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Objectives To explore and compare the clinical characteristics and risk factors for mortality between patients with artificial quartz stone silicosis and those with classic silicosis. Methods A total of 48 patients with artificial quartz stone silicosis (experiment group) and 98 patients with classic silicosis (control group) were recruited as the research subjects using the convenience sampling method. Data of clinical symptoms, laboratory tests, high-resolution computed tomography (HRCT), and pulmonary pathology of the research subjects were retrospectively analyzed. The Cox proportional hazards regression model was used to analyze the influencing factors on the survival time of silicosis patients. Results Patients in the experiment group had shorter years of dust exposure, latency period and time since last exposure than those in the control group (all P<0.01). The positive rate of anti-nuclear antibodies and the expression of neuron-specific enolase in the experiment group were higher than those in the control group (39.6% vs 10.2%, median： 28.44 vs 16.25, both P<0.01). The PaO2 levels in the experiment group were lower than those in the control group (median： 66.0 vs 89.0, P<0.01). The patients in the experiment group had lower vital capacity, inspiratory reserve volume, forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and carbon monoxide diffusion capacity compared to the control group (all P<0.05), but the maximal expiratory flow in 75% vital capacity was higher than the control group (P<0.05). Compared with the control group, patients in the experiment group had the presence of ground-glass opacity (GGO) in both lungs, aggregation and fusion of subpleural nodules, and gradual formation of progressive massive fibrosis (PMF), with higher potential of pneumothorax. Within 5 years after diagnosis, the mortality of patients in the experiment group was higher than that in the control group (27.1% vs 4.1%, P<0.01). The Cox regression model analysis results showed that patients with nodule aggregation on lung HRCT images had a higher risk of mortality than those without nodule aggregation, and lower lung function including vital capacity, FVC, FEV1 and maximum expiratory flow in 25% vital capacity had higher risk of reduced survival time (all P<0.05). Conclusion Compared with patients with classic silicosis, patients with artificial quartz stone silicosis have higher level of serum neuron-specific enolase, increasing the risk of autoimmune diseases. Pulmonary imaging features in patients with artificial quartz stone silicosis include GGO, PMF and susceptibility to pneumothorax, and rare calcification of mediastinal lymph nodes, leading to a higher mortality rate within 5 years after diagnosis.
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Abstract Objective: To evaluate the perception of rheumatologists regarding the recommendations of the Brazilian Consensus for detection of Autoantibodies (BCA) on HEp-2 Cells by Indirect Immunofluorescence assay (IFA) and how BCA recommendations help in clinical practice. Methodology: A structured questionnaire regarding the BCA recommendations for detection and interpretations of autoantibodies in HEp-2 cells was applied to randomly selected rheumatologists. The results were tabulated using the Microsoft® Excel program, expressed as a simple percentage and the dichotomous data were analyzed using the Chi-square test and the Epi Info® program. Results: Four hundred fuorteen rheumatologists participated in the study: 70% of them considered their knowledge of the HEp-2 IFA test satisfactory or excellent, and 43% said they knew the BCA recommendations in general, without distinguishing the edition of the BCA to which they refer. The Revista Brasileira de Rheumatologia/ Advances in Rheumatology was the means of dissemination most consulted by specialists (50%). According to the rheumatologists' opinion, the most relevant pattern was the homogeneous nuclear (78%) and 65% stated they were satisfied with the BCA recommendations at a level of satisfaction greater than or equal to 80%. There was no significant difference in the perception of rheumatologists from the several Brazilian geographic regions. Conclusion: Brazilian rheumatologists are aware of the BCA guidelines and most are satisfied with the content published, considering that the BCA recommendations assist positively in the clinical practice. Most rheumatologists recognize the patterns associated with rheumatic autoimmune diseases and have used BCA recommendations to interpret the results of the HEp-2 IFA test.
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Background: Lichen planus is a common chronically relapsing autoimmune skin condition with poorly understood etiology. Apart from cellular immunity, presence of various antibodies has been hypothesized. Various studies have found the presence of serum anti-nuclear antibody, anti-mitochondrial antibody, anti-desmoglein 1 and 3 antibodies, anti-keratinocyte antibody and anti-thyroglobulin antibody in patients of cutaneous and oral lichen planus. Aim: To study the prevalence of autoantibodies and the clinical spectrum of disease in an Indian patient subpopulation with lichen planus. Methods: A cross-sectional epidemiological study comprising 100 lichen planus patients was conducted in the dermatology outpatient department of Seth G.S Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India. Serum concentrations of circulating anti-nuclear antibodies, anti-desmoglein 1 antibody, anti-desmoglein 3 antibody, anti-keratinocyte antibodies, anti-mitochondrial antibodies and anti-thyroglobulin antibodies were determined by indirect immunofluorescence. Pairs of groups were compared using “Student's t-test” for normally distributed continuous data. The “χ2-test” was used for the categorical variables as needed. Statistical significance was set at P < 0.05. Results: It was found that 65 (65%) patients showed the presence of at least one of the six autoantibodies that we studied, while 35 (35%) tested negative for all six of them. Positivity of anti-keratinocyte antibody in 26 (26%), anti-nuclear antibody in 22 (22%), anti-desmoglein 1 antibody in 19 (19%), anti-desmoglein 3 antibody in 16 (16%), anti-mitochondrial antibody in 9 (9%) and anti-thyroglobulin antibody in 6 (6%) patients was detected. It was observed that 55 (71.4%) patients of cutaneous lichen planus, 6 (46.1%) patients of mucosal lichen planus and 4 (40%) patients of cutaneous and mucosal lichen planus overlap showed presence of at least one autoantibody. Conclusion: This study provides the serological parameters of a population of lichen planus from western India. Presence of autoantibodies in lichen planus suggests the possible role of humoral immunity in lichen planus. Identifying antibodies linked to lichen planus may help in identifying suitable diagnostic tests and therapeutic targets. Well-controlled studies with larger sample size are the need of the hour to confirm the role of humoral immunity in lichen planus. Limitations: Studies with a larger number of patients as well as controls should be undertaken to further evaluate the role of autoantibodies in lichen planus.
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To determine the possibility whether DNA vaccines pcDNA3/SjSDISP of Schistosoma japonicum to induce autoimmunity and immune tolerance in the vaccinated mice, the titer of the specific antibodies against SjSDISP and the production of the autoimmune antibodies, such as presence of anti-nuclear and anti-dsDNA antibodies in the vaccinated mice were detected by ELISA assay and the toxicity of the plasmid DNA was studied through the observation of the change in body weight and the pathological examination of the major organs in mice. It was found that the titer of the specific antibody against SjSDISP was 1∶400 as determined by ELISA, but no autoimmune antibody could detected. The difference of the body weight of mice between the experimental and the control groups was not significant. No abnormal results of histopathological examination were obtained in both groups. From these observations, it is clear that there is no evidence to show that DNA vaccine pcDNA3/SjSDISP can induce auto-immunity and immune tolerance in mice.
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El objetivo de este estudio fue determinar la prevalencia de autoanticuerpos titulares y de factor reumatoideo (FR) en la infección crónica por Virus de la Hepatitis C (VHC) y su relación con el genotipo viral y tratamiento antiviral. Este estudio incluyó a 21 pacientes infectados con VHC y 24 sujetos sanos. Los autoanticuerpos: antinucleares (ANA), anti-músculo liso (ASMA), anti-mitocondriales (AMA) y anti-microsomales de hígado y riñón-1 (LKM-1) fueron investigados por inmunofluorescencia indirecta y el FR por aglutinación de látex. ANA fueron detectados en el 43% de pacientes y en el 4% de controles (p<0,05). ASMA, AMA Y LKM-1 no se detectaron en pacientes ni en controles. El FR estuvo presente en el 48% de los pacientes, pero en ninguno de los controles. En pacientes ANA (+) y/o FR (+), el nivel de la enzima alanina-aminotransferasa fue similar al nivel detectado en pacientes ANA y FR negativos. Además, la presencia de ANA o FR no estuvo asociada con el genotipo viral o tratamiento antiviral. En conclusión, una alta prevalencia de ANA y FR a títulos bajos pueden ser detectados en la infección crónica por VHC. Estas manifestaciones autoinmunes no están relacionadas con signos bioquímicos de daño hepático, ni genotipo viral o tratamiento antiviral.
The aim of this study was to determine the prevalence of tissue autoantibodies and rheumatoid factor (RF) in patients with chronic hepatitis C virus (HCV) infection and their relationship with viral genotype and antiviral treatment. This study included 21 patients infected with HCV and 24 healthy subjects. Anti-nuclear (ANA), anti-smooth muscle (SMA), anti-mitochondrial (AMA) and anti-liver-kidney microsomal-1 (LKM-1) autoantibodies were investigated by indirect immunofluorescence technique, and RF by latex agglutination. ANA were found in 43% of the patients with HCV infection and 4% of the controls (p<0.05). SMA, AMA and LKM-1 were absent from both groups (patients and controls). RF was detected in 48% of the patients but none of the controls. The level of serum alanine aminotransferasa enzyme was similar in all the patients' positive or negative results for ANA and/ or RF. Furthermore, the presence of ANA or RF was not associated with viral genotype or antiviral treatment. In conclusion, a high prevalence of ANA and RF at low titre can be detected in patients with HCV chronic infection. These autoimmune manifestations are not related with biochemical findings of hepatic injury, nor with genotype or antiviral treatment.