[New methods for the determination of transferrin isoforms in the diagnostics of alcohol abuse]. / Nowe metody oznaczania izoform transferyny w diagnostyce uzaleznienia od alkoholu.

The new biochemical marker of chronic alcohol abuse are transferrin isoforms with a reduced number of sialic acids (asialo-, monosialo-, and disialotransferrin) called carbohydrate-deficient transferrins (CDTs). The usefulness of this indicator in the diagnostics of alcohol abuse has clearly been confirmed during the last years. The sensitivity and specificity of the CDT method as a marker of chronic alcohol abuse are higher than those found in commonly used tests. In routine analysis, CDTs have been assayed in the laboratories for ten years. Current CDT techniques allow for the determination of total CDT concentration (the absolute and/or relative amount) and provide the possibility of assaying its isoforms. In this paper the molecular structure of transferrin and different methods of CDT analysis are shown, with particular attention given to commercial tests. Analytical specificity and method-dependent (electrophoretic and chromatographic) reference values or cut-offs for serum CDT concentrations indicating chronic alcohol abuse are given in a table. Electrophoretic methods are characterized by higher selectivity (genetic variants) and higher sensitivity than chromatographic techniques. Isoelectric focusing, capillary electrophoresis, and high-performance liquid chromatography are used as the reference methods. Commercial procedures are based on transferrin saturation with iron followed by fractionation of protein (separating CDTs from non-CDT forms) by ion-exchange chromatography using microcolumns and a quantitative determination of CDT isoforms by immunological methods (radioimmunoassay, enzyme immunoassay, and turbidimetric immunoassay). Due to the different existing analytical methods, further standardization of CDT analysis and a redefinition of CDTs are necessary.

Histological patterns of synovitis and serum chemokines in patients with rheumatoid arthritis.

OBJECTIVE: Studies indicate the genetic, biological, and clinical heterogeneity of rheumatoid arthritis (RA). Recently the histological diversity of RA has been postulated. We investigated whether serum concentrations of interleukin 8 (IL-8), RANTES (regulated upon activation normal T cell expressed and secreted), and monocyte chemoattractant protein-1 (MCP-1) are correlated with histological appearance of the rheumatoid synovitis. METHODS: Using ELISA we assessed IL-8, RANTES, and MCP-1 concentrations in serum of 47 patients with RA and 30 patients with osteoarthritis (OA). RESULTS: Morphological analysis of synovial specimens distinguished 2 types of rheumatoid synovitis. Twenty-eight RA samples presented diffuse infiltrates of mononuclear cells with no specific microanatomical organization and were categorized as diffuse synovitis. In the remaining 19 specimens, classified as follicular synovitis, formation of lymphocytic follicles with germinal center-like structures was observed. Serum levels of studied chemokines were increased in patients with RA compared to the OA control group (p < 0.001 for all comparisons). Concentrations of IL-8, RANTES, and MCP-1 were highest in serum of RA patients with follicular synovitis in comparison with patients with diffuse synovitis (p < 0.01, p < 0.01, and p < 0.05, respectively) and could distinguish RA patients with these 2 histological disease patterns. Serum levels of chemokines correlated with markers of disease activity such as erythrocyte sedimentation rate, C-reactive protein concentrations, and Disease Activity Score. CONCLUSION: Distinct histological variants of rheumatoid synovitis associated with different serum levels of IL-8, RANTES, and MCP-1 reflect clinical activity of the disease and confirm the concept of RA heterogeneity.