Determinations of Soluble Fas and Soluble Fas Ligand in Patients with Systemic Lupus Erythematosus

Background :The Fas/Fas ligand (FasL) system plays an important role in apoptosis by involvement in various immunologic functions, especially the removal of autoreactive and activated T-cells. sFas is a variant of the Fas receptor molecule, which lacks the transmembrane domain by alternative splicing of Fas mRNA and has an inhibitory effect in apoptosis by inhibition of the Fas/FasL pathway. sFasL is a coverted form of FasL by metalloproteinase and is increased in various malignant and autoimmune diseases. In this study, we investigated the expression of sFas and sFasL in systemic lupus erythematosus (SLE) and evaluated their usefulness as markers of disease activity. Method :The concentration of sFas and sFasL in sera from 43 patients with SLE, 17 with rheumatoid arthritis (RA) and 15 normal healthy persons were measured using sFas (S) ELISA Kit and sFas Ligand ELISA Kit (MBL Co., LTD., Nagoya, Japan), respectively. Twenty of 43 SLE sera were paired samples of 10 patients obtained on admission and discharge. Result :The concentration of sFas in SLE (3.12±2.28 ng/mL) was significantly higher than in RA (2.23±0.37 ng/mL) and in the normal control (2.12±0.33 ng/mL). In particular, the concentration of sFas in sera on admission (4.35±3.68 ng/mL) was significantly higher than in the sera on discharge (2.89±0.66 ng/mL), but, the concentration of sFasL among the 3 groups was not statistically different. Conclusion :These results suggest that apoptosis is involved in the pathogenesis of SLE and sFas might be a useful marker as a predictor of disease activity. Further study on the correlation between sFas and other disease activity markers, such as CRP, CH50, CD4 cell count and autoantibody titer is needed. Also, the evalution of sFas as a predictor of disease progression on follow-up studies of these patients is needed.ope

Combined Treatment with Interferon Alpha and Ribavirin for Chronic Hepatitis C in Patients with Previous Non-response or Relapse to Interferon Alone

Background/Aims: Interferon-alpha has been effective in 10-20% of treated patients with chronic hepatitis C (CH-C) on a long term basis. We conducted this study to evaluate the biochemical and virological outcomes of combined treatment with interferon alpha and ribavirin for the patients who had CH-C but showed non-response or relapse to interferon alpha alone. Methods: Twenty five patients with CH-C who had not responded or relapsed to interferon alpha alone treatment were enrolled. Eighteen patients were given by the combined treatment of interferon alpha and ribavirin and 7 patients were not given any specific treatment as control. Interferon alpha-2a was given subcutaneously, at a dose of 4.5 MU thrice weekly. Ribavirin was also given orally, at a dose of 900 mg/day for 24 weeks. We quantified serum HCV-RNA levels at the end of treatment. Results: The normalization rate of serum ALT at the end of treatment was 47.1% (8/17) in treated group and 14.3% (1/7) in control group and negative conversion of HCV-RNA was noted in all patients. In the treated group, 75% (6/8) of responders at the end of treatment sustained serum ALT level normally during 24 weeks follow-up, but none has responded persistently in the control group. Conclusions The combined treatment with interferon alpha and ribavirin is effective and safe for treating chronic hepatitis C in patients who showed non-response or relapse to interferon alone.ope

Performance Evaluation of a New Automated Chemiluminescent Immunoanalyzer-Based Interferon-Gamma Releasing Assay AdvanSure I3 in Comparison With the QuantiFERON-TB Gold In-Tube Assay

BACKGROUND: The interferon-gamma (IFN-γ) releasing assay (IGRA) is widely used for latent tuberculosis infection (LTBI) diagnosis. We evaluated the analytical performance of a new automated chemiluminescent immunoanalyzer-based IGRA (CLIA-IGRA), AdvanSure I3 (LG Life Sciences, Seoul, Korea) and compared it with that of the QuantiFERON-TB Gold In-Tube (QFT-GIT) assay. METHODS: Repeatability and reproducibility were evaluated at four levels. Detection capability, including limit of blank (LoB), limit of detection (LoD), and limit of quantification (LoQ), was evaluated using IFN-γ standard material (National Institute for Biological Standards and Control code: 87/586). Agreement between the results of two assays was evaluated using 341 blood samples from healthcare workers and patients at a tertiary care hospital. To determine the cut-off value of CLIA-IGRA for diagnosing LTBI, the ROC curve was analyzed. RESULTS: Repeatability and reproducibility were 4.86-7.00% and 6.36-7.88% CV, respectively. LoB, LoD, and LoQ were 0.022, 0.077, and 0.249 IU/mL, respectively. IFN-γ values between CLIA-IGRA and QFT-GIT showed a strong correlation within the analytical measurable range of both assays, especially when the value was low. Qualitative comparison of the two assays yielded a 99.1% overall agreement (kappa coefficient=0.98). A cut-off value of 0.35 IU/mL was appropriate for diagnosing LTBI. CONCLUSIONS: CLIA-IGRA is a reliable assay for LTBI diagnosis, with performance similar to that of QFT-GIT.ope

Clinical Significance of Anti-HSP 70 Antibody in the Patients with Systemic Lupus Erythematosus

Background :Heat shock proteins (HSPs), or stress proteins, are immunodominant antigens of many microorganisms. In this study, we have detected the anti-HSP 70 antibody and tried to explain the role of the antibody with respect to the pathogenesis of SLE. Furthermore, we have attempted to find out the possibility to link the presence of the autoantibody with the monitoring and diagnosis of systemic lupus erythematosus (SLE). Method :A total of 80 samples from 55 SLE patients were screened for the presence of anti-HSP 70 antibodies. Simultaneously 59 healthy people were tested as a control group. The anti-HSP 70 antibodies were measured by enzyme-linked immunosorbent assay (ELISA) and confirmed by western blot in anti-HSP 70 antibody ELISA positive samples. The activity of disease state was confirmed by the patients’medical record and systemic lupus activity measure (SLAM). Result :The mean optical density (O.D.450) of ELISA in healthy controls and SLE patients were 0.15±0.18 (mean±S.D.) and 0.13±0.14. The correlation of SLAM Score and ELISA O.D. was r2 = 0.19, P = 0.014. And, the mean O.D. value of ELISA was 0.18±0.02 and 0.11±0.01 before and after treatment (P < 0.05). We compared samples with SLAM Score. The O.D. of anti-HSP 70 ELISA in these patients were 0.20±0.02 and 0.08±0.002 before and after treatment respectively (n=10, mean±S.D., P < 0.01). Conclusion :Anti-HSP 70 antibody was not a clinically useful diagnostic marker in SLE patients. However, the titer of anti-HSP 70 antibody can be used for the monitoring of the therapeutic effectiveness in these patients.ope

Detection of Anti-Extractable Nuclear Antigens in Patients with Systemic Rheumatic Disease via Fluorescence Enzyme Immunoassay and Its Clinical Utility

PURPOSE: Testing for autoantibodies to extractable nuclear antigens (ENAs) plays an important role in the diagnosis and management of systemic rheumatic disease. Currently, no gold standard tests are available for detecting anti-ENAs. To address this gap, we aimed to identify an assay that exhibits satisfactory diagnostic performance in the detection of five common anti-ENAs by comparing two commonly used assays, an automated fluorescent enzyme immunoassay (FEIA) and a microplate ELISA assay. MATERIALS AND METHODS: Sera from 100 patients with systemic rheumatic disease were collected and assayed with FEIA and microplate ELISA to detect anti-ENAs. Statistical analyses were performed to check the agreement rate between the two platforms using kappa coefficients. Analytical sensitivity and specificity for each assay were calculated. RESULTS: The concordance rates between ELISA and FEIA ranged from 89% for anti-RNP to 97% for anti-Scl-70, and the kappa coefficients of the two assays were in the range of 0.44 to 0.82. Between the two assays, a significant difference in sensitivity and specificity was seen only for anti-Sm and anti-RNP, respectively. CONCLUSION: In this study, FEIA and ELISA showed comparable efficiency for detecting anti-ENAs.ope

베트남 체제 변화 요인에 관한 연구 - 국제기구의 굿 거버넌스 정책을

본 논문은 개혁개방정책을 통하여 체제 내 개혁을 시도하였던 베 트남의 체제변화 요인에 관한 연구이다. 경제개혁을 통한 베트남의 체제변화가 지속될 수 있을 것인지 그리고 이런 경제개혁이 정치체 제 개혁에 영향을 미칠 수 있을 것인지에 대한 관심에서 연구가 시 작되었다. 또한 베트남 사회주의가 어떤 길을 걷게 될 것인지에 대 한 해답을 찾기 위해서는 베트남 체제변화의 영향요인 파악이 우선 적으로 이루어져야 한다고 보았다

Reactivities of Commercial Antisera for HLA Typing

Background : The most common problem in HLA typing is unsatisfactory quality of the antisera, or a lack of understanding of their reactivities. Therefore, commercial antisera must be verified under the conditions applied in a particular tissue typing laboratory. Methods : We evaluated the antisera reactivities of a commercial HLA-typing tray, Lymphotype HLA-ABC 72 oriental, the lot 7220999, 7230100 (Biotest, Germany), in about 300 samples from organ transplant recipients and healthy potential donors. Results : The relatively weak antisera were those that defined A26, A33, Cw5, Cw14, B46, B58, B64 and B71 etc. Some of these antisera were not indicated as ‘weak reaction’in the test result catalogue. The reactivities of each antisera indicated as ‘extra reaction’or ‘sometimes missing’ were various. Conclusions : As for antisera reactivities, the data obtained by a laboratory itself are necessary in addition to those in the test result catalogue. These data will be helpful for the correct interpretation for laboratories using same commercial kits. (Korean J Clin Pathol 2000; 20: 510-5)ope

Clinical Usefulness of TrepanostikaTM, Enzyme-Linked Immunosorbent Assay for Detection of Treponema pallidum-Specific Antibody

Background :The TrepanostikaTM is an enzyme-linked immunosorbent assay (ELISA) for the qualitative determination of specific antibody (Ab) to Treponema pallidum. It is important to detect Treponenia pallidum-specific Ab to confirm syphilis in patients with positive nontreponemal result or at late latent stage/late stage. Currently various ELISA methods for Treponema pallidum-specific Ab haute been developed in addition to widely used treponemal tests such as fluorescent treponemal antibody absorption (FTA-ABS) test or Treponema pallidum hemagglutination (TPHA) test. We evaluated TrepanostikaTM, anti-treponemal ELISA test. Method :The sensitivity anti specificity of this ELISA method for detecting Treponema pallidum-specific Ab (TrepanostikaTM) were evaluated and compared with other treponemal tests such as FTA-ABS and TPHA. Result :The sensitivity and specificity of TrepanostikaTM were 55.7% and 95.8%, respectively. The concordance rate with FTA-ABS was 98.9% (283/286) and 100% (272/272) with TPHA. Conclusion :TrepanostikaTM which has similar sensitivity and specificity with FTA-ABS or TPHA could replace the well-known treponemal test such as FTA-ABS or TPHA.ope

Hepatitis C Viral Markers in the Recipients before and after Kidney Transplantation

Background : Hepatitis C virus (HCV) has been identified as one of the most frequent causative agent of posttransplant non-A, non-B hepatitis, but the significance of anti-HCV antibodies after transplantation remains controversial. In the present study, we performed anti-HCV and HCV-RNA RT-PCR (HCV PCR) in the kidney recipients to assess the incidence and the outcome of HCV markers after transplantation. Materials and Methods : In randomly selected 95 patients’ paired sera (before and after transplant samples, respectively), we performed anti-HCV test by Abbott� HCV EIA 3.0. We also performed HCV PCR in 80 paired sera of the 95 patients. We evaluated the incidence of anti-HCV and HCV PCR and compared the results in the kidney recipients between anti-HCV test and HCV PCR before and after transplantation. Results : In the recipients’ sera before transplantation, 16 (16.8%) among 95 sera were anti-HCV positive and 27 (33.8%) among 80 sera were HCV RNA positive. Among the 80 pretransplant sera performed HCV PCR, 23 (28.8%) discordant results were noted between anti-HCV and HCV PCR, and 17 sera among these were HCV PCR positive and anti-HCV negative. A seroconversion from anti-HCV negative to positive after transplantation was observed in 10 sera, but a conversion from positive to negative was not observed. In case of HCV PCR, a conversion from negative to positive was observed in 21 paired sera, and positive to negative in 13 paired sera. Conclusions : Our study indicated that disappearance of anti-HCV antibodies after transplantation in kidney recipients was rare. The overall concordance rates between anti-HCV test and HCV PCR in the recipients before and after renal transplantation were lower than other non-transplanted groups reported, and it may be due to the immunosuppressive therapy or the changes in immunoregulatory function of the patients. Further study such as follow-up liver function tests or liver biopsy will be needed for accurate decision about posttransplant HCV status of kidney recipients.Purpose : This st니dy was designed to compare fracture healing in normal and ovariectomizedope

Immunologic Control for Polyomavirus Infection after Kidney Transplantation

Purpose: The purposes of this study were to compare the relative efficacy of urine decoy cell (UDC) and polymerase chain reaction (PCR) for the polyomavirus infection (PVI), and to search the efficacy of preemptive immunologic control for PVI in earlier stage before irreversible graft injury. Methods: Between Mar. 2003 to Sep. 2005, 265 patients were monitored for the PVI after kidney transplantation. Of the 265 patients, the results of preemptive immunologic modifications were searched among 222 recipients who had the complete data. Results: Of the total 222 patients, 75 patients (33.8%) were positive for UDCs in at least one examination. Overall cumulative incidence of PVI was 32.9%. According to the episode of acute rejection, the one year incidences of PVI were 51.4% and 29.5% in recipients with and without the episode of acute rejection, respectively (P=0.0047). Using decoy cells as a marker of PV viruria, cytology has a sensitivity of 57.1% and negative predictive value of 74.1%. The specificity and positive predictive value for viruria (not viral nephropathy) are 67.2% and 48.8%. False-negative results occurred in samples with suboptimal cellularity, and a low viral load. Three cases of PV nephropathy (PVN) were documented. From January 2001 to December 2002, when we did not prospectively monitor UDCs, 7 cases of PVN were documented among the 116 recipients. Conclusion: The combination test of UDC and PV PCR should be considered as screening test for PVI due to low positive predictive value of UDC. The modulation of net immunosuppression based on UDC values and PV viral loads may reduce the development of PVN.ope