Autoimmunity
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Lupus anticoagulant (LA) and beta2-glikoprotein I (b2GPI) dependent anti-cardiolipin (aCL) are part of the diagnostic criteria both of systemic lupus erythematosus (SLE) and anti-phospholipid syndrome (APS). Anti-phospholipid antibodies (aPL) may also bind to other phospholipids and/or protein co-factors. In the present study, besides aCL and anti-b2GPI, antibodies directed against phosphatidylserine, prothrombin (PT) and annexin V (aANX) were measured in 85 randomly selected SLE patients, 14 suffering from secondary APS. ⋯ The presence of such rare aPLs cumulated in APS patients, their presence increased the frequency of thrombotic events in the entire study population, furthermore in patients positive for LA or aCL. Rare anti-phospholipid/co-factor antibodies were found in 12% of an un-selected lupus patient population. Their presence was more frequent in patients with secondary APS, and further increased the risk of thrombotic complications.
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Recent studies suggest that celiac disease (CD) is common in many developing countries. Because the disease may be under diagnosed in Cuba, we studied the presence of the disease in a group of apparently healthy adult. ⋯ This study confirms the existence of silent CD among healthy adult in Cuba and highlights the importance of mass screening for this disease among them. The one-step immunochromatographic assay is a good tool for this purpose.
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Immune thrombocytopenia (ITP) is an immune-mediated disorder in which destruction of platelets is accelerated by anti-platelet autoimmune antibodies. B-cell-activating factor (BAFF) and a proliferation-inducing ligand (APRIL), essential factors for B cell survival are elevated in systemic autoimmune diseases and correlated with clinical findings. High expression of BAFF has been shown in patients with ITP, but the status of APRIL in ITP is still unknown. ⋯ APRIL is over expressed in untreated active ITP patients and might be a pathogenic factor of this disorder.
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Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a clinical syndrome of a chronic progressive or relapsing and remitting, symmetrical, sensory and motor radiculoneuropathy. The immune reaction in CIDP is characterised by selective inflammation of peripheral nerves and is probably due to the interaction of cellular and humoral responses. Only three treatments for CIDP have demonstrated benefit in randomised studies, corticosteroids, plasma exchange and intravenous immunoglobulin. 25% of patients fail to respond or do not respond adequately to these treatments. ⋯ Haematopoietic stem cell transplantation (HSCT) has been performed with varying success in over 700 patients with autoimmune disorders throughout Europe. The experience in CIDP is very limited. This article will review current understanding of CIDP and experience of the use of HSCT in refractory CIDP.
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Alopecia areata (AA) is a chronic inflammatory disease with evidence of T-cell involvement that causes hair follicle "immune privilege collapse". Nitric monoxide was shown to contribute in the pathogenesis of AA. We are investigating evidence for the association of eNOS gene polymorphism with AA. ⋯ A significant association was found between the intron-4 27 bp-VNTR and AA, where 4b was identified as the risk allele had (chi(2) = 4.42, p = 0.035, OR = 2.03). Genotype (4b/4b) showed a significant association with susceptibility to AA and have a frequency of 22% higher in AA patients than in healthy controls (71 vs 49%) and a chi(2) = 6.39, (p = 0.011, OR = 2.63). We report a significant association of a polymorphism within the eNOS gene and susceptibility to AA.