Optimization of Laboratory Diagnostics of Primary Biliary Cholangitis: When Solid-Phase Assays and Immunofluorescence Combine

The laboratory diagnostics of primary biliary cholangitis (PBC) have substantially improved, thanks to innovative analytical opportunities, such as enzyme-linked immunosorbent assays (ELISA) and multiple immunodot liver profile tests, based on recombinant or purified antigens. This study aimed to identify the best diagnostic test combination to optimize PBC diagnosis. Between January 2014 and March 2017, 164 PBC patients were recruited at the hospitals of Parma, Modena, Reggio-Emilia, and Piacenza. Antinuclear antibodies (ANA) and anti-mitochondrial antibodies (AMA) were assayed by indirect immunofluorescence (IIF), ELISA, and immunodot assays (PBC Screen, MIT3, M2, gp210, and sp100). AMA-IIF resulted in 89.6% positive cases. Using multiple immunodot liver profiles, AMA-M2 sensitivity was 94.5%, while anti-gp210 and anti-sp100 antibodies were positive in 16.5% and 17.7% of patients, respectively. PBC screening yielded positive results in 94.5% of cases; MIT3, sp100, and gp210 were detected by individual ELISA test in 89.0%, 17.1%, and 18.9% of patients, respectively. The association of PBC screening with IIF-AMA improved the diagnostic sensitivity from 89.6% to 98.2% (p < 0.01). When multiple immunodot liver profile testing was integrated with AMA-IIF, the diagnostic sensitivity increased from 89.1% to 98.8% (p < 0.01). The combination of IIF with solid-phase methods significantly improved diagnostic efficacy in PBC patients

The serum concentrations of leptin and MCP-1 independently predict low back pain duration

Low back pain (LBP) is a very frequent condition, affecting most people at some point throughout their life. This cross-sectional study was aimed to investigate a selected panel of cytokines and inflammatory biomarkers in patients with or without LBP

Mobile phone radiofrequency exposure has no effect on DNA double strand breaks (DSB) in human lymphocytes

The results of this experimental study demonstrate that exposure of human lymphocytes to a conventional 900 MHz RF emitted by a commercial mobile phone for 30 min does not significantly impact DNA integrity

Genetic susceptibilty and celiac disease: what role do HLA haplotypes play?

Celiac disease is a chronic immune-mediated enteropathy triggered by exposure to dietary gluten in genetically predisposed individuals. Many genes involved in the pathogenesis have been identified and a crucial role is known to be played by the Human Leukocyte Antigen (HLA) system. The main determinants for genetic susceptibility are HLA-DQA1 and HLA-DQB1 genes encoding for HLA-DQ2 and HLA-DQ8 molecules, carried by almost all patients affected. However, since HLA-DQ2 and HLA-DQ8 heterodimers explain almost 40% of the disease heritability, HLA typing should not be applied in diagnosis, but exclusively to clarify uncertain diagnoses, considering its negative predictive value

The new test for monitoring infliximab therapy: From laboratory to clinical practice

Background: Biological agents for anti-tumor necrosis factor-α therapy have revolutionized treatments for autoimmune diseases; however, approximately 20% of rheumatology and 40% of gastroenterology patients do not respond to the therapy, or they show reduced drug efficacy because of anti-drug antibody (ADA) formation. Objectives: To evaluate laboratory tools for individual monitoring of infliximab therapy and the relationship between ADA and infliximab serum levels, ADA and clinical response, and ADA and autoantibodies. Methods: Our study comprised patients treated with infliximab and affected by selected rheumatology and gastroenterology diseases. Sera were analyzed for infliximab, total-anti-drug antibodies (Total-ADA), and free-anti-drug antibodies (Free-ADA) serum levels and for the detection of specific autoantibodies. Results: We analyzed 73 patients. Total-ADA were detected in 26 rheumatology and 21 gastroenterology patients. Serum infliximab levels were significantly lower in Total-ADA positive patients (P = 0.01 for rheumatology group, P = 0.02 for gastroenterology group). A lack of response was observed in 7 rheumatology and 15 gastroenterology samples. Total-ADA serum levels were statistically significantly higher in patients with treatment failure in both groups (P = 0.01 and P = 0.001, respectively). There was no significant association between the presence of Total-ADA and other autoantibodies. Free-ADA were detected in only 27 rheumatology patients. Results showed a significant correlation with clinical outcome (P = 0.006). Conclusions: The correlation with clinical response suggests that the presence of ADA could interfere with efficacy of therapy. The tests for monitoring therapy may be an important tool to assist clinicians in early detection and prevention of therapy failure

DNA injury is acutely enhanced in response to increasing bulks of aerobic physical exercise

The aim of this study was to evaluate DNA damage in response to increasing bulks of aerobic physical exercise. Fifteen adult and trained athletes performed four sequential trials with increasing running distance (5-, 10-, 21- and 42-km) in different periods of the year. The gamma-H2AX foci parameters were analyzed before and 3 h after the end of each trial. The values of all gamma-H2AX foci parameters were enhanced after the end of each trial, with values gradually increasing from the 5- to the 42-km trial. Interestingly, a minor increase of gamma-H2AX foci was still evident after 5- to 10-km running, but a much higher increase occurred when the running distance exceeded 21 km. The generation of DNA injury was then magnified by running up to 42-km. The increase of each gamma-H2AX foci parameter was then found to be associated with both running distance and average intensity. In multivariate linear regression analysis, the running distance was significantly associated with average intensity and post-run variation in the percentage of cells with gamma-H2AX foci. We can hence conclude that aerobic exercise may generate an acute DNA damage in trained athletes, which is highly dependent upon running distance and average intensity. (C) 2016 Elsevier B.V. All rights reserved

Non-invasive tests for the diagnosis of helicobacter pylori: state of the art

Usually, non-invasive tests are the first methods for diagnosing Helicobacter pylori (HP) infection. Among these, serological test, stool antigen research and urea breath test are the most used. Antibodies anti-HP are not recommended in low prevalence population, moreover they cannot reveal an ongoing infection, but they only prove a contact with the bacterium. Also, they can persist for a long time after the eradication of the infection, therefore, they should not be used to verify the success of eradication therapy. Stool antigen research and Urea Breath Test (UBT) are useful both in diagnosis and during follow-up after eradication treatment. The stool antigen test is cheaper than Urea breath test with similar sensitivity and specificity.  Non-invasive tests are not able to diagnose the associated complications to HP infection

DNA double-strand breaks are increased in athletes completing a 10-km and a 21-km runs.

DNA double-strand breaks are increased in athletes completing a 10-km and a 21-km run

Middle-distance running and DNA damage in diabetics

Background: Physical activity is an essential part of prevention and therapeutic management in diabetes. Nevertheless, doubts remain as to whether endurance sports may contribute to worsen an enhanced oxidative DNA injury, frequently observed in diabetics. Methods: The study population consisted of 19 euglycemic and 16 diabetic amateur runners (9 with type 1 and 7 with type 2 diabetes), who were engaged in a 21.1 km running trial. Blood samples for analysis of DNA damage with phosphorylated histone protein H2AX (\u3b3-H2AX) foci assessment were collected before the run and 3 hours afterward. Results: The values of \u3b3-H2AX foci parameters at rest were similar in diabetic and euglycemic athletes. Although type 2 diabetics displayed a trend toward higher values of all \u3b3-H2AX foci parameters at rest compared to type 1 diabetics, in no case such difference reached statistical significance. A substantial increase of all \u3b3-H2AX foci parameters was observed after the 21.1 km running trial, both in euglycemic and diabetic subjects, but the absolute increases were non-significantly different between the two study groups. Interestingly, the absolute increase of cells with \u3b3-H2AX foci was slightly but not significantly higher in type 2 than in type 1 diabetics, whilst the values of \u3b3-H2AX foci/cell and total \u3b3-H2AX foci exhibited an absolute increase that was significantly higher in type 2 than in type 1 diabetics. The difference was no longer significant after correcting \u3b3-H2AX foci parameters for age. Conclusions: The burden of DNA injury at rest in physically active diabetics is comparable to that of a population of euglycemic recreational athletes and the extent of DNA damage in diabetics engaged in middle-distance running is non-significantly different from that observed in euglycemic athletes