:maternal 125 I-hIgG2 plasma concentration ratio was approximately 2.3 fold higher on GD 140, in comparison to ratios on GD 40. Importantly, placental FcRn protein expression was confirmed at all timepoints. These data demonstrate placental transfer of hIgG2 in a nonhuman primate model, and at levels comparable to the rat model, raising the potential for adverse developmental outcomes by direct antibody binding to biological targets.

Asunto(s)

RESUMEN

DESIGN: Review article. SETTING: Department of Obstetrics and Gynecology, Palacky University Olomouc, Faculty of Medicine and Dentistry, University Hospital Olomouc. Methods, results: Every person exposed to a foreign red blood cell antigen (erythrocyte antigen) develops an antibody. If the contact with a foreign erythrocyte antigen occurs during pregnancy, the erythrocyte alloimmunization of the pregnant woman develops and, due to antibodies crossing through the placenta also Haemolytic disease of the foetus and newborn (HDFN) can occur. Antibodies are made by pregnant woman's immune system and their quantity and quality depend on many factors. Their function is to eliminate foetal "foreign" erythrocytes. Ways of elimination of antibody-labelled foetal erythrocytes are the same in the bloodstream of pregnant women and foetuses/newborns and their principle is type II hypersensitivity (cytotoxic), according to the Coombs and Gell classification. Severe forms of HDFN can lead to increased perinatal morbidity and mortality. Prevention of the development of RhD alloimmunization and severe forms of HDFN is based on the administration of polyclonal immunoglobulin (Ig) G anti-D in all potentially sensitizing events. It is assumed that the mechanism of anti-D IgG action is based on the rapid removal of the antigen by antibody overflow, and on antibody mediated immune suppression (AMIS). However, the exact immunological principle is not fully known yet. CONCLUSION: This article describes the development of irregular antibodies, methods of foetal erythrocytes destruction and the mechanism of prevention of anti-D immunoglobulin from the immunological point of view.

Asunto(s)

RESUMEN

La policondritis recidivante (RP) es un trastorno autoinmune sistémico poco frecuente que se caracteriza por episodio y deterioro progresivo de la inflamación del cartílago. Aproximadamente el 30% de los pacientes con RP tienen enfermedad concurrente. Sin embargo, hay tres casos previos reportados de RP relacionado con enfermedad relacionada con la inmunoglobulina G4 (IgG4-RD). Nosotros presentamos otro caso de una mujer de 37 años que desarrolló RP aproximadamente 1 año antes del diagnóstico de IgG4-RD. La asociación entre ER- IgG4 y RP sigue sin estar clara.

Relapsing polychondritis (RP) is a rare systemic autoimmune disorder characterized by the episodic and progressive deterioration of cartilage inflammation. Approximately 30% patients with RP have concurrent disease. However, there are three cases reports of RP complicated by immunoglobulin G4-related disease (IgG4-RD). Here we report another case of a 37-year-old female who developed RP approximately 1 years before IgG4-RD diagnosis. The association between IgG4-RD and RP remains unclear

Asunto(s)

RESUMEN

This study aims to explore the diagnostic value of specific immunoglobulin E (sIgE) and specific immunoglobulin G (sIgG) of Aspergillus fumigatus in the diagnosis of allergic broncho-pulmonary aspergillosis (ABPA) and severe asthma with fungal sensitization (SAFS). A total of 17 ABPA patients and 14 SAFS patients were enrolled. The levels of sIgG [2 294.00 (1 527.00, 14 170.00) U/ml vs. 972.60 (650.90, 1 792.00) U/ml] and sIgE [8.77 (1.64, 16.85) kU/L vs. 1.04 (0.70, 2.05) kU/L] in ABPA patients were significantly higher than those in SAFS patients (P<0.05). Aspergillus fumigatus sIgG was strongly correlated with Aspergillus fumigatus sIgE (r(s)=0.797, P<0.001) in ABPA patients. When combined with Aspergillus fumigatus sIgG (>1 000.00 U/mL) and Aspergillus fumigatus sIgE (>1.00 kU/L), the sensitivity was 82.3% and specificity 78.6% for the differential diagnosis of ABPA and SAFS. It demonstrates the diagnostic value of Aspergillus fumigatus sIgG and sIgE.

Asunto(s)

RESUMEN

Immunoglobulin (IgG) 4-related disease is a systemic inflammatory disease, and it affects vascular system as aortitis, periaortitis, or aneurysm. However, due to a lack of serum biomarker on aortic damage and the multiorgan involvement, it is difficult to assess aortic inflammatory activity of IgG4-related disease. We described a case of IgG4-related pancreatitis and aortitis, which was visualized with magnetic resonance merged image of diffusion weighted and T1 weighted images. The aortic signal intensity or apparent diffusion coefficient value reduced or increased after oral prednisone administration, respectively. Magnetic resonance diffusion weighted image and apparent diffusion coefficient may be a useful imaging tool for assessment of vascular inflammation in IgG4-related aortitis.

RESUMEN

This study aims to explore the diagnostic value of specific immunoglobulin E (sIgE) and specific immunoglobulin G (sIgG) of Aspergillus fumigatus in the diagnosis of allergic broncho-pulmonary aspergillosis (ABPA) and severe asthma with fungal sensitization (SAFS). A total of 17 ABPA patients and 14 SAFS patients were enrolled. The levels of sIgG [2 294.00 (1 527.00, 14 170.00) U/ml vs. 972.60 (650.90, 1 792.00) U/ml] and sIgE [8.77 (1.64, 16.85) kU/L vs. 1.04 (0.70, 2.05) kU/L] in ABPA patients were significantly higher than those in SAFS patients (P<0.05). Aspergillus fumigatus sIgG was strongly correlated with Aspergillus fumigatus sIgE (rs=0.797, P<0.001) in ABPA patients. When combined with Aspergillus fumigatus sIgG (>1 000.00 U/mL) and Aspergillus fumigatus sIgE (>1.00 kU/L), the sensitivity was 82.3% and specificity 78.6% for the differential diagnosis of ABPA and SAFS. It demonstrates the diagnostic value of Aspergillus fumigatus sIgG and sIgE.

Asunto(s)

RESUMEN

INTRODUCTION: Glycosylation is recognized as a Critical Quality Attribute for therapeutic glycoproteins such as monoclonal antibodies, fusion proteins and therapeutic replacement enzymes. Hence, efficient and quantitative glycan analysis techniques have been increasingly important for their discovery, development and quality control. The aim of this review is to highlight relevant and recent advances in analytical technologies for characterization of biotherapeutic glycoproteins. Areas covered: The review gives an overview of the glycosylation trends of biotherapeutics approved in 2016 and 2017 by FDA. It describes current and novel analytical technologies for characterization of therapeutic glycoproteins and is explored in the context of released glycan, glycopeptide or intact glycoprotein analysis. Ultra performance liquid chromatography, mass spectrometry and capillary electrophoresis technologies are explored in this context. Expert commentary: There is a need for the biopharmaceutical industry to incorporate novel state of the art analytical technologies into existing and new therapeutic glycoprotein workflows for safer and more efficient biotherapeutics and for the improvement of future biotherapeutic design. Additionally, at present, there is no 'gold-standard' approach to address all the regulatory requirements and as such this will involve the use of orthogonal glycoanalytical technologies with a view to gain diagnostic information about the therapeutic glycoprotein.

Asunto(s)

RESUMEN

Idiopathic Brachial Neuritis (IBN), is a rare brachial plexopathy with an unknown aetiology. Multiple myeloma is a neoplastic plasma cell disease characterised by bone lesions. In this article, we present the case of a 59-year-old male patient with IBN associated with multiple myeloma, who was admitted to our clinic with right shoulder pain and right arm weakness. He experienced muscle weakness and atrophy in his right arm after a sudden onset of pain attack in the shoulder. Plexus and cervical vertebral MRI showed no pathology. Electrodiagnostic studies showed upper and middle trunk plexopathies. Laboratory analysis revealed anaemia, hypercalcaemia, renal dysfunction and monoclonal gammopathy in immunoglobulin electrophoresis. A bone marrow biopsy established the diagnosis of IgG kappa multiple myeloma. This is the first case report that presents the association of multiple myeloma and IBN.