CLASS-SPECIFIC RHEUMATOID FACTORS IN JUVENILE CHRONIC ARTHRITIS. CLINICAL ASSOCIATIONS

The study aimed at determining the prevalence of the class-specific rheumatoid factors (RFs) in juvenile chronic arthritis (JCA) and evaluating the diagnostic test qualities. A total of JCA 79 patients (48 with pauciarticular form, 17 of whom with extending pauciarthritis), 31 with polyarticular for, as well as 125 control children (58 healthy and 67 disease controls) were tested. Most JCA patients (95%) had negative Waaler-Rose test. ELISAfor the detection of IgM-, IgA- and IgG- isotypes of RFs was used. The diagnostic characteristics of the tests were evaluated by clinico-epidemiological methods (assessment of sensitivity, specificity, positive predictive value, and likelihood ratio). The prevalence of IgG-, IgA- and IgM-RF in JCA versus all controls at optimal cut offtitres was 16 %, 22 c/c and 32%, respectively. The test for IgG-RF was not diagnostically significant. IgA-RF had the highest prevalence in the polyarticular form (40 %). The diagnostic qualities of the test were significant, mostly concerning the differentiation of the polyarticular course of JCA and the presence of erosive arthritis. IgM-RF was most typical of the polyarticular form (55 %) followed by the extending pauciarthritis (41 %). The diagnostic test qualities were significant and most prominent to distinguish the polyarticular course and erosive arthritis. IgM- and IgA-RFs had significant diagnostic value in JCA, mainly for the polyarticular and extending pauciarticular form and also in regard to more severe disease course. IgGRF had no diagnostic significance for JCA

ANTIBODIES DIRECTED TO INDIVIDUAL HISTONES IN JUVENILE CHRONIC ARTHRITIS. ASSOCIATION WITH UVEITIS

The trials for identification of the specific target antigen for antinuclear antibodies (ANA) in juvenile chronic arthritis (JCA) revealed that a significant number of patients produce antibodies directed to individual histories and histone peptides. Fifty JCA patients, 58 healthy children and 58 children with autoimmune and rheumatologic disorders were studied for a presence of IgG- and IgM-antibodies against histone 1, histone 2 and histone 3 measured by ELISA. The levels of IgGand IgM-antibodies directed to histone 1, 2 and 3 were elevated in JCA as compared to the healthy controls. IgG-antibodies to histone 2 and IgM-antibodies to histone 3 also were elevated in comparison with the disease controls. IgG- and IgM-antibodies against histone 1 were found to be positive in 30 % and 26 % of JCA patients, respectively, in significant association with ANA (p = 0,038 and p = 0,03, respectively) and uveitis (p = 0,02 and p = 0,016, respectively). The same prevalence of IgG- and IgM-antibodies to histone 2 was established but only the IgG-isotype showed significant association with uveitis (p = 0,018). Anti-histone 3 IgG- and IgM-antibodies were found in 34 % and 27 % of JCA patients, respectively. IgM-antibodies to histone 3 were proved to be significantly associated with uveitis (p - 0,009). It was concluded that antibodies to histone 1, histone 2, and histone 3 represented a common serological feature of JCA. Their presence was related to the manifestation of chronic anterior uveitis, associated with JCA

CpG-island methylation of the ER promoter in colorectal cancer: analysis of micrometastases in lymph nodes from UICC stage I and II patients

Patients with UICC stage II colorectal cancer (CRC) have a risk of approximately 20% to develop disease recurrence after tumour resection. The presence and significance of micrometastases for locoregional recurrence in these patients lacking histopathological lymph node involvement on routine stained HE sections is undefined. Oestrogen receptor (ER) promoter methylation has earlier been identified in CRC. Therefore, we evaluated the methylation status of the ER promoter in lymph nodes from 49 patients with CRC UICC stage I and II as a molecular marker of micrometastases and predictor of local recurrence. DNA from 574 paraffin-embedded lymph nodes was isolated and treated with bisulphite. For the detection of methylated ER promoter sequences, quantitative real-time methylation-specific PCR was used. Of the 49 patients tested, 15 (31%) had ER methylation-positive lymph nodes. Thirteen of those (86%) remained disease free and two (14%) developed local recurrence. In the resected lymph nodes of 34 of the 49 patients (69%), no ER promoter methylation could be detected and none of these patients experienced a local relapse. The methylation status of the ER promoter in lymph nodes of UICC stage I and II CRC patients may be a useful marker for the identification of patients at a high risk for local recurrence