Anti-proteinase 3 antibodies in diffuse systemic sclerosis (SSc) with normotensive renal impairment: is it suggestive for an overlapping between SSc and idiopathic vasculitis?

Objective. To test the prevalence of anti-neutrophil cytoplasmic antibodies (ANCA) in systemic sclerosis (SSc) and to verify a possible association of ANCA with normotensive renal involvement in SSc. Patients and methods: 51 patients affected by SSc, 35 with diffuse scleroderma (dSSc) and 16 with limited scleroderma (lSSc), were tested for ANCA by indirect immunofluorescence (IIF) on human ethanol and formalin-acetone-fixed granulocytes (before and after DNase treatment), by conventional enzyme linked immuno-sorbent assay (ELISA) and by capture-ELISA. Results. Six out of 51 selected SSc patients had ANCA by IIF (11.7%) and five presented a perinuclear/nuclear atypical ANCA pattern. In all cases we only found anti-proteinase3 (aPR3) antibodies. All ANCA positive patients had diffuse form of SSc (17.1%), all were anti-Scl70 positive (aScl70), five patients had proteinuria, three had microscopic haematuria. All ANCA positive patients were normotensive with normal renin plasma levels, the mean erythrocyte sedimentation rate (ESR) was higher in this group compared to the other SSc patients. Conclusions. Our study shows that aPR3 is not rare in dSSc. According to the clinical and serological findings and to the recent literature, we can hypothesise that when ANCA are found in SSc, an overlapping of scleroderma with systemic necrotizing vasculitis should be suspected

Circulating levels of the adipokines vaspin and omentin in patients with juvenile idiopathic arthritis, and relation to disease activity

OBJECTIVES: Vaspin and omentin are two recently discovered adipokines that have been involved in chronic inflammatory processes. The aims of our study were to evaluate their serum levels in patients affected by juvenile idiopathic arthritis (JIA), in comparison to healthy controls, and to correlate circulating levels to parameters of disease activity. METHODS: Serum levels of omentin and vaspin were assayed by enzyme-linked immunosorbent assay in 40 patients with JIA classified according to the ILAR criteria and 26 healthy controls. RESULTS: Serum omentin levels were significantly higher in JIA patients versus healthy controls (p<0.0001) whereas serum vaspin levels did not significantly differ between the two groups. JIA children with active joints showed higher omentin serum levels than JIA children without active joints (p<0.001) and omentin serum levels significantly correlated with the presence of active joints (p<0.0001). Omentin serum levels were also significantly related with the number of active joints (p<0.002). Vaspin serum level did not show statistical significant differences between JIA children with active joints and those with no active joints. There was no correlation between plasma vaspin levels and the presence of active joints, or the number of active joints CONCLUSIONS: Our study is the first report on the new adipokines vaspin and omentin in patients with JIA, and it shows that omentin is significantly higher in JIA patients in comparison with healthy controls. In addition, we also report that omentin plasma levels are significantly correlated with the presence and the number of active joints

Comparison of different methods for the detection ofanti-Ro/SSA antibodies in connective tissue diseases.

OBJECTIVE: To compare the performance characteristics of various tests commonly used to detect anti-SSA/Ro autoantibodies in the sera of patients affected by connective tissue diseases (CTD). METHODS: Indirect immunofluorescence (IIF) with HEp-2000 as substrate (ImmunoConcepts, USA), Ouchterlony's double immunodiffusion (ID) (home made), commercial Varelisa ReCombi anti-Ro kit (Pharmacia & Upjohn, Germany), research kits (60 kDa and 52 kDa) with human recombinant antigens (Pharmacia & Upjohn, Germany) and a commercial western blot (WB) kit (MarDx, USA) were evaluated in our study. Sixty-four sera from patients affected by CTD were tested: 15 had primary Sjögren's syndrome (SS), 34 only had sicca syndrome, and 15 had systemic lupus erythematosus (SLE). Thirty sera from healthy subjects were selected as controls. RESULTS: 54 sera were positive by at least one method. The specificity of all tests was good. The prevalence of anti-SSA antibodies on 54 positive sera was 76% (ID), 89% (IIF), 89% (Varelisa), 89% (ELISA Ro-60 kDa), 67% (ELISA Ro-52 kDa) and 85% (WB). Some differences were found between WB and ELISA in the detection of anti-60 kDa SSA and anti-52 kDa SSA; in 3 SS sera only anti-52 kDa protein was found by WB. CONCLUSION: Our data confirm that, although IIF HEp 2000 (Immuno Concepts) and Varelisa anti-Ro (Pharmacia & Upjohn) both performed well, a combination of 2 or more methods must still be recommended for anti-SSA antibody detection