Serum antibodies to anaerobic coccoid rods in Crohn's disease

The faecal flora of patients with Crohn's disease has been found to differ from that of healthy subjects in that the numbers of anaerobic gramnegative rods and of gram-positive coccoid anaerobes, belonging to species of Eubacterium and Peptostreptococcus were higher. The flora composition was independent of duration of illness and was not influenced by ileocaecal resection. Serum agglutinins against some strains of coccoid rods were found in a considerable percentage of patients with Crohn's disease, whereas percentages of positive sera were much lower in healthy subjects and in patients with various diseases. The interpretation of these data established by Wensinck and the use of the agglutination reactions as a diagnostic test are the subject of this thesis. In Chapter 2 recent microbiological and immunological findings in patients with Crohn's disease are reviewed. They show that in Crohn's disease as well as in other intestinal diseases, like ulcerative colitis, antibodies to dietary and microbial antigens are found frequently. In Chapter 3 results are presented of investigations on the prevalence of agglutinins to four strains of anaerobic coccoid rods in patients with Crohn's disease, ulcerative colitis, a number of other diseases and in healthy subjects. Antibodies to coccoid rods were found much more frequently in Crohn's disease than in ulcerative colitis and other diseases. Using the interpretation of agglutination reactions as described in Chapter 7, the percentage of false positive results of sera submitted for diagnosis was found to be satisfactorily low. The data in Chapter 4 show that the presence of antibodies to the coccoid rods in patients with Crohn's disease is correlated with colonic disease, the presence of fistulae and with serum immunoglobulin levels. No correlation was found between antibodies and any index of disease activity

Quality of life and costs of Filgrastim® (G-CSF) treatment in patients with persistent chronic rhinosinusitis

This is the first report of the double blind randomized clinical trial, in which we investigated the influence of Filgrastim(r) on the quality of life and treatment costs of chronic sinusitis patients who did not respond to regular treatments. The quality of life of 56 patients was assessed 5 times during the 24-week trial with the EuroQol, the SF-36 and the McGill Pain questionnaire. We further controlled for "responsiveness", based on clinical impression. Direct medical and indirect non-medical costs per patient during the trial were analyzed, based on data from clinical record forms and the hospital information system. We further compared the direct medical costs to the costs of regular treatment. The quality of life scores were all below population norm scores. Quality of life scores of the Filgrastim(r) group suggested a better quality of life than the placebo group, although none of the differences were statistically significant. There were indications that controlling for responsiveness increased the power of the design. The difference in costs between the trial groups were driven by the Filgrastim(r) costs (Euro 4899). When Filgrastim(r) costs were neglected, no difference in costs remained. Except for Filgrastim(r), total direct costs summed up to Euro 2712 and the indirect costs to Euro 582. Total direct costs of a 24-week regular treatment were three times lower than the costs of the trial treatment. While significantly increasing treatment costs, Filgrastim(r) administration does not lead to a better quality of life of chronic sinusitis patients, although there were

Prevalence of interferon type I signature in CD14 monocytes of patients with Sjögren's syndrome and association with disease activity and BAFF gene expression

Objective To determine the prevalence of upregulation of interferon (IFN) type I inducible genes, the so called "IFN type I signature", in CD14 monocytes in 69 patients with primary Sjögren's syndrome (pSS) and 44 healthy controls (HC) and correlate it with disease manifestations and expression of B cell activating factor (BAFF). Methods Expression of IFI44L, IFI44, IFIT3, LY6E and MX1 was measured using real time quantitative PCR in monocytes. Expression values were used to calculate IFN type I scores for each subject. pSS patients positive for the IFN type I signature (IFN score≥10) and patients negative for the signature (IFN score<10) were then compared for clinical disease manifestations and BAFF expression. A bioassay using a monocytic cell line was performed to study whether BAFF mRNA expression was inducible by IFN type I activity in serum of patients with pSS. Results An IFN type I signature was present in 55% of patients with pSS compared with 4.5% of HC. Patients with the IFN type I signature showed: (a) higher EULAR Sjögren'

MxA as a clinically applicable biomarker for identifying systemic interferon type I in primary Sjögren's syndrome

Objective: To establish an easy and practical assay for identifying systemic interferon (IFN) type I bioactivity in patients with primary Sjögren's syndrome (pSS). The IFN type I signature is present in over half of the pSS patients and identifies a subgroup with a higher disease activity. This signature is currently assessed via laborious expression profiles of multiple IFN type I-inducible genes. Methods: In a cohort of 35 pSS patients, myxovirus-resistance protein A (MxA) was assessed as a potential biomarker for ty