Antibodies against peripheral nerve antigens in chronic inflammatory demyelinating polyradiculoneuropathy

Altres ajuts: Beca Juan Rodes JR1300014Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a heterogeneous disease in which diverse autoantibodies have been described but systematic screening has never been performed. Detection of CIDP-specific antibodies may be clinically useful. We developed a screening protocol to uncover novel reactivities in CIDP. Sixty-five CIDP patients and 28 controls were included in our study. Three patients (4.6%) had antibodies against neurofascin 155, four (6.2%) against contactin-1 and one (1.5%) against the contactin-1/contactin-associated protein-1 complex. Eleven (18.6%) patients showed anti-ganglioside antibodies, and one (1.6%) antibodies against peripheral myelin protein 2. No antibodies against myelin protein zero, contactin-2/contactin-associated protein-2 complex, neuronal cell adhesion molecule, gliomedin or the voltage-gated sodium channel were detected. In IgG experiments, three patients (5.3%) showed a weak reactivity against motor neurons; 14 (24.6%) reacted against DRG neurons, four of them strongly (7.0%), and seven (12.3%) reacted against Schwann cells, three of them strongly (5.3%). In IgM experiments, six patients (10.7%) reacted against DRG neurons, while three (5.4%) reacted against Schwann cells. However, results were not statistically significant when compared to controls. Immunoprecipitation experiments identified CD9 and L1CAM as potential antigens, but reactivity could not be confirmed with cell-based assays. In summary, we describe a diverse autoantibody repertoire in CIDP patients, reinforcing the hypothesis of CIDP's pathophysiological heterogeneity

Model d’atenció a l’endometriosi a Catalunya

Endometriosi; Planificació sanitària; Model d'atencióEndometriosis; Planificación sanitaria; Modelo de atenciónEndometriosis; Health planning; Attention modelEl Model d’atenció a l’endometriosi a Catalunya estableix les bases per a l’ordenació dels serveis assistencials que intervenen en el procés integral d’atenció a les dones afectades amb endometriosi, inclou aspectes clínics, aspectes assistencials i aspectes d’ordenació de circuits assistencials, que venen determinats per les actuacions necessàries per donar una atenció integral a les dones afectades

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Caracterização microbiológica e avaliação de uma cepa de Bacillus subtilis no desempenho de bezerros da raça Holandesa

O presente trabalho objetivou caracterizar um isolado de Bacillus subtilis para utilização como agente probiótico para bovinos. Foram determinadas “in vitro” a capacidade e o tipo de efeito inibitório do isolado de B. subtilis do produto comercial Biotop sobre Salmonella, Escherichia coli e Clostridium perfringens, além de sua estabilidade, viabilidade, resistência a antimicrobianos e potencial de ação em comparação com a Nisina e em combinação com EDTA. Foram avaliados os efeitos da adição do isolado na dieta de 32 bezerros da raça Holandesa, em quatro diferentes tratamentos (controle; 1 g/dia; 2 g/dia e 4 g/dia), sobre o consumo de matéria seca, perímetro torácico, ganho de peso, consistência fecal e incidência de doenças. Também foi realizado um desafio com E. coli e monitoramento do “score” de fezes, temperatura retal (oC) e parâmetros sanguíneos. O isolado de B. subtilis foi mais eficaz contra C. perfringens, principalmente quando associado com a Nisina e EDTA. A adição do probiótico na dieta de bezerros aumentou o consumo de matéria seca, ganho de peso e perímetro torácico. No desafio bacteriano não foram observadas diferenças significativas para presença de Bacillus spp. e E. coli nas fezes. A análise do “score” de fezes, temperatura retal e parâmetros sanguíneos não demonstraram diferenças significativas entre os tratamentos. O produto avaliado demonstrou resultados satisfatórios quanto aos parâmetros de produção animal, sendo recomendada sua utilização para bezerros lactantes, principalmente na dosagem de 4 g/animal/dia.The present work aimed to characterize an isolated of Bacillus subtilis to be used as a probiotic for calves. Were determinate in vitro its inhibition capacity and the type of effect of the isolated, that is present in the commercial product Biotop against Salmonella, Escherichia coli and Clostridium perfringens. It also was tested its stability, viability, resistance to antibiotics and its potential action in comparison with Nisin and in combination with EDTA. They were appraised the effects of the addition of the isolated in the diet of 32 calves Holstein Frisian in four different treatments (control; 1 g/day; 2 g/day and 4 g/day), over the intake of dry matter, thoracic perimeter, gain of weight, faecal consistence and incidence of diarrhoea. Also a challenge was accomplished with E. coli and the score of faeces monitored, rectal temperature (oC) and sanguine parameters. The isolated of B. subtilis was more effective against C. perfringens, mainly when associated with Nisin and EDTA. The addition of the probiotic in the diet of calves increased the dry matter intake, weight enhance and thoracic perimeter. In the bacterial challenge significant differences were not observed in the counting of Bacillus spp. and E. coli in the faeces. The analysis of the score of faeces, rectal temperature and sanguine parameters didn't demonstrate significant differences between the treatments. The appraised product demonstrated satisfactory results as for the parameters of animal production, being recommended to be use for nursing calves, mainly in the dosage of 4 g/animal/day.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES