Prevalencia de anticuerpos anticitoplasma de neutrófilos en pacientes con artritis psoriática / Prevalence of antibodies anticytoplasm of neutrophils in patients with Psoriatic Arthritis

Los anticuerpos anticitoplasma de neutrófilos (ANCA) han cobrado relevancia en distintas patologías. Recientemente se ha reportado un elevado porcentaje (79%) de ANCAp en pacientes con Artropatía Psoriática (APs). Los objetivos de este estudio fueron evaluar la prevalencia ANCAp en pacientes con APs y compararlo con pacientes con artritis reumatoidea (AR), espondilitis anquilosante (EA), psoriasis cutánea (Ps) y controles sanos (CS). Material y métodos: Se incluyeron pacientes consecutivos con APs según criterios CASPAR, AR (criterios ACR 87), EA (criterios de NY modificados); los CS fueron personas de la población general sin antecedentes o evidencias de enfermedades inmunológicas. Se excluyeron pacientes con antecedentes oncológicos, infecciosos, sarcoidosis u otras enfermedades del tejido conectivo y/o vasculitis. Se consignaron datos demográficos, clínicos, radiológicos, antecedentes familiares y terapéutica actual. Se realizaron cuestionarios de actividad de enfermedad y capacidad funcional: BASDAI, BASFI, PASI y HAQ. Se extrajeron muestras de sangre para determinación de ANCA por IFI en etanol que posteriormente fueron confirmadas por IFI en formol. Se realizó además laboratorio general de rutina. Análisis estadístico: Las variables continuas fueron comparadas por ANOVA o test Student y las variables categóricas por Chi-cuadrado o test de Fisher. Resultados: Se incluyeron 148 pacientes (APs = 43, EA = 22, AR = 41, Controles = 38, Psoriasis cutánea = 4). La mediana de edad fue de 52 años (RIQ: 39,5-59), 66% eran mujeres. En el análisis intergrupo, las EA eran más jóvenes y más frecuentemente (87%) de sexo masculino. El resto de los grupos eran comparables para todas las variables demográficas. 57 pacientes mostraron fluorescencia positiva en etanol: AR: 25 (61%), APs: 14 (32,6%), EA: 11 (50%), CS: 6 (15,8%) y Ps: 1 (25%).

Antibodies ANCA are important diagnostic tools in different diseases. Recently it has been shown that these antibodies can be observed in 79% of patients with Psoriatic Arthritis (PsA). The purpose of our study was to determine the prevalence of ANCA in patients with PsA and compared to patients with Rheumatoid Arthritis (RA), Ankylosing Spondylitis (AS), Psoriasis (Ps) and healthy controls (HC). Material and methods: Consecutive patients with PsA (CASPAR criteria), RA (ACR ’87) and AS (New York criteria) were included. HC were people of the general population without evidence of immunological diseases. Patients with a previous history of oncologic, infectious diseases and sarcoidosis were excluded. Demographic, clinical, radiological and therapeutic data were collected. Disease activity and functional capacity were evaluated using validated and specific questionnaires (BASDAI, BASFI, PASI, and HAQ). ANCAs were determined by indirect immunofluorescence (IIF) on ethanol. Then, the positive ones were confirmed by IIF on formol. Student test, ANOVA, Chi square and Fisher exact test were used for Statistical analysis. Results: 148 patients were included (PsA = 43, AS = 22, RA = 41, Ps = 4 y HC = 38). Median age was 52 years (IQR: 39.5 – 59), 66% were women. AS patients were younger and more frequently men. Other variables were comparable between groups. 57 patients exhibited positive ethanol fluorescence: RA: 25 (61%), PsA: 14 (32.6%), AS: 11 (50%), HC: 6 (15.8%) and Ps: 1 (25%). However only 5 patients showed formol fluorescence: AS: 4/22 (ANCAp = 2, ANCAc = 2) y RA: 1/41 (ANCAp). The frequency of positive ANCA was significantly greater in AS vs. RA (p = 0.046).

Uses and limitations of two molecular cytogenetic techniques for the study of arrested embryos obtained through assisted reproduction technology

We studied chromosomal abnormalities in arrested embryos produced by assisted reproductive technology with fluorescence in situ hybridization (FISH) and comparative genomic hybridization (CGH) in order to determine the best technique for evaluating chromosomal aneusomies to be implemented in different situations. We examined individual blastomeres from arrested embryos by FISH and arrested whole embryos by CGH. All of the 10 FISH-analyzed embryos gave results, while only 7 of the 30 embryos analyzed by CGH were usable. Fifteen of the 17 embryos were chromosomally abnormal. CGH provided more accurate data for arrested embryos; however, FISH is the technique of choice for screening in preimplantation genetic diagnosis, because the results can be obtained within a day, while the embryos are still in culture.