1
|
Park HS, Martínez-Martínez L, Magallares López B, Castellví I, Moya P, Codes-Mendez H, Hernandez Sosa N, Diaz-Torne C, Laiz A, Sainz L, Tandaipan JL, Mariscal A, Franco-Leyva T, Casademont J, Juarez C, Corominas H. Prognostic significance of lymphocytic foci composition in minor salivary gland biopsies for severe disease flare and severity in Sjögren's syndrome: a 3-year follow-up cohort study. Front Immunol 2024; 15:1332924. [PMID: 38469314 PMCID: PMC10925694 DOI: 10.3389/fimmu.2024.1332924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/23/2024] [Indexed: 03/13/2024] Open
Abstract
Introduction This was an ambispective cohort study evaluating the prognostic significance of lymphocytic foci and its lymphoid composition in minor salivary gland biopsy (MSGB) for short-term disease flare and severity in Sjögren's syndrome (SS). Methods The inclusion criteria comprised individuals meeting the ACR/EULAR 2016 criteria who underwent MSGB with an infiltration of more than 50 lymphocytes and received clinical diagnosis between September 2017 and December 2018. Patients with inadequate biopsy samples were excluded. The number of lymphocytic foci and their lymphoid composition in MSGB were assessed using immunofluorescence staining. Major organ damage and improvements in the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) were measured. Statistical analyses, including Cox and linear regressions, were conducted. Results A total of 78 patients with at least one lymphocytic focus were included in the study. The presence of higher T-cell counts in lymphocytic foci in MSGB was associated with severe disease flare, and a logarithmic transformation of T-cell count indicated increased risk (HR 1.96, 95% CI 0.91-4.21). Improvements in the ESSDAI were associated with higher total lymphocyte count and T- and B-cell numbers in the lymphoid composition of the lymphocytic foci. Seropositive patients exhibited higher T CD4+ cell numbers. Correlation analysis showed negative associations between age and lymphocytic foci and the T-cell count. Positive correlations were observed between antinuclear antibody (ANA) titers and total lymphocyte numbers. Discussion Patients with a higher number of T cells in the lymphocytic infiltrates of lymphocytic foci may have a two-fold risk of severe disease flare. The number of B cells and T CD4+ cells in the lymphocytic infiltrates of lymphocytic foci showed a weak but positive relation with the ESSDAI improvement during follow-up. Age and seropositivity appeared to influence the lymphoid composition of the lymphocytic foci.
Collapse
Affiliation(s)
- Hye-Sang Park
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Martínez-Martínez
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Immunology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Berta Magallares López
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ivan Castellví
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Patricia Moya
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Helena Codes-Mendez
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Nerea Hernandez Sosa
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cesar Diaz-Torne
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ana Laiz
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Luis Sainz
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jose Luis Tandaipan
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anaís Mariscal
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Immunology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Teresa Franco-Leyva
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Immunology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi Casademont
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Candido Juarez
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Immunology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Hector Corominas
- Functional Unit of Systemic Autoimmune Diseases (UFMAS), Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
2
|
Lleixà C, Caballero-Ávila M, Pascual-Goñi E, Martín-Aguilar L, Vidal N, Tejada C, Valdés-Hevia E, Zárate E, Vesperinas A, Collet R, Franco-Leyva T, Martínez-Martínez L, Moga E, Cortés-Vicente E, Rojas-García R, Gómez-Anson B, Gil A, González-Mingot C, Brieva L, Martínez-Yélamos S, Querol L. Antibodies against the flotillin-1/2 complex in patients with multiple sclerosis. Brain Commun 2023; 5:fcad109. [PMID: 37091585 PMCID: PMC10116574 DOI: 10.1093/braincomms/fcad109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/16/2023] [Accepted: 04/03/2023] [Indexed: 04/07/2023] Open
Abstract
Abstract
Multiple sclerosis is a tissue-specific autoimmune disease of the central nervous system in which the antigen(s) remains elusive. Antibodies targeting the flotillin-1/2 complex have been described in 1-2% of the patients in a recent study. Other candidate antigens as anoctamin-2 or neurofascin-155 have been previously described in multiple sclerosis patients, although their clinical relevance remains uncertain. Our study aims to analyse the frequency and clinical relevance of antibodies against neurofascin-155, anoctamin-2 and the flotillin-1/2 complex in multiple sclerosis.
Serum (n = 252) and CSF (n = 50) samples from 282 multiple sclerosis patients were included in the study. The control group was composed of 260 serum samples (71 healthy donors and 189 with other neuroinflammatory disorders). Anti-flotillin-1/2, anti-anoctamin-2 and anti-neurofascin-155 antibodies were tested by cell-based assays using transfected cells. We identified 6 multiple sclerosis patients with antibodies against the flotillin-1/2 complex (2.1%) and 1 multiple sclerosis patient with antibodies against anoctamin-2 (0.35%). All multiple sclerosis patients were negative for anti-neurofascin-155 antibodies. Three of the anti-flotillin-1/2 positive patients showed anti-flotillin-1/2 positivity in other serum samples extracted at different moments of their disease. Immunoglobulin G subclasses of anti-flotillin-1/2 antibodies were predominantly 1 and 3.
We confirm that antibodies targeting the flotillin-1/2 complex are present in a subgroup of patients with multiple sclerosis. Further studies are needed to understand the clinical and pathological relevance of anti-flotillin-1/2 autoantibodies in multiple sclerosis.
Collapse
Affiliation(s)
- Cinta Lleixà
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau , Universitat Autònoma de Barcelona , Spain
- Centro para la Investigación Biomédica en Red en Enfermedades Raras (CIBERER) , Spain
| | - Marta Caballero-Ávila
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau , Universitat Autònoma de Barcelona , Spain
| | - Elba Pascual-Goñi
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau , Universitat Autònoma de Barcelona , Spain
| | - Lorena Martín-Aguilar
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau , Universitat Autònoma de Barcelona , Spain
| | - Nuria Vidal
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau , Universitat Autònoma de Barcelona , Spain
| | - Clara Tejada
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau , Universitat Autònoma de Barcelona , Spain
| | - Eduardo Valdés-Hevia
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau , Universitat Autònoma de Barcelona , Spain
| | - Elisa Zárate
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau , Universitat Autònoma de Barcelona , Spain
| | - Ana Vesperinas
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau , Universitat Autònoma de Barcelona , Spain
| | - Roger Collet
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau , Universitat Autònoma de Barcelona , Spain
| | - Teresa Franco-Leyva
- Immunology department, Hospital de la Santa Creu i Sant Pau , Universitat Autònoma de Barcelona , Spain
| | - Laura Martínez-Martínez
- Immunology department, Hospital de la Santa Creu i Sant Pau , Universitat Autònoma de Barcelona , Spain
| | - Esther Moga
- Immunology department, Hospital de la Santa Creu i Sant Pau , Universitat Autònoma de Barcelona , Spain
| | - Elena Cortés-Vicente
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau , Universitat Autònoma de Barcelona , Spain
- Centro para la Investigación Biomédica en Red en Enfermedades Raras (CIBERER) , Spain
| | - Ricard Rojas-García
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau , Universitat Autònoma de Barcelona , Spain
- Centro para la Investigación Biomédica en Red en Enfermedades Raras (CIBERER) , Spain
| | - Beatriz Gómez-Anson
- Department of Radiology, Hospital de la Santa Creu i Sant Pau , Universitat Autònoma de Barcelona , Spain
| | - Anna Gil
- Department of Neurology, Hospital Arnau de Vilanova , Lleida , Spain
| | | | - Luis Brieva
- Department of Neurology, Hospital Arnau de Vilanova , Lleida , Spain
| | - Sergio Martínez-Yélamos
- Multiple Sclerosis Unit, Department of Neurology, Hospital Universitari de Bellvitge, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Departament de Ciències Clíniques, Facultat de Medicina , Universitat de Barcelona , Spain
| | - Luis Querol
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau , Universitat Autònoma de Barcelona , Spain
- Centro para la Investigación Biomédica en Red en Enfermedades Raras (CIBERER) , Spain
| |
Collapse
|
3
|
Franco-Leyva T, Torres OH, Saez Prieto ME, Boera-Carnicero G, Santos Á, Clotet S, Albert-Jares D, El-Ebiary Y, Agustí-Martí M, Casademont J, Juárez C, Martínez-Martínez L. Early differentiated CD28 + CD27 + T lymphocytes as a biomarker for short and long-term outcomes in older patients with pneumonia. J Leukoc Biol 2022; 112:1183-1190. [PMID: 35748037 DOI: 10.1002/jlb.5ma0422-370r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 04/28/2022] [Accepted: 05/23/2022] [Indexed: 12/24/2022] Open
Abstract
This study tested the hypothesis that a more senescent immune system would predict a worse outcome in older patients hospitalized for community-acquired pneumonia (CAP). CAP has long been responsible for high rates of mortality and readmissions among older people. Although immunosenescence is a key factor in the increased susceptibility to infections, there are no related biomarkers currently available in clinical practice. In this context, the aim of this prospective study was to identify immunosenescence-related biomarkers to predict outcomes in patients older than 65 years hospitalized for CAP. We evaluated 97 patients admitted to our hospital for CAP in 2019 and 2020. All patients were followed for 1 year. Our findings showed that elevated levels of early differentiated CD28+ CD27+ T cells at admission were associated with better short (2 months) and long-term (1 year) outcomes in terms of mortality and readmissions. Early differentiated CD28+ CD27+ CD4+ T cell counts were even better long-term predictors. In conclusion, early differentiated CD28+ CD27+ T cells could be useful biomarkers to identify high-risk older patients with CAP, helping clinicians with risk stratification and follow-up.
Collapse
Affiliation(s)
- Teresa Franco-Leyva
- Immunology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Olga H Torres
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain.,Geriatrics Unit, Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - María Encarnación Saez Prieto
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain.,Geriatrics Unit, Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Álvaro Santos
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain.,Geriatrics Unit, Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Sandra Clotet
- Universitat Autònoma de Barcelona, Barcelona, Spain.,Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Daniel Albert-Jares
- Immunology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Yasmin El-Ebiary
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain.,Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Jordi Casademont
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain.,Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Cándido Juárez
- Immunology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Martínez-Martínez
- Immunology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
4
|
Mariscal A, Milán M, Baucells A, Martínez MA, Guillen AG, Trallero-Araguás E, Alvarado-Cardenas M, Martínez-Martínez L, Alserawan L, Franco-Leyva T, Sanz-Martínez MT, Viñas-Giménez L, Corominas H, Juárez C, Castellví I, Selva-O'Callaghan A. Anti-TIF-1γ Antibody Detection Using a Commercial Kit vs In-House Immunoblot: Usefulness in Clinical Practice. Front Immunol 2021; 11:625896. [PMID: 33613568 PMCID: PMC7894254 DOI: 10.3389/fimmu.2020.625896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/14/2020] [Indexed: 11/28/2022] Open
Abstract
Objectives Anti-TIF-1γ autoantibody detection is important for cancer screening in patients with dermatomyositis. The gold standard for anti-TIF-1γ detection, immunoprecipitation, is only available from a few specialized laboratories worldwide, so commercial ELISA/immunoblot tests have emerged in recent years. To analyze their usefulness in diagnosing cancer-associated dermatomyositis, we compared Euroimmun Euroline profile with our previously validated in-house immunoblot assay with human recombinant TIF-1γ. Methods We included 308 adult patients from Hospital de la Santa Creu I Sant Pau and Vall Hebrón Hospital (Barcelona, Spain) tested for anti-TIF-1γ autoantibodies using the Euroline profile and an in-house immunoblot assay. Results A total of 27 anti-TIF-1γ were detected by the Euroline and 12 by the in-house assay. Fair agreement was observed between Euroline and the in-house immunoblot Cohen’s kappa 0.3163. Expected prevalence of anti-TIF-1γ autoantibodies was observed for the two methods for dermatomyositis and undifferentiated connective tissue diseases, but unexpectedly high prevalence of anti-TIF-1γ autoantibodies was detected by Euroline compared to the in-house immunoblot for other diseases (16.5% Euroline vs 0.8% in-house immunoblot, p<0.01). The in-house IB compared to Euroline more reliably detected cancer in patients with DM with anti-TIF-1γ antibodies (p=0.0014 vs p=0.0502 for in-house immunoblot vs Euroline). Conclusion We recommend using a second validated method to confirm Euroline-detected anti-TIF-1γ antibodies when the dermatomyositis diagnosis is not definitive. Furthermore, in the context of definite DM diagnosis with negative anti-TIF-1γ antibodies by Euroline and no other myositis specific antibody, is also recommendable to confirm by a second validated method.
Collapse
Affiliation(s)
- Anaís Mariscal
- Immunology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Milena Milán
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Andrés Baucells
- Immunology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Maria Angeles Martínez
- Immunology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Andrea Garcia Guillen
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | | | | | - Laura Martínez-Martínez
- Immunology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Leticia Alserawan
- Immunology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Teresa Franco-Leyva
- Immunology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | | | | | - Hector Corominas
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Cándido Juárez
- Immunology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Iván Castellví
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Albert Selva-O'Callaghan
- Internal Medicine Department, Hospital Vall d'Hebrón, Barcelona, Spain.,Universitat Autónoma de Barcelona, Barcelona, Spain
| |
Collapse
|