Anti-nuclear antibody detection in cryoprecipitates: Distinctive patterns in hepatitis C virus-infected patients

Basile, Umberto; Gulli, Francesca; Torti, Eleonora; Matthaeis, Nicoletta De; Colacicco, Luigi; Cattani, Paola; Rapaccini, Gian Lodovico

doi:10.1016/j.dld.2014.09.010

Cited by 10 publications

(23 citation statements)

References 40 publications

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“…However, Pieter Vermeersch et al concluded that the observation of a rare ANA pattern could be helpful for the diagnosis of specific ADs, but the clinical significance is low when found as part of a routine clinical investigation (27), and may be considered as not important. It is important to remember that there are some non-autoimmune causes of rare ANA patterns on IIF, which include carcinoma, hepatitis C infection, and transplantation (28)(29)(30). In the present study, out of 15 cases of malignancies, 2 cases were positive for common antibody SSA-Ro60, and rare antibody SRP-54 (1), CENP-A/B (1), sp-100(1) and F-actin (3) were found.…”

Section: Comparison Of Results Of Iif and Immunodot Assaymentioning

confidence: 99%

The incidence of immunofluorescence patterns and specific autoantibodies observed in autoimmune patients in a tertiary care centre

Chauhan

Jain

Dorwal

et al. 2019

Eur Ann Allergy Clin Immunol

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Objectives. Testing for antinuclear antibodies (ANA) facilitates the diagnosis of autoimmune diseases (ADs). Here, we report an incidence of ANA positivity and its patterns by indirect immunofluorescence (IIF) and specific autoantibodies through immunodot assay. Methods. Sera from 993 patients presenting with various ADs were tested by IIF and immunodot assay. Results. ANAs were detected in 39.7%, of which speckled pattern was predominantly observed (50.8%). 56.8% of samples were positive on the immunodot assay, with SSA Ro 60 antibody being the most prevalent (30.7%). Discussion. A significant correlation (p < 0.0001) was observed between patterns and auto-antibodies. Coarse speckled (CS) and homogeneous were overly represented by antibodies SSA Ro 60 (13%) and nucleosomes (5.8%), respectively. Mi-2, PL-7, PL-12, and SP-100 were the rarest autoantibodies specificities found. Conclusions. The presence of a particular IIF pattern is predictive of a specific autoantibody in the sample. Association of IIF patterns and specific autoantibody are relevant for a more accurate diagnosis of disease. ADs from 7.5 to 12%, which indicated a significant health care burden (12). Serum antibodies against nucleus and anti-extractable nuclear antigens (ENA) are widely used in clinical practice and are included in the diagnosis of ADs (13,14). The most common autoantibodies are ANAs, which are conventionally assessed by IIF and include antibodies to both nuclear and cytoplasmic components (15). The immunofluorescence staining patterns and specific autoantibodies are clinically relevant as they are associated with particular ADs (16). Due to the ethnic variations, genetic and environmental factors, there is a significant variation in incidence and disease-specific autoantibodies (17,18). Nonetheless, ANA is frequently found in a considerable proportion of healthy subjects although studies are generally performed in selected populations, such as blood donors or employees, while data on ANA prevalence (19-21) and clinical significance over time (22) in an unselected general population, are limited.

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Section: Comparison Of Results Of Iif and Immunodot Assaymentioning

confidence: 99%

The incidence of immunofluorescence patterns and specific autoantibodies observed in autoimmune patients in a tertiary care centre

Chauhan

Jain

Dorwal

et al. 2019

Eur Ann Allergy Clin Immunol

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“…Circulating auto‐antibodies are higher in patients with chronic HCV infection when compared to normal individuals and in presence of higher RF‐IgG levels it is conceivable that immune system is stimulated to a progressive activation, which in turn can trigger an autoimmune disorder. This biomarker may constitute a prognostic factor for the onset of autoimmune disease in HCV‐infected individuals . In our hands, more than RF‐IgG, the mean levels of RF‐IgM are significantly lower in HCV‐naïve patients without CGs and progressively higher in asymptomatic (with low level of CGs) and symptomatic MC patients with high levels of cryocrit (Fig.…”

Section: Discussionmentioning

confidence: 56%

“…They analyzed clinical significance of low levels (≤0.05 g/L) of CGs in HCV‐negative patients, that may be associated with increased morbidity and mortality as well as in patients with high levels. HCV infection is likely to activate nonspecific autoreactive clones, which are thought to induce the pathogenesis of extrahepatic manifestations in the long run; the American Association for the Study of Liver Diseases guidelines indicate new DAAs for mixed cryoglobulinemia, that is officially ascribed among the HCV‐related disorder requiring the highest priority of treatment . CGs may represent the trigger of extrahepatic disorders in course of HCV infection and an accurate significance of low level of cryoglobulin appears of utmost importance to improve patients' management.…”

Section: Discussionmentioning

confidence: 99%

Serological profile of asymptomatic HCV positive patients with low level of cryoglobulins

et al. 2018

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Clinical spectrum of hepatitis C virus (HCV)-related cryoglobulinemia varies from an asymptomatic presentation to severe vasculitis and lymphoma. A recent study in HCV-negative patients suggests that low cryoglobulins (CGs) levels are responsible for severe renal and neurological complications. The aim of this study was to identify a panel of serological biomarkers associated with low levels of CGs in HCV-positive patients. We studied a population of 79 untreated patients with chronic HCV infection: 13 naïve patients without CGs; 28 patients with asymptomatic mixed cryoglobulinemia (MC) and low levels of CGs (16/28 with polyclonal type III and 12/28 with microheterogeneous type III CGs); 38 patients with symptomatic MC and high levels of type II CGs. Serum samples were collected and examined for rheumatoid factor (RF) IgG and IgM, free light chains (FLCs) and C3 and C4 complement components. We found that RF-IgG and IgM, free k chains and k+λ were increased while C4 component was reduced, both in symptomatic and asymptomatic patients. Our results suggest that, even in absence of MC symptoms, the low levels of CGs may represent a trigger of activation for immune system in course of HCV infection. The identification of a correlated biomarkers panel could improve the clinical management of these patients and pave the way for target treatment strategies. © 2018 Bio-Factors, 45(3):318-325, 2019

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“…IgG3 fixes complement most efficiently among the subclasses, thereby leading to activation of the classical pathway 41. The presence of IgG3 in cryoprecipitates of HCV- and ANA-positive patients constitutes the decisive factor for the possible activation of autoimmune mechanisms over the long term 30. In addition, IgG3 positive patients are also positive for IgG-RF [30], known to be autoreactive clones and their capacity to activate several cell clones is confirmed by many clinical studies 42,43.…”

Section: Rheumatoid Factormentioning

confidence: 99%

“…Thus, the presence of IgG3 in cryoprecipitates may suggest a more highly activated immune system, which is then more exposed to the mechanisms of autoimmune diseases. These markers may constitute a prognostic factor for autoimmune diseases in HCV-affected individuals, as opposed to ANA-negative and IgG3- and IgG RF- negative subjects 30. In naïve, asymptomatic CG- and HCV-positive patients, the presence of IgG RF and serum free light chains suggests their use as biomarkers, in order to identify the transition between a silent state of probable autoimmune lymphoproliferative disease and frank illness.…”

Section: Rheumatoid Factormentioning

confidence: 99%

Cryoglobulin Test and Cryoglobulinemia Hepatitis C-Virus Related

Gulli¹,

Santini

Napodano

et al. 2016

Mediterr J Hematol Infect Dis

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Cryoglobulins are immunoglobulins that precipitate in serum at temperatures below 37°C and resolubilize upon warming. The clinical syndrome of cryoglobulinemia usually includes purpura, weakness, and arthralgia, but the underlying disease may also contribute other symptoms. Blood samples for cryoglobulin are collected, transported, clotted and spun at 37°C, before the precipitate is allowed to form when serum is stored at 4°C in a Wintrobe tube for at least seven days. The most critical and confounding factor affecting the cryoglobulin test is when the preanalytical phase is not fully completed at 37°C. The easiest way to quantify cryoglobulins is the cryocrit estimate. However, this approach has low accuracy and sensitivity. Furthermore, the precipitate should be resolubilized by warming to confirm that it is truly formed of cryoglobulins. The characterization of cryoglobulins requires the precipitate is several times washed, before performing immunofixation, a technique by which cryoglobulins can be classified depending on the characteristics of the detected immunoglobulins. These features imply a pathogenic role of these molecules which are consequently associated with a wide range of symptoms and manifestations. According to the Brouet classification, Cryoglobulins are grouped into three types by the immunochemical properties of immunoglobulins in the cryoprecipitate. The aim of this paper is to review the major aspects of cryoglobulinemia and the laboratory techniques used to detect and characterize cryoglobulins, taking into consideration the presence and consequences of cryoglobulinemia in Hepatitis C Virus (HCV) infection.

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Anti-nuclear antibody detection in cryoprecipitates: Distinctive patterns in hepatitis C virus-infected patients

Cited by 10 publications

References 40 publications

The incidence of immunofluorescence patterns and specific autoantibodies observed in autoimmune patients in a tertiary care centre

The incidence of immunofluorescence patterns and specific autoantibodies observed in autoimmune patients in a tertiary care centre

Serological profile of asymptomatic HCV positive patients with low level of cryoglobulins

Cryoglobulin Test and Cryoglobulinemia Hepatitis C-Virus Related

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