bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Systemic Lupus Erythematosus in India
Authors: Malaviya A.N. , Singh R.R. , Singh Y.N. , Kapoor S.K. , Kumar A. 
Published: November 2007

Prevalence of systemic lupus erythematosus (SLE) was studied in the northern Indian population by means of a two-pronged approach: (a) antinuclear antibody (ANA) screening of the general population by a new well-standardized finger-prick 'filter paper' technique (sensitivity and specificity: 95.4% and 86.2%, respectively); and (b) a questionnaire survey carried out primarily by trained personnel in the community (sensitivity and specificity: 100% and 68.6% respectively). The low specificity of the two methods was improved by the introduction of a step of secondary screening by the authors, thus excluding false positives. ANA screening of 52 062 individuals yielded 13 positive results, of which only two were found to be true cases of SLE after secondary screening. Questionnaire survey of 39 826 individuals similarly yielded 3393 positive results. On secondary screening, only one of these persons was found to be a case of SLE. Thus, three cases of SLE were detected in a population survey of 91 888, giving a point prevalence of 3.2 per 100 000 (95% CI = 0-6.86 per 100 000). The reported prevalence of SLE ranges from 14 to 60 per 100 000. Thus, the prevalence of SLE in India is comparatively low. Although the reasons for low prevalence are not clear, the study used highly sensitive methodology and it is therefore unlikely that SLE cases were missed. It is hypothesized that SLE is a disease of modernization and therefore its prevalence in a predominantly rural population like that of India is low.
A vascular Osteonecrosis in Patients with SLE: Relation to Corticosteroid Therapy and Anticardiolipin Antibodies
Authors: Migliaresi Sergio , Picillo Ugo , Ambrosone Lucia , Di Palma Gaetano , Mallozzi Matteo , Tesone Elena R. , Tirri Giuseppe 
Published: November 2007

Sixty-nine unselected SLE patients were studied to evaluate the prevalence of avascular osteonecrosis (AVN) and its relationship with steroid therapy and with anticardiolipin antibodies (aCL). All the patients were under treatment with corticosteroids. AVN occurred in seven of the 69 patients (10. 14%) and was not related to corticosteroid intake. Seventeen of the 69 patients were also treated with methylprednisolone pulse therapy (MPPT) and cumulated the highest corticosteroid doses but none of them suffered from AVN. Excluding the 17 MPPT-treated SLE patients, corticosteroid intake was significantly higher in the AVN-SLE patients. Abnormal IgG and/or IgM aCL serum levels were found in two of the seven AVN-SLE patients and in 24 of the 62 non-AVN SLE, without a statistically significant difference. None of the seven AVN-SLE patients showed features of antiphospholipid syndrome. We conclude that in SLE patients a continuous high-dose steroid treatment may be considered a risk factor for AVN. On the contrary, MPPT regimen may reduce this risk. Anticardiolipin antibodies might represent an added factor which could play a role in some patients but not in all.
Lack of relationship between human immunodeficiency virus infection and systemic lupus erythematosus
Authors: Font Josep , Vidal Josep , Cervera Ricard , López-Soto Alfons , Miret Carles , Jiménez de Anta Maria Teresa , Ingelmo Miguel 
Published: November 2007

The objective of this work was to determine whether HIV-1 and HIV-2 could be involved in the pathogenesis of systemic lupus erythematosus (SLE). Seventy-five consecutive Caucasian patients with SLE presenting at one institution over a 2-year period were studied. Serum samples were surveyed for anti-HIV-1 antibodies by a commercial ELISA coated with HIV-1-p24. For confirmation, conventional immunoblots were performed with the following antigens: HIV-1-gp41, p31, p24 and p17 (recombinant) and HIV-2-gp36 (synthetic peptide). Additionally, Western blots with HIV-1-gp160, gp120, gp41, p65, p51, p24 and p18 bands were applied. Seventeen (23%) patients exhibited reactivity with HIV-1-p24 in the ELISA, but in the immunoblots and Western blots these sera samples were negative. Patients with SLE may exhibit a reactivity with HIV-1-p24 in the ELISA for HIV infection screening but not in the confirmatory blots. This false-positive reactivity is probably due to molecular mimicry between autoantigens and retroviruses or a contaminant or artefacts in the antigen preparation procedure.
False positive seroreactivity to Borrelia burgdorferi in systemic lupus erythematosus: the value of immunoblot analysis
Authors: Weiss Nancy L , Sadock Victoria A , Sigal Leonard H , Phillips Mark , Merryman Parvin F , Abramson Steven B 
Published: November 2007

The object of this study was to determine the incidence of seropositivity to B. burgdorferi by the commonly available enzyme-linked immunosorbent assay (ELISA) in patients with SLE and other rheumatic diseases and to evaluate immunoblot analysis as a tool to differentiate true from false positive ELISA. Sera were obtained from patients with SLE ( n = 35), rheumatoid arthritis ( n = 26), seronegative arthritis (n = 28) and Lyme disease ( n = 18). Reactivity to B. burgdorferi antigens was analysed by two available diagnostic techniques: ELISA and immunoblot. Correlations were made between seroreactivity to B. burgdorferi and standard serological tests of autoimmunity: antibodies to nuclear antigens, dsDNA, cardiolipin, SSA and SSB. Seroreactivity to B. burgdorferi antigens by the ELISA system was detected in 40% of patients with SLE, 8% of patients with rheumatoid arthritis and 4% with seronegative arthritis. Among patients seropositive by ELISA, immunoblots were negative in all cases. However, eight of 14 patients with rheumatoid arthritis (57%) showed cross-reactivity to multiple borrelial antigens. No significant correlations were found between Lyme seropositivity by ELISA and other autoantibodies except IgM rheumatoid factor (r = 0.61, P < 0.01 ) in patients with rheumatoid arthritis. In conclusion: a positive ELISA for Lyme disease was found in up to 40% of patients with established SLE and also in other rheumatic diseases. However, specific serum antibodies to Borrelia were not confirmed by the more specific immunoblot technique. We conclude that immunoblot analysis can help differentiate a false from true positive ELISA for Lyme disease. These findings should caution the clinician with regard to the limitations of current diagnostic testing for Lyme disease, particularly in patients with connective tissue disease.
Specific antiphospholipid antibodies (aPL) eluted from placentae of pregnant women with aPL-positive sera
Authors: Katano K. , Aoki K. , Ogasawara M. , Sasa H. , Hayashi Y. , Kawamura M. , Yagami Y. 
Published: November 2007

The mechanism by which antiphospholipid antibodies (aPL) cause recurrent pregnancy loss remains unclear. It has however been reported that aPL may affect cytotrophoblasts in vitro and thus direct placental damage might occur. Therefore, we investigated whether aPL are bound directly to placental tissues in patients with immunoglobulin G (IgG) -aPL positive sera. The material investigated comprised the placentae of six patients with a history of recurrent pregnancy loss and subclinical autoimmune disorder and one with systemic lupus erythematosus, who were treated with a combination of prednisolone and aspirin. Normal controls consisted of placentae derived from six women, negative for serum aPL, with no medical or obstetrical complication during their pregnancy. Five kinds of IgG- and IgM-antiphospholipid (anti-PS, PI, PA, PG and CL) antibodies were eluted from the placentae of both patients and controls, which were measured by enzyme-linked immunosorbent assay. IgG-aPL were detected in the placental eluates of four of seven (57%) patients, whereas IgM-aPL were not found in any. With respect to the pregnancy outcome of the four patients with IgG-aPL-positive placental eluates, one experienced intrauterine fetal death (IUFD) at 23 weeks of gestation and three demonstrated intrauterine growth retardation (IUGR). In contrast, the remaining three patients, evaluated negative for IgG-aPL in placental eluates, gave birth to one baby with IUGR and two appropriate-for-date babies. The placentae of the four mothers with IgG-aPL-positive placental eluates pathologically showed severe thrombotic findings. These results suggest that IgG-aPL can directly bind to placental tissue and might cause pathologic damage resulting in IUFD or IUGR.
The presence of antiphospholipid antibodies in acute myocardial infarction
Authors: Adler Y. , Finkelstein Y. , Zandeman-Goddard G. , Blank M. , Lorber M. , Lorber A. , Faden D. , Shoenfeld Y. 
Published: November 2007

This study was undertaken to determine if there is an association between increased titers of five different antiphospholipid antibodies (aPLA) in young patients' sera and the occurrence of acute myocardial infarction (AMI). Antibodies to anticardiolipin (aCL), anti-phosphatidylserine (aPS), antiphosphatidylinositol (aPI), anti-phosphatidylcholine (aPC), and anti-phosphatidylethanol amine (aPEA) were measured in 214 patients (102 patients, 102 healthy controls and 10 patients with antiphospholipid syndrome). These antibodies were measured twice (within 4 h of onset of acute myocardial ischemic chest pain and 3 months after the myocardial infarction) by enzyme linked immunosorbent assay (ELISA). Elevated titers of four different aPLA were detected in 6.9% of all patients with AMI on hospitalization. Titers of aPLA in AMI were elevated in the younger age group <50 years old (P < 0.001) and in men only (not statistically significant). No correlation was found between the presence of aPLA and cardiovascular risk factors (smoking, hypertension, diabetes mellitus and hypercholesterolemia). Three of the seven patients with increased titers of aPLA did not have any other cardiovascular risk factors. The titers of aPLA were within normal range 3 months after AMI. Evidence of significantly elevated titers of different aPLA at the early stage of AMI suggests that these autoantibodies are present before the AMI and are not secondary to them. The disappearance of the elevated aPLA 3 months after AMI may be due to an absorption effect or possibly a cyclic phenomenon similarly found in other autoimmune diseases. aPLA may be an additional risk factor for AMI, and should especially be considered in a patient of the younger age group without apparent cardiovascular risk factors.
Prolactin and systemic lupus erythematosus: prolactin secretion by SLE lymphocytes and proliferative (autocrine) activity
Authors: Gutiérrez MA , Molina JF , Jara LJ , Cuéllar ML , García C. , Gutiérrez-Ureña S. , Gharavi A. , Espinoza LR 
Published: November 2007

Accumulated evidence suggests that prolactin (PRL) is an important immunoregulator and might have a role in the pathogenesis of systemic lupus erythematosus (SLE). Moreover, a PRL-like molecule is secreted by normal human lymphocytes and acts as an autocrine growth factor for lymphoproliferation. The objective of this study was to explore the PRL-like peptide production by peripheral blood mononuclear cells (PBMC) from patients with SLE. We investigated the PRL secretion by PBMC from six female SLE patients and nine normal subjects (5 women and 4 men). Ficoll-Hypaque isolated PBMC (1 X 106 cells/ml) were cultured with and without maximal stimulatory doses of PHA (1 mg/ml) or PWM (1/200). At 72 h of culture supernatants were harvested and used to determine PRL immunoreactivity by a radioimmunoassay (NIDDK-reagents). Cell extracts and concentrated supernatants were prepared to determine PRL by Western blot analysis (NIDDK-reagents). SLE non-stimulated PBMC secreted significantly higher levels of PRL than normal non- stimulated PBMC (8.09 ± 4.15 ng/ml vs. 3.48 ± 2.36 ng/ml, P = 0.02 by Mann-Whitney test). High levels of PRL were secreted by SLE-PHA stimulated PBMC (6.88 ± 4.53 ng/ml) and SLE-PWM stimulated PBMC (16.57 ± 16.39 ng/ml) compared with normal-PHA stimulated PBMC (5.83 ± 5.27ng/ml) and normal-PWM stimulated PBMC (8.54 ± 5.49ng/ml), respectively, but the differences were not significant. The maximal production of PRL was found in PWM-stimulated lymphocytes in both groups. Cells extracts prepared from SLE non-stimulated and stimulated PBMC contained a 11 KDa PRL immunoreactive material. Concentrated supernatants from SLE non-stimulated and stimulated PBMC contained both a 11 KDa and a 24-27 KDa PRL immunoreactive material. Our data indicate that PBMC from patients with SLE have an increased production of PRL-like immunoreactive material. This PRL is released in vitro as two different molecular weight forms, and appears to be derived from B rather than T lymphocytes.
Longitudinal measurement of anticardiolipin antibodies during normal pregnancy: a prospective study
Authors: Lynch AM , Rutledge JH , Stephens JK , Murphy JR , Marlar RA , Davila GH , Santos ME , Emlen W. 
Published: November 2007

We have previously shown that elevation of anticardiolipin antibodies (aCL) at the first prenatal visit is associated with increased fetal loss in normal pregnancy. The variation in aCL levels during normal pregnancy has not been established. To examine this question we measured IgG, IgM and IgA aCL levels five times during pregnancy at weeks 5-15, 16-25, 26-35, 36-37 and at delivery. Data were analyzed to determine: (a) the within and between subject variability of aCL during pregnancy; (2) the temporal trend of aCL; and (3) the relation of serial measures of aCL with maternal complications of pregnancy. We divided our cohort of 354 subjects into two groups. Group A included those subjects with consistently normal levels of aCL and group B those subjects with at least one elevated level of aCL. In group A the within subject variability was relatively low (28-34%). In group B we found wide fluctuations in aCL levels and a within subject variability of 88-91 %. Subjects in group B had no increase in maternal complications of pregnancy. The present data suggest that aCL may fluctuate significantly during normal pregnancy and there is little clinical value in measuring aCL on a serial basis during pregnancy.
Prolactin levels and antinuclear antibody profiles in women tested for connective tissue disease
Authors: Allen SH , Sharp GC , Wang G. , Conley C. , Takeda Y. , Conroy SE , Walker SE 
Published: November 2007

Hyperprolactinemia has been reported in some patients with active systemic lupus erythe matosus (SLE). To determine if there was an association between selected autoantibodies and hyperprolactinemia, we assayed prolactin concentrations in sera from women sub mitted to a reference antinuclear antibody laboratory. Autoantibody-positive samples were separated into groups that contained antibodies to double-stranded DNA (anti-DNA), anti bodies to SSA/Ro (anti-SSA/Ro), or antibodies to both SSA/Ro and SSB/La (anti-SSA/Ro- SSB/La). Results were compared with autoantibody-negative sera from age-matched women, submitted to the same laboratory. We also compared the study groups with a separate cohort of 84 healthy women who were not referred for autoantibody testing. Elevated prolactin levels were clustered in 20% of sera from anti-DNA-positive women ≤50 years of age. Twenty-one percent of anti-SSA/Ro-SSB/La-positive women < 50 years of age were hyperprolactinemic. Four of the 15 hyperprolactinemic women identified in this survey had no known cause of elevated prolactin. In the other 11 individuals, secondary causes such as hypothyroidism, pregnancy, chronic renal failure, and medications may have accounted for high serum prolactin values. We also examined sera by Western blot, to determine if immunoblot patterns were associated with elevated serum prolactin concentra tions. The hyperprolactinemic sera yielded novel bands migrating at 70 kd, 32 kd, and 16.5 kd. This study confirmed the reported associations of hyperprolactinemia with SLE and Sjögren's syndrome. Multiple factors appeared to contribute to elevated serum prolactin levels in women with connective tissue diseases, and the presence of hyperprolactinemia was related to unique findings on immunoblot analysis.
Respiratory function in systemic lupus erythematosus: relation with activity and severity
Authors: Rolla G. , Brussino L. , Bertero MT , Bucca C. , Converso M. , Caligaris-Cappio F. 
Published: November 2007

The objective of this study was to examine the relation between respiratory function tests, disease activity and disease severity in ambulatory patients with systemic lupus erythematosus (SLE) who did not present with overt respiratory problems. Lung volumes, maximal expiratory flows at 50% and 25% of vital capacity (MEF50 and MEF25), bronchial threshold to methacholine (PD15FEV 1), transfer factor CO (KCO) were measured in 24 consecutive SLE outpatients (22 women, age 41 ± 14.8 years) and in 24 healthy controls matched for age and sex. In SLE patients alveolar-arterial oxygen gradient (AaO2) was also measured. Disease activity was assessed by European Consensus Lupus Activity Measurement (ECLAM) scoring system and disease severity by Lupus Severity of Disease Index. In comparison to controls SLE patients showed a significant decrease of total lung capacity (TLC) (91.7 ± 16.5 vs 102.7 ± 12.9% predicted, P < 0.01), MEF25 (58.4 ± 25.2 vs 73.5 ± 19.5% predicted, P < 0.005), PD15FEV1 (2164 ± 1122 vs 4230 ± 1014 μg methacholine, P < 0.0001) and KCO (77.1 ± 20.5 vs 96.3 ± 12.4% predicted, P < 0.001). AaO2 (mean value 13.2 ± 8.4) was abnormally high (>20 mm Hg) in 12 patients. The ECLAM score of activity was inversely related with KCO (r = 0.48, P < 0.02). The severity index was significantly related with FEV1/VC ratio (r = 0.43, P < 0.05), MEF50 (r = 0.51, P < 0.01), MEF25 (r = 0.40, P < 0.05) and PD15FEV1 (r = 0.51, P < 0.01). In eight patients, evaluated also after treatment intensification, there was a significant increase in KCO (from 71.8 ± 24.7 to 84.9 ± 22.3% predicted, P < 0.01) along with a decrease in ECLAM score (from 3.0 ± 1.34 to 0.69 ± 0.75, P < 0.01). The relation between disease activity and KCO suggests a relation between systemic and alveolar inflammation whereas the relation between severity index, airway patency and reactivity indices suggests a cumulative damage to the airways in SLE patients, even in the absence of overt respiratory manifestations.
Factors associated with fetal losses in severe systemic lupus erythematosus
Authors: Martinez-Rueda JO , Arce-Salinas CA , Kraus A. , Alcocer-Varela J. , Alarcón-Segovia D. 
Published: November 2007

We evaluated factors associated with fetal losses in patients with severe lupus in a nested case-control study. We assessed separately 73 pregnancies that occurred in 46 women from a cohort of 633 Systemic Lupus Erythematosus (SLE) patients. They had at least one preg nancy after SLE diagnosis, one or more of our severity criteria and all had taken immuno suppressive drugs. Included data were related to disease severity, anti-phospholipid syndrome (APS), anticardiolipin antibodies (a-CL ab), and drugs received during preg nancy. Cases were pregnancies with fetal wastage; controls were pregnancies with live-born children. The mean age at pregnancy was 26.6 ± 4.5 years. Cases had longer disease duration, 6.1 ± 3.5 years vs 4.5 ± 4.3 of controls (p = 0.02); higher prevalence of renal involvement, hemolysis and recurrent venous thrombosis (p < 0.05); they also tended to have a greater prevalence of a-CL ab, and previous fetal losses (p = 0.06). Cases used azathioprine more frequently than controls (p = 0.04). Univariate analysis showed an association of renal involvement, hemolytic anemia, azathioprine or cyclophosphamide prescription during pregnancy, previous fetal losses and APS with fetal wastage. Immunosuppressive drugs and the APS remained significant in the multivariate analysis (p = 0.05; F = 0.01). Factors related with fetal losses in women with severe SLE were: longer disease duration, ingestion of immunosuppressive drugs during pregnancy and any related manifestation of APS. We did not find macroscopic malformations in live-children of women that took azathioprine during pregnancy.
Abnormal prostanoid metabolism in lupus nephritis and the effects of a thromboxane A2 synthetase inhibitor, DP-1904
Authors: Yoshida T. , Ichikawa Y. , Tojo T. , Homma M. 
Published: November 2007

Abnormalities of prostanoid metabolism, which may affect renal function, were studied in lupus nephritis. The subjects were 31 patients with lupus nephritis, ten with non-renal SLE, and four with renal, non-SLE collagen disease. Urinary levels of various prostanoids, thromboxane B2(TXB2), 11-dehydro-TXB 2, 6-keto-PGF1α,2,3-dinor-6-keto-PGF1α and PGE2, and plasma level of 11-dehydro-TXB2 were determined. The effects of four days' dosing of a selective thromboxane A2 (TXA2 ) synthetase inhibitor, DP-1904 (DP), on pros tanoid metabolism, were also studied. Urinary excretion of TXB 2, which reflects the renal production of TXA2, was signifi cantly increased in the patients with lupus nephritis as compared with non-renal SLE (p < 0.05). The urinary TXB2/6-keto-PGF1α ratio was also increased in lupus nephritis as compared with non-renal SLE or healthy controls (p < 0.01), indicating a prostanoid imbal ance, which may lead to impaired renal function and subsequent pathology. The urinary TXB2/6-keto-PGF1α ratio in these lupus nephritis patients showed negative correlations with Ccr and positive correlations with anti-DNA antibody titer (p < 0.001). DP was administered orally (400 mg/day, given in two divided doses) for four days to eight lupus nephritis patients. The urinary excretion of TXB2 and urinary TXB2/6-keto- PGF1α ratio were decreased after one to two days of treatment in all patients. An increase in creatinine clearance used as a measure of renal function was observed in four of eight patients. Furthermore, no side effects were elicited during the four days of treatment. The conclusions reached were that the abnormal prostanoid metabolism observed in lupus nephritis could aggravate renal function through hemodynamic mediation, and that the deviated metabolism was reversible and, at least partially, corrected by a TXA2 syn thetase inhibitor.
A comparison of five health status instruments in patients with systemic lupus erythematosus (SLE)
Authors: Gladman DD , Urowitz MB , Ong A. , Gough J. , MacKinnon A. 
Published: November 2007

The aim of the present investigation was to assess and compare health status instruments in SLE. One hundred and twenty-five patients completed five health status instruments: the Health Assessment Questionnaire (HAQ), Functional Ability Index, the Fatigue Severity Scale (FSS), the Disability Days Measure (DDM), the Centre for Epidemiological Studies- Depression Scale (CES-D), and the Medical Outcomes Study (MOS) Short Form Health Survey during their Clinic visit. Disease activity was measured using the SLE Disease Activ ity Index (SLEDAI). All instruments described a spectrum of quality of life outcomes in these patients. An inter-instrument correlation analysis revealed that components of the MOS correlated sig nificantly with each of the other instruments used. There was no correlation between any of the instruments used and the SLEDAI. We conclude that health status assessment as measured by the MOS short form is a valid independent outcome measure in patients with SLE.