[The role of anti-nucleosome antibodies in systemic lupus erythematosus. Results of a study of patients with systemic lupus erythematosus and other connective tissue diseases]. / Ruolo degli anticorpi anti-nucleosomi nel lupus eritematoso sistemico. Risultati di uno studio condotto in pazienti con lupus eritematoso sistemico ed altre connettiviti sistemiche.

OBJECTIVE: The aim of our study was to investigate the prevalence and the disease specificity of anti-nucleosome antibodies in systemic lupus erythematosus and their association with disease activity and renal involvement. METHODS: Anti-nucleosome antibodies were measured by ELISA in the sera of patients with systemic lupus erythematosus (SLE) (47), rheumatoid arthritis (RA) (22), mixed connective tissue disease (MCTD) (19), systemic sclerosis (SSc) (11) and Sjögren's syndrome (SS) (10). Anti-dsDNA antibodies were measured by IIF on Crithidia luciliae. In the patients with SLE serum levels of C3 and C4 complement components were also measured. Sera of 22 healthy individuals were assayed as controls. SLE activity was evaluated by the ECLAM score. RESULTS: Anti-nucleosome antibodies were found in 40 patients with SLE (85.1%), in 10 with RA (45.4%), in 8 with MCTD (42.1%), in 4 with SSc (36.3%), in 1 with SS (10%) and in none of the healthy controls. Anti-dsDNA antibodies were found in 23 patients with SLE and were absent in the patients with other CTD and in controls. All the patients with SLE and renal involvement were positive both for anti-dsDNA antibodies and anti-nucleosome antibodies. No significant correlation was observed between anti-nucleosome antibodies and disease activity and renal involvement. CONCLUSION: Anti-nucleosome antibodies are present in a high percentage of the patients with SLE but they don't seem to be specific markers of the disease. Our data don't support a clear correlation between anti-nucleosome antibodies and disease activity and renal involvement.

[Anticardiolipin antibodies in hemodialysis patients and in renal transplant recipients: prevalence and significance]. / Anticorpi anticardiolipina in pazienti in emodialisi e con trapianto renale: prevalenza e significato.

Increased anticardiolipin antibodies (aCL) serum levels have been recently described in haemodialysis patients and in renal transplant recipients, with a prevalence ranging from 4.8 to 46.4%. The causes and the clinical significance of aCL positivity in these patients are uncertain. We measured IgG- and IgM-aCL serum levels in 61 haemodialysis patients, in 14 renal transplant recipients and in 38 healthy controls. Increased levels of IgG-aCL were found in 4 haemodialysis patients (6.55%), in 2 transplant patients (14%) and in 2 of the healthy controls (5.26%). IgM-aCL serum levels were normal in all the patients. After one year of follow-up, no vascular events have been observed in aCL positive patients. It is probable that the presence of aCL in the serum of patients with end-stage renal disease is only an epiphenomenon and does not play a pathogenetic role.

[High levels of blood IgA in patients with rheumatoid arthritis]. / Alti livelli di IgA seriche in pazienti con artrite reumatoide.

MATERIALS AND METHODS: Serum levels of IgA, IgG and IgM were measured in 46 patients (34 women, 12 men) with rheumatoid arthritis. The duration of the disease ranged from 6 months to 30 years; the patients follow-up ranged from 6 months to 12 years. RESULTS: Serum IgA levels higher than the normal (> 450 mg/dl) were found in 20 patients (43.4%). These patients had mean levels of IgG, C3c and erythrocyte sedimentation rate significantly higher than the patients with normal IgA levels. CONCLUSIONS: A significant relationship between the IgA levels and the activity of the disease or its clinical and radiological features was not observed. On the other hand, a relationship was observed between IgA levels and the mean duration of the disease which was significantly more prolonged in patients with high IgA serum levels.

[Presence and significance of anticardiolipin antibodies in infectious diseases]. / Sulla presenza e sul significato degli anticorpi anti-cardiolipina nelle malattie infettive.

IgG and IgM anti-cardiolipin antibodies were measured, by an ELISA technique, in the sera of patients with B hepatitis (28), infectious mononucleosis (10), chicken pox (12), HIV infection (20), acquired toxoplasmosis (41) and other infectious diseases [HBsAg+ chronic hepatitis (5), brucellosis (6), herpes zoster (4), boutonneuse fever (3), viral pneumonitis (4), rheumatic fever (2)]. Increased levels of anti-cardiolipin antibodies (aCL), at least in one immunoglobulin class, were detected in 37 out of 135 patients [27.4%; range: 7.3% (in the patients with toxoplasmosis) -80% (in the patients with HIV infection)]. Low or medium titer aCL were present in 28 patients, high titer in 9 (6 with HIV infection, 2 with chicken pox and I with lymphoadenopathic toxoplasmosis). None of the manifestations associated with aCL was present in the aCL-positive patients. Finally, positivity for aCL didn't seem to modify the clinical picture and the prognosis of the infectious disease.

[Clinical contribution to the problem of correlations between hereditary angioneurotic edema and pregnancy]. / Contributo clinico al problema dei rapporti tra edema angioneurotico ereditario e gravidanza.

Hereditary angioneurotic edema (HAE) is an autosomal dominant disease caused by a deficiency of a complement regulatory protein, the C1INH.HAE is clinically characterized by recurrent, self-limited attacks of edema involving the extremities, face, upper respiratory tract or gastrointestinal tract. Pregnancy in a woman affected by HAE poses therapeutical problems. In fact, prophylactic treatment with danazole or tranexamic acid is control indicated in a pregnant woman. However HAE shows a favourable course in most cases and the delivery, despite the local trauma, is not usually associated with complications. But the occasional occurrence of local edema and the literature report of a death in postpartum, suggest the administration of purified C1INH prophylactically before the delivery. HAE, per sé, neither alters the evolution of pregnancy nor does foetus harm. The A. report on a 22-years old primigravida affected by HAE. She had no attack during the whole gestation, the delivery and the postpartum. She was given 1000 units of purified C1INH concentrate both four hours before the delivery and 24 hours after it.

[The hepatitis A and B virus markers (anti-HAV, HBsAg, HBsAb, HBeAg, HBeAb) in leprous patients (author's transl)]. / Marcatori sierici dell'infezione da virus dell'epatite "A" (anti-HAV) e "B" (HBsAg-HBsAb, HBeAg-HBeAb) nei lebbrosi.

The hepatitis A and B virus markers (anti-HAV, HBsAg, HBsAb, HBeAg, HBeAb) were studied in the serum of 25 patients at the leprosy hospital of Messina. Anti-HAV were detected, by RIA in 100% of the patients; by the same method HBsAg was found in 12% and HBsAb in 48% of the cases. In no patient HBeAg was detected by immunodiffusion; on the contrary, HBsAb was found in 4% of the cases. No significant difference between lepromatous and tuberculoid leprosy was found.

[The behaviour of the seric immunoglobulins in brucellosis (author's transl)]. / Sul comportamento delle immunoglobuline sieriche nella brucellosi.

The Authors studied the behaviour of the seroproteic picture and of the seric immunoglobulins in 34 patients affected with brucellosis, almost all of which came from a single epidemic center, some in the initial phase and others in an advanced stage. As regards the seroproteins they found a constant increase in the globulin, which was more apparent in the beta and gamma fractions. As far as the immunoglobulins are concerned they demonstrated an increase in all three classes examined, but a clearer one in the IgM at the beginning of the illness. However the Authors were not able to find evidence of the usual diphasism probably depending on the fact that the primary phase can develope in a pre-clinical stage.

[Studies on the relation between the production of anti-O and anti-H agglutinins and the specific treatment of typhoid fever]. / Studio dei rapporti tra produzione di agglutinine anti-O e anti-H e trattamento specifico della febbre tifoide

The AA, studied the behaviour of anti-O and anti-H agglutinins in patients with typhoid fever treated with CAF or with CAF+ corticosteroides. They have shown that, during the treatment with antibiotics, the O-agglutinins, which appeared extremely quickly, can be present at a high level and for a long time in the serum; on the other hand the H-agglutinins are usually present at a lower level and tend to decrease more rapidly. In patients treated with CAF+ corticosteroides the agglutinins behaviour was not substancially different from that in patients treated with antibiotic only. These modifications in humoral immunity are notable only when treatment is begun early. On the basis of the results and of data in the most recent literature, the AA. also discuss the problem of typhoid relapses, the pathogenesis of which cannot depend from the modifications of humoral immunity only.