Epidemiologija i dijagnostika primarnoga Sjögrenovog sindroma

This review paper contains selected aspects of Sjögren’s syndrome. It consists of epidemiology, ultrasound of salivary glands and antimuscarinic antibodies. The first part present studies aimed to determine the prevalence and the incidence of the disease with special emphasize on epidemiological studies performed in Slovenia. This is followed by the demonstration of the role of ultrasound of salivary glands in the diagnosis of Sjögren’s syndrome and the value of antimuscarinic antibodies in global assesment of the secretory failure.U preglednom su članku opisani epidemiologija, ultrazvučni nalaz slinovnica i antimuskarinska antitijela u Sjögrenovom syndromu. U prvomu su dijelu rada prikazani prevalencija i incidencija bolesti u odnosu na epidemiološke studije u Sloveniji. Prikazana je uloga ultrazvučne pretrage slinovnica u dijagnozi Sjögrenova sindroma i vrijednost antimuskarinskih antitijela u općoj procjeni sekrecijske poremetnje

Comparison and evaluation of different methodologies and tests for detection of anti-dsDNA antibodies on 889 Slovenian patients’ and blood donors’ sera

Aim To evaluate four different commercially available assays for anti-double stranded DNA (dsDNA) detection and compare them with the in-house radioimmunoassay according to Farr (FARR-RIA) in order to select the optimal primary method for use in combination with FARR-RIA. Methods Sera from 583 consecutive patients sent to our laboratory for routine diagnosis, 156 selected patients with autoimmune diseases (76 systemic lupus erythematosus [SLE] patients and 80 patients with other autoimmune diseases), and 150 blood donors were tested for anti-dsDNA antibodies with two enzyme-linked immunoassays (ELISA), two Crithidia luciliae immunoflourescence tests (CLIFT), and FARR-RIA. The specificities and sensitivities of the tests were calculated and compared. Results FARR-RIA and CLIFT 2 showed the highest specificity for SLE (100%), with CLIFT 2 showing higher sensitivity (33% vs 47%). Both ELISAs showed higher sensitivities (>53%) than FARR-RIA but lower specificities (<93%), whereas CLIFT 1 showed the lowest overall agreement with FARR-RIA. Conclusion CLIFT 2 was selected as the primary test for use in combination with FARR-RIA. The use of CLIFT 2 reduced the number of sera that needed to be tested by FARR-RIA, the time needed to report the results, and environmental toxicity, cancerogenicity, and radioactivity

Laboratory Methodology Important in the Diagnosis and Prognosis of Antiphospholipid Syndrome

Antiphospholipid syndrome (APS) is an autoimmune disease, characterized by thrombosis and pregnancy complications with persistently elevated levels of antiphospholipid antibodies (aPL). Recently, a unique mathematical calculation has been presented to assess the risk of thrombosis in patients with APS called antiphospholipid score or global antiphospholipid syndrome score (GAPSS). This new approach in the diagnosis of APS leads to the assessment of the risk of thrombosis considering the results of different aPL (lupus anticoagulants (LA), anticardiolipin antibodies (aCL), antibodies against β2GPI (anti-β2GPI), and phosphatidylserine-dependent antiprothrombin antibodies (aPS/PT) (isotypes IgG and IgM). This chapter provides an overview of the algorithm strategy for APS diagnosis with the aims of characterizing in detail the laboratory methodology of criteria aPL (LA, aCL, and anti-β2GPI) and noncriteria aPL, such as IgA aCL and IgA anti-β2GPI, anti-domain I β2GPI, and antiprothrombin antibodies. In order to improve APS diagnosis, several new approaches in aPL detection have recently been suggested, such as multiline immunodot assay, detection of aPL by flow cytometry using beads with particular surface properties, and the newly developed automated BioPlex system technology for parallel detection of aCL and anti-β2GPI antibodies of IgG, IgA, and IgM isotypes. A completely different and promising approach in future research lies in the potential of microRNAs as biomarkers for risk of thrombosis and/or obstetric complication

Teaching Slovene to fourth graders with the help of creative movement

The aim of our master’s thesis is to find out whether the teaching of Slovenian linguistic and literary work intertwined with creative movement helps with improving the orthographic ability and enhancing the understanding of vocabulary and text with immigrant and local students. What we were interested is to determine if this kind of teaching helps with the more permanent memorization of learning content among all students, although we did focus on the results of immigrant students. We were interested in the presence of differences in the attitude of immigrant and local students in the aspect of teaching them with the help of creative movement or without it. Furthermore, finding out if class teachers at several Slovenian grammar schools actually use creative movement while teaching Slovenian, was one of our aims, and consequently, what the reasons are that make teachers use creative movement and include it in their classes. The theoretical part of this master’s thesis deals with the general characteristics of immigrant students, the ways of including them in the educational system and teaching them the Slovenian language, the characteristics of the movement and creative movement, including the latter in the lessons of Slovenian and lastly, what the advantages of doing that are. The empirical part presents the detailed analysis of the research. The research takes an in-depth look into teaching fourth year Slovene with creative movement. Two classes of fourth graders (N = 48) were included in the research itself. Out of these 48, 23 students were in the experimental group (teaching Slovenian with the help of creative movement) and 25 students in the control group (teaching Slovenian without the help of the creative movement). The results were collected by using different methodological instruments (current welfare scale, examination, survey questionnaire for teachers and watch list). We obtained the results of how the students felt after each Slovenian class (experimental and control group) by using the current welfare scale. We got the results of the at-the-moment, in-between and final welfare of the students with the help of the examination and the results of using creative movement in class at four different grammar schools in Slovenia by giving the teachers the survey questionnaire. The research data shows that creative movement, from the important statistical point of view, does not affect a better understanding of vocabulary and text, but it does have an effect on a better understanding of orthographic ability for the immigrants of the second generation. It is of equal statistical importance that it does not affect the long-lasting memorisation of learning content. We have also reached the conclusion that immigrant as well as local students from both groups feel excellent and that the majority of teachers use creative movement in their classes. With both the control and experimental groups of immigrant and local fourth year students sharing their experiences, we therefore conclude that creative movement does indeed help with the positive welfare of all students when teaching them Slovenian (literary and linguistic content) as well as having an impact on a better understanding of the orthographic ability. The latter applies only for the students of the second generation

Detection of Antiphosphatidylserine/Prothrombin Antibodies and Their Potential Diagnostic Value

Antiprothrombin antibodies, measured with phosphatidylserine/prothrombin complex (aPS/PT) ELISA, have been reported to be associated with antiphospholipid syndrome (APS). They are currently being evaluated as a potential classification criterion for this autoimmune disease, characterized by thromboses and obstetric complications. Given the present lack of clinically useful tests for the accurate diagnosis of APS, we aimed to evaluate in-house and commercial assays for determination of aPS/PT as a potential serological marker for APS. We screened 156 patients with systemic autoimmune diseases for antibodies against PS/PT, β2-glycoprotein I, cardiolipin and for lupus anticoagulant activity. We demonstrated a high degree of concordance between the concentrations of aPS/PT measured with the in-house and commercial assays. Both assays performed comparably relating to the clinical manifestations of APS, such as arterial and venous thromboses and obstetric complications. IgG aPS/PT represented the strongest independent risk factor for the presence of obstetric complications, among all tested aPL. Both IgG and IgM aPS/PT were associated with venous thrombosis, but not with arterial thrombosis. Most importantly, the association between the presence of IgG/IgM aPS/PT and lupus anticoagulant activity was highly significant. Taken together, aPS/PT antibodies detected with the in-house or commercial ELISA represent a promising serological marker for APS and its subsets

Anti-Phosphatidylserine/Prothrombin Antibodies Are Associated with Adverse Pregnancy Outcomes

Objective. To determine the prevalence and clinical association of anti-phosphatidylserine/prothrombin antibodies (aPS/PT) in patients with a history of pregnancy complications relevant to antiphospholipid syndrome (APS). Materials and Methods. Two hundred and eleven patients with a history of (a) three or more consecutive miscarriages before 10th week of gestation (WG) (n=64), (b) death of a morphologically normal fetus beyond 10th WG (n=72), (c) premature birth of a morphologically normal neonate before 34th WG due to eclampsia, preeclamsia and placental insufficiency (n=33), and (d) less than three unexplained consecutive miscarriages before 10th WG (n=42). Subjects sera were analyzed for lupus anticoagulant (LA), anti-cardiolipin (aCL), anti-β2-glycoprotein I (anti-β2GPI), and aPS/PT antibodies. Results. 41/169 (24.3%) of patients were positive for at least one measured aPL. The highest prevalence was found for aPS/PT and aCL (13.0% and 12.4%, resp.) followed by LA (7.7%) and anti-β2GPI (7.1%). 11/169 with APS-related obstetric manifestations had only aPS/PT. 17.8% of patients were positive for LA or aCL and/or anti-β2GPI; however when adding the aPS/PT results, an additional 7% of patients could be evaluated for APS. Conclusion. aPS/PT are associated with recurrent early or late abortions and with premature delivery irrespective of other aPL

International cohort study of 73 anti-Ku-positive patients: association of p70/p80 anti-Ku antibodies with joint/bone features and differentiation of disease populations by using principal-components analysis

ABSTRACT: INTRODUCTION: An international cohort study of 73 anti-Ku-positive patients with different connective tissue diseases was conducted to differentiate the anti-Ku-positive populations of patients based on their autoantibody profile and clinical signs/symptoms and to establish possible correlations between antibodies against Ku p70 and Ku p80 with autoimmune diseases. METHODS: Sera of anti-Ku-positive patients were collected from six European centers and were all secondarily tested (in the reference center); 73 were confirmed as positive. Anti-Ku antibodies were detected with counter-immunoelectrophoresis (CIE), line immunoassay (LIA), and immunoblot analyses. All clinical and laboratory data were follow-up cumulative data, except for anti-Ku antibodies. Statistical analyses were performed by using R (V 2.12.1). The Fisher Exact test was used to evaluate the association between anti-Ku antibodies and diagnosis, gender, clinical signs, and other observed antibodies. The P values were adjusted for multiple testing. Separation of disease populations based on the presence of antibodies and clinical signs was investigated by principal-components analysis, which was performed by using thr// R's prcomp function with standard parameters. RESULTS: A 16% higher prevalence of anti-Ku p70 was found over anti-Ku p80 antibodies. In 41 (57%) patients, a combination of both was detected. Five (7%) patients, who were CIE and/or LIA anti-Ku positive, were negative for both subsets, as detected with the immunoblot; 31% of the patients had undifferentiated connective tissue disease (UCTD); 29% had systemic sclerosis (SSc); 18% had systemic lupus erythematosus (SLE); 11% had rheumatoid arthritis; 7% had polymyositis; and 3% had Sjögren syndrome. CONCLUSIONS: A significant positive association was found between female patients with anti-Ku p70 and joint/bone features, and a significant negative association was found between female patients with anti-Ku p80 only and joint/bone features (P = 0.05, respectively). By using the first and the third components of the principal-component analysis (PCA) with 29 parameters evaluated, we observed that the anti-Ku-positive population of UCTD patients had overlapping parameters, especially with SLE, as opposed to SSc, which could be helpful in delineating UCTD patients