Immunological diagnosis of vasculitis

Inflammation of blood vessels, or vasculitis, is caused by a heterogenous group of autoimmune conditions with wide spectrum of systemic, and often overlapping, clinical manifestations. Some of these conditions present acutely and result in major organ's damage and, therefore, require prompt diagnosis and treatment in order to avoid the high morbidity and mortality that otherwise occur. The clinical immunology laboratory plays a vital role in the diagnosis of vasculitis. Moreover, due to the availability of simple tests, with quick turn around time, immunological findings can provide an early picture of the type of vasculitis involved thereby allowing initiation of prompt treatment in life threatening situations. In the present review, we will outline the various tests available in the immunology laboratory for the investigation of vasculitides, discuss the assays used to carry out these tests and, finally, comment on the significance of the results produced in relation to the diagnosis, or exclusion, of vasculitis. We hope that such information would prove of great importance to physicians and immunologists alike and lead to more efficient diagnosis of these important and, often, life threatening conditions

Mechanism of CD11b down-regulation from phorbol myristate acetate stimulated polymorphonuclear neutrophils

To investigate the mechanism of CD11b down-regulation in phorbol myristate acetate [PMA] stimulated polymorphonuclear leukocytes [PMN]. Purified PMN were stimulated with PMA in the presence, or absence, of various enzyme inhibitors. Following stimulation, PMN CD11b expression was examined by flow cytometry and Western-blotting. The entire work was carried out at Liverpool University between the period of 1998 and 2001. Stimulation of PMN with PMA induced the down-regulation of CD11b by a mechanism involving a combination of an oxidant and a serine protease; most likely the primary granule derived elastase. The present study shows for the first time the cooperation of both oxidants and enzymes in the down-regulation of PMN adhesion receptors

Serological diagnosis of autoimmune hepatobiliary diseases

Autoimmune hepatobiliary diseases AIHBD comprise autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis and the overlap syndromes. Early diagnosis and treatment of AIHBD are essential for the prevention of the high morbidity, and mortality, that is, otherwise, associated with untreated patients. Screening for AIHBD relies heavily on the use of serological tests for the detection of serum autoantibodies that associate with the diseases. Understanding these tests, and the results produced, is important for the efficient diagnosis/exclusion of these diseases. In this review, we discuss the various tests available in the clinical immunology laboratory for screening of AIHBD and comment on the significance of the results produced by each test. We hope that this review will highlight this group of autoimmune diseases and lead to more efficient and earlier diagnosis, and treatment, of patients with AIHBD