Obstructive Sleep Apnea (OSA) is a sleep-related breathing disorder associated with the development of cardiovascular diseases and atherosclerosis. Systemic inflammation plays an important role in the development of cardiovascular complications in OSA patients. The aim of the study was to evaluate the relationship between carotid intima-media thickness (cIMT) and inflammatory markers plasma levels in OSA patients. We enrolled 80 OSA patients and 40 controls matched for age and body mass index (BMI). The presence and severity of sleep apnea was determined by in-laboratory portable monitoring (PM). Demographic data, blood pressure, heart rate, and cIMT were measured. High-sensitive C-Reactive Protein (hsCRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α and pentraxin (PTX)-3 serum concentrations were detected. cIMT was higher in OSA patients than controls (0.89 ± 0.13 mm vs. 0.65 ± 0.1 mm, p < 0.01). Moderate-severe OSA OPEN ACCESSMolecules 2014, 19 1652 patients (0.95 ± 0.09 mm) had significantly increased cIMT than mild OSA (0.76 ± 0.1 mm; p < 0.01) and control (0.65 ± 0.1 mm; p < 0.01). hsCRP, IL-6, TNF-α, and PTX-3 in patients with OSA (1.67 ± 0.66 mg/L, 2.86 ± 1.39 pg/mL, 20.09 ± 5.39 pg/mL, 2.1 ± 0.59 ng/mL, respectively) were significantly higher than in controls (1.08 ± 0.53 mg/L, p < 0.01; 1.5 ± 0.67 pg/mL, p < 0.01; 12.53 ± 3.48 pg/mL, p < 0.01; 1.45 ± 0.41 ng/mL, p < 0.01, respectively). Carotid IMT was significantly correlated to CRP (r = 0.44; p < 0.01), IL-6 (r = 0.42; p < 0.01), TNF-α (r = 0.53; p < 0.01), and PTX-3 (r = 0.49; p < 0.01). OSA patients showed increased cIMT, CRP, IL-6, TNF-α, and PTX-3 levels. Inflammatory markers levels are correlated to cIMT in OSA patients.

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Background: Autoimmune blistering skin diseases are a heterogeneous group of diseases characterized by autoantibodies against structural components of the skin. In pemphigus vulgaris (PV) autoantibodies react mainly with desmoglein 3 (Dsg3) alone and/or in combination with desmoglein 1 (Dsg1). In bullous pemphigoid (BP) autoantibodies target two hemidesmosomal proteins, BP180 and BP230. Objective: To evaluate the diagnostic accuracy of a new indirect immunofluorescence (IIF) multiplex biochip method for the detection of anti-skin specific autoantibodies. Methods: Sera from 36 patients with PV and from 40 patients with BP were collected. The control group included 54 patients with other skin diseases and 40 healthy subjects. The detection of circulating autoantibodies to Dsg1, Dsg3, BP230 and BP180 was performed with a new IIF multiplex biochip method and with two currently commercially available ELISA methods. Results: The multiplex IIF method showed a high diagnostic sensitivity (100%) for PV on cells transfected with Dsg3. In patients with BP, the positivity to the BP180 antigen was higher (90%) than that on monkey esophagus (50%) and on cells transfected with BP230 (40%). A good rate of agreement was observed among methods (IIF vs. ELISA) and among ELISA systems. Conclusions: The new multiplex biochip IIF method has a high diagnostic accuracy for the diagnosis of PV and BP, comparable to ELISA methods, and is able to screen autoimmune bullous diseases.

The diagnosis of bullous pemphigoid is based on clinical observations and on the presence of autoantibodies directed against proteins of the dermoepidermal junction. Human recombinant BP180 and BP230 peptides have been used to develop new quantitative enzyme immunoassays (EIA) for the detection of specific antibodies. This study evaluated the sensitivity and specificity of a new immunoassay for the detection of BP230 autoantibodies and clinical correlations. Serum samples were tested from patients with bullous pemphigoid, other skin diseases, and from healthy donors. Autoantibodies anti-BP230 and anti-BP180 were assayed using the EIA method. Diagnostic specificity for both tests was over 98%; diagnostic sensitivity was 90% and 60% for anti-BP180 and anti-BP230, respectively. IgG anti-BP180 titers exhibited a significant correlation with disease activity. No patient in remission was positive for anti-BP230. In conclusion, anti-BP180 and anti-BP230 assays are useful in the diagnosis of bullous pemphigoid and provide information on disease activity.

The aim of this work was to evaluate the diagnostic accuracy of three different analytical methods for the detection of antineuronal antibodies and outline how they might be used to diagnose Paraneoplastic Neurological Syndromes (PNS) in a more effectively and rationally way. One hundred and four patients with neurological diseases were studied: 38 with paraneoplastic neurological disorder, 44 with other neurological diseases, and 22 with systemic autoimmune diseases and neurological disorders. 20 healthy subjects and 18 subjects with tumour without neurological disorders were also studied. Antineuronal antibodies were tested using three methods: Western blot (WB); Line-blot (LB); and indirect immunofluorescence (IIF) on primate cerebellum. The diagnostic sensitivity of the IIF, WB and LB methods was 28.9%, 26.3% and 36.8%, respectively, and their specificity was 95.2%, 97.1% and 98.1% respectively. The combined use of the three methods brought the sensitivity to 39.4%. The results of this study show that the methods used in clinical laboratories for the detection of antineuronal antibodies have good specificity. Among the three methods assessed, LB showed the highest diagnostic accuracy and also allowed for recognition of fine antibody specificities. According to these results we can suggest that LB should be used as the method of choice to search for paraneoplastic antibodies.

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Context.—Because of a marked increase in the number of requests for antinuclear antibodies, anti–extractable nuclear antigen antibodies, and anti–double-stranded DNA antibodies for the diagnosis of autoimmune rheumatic disease, guidelines have been proposed for their appropriate use. Objective.—To evaluate in terms of clinical efficacy and cost-benefit ratio the outcome of applying a protocol for the diagnosis of autoimmune rheumatic disease. Design.—A diagnostic protocol for the rational utilization of second-level tests (anti–extractable nuclear antigen antibodies and anti–double-stranded DNA antibodies) was applied at Hospital Polyclinic beginning January 2004. The appropriateness of 685 consecutive requests received at the clinical pathology laboratory from January to June 2004 was assessed. Patients who underwent these laboratory tests were followed up for 12 months after blood sample drawing. Results.—Introduction of the protocol led to a significant reduction in the number of second-level tests prescribed (27.9% vs 49.5% for anti–extractable nuclear antigen antibodies; 27.5% vs 56.6% for anti–double-stranded DNA antibodies). After the period of observation, none of the 163 patients who had negative results on the first-level test and were asymptomatic, for whom second-level tests had not therefore been performed, were found to have autoimmune rheumatic disease. In 90.5% (77/85) of patients positive for the second-level tests, clinical confirmation of autoimmune rheumatic disease was obtained. Conclusions.—Not only did application of the diagnostic protocol reduce the number of second-level tests performed but it also increased their specificity. Our data thus indicate that the use of shared guidelines by clinical and laboratory specialists yields satisfactory results.

sono stati sviluppati metodi immunoenzimatici che utilizzano peptidi umani ricombinanti e ricercano autoanticorpi specifici di malattia. In questo studio abbiamo valutato se esiste un'associazione tra i livelli di autoanticorpi anti-BP180 e anti-BP230 e l'attività di malattia e la remissione clinica in pazienti affetti da PB. Metodi. Da gennaio 2008 a gennaio 2010 sono stati arruolati 52 pazienti affetti da PB, 25 dei quali hanno avuto un follow-up di 12 mesi. Gli autoanticorpi anti-BP180 e anti-BP230 sono stati ricercati con metodo immunoenzimatico nel campione basale e nel follow-up. Risultati. Al momento dell'arruolamento 43 pazienti erano positivi agli autoanticorpi anti-BP180 (83%) e 19 pazienti agli autoanticorpi anti-BP230 (36%). Complessivamente, 44/52 pazienti (85%) erano positivi ad almeno un autoanticorpo. In un modello di regressione multipla, il dosaggio degli autoanticorpi anti-BP180 ha mostrato la più forte associazione con l'attività di malattia. La positività agli autoanticorpi anti-BP230 ha invece riportato il più alto valore di Odds Ratio nel predire la mancata remissione di malattia. Conclusioni. Gli autoanticorpi anti-BP180 e anti-BP230 non sono marcatori predittivi equivalenti di severità di malattia e remissione clinica, pertanto l'utilizzo di entrambi sembra giustificato non solo nella fase diagnostica, ma anche nel follow-up clinico dei pazienti affetti da PB.Parole chiave Pemfigoide bolloso · Autoanticorpi anti-BP180 · Autoanticorpi anti-BP230 · Marcatori predittivi · Severità di malattia Riassunto Premesse. La diagnosi di pemfigoide bolloso (PB) si basa sulla presenza di criteri clinici e di laboratorio che comprendono la ricerca di autoanticorpi diretti contro proteine della giunzione dermo-epidermica. Recentemente