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Biomedical subjects

M Tikly

Publications and source records attributed to M Tikly.

28 records · Page 2Linked to original sources

Cystic lung disease in systemic sclerosis: a case report with high resolution computed tomography findings.

A 31-year old black female presented with limited scleroderma. Although she had no chest symptoms, chest radiographs showed a basal reticular pattern with large cysts in both lung fields. High resolution computed tomography revealed almost complete effacement of normal lung architecture by multiple large cysts, honeycombing and interstitial fibrosis. Cystic lung disease is an uncommon manifestation of interstitial lung disease in systemic sclerosis, and its natural history needs to be better defined.

Adult↗

Interethnic differences in the association of tumor necrosis factor promoter polymorphisms with systemic lupus erythematosus.

OBJECTIVE: To assess the role of polymorphisms in the promoter region of the tumor necrosis factor-alpha (TNF-alpha) gene in susceptibility to systemic lupus erythematosus (SLE). METHODS: Two ethnically different populations of patients with SLE (49 white from the UK and 49 black from South Africa) were genotyped for TNF-238 and TNF-308 polymorphisms using amplification refractory mutation system-polymerase chain reaction (PCR). HLA-DR genotypes were assigned to the patients and controls either serologically or by PCR and sequence specific oligonucleotides. The frequencies of the respective variants were compared between patients and ethnically matched controls. RESULTS: No significant differences were found in the frequency of the TNF-238 variants in either ethnic group. At TNF-308, the TNF2 variant was significantly increased (p = 0.04) in white patients with SLE compared to controls. However, TNF2 was strongly associated with HLA-DR3 (p = 0.00002), which also showed a strong trend of increase in the white patients (p = 0.06). In contrast, in the black patients with SLE in whom DR2 but not DR3 was increased, the frequency of TNF2 was actually reduced rather than increased. CONCLUSIONS: The increase of TNF2 in Caucasians with SLE is most likely due to linkage disequilibrium between TNF2 and DR3. Furthermore, the observation that TNF2 seems to be reduced in blacks with SLE strongly suggests this polymorphism is not an independent risk factor for SLE. Overall, our data indicate that the TNF-238 and TNF-308 promoter polymorphisms do not confer susceptibility to SLE.

Base Sequence↗

HLA class II antigens associated with systemic lupus erythematosus in black South Africans.

OBJECTIVE: To assess the associations of HLA class II antigens with systemic lupus erythematosus (SLE) in black South Africans. METHODS: HLA-DRB1 genotype frequencies assigned by polymerase chain reaction (PCR) amplification and sequence specific oligonucleotide probes were compared between 49 black SLE patients from Baragwanath Hospital and 87 ethnically matched controls. HLA-DQA1 and -DQB1 genotypes were also assigned in 45 of the SLE patients and 74 controls by PCR using sequence specific primers. RESULTS: HLA-DRB1*02 was increased in the patients compared with controls (odds ratio = 3.67; 95% confidence interval = 1.49 to 9.02; p < 0.005). HLA-DQB1*0201 was not associated with development of the disease itself, but was associated with the presence of Ro antibodies (p = 0.01). HLA-DRB1*03 was less strongly linked to DQB1*02 in this population than in white populations and was not associated with SLE. CONCLUSIONS: In black South Africans there is evidence for a locus on DR2 haplotypes contributing to SLE. Another gene, possibly HLA-DQB1*02, not linked to DR2 is involved in the subset of patients exhibiting Ro antibodies.

Adolescent↗

Interleukin 1 beta, hand and foot bone mineral content and the development of joint erosions in rheumatoid arthritis.

OBJECTIVE: To assess the relationship between plasma levels of the cytokine interleukin-1 beta (IL-1 beta) and the progression of rheumatoid arthritis (RA). METHODS: Two subgroups of patients, one with persistently raised ESR (>/= 50 mm/hour, n = 16, group A) and one with persistently low ESR (</= 28 mm/hour), n = 18, group I) were chosen to represent stable extremes of inflammatory activity from a prospective study of 106 patients with active RA studied over one year in a single centre. The change from baseline in hand, foot and calcaneal bone mineral content measured by single photon absorptiometry and radiographic score of joint damage was measured over 12 months, together with plasma IL-1 beta and erythrocyte sedimentation rate. RESULTS: Significant progression of joint damage occurred in both subgroups over one year (p < 0.0001, paired t test) though progression was significantly less in the subgroup with low ESR (p < 0.05, ANOVA). Hand and foot bone mineral content decreased by almost 10% in the subgroup with raised ESR (p < 0.005, paired t test). Stepwise linear regression analysis revealed significant independent relationships between radiographic progression over one year and plasma IL-1 beta and ESR (multiple R 0.674, F = 11.64, p < 0.0002). No such relationships were observed for changes in bone mineral content parameters. CONCLUSIONS: Plasma IL-1 beta levels correlate weakly with progression of joint damage though not with loss of peripheral bone density in RA. A significant reduction in peripheral bone mineral content occurs over one year in patients with active RA with persistently raised ESR.

Adult↗

Infective endocarditis, rheumatoid factor, and anticardiolipin antibodies.

Serum samples from 22 patients with infective endocarditis were analysed for the presence of antibodies to cardiolipin, false positive Venereal Disease Research Laboratory (VDRL) test, and rheumatoid factor in order to determine the prevalence of anticardiolipin antibodies, their level, and to ascertain whether there was any correlation with the presence of rheumatoid factor. Although the latex test was positive in 10/22 (45%) patients, anticardiolipin antibodies, usually of a low level, were raised in only four (18%), and the VDRL test was positive in two patients in whom other antibodies were negative. These results show a clear discordance between these three tests, indicating that B cell production of these antibodies is separate and distinct. As with other infections which result in anticardiolipin antibody production, no thrombotic events were encountered.

Autoantibodies↗

Photosensitivity and anti-Ro (SS-A) antibodies in black patients with systemic lupus erythematosus (SLE).

Ninety-two patients with SLE, 36 black and 56 white, were studied prospectively for photosensitivity and anti-Ro (SS-A) and anti-La (SS-B) antibodies. Photosensitivity was found in 19% of black patients, compared to 71% of white patients (p = 0.001). Anti-Ro antibodies were found in 69% of black and 54% of white patients (p = 0.013). Photosensitivity was present in 87% of Ro-positive white patients and in 54% of Ro-negative white patients (p = 0.007). However, in black patients with SLE there was a strong negative association: 4% of Ro-positive patients were photosensitive while 55% of Ro-negatives were photosensitive (p = 0.001). This suggests that black SLE patients may possess a factor which 'blocks' photosensitivity, perhaps by preventing local tissue damage caused by the interaction of Ro antibodies and ultraviolet light.

Antibodies, Antinuclear↗

Normal haematological reference values in the adult black population of the Witwatersrand.

Normal haematological reference values for healthy adult blacks residing on the Witwatersrand are given. The haemoglobin concentration was 13.95 +/- 0.8 g/dl for women and 15.82 +/- 1.05 g/dl for men. Leucocyte counts were lower than those found in whites, being 5.60 +/- 1.51 X 10(9)/l for both sexes. Platelet counts were 280 +/- 59.4 X 10(9)/l for men and 317 +/- 64.0 X 10(9)/l for women. The differential counts and other parameters are given in the text.

Adult↗

Prevalence and clinical correlates of anti-phospholipid antibodies in South Africans with systemic lupus erythematosus.

OBJECTIVE: To determine the prevalence and clinical correlates of anti-phospholipid antibodies (aPL), including anti-cardiolipin antibodies (aCL), lupus anti-coagulant (LA), anti-beta2-glycoprotein 1 (abeta2GP1), and anti-prothrombin (aPT) antibodies, in Black South African patients with systemic lupus erythematosus (SLE). METHODS: A cross-sectional study of 100 SLE patients in whom clinical characteristics, including features of the anti-phospholipid syndrome (APS), disease activity, and damage were documented, and sera tested for aCL, abeta2GP, and aPT of all isotypes, and LA. RESULTS: Positive aCL, abeta2GPI, aPT, and LA were found in 53, 84, 20, and 2 patients, respectively. Immunoglobulin (Ig)A aCL and IgG abeta2GPI were the commonest aCL (49.1%) and abeta2GPI (47%) isotypes, respectively. IgA abeta2GPI were associated with both a history of thrombosis alone (p<0.05) and a history of any clinical feature, thrombosis, and/or spontaneous abortion of the APS (p<0.05); IgA aCL were associated with a history of any clinical APS event (p<0.05); and abeta2GPI of any isotype were associated with a history of arthritis (p<0.001). CONCLUSION: Our findings provide further evidence that screening for abeta2GPI and IgA aCL isotypes may improve the risk assessment for APS in SLE patients of African extraction. Further prospective studies are warranted to determine the clinical utility of these tests and to elucidate the genetic basis for the increased IgA aPL response in SLE patients of African extraction.

Antibodies, Antinuclear↗