bromochloroacetic-acid and Rheumatic-Diseases

Peripheral blood cytology and acute phase reactants are used to distinguish between non-inflammatory and inflammatory rheumatic diseases, whereas chronic phase reactants and immunoglobulins can give guidance in distinguishing acute from chronic inflammatory conditions. The complicated path to a well-defined diagnosis of rheumatic disease involves autoimmune serology. This review puts special emphasis on the rational use of autoantibody results for diagnosis, prognosis, planning of follow-up, and estimating the need for therapy. A clinically important use of serodiagnostics can only be implemented by a close collaboration between clinicians and laboratory specialists. A tentative diagnosis is the best basis for ordering and interpreting laboratory results.

Topics: Antibodies, Antineutrophil Cytoplasmic; Antibodies, Antinuclear; Antibodies, Antiphospholipid; Autoantibodies; Autoimmune Diseases; Diagnosis, Differential; Follow-Up Studies; Humans; Immunologic Techniques; Keratins; Prognosis; Rheumatic Diseases; Rheumatoid Factor; Serologic Tests

Topics: Antibodies; Arthritis, Rheumatoid; Chronic Disease; Humans; Intermediate Filament Proteins; Keratins; Lupus Erythematosus, Systemic; Rheumatic Diseases; Scleroderma, Systemic; Sjogren's Syndrome; Spondylitis, Ankylosing; Vimentin

To analyse the prevalence and clinical significance of anti-cyclic citrullinated peptide antibodies (anti-CCP) and antikeratin antibodies (AKA) in patients with palindromic rheumatism (PR).. Sixty-three patients with PR were included: 33 were defined as pure or persistent PR at the time of serum test measurement, and 30 as associated PR, defined as patients with past history of PR who had developed persistent arthritis at the time of serum test: [21 with rheumatoid arthritis (RA)]. Sixty patients with early RA, and 80 with seronegative spondyloarthropathy were included as control groups. Anti-CCP were determined by a standardized ELISA test and AKA by indirect immunofluorescence in rat oesophagus. Clinical characteristics of these pure PR patients were compared according to the presence or absence of anti-CCP antibodies. A follow-up study was also performed.. Anti-CCP were detected in 18 out of 32 (56.3%) patients with pure PR and 10 out of 30 (33.3%) with associated PR (38.1% in RA-associated PR patients). AKA were detected in 12 patients out of 33, with pure PR (36.4%), and in 9 out of 30 with associated PR (30%) (33.3% in RA-associated PR patients). The prevalence of anti-CCP and AKA in the RA control group was 55% (not significantly different from the pure PR group) and 61.7% (with respect to pure PR patients, P=0.02), respectively. In the spondyloarthropathy group, the prevalence of anti-CCP and AKA was 2.5 and 3.8%, respectively (P<0.001 compared with pure PR patients). No significant clinical differences were observed between pure PR patients with and without CCP antibodies.. Anti-CCP and, to a lesser extent, AKA, were found in a high proportion of patients with PR, suggesting that this syndrome is an abortive form of RA. The predictive value of these antibodies in PR, as markers of progression to an established RA, remains uncertain.

Topics: Adult; Antibodies; Autoantibodies; Biomarkers; Chi-Square Distribution; Female; Humans; Keratins; Male; Middle Aged; Prevalence; Rheumatic Diseases; Statistics, Nonparametric

To assess the clinical value of several serological markers in Lithuanian patients with rheumatoid arthritis (RA) compared with control patients with rheumatic disease and age matched healthy controls.. Serum samples from 96 patients with RA of approximately 8 years' duration, 90 rheumatic disease controls, and 37 healthy subjects were tested. Antikeratin antibody (AKA), antineutrophil cytoplasmic antibody (ANCA), and antinuclear antibody (ANA) titres were estimated by indirect immunofluorescence (IIF) and serum samples positive for ANA and ANCA were further studied by enzyme linked immunosorbent assay (ELISA). IgA and IgM rheumatoid factors (RF) were measured by ELISA.. A positive AKA test was highly specific for RA (diagnostic specificity 97%), being found in 44% of the patients. Although both RF tests had a higher sensitivity, they were less specific for RA. ANCA was detected in 33% of patients with RA but lacked diagnostic specificity. AKA and ANCA were associated with more erosive disease and the presence of extra-articular manifestations. Positivity for AKA, IgA RF, and ANCA was significantly associated with disease activity and worse functional capacity. However, in multiple regression analysis only positivity for AKA was significantly correlated with functional disability (p=0.0001), evaluated by the Steinbrocker functional classification, and no single marker had any relation with radiological damage.. Although AKA showed the highest disease specificity, all serological markers studied except ANA exhibited interesting associations with important clinical and paraclinical parameters of RA.

Topics: Adult; Aged; Antibodies, Antineutrophil Cytoplasmic; Antibodies, Antinuclear; Arthritis, Rheumatoid; Autoantibodies; Biomarkers; Case-Control Studies; Enzyme-Linked Immunosorbent Assay; Female; Fluorescent Antibody Technique, Indirect; Humans; Immunoglobulin G; Immunoglobulin M; Keratins; Male; Middle Aged; Prevalence; Regression Analysis; Rheumatic Diseases; Rheumatoid Factor

We have used a panel of anti-cytokeratin antibodies and immunofluorescence microscopy to examine synovial tissue from a variety of large and small joints in patients with various rheumatic conditions, including RA, OA, AS, pigmented villonodular synovitis (PVNS) and tenosynovitis (TS). In every case we regularly found blood vessels with endothelia which express cytokeratin. Positive staining was obtained with a guinea pig anti-keratin antibody, with monoclonal antibody 8.13 and with a monoclonal antibody specific for keratin 18. Staining of endothelial cells was confirmed by double labelling with antibodies to cytokeratin and factor VIII/von Willebrand factor. We also detected a polypeptide corresponding to cytokeratin 18 (MW 45,000) by Western blotting of synovial tissue. In addition we have isolated pure populations of synovial endothelial cells in culture and demonstrate an extensive cytokeratin intermediate filament network which co-localizes with vimentin filaments. An understanding of the role of the cytokeratin 18 network in synovial endothelium may be important for our understanding of endothelial changes in synovial disease.

Topics: Cells, Cultured; Endothelium, Vascular; Humans; Keratins; Rheumatic Diseases; Synovial Membrane; Vimentin

Topics: Autoantibodies; Cell Nucleus; Cytoplasm; Humans; Keratinocytes; Keratins; Lupus Erythematosus, Systemic; Rheumatic Diseases; RNA Splicing

In order to study the relationships between the circulating IgG autoantibodies to epidermal cytokeratins (AECK), which were described in normal human sera as well as in sera from patients with various diseases, and the so-called 'antikeratin' IgG antibodies ('AKA'), which are highly specific for rheumatoid arthritis (RA), we simultaneously investigated AECK by a specific ELISA using cytokeratins from human stratum corneum (SC) and 'AKA' by semiquantitative indirect immunofluorescence assay on rat oesophagus epithelium, in a large series of 595 rheumatic sera including 229 RA. AECK were found to be present in all the 595 sera, with large inter-individual variations in titre. Whatever the titre chosen as threshold, the autoantibodies (auto-Ab) were never found to be specific for any rheumatic disease. Moreover, in RA, they were found to vary independently of IgM rheumatoid factor (IgM-RF), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), while they were found to vary in parallel with the total serum IgG concentration. In contrast, although 568 of the 595 rheumatic sera contained antibodies that labelled the rat oesophagus SC, the highest titre-like values were obtained with RA sera. At a convenient threshold, 95 (41.5%) of the 229 RA were detected while only three false positives (0.08%) remained among the 366 non-RA sera. Moreover, in RA, 'AKA' were found to be related to IgM-RF, ESR and CRP, while their titre was found to be independent of the total serum IgG concentration. Lastly, no statistical correlation was found between the antibodies, either in the whole sample of 595 sera or in any diagnostic group. In conclusion, the simultaneous investigation of AECK and 'AKA' showed that they differ from each other in all the aspects explored. AECK belong to the widely explored family of natural auto-Ab against cytoskeleton components and do not constitute a diagnostic marker while, on the other hand, 'AKA' confirmed their high diagnostic specificity for RA. It can also be asserted that, in spite of their name, 'AKA' do not recognize human epidermal cytokeratins, at least in the denatured form they present in ELISA. Therefore, they recognize either conformational epitope(s) appearing on cytokeratins during the late stages of the cornification process, or epitope(s) borne by rat cytokeratins but absent on human cytokeratins, or lastly a non-cytokeratin SC antigen.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antibody Specificity; Arthritis, Rheumatoid; Autoantibodies; Epithelium; Esophagus; Female; Humans; Immunity, Innate; Immunoglobulin G; Keratins; Male; Middle Aged; Rheumatic Diseases; Skin