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Biomedical subjects

E Martínez-Cordero

Publications and source records attributed to E Martínez-Cordero.

At least 19 recordsLinked to original sources

Anti-avian antibodies and rheumatoid factor in pigeon hypersensitivity pneumonitis.

BACKGROUND: Although several immunological abnormalities may be present in pigeon hypersensitivity pneumonitis (HP), few specific hallmarks have been described. OBJECTIVE: To determine whether the presence of rheumatoid factor (RF) could be useful to discriminate pigeon HP from asymptomatic breeders (AB) and other interstitial lung diseases. METHODS: Fifty-three patients with pigeon HP, 47 AB, 31 idiopathic pulmonary fibrosis (IPF) patients and a rheumatoid arthritis (RA) group were studied. IgM RF was determined through enzyme-linked immunosorbent assay (ELISA) and western blot using human IgG and IgG Fc fragment as antigens. IgG and IgA anti-avian antibodies (AA) against pigeon serum antigen were also measured. The use of F(ab')2 fraction of peroxidase-labelled anti-human immunoglobulins prevented endogenous interferences. Possible cross-binding of RF with avian antigens and the reactivity against human IgG by AA were studied. RESULTS: RF tests were frequently positive in HP (52.8%) in comparison to AB (4.2%) and IPF (12.9%; P = 2.6 x 10-10 and 4.1 x 10-5). Therefore, the presence of RF in pigeon HP showed a sensitivity of 52% and was highly specific considering the results of AB and IPF (95 and 87%, respectively). The RA group revealed positive RF but negative AA tests. RF activity was confirmed through western blot using purified IgG Fc fragment. Overlapping levels of IgG and IgA AA were found in HP and AB. The frequency of AA was low in IPF. The cross-reaction of RF with avian antigens was excluded, and no reactivity against human IgG by AA was detected. Other endogenous interferences were ruled out. CONCLUSION: No single immunological test may definitively distinguish pigeon HP from AB and other interstitial lung disorders; however, positive RF, together with high AA levels, seems to be useful in differentiating the diagnosis.

Adult↗

Interference by rheumatoid factor activity in the detection of antiavian antibodies in pigeon breeders disease.

The assessment of antiavian antibodies is relevant for the study of pigeon breeder's disease; nevertheless, different factors may hamper their accurate detection. The objective of this study was to determine whether an endogenous interfering effect in pigeon breeder's disease might explain the simultaneous presence of IgM, IgG, and IgA antiavian antibodies in high titers as assessed by ELISA. Fifty-nine patients with pigeon breeder's disease, 80 healthy controls, and 47 asymptomatic breeders were studied. To assess possible interfering effects by endogenous immunoglobulins, serum IgG was separated through protein A-Sepharose CL-4B chromatography. Antiavian antibodies were measured in whole and separated samples by ELISA. Since a decline of IgM antiavian antibodies following IgG removal was consistent with a false-positive effect, the causes were studied. High values of IgM, IgG, and IgA antiavian antibodies were found in 47.4% [corrected] of patients with pigeon breeder's disease. An IgM rheumatoid factor activity against IgG was found through ELISA in sera with false-positive IgM antiavian antibodies. Rheumatoid factor binding was confirmed by Western blot. Experimental addition of purified rheumatoid factor to sera with IgG antiavian antibodies replicated the interfering effect. A control group of rheumatoid arthritis with high rheumatoid factor values did not show positive antiavian antibodies tests. No IgG with anti-IgM or anti-IgA activity was found, and the detection of IgA against IgM and IgG was negative. In conclusion, the study of antiavian antibodies might be affected by different immunoassay conditions. An endogenous rheumatoid factor activity produced false-positive IgM results. Other similar interferences warrant a careful evaluation during the serological assessment of pigeon breeder's disease.

Adult↗

Association of polymyositis with rheumatoid arthritis.

The association of polymyositis (PM) and rheumatoid arthritis (RA) is described in a 40-year-old female Mexican patient who was studied for a long period of time. The characteristic changes of PM that preceded the onset of RA for 7 years included proximal symmetrical muscle weakness, increased creatine kinase activity, and distinctive electromyography and muscle biopsy results. The occurrence of RA during the final 4 years of the 11-year period was characterized by long-lasting deforming and symmetric polyarthritis, high positive rheumatoid factor, subcutaneous nodules, and erosive joint changes. Through observation, myopathic changes other than those from PM were excluded. Joint changes other than from RA were also ruled out. A review of the literature revealed few specific reports of the coexistence of both diseases.

Adult↗

IgM antiavian antibodies in sera from patients with pigeon breeder's disease.

The authors' objective was to study the presence of IgM antiavian antibodies in sera from patients with pigeon breeder's disease. We studied 93 patients with interstitial lung disease admitted for the assessment of pigeon breeder's disease. Eighty sera from healthy donors with no history of bird contact and 47 asymptomatic pigeon breeders were included as controls. The presence of IgM, IgG, and IgA antiavian antibodies was detected by ELISA and Western blot using avian-pooled serum antigen. Fifty-three patients were classified as having definite pigeon breeder's disease, whereas 40 did not fulfill these diagnostic criteria. The levels of IgM antiavian-antibodies in pigeon breeder's disease by ELISA exceeded both the values of healthy subjects with no history of avian contact (P = 2.5 x 10(-8)) and the results of asymptomatic breeders (P = 0. 03). Positive IgA antiavian antibodies were the most frequent abnormalities in pigeon breeder's disease showing values over the reference levels of control groups that reach significant statistical differences. Both precipitin-positive and -negative samples demonstrated IgM reactivity. IgM antiavian antibodies were confirmed by Western blot. A relationship of IgM positive tests with a recent history of avian antigen exposure and acute disease was found. Additionally, the positive IgM group included patients having subacute and chronic lung disease. Antiavian antibodies have previously been considered of minor significance in hypersensitivity pneumonitis; nevertheless, recent studies support their use in clinical diagnosis. Although no specific laboratory tests can confirm the diagnosis in pigeon breeder's disease, IgM antiavian antibodies may be useful for detecting recent antigen exposure and the acute stage of the disease.

Adult↗

Anti-dsDNA and Sm autoantibodies in systemic lupus erythematosus.

During the present study the coincidence of anti-dsDNA and Sm antibodies was detected in 16 percent of 51 consecutive SLE patients. These antibodies were detected by the standard indirect immunofluorescence and Ouchterlony tests. All patients with anti-dsDNA and Sm antibodies showed disease activity, including renal, CNS and pulmonary disease. We excluded a cross reactivity of these antibodies by ELISA, using competitive experiments with dsDNA and Sm antigens. The results support the presence of multiple autoantibody production during SLE activity, and suggest that different mechanisms may underlie the induction and regulation of both autoantibodies.

Adolescent↗

Rheumatoid arthritis associated with ankylosing spondylitis defined by scintigraphic and CT abnormalities.

Rheumatoid arthritis and ankylosing spondylitis were detected in the same patient after a long period of observation of the disease. X-ray studies demonstrated the characteristic rheumatoid arthritis changes in peripheral joints. By contrast, few X-ray changes of ankylosing spondylitis were detected, during follow-up. Diagnostic approach through scintigraphic studies disclosed a symmetric uptake of the radionuclide in sacroiliac joints, and computed tomography revealed bilateral ankylosis. The combination of these tests was useful to define the presence of axial disease. This patient was both HLA B27 and DR4 positive. Rheumatoid arthritis occurred before ankylosing spondylitis, that interestingly was defined as a late onset disease.

Adult↗

[Thrombocytopenic purpura and hemolytic anemia in children with generalized lupus erythematosus].

We studied 30 children with systemic lupus erythematosus in order to detect the clinical, pathological and serological findings associated with the development of thrombocytopenic purpura and hemolytic anemia. A group of 13 of the 30 children revealed hematological manifestations as the most prominent changes of SLE. Thrombocytopenic purpura and hemolytic anemia were the beginning manifestation of SLE in 11 children. Different causes, for these hematological changes such as hypersplenism, renal microangiopathy or drugs reactions were excluded by history and examination. Interestingly, other immunohematological manifestations including splenomegaly and lymphadenopathy were more frequent in children with thrombocytopenic purpura and hemolytic anemia, than in those patients without these hematological complications. Positive antiplatelet antibodies were found in 4/6 children with thrombocytopenia and 2/5 with hemolytic anemia. A relation of antiplatelet with anticardiolipin antibodies occurred in 4 patients; 3 of them in children with thrombocytopenic purpura and one with hemolytic anemia. Anti-dsDNA and anti-Sm antibodies were positive in almost all patients. Four children shown a transition from anti-dsDNA to anti-Sm antibodies or viceversa and all of them revealed a significant variation in the titer of these antibodies by ELISA, in relation with disease activity. The presence of hematological manifestations associated with anti-platelet and anti-cardiolipin antibodies in children with SLE support that different mechanisms triggers autoimmunity in childhood.

Adolescent↗

[Generalized sclerosis (scleroderma) in children].

Five patients with childhood scleroderma, were studied from a total group of 50 cases with the disease, 39 of them with diffuse systemic sclerosis and 11 with the CREST syndrome. The average age for these five patients when the disease onset was 13 (the age ranged from 5.5 to 16 years) with an average follow-up of 3.6 years (ranging from 1 to 6.5 years). Of the five, four girls were classified as having diffuse systemic sclerosis and the remaining boy, as suffering from the CREST syndrome. We found no family history or personal and occupational antecendents related with the appearance of the illness. Also excluded were conditions associated with changes similar to scleroderma as are seen in cases of diabetes mellitus, phenylketonuria, toxic oil syndrome, or graft-host rejection reactions. The clinical manifestations seen at the start of the disease included the Raynaud phenomenon, subcutaneous edema and muscular-skeletal abnormalities as arthralgia and myalgia with objective data of inflammatory myopathy. Proximal scleroderma was seen in all five patients; three of them, in addition, developed rapidly progressive cutaneous changes, causing the loss of elasticity and cutaneous hardening of the face during the first year of the disease. In all of the cases, the skin biopsy showed histopathological changes compatible with the diagnosis already given. The most important changes seen in the organs of these children were oesophageal dysfunction and fibrosis of the lung. The X-rays of three of the patients showed them to suffer from intestinal malfunction. We found no kidney, liver or nervous system disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Autoantibodies in juvenile rheumatoid arthritis. Clinical and serologic study].

Twenty five patients with juvenile rheumatoid arthritis were studied in order to define the frequency and kind of circulating autoantibodies in this entity, as well as, their relationship with the different disease subgroups and complications. Also the association of these autoantibodies with the activity stage of the illness was determined. There were 14 pauciarticular, 8 polyarticular and 3 systemic juvenile rheumatoid arthritis patients. Twelve have a flare of the disease and 13 were completely asymptomatic. Rheumatoid factor measured by the latex agglutination tests was positive in 6 children. These included 2 patients with pauciarticular disease, showing titers below 1:40 and 4 cases with polyarticular disease, showing titers above 1:320. One of these last patients developed and adult type rheumatoid arthritis during her evolution and was treated with D-penicillamine. The polyarticular but not the pauciarticular patients showed positive tests for rheumatoid factor by nephelometry. No definite association between these laboratory results and the activity of the disease was noted. Positive antinuclear antibodies by the indirect immunofluorescence test were found in 3 pauciarticular and one polyarticular patients. A predominant homogeneous staining was found with the mouse kidney substrate, whereas homogeneous and speckled patterns were noted with the homologous HEp-2 cells. One patient with persistent positive antinuclear antibodies revealed uveitis. Three of the 4 sera with positive antibodies by the indirect immunofluorescent test have also anti-nucleoprotein antibodies by the hemagglutination test with titers above 1:32.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Systemic lupus erythematosus in children with renal and hematologic manifestations. Relation to anti-nDNA antibodies].

We studied prospectively 22 children with systemic lupus erythematosus. Serologic tests included: immunoglobulins, C3 and C4 determinations. Antinuclear antibodies, by the indirect immunofluorescence test, anti-nDNA, anti-nRNP, anti-Sm and anti-SSB (La) studies were also obtained. From the 22 patients there were 16 girls and 6 boys. The mean age at the onset of the disease was 12.4 years (range 8-15 years). Four patients had the disease before being 10 years old. We mainly observed two clinical subgroups, those with kidney injury, which included 11 patients (50%), and a second group of 8 patients (36%) with prominent hematologic manifestations, 4 with hemolytic anemia and 4 with thrombocytopenic purpura. The patients with kidney disease included 7 with diffuse proliferative glomerulonephritis, one with focal and one with mesangial glomerulonephritis. No biopsies were obtained in two patients. From the group with hematological disturbances, only one patient with hemolytic anemia developed renal involvement during her evolution. Three of the 22 patients presented lymphoproliferative disorders in coexistence with systemic lupus erythematosus. The presence of anti-nDNA antibodies and the decrease of C3, were statistically associated with kidney disease, but not with the hematologic manifestations. Nevertheless 50% of patients with hemolytic anemia and thrombocytopenic purpura have positive anti-nDNA and low C3 determinations. If immunochemical differences between the anti-nDNA antibodies in these groups of patients with systemic lupus erythematosus can establish a distinction in their clinical evolution with or without nephropathy is an interesting question that remains to be determined.

Adolescent↗

Concomitant gout and rheumatoid arthritis.

The coexistence of gout and rheumatoid arthritis is described in a patient who was followed for 7 years before the association was established. This is the 4th non-Caucasian patient recorded in the literature. He was HLA-DR4 positive, and no data suggestive of a predisposition to gout were found. Interestingly, during followup rheumatoid and gouty phases alternated, without simultaneous manifestations of both diseases.

Adult↗

Increase of HLA-DR7 in pigeon breeder's lung in a Mexican population.

The phenotypes of the major histocompatibility complex, loci A, B, C, and DR, were studied in 48 patients with hypersensitivity pneumonitis induced by avian antigen (pigeon breeder's lung) and the results were compared to those obtained from 200 normal subjects of similar ethnic background. Furthermore, we analyzed the delta values of the observed and expected frequencies in the deduced haplotypes of the affected population. Our results showed a significant increase of the antigen HLA-DR7 (corrected P less than 0.001) in patients with pigeon breeder's lung and an equally important difference in the delta values of the haplotypes A1-B8, A25-B14, B35-DR4, and B4-DR5. In addition, the phenotypes of locus DQ were analyzed in 21 patients and 20 controls and no apparent differences were observed. These results suggest that a multifactorial genetic susceptibility associated at least in part with the major histocompatibility complex plays in important role in the development of this disease.

Adult↗

Ankylosing spondylitis and rheumatoid arthritis in a patient with Paget's disease. Differential effects of indomethacin, D-penicillamine, or gold sodium thiomalate in the respective arthritides.

A patient developed both ankylosing spondylitis and rheumatoid arthritis, each of which responded to D-penicillamine or gold sodium thiomalate and indomethacin, respectively. The patient was both HLA-B27 and -DR4 positive. In addition, he was found to have Paget's disease of bone, which has required no treatment.

Aged↗

Natural killer cell-mediated activity in mixed connective tissue disease and its response to induction by interleukin-2.

We studied natural killer cell-mediated (NKCM) activity and its enhancement by interleukin-2 (IL-2) in 15 patients with mixed connective tissue disease (MCTD). The mean baseline NKCM activity of peripheral blood mononuclear cells (MNC) against K562 target cells in the 51Cr release assay was found to be similar to that found in age/sex-matched controls. MCTD patients' cells, however, responded significatively less to IL-2 induction of NKCM than did those of the controls. Using the single-cell agarose NK assay, we found that MCTD patients have a small number of active NK cells that exhibit a high rate of recycling capacity in the baseline state. These preactivated cells could not be stimulated further by IL-2. In two MCTD patients the response to IL-2 was nil, and in the serum from both of them we found an IgM inhibitory factor of such IL-2 induced enhancement. This factor could be absorbed only partially by normal MNC and NK cell-depleted MNC but completely by an IL-2-dependent T-cell line, suggesting that the inhibitory factor may be acting on the IL-2 receptor. These findings seem to be different from those reported in systemic lupus erythematosus and strengthen the notion that MCTD is due to a different immunoregulatory aberration.

Adult↗