An enzyme-linked immunosorbent assay for the detection of autoantibodies to albumin.

The development of an enzyme-linked immunosorbent assay (ELISA) for anti-albumin autoantibodies (AAA), using immobilized monomeric or glutaraldehyde-polymerized human, bovine or egg albumin, is described. Major problems in detection by the ELISA of AA against human albumin (HSA) were due to high 'non-specific' binding with the commercial anti-human immunoglobulin antisera used and to interference by IgM/HBs circulating complexes. However, it was found that AAA are not species-specific and that these problems may be overcome using immobilized bovine (BSA) or egg (EggA) albumin. AAA were found to have a similar affinity for BSA as for HSA but slightly lower for EggA, while AAA affinities for the monomeric forms were lower than for the corresponding polymeric albumins. All sera from the 28 normal subjects tested were found to contain both IgM- and IgG-AAA. Patients with acute hepatitis B (n = 23) had significantly lower titres of IgM-AAA than normal subjects, as did chronic HBV carriers with (n = 33) or without (= 17) underlying liver disease, while IgG-AAA titres were reduced only in the acute hepatitis patients. These findings support the concept that AAA have a normal physiological function (probably for removal of effete albumin molecules) and that, in HBV infection, there is a decrement in titres that may be related to the clearance of the virus

Autoantibody to albumin of type G and M in acute and chronic viral hepatitis.

Autoantibodies to albumin (AAA) were tested by an ELISA method in patients with A, B and NANB acute and chronic hepatitis, and in a control group. AAA-IgM had a different behaviour in acute hepatitis type A, in which we observed a high average titre as compared with B, and NANB hepatitis, in which we observed a decrease in the average titre. In the chronic phase, we noted a decrement of the average titre in all the types of hepatitis. For AAA-IgG, in the acute phase the average titre in hepatitis A, B and NANB was lower than in the control group. In the chronic stage, only NANB hepatitis showed a decrement of the average titre of the antibody. On the base of these results, we can say that the involvement of AAA seems to be different in hepatitis A from the other two types, in which the decrement of average titre may be explained by the formation of immunocomplexes which are not detected by this test

Demonstration of HBsAg as the antigen component in circulating immune complexes detected by peg-solid phase test.

The development of an enzyme-linked immunosorbent assay to identify HBsAg as the antigen component within circulating immune complexes using immobilized polyethylene glycol (PEG) is described. The method utilizes, on one hand, the ability of PEG to bind stably to plastic supports and, on the other, to precipitate circulating macromolecules. This method is easily performed, very cheap, quick and, above all, it helps define the biological nature of the immune complexes. HBsAg can be revealed as the antigen component of HBsAg/anti-HBs soluble immune complexes at concentrations of at least 20 ng/ml and either in antigen or antibody excess. Our results indicate that HBsAg circulates in a complexed form in 47% of HBsAg chronic carriers and in 10.7% of patients with liver disease who are positive for serum antibody to hepatitis B surface antigen (anti-HBs) and to core antigen (anti-HBc). None of the other groups of patients in the study had circulating HBsAg in the complexed form

Role of surgical setting and patients-related factors in predicting the occurrence of postoperative pulmonary complications after abdominal surgery

objective: The aim of this retrospective study was to evaluate the role of surgical setting (urgent vs. elective) and approach (open vs. laparoscopic) in affecting postoperative pulmonary complications (PPCs) prevalence in patients undergoing abdominal surgery. patients and methods: After local Ethical Committee approval, 409 patients who had undergone abdominal surgery between January and December 2014 were included in the final analysis. PPCs were defined as the development of one of the following new findings: respiratory failure, pulmonary infection, aspiration pneumonia, pleural effusion, pneumothorax, atelectasis on chest X-ray, bronchospasm or un-planned urgent re-intubation. results: PPCs prevalence was greater in urgent (33%) vs. elective setting (7%) (X2with Yates correction: 44; p=0.0001) and in open (6%) vs. laparoscopic approach (1.9%) (X2with Yates correction: 12; p=0.0006). PPCs occurrence was positively correlated with in-hospital mortality (Biserial Correlation r=0.37; p=0.0001). Logistic regression showed that urgent setting (p=0.000), Ariscat (Assess Respiratory Risk in Surgical Patients in Catalonia) score (p=0.004), and age (p=0.01) were predictors of PPCs. A cutoff of 23 for Ariscat score was also identified as determining factor for PPCs occurrence with 94% sensitivity and 29% specificity. conclusions: Patients undergoing abdominal surgery in an urgent setting were exposed to a higher risk of PPCs compared to patients scheduled for elective procedures. Ariscat score fitted with PPCs prevalence and older patients were exposed to a higher risk of PPCs. Prospective studies are needed to confirm these results

Asthma in patients admitted to emergency department for COVID-19: prevalence and risk of hospitalization

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