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Zammataro A, Koy C, Ruß M, Röwer C, Glocker MO. Intact Transition Epitope Mapping—Serological Inspection by Epitope EXtraction (ITEM—SIX). Molecules 2023; 28:molecules28073092. [PMID: 37049857 PMCID: PMC10096252 DOI: 10.3390/molecules28073092] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
Precision medicine requests accurate serological inspections to precisely stratify patients for targeted treatment. Intact transition epitope mapping analysis proved surrogate seroconversion of a model organism’s serum when spiked with a monoclonal murine anti-Ovalbumin antibody (mAb) with epitope resolution. Isolation of the IgG fraction from blood serum applied two consecutive protein precipitation steps followed by ultrafiltration and resulted in an ESI-MS analysis-ready IgG preparation. For epitope mapping by epitope extraction, the Ovalbumin antigen was digested with trypsin. After desalting, the peptide mixture was added to the ESI-MS-ready IgG preparation from mAb-spiked serum and the solution was incubated to form an immune complex between the Ovalbumin-derived epitope peptide and the anti-Ovalbumin mAb. Then, the entire mixture of proteins and peptides was directly electrosprayed. Sorting of ions in the mass spectrometer’s gas phase, dissociation of the immune complex ions by collision-induced dissociation, and recording of the epitope peptide ion that had been released from the immune complex proved the presence of the anti-Ovalbumin mAb in serum. Mass determination of the complex-released epitope peptide ion with isotope resolution is highly accurate, guaranteeing high specificity of this novel analysis approach, which is termed Intact Transition Epitope Mapping—Serological Inspections by Epitope EXtraction (ITEM—SIX).
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Mendis T, Filipova B, Wang JJ, Pietropaolo M, Jackson MW. Affinity purification of serum-derived anti-IA-2 autoantibodies in type 1 diabetes using a novel MBP-IA-2 fusion protein. Biochem Biophys Rep 2022; 33:101413. [PMID: 36578528 PMCID: PMC9791830 DOI: 10.1016/j.bbrep.2022.101413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Autoantibodies targeting epitopes contained within the intracellular domain (IC) of the protein phosphatase-like islet antigen 2 (IA-2) are a common marker of autoimmune type 1 diabetes (T1D), however the isolation of genuine, serum derived anti-IA-2 autoantibodies has proven challenging due to a lack of suitable bioassays. In the current study, an ELISA format was developed for affinity purification of human anti-IA-2ic autoantibodies utilizing a fusion protein (FP) incorporating maltose binding protein and the full-length IA-2IC domain. Using a T1D patient cohort validated for anti-IA-2ic autoantibodies by commercial ELISA, we demonstrate the MBP-IA-2ic FP ELISA detects serum anti-IA-2IC autoantibodies from 3 of 9 IA-2 positive patients. Further to this, a multi-plate MBP-IA-2ic FP ELISA protocol specifically affinity purifies IgG enriched for anti-IA-2ic autoantibodies. Interestingly, serum derived autoantibodies immobilised on the MBP-IA-2ic FP ELISA demonstrate increased Kappa light chain usage when compared to the respective total IgG derived from donor patients, suggesting a clonally restricted repertoire of anti-IA-2ic autoantigen specific B plasma cells is responsible for autoantibodies detect by the MBP-IA-2ic FP ELISA. This study is the first to demonstrate the generation of specific, genuine human derived anti-IA-2ic autoantibodies, thereby facilitating further investigation into the origin and functional significance of IA-2 autoantibodies in T1D.
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Affiliation(s)
- Thilini Mendis
- Department of Immunology, Allergy & Arthritis, Flinders Medical Centre and Flinders University, Bedford Park, 5042, South Australia, Australia
| | - Barbora Filipova
- Department of Immunology, Allergy & Arthritis, Flinders Medical Centre and Flinders University, Bedford Park, 5042, South Australia, Australia
| | - Jing Jing Wang
- Department of Immunology, Allergy & Arthritis, Flinders Medical Centre and Flinders University, Bedford Park, 5042, South Australia, Australia
| | - Massimo Pietropaolo
- Dept of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA
| | - Michael W. Jackson
- Department of Immunology, Allergy & Arthritis, Flinders Medical Centre and Flinders University, Bedford Park, 5042, South Australia, Australia,Corresponding author. Department of Immunology, Allergy and Arthritis, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia.
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3
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Anti-Ro52/TRIM21 serological subsets identify differential clinical and laboratory parameters. Clin Rheumatol 2022; 41:3495-3501. [PMID: 35871174 PMCID: PMC9568495 DOI: 10.1007/s10067-022-06299-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 12/03/2022]
Abstract
Introduction Anti-Ro52/tripartite motif-containing protein 21 (TRIM21) IgG is one of the most common autoantibodies found in systemic autoimmune diseases and is typically found in conjunction with anti-Ro60 and/or anti-La. A retrospective, cross-sectional study was undertaken to examine the clinical and laboratory features of two serological subsets: patients with anti-Ro52/TRIM21 autoantibodies in the absence of anti-Ro60 and anti-La (isolated anti-Ro52/TRIM21) and patients with anti-Ro52/TRIM21 in the presence of anti-Ro60 and/or anti-La. Methods Over a 12-month period, patients tested positive for anti-Ro52/TRIM21 via line immunoassay (LIA) at the Westmead Hospital (Australia) immunopathology laboratory were included. The presence of anti-Ro60 and/or anti-La via same LIA was noted. Associated laboratory and medical records were perused to extract demographic, laboratory, and clinical information. Results There were 346 patients within the study period, and 39.9% of the patients positive for anti-Ro52/TRIM21 lacked anti-Ro60/anti-La autoantibodies. Isolated anti-Ro52/TRIM21 patients tend to be older, have lower anti-Ro52/TRIM21 titres, have lower rheumatoid factors, and have lower proportions of neutropaenia compared to patients who were positive for anti-Ro52/TRIM21 and anti-Ro60/La. This occurred independent to diagnoses of Sjögren’s syndrome or systemic lupus erythematosus. Coexisting neurological syndromes, pulmonary pathologies, and malignancies were more prevalent in the isolated anti-Ro52/TRIM21 subset. Conclusions Patients with isolated anti-Ro52/TRIM21 tend to have distinct and important clinical and laboratory associations. It is unclear if these patients evolve or remain a stable subset and how they originate immunologically. Longitudinal and prospective studies are required to ascertain the overall predictive and prognostic value of this stratification.Key Points • Anti-Ro52/TRIM21 is an autoantibody found in autoimmunity and non-immunological conditions. • Sixty percent of anti-Ro52/TRIM21 patients are positive for anti-Ro60. • Isolated anti-Ro52/TRIM21 has reduced anti-Ro52/TRIM21 and rheumatoid factor titres. • Isolated anti-Ro52/TRIM21 is associated with anaemia and malignancies. |
Supplementary Information The online version contains supplementary material available at 10.1007/s10067-022-06299-5.
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Ulndreaj A, Wang M, Misaghian S, Paone L, Sigal GB, Stengelin M, Campbell C, Van Nynatten LR, Soosaipillai A, Ghorbani A, Mathew A, Fraser DD, Diamandis EP, Prassas I. Patients with severe COVID-19 do not have elevated autoantibodies against common diagnostic autoantigens. Clin Chem Lab Med 2022; 60:1116-1123. [PMID: 35475723 DOI: 10.1515/cclm-2022-0239] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/14/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Infection by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative pathogen of coronavirus disease 2019 (COVID-19) presents occasionally with an aberrant autoinflammatory response, including the presence of elevated circulating autoantibodies in some individuals. Whether the development of autoantibodies against self-antigens affects COVID-19 outcomes remains unclear. To better understand the prognostic role of autoantibodies in COVID-19, we quantified autoantibodies against 23 markers that are used for diagnosis of autoimmune disease. To this end, we used serum samples from patients with severe [intensive care unit (ICU)] and moderate (ward) COVID-19, across two to six consecutive time points, and compared autoantibody levels to uninfected healthy and ICU controls. METHODS Acute and post-acute serum (from 1 to 26 ICU days) was collected from 18 ICU COVID-19-positive patients at three to six time points; 18 ICU COVID-19-negative patients (sampled on ICU day 1 and 3); 21 ward COVID-19-positive patients (sampled on hospital day 1 and 3); and from 59 healthy uninfected controls deriving from two cohorts. Levels of IgG autoantibodies against 23 autoantigens, commonly used for autoimmune disease diagnosis, were measured in serum samples using MSD® U-PLEX electrochemiluminescence technology (MSD division Meso Scale Discovery®), and results were compared between groups. RESULTS There were no significant elevations of autoantibodies for any of the markers tested in patients with severe COVID-19. CONCLUSIONS Sample collections at longer time points should be considered in future studies, for assessing the possible development of autoantibody responses following infection with SARS-CoV-2.
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Affiliation(s)
- Antigona Ulndreaj
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - Mingyue Wang
- Meso Scale Diagnostics, LLC. (MSD), Rockville, MD, USA
| | | | - Louis Paone
- Meso Scale Diagnostics, LLC. (MSD), Rockville, MD, USA
| | | | | | | | - Logan R Van Nynatten
- Lawson Health Research Institute, London, ON, Canada.,Department of Pediatrics, Clinical Neurological Sciences and Physiology and Pharmacology, Western University, London, ON, Canada
| | - Antoninus Soosaipillai
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Atefeh Ghorbani
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Anu Mathew
- Meso Scale Diagnostics, LLC. (MSD), Rockville, MD, USA
| | - Douglas D Fraser
- Lawson Health Research Institute, London, ON, Canada.,Department of Pediatrics, Clinical Neurological Sciences and Physiology and Pharmacology, Western University, London, ON, Canada
| | - Eleftherios P Diamandis
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.,Department of Clinical Biochemistry, University Health Network, Toronto, ON, Canada
| | - Ioannis Prassas
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
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Abstract
Anti-histone antibodies (AHAs) make their appearance in a number of systemic autoimmune diseases including systemic lupus erythematosus (SLE) and drug-induced lupus erythematosus (DILE). Although being known for over 50 years, they are poorly studied and understood. There is emerging evidence for their use in predicting clinical features of SLE, diversifying their clinical use. AHAs, however, are probably less prevalent in DILE than once thought owing to a move away from older DILE drugs to modern biological agents which do not appear to elicit AHAs. This review examines the historical studies that have defined AHAs and looks at some of the recent work with these autoantibodies.
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Affiliation(s)
- Adrian Y S Lee
- Department of Immunology, Westmead Hospital, Westmead, Australia.,ICPMR, NSW Health Pathology, Westmead, Australia.,Westmead Clinical School, University of Sydney, Westmead, Australia
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6
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Lee AYS. IgA anti-dsDNA antibodies: A neglected serological parameter in systemic lupus erythematosus. Lupus 2022; 31:137-142. [PMID: 35049409 DOI: 10.1177/09612033221074184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Anti-double-stranded DNA (anti-dsDNA) autoantibodies are archetypal biomarkers found in systemic lupus erythematosus (SLE). Although they can exist in any isotype, very little is understood about the IgA isotype for which most of our knowledge is derived from observational studies. This review article summarises our knowledge of this autoantibody isotype to date. Attention will be spent on clinical associations as well as its potential links with lupus nephritis for which there is still some controversy. Further understanding of this serological parameter may facilitate diagnosis, prognosis and treatments of systemic lupus erythematosus patients.
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Affiliation(s)
- Adrian Y S Lee
- 8539Westmead Hospital, Westmead, NSW, Australia.,ICPMR, NSW Health Pathology, Westmead, NSW, Australia.,Westmead Clinical School, University of Sydney, Westmead, NSW, Australia
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Lee AYS, Brown DA, McDonald D, Lin MW. Longitudinal Tracking of Extractable Nuclear Antigen (ENA) Antibodies in a Quaternary Hospital Laboratory Cohort Reveals Dynamic Antibody Profiles. J Appl Lab Med 2022; 7:26-35. [PMID: 34996068 DOI: 10.1093/jalm/jfab104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 07/14/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Antiextractable nuclear antigens (anti-ENAs) are regarded as diagnostic tests with no established value for serial monitoring. We therefore sought to establish the stability over time of anti-ENAs in a large diagnostic immunopathology laboratory. METHODS A retrospective review of all patients who had a serial anti-ENA ordered at the Westmead Hospital (Sydney, Australia) was performed over 24 months. Anti-ENA characterization was performed using line immunoassay, and historical data were available from 2013 onward. The earliest available densitometry readings were compared with the latest available to examine for a change in quantitation or qualitative (serostatus) result (from negative to positive, and vice versa). Medical records were examined for clinical correlations. RESULTS A total of 283 patients (24.1%) had serial testing of anti-ENA in the audit period, with each patient having an average of 3.9 ± 2.9 tests each. Most patients were diagnosed with systemic lupus erythematosus or primary Sjögren's syndrome. About 25% and 58% of patients had a qualitative and quantitative change, respectively, in at least 1 anti-ENA in the study period. Changes in anti-ENA levels correlated with erythrocyte sedimentation rate and disease activity. Increasing duration between serial tests increased the probability of observing a change in anti-ENA levels. CONCLUSION Certain anti-ENAs are dynamic autoantibodies that may have significance for monitoring disease activity. Laboratories may consider reporting quantitative results. Further disease- and autoantibody-specific studies are required to determine the clinical significance of changes in anti-ENAs.
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Affiliation(s)
- Adrian Y S Lee
- Department of Immunopathology, ICPMR and NSW Health Pathology, Westmead Hospital, NSW, Australia.,Department of Immunology, Sydney Medical School, Westmead Hospital, NSW, Australia
| | - David A Brown
- Department of Immunopathology, ICPMR and NSW Health Pathology, Westmead Hospital, NSW, Australia.,Department of Immunology, Sydney Medical School, Westmead Hospital, NSW, Australia.,Centre for Allergy and Immunology Research, The Westmead Institute for Medical Research, NSW, Australia
| | - David McDonald
- Department of Immunopathology, ICPMR and NSW Health Pathology, Westmead Hospital, NSW, Australia
| | - Ming-Wei Lin
- Department of Immunopathology, ICPMR and NSW Health Pathology, Westmead Hospital, NSW, Australia.,Department of Immunology, Sydney Medical School, Westmead Hospital, NSW, Australia.,Centre for Allergy and Immunology Research, The Westmead Institute for Medical Research, NSW, Australia
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8
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Lee AYS, Culican S, Campbell D, Lin M. Clinical associations of serum Golgi apparatus antibodies in an immunology laboratory cohort. Scand J Immunol 2021; 95:e13133. [DOI: 10.1111/sji.13133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 12/04/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Adrian Y. S. Lee
- Department of Immunopathology Institute of Clinical Pathology and Medical Research NSW Health Pathology Westmead NSW Australia
- Department of Clinical Immunology & Allergy Westmead Hospital Westmead NSW Australia
- Westmead Clinical School University of Sydney Westmead NSW Australia
| | - Suzanne Culican
- Department of Immunopathology Institute of Clinical Pathology and Medical Research NSW Health Pathology Westmead NSW Australia
| | - David Campbell
- Department of Immunopathology Institute of Clinical Pathology and Medical Research NSW Health Pathology Westmead NSW Australia
| | - Ming‐Wei Lin
- Department of Immunopathology Institute of Clinical Pathology and Medical Research NSW Health Pathology Westmead NSW Australia
- Department of Clinical Immunology & Allergy Westmead Hospital Westmead NSW Australia
- Westmead Clinical School University of Sydney Westmead NSW Australia
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9
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Nony E, Moingeon P. Proteomics in support of immunotherapy: contribution to model-based precision medicine. Expert Rev Proteomics 2021; 19:33-42. [PMID: 34937491 DOI: 10.1080/14789450.2021.2020653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Proteomics encompasses a wide and expanding range of methods to identify, characterize, and quantify thousands of proteins from a variety of biological samples, including blood samples, tumors, and tissues. Such methods are supportive of various forms of immunotherapy applied to chronic conditions such as allergies, autoimmune diseases, cancers, and infectious diseases. AREAS COVERED In support of immunotherapy, proteomics based on mass spectrometry has multiple specific applications related to (i) disease modeling and patient stratification, (ii) antigen/ autoantigen/neoantigen/ allergen identification, (iii) characterization of proteins and monoclonal antibodies used for immunotherapeutic or diagnostic purposes, (iv) identification of biomarkers and companion diagnostics and (v) monitoring by immunoproteomics of immune responses elicited in the course of the disease or following immunotherapy. EXPERT OPINION Proteomics contributes as an enabling technology to an evolution of immunotherapy toward a precision medicine approach aiming to better tailor treatments to patients' specificities in multiple disease areas. This trend is favored by a better understanding through multi-omics profiling of both the patient's characteristics, his/her immune status as well as of the features of the immunotherapeutic drug.
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Affiliation(s)
- Emmanuel Nony
- Protein Sciences Department, Institut de Recherches Servier, Croissy Sur Seine, France
| | - Philippe Moingeon
- Center for Therapeutic Innovation, Immuno-inflammatory Disease, Institut de Recherches Servier, Croissy Sur Seine, France
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10
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Lee AYS, Reed JH, Gordon TP. Anti-Ro60 and anti-Ro52/TRIM21: Two distinct autoantibodies in systemic autoimmune diseases. J Autoimmun 2021; 124:102724. [PMID: 34464814 DOI: 10.1016/j.jaut.2021.102724] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/16/2021] [Accepted: 08/24/2021] [Indexed: 11/27/2022]
Abstract
As iconic and important diagnostic autoantibodies, anti-Ro60 and anti-Ro52/tri-partite motif-containing 21 (TRIM21) make a common appearance in a number of systemic autoimmune disorders such as systemic lupus erythematosus (SLE). These autoantibodies often co-exist together; yet despite their close relationship, there is no evidence that they are physically linked and probably reflect a convergence of separate processes of failed immunological tolerance. Confusingly, they are sometimes classed together as the "SSA" or "Ro" autoantibody system without clear distinction between the two. In this Short Communication, we discuss the diagnostic merits for separate detection and reporting of these two autoantibodies, and discuss avenues for future research. Indeed, further insight into their fascinating origins and pathogenic roles in autoimmunity will surely shed light on how we can prevent and treat devastating autoimmune disorders.
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Affiliation(s)
- Adrian Y S Lee
- Department of Immunology, Westmead Hospital & ICPMR, Westmead, NSW, Australia; Westmead Clinical School, The University of Sydney, Westmead, NSW, Australia.
| | - Joanne H Reed
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia; St Vincent's Clinical School, Faculty of Medicine, UNSW, Sydney, NSW, Australia
| | - Tom P Gordon
- Department of Immunology, SA Pathology and Flinders Medical Centre, Bedford Park, SA, Australia; Department of Immunology, Flinders University, Bedford Park, SA, Australia
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11
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Lee A, Patterson KA, Tan DJ, Wilson ME, Proudman SM, Stevens W, Nikpour M, Sahhar J, Ngian GS, Roddy J, Roberts-Thomson PJ, Walker JG. Anti-Ro52/TRIM21 is independently associated with pulmonary arterial hypertension and mortality in a cohort of systemic sclerosis patients. Scand J Rheumatol 2021; 50:469-474. [PMID: 33851896 DOI: 10.1080/03009742.2021.1887927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: We undertook a comprehensive cross-sectional analysis of a multicentred Australian cohort of systemic sclerosis (SSc) patients to evaluate the associations of anti-Ro52/TRIM21 with SSc pulmonary involvement.Method: The study included 596 patients from the Australian Scleroderma Cohort Study database whose anti-Ro52/TRIM21 status was known. Anti-Ro52/TRIM21 was measured via line immunoassay. Data on demographic variables, autoantibody profiles, presence of interstitial lung disease (ILD), presence of pulmonary arterial hypertension (PAH), oxygen saturation, Six-Minute Walk Test distance, Borg dyspnoea score, and lung function tests were extracted. SPSS software was used to examine associations using univariate and multivariate analyses.Results: Anti-Ro52/TRIM21 was present in 34.4% of SSc patients. In the cross-sectional analysis, anti-Ro52/TRIM21 was independently associated with PAH [odds ratio 1.75, 95% confidence interval (CI) 1.05-2.90], but not ILD or other surrogate measures of pulmonary involvement such as average patient oxygen saturation. The antibody, however, was also associated with a higher forced vital capacity/diffusing capacity of the lung for carbon monoxide ratio. Prospectively, anti-Ro52/TRIM21 was also associated with an increased risk of death in patients with SSc (hazard ratio 1.62, 95% CI 1.11-2.35), independent of confounding factors. The primary cause of death appeared to be related to PAH and/or ILD, and anti-Ro52/TRIM21 was associated with PAH-related complications.Conclusion: Anti-Ro52/TRIM21 was independently associated with PAH and mortality in SSc patients. Future longitudinal studies are recommended to investigate the timing and pathogenic mechanisms of this autoantibody in PAH.
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Affiliation(s)
- Ays Lee
- Departments of Rheumatology and Immunology, Flinders Medical Centre, Bedford Park, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park, Australia.,Department of Immunology, SA Pathology, Flinders Medical Centre, Bedford Park, Australia
| | - K A Patterson
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - D J Tan
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - M E Wilson
- Department of Rheumatology, St Vincent's Hospital (Melbourne), Fitzroy, Australia
| | - S M Proudman
- Rheumatology Unit, Royal Adelaide Hospital, Adelaide, Australia.,Discipline of Medicine, University of Adelaide, Adelaide, Australia
| | - W Stevens
- Department of Rheumatology, St Vincent's Hospital (Melbourne), Fitzroy, Australia
| | - M Nikpour
- Department of Rheumatology, St Vincent's Hospital (Melbourne), Fitzroy, Australia.,Department of Medicine, The University of Melbourne, Fitzroy, Australia
| | - J Sahhar
- Department of Rheumatology, Monash Health, Clayton, Australia.,Department of Medicine, Monash University, Clayton, Australia
| | - G-S Ngian
- Department of Rheumatology, Monash Health, Clayton, Australia.,Department of Medicine, Monash University, Clayton, Australia
| | - J Roddy
- Department of Rheumatology, Fiona Stanley Hospital, Murdoch, Australia
| | - P J Roberts-Thomson
- Departments of Rheumatology and Immunology, Flinders Medical Centre, Bedford Park, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park, Australia.,Department of Immunology, SA Pathology, Flinders Medical Centre, Bedford Park, Australia
| | - J G Walker
- Departments of Rheumatology and Immunology, Flinders Medical Centre, Bedford Park, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park, Australia
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12
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Lee AYS, Lin MW. Polymeric IgA paraprotein on agarose gel electrophoresis immunofixation identifies a unique subset of IgA myeloma patients. Clin Chim Acta 2020; 512:112-116. [PMID: 33127346 DOI: 10.1016/j.cca.2020.10.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/13/2020] [Accepted: 10/22/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES On agarose gel electrophoresis, IgA paraprotein has a tendency to polymerise and form multiple bands on immunofixation. We decided to investigate if there are any differences in clinical parameters with monomeric vs. polymeric IgA paraprotein multiple myeloma (MM) patients. METHODS During an 18-month retrospective and prospective cross-sectional audit review period at one Australian laboratory, we identified 92 IgA MM patients that were divided up according to monomeric or polymeric IgA paraproteins based on their appearance on IFE. Medical and pathology records were reviewed for demographic details, and laboratory data to examine for end-organ manifestations of MM. RESULTS After correcting for age, polymeric IgA MM patients had a greater degree of proteinuria and hence, higher incidence of hypogammaglobulinaemia. The patients tended to have a higher quantity of paraprotein as well. No difference in mortality was seen. CONCLUSIONS Our study is the first to stratify IgA MM patients according to the laboratory appearance of their paraprotein and may hold important prognostic and predictive clues for these patients.
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Affiliation(s)
- Adrian Y S Lee
- Department of Immunopathology, NSW Pathology and Institute of Clinical Pathology and Medical Research, Westmead Hospital, NSW, Australia; Sydney Medical School, The University of Sydney, NSW, Australia
| | - Ming-Wei Lin
- Department of Immunopathology, NSW Pathology and Institute of Clinical Pathology and Medical Research, Westmead Hospital, NSW, Australia; Sydney Medical School, The University of Sydney, NSW, Australia.
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13
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Wang JJ, Lee AY, Colella AD, Chataway TK, Gordon TP, Wechalekar MD. Proteomic mapping of rheumatoid factors in early rheumatoid arthritis. Arthritis Rheumatol 2020; 72:2159-2161. [DOI: 10.1002/art.41446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 06/27/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Jing J. Wang
- Flinders Medical Centre and Flinders University Bedford Park South Australia Australia
| | - Adrian Y.S. Lee
- Flinders Medical Centre and Flinders University Bedford Park South Australia Australia
| | - Alex D. Colella
- Flinders Medical Centre and Flinders University Bedford Park South Australia Australia
| | - Tim K. Chataway
- Flinders Medical Centre and Flinders University Bedford Park South Australia Australia
| | - Tom P. Gordon
- Flinders Medical Centre and Flinders University Bedford Park South Australia Australia
| | - Mihir D. Wechalekar
- Flinders Medical Centre and Flinders University Bedford Park South Australia Australia
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14
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Lee AY, Körner H. CC chemokine receptor 6 (CCR6) in the pathogenesis of systemic lupus erythematosus. Immunol Cell Biol 2020; 98:845-853. [PMID: 32634857 DOI: 10.1111/imcb.12375] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 07/05/2020] [Accepted: 07/05/2020] [Indexed: 01/10/2023]
Abstract
The CC chemokine receptor 6 (CCR6) and its sole chemokine ligand, CCL20, are an intriguing pair that have been implicated in a growing number of inflammatory, autoimmune and malignant disease processes. Recent observations have also highlighted this chemokine axis in the regulation of humoral immune responses. Through this review article, we explore the emerging links of CCR6-CCL20 with an archetypal autoimmune disease of humoral dysregulation: systemic lupus erythematosus (SLE). CCR6 is expressed prominently on several immune cells involved in the pathogenesis of SLE, such as dendritic cells and T-helper 17 cells. CCR6's expression is correlated with disease activity and serological markers of disease severity, suggesting a possible role in disease pathogenesis. However, there are numerous holes in our understanding of the functions of CCR6 and CCL20, and future studies are required to determine if there are any diagnostic, prognostic or monitoring roles for these important molecules.
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Affiliation(s)
- Adrian Ys Lee
- Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, NSW, Australia.,Sydney Medical School, The University of Sydney, Westmead, NSW, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Heinrich Körner
- Institute of Clinical Pharmacology, Anhui Medical University, Hefei, Anhui Province, PR China
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