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T Kveder

Publications and source records attributed to T Kveder.

At least 19 recordsLinked to original sources

Serum amyloid A in autoimmune thrombosis.

The objectives of this study were (1) to determine how levels of serum amyloid A (SAA), high sensitivity C-reactive protein (CRP) and interleukin-6 (IL-6) correlate to autoimmune diseases in patients with or without thrombosis, and (2) to discuss the parameters that influence the relative SAA values. SAA, CRP and IL-6 concentrations were determined by enzyme linked immunosorbent assay (ELISA). 84 patients with secondary antiphospholipid syndrome (SAPS), primary antiphospholipid syndrome (PAPS), systemic lupus erythematosus with antiphospholipid antibodies (SLE+aPL), SLE, venous thrombosis (VT), arterial thrombosis (AT) were compared to healthy donors (n=60). The percentages of patients above cut-off were highest in the SAPS, SLE and SLE+aPL groups. Significant differences were observed between healthy donors and inflammatory groups of patients (SAPS and SLE+aPL) in all three measured parameters. SAA and CRP were shown to be correlated to a greater extent in SAPS patients than SLE+aPL patients. In summary, this cross-sectional, retrospective, small study and accompanying clinical considerations limit the ability to make definite conclusions. SAA would not serve as a useful marker for venous, arterial thrombosis or PAPS (pro-coagulant events). It could however, be a good predictor of progression from a non-inflammatory thrombotic condition to an inflammatory one.

Amyloid↗

Changes in avidity and specificity of IgG during electro-oxidation. Relevance of binding of antibodies to beta2-GPI.

The immune response may be changed due to altered proteins or modifications of immunoglobulins, including oxidative processes. The susceptibility to oxidative modifications depends greatly on amino-acid moiety composition due to chemical characteristics (instability) of their side-chains. Initial steps of oxidation may change the specificity and avidity of immunoglobulins due to chemical alteration of the hypervariable region. The oxidation of antibodies increases the hydrophilic nature of the paratopes and makes them more susceptible for the binding to cationic surfaces even without the strong surface-to-surface fitting. The electro-oxidation of IgG significantly changes the immunoreactivity and specificity of IgG fractions, regardless of the initial immunoreactivity to a specific autoantigen also in healthy persons. Data are presented on changes in the immunoreactivity as well as the avidity of antibodies against beta2-glycoprotein I after being exposed to direct current. ELISA measurements showed increased reactivity of anti-beta2-glycoprotein I antibodies at the beginning and various, fluctuating results after prolonged exposure to electro-oxidation. Inter-individual differences in chemical stability of immunoglobulins and patient's antioxidative status may influence the range of their alterations and their impact on health/disease balance.

Antibody Affinity↗

Ultrasonographic changes of major salivary glands in primary Sjogren's syndrome. Diagnostic value of a novel scoring system.

OBJECTIVES: To reveal typical ultrasonographic (US) changes in major salivary glands associated with Sjogren's syndrome (SS) and to determine the diagnostic value of a novel US scoring system. METHODS: In 218 consecutive patients with suspected SS, US of both parotid and submandibular salivary glands was performed besides the regular diagnostic procedure following the American-European Consensus Group criteria of 2002. Five US parameters were assessed: echogenicity, inhomogeneity, number of hypoechogenic areas, the hyperechogenic reflections and clearness of the borders of the salivary gland. The grades of these five parameters for all four salivary glands were summed. The final US score ranged from 0 to 48. RESULTS: SS was established in 68 patients. The remaining 150 subjects, in whom SS was not confirmed, constituted our control group. All five US parameters were significantly associated with SS. The patients with SS had significantly higher US scores than those not diagnosed with SS (P<0.01). Setting the cut-off US score at 17 resulted in the best ratio of specificity (98.7%) to sensitivity (58.8%). CONCLUSIONS: Well-defined US changes in the major salivary glands summarized in our novel scoring system were typical of SS patients. Advanced structural changes found on US imaging almost invariably represent SS salivary gland involvement.

Adult↗

Avidity of anti-beta-2-glycoprotein I antibodies.

The terms affinity and avidity are often used indiscriminately, despite clearly differing. Since affinity refers to monovalent binding of antibodies to a monovalent epitope, the majority of data on the binding of anti-beta2-glycoprotein I antibodies (anti-beta2-GPI) characterized their avidity rather than affinity. Anti-beta2-GPI were generally believed to be of low avidity, but heterogeneous avidity of patients' IgG anti-beta2-GPI has been demonstrated. High avidity anti-beta2-GPI monoclonals were reported to possess higher pathogenicity than low avidity anti-beta2-GPI. Polyclonal high avidity anti-beta2-GPI were found to be more common in patients with antiphospholipid syndrome (APS) and associated with thrombosis. Some conformational changes of beta2-GPI are required for the binding of polyclonal anti-beta2-GPI to the antigen: neither high density of the antigen nor high avidity of the anti-beta2-GPI alone is sufficient for the recognition. Avidity of anti-beta2-GPI should be considered in any attempt of inter-laboratory standardisation and/or evaluation of anti-beta2-GPI enzyme-linked immunosorbent assay (ELISA).

Animals↗

Anti-phospholipid antibodies following vaccination with recombinant hepatitis B vaccine.

This study was undertaken to evaluate the possible role of hepatitis B recombinant vaccine inducing the synthesis of IgG and IgM anti-cardiolipin antibodies (aCL), antibodies against beta(2)GPI (anti-beta(2)GPI), lupus anti-coagulant (LA), anti-nuclear antibodies and antibodies against extractable nuclear antigens (anti-ENA). The study population consisted of 85 healthy students (63 female, 22 male; mean age 20.8 years), vaccinated with three doses of recombinant DNA hepatitis B vaccine. One month after vaccination with the first dose of hepatitis B vaccine a minority of vaccinated individuals showed changes in IgG or IgM aCL or anti-beta(2)GPI or LA activity (P < 0.001). Among subjects in whom changes of IgG anti-beta(2)GPI were observed, a significantly higher number of increased (8/85) than decreased (2/85) values were found (P < 0.01). Analyses of paired data showed that differences in aCL or anti-beta(2)GPI levels before vaccination or 1 month later did not reach statistical significance. In two people aCL transitorily reached medium positivity after the first dose of hepatitis B vaccine with a drop 5 months later. Similar evident anti-beta(2)GPI fluctuation was also observed in one person. Another participant was initially low positive for IgG anti-beta2GPI and the levels were increasing after vaccination. Two participants became positive for anti-nuclear antibodies during 6 months' follow-up. There were no sex-dependent differences in tested antibodies observed and no associations between levels of aPL and levels of anti-HBV antibodies. We conclude that HBV can induce aPL, although rarely. In genetically susceptible individuals or together with some other triggers such combination might confer the risk of developing a continuous autoimmune response in an individual.

Adult↗

Avidity of anti-beta2-glycoprotein I and thrombosis or pregnancy loss in patients with antiphospholipid syndrome.

We aimed to evaluate avidity of anti-beta(2)-glycoprotein I antibodies (anti-beta(2)-GPIs) in patients with antiphospholipid syndrome (APS) at the time of acute thrombotic events or pregnancy loss as compared with clinical event-free periods. To do so, 69 sera samples from 16 patients (6 with primary APS and 10 with APS secondary to systemic lupus erythematosus ) were selected on the basis of anti-beta(2)-GPI positivity. Avidity of IgG anti-beta(2)-GPIs was determined by chaotropic enzyme-linked immunosorbent assay (ELISA), using increased NaCl concentration during antibody binding. High, heterogeneous, and low-avidity anti-beta(2)-GPIs were measured in APS patients, with no clear pattern regarding the time of thrombotic events or pregnancy failure. In general, anti-beta(2)-GPI avidity did not change substantially during disease course. We concluded that avidity of anti-beta(2)-GPIs appears to be a rather stable parameter in an individual APS patient. Considering the previously shown association of high-avidity anti-beta(2)-GPIs with venous thrombosis, avidity of anti-beta(2)-GPIs may be a better predictor of predisposition to thrombosis and unsuccessful pregnancy than levels of antiphospholipid antibodies, which may fluctuate over time owing to several factors.

Abortion, Spontaneous↗

Binding of high-avidity anti-beta2-glycoprotein I antibodies.

OBJECTIVES: We studied the influence of different binding conditions on the interaction between high- or low-avidity IgG anti-beta2-glycoprotein I antibodies (anti-beta2-GPI) and beta2-GPI, which was either free in solution or bound to microtitre plates or nitrocellulose membranes. METHODS: Sera from 30 patients with antiphospholipid syndrome and/or systemic lupus erythematosus were selected on the basis of anti-beta2-GPI positivity. Avidity of IgG anti-beta2-GPI was determined by chaotropic ELISA, using increased NaCl concentration during the antibody binding. Immunodetection on nitrocellulose membrane followed reducing or non-reducing sodium dodecyl sulphate-polyacrylamide gel electrophoresis (PAGE) of beta2-GPI. In converted, non-reducing PAGE, the preparation with high-affinity Fab fragments (obtained by papain digestion) was subjected to electrophoresis, while purified beta2-GPI was used as the sample in immunodetection. RESULTS: Anti-beta2-GPI antibodies of high, low or heterogeneous (low and high) avidity were found in 5/30, 9/30 and 16/30 sera, respectively. The density of beta2-GPI, which was 20-30 times higher on the nitrocellulose membrane than on the surface of ELISA plates, was not sufficient for the recognition of the antigen by anti-beta2-GPI: 2/5 high-avidity samples reacted only with non-reduced beta2-GPI, 3/9 low-avidity samples recognized only denatured and reduced beta2-GPI, and 1/16 samples with heterogeneous-avidity antibodies reacted with reduced and non-reduced beta2-GPI. CONCLUSIONS: Our results suggest that neither high density of the antigen nor high avidity of the antibodies (or Fab fragments) alone was sufficient for the binding of anti-beta2-GPI to beta2-GPI. Some conformational modifications and, consequently, exposed neo-epitopes are required for the recognition of beta2-GPI by polyclonal anti-beta2-GPI antibodies.

Antibody Affinity↗

Incidence of primary Sjogren's syndrome in Slovenia.

OBJECTIVE: To determine the annual incidence of primary Sjögren's syndrome (pSS) in Slovenia. METHODS: All patients admitted to our department of rheumatology or referred to our outpatient clinic between 1 January 2000 and 31 December 2002 owing to sicca symptoms or because of a suspicion of SS were examined. Our rheumatological department is the only tertiary referral centre for the Ljubljana region, which has a population of 599 895 Caucasian people. All patients were evaluated by the validated European criteria for SS. The exact 95% confidence interval (CI) based on binomial distribution was created for the incidence estimate. RESULTS: 248 patients were examined; 71 of them (28.6%; 65 women, 6 men) were diagnosed as having pSS. Their mean (SD) age was 51.3 (14.5) years (range 19-78). The average annual incidence for pSS in our study population was calculated as 3.9 cases per 100 000 inhabitants (95% CI 1.1 to 10.2). CONCLUSION: The estimated annual incidence of pSS in Slovenia is 3.9/100 000.

Adult↗

High avidity anti-beta 2-glycoprotein I antibodies in patients with antiphospholipid syndrome.

OBJECTIVE: To evaluate avidity of IgG anti-beta 2-glycoprotein I antibodies (anti-beta2-GPI) in patients with antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) in relation to thrombosis, and to demonstrate a possible affinity maturation of IgG anti-beta 2-GPI during the disease course. METHODS: 64 sera from 32 patients (18 with primary or secondary APS, 14 with SLE without APS) and their respective IgG fractions or affinity purified anti-beta 2-GPI were studied by anticardiolipin (aCL) and anti-beta 2-GPI enzyme linked immunosorbent assay and by chaotropic assay. RESULTS: Six, 12, and 14 patients had high, low, and heterogeneous avidity IgG anti-beta 2-GPI, respectively. In 12 patients an increase in antibody avidity was observed over a period of between four and 12 years. More patients with APS were in the high avidity than in the low avidity anti-beta 2-GPI group, while the opposite was observed for SLE alone (both p<0.05). The most common clinical feature among patients with high avidity anti-beta 2-GPI was thrombosis, mainly venous thrombosis (p<0.05 and p<0.02, respectively, v the low avidity anti-beta 2-GPI group). CONCLUSIONS: Patients with APS with or without SLE may have anti-beta2-GPI of high, low, or heterogeneous avidity. High avidity anti-beta 2-GPI appear to be associated with thrombosis and APS, while in pure SLE low avidity anti-beta 2-GPI may prevail. Monitoring of avidity may help elucidate the role of anti-beta 2-GPI affinity maturation in the pathogenesis of APS.

Adult↗

The contribution of HLA-DQB1 coding and QBP promoter alleles to anti-Ro alone autoantibody response in systemic lupus erythematosus.

OBJECTIVE: To analyse the influence of HLA-DR, DQ and corresponding DQA1 and DQB1 promoter alleles (QAP and QBP) on the anti-Ro alone autoantibody response in systemic lupus erythematosus (SLE). METHODS: Sixty-five unrelated anti-La antibody-negative SLE patients, 37 of them with and 28 without anti-Ro antibodies, were included. Anti-Ro antibodies were determined by both counter-immunoelectrophoresis and enzyme-linked immunosorbent assay. Seventy-four healthy individuals were selected as controls. The patients and controls were analysed for HLA-DRB1, QAP, DQA1, QBP and DQB1 alleles by DNA typing. The allelic frequencies of anti-Ro alone-positive and anti-Ro-negative SLE patients and healthy controls were compared using the chi(2) test or Fisher's exact test as appropriate. RESULTS: The DQB1*0202 allele showed a significant positive correlation with anti-Ro alone antibodies [odds ratio (OR)=16.949, P=0.0015, corrected P=0.018], while the QBP5.11 allele and the combination of DQB1*0301 and its promoter QBP3.1 were under-represented in anti-Ro-alone-positive SLE patients (P=0.01, corrected P=0.048 and corrected P=0.048 respectively). CONCLUSIONS: The above-mentioned alleles may contribute to the presence or absence of anti-Ro alone autoantibodies in SLE patients.

Adult↗

Anticardiolipin and anti-beta(2) glycoprotein I antibodies in sera of 61 apparently healthy children at regular preventive visits.

OBJECTIVES: To determine anticardiolipin (aCL) and anti-beta(2) glycoprotein I antibodies (anti-beta(2)GPI) in apparently healthy children and express the cut-off levels in concentrations of monoclonal antibodies, and to compare the mean values and frequencies of aCL and anti-beta(2)GPI in children with those in blood donors. METHODS: Blood samples were collected from 29 preschool children and 32 adolescents during their routine preventive follow-up visits. The control group consisted of 52 blood donors. aCL and anti-beta(2)GPI were assayed by an ELISA method. Two monoclonal beta(2)GPI-dependent aCL (HCAL and EY2C9) were used as calibrators. RESULTS: The estimated cut-off values for immunoglobulin G (IgG) and immunoglobulin M (IgM) aCL, expressed in concentrations of monoclonal antibodies and standardized international units (GPL/MPL units), were 13.9 ng/ml (7.6 GPL) and 33.1 ng/ml (3.3 MPL) for preschool children, 13.5 ng/ml (7.2 GPL) and 36.9 ng/ml (4.0 MPL) for adolescents, and 14.4 ng/ml (8.0 GPL) and 42.6 ng/ml (5.1 MPL) for blood donors. No statistically significant differences in the mean values for IgG and IgM aCL were found between the age groups. The mean value of IgA aCL was significantly higher in blood donors than in preschool children and adolescents (P<0.037 and P<0.025 respectively). Seven (11.4%) of 61 apparently healthy children had low positive values for aCL (IgG for all seven). The estimated cut-off values for IgG and IgM anti-beta(2)GPI were 4.2 and 13.1 ng/ml respectively for preschool children, 3.2 and 13.1 ng/ml for adolescents, and 2.9 and 20.5 ng/ml for blood donors. The mean value for IgG anti-beta(2)GPI was found to be higher in preschool children than in adolescents and blood donors (P<0.0001 and P<0.0001). The mean values for IgM and IgA anti-beta(2)GPI were higher in blood donors than in preschool children (IgM, P<0.007; IgA, P<0.0001) and adolescents (IgM, P<0.01; IgA, P<0.0001). Four (6.6%) of 61 apparently healthy children had positive values for anti-beta(2)GPI (two for IgG and two for IgA). CONCLUSIONS: This is the first report in which the cut-off values for aCL and anti-beta(2)GPI in children are expressed in concentrations of monoclonal antibodies. Low titres of aCL, which were identified frequently in apparently healthy children, were hypothesized to be the result of previous infections. The high mean value of IgG anti-beta(2)GPI observed in preschool children was an unexpected result of the study and might indicate a default response to nutritional exposure to beta(2)GPI in this age group.

Adolescent↗

Immunoserological aspects of idiopathic inflammatory muscle disease.

In the present study, the autoantibody profile of 31 Slovenian patients with idiopathic inflammatory muscle disease was estimated: 11 with polymyositis, 11 with dermatomyositis--both groups diagnosed according to the criteria of Bohan and Peter--and 9 with myositis-overlap syndromes. Autoantibodies against most relevant muscle specific (Jo-1, Mi-2) and non-specific antigens (PM-Scl, U1RNP, native Ro, Ro60, Ro52, and La) were detected with one or more detection techniques: counter-immunoelectrophoresis, enzyme-linked immunoassay, immunoblot and immunoprecipitation, each using different antigen preparations (native, recombinant). With counter-immunoelectrophoresis using a native antigen substrate (rabbit thymus extract), we were able to detect anti-PM-Scl antibodies more readily than with other techniques, probably due to conformational epitopes of native PM-Scl. Patients with this serological profile constituted a distinct group, sharing features of polymyositis and systemic sclerosis. Compared to previously reported data, the greater frequency of anti-Jo-1 found in all groups of patients (64-87% for PM, 18-20% for dermatomyositis and 33-44% for overlap syndromes) was probably due to the various methods used and the different clinical characteristics of patients. The greater prevalence of anti-Mi-2 antibodies in dermatomyositis patients (67%) and in particular in polymyositis patients (33%) and myositis-overlap syndromes (33%) seemed to be mainly due to methodological differences. A strikingly high prevalence of anti-Ro52 positive patients with polymyositis (55%), dermatomyositis (22%), and myositis-overlap syndromes (33%) was demonstrated, but was detected by only one technique. Moreover, concurrence with anti-Jo-1 antibodies was noted (69%).

Autoantibodies↗