Fibronectin molecular status determination useful to differentiate between rheumatoid arthritis and systemic lupus erythematosus patients.

To find whether the plasma fibronectin (FN) molecular status can be useful to differentiate between rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). The expression of plasma FN domains was determined by ELISA using monoclonal domain-specific antibodies. FN molecular forms were revealed by immunoblotting and analyzed by densitometry. The following findings were found: (1) Mean values of (Fibrin-Heparin)FN concentration were lower in SLE and RA patients than in normal plasmas. The cut off points at 31 mg/l in SLE and at 45 mg/l in RA showed a sensitivity and specificity of 54, 55 and 75%, respectively. (2) Mean values of concentrations of (CBD)FN and (Ct)FN were lower in SLE than those in normal and RA plasmas. Quantified data showed the cut off points of (CBD)FN and (Ct)FN at 200 mg/l (58% of sensitivity, 56% of specificity) and 350 mg/l (58% of sensitivity, 58% of specificity) in SLE, as well as at 295 mg/l (52% of sensitivity, 51% of specificity) and 460 mg/l in RA (70% of sensitivity, 73% of specificity). (3) The plasma FN immunopatterns, characterized by the presence of high-molecular (260-310 kDa) and/or low-molecular (158-209 kDa) FN bands, were specific only for SLE samples. The analysis of plasma FN status revealed by its Fibrin-Heparin-, CBD- and Ct-domain reactivity with monoclonal antibody and immunoblotting can be helpful to differentiate the SLE in respect to RA and normal plasmas.

Anti-ox-LDL antibodies and anti-ox-LDL-B2GPI antibodies in patients with systemic lupus erythematosus.

OBJECTIVES: The aim of the study was to assess the concentration of anti-oxidized low-density lipoprotein (anti-oxLDL) antibodies and antibodies against oxLDL-beta2GPI (oxLDL-beta 2 glycoprotein I) complexes in the serum of patients with systemic lupus erythematosus (SLE). Correlations between clinical and laboratory factors and the intima media thickness (IMT) were also investigated. MATERIAL AND METHODS: The study included 16 patients (14 females, 2 males) with an established diagnosis of SLE. The mean disease duration was 6.3 years (range: 2-23 years). Thirteen age-matched healthy volunteers comprised the control group. IMT, the concentration of anti-oxLDL and anti-oxLDL-beta2GPI antibodies and lipid profile were assesed. Data concerning other cardiovascular risk factors were also collected. RESULTS: In the SLE group the intima media was significantly thicker than in control group. In the SLE group a statistically significant positive correlation was noted between age and mean IMT. Immunological assays revealed elevated serum concentration of anti-oxLDL antibodies in the SLE group; serum concentration of IgG anti-oxLDL-beta2GPI antibodies and IgM anti-oxLDL-beta2GPI antibodies were also elevated in the SLE group compared to the controls. There was a statistically significant positive correlation between LDL concentration and anti-oxLDL antibody concentration in the SLE group. CONCLUSIONS: The study findings support the thesis that cardiovasular risk is significantly higher in SLE patients. Elevated concentrations of anti-oxLDL antibodies, IgG anti-oxLDL-beta2GPI antibodies and IgM anti-oxLDL-beta2GPI antibodies were detected in the SLE group, which may contribute to the elevated cardiovascular risk in SLE patients.

Terminal monosaccharide screening of synovial immunoglobulins G and A for the early detection of rheumatoid arthritis.

The expressions of some terminal glycotopes of synovial immunoglobulins G, A, and M were analysed in relation to rheumatoid arthritis (RA) progression defined according to early and advanced radiological changes in patients' hands. The relative amounts of terminal monosaccharides were determined by lectin-immunoblotting of immunoglobulin preparations using appropriate lectins able to recognize alpha2,6-linked (Sambucus nigra agglutinin) and alpha2,3-linked (Maackia amurensis agglutinin) sialic acid, galactose (Ricinus communis agglutinin I), N-acetylglucosamine (Griffonia simplicifolia agglutinin II) as well as alpha1,6-linked (Aleuria aurantia lectin), alpha1,3-linked (Lotus tetragonolobus agglutinin), and alpha1,2-linked (Ulex europaeus agglutinin) fucose. The results indicate differences between early and advanced RA stages in the terminal sugar exposition of synovial IgG and IgA, but not IgM. The galactose-deficient glycotope with exposed N-acetylglucosamine of the synovial 33.1-kDa IgG fragment appeared exclusively in the early stage of RA. In contrast, this glycotope of intact synovial IgG and IgA was present in both groups, although with higher proportions in advanced RA. The proportions of the sialyl and fucosyl determinants of intact synovial A and G immunoglobulins were clearly lower in the early RA group than in the advanced. The analysis of terminal oligosaccharide exposition in IgG, IgG fragments, and IgA present in the synovial fluid of RA patients might be applicable as a stage-specific marker in the diagnosis and therapy of RA patients.

Differences between the early and advanced stages of rheumatoid arthritis in the expression of EDA-containing fibronectin.

In the present study the expression of alternatively spliced synovial EDA-containing FN (EDA-FN) was analyzed in plasma and synovial fluid samples of rheumatoid arthritis (RA) patients with from 2 months to 20 years disease duration. The patient samples were divided into groups: those with early, established, and late progressive radiographic changes as well as those with different disease activity established by a CRP concentration. The expression of EDA-FN was determined by sandwich-type ELISA using a specific anti-EDA monoclonal antibody. The relative amount of EDA-FN in synovial fluid, but not in plasma samples, was significantly lower in the early RA group than in established and late RA. In contrast, its level did not correlate with the CRP concentration. Synovial EDA-FN might be used as a supplemented marker of early RA.

Relative sialylation and fucosylation of synovial and plasma fibronectins in relation to the progression and activity of rheumatoid arthritis.

The expressions of terminal sugars in synovial and plasma fibronectins were studied in relation to rheumatoid arthritis (RA) progression defined according to the early, established and late radiological changes in the patients' hands. The relative amounts of sialic acid and fucose were analyzed by lectin-ELISA using appropriate sialic acid-linked alpha2-3 (Maackia amurensis) and alpha2-6 (Sambucus nigra) lectins as well as fucose-linked alpha1-6 (Aleuria aurantia), alpha1-2 (Ulex europaeus), and alpha1-3 (Tetragonolobus purpureus). In the early RA group, the synovial fibronectin reactivities were the lowest with the all lectins used. In the established and late groups, relative sialylation and fucosylation significantly increased. However, sialylation negligibly decreased, whereas fucosylation remained at nearly the same level in the late group. Moreover, the expression of alpha1-6-linked fucose was found to be related to disease activity. In contrast, plasma fibronectin reactivity with lectins showed different dynamic alterations. In the early RA group, the reactivity of fibronectin with the lectins used was similar to that of healthy individuals, whereas it increased significantly in the established RA group compared with the early and normal plasma groups. In the late RA group it decreased to a level similar to that of the normal group. The lower expressions of terminal sugars in synovial fibronectin were mainly associated with the early degenerative processes of RA. In conclusion, such alterations may be applicable as a stage-specific marker for diagnosis and therapy of RA patients. The higher expression of terminal sugars in fibronectin could be associated with repair and adaptation processes in longstanding disease.

[Behçet's disease--difficulty in diagnostic and management]. / Choroba behçeta--trudnosci diagnostyczne i terapeutyczne.

We present a 31-year-old female patient with Behçet's disease. Behcet's disease is a systematic vasculitis of unknown cause involving veins and arteries of all sizes and having reccurent mucocutaneous and frequent ocular involvement. Our patient was suffering from oral and genital ulcers, fever, painful left knee and erythema nodosum. After having excluded differential diagnoses Behçet's disease was diagnosed. The treatment must be individual and it depends on the presence and severity of symptoms. The optimal improvement was observed after treatment with azathioprine, cyclosporine A and metylprednisolon. Behçet's disease is very seldom in our country but perhaps sometimes it isn't good diagnosed.