bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression and Relationships of Seven Public Idiotypes of DNA-Binding Autoantibodies on Monoclonal Antibodies and Serum Immunoglobulins
Authors: Staines N.A. , Ravirajan C.T. , Morgan A. , Belcher A.J. , Henry A.J. , Lake R.A. , Smith D.A. , Hamblin A.S. , Hara M. , Adu D. , Morland C. , Isenberg D.A. 
Published: November 2007

Many studies have shown that DNA-reactive autoantibodies share cross-reactive public idiotypes that are defined, usually, by single anti-idiotype reagents. Because anti-idiotype antibodies or antisera will be limited in their ability to detect all the idiotopes of a particular antibody, their use will tend to underestimate the full extent of idiotype sharing between different antibodies. In order to define more comprehensively the extent of idiotype sharing in DNA autoantibodies, a panel of DNA-binding monoclonal autoantibodies from lupus mice was examined with a range of anti-idiotype antisera prepared in rabbits (five sera), guinea pigs (four sera) and a sheep. Each idiotype was detected on more antibodies than its original reference monoclonal antibody, and idiotopes of each were also present on serum immunoglobulins from lupus mice. Of 23 monoclonal antibodies 65% reacted with one or more of the anti-idiotype reagents. On these criteria, all the idiotypes were public; none was private in its expression. In about half the cases the idiotypes were located in or near the antigen-binding sites of the antibodies, but a direct relationship to specificity was not obvious except in the case of Id.228 present on antibodies with a relatively high affinity for single-stranded DNA. In other cases there was no obvious relationship between idiotype and specificity. Antibodies from the same mouse did not each express the same array of idiotopes. None of the idiotypes was restricted to either (NZB x NZW)F1 or MRL/Mp-lpr/lpr mice, but there were differences between the strains. In the former, the expression of idiotype Id.88 notably decreased with age, whereas it rose with age in mice of the latter strain. The extent of sharing of the idiotypes of these DNA antibodies indicates that the great majority of the antibodies are related to each other idiotypically. From these studies, it is clear that the definition of idiotype sharing can be achieved comprehensively only if antibodies against many idiotopes are used.
Fetal Outcome in Lupus Pregnancy: A Retrospective Case-Control Study of 242 Pregnancies in 112 Patients
Authors: Julkunen Heikki , Jouhikainen Taneli , Kaaja Risto , Leirisalo-Repo Marjatta , Stephansson Eija , Palosuop Timo , Teramo Kari , Friman Claes 
Published: November 2007

Fetal outcome in systemic lupus erythematosus (SLE) was retrospectively analysed in 242 pregnancies in 112 unselected patients, and the outcome was compared with that of 417 pregnancies in 192 control women matched for age, parity and socio-economic status. Relative risk for fetal loss after the diagnosis of SLE was 2.5 (95% confidence interval (CI), 1.4-4.5), for prematurity 5.8 (3.2-10.5) and for intra-uterine growth retardation (IUGR) 8.6 (3.0-24.3). Fetal outcome of pregnancy in patients with pre-existing stable lupus nephritis was no worse than in other SLE pregnancies. Relations of three lupus anticoagulant (LA) assays and three anticardiolipin (aCL) enzyme-linked immunosorbent assays to fetal outcome were studied. Patients positive by any LA assay had a previous fetal loss more often than patients negative by all LA assays (odds ratio 3.4; 95% CI, 1.3-9.0; P = 0.01). Of the 41 patients whose antiphospholipid antibody (aPL) tests were all negative, five (12%) had a history of fetal loss (16% in controls). As a group, aCL was more sensitive for fetal loss than LA (64% vs 50%), but LA was more specific (77% vs 52%). Combinations of one aCL assay with one LA assay had a 41-73% sensitivity and a 64-73% specificity for a history of fetal loss. aPL did not correlate to prematurity or fetal growth retardation. In conclusion, fetal loss in SLE is 2.5 times more prevalent than in the normal population. The presence of LA indicates a high risk for fetal loss, and the absence of aPL is an indication of a favorable pregnancy outcome. Prematurity and IUGR are common in SLE, but they are not associated with aPL.
Reciprocal Changes in Complement Activity and Immune-Complex Levels during Plasma Infusion in a C2-Deficient SLE Patient
Authors: Erlendsson Kristján , Traustadóttir Kristin , Freysdóttir Jóna , Steinsson Kristján , Jónsdóttir Ingileif , Valdimarsson Helgi 
Published: November 2007

Although systemic lupus erythematosus (SLE) is abnormally common in individuals with complement deficiency, conclusive evidence has been lacking for a direct causal relationship between disease manifestations and a missing complement component. A patient with C2 deficiency and SLE has been treated with 56 courses of fresh frozen plasma (FFP) infusions over a period of 8 years. Each infusion, involving a total of 12 units of FFP administered in equal doses over 4 consecutive days, has consistently resulted in a transient restoration of the classical pathway of complement, and a full clinical remission lasting 6-8 weeks. This report is concerned with changes in the levels of immune complexes, C2 and C3d during an infusion cycle. Four progressively rising peaks in C2 and C3d were observed during the 4 days of the plasma infusion, and these peaks coincided with four reciprocally descending troughs in the levels of immune complexes. Identical fluctuations have been consistent in all the plasma-infusion cycles that have so far been monitored, and their consistent association with clinical remissions indicates a causal relationship between the C2 restoration and clinical remissons in this C2-deficient SLE patient.
Allergic Disorders in Systemic Lupus Erythematosus
Authors: Sequeira Joao F. , Cesic Dajana , Keser Gokhan , Bukelica Mirjana , Karanagnostis Sotirios , Khamashta Munther A. , Hughes Graham R.V. 
Published: November 2007

Allergic disorders commonly occur in patients with systemic lupus erythematosus (SLE) and allergies to some drugs may occasionally be related to disease flares. We evaluated the prevalence of several types of allergy in 132 patients with SLE and their families and compared the SLE patients with a control group of 66 patients with non-lupus disorders. Total IgE levels were tested in 117 SLE patients and 61 controls. Eighty-three of the 132 SLE patients (63 %) had a history of at least one type of allergic disorder. This prevalence was significantly higher (P < 0.0001) than that of the control group (20 of 66 controls). The prevalence of drug allergy (38 % vs. 17 %; P < 0.005), skin allergy (36 % vs. 17 %; P < 0.01) and insect allergy (14 % vs. 2 %; P < 0.02) were significantly higher in SLE patients when compared with controls. Family members of SLE patients had an increased prevalence of at least one type of allergy (55 % vs. 24 %; P < 0.0001), allergic rhinitis (30 % vs. 14 %; P < 0.02), asthma (25 % vs. 9 % P < 0.02), and both rhinitis or asthma (44 % vs. 20 %; P ≤ 0.002). The presence of allergy both in the patient and in the family was more frequent in SLE patients than controls (42 '10 vs. 15 %; P < 0.001). We found no differences in total IgE levels between the two groups. Drug, skin and insect allergies were particularly frequent in SLE patients. We also found a high prevalence of rhinitis and asthma in their families.
Pregnancy in Systemic Lupus Erythematosus: a Prospective Study
Authors: Derksen Ronald H.W.M. , Bruinse Hein W. , de Groot Philip G. , Kater Louis 
Published: November 2007

The objective of this work was to analyse the course of maternal disease and fetal outcome in pregnant patients with systemic lupus erythematosus (SLE) counselled and followed according to a protocol intended to optimize maternal and fetal outcome. The prospective study included all pregnancies between 1987 and 1993 in SLE patients known at least 6 months before pregnancy at the Lupus Clinic of our hospital. In 25 patients there were 35 pregnancies. Thirty-four (97%) started at sustained remission of disease; 11 (31%) were in women with antiphospholipid antibodies (aPL); 14 (40%) in women with a history of biopsy-proven lupus nephritis; one (3% in a woman with a serum creatinine above 125 μmol/l. In 29 pregnancies (82%) maternal disease remained inactive during gestation. In three pregnancies (9%) active disease was treated with prednisone. There were no serious post-partum flares of disease. Pregnancy resulted in 25 (71%) live births, 8 (23%) first trimester abortions, and one intrauterine fetal death. One pregnancy was terminated because of hydrocephalus. Nine of 25 (36%) live births were delivered by caesarean section. For 6 of 9 (67%) caesarean sections the indication was fetal distress and pre-eclampsia. In the majority of patients with SLE who conceive at remission, the disease does not flare in pregnancy. With optimal obstetric care, close follow-up and treatment with low-dose aspirin if aPL are present, a high success rate (71%) can be achieved.
Acute Sideroblastic Anemia in Active Systemic Lupus Erythematosus
Authors: Javier Jiménez-Balderas F. , Morales-Polanco Manuel R. , Gutierrez Laura 
Published: November 2007

This work describes the development of sideroblastic anemia (SA) during the clinical activity of systemic lupus erythematosus (SLE) in two patients. The cases refer to two women with SLE who developed SA during a relapse of the illness. Both patients fulfilled at least four criteria of the American Association of Rheumatology for SLE. In one patient, the treatment with prednisone was followed by the resolution of the SLE activity and the disappearance of the SA. Several years later there was no evidence of ringed sideroblasts or malignancy in the bone marrow. In the other patient, the clinical activity of the SLE and SA developed during the beginning of a septicemic event which finally led to her death. Our clinical cases allow us to show that the transitory development of SA can occur during a period of clinical activity of SLE and that its association, although infrequent, is due to a common physiopathogenic mechanism.
IgA-alpha-1-antitrypsin complex in systemic lupus erythematosus: preliminary report
Authors: Lacki J.K. , Schochat T. , Leszczynski P. , Mackiewicz S.H. , Muller W. 
Published: November 2007

To investigate the role of the complex IgA-alpha-1-antitrypsin (IgA-AT) in systemic lupus erythematosus (SLE) and in mixed connective tissue disease (MCTD), and its possible relations to either activity of the disease or a treatment, we examined a concentration of IgA-AT complex in 65 SLE and 9 MCTD sera. Complex IgA-AT was evaluated using a double antibody enzyme-linked immunoassay (ELISA). Twenty nine patients with SLE (44.6%) and three patients with MCTD (33.3%) had increased serum IgA-AT levels. The mean values of IgA-AT complex in patients with SLE and MCTD were higher than in healthy controls. Among the SLE group, patients with current neurological manifestation were characterized by an increase in IgA-AT serum concentration (2.45 ± 2.07 U vs. 0.78 ± 0.70 U, P < 0.001). No relation was found between this complex and ESR level, C-reactive protein (CRP) concentration, or hemoglobin level. Ten SLE patients were treated with CTX intravenously. In this group of patients, IgA-AT complex level was found to be increased compared with patients without such a treatment (1.82 ± 1.30 U vs. 0.80 ± 0.67 U, P <0.05). The present study provides two new observations. Firstly, IgA-AT complex is increased in SLE and MCTD compared with healthy controls, and secondly, patients with CNS involvement displayed a striking increased IgA-AT level.
Cerebellar atrophy in systemic lupus erythematosus
Authors: Al-Arfaj HF , Naddaf HO 
Published: November 2007

Central nervous system involvement in systemic lupus erythematosus (SLE) is common; this is especially so in patients with positive antiphospholipid antibody. However, cerebellar involvement is very unusual. In our institution, we have seen 150 cases of SLE over the last 10 years; however, this is the only patient who has cerebellar involvement due to SLE. The patient had no other neurological deficit, and no other cause apart from her SLE to explain her cerebellar ataxia. Her antiphospholipid antibody was negative. The patient showed some improvement on high-dose steroids and azathioprin.
Libman-Sacks endocarditis in the antiphospholipid syndrome: immunopathologic findings in deformed heart valves
Authors: Ziporen L. , Goldberg I. , Arad M. , Hojnik M. , Ordi-Ros J. , Afek A. , Blank M. , Sandbank Y. , Vilardell-Tarres M. , de Torres I. , Weinberger A. , Asherson RA , Kopolovic Y. , Shoenfeld Y. 
Published: November 2007

Objective. To examine the potential immunologic mechanism and involvement of antiphos pholipid antibodies in the pathogenesis of heart valve lesions in patients with the antiphos pholipid syndrome (APS). Methods. Immunoperoxidase and immunofluorescence staining methods were used to evaluate 13 heart valve specimens derived from eight patients with the APS, either primary or secondary to systemic lupus erythematosus. Primary antibodies to human immuno globulins, complement components, serum albumin and a monoclonal anti-idiotypic anti body to human anticardiolipin antibodies (aCL) were employed. Various tissue specimens from a patient with the APS as well as deformed and normal valves from subjects without the APS were used as controls. Results. Linear subendothelial deposition consisting of immunoglobulins with complement components but not of a non-specific serum protein was found in deformed valves from patients with the APS. None of the control valves or tissues disclosed similar deposition. The same pattern and location of staining was obtained by the anti-idiotypic antibody to aCL. A significant amount of IgG immunoglobulins that bound to cardiolipin was eluted from a valve of a patient with secondary APS. Conclusion. Deposits of immunoglobulins including aCL, and of complement components, are common in affected valves of patients with primary and secondary APS. Such deposits may be involved in the pathogenesis of valvular lesions.
Review : Ultraviolet-A1 (340-400 nm) irradiation therapy in systemic lupus erythematosus
Authors: McGrath H. , Martínez-Osuna P. , Lee FA 
Published: November 2007

Ultraviolet-A1 (UV-A1) wavelengths have been found effective in mitigating signs and symp toms of disease activity in systemic lupus erythematosus (SLE) but studies have been uncon trolled. To rigorously assess the effectiveness and safety of daily low-dose UV-A1 irradiation as a therapeutic agent in this disorder we enrolled 26 women with SLE in an 18-week two-phase study. During the initial six-week prospective, double-blind, placebo-controlled phase, the patients were divided into two groups; Group A was exposed to 60 kJ/m 2 of UV-A1 (340-400 nm) irradiation within a sunbed five days a week for three weeks and Group B was exposed for an equal amount of time to visible light of greater than > 430 nm (placebo). Each group was then crossed over for exposure to the other source for three weeks. During the second phase - 12 weeks - patients and physicians were unblinded and patients were irradiated with progressively decreasing levels of UV-A1 only. Twenty-five patients completed the six-week placebo-controlled phase of the study and eighteen patients participated for the entire 18 weeks. In Group A the systemic lupus activ ity measure (SLAM) score improved significantly after three weeks of five-day-a-week UV-A1 irradiation (P < 0.05), regressing to baseline during the three weeks of placebo irra diation. Improvement recurred and progressed with six weeks of three-day-a-week UV-A1 irradiation (P < 0.05). Group B patients responded negligibly to the three weeks of visible light, more sharply to UV-A1, and as with Group A, maximally to the six weeks of three- day-a-week UV-A1 (P < 0.01). With twice- and then once-weekly UV-A1 irradiation the SLAM scores worsened slightly. All patients decreased their drug use. Anti-double-stranded DNA antibodies (anti- dsDNA) decreased significantly (P < 0.05) and anti-nuclear antibodies non-significantly. Side effects were negligible. Visible light had no significant effect. In conclusion, low-dose UV-A1 irradiation effectively, comfortably, and without apparent toxicity diminished signs and symptoms of disease activity in SLE.
Epidemiology and socioeconomic impact of skin disease in lupus erythematosus
Authors: Tebbe B. , Orfanos CE 
Published: November 2007

The prevalence rates of systemic lupus erythematosus (SLE) may vary within 17-48/100 000 population worldwide. Although population-based epidemiological studies are still missing, the cutaneous variants of lupus erythematosus (LE) are 2-3 times more frequent than SLE itself. The most common age of onset is 20-40 y. Overall, cutaneous LE is regarded as a variant with less severe course and better prognosis. However, CDLE and SCLE last for many years and may lead, like SLE, to severe disability for work and limited life quality; also, a small proportion of patients with cutaneous LE develops SLE during the course of their disease. This implies considerable amount of medical management and costs for the community. Early recognition of cutaneous LE patients at risk to develop SLE and preventive measures against disease triggering factors are important tasks for physicians attending with cutaneous LE patients. It seems that signs of nephropathy, elevated ANA-titers and arthralgias may serve as prognostic predictors for transition into SLE. Characteristic features of cutaneous LE are photosensitivity and female predominance. UV light is a major environmental triggering factor in cutaneous LE. Skin lesions may be induced or preexistent lesions may exacerbate due to UV light in up to 80-90% of all patients. Therefore, socioeconomic counseling of the young patients, for example choice of occupation and sun protection, are essentials in compliant patients. Also, since females are 3—6 times more frequently affected than males, the possibility of hormonal influences including pregnancy and estrogen- containing drugs should be discussed. Risk considerations for females wishing to become pregnant are required, and avoidance of estrogen-containing contraceptives should be recommended.
Primary antiphospholipid syndrome emerging following thymectomy for myasthenia gravis: Additional evidence for the kaleidoscope of autoimmunity
Authors: Shoenfeld Y. , Lorber M. , Yucel T. , Yazici H. 
Published: November 2007

The etiology of autoimmune diseases is multifactorial. In many of them the stimulation by a specific autoantigen is claimed to be responsible for the initiation of the disease. Alternatively, an autoimmune state may be induced by a pure dysregulation of the immune system. Such is the case in which severe systemic lupus erythematosus (SLE) is induced in young patients with myasthenia gravis following thymectomy. We have referred to this set of events as the 'kaleidoscope of autoimmunity'. Herewith, we would like to present another example of the kaleidoscope phenomenon, namely: the emergence of a full blown clinical presentation of the primary antiphospholipid syndrome (APS-recurrent thromboembolic phenomena, repeated fetal loss with high titers of anti-cardiolipid antibodies) in a 32 y old female with myasthenia gravis, two years following thymectomy. Thymectomy in myasthenic patients may be associated with the emergence of new autoimmune conditions such as SLE and APS, pointing to the importance of immune dysregulation in the induction of these autoimmune diseases.
Out On a Limb: a Qualitative Study of Patient Advocacy in Institutional Nursing
Authors: Sellin Sandra C. 
Published: November 2007

This study explored the nature of patient advocacy among 40 institutionally employed registered nurses, nurse managers, clinical nurse specialists and nursing administrators. Participants were asked to define patient advocacy, to discuss their experiences with advocacy in institutions and their perceptions of risk associated with advocacy in institutional settings, and to identify one concept central to patient advocacy. The results delineated conceptual definitions of advocacy and numerous factors that influence nurses' decisions about acting as patient advocates in institutions. Additionally, they showed striking similarities between conceptual terms used to define advocacy and terms used to define caring. Cet article est basé sur une enquête auprés de quarante infirmiers/ères, directeurs/ directrices, infirmiers/ères spécialisé(e)s et administrateurs employés dans des institu tions. On a demandé aux participants de définir la défense des malades, de discuter de leurs expériences concernant cette activité dans les institutions, de leurs perceptions des risques courus au cours de la défense et d'identifier un principe central à la défense des malades. Les résultats de l'enquête présentaient des définitions conceptuels de la défense ainsi que de nombreux éléments qui influencent les décisions prises par les infirmiers/ères qui assument la défence des malades dans les institutions. En plus, les résultats montraient de grandes ressemblances entre les expressions conceptuelles utilisées pour définir cette défense et les expressions utilisées pour définir les soins. In dieser Studie wird untersucht, was vierzig in Insitutionen angestellte Pflegende, Man ager, und andere Pflegeexperten unter Fürsprache verstehen, wie sie sie definieren, und was ihre Erfahrung mit Fürsprache am Arbeitsort ist. Die Beteiligten wurden gefragt, wie sie die Risiken der Fürsprache in Institutionen einschätzen, und sie wurden aufgefordert, ein allgemein gültiges Konzept für Patientenfürsprache zu identifizieren. Das Resultat zeigt begriffliche Definitionen der Fürsprache sowei verschiedene Faktoren, die die Entscheidungen des Pflegepersonals beeinflussen, wenn sie als Fürsprecher der Patienten handeln. Zugleich zeigte diese Studie auch grosse Aehnlichkeiten zwischen Begriffen der Fürsprache und der Pflege.