The protective arm of the renin -angiotensin system may counteract the intense inflammatory process in fetuses with posterior urethral valves / O braço protetor do sistema renina-angiotensina pode contrapor-se ao intenso processo inflamatório em fetos com válvula de uretra posterior

Abstract Objective: Posterior urethral valve is the most common lower urinary tract obstruction in male children. A high percentage of patients with posterior urethral valve evolve to end‐stage renal disease. Previous studies showed that cytokines, chemokines, and components of the renin-angiotensin system contribute to the renal damage in obstructive uropathies. The authors recently found that urine samples from fetuses with posterior urethral valve have increased levels of inflammatory molecules. The aim of this study was to measure renin-angiotensin system molecules and to investigate their correlation with previously detected inflammatory markers in the same urine samples of fetuses with posterior urethral valve. Methods: Urine samples from 24 fetuses with posterior urethral valve were collected and compared to those from 22 healthy male newborns at the same gestational age (controls). Renin-angiotensin system components levels were measured by enzyme‐linked immunosorbent assay. Results: Fetuses with posterior urethral valve presented increased urinary levels of angiotensin (Ang) I, Ang‐(1‐7) and angiotensin‐converting enzyme 2 in comparison with controls. ACE levels were significantly reduced and Ang II levels were similar in fetuses with posterior urethral valve in comparison with controls. Conclusions: Increased urinary levels of angiotensin‐converting enzyme 2 and of Ang‐(1‐7) in fetuses with posterior urethral valve could represent a regulatory response to the intense inflammatory process triggered by posterior urethral valve.

Resumo Objetivo: A válvula de uretra posterior é a obstrução do trato urinário inferior mais comum em crianças do sexo masculino. Uma alta porcentagem de pacientes com válvula de uretra posterior evolui para doença renal em estágio final. Estudos anteriores mostraram que citocinas, quimiocinas e componentes do sistema renina-angiotensina contribuem para o dano renal em uropatias obstrutivas. Recentemente, descobrimos que amostras de urina de fetos com válvula de uretra posterior tinham níveis aumentados de moléculas inflamatórias. O objetivo deste estudo foi medir as moléculas de renina-angiotensina e investigar sua correlação com marcadores inflamatórios previamente detectados nas mesmas amostras de urina de fetos com válvula de uretra posterior. Métodos: Amostras de urina de 24 fetos com válvula de uretra posterior foram coletadas e comparadas com amostras de urina de 22 recém-nascidos saudáveis de mesma idade gestacional (controles). Os níveis dos componentes de SRA foram medidos por ensaio de imunoabsorção enzimática. Resultados: Os fetos com válvula de uretra posterior apresentaram níveis urinários aumentados de angiotensina (Ang) I, Ang-(1-7) e enzima conversora de angiotensina 2 em comparação com os controles. Os níveis de enzima conversora de angiotensina eram significativamente menores e os níveis de Ang II eram semelhantes nos fetos com válvula de uretra posterior em comparação com os controles. Conclusões: O aumento dos níveis urinários de enzima conversora de angiotensina 2 e de Ang-(1-7) em fetos com válvula de uretra posterior poderia representar uma resposta regulatória ao intenso processo inflamatório desencadeado pela válvula de uretra posterior.

Prevalência sorológica e molecular de Babesia bovis e Babesia bigemina em búfalos (Bubalus bubalis) na Ilha de Marajó, Pará / Molecular and serological prevalence of Babesia bovis and Babesia bigemina in water buffaloes (Bubalus bubalis) on Marajo Island, State of Pará, Brazil

The aim of the study was to estimate the prevalence of Babesia bovis and Babesia bigemina in water buffaloes of the Marajó Island, State of Pará, Brazil. We used an indirect enzyme-linked immunosorbent assay (iELISA), with total antigen containing proteins outer surface, and polymerase chain reaction (qPCR), involving the use of SYBR Green based on amplification of a small fragment of the cytochrome b gene. The prevalence of positive animals in iELISA to B. bovis B. bigemina and mixed infection was 24.87% (199/800), 20.75% (166/800) and 18.75% (150/800), respectively. Using the PCR, the presence of B. bovis was detected in 15% (18/199) and B. bigemina in 16% (19/199) of animals, and of these, 58% (11/19) presented co-infected by the two agents. The results show a low prevalence of antibodies anti-B. bovis and anti-B. bigemina in water buffaloes from Marajó Island. However, it was observed that the agents of bovine babesiosis circulate in buffaloes, and these may act as reservoirs.

O objetivo do estudo foi testar a prevalência sorológica e molecular de Babesia bovis e Babesia bigemina em búfalos da Ilha de Marajó, Pará. Foi utilizado ensaio de imunoadsorção enzimático indireto (iELISA) com antígeno total contendo proteínas de superfície externa e reação em cadeia da polimerase (qPCR), envolvendo o uso de SYBR Green com base na amplificação de um pequeno fragmento de gene do citocromo b. A prevalência de animais positivos no ELISA para B. bovis, B. bigemina e para infecção mista foi de 24.87% (199/800), 20.75% (166/800) e 18.75% (150/800), respectivamente. Na PCR foi detectado a presença de B. bovis em 15% (18/199) e de B. bigemina em 16% (19/199) dos animais, sendo que destes, 58% (11/19) apresentavam-se co-infectados pelos dois agentes. Os resultados mostram uma baixa prevalência de anticorpos anti-B. bovis e anti-B. bigemina em búfalos da Ilha do Marajó. Porém, observou-se que os agentes da babesiose bovina circulam em búfalos, podendo estes atuar como reservatórios.

Prevención de la toxoplasmosis congénita en un hospital de Buenos Aires / Prevention of congenital toxoplasmosis in a Buenos Aires hospital

La prevención de la toxoplasmosis congénita se basa en la información de la mujer con medidas de prevención primaria, el diagnóstico serológico y el tratamiento de la embarazada y del niño. Se presentan los resultados de 12 años de implementación de un programa de prevención de la toxoplasmosis congénita, la tasa de madres infectadas, de transmisión vertical, de niños infectados y la gravedad de la afección causada. Se realizó un estudio observacional prospectivo sobre 12 035 gestantes atendidas en la maternidad del Hospital Alemán de Buenos Aires entre enero de 2000 y diciembre de 2011. Se observó una prevalencia de anticuerpos anti Toxoplasma gondii de 18.33% (2 206/12 035). Treinta y siete mujeres de 9 792 susceptibles tuvieron infección aguda, la tasa de incidencia de infección materna fue de 3.78 por 1 000 nacimientos. La tasa de transmisión transplacentaria de la infección fue 5.4% (2/37). Dos recién nacidos tuvieron toxoplasmosis congénita, uno no tuvo signos clínicos y el otro presentó coriorretinitis y estrabismo. Recibieron tratamiento 35 madres y los 2 niños con toxoplasmosis congénita. En conclusión: Las cifras de transmisión obtenida permiten considerar a este programa de prevención como un recurso válido para minimizar el impacto de la toxoplasmosis congénita.

The prevention of congenital toxoplasmosis is based on providing information to women, serologic diagnosis and treatment of the infected mother and child. In this article we present the results of 12 years of implementation of a congenital toxoplasmosis prevention program in which we measured the mother´s infection incidence rate, the transmission rate and the number and severity of infection in newborns. The study was performed on 12 035 pregnant women in the period 2000-2011. The prevalence rate of antibodies against Toxoplasma gondii was 18.33% (2 206/12 035). Thirty-seven out of 9 792 susceptible women presented acute infection and the mother's infection incidence rate was 3.78 per 1000 births. The transplacental transmission rate was 5.4% (2/37). Two newborns presented congenital toxoplasmosis infection, one had no clinical signs while the other presented strabismus and chorioretinitis. Thirty-five infected mothers and the two children with congenital infection were treated. The transmission rates obtained allow consider this prevention program as a valid resource to minimize the impact of congenital toxoplasmosis.

Research of on-line vision inspection technology for width of NC membrane / 生物医学工程学杂志

This paper presents a vision-based method for the width of NC membrane online inspection. In the production of bio-test strip, the number of antigen or antibody which is coated on the membrane depends on the width and the uniformity of test line T and control line C. People should control the width and the uniformity strictly to ensure the accuracy of lines in order to achieve quantitative inspection with high sensitivity. And online inspection must be done, it cannot be processed when the solution has been dry up. This paper gives a design of online inspection system based on linear charge-coupled device (linear CCD), it makes such advantages in terms of speed, accuracy, and the operation to achieve real-time, online inspection.

Influência de diferentes condições de armazenamento sobcongelamento na reatividade de anticorpos séricos / Influence of different freezing storage conditions on the the reactivity of serum antibodies

Anticorpos, importantes marcadores sorológicos usados rotineiramente no imunodiagnóstico para caracterizar diversas doenças, possuem uma estrutura quaternária crucial no reconhecimento antigênico e na reação imunológica. A estocagem de amostrasde soro é um fator determinante na alteração da estrutura química dessas glicoproteínas. A estabilidade de amostras soropositivas para a doença de Chagas (DC), Toxoplasmose e Streptoccocidiose foi avaliada após estocá-las em diferentes temperaturasde congelamento (-8ºC e -20ºC) e a -20°C em freezer tipo Frost-free (FF) poraferição dos títulos sorológicos em períodos de tempo (0, 60 e 90 dias), testando as reatividades por Enzyme-linked immunosorbent assay (ELISA) e hemaglutinação HAI para DC, ELISA e imunofluorescência indireta (IFI) para toxoplasmose, e aglutinação enefelometria para anticorpo antiestreptolisina O (ASLO). O armazenamento em FF mostrouser a melhor condição para conservar amostras para análises por HAI para DC, por IFI para toxoplasmose e por nefelometria (ASLO). As análises por ELISA para DC e toxoplasmose e as de ASLO (aglutinação) mostraram uma alta redução de reatividade quando comparadas àquelas estocadas a -8ºC e -20ºC. Isto pode indicar heterogeneidade entre grupos de anticorpos e/ou possíveis diferenças de especificidade nos métodos dediagnóstico utilizados.

Efficacy of immunoadsorption therapy in the treatment of myasthenia gravis and the mechanism / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of immunoadsorption therapy in patients with myasthenia gravis (MG) and explore the mechanism.</p><p><b>METHODS</b>This investigation involved 20 patients with MG treated with immunoadsorption combined with hormonal therapy and another 20 with only hormonal therapy, and 15 healthy subjects served as the control group. Enzyme-linked immunosorbent assay (ELISA) was used to measure the changes in serum tumor necrosis factor-α (TNF-α) and interleukin-18 (IL-18) after the treatments, and the therapeutic effect of the treatments was evaluated using clinical scores.</p><p><b>RESULTS</b>The clinical scores were significantly decreased after immunoadsorption therapy, showing a significant difference from that in the hormonal treatment group (P<0.05). The serum TNF-a and IL-18 levels were significantly higher in the two patient groups than in the control group (P<0.05), but in the former two groups, their levels were significantly lower in immunoadsorption therapy group (P<0.01).</p><p><b>CONCLUSION</b>Immunoadsorption therapy eliminates the inflammatory cytokines and free radicals as well as the circulating autoantibodies to improve the clinical symptoms of MG.</p>

Protein A immunoadsorption combined with rituximab in highly sensitized kidney transplant recipients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The number of highly sensitized patients is rising, and sensitization can lead to renal transplant failure. The present study aimed to investigate the safety and efficacy of protein A immunoadsorption combined with rituximab (RTX) in highly sensitized recipients of kidney transplants.</p><p><b>METHODS</b>Seven highly sensitized recipients of living-related renal transplants (4 men and 3 women, mean aged 42.5 years old (range 33 - 51)) were pretreated with this combination. Human leukocyte antigen (HLA) mismatch number was 2 - 5. Panel reactive antibody (PRA) of class I was high in 2 cases and that of class II was high in 1 case. All patients were pretreated with immunoadsorption 2 - 10 times. Immunoglobulin and PRA changes were monitored before and after absorption. The operation was conducted when PRA or immunoglobulin levels were at or below normal levels. Immunosuppressive drugs were provided 3 - 5 days before the operation, and one dose of RTX (375 mg/m(2)) was infused with polyclonal antibody on the day of operation. Postoperative creatinine (Cr), creatinine clearance rate (Ccr), PRA ratio, and immunoglobulin changes were monitored.</p><p><b>RESULTS</b>All 7 patients had good recovery without delayed graft function. Acute rejection occurred in 3 cases at postoperative days 8, 10, and 14, respectively. The Banff 07 biopsy grades were Ia in 1 case and IIa C4d0 in 2 cases. Successful reversion was achieved after giving methylprednisolone or antithymocyte immunoglobulin + cyclophosphamide. All patients were discharged with normal renal function, mean class I PRA was 14% and mean class II PRA was 35%. PRA was completely negative in 3 cases.</p><p><b>CONCLUSION</b>Protein A immunoadsorption combined with RTX can safely reduce the occurrence of humoral rejection in highly sensitized renal transplant recipients.</p>

El paciente altamente sensibilizado: Alternativas terapéuticas para el trasplante renal / The highly sensitized patient therapeutic alternatives for kidney transplantation

Patients become sensitized after exposure to non-self human leukocyte antigen (HLA) during pregnancy, blood transfusion, and organ transplantation. Performing transplantation in highly sensitized receptors represents a challenge for transplant programs, organ allocation organizations and usually patients are forced to stay on transplant waiting lists for many years and ultimately may never find a donor. There are various approaches that can be adopted in order to transplant these patients such as plasmapheresis, immunoadsorption, intravenous immune globulin, anti-timocitic agents, monoclonal antibodies (anti CD-20) and splenectomy with similar results as obtained in non highly sensitized patients with the increased risk of severe and recurrent rejection which may carry implications for long-term graft outcomes. Thus a positive crossmatch test is not necessarily an absolute contraindication and allows access for transplantation.

El paciente candidato a trasplante renal puede sensibilizarse hacia su donador cuando se expone a antígenos humanos leucocitarios (HLA) no propios principalmente durante las siguientes circunstancias: embarazo, transfusiones sanguíneas y trasplante previo. La realización de trasplantes en este tipo de pacientes representa un reto para el grupo médico y comités encargados de asignar los órganos, por lo que generalmente este tipo de pacientes permanecen en listas de espera por años e incluso pueden nunca ser trasplantados. Múltiples procedimientos terapéuticos han sido desarrollados con la finalidad de permitir la realización del trasplante en estos pacientes, siendo los principales: plasmaféresis, inmunoadsorción, inmunoglobulina intravenosa, agentes antitimocíticos, anticuerpos monoclonales (antiCD20) y esplenectomía. Estos procedimientos terapéuticos han permitido a ciertos grupos de trasplante obtener resultados similares a los observados en pacientes trasplantados no sensibilizados aunque el riesgo para rechazo severo o recurrente sigue siendo mayor, lo cual puede tener implicaciones negativas en la sobrevida a largo plazo. De lo anteriormente expuesto se concluye que una prueba cruzada positiva no necesariamente es una contraindicación absoluta para la realización de un trasplante.

Management of lupus nephritis.

Management of lupus nephritis is relatively nonspecific and includes various immunosuppressive drugs, cytotoxic agents and other modalities directed against the aberrant immune response. Treatment decisions are influenced by the clinical features, histology, response to treatment, relapses, patient consent and tolerance to medications. Guidelines based on available evidence, as to how best to manage lupus nephritis and possible future interventions are discussed.

Seroprevalence of Trypanosoma cruzi infection in three rural communities in Guatemala

A systematic, house-based serological survey for Trypanosoma cruzi seroreactivity was conducted in three contiguous communities in Olopa municipality, Chiquimula Department, Guatemala. Blood samples from a total of 292 individuals in 63 households were examined by enzyme-linked immunosorbent assay. The seropositive rate ranged from 0 x cent to 20.8 x cent for the three communities, with a mean of 15.1 x cent. Log-linear models showed that seroprevalence was significantly related to age (P<0.005) but not to sex. However, when the age group with the lowest prevalence (1-9 years) was excluded from the analysis, age was not a significant factor (P=0.55). Data from a stratified sample collected at the same time were combined with those of the systematic sample to analyze the relationship between seropositivity and possible explanatory variables. Log-linear models, based on 586 individuals in 129 households from the two surveys, revealed a significant positive association between seropositivity and thatched roofs (P=0.01)

Characterization of Plasmodium falciparum glutamate dehydrogenase-soluble antigen

The major aim of this study was to characterize a soluble Plasmodium falciparum antigen from the plasma of malaria-infected humans and Plasmodium falciparum culture supernatants, using immunoabsorbent techniques and Western blotting. An Mr 60-kDa protein was isolated from the plasma of patients with Plasmodium falciparum malaria by affinity chromatography using rabbit anti-Proteus spp GDH(NADP+) serum as ligand. This protein, present in plasma of patients with acute Plasmodium falciparum infection, in Plasmodium falciparum culture supernatants, and in immune complexes, was tested with Plasmodium falciparum malaria hyperimmune serum from patients living in hyperendemic areas and rabbit anti-Proteus spp GDH(NADP+) serum prepared in the laboratory. In this report, we describe the results of a study showing that parasite GDH(NADP+) can be used to detect the presence of Plasmodium falciparum. It appears that this technique permits the chromatographic detection of a Plasmodium falciparum excretion antigen that may be used in the production of monoclonal antibodies to improve immunodiagnostic assays for the detection of antigenemia, and opens the possibility of its use as a non-microscopic screening method.

Uso de las pruebas de ensayo inmunoabsorbente ligado a enzimas y aglutinación con rivanol para el diagnóstico de brucelosis bovina en Yucatán, México / Use of an enzyme-linked immunosorbent assay and the rivanol agglutination test for the diagnosis of bovine brucellosis in Yucatan, Mexico

Se usaron sueros negativos de animales vacunados (322) y no vacunados (248) provenientes de hatos libres de brucelosis y sueros positivos (90) a las pruebas de Rosa de Bengala (RB) y fijación de complemento (FC) de hatos infectados con Brucella abortus, para determinar la sensibilidad relativa y la especificidad de las pruebas inmunoenzimática indirecta (I-ELISA) y de aglutinación con rivanol (RIV). La concordancia entre pruebas se determinó mediante el análisis kappa usando 688 sueros. La prueba I-ELISA mostró una sensibilidad del 100 por ciento y especificidad de 92.8 por ciento. La RIV tuvo una sensibilidad de 97.8 por ciento y especificidad de 100 por ciento. La concordancia (Kappa) entre I-ELISA y FC fue de 0.73, entre I-ELISA y RIV de 0.74, entre I-ELISA y RB de 0.79 y entre RIV y FC fue de 0.96. Los valores predictivos (VP); para I-ELISA fueron 66.9 por ciento para positivos y 100 por ciento para negativos y para RIV, 100 por ciento para positivos y 99.7 por ciento para los negativos. La prueba I-ELISA puede ser usada como tamiz en las condiciones de Yucatán o como prueba confirmatoria en lugares donde la vacunación no se lleva a cabo. La prueba de RIV mostró una falta de sensibilidad, por tanto no se recomienda en etapas finales de programas de erradicación, pero podría usarse como prueba confirmatoria en programas de control o etapas tempranas en campañas de erradicación

Oncogen C-erb B2: su expresión en un estudio inmuno-histoquímico de enfermedad de Paget extramamaria / C-erb B2 oncogene: its expression in Paget's extramammary disease

Presentamos el caso de una paciente de 69 años, de sexo femenino, con enfermedad de Paget extramamaria variante parianal, de 8 años de evolución, asociada a adenocarcinoma rectal subyacente, a quien se le realizan estudios histopatológicos convencionales, histoquímica e inmunohistoquímica, incluyendo en los mismos el anticuerpo monoclonal para el oncogen C-erb B2. Se destacan los aspectos salientes del mismo y se evalúa su utilización en esta entidad.

Detecçäo de toxinas (microcistinas) produzidas por cianobactérias (algas azuis) em represas para abastecimento público, pelo método de imunoadsorçäo ligado à enzima (ELISA) / Detection of the toxins (microcystins) produced by cyanobacterias (blue algaes) in reservoirs for public provision for immunosorbrnte assay method linked the enzyme (ELISA) and chemical identification

O presente trabalho de pesquisa teve como objetivo a detecçäo de toxinas, microcistinas, produzidas por cianobactérias, ou algas azuis, na água e plâncton de represas para abastecimento público. A metodologia utilizada para este fim foi a de imunoadsorçäo ligada à enzima por competiçäo direta (ELISA). O cultivo de linhagens de cianobactérias tóxicas, mais especificamente do gênero Microcystis, foi realizado com o intuito de se obter suficiente biomassa, utilizada no processo de extraçäo e purificaçäo das microcistinas. A extraçäo das microcistinas por meio de álcoois e "clean up" do extrato obtido foi necessário para a separaçäo e purificaçäo cromatográfica realizada por cromatografia líquida de alta eficiência (HPLC). A identificaçäo química das microcistinas foi realizada pelo conhecimento da constituiçäo dos aminoácidos e peso molecular. Os métodos empregados foram os de análise de aminoácidos por HPLC e espectrometria de massa por bombardeamento atômico rápido (FABMS). A presença das microcistinas foi constatada nas amostras de água e plâncton coletadas em diferentes represas, sendo que duas linhagens de cianobactérias tóxicas, identificadas como BRJU20a e BRAM 9 foram cultivadas e estudadas em relaçäo aos seus análogos da microcistina. Os análogos da microcistina que foram encontrados nestas linhagens säo a microcistina-LR, microcistina-RR, microcistina-YR, microcistina-FR e seus análogos demetilados, como a [D- 'Asp POT. 3'] microcistina-LR, [D- 'Asp POT.3'] microcistina-RR e [D- 'Asp POT. 3'] microcistina-YR. Os resultados obtidos com o presente trabalho de pesquisa comprovam a existência de toxinas, microcistinas, produzidas por cianobactérias em águas de represas para fins de abastecimento público. Este dado endossa a importância de se desenvolver um programa de monitorizaçäo das toxinas, iniciando-o pelas microcistinas, avaliando-se o risco do consumo de água na saúde humana

Development of immuno sorbent agglutination assay [ISAGA] for determination of speeifie antihouse dust mite IGE

Atopy poses a world wide health problem to large segments of population and is relevant from early childhood to adulthood. Diagnosis of atopy is simply based on skin tests which must be avoided in many occasions, or on total Ig[E] estimation which may be misleading. Other tests to detect serum specific Ig[E] are expensive and need special instrumentation. This study presented a less expensive modification of ISAGA to detect specific Ig[E] antibodies of 180 asthmatic children and 89 healthy children control evaluated clinically and by pulmonary function. 137 children were proved to be asthmatic 59 [43.1%] of cases and 8 [8.9%] gave SPT and intradermal positive tests to house dust mite [HDM] allergen extract. Collection of the mite D-pteronyssinus from houses of all asthmatic cases and control detected high infestation rate in all houses [94.9 - 93.5% respectively]. Agglutination score [of three wells] encountered by different serial dilution among 59 atopic children with +ve SPT to HDM allergens showed that 1/25 serum dilution is effective to perform ISAGA test. Correlation of ISAGA with skin tests showed that the sensitivity of the test is 100% [67 positive by the test of 67 true positive] the test was [98.4%] specific [one false positive case out of 61 true negative]. The test also prooved to be reproducible. Application of the test showed that 76.1% of asthmatic patients had specific Ig[E], the test also correlates well with the intensity of the skin reaction. Such findings accomodate it as a test for atopy among asthmatics

Comparaçäo entre os testes de eritroimunoadsorçäo por captura, imunoenzimático e hemaglutinaçäo passiva utilizados no diagnóstico da neurocisticercose / Comparison of the erythroimmunoadsorption by capture, immunoenzymatic and passive haemagglutination tests used in the diagnosis of neurocysticercosis

Foi realizada a comparaçäo entre os testes de eritroimunoadsorçäo por captura (EIAC), imunoenzimático (ELISA) e de hemaglutinaçäo passiva (HAP) utilizados no diagnóstico da neurocisticercose. Foram comparados dois testes já anteriormente utilizados na rotina diagnóstica da neurocisticercose (ELISA E HAP) e um recentemente pradonizado (EIAC) para a detecçäo de anticorpos anti-Cysticercus cellulosae. O antígeno empregado nos três testes foi o extrato salino bruto (ESB), com um rendimento de 0,1; 1 e 1micrag proteína/cavidade para os testes EIAC, ELISA e HAP, respectivamente. Quando se analisou em grupo de 58 pacientes com neurocisticercose, a sensibilidade observada foi de 98,2 porcento, 84,5 porcento e 77,2 porcento nos testes ELISA, EIAC e HAP, respectivamente, para um grupo controle de 85 indivíduos, saudáveis ou com outras encefalotipatias, mas sem neurocisticercose, a especificidade foi de 94,1 porcento, 95,3 porcento, 91,8 porcento respectivamente, nos testes. Esta ordem de escolha poderia ser obedecida na medida dos recursos disponíveis

Evaluation of anti-ds DNA antibody measurement by using commercial kits for use in a clinical laboratory

Three hundred and seventy-six consecutive antinuclear antibody-positive sera were tested for anti-ds DNA antibody by using three commercial kits which use 125 I recombinant DNA [radioimmunoassay], highly purified calf thymus DNA [enzyme linked immunosorbent assay] and Crithidia lucilliae [immunofluorescence assay] as substrates. All patients' sera, after reviewing medical records, were classified into three broad groups: Group I [systemic lupus erythematosus], Group II [rheumatic diseases and rheumatoid arthritis], and Group III [nonspecific ANA antibody test positive]. A sensitivity, specificity, positive predictive test value and negative predictive test value for Group I against Group II-III [generally these two groups of sera should not show any anti-ds DNA antibody] combined showed for Crithidia lucilliae [IF assay] 58.8%, 93.6%, 82% and 82%, for 125 I recombinant DNA [RIA] assay, 75.8%, 94%, 86.2% and 88.7% and calf thymus highly purified DNA [ELISA] assay using positive cut-off value >100 U/mL, 97.5%, 35%, 42.9% and 24%. The 125 I recombinant DNA [RIA] assay based on the principle of the Farr technique, which is still considered to be the gold standard for anti-ds DNA antibody detection, showed the best specificity and sensitivity among all three methods tested in this study