Laboratory diagnosis of rheumatic diseases

Александрова, Е. Н.; Новиков, А. А.; Насонов, Е. Л.

doi:10.17116/labs20154244-58

Lab. sluzh.

2015

DOI: 10.17116/labs20154244-58

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Laboratory diagnosis of rheumatic diseases

Е. Н. Александрова¹,

А. А. Новиков²,

Е. Л. Насонов³

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Cited by 4 publications

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“…В зависимости от типа свечения в НРИФ на фиксированных этанолом нейтрофилах человека различают две основных разновидности ANCA -цитоплазматические (c) ANCA и перинуклеарные (р) ANCA. Обнаружение сANCA и рANCA в сыворотках крови наиболее характерно для системных некротизирующих васкулитов сосудов среднего и мелкого калибра (АNCA-ассоциированных системных васкулитов) [34]. cANCA дают диффузный цитоплазматический гранулярный тип свечения с большей интенсивностью по направлению к ядру нейтрофилов, чем к периферии, взаимодействуют с протеиназой 3 (PR3) и являются высокоспецифичным диагностическим маркером гранулематоза с полиангиитом (ГПА).…”

unclassified

Аutoantibodies in Autoimmune Liver Diseases (Review of Literature)

Aleksandrova,

Dorofeev,

Novikov

et al. 2023

RCLD

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ГБУЗ "Московский клинический научно-практический центр имени А.С. Логинова Департамента здравоохранения города Москвы", 111123, Москва, Россия В обзоре рассматриваются актуальные аспекты исследования аутоантител при аутоиммунных заболеваниях печени (АИЗП). Аутоиммунный гепатит (АИГ) характеризуется обнаружением в сыворотках пациентов антинуклеарных антител (АNА), антител к гладкой мускулатуре (ASMA), микросомам печени и почек (LKM-1), цитоплазматическому антигену печени (LC-1), растворимому антигену печени/печеночно-панкреатическому антигену (SLA/LP), атипичных перинуклеарных антинейтрофильных цитоплазматических антител (pANCA), антител к асиалогликопротеиновому рецептору (ASGPR). Маркерами первичного билиарного холангита (ПБХ) являются антимитохондриальные антитела (АМА-М2), антиген-специфические ANA к sp100, gp210 и центромерам, антитела к антигенам Kelh-like 12 и Hexokinase-1. При первичном склерозирующем холангите (ПСХ) среди множества циркулирующих аутоантител наиболее часто идентифицируют атипичные pANCA. Представлен современный алгоритм исследования аутоантител при АИЗП. Стандартными диагностическими маркерами АИЗП служат ANA, ASMA, антитела к LKM-1 и AMA-M2. Комплексный анализ профилей стандартных и дополнительных субтипов аутоантител позволяет повысить чувствительность диагностики АИЗП и уменьшить количество «серонегативных» вариантов данных патологических состояний. Наибольшее прогностическое значение при АИГ и ПБХ имеют антитела к F-актину, LC-1, SLA/LP, ASGPR, sp100, gp210, центромерам, Kelh-like 12 и Hexokinase-1, обнаружение которых ассоциируется с высокой воспалительной активностью, тяжелым рецидивирующим течением заболевания, прогрессированием гистологического повреждения печени, циррозом, печеночной недостаточностью и необходимостью трансплантации печени. У больных ПСХ наличие атипичных рANCA и IgA-антител к GP2 в сыворотке крови является фактором риска обширного поражения желчевыводящих путей и развития холангиокарциномы. Перспективы иммунодиагностики АИЗП связаны с необходимостью стандартизации методов исследования аутоантител, поиском и клинической валидацией новых разновидностей данных биомаркеров на основе современных лабораторных технологий.

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unclassified

Аutoantibodies in Autoimmune Liver Diseases (Review of Literature)

Aleksandrova,

Dorofeev,

Novikov

et al. 2023

RCLD

View full text Add to dashboard Cite

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The prognostic value of hematological indices in systemic inflammatory diseases of connective tissue

Manzyuk,

Morozova,

Gertsog

et al. 2024

Medicinskij sovet

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Introduction. The lack of available and effective laboratory markers makes predicting exacerbations and progression in systemic inflammatory diseases of connective tissue an intractable task for rheumatologists and primary care specialists who monitor patients. Hematological indices calculated from a complete blood count have demonstrated effectiveness in predicting the course of several diseases.Aim. To determine the prognostic value of hematological indices of complete blood count (RDW, MPV, PLR, NLR, LMR, PMR,PNR, SII) in predicting exacerbations and progression of systemic inflammatory diseases of connective tissueMaterials and methods. For a retrospective observational case-control study, patients with systemic lupus erythematosus (SLE) and ANCA-associated vasculitis (microscopic polyangiitis, granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis) were selected. Patients with an exacerbation or progression of the disease that occurred within 3–12 months were assigned to the main group, patients with stable disease were assigned to the control group.Results. 60 patients were selected, of which 25 had an exacerbation or progression over the next 3–12 months, 35 had a stable course of the disease. The initial clinical and demographic characteristics of patients had no significant differences, including between the subgroups with ANCA-associated vasculitis (n = 35) and systemic lupus erythematosus (n = 25). Patients in the main group had a higher initial erythrocyte distribution width (p < 0.001). Statistically significant differences were observed between the groups in the baseline level of platelet-lymphocytic, neutrophil-lymphocytic, platelet-neutrophil ratios and the index of systemic inflammation, but in the subgroups of SLE and ANCA-associated vasculitis, the differences were divergent.Conclusion. The red blood cell distribution width demonstrated a higher prognostic value in relation to exacerbations and progression of ANCA-associated vasculitis and SLE compared with ESR and C-reactive protein and appears to be the most universal among the studied markers of prognosis of systemic inflammatory diseases of connective tissue.

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Diagnostic value of antibody immunoblotting detection in rheumatoid arthritis patients

Akhverdyan,

Zavodovsky,

Papichev

et al. 2024

Tihookeanskij medicinskij žurnal

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Objective. To assess the diagnostic value of antinuclear antibody (ANA) profiling in rheumatoid arthritis by immunoblotting.Materials and methods. In total, 46 patients with rheumatoid arthritis (RA) with a mean age of 34.6 years (21.3–63.2) were observed. The disease duration was 11.2 years (3.7–19.8); the activity according to DAS 28 was 3.15 ± 1.36 (3.05–3.61) points. The RA diagnosis was based on generally accepted clinical guidelines. The control group included 28 patients with osteoarthritis. Laboratory examinations were conducted using a set of reagents to determine IgG antibodies to nuclear antigens by immunoblotting. Results. The RA patients showed an increased level of antibodies to the RNP/Sm antigen, with its frequency being significantly higher than in the control group (p = 0.007). The most specific testomes for diagnosing RA were anti-RNP/Sm (specificity 96%, sensitivity 25%) and antibodies to the recombinant antigen (sensitivity 25%, specificity 88.1%). The method of ROC analysis found that the value of anti-RNP/Sm = 0 is the point corresponding to the optimal ratio of sensitivity/specificity. This value corresponds to a sensitivity of 50% and a specificity of 73.8%.Conclusion. The studied laboratory tests, as a rule, showed high specificity, but rather low sensitivity. The most specific test for RA is anti-RNP/Sm. The conducted ROC analysis showed that the anti-RNP/Sm test has an average quality index for diagnosing RA.

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Laboratory diagnosis of rheumatic diseases

Cited by 4 publications

References 32 publications

Аutoantibodies in Autoimmune Liver Diseases (Review of Literature)

Аutoantibodies in Autoimmune Liver Diseases (Review of Literature)

The prognostic value of hematological indices in systemic inflammatory diseases of connective tissue

Diagnostic value of antibody immunoblotting detection in rheumatoid arthritis patients

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