Analytical variability in the determination of anti-double-stranded DNA antibodies: the strong need of a better definition of the old and new tests.

Anti-dsDNA antibodies are a heterogeneous group of antibodies, quite specific for SLE. Their variability is related to the assay used, the immunoglobulin class secondary antibody, and the dsDNA source. The standardization of measuring anti-dsDNA antibodies is still poor and different methods yield different results. Several novel technologies were developed during the last decades that represent viable alternatives to the traditional methods such as the chemiluminescent immunoassay (CIA) and multiplex flow immunoassay (MFI). Additionally, positive results for anti-dsDNA antibodies can be detected in patients with inflammatory arthritis (IA) treated with different biologics reducing its clinical specificity for SLE. Anti-dsDNA antibody levels were evaluated in 246 patient samples: 70 SLE and 176 disease control (including 96 IA during treatment with different biologics), using three enzyme immunoassays (indirect enzyme immunoassay, Bio-Rad Laboratories; chemiluminescent immunoassay, Inova Diagnostics; multiplex flow immunoassay, Bio-Rad Laboratories) and three Crithidia luciliae immunofluorescence tests (CLIFT) (Euroimmun AG, Bio-Rad Laboratories, INOVA Diagnostics). Diagnostic performances were assessed both including and excluding the IA patients. Agreements, measured by the Cohen's Kappa between all methods, ranged from moderate to substantial (0.47-0.68). The clinical sensitivities for the anti-dsDNA antibody tests varied from 5.7% by CLIFT A up to 33.3% provided by EIA while the clinical specificities varied from 89.8% by MFI to 98.9% provided by CLIFT B and C. Newer technologies, such as MFI and CIA, showed great potential as a diagnostic application. Significant variations among anti-dsDNA antibody assays were observed confirming the lack of standardization.

Performance analysis of automated evaluation of Crithidia luciliae-based indirect immunofluorescence tests in a routine setting - strengths and weaknesses.

BACKGROUND: Antibodies directed against dsDNA are a highly specific diagnostic marker for the presence of systemic lupus erythematosus and of particular importance in its diagnosis. To assess anti-dsDNA antibodies, the Crithidia luciliae-based indirect immunofluorescence test (CLIFT) is one of the assays considered to be the best choice. To overcome the drawback of subjective result interpretation that inheres indirect immunofluorescence assays in general, automated systems have been introduced into the market during the last years. Among these systems is the EUROPattern Suite, an advanced automated fluorescence microscope equipped with different software packages, capable of automated pattern interpretation and result suggestion for ANA, ANCA and CLIFT analysis. METHODS: We analyzed the performance of the EUROPattern Suite with its automated fluorescence interpretation for CLIFT in a routine setting, reflecting the everyday life of a diagnostic laboratory. Three hundred and twelve consecutive samples were collected, sent to the Central Diagnostic Laboratory of the Maastricht University Medical Centre with a request for anti-dsDNA analysis over a period of 7 months. RESULTS: Agreement between EUROPattern assay analysis and the visual read was 93.3%. Sensitivity and specificity were 94.1% and 93.2%, respectively. The EUROPattern Suite performed reliably and greatly supported result interpretation. CONCLUSIONS: Automated image acquisition is readily performed and automated image classification gives a reliable recommendation for assay evaluation to the operator. The EUROPattern Suite optimizes workflow and contributes to standardization between different operators or laboratories.

Automated Evaluation of Crithidia luciliae Based Indirect Immunofluorescence Tests: A Novel Application of the EUROPattern-Suite Technology.

Systemic lupus erythematosus (SLE) is a severe rheumatic autoimmune disease with various clinical manifestations. Anti-dsDNA antibodies are an important immunological hallmark of SLE and their occurrence represents a major criterion for the diagnosis. Among the commonly applied test systems for determination of anti-dsDNA antibodies, the indirect immunofluorescence test (IIFT) using the flagellated kinetoplastida Crithidia luciliae is considered to be highly disease specific at moderate sensitivity. Since IIFT, however, is claimed to be affected by subjective interpretation and a lack of standardization, there has been an increasing demand for automated pattern interpretation of immunofluorescence reactions in recent years. Corresponding platforms are already available for evaluation of anti-nuclear antibody (ANA) IIFT on HEp-2 cells, the recommended "gold standard" for ANA screening in the diagnosis of various systemic rheumatic autoimmune diseases. For one of these systems, the "EUROPattern-Suite" computer-aided immunofluorescence microscopy (CAIFM), automated interpretation of microscopic fluorescence patterns was extended to the Crithidia luciliae based anti-dsDNA IIFT.

Evaluation of five commercial assays for the detection of anti-dsDNA antibodies: three Crithidia luciliae indirect immunofluorescence test kits and two enzyme immunoassay kits.

OBJECTIVE: There are various methods for anti-dsDNA detection. Crithidia luciliae indirect immunofluorescence test (CLIFT) and enzyme immunoassay (EIA) are the most commonly used at present. A number of CLIFT and EIA kits are commercially available. The objective of the present study was to evaluate the diagnostic performance of three commercial CLIFT kits, two commercial EIA kits, and their combinations for anti-dsDNA detection. MATERIAL AND METHOD: One hundred thirty nine sera sent for anti-dsDNA testing were investigated. Three commercial CLIFT kits (kit C1, C2, and C3) and two commercial EIA kits (kit E1 and E2) were evaluated. Sensitivities and specificities were calculated. The gold standard methods were the consensus results of all five kits, together with the clinical diagnosis when the results of five kits were discrepant. RESULTS: Of 139 sera investigated, 94 (67.6%) sera showed concordant results for all five kits and 45 (32.4%) sera showed discordant results. Thirty-five of those 45 patients (77.7%) were diagnosed as SLE. Sensitivities and specificities of the kits were as follows, Cl 82.1% and 94%, C2 46.4% and 100%, C3 78.6% and 98.8%, E1 71.4% and 94%, and E2 75% and 93.8%, respectively. Kit C3 yielded the maximum sum of sensitivity and specificity (177.4%). Sensitivities and specificities of the combinations of CLIFT and EIA kits were as follows, C1 + E1 89.3% and 90.4%, C1 + E2 98.2% and 87.9%, C2 + E1 73.2% and 94%, C2 + E2 82.1% and 92.8%, C3 + E1 85.7% and 94%, and C3 + E2 94.6% and 91.6%, respectively. The combination of kit C3 and E2 yielded the maximum sum of sensitivity and specificity (186.2%). CONCLUSION: Kit C3 was the assay of choice for anti-dsDNA detection. EIA kits yielded lower sensitivities and specificities than two of three CLIFT kits. Therefore, they should not be used as the first assay for anti-dsDNA screening. When CLIFT and EIA assays were combined, sensitivities were increased Kit E2 helped CLIFT kits to detect more SLE cases than E1.

New insights about cross-reactive epitopes of six trypanosomatid genera revealed that Crithidia and Leptomonas have antigenic similarity to L. (L.) chagasi.

We investigated whether ELISA using crude antigens from insect and plant trypanosomatids, which are non-pathogenic and easily cultivated in large scale, has the same positivity data as Leishmania (Leishmania) chagasi, the etiological agent of human visceral leishmaniasis (VL) or canine leishmaniasis (CanL), or as Trypanosoma cruzi, the etiological agent of Chagas disease (CD). The antigens from Crithidia fasciculata, Crithidia luciliae, and Leptomonas seymouri showed 100% cross-reactivity with VL and CanL samples, with no statistically titers differences from L. (L.) chagasi, however, 34% (17/50) of VL samples revealed higher titers using the insect trypanosomatids than the homologous antigen. On the other hand, antigens from Strigomonas culicis, Angomonas deanei, and Phytomonas serpens showed low cross-reactivity with VL and CanL samples. The sera from patients with American tegumentary leishmaniasis showed low levels of cross-reactivity with all trypanosomatids investigated, even with L. (L) chagasi, without titers dissimilarity among them. These parasites were also worthless as antigen source for detection of CD cases, which required homologous antigens to reach 100% positivity. This study showed, by ELISA, that crude extract of Crithidia and Leptomonas have epitopes similar to L. (L.) chagasi, which supports the idea of using them as antigens source for the serodiagnosis of visceral leishmaniasis.

Antimicrobial peptides play a functional role in bumblebee anti-trypanosome defense.

Bumblebees, amongst the most important of pollinators, are under enormous population pressures. One of these is disease. The bumblebee and its gut trypanosome Crithidia bombi are one of the fundamental models of ecological immunology. Although there is previous evidence of increased immune gene expression upon Crithidia infection, recent work has focussed on the bumblebee's gut microbiota. Here, by knocking down gene expression using RNAi, we show for the first time that antimicrobial peptides (AMPs) have a functional role in anti-Crithidia defense.

Qualitatively different immune response of the bumblebee host, Bombus terrestris, to infection by different genotypes of the trypanosome gut parasite, Crithidia bombi.

Insects have a complex and highly successful immune system that responds specifically to different types of parasites. Different genotypes of a parasite species can differ in infectivity and virulence; which is important for host-parasite co-evolutionary processes, such as antagonistic, fluctuating selection. Such coevolution obviously requires a genetic basis, but little is known about how hosts immunologically respond to different genotypes. The common European bumblebee Bombus terrestris is infected by the highly prevalent trypanosome gut parasite, Crithidia bombi. Here we examined expression of 26 immunological and metabolic genes in response to infection by two clones of C. bombi and compared that with exposure to injection with a bacterial challenge. Exposure to the two clones of C. bombi elicits qualitatively different immune expression responses. Interestingly, infection with one clone results in up regulation of AMP's similar to bees given the bacterial challenge, while genes related to metabolism, signalling, and other effectors were similar between the two Crithidia exposures. Bees given different challenges were distinct enough to discern using linear discriminant analyses. We also found strong correlations, both positive and negative, among genes, which may shed light on how suites of genes are regulated and trade-offs in expression within this gene set.

Immune gene expression in Bombus terrestris: signatures of infection despite strong variation among populations, colonies, and sister workers.

Ecological immunology relies on variation in resistance to parasites. Colonies of the bumblebee Bombus terrestris vary in their susceptibility to the trypanosome gut parasite Crithidia bombi, which reduces colony fitness. To understand the possible origin of this variation in resistance we assayed the expression of 28 immunologically important genes in foraging workers. We deliberately included natural variation of the host "environment" by using bees from colonies collected in two locations and sampling active foraging workers that were not age controlled. Immune gene expression patterns in response to C. bombi showed remarkable variability even among genetically similar sisters. Nevertheless, expression varied with parasite exposure, among colonies and, perhaps surprisingly, strongly among populations (collection sites). While only the antimicrobial peptide abaecin is universally up regulated upon exposure, linear discriminant analysis suggests that the overall exposure effect is driven by a combination of several immune pathways and further immune functions such as ROS regulation. Also, the differences among colonies in their immune gene expression profiles provide clues to the mechanistic basis of well-known inter-colony variation in susceptibility to this parasite. Our results show that transcriptional responses to parasite exposure can be detected in ecologically heterogeneous groups despite strong background noise.

Single and mixed-species trypanosome and microsporidia infections elicit distinct, ephemeral cellular and humoral immune responses in honey bees.

Frequently encountered parasite species impart strong selective pressures on host immune system evolution and are more apt to concurrently infect the same host, yet molecular impacts in light of this are often overlooked. We have contrasted immune responses in honey bees to two common eukaryotic endoparasites by establishing single and mixed-species infections using the long-associated parasite Crithidia mellificae and the emergent parasite Nosema ceranae. Quantitative polymerase chain reaction was used to screen host immune gene expression at 9 time points post inoculation. Systemic responses in abdomens during early stages of parasite establishment revealed conserved receptor (Down syndrome cell adhesion molecule, Dscam and nimrod C1, nimC1), signaling (MyD88 and Imd) and antimicrobial peptide (AMP) effector (Defensin 2) responses. Late, established infections were distinct with a refined 2 AMP response to C. mellificae that contrasted starkly with a 5 AMP response to N. ceranae. Mixed species infections induced a moderate 3 AMPs. Transcription in gut tissues highlighted important local roles for Dscam toward both parasites and Imd signaling toward N. ceranae. At both systemic and local levels Dscam, MyD88 and Imd transcription was consistently correlated based on clustering analysis. Significant gene suppression occurred in two cases from midgut to ileum tissue: Dscam was lowered during mixed infections compared to N. ceranae infections and both C. mellificae and mixed infections had reduced nimC1 transcription compared to uninfected controls. We show that honey bees rapidly mount complex immune responses to both Nosema and Crithidia that are dynamic over time and that mixed-species infections significantly alter local and systemic immune gene transcription.

Barrier immune effectors are maintained during transition from nurse to forager in the honey bee.

Foragers facilitate horizontal pathogen transmission in honey bee colonies, yet their systemic immune function wanes during transition to this life stage. In general, the insect immune system can be categorized into mechanisms operating at both the barrier epithelial surfaces and at the systemic level. As proposed by the intergenerational transfer theory of aging, such immunosenescence may result from changes in group resource allocation. Yet, the relative influence of pathogen transmission and resource allocation on immune function in bees from different stages has not been examined in the context of barrier immunity. We find that expression levels of antimicrobial peptides (AMPs) in honey bee barrier epithelia of the digestive tract do not follow a life stage-dependent decrease. In addition, correlation of AMP transcript abundance with microbe levels reveals a number of microbe-associated changes in AMPs levels that are equivalent between nurses and foragers. These results favor a model in which barrier effectors are maintained in foragers as a first line of defense, while systemic immune effectors are dismantled to optimize hive-level resources. These findings have important implications for our understanding of immunosenescence in honey bees and other social insects.

Robustness of the outcome of adult bumblebee infection with a trypanosome parasite after varied parasite exposures during larval development.

The outcome of defence by the invertebrate immunity has recently been shown to be more complex than previously thought. In particular, the outcome is affected by biotic and abiotic environmental variation, host genotype, parasite genotype and their interaction. Knowledge of conditions under which environmental variation affects the outcome of an infection is one important question that relates to this complexity. We here use the model system of the bumblebee, Bombus terrestris, infected by the trypanosome, Crithidia bombi, combined with a split-colony design to test the influence of the parasite environment during larval rearing on adult resistance. We find that genotype-specific interactions are maintained and adult resistance is not influenced. This demonstrates that environmental dependence of bumblebee-trypanosome interactions is not ubiquitous, and yet unknown constraints will maintain standard coevolutionary dynamics under such environmental deviations.

[The anti-dsDNA antibodies: validation of an original two step strategy of detection]. / Les anticorps anti-ADN natif : validation d'une stratégie originale de détection en deux temps.

Detection of anti-dsDNA antibodies is one of the major biological criteria of use in the diagnosis of systemic lupus erythematosus. Sensitivity and specificity vary greatly between existing techniques, and differ largely from one study to another. The aim of our prospective study was to evaluate a new strategy of detection comprising two steps, first, the use of a sensitive automated technique, ELISA Phadia EliA™, and second, if necessary, a more specific technique: the Crithidia luciliae immunofluorescence test (CLIFT). The latter was used in case of discrepancy with previous laboratory findings or according to the available clinical data. During the study period of 18 months, 1729 tests were requested of which 96 were finally assayed using CLIFT. Analysis of 53 discordant results showed 14 cases of lupus identified only with ELISA, and 3 only by Crithidia. In addition, 35 likely false positives of ELISA were evidenced by negative CLIFT results. These data show a clear gain in sensitivity without any loss of specificity due to the use of a second technique. Thus, this strategy was validated in our lab; it can be useful by any medical laboratory because the cost of few Crithidia luciliae slides is very low.

Técnicas inmunológicas que apoyan el diagnóstico de las enfermedades autoinmunes / Immunological Techniques that support the diagnosis of the autoimmune diseases

Durante los últimos años el avance tecnológico ha permitido desarrollar técnicas que ayudan al diagnóstico de múltiples enfermedades. En el caso de las enfermedades autoinmunes, las técnicas inmunológicas son de gran ayuda ya que permiten la detección de varios autoanticuerpos simultáneamente a partir de volúmenes de muestra pequeños. Aunado al desarrollo de las nuevas técnicas, la sensibilidad y especificidad en la detección de las especificidades de los anticuerpos también han ido en aumento, de tal manera que el clínico puede contar con pruebas que le permiten hacer los diagnósticos tempranos con mayor certeza y hacer también el seguimiento del curso de la enfermedad en función de la variación de los anticuerpos presentes en las muestras de los pacientes. Cabe destacar que las nuevas técnicas de laboratorio que se utilizan para el apoyo en el diagnóstico de las enfermedades autoinmunes ya no son exclusivas de laboratorios de investigación, sino que por su control de calidad, facilidad de estandarización y reproducibilidad pueden usarse en laboratorios clínicos medianos y pequeños. En el presente trabajo se describen las técnicas de mayor aplicación en el laboratorio clínico para enfermedades autoinmunes (AU)

During the past few years technological advance have been allowed the developing of techniques that help to the diagnosis of multiple diseases. In the case of the autoimmune diseases, immunological techniques are helpful since they allow the detection of multiple autoantibodies at the same time with small volumes of sample. Together with the development of the new techniques, sensitivity and specificity in the detection of the antibodies specificities’ also have been increased, in such a way that the clinicians can count with tests that allow them to make early diagnoses with greater certainty and also to follow the course of the disease based on the variation of the antibodies presents in the patient's samples. It is important to emphasize that the new techniques of laboratory that are used for the support of the diagnosis of autoimmune diseases, no longer are exclusive for research laboratories but by their facility of standardization, quality control and reproducibility they can be used in clinical laboratory of medium and small sizes. In the present paper we describe those techniques with greater application in the clinical laboratory of autoimmune diseases (AU)

Myth and reality: practical test system for the measurement of anti-DNA antibodies in the diagnosis of systemic lupus erythematosus (SLE).

The myth persists that only the labor intensive Farr radioimmunoassay and Crithidia luciliae immunofluorescence (CL-IFA) are systemic lupus erythematosus (SLE)-specific tests. We compared them to ELISA with bacteriophage lambda DNA (EL-dsDNA) and denatured calf thymus DNA (EL-ssDNA). By percentile ranking, the specificity cut-off level was set both out of clinical context (SOCC) on 100 blood bank donors, and in clinical context (SICC) on 100 patients with either rheumatoid arthritis or scleroderma (50/50). Clinical sensitivity was calculated on 100 random SLE patients. At 95% SICC, the sensitivity of Farr, CL-IFA, EL-dsDNA, and EL-ssDNA was similar (95%CI): 76% (66-84), 76% (66-84), 63% (53-72), and 75% (65-83), respectively; 87% of the patients were positive by at least one method and 55%by all methods. At 99% SICC, the sensitivity was also similar (95% CI): 57% (47-67), 47% (37-57), 58% (47-67), and 43% (33-53), respectively. The areas under ROC curve were similar (95% CI) when patients were used as controls for specificity. At 99% SOCC, EL-ssDNA identified 89% positive, 2 negative but positive by another method at 95% SICC, and 9 negative (i.e. 89/2/9), followed by CL-IFA (80/6/14), Farr (76/12/12), and EL-dsDNA (64/23/13). Thus, at relatively low cost and easy automation, under the same conditions of specificity, the two ELISA tests combined were at least as good, if not superior, to CL-IFA or Farr: they showed similar clinical sensitivity and also identified more patients with anti-DNA antibodies.

Infection with the trypanosome Crithidia bombi and expression of immune-related genes in the bumblebee Bombus terrestris.

Social bees and other insects are frequently parasitized by a large range of different microorganisms. Among these is Crithidia bombi (Kinetoplastida: Trypanosomatidae), a common gut parasite of bumblebees, Bombus spp. (Insecta: Apidae). Bumblebees are important pollinators in commercial and natural environments. There are clear detrimental effects of C. bombi infections on the fitness of bumblebees. However, little has been known about how the bee's immune system responds to infections with trypanosome parasites. Here, we study the immune response of Bombus terrestris on infection by C. bombi. We measured the expression of four immune-related genes (Hemomucin, MyD88, Relish, and TEP7) using RT-qPCR in adult B. terrestris workers that were either healthy or infected with the trypanosome parasite C. bombi. The potential recognition gene Hemomucin was significantly upregulated in the infected bees. Further, there was substantial and significant variation in all four genes among different bumblebee colonies irrespective of infection status.

Diagnosing systemic lupus erythematosus: new-generation immunoassays for measurement of anti-dsDNA antibodies are an effective alternative to the Farr technique and the Crithidia luciliae immunofluorescence test.

The aim of this study was to evaluate the diagnostic performance of four new enzyme immunoassays (EIAs) for anti-double-stranded-DNA (anti-dsDNA) antibodies, in comparison with the Farr assay and the Crithidia luciliae immunofluorescence test (CLIFT). To this purpose, sera from four patient groups were collected: 52 sera from patients with systemic lupus erythematosus (SLE); 28 from patients with other connective tissue diseases (CTD); 36 from patients with hepatitis C virus (HCV) infection; and 24 from those with acute viral infection. All sera were tested for anti-dsDNA antibodies by four EIA methods using a different antigenic DNA source [synthetic oligonucleotide (Method A), circular plasmid (Method B), recombinant (Method C), and purified extracted (Method D)], and by CLIFT and Farr assays. The diagnostic sensitivity of the assays was as follows: 84.6% (Method A), 73% (B), 82.7% (C), 84.6% (D), 55.8% (CLIFT), and 78.8% (Farr). Specificity was 82.9% (A), 97.7% (B), 96.5% (C), 94.3% (D), 96.5% (CLIFT), and 90.9% (Farr). From these data, we can conclude that the new-generation EIA methods evaluated in this study have higher sensitivity than the CLIFT and Farr assays and, with the exception of Method A, have specificity similar to the CLIFT and slightly higher than the Farr assay. These findings suggest that EIA tests may replace CLIFT as a screening test and the Farr assay as a specific test, for anti-dsDNA antibody detection.

High sensitive detection of double-stranded DNA autoantibodies by a modified Crithidia luciliae immunofluorescence test.

Anti-double-stranded (ds)DNA antibodies are serological markers of systemic lupus erythematosus (SLE). Of all anti-dsDNA antibody detection methods, the Crithidia luciliae immunofluorescence test (CLIFT) is thought to have the highest specificity for SLE. However, the clinical application is hampered by the low diagnostic sensitivity. A CLIFT with modified assay buffer (mCLIFT) was developed and compared with conventional CLIFT, using sera from 110 patients with SLE, 89 anti-dsDNA ELISA-positive patients with other diseases (non-SLE group A), 157 non-SLE patients with undetectable anti-dsDNA antibodies by ELISA (non-SLE group B), 77 disease controls (non-SLE group C), and 50 healthy blood donors. Out of the 110 anti-dsDNA antibody ELISA-positive SLE patients, 84 (76.4%) demonstrated a positive kinetoplast staining, using the mCLIFT, compared to only 42.3%, using the conventional CLIFT. The diagnostic specificity of mCLIFT was 100% with healthy blood donors and 98.1% with the non-SLE group C (anti-nuclear antibodies negative; no signs or symptoms of an autoimmune disease) included. In the non-SLE groups A and B with various other autoimmune diseases or symptoms of a possible autoimmune disease, positive mCLIFT results were obtained in 33.7% and 3.2%, respectively. In conclusion, by modification of the assay buffer, a significant increase in sensitivity of the CLIFT could be observed while retaining the high specificity for SLE. Further investigation is required to check whether the CLIFT-positive non-SLE patients develop SLE and whether anti-dsDNA antibodies detected by the mCLIFT represent a pathogenetic and diagnostic subgroup of autoantibodies that may improve the early diagnosis of SLE or SLE-overlap syndromes.

A distinct infection cost associated with trans-generational priming of antibacterial immunity in bumble-bees.

The adaptive value of facultative maternal adjustment of offspring immunity, or trans-generational immune-priming, will depend on the ecological background. In particular, where there is a mismatch between the immune adjustment and offspring environment, the immunological link between mothers and offspring may be disadvantageous owing to the presence of associated costs. Costs to an individual of responding to an immune challenge are extensively documented. However, in addition to parents, the relevant costs for trans-generational immune-priming also pertain to offspring, but as yet it is unknown what costs offspring will bear. In bumble-bees, higher antibacterial activity has been shown as a trans-generational effect when mothers receive a bacterial-based immune challenge prior to colony founding. Here we show that while naive offspring from immune-challenged mothers do not show evidence for a direct energy-related survival cost, they do show increased susceptibility to a parasite distinctly unrelated to the maternal challenge. The presence of costs associated with trans-generational immune-priming will shape the evolution of this trait depending on the ecological setting.

Anti-dsDNA antibodies in Brazilian patients of mainly African descent with systemic lupus erythematosus: lack of association with lupus nephritis.

Renal disease is associated with morbidity and mortality in systemic lupus erythematosus (SLE) and anti-dsDNA antibodies with SLE immunopathogenesis. We investigated the dsDNA antibody profile of 84 Brazilian SLE patients, 27 with lupus nephritis. Thirty-six (39.1%) patients had dsDNA IgG antibodies shown in enzyme-linked immunosorbent assay (454.7 +/- 281.1 WHO units/mL), nine presenting renal disease. The following profile of dsDNA antibodies was demonstrated in Crithidia luciliae test: IgA (seven out of 36; 19.4%), IgG (22 out of 36, 66.1%); IgM (nine out of 36, 25.0%), and IgE (four out of 36, 11.1%). Two or three isotypes of dsDNA antibodies were observed in nine (25.0%) patients, while 11 (30.5%) were seronegative in the C. luciliae test. Patients with dsDNA antibodies had lower serum C3 and C4 when compared with SLE individuals without these immunoglobulins (P < 0.01 and P < 0.001, respectively). There was no association between any dsDNA antibody isotype and lupus kidney disease nor was anti-dsDNA IgM antibody associated with absence of nephritis.

Crithidia deanei: influence of parasite gp63 homologue on the interaction of endosymbiont-harboring and aposymbiotic strains with Aedes aegypti midgut.

The present study demonstrates that the endosymbiont of Crithidia deanei influences the expression of surface gp63 molecules. Ultrastructural immunocytochemical analysis shows the presence of the gp63-like protein in the protozoan flagellum and flagellar pocket, either attached to shed membranes or in a free form. This molecule is glycosylphosphatidylinositol (GPI) anchored to the plasma membrane as demonstrated by phospholipase C (PLC) treatment and cross-reacting determinant detection by immunoblotting. The gp63 molecule mediates the adhesive process of the protozoan to Aedes aegypti explanted guts, since the binding was reduced by pre-incubating the C. deanei parasites (wild and aposymbiotic strains) with anti-gp63 antibodies, PLC or PLC followed by anti-gp63 antibodies incubation. In addition, the number of wild C. deanei bound to A. aegypti explanted guts was twice as that of aposymbiotic parasites. Flow cytometry assays revealed that the reactivity of the wild strain with anti-gp63 antibodies was approximately twice as that of the aposymbiotic strain. We may conclude that higher expression of surface gp63 by the wild strain of C. deanei may positively influence this interaction, posing a prominent advantage for the endosymbiont-containing trypanosomatids.