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Emerging evidence suggests that infection by CagA-positive Helicobacter pylori strains is related to the development of more serious gastroduodenal diseases, thus conferring to the determination of anti-CagA antibodies a relevant clinical significance in serological screenings. The detection of anti-CagA positivity in sera negative for anti-H. pylori antibodies raises the question of whether this apparently nonsense result is merely due to a false positive reaction. To address this issue, we compared three different methods for the detection of anti-CagA antibodies. In all, 272 selected sera from patients with precisely defined H. pylori status (positive or negative concordance of five tests, ie, histology by Giemsa in both antrum and corpus, rapid urease test, culture, [13C]urea breath test, IgG ELISA) were tested for anti-CagA reactivity by three different techniques (western immunoblotting, ELISA, and recombinant immunoblotting assay). In order to assess the sensibility and specificity of each tests, we considered as "true" anti-CagA positive sera those with two out of three positive results. Sera from 70% of H. pylori-positive patients and 10% from H. pylori-negative patients turned out to be "true" positives for anti-CagA antibodies. The three methods showed similar excellent results, in terms of both sensitivity and specificity, always over 93%. It is confirmed that a proportion of patients with a negative conventional serology against H. pylori possess anti-CagA antibodies in their sera. In this paper we demonstrate that it can happen even in patients without any biological signs of actual H. pylori infection. The possibility that this can be due to a false positive laboratory result is very likely ruled out by the accuracy of the three methods used. The clinical management of these patients needs further study on larger series. [ABSTRACT FROM AUTHOR]

Using counterimmunoelectrophoresis (CIE), serum antibodies to rabbit thymus extractable antigens were detected in 15% (38/259) of patients with chronic liver disease (CLD) of various aetiologies and 33% (41/124) of patients with miscellaneous connective tissue diseases (CTD). A remarkable diversity of precipitating systems was apparent among cases with the two classes of disorders. All the five systems found in CLD (XR, XR2, SS-B, XR3, XR4) were associated mostly with immunological hepatic disorders. In the 52 autoimmune hepatitis cases, XR was mainly detected (29%), whereas in the 82 primary biliary cirrhosis patients the whole spectrum of reactivities was represented (XR: 11%, XR2:10%. SS-B and XR3:2% each, XR4:1%). XR proved to be closely associated with smooth muscle antibodies (SMA, detected by indirect immunofluorescence on rat kidney sections) both qualitatively and quantitatively. Since all SMA positive sera with anti-actin specificity (SMAT, SMAG) were XR positive and purified actin could absorb out XR CIE reactivity, the hypothesis is made that a cross-reaction occurs between XR antigen and actin epitope(s). [ABSTRACT FROM AUTHOR]

Presents letters to the editor referencing articles discussed in previous issues of the "British Journal of Dermatology." Chronic actinic dermatitis; Effects of lasers in psoriasis; Treatment of steatocystoma multiplex suppurativum with isotretinoin.

Seventy seven sera with antimitochondrial antibody exhibiting the M2-M4 pattern in immunofluorescence (56 from primary biliary cirrhosis (PBC), 21 from non-primary biliary cirrhosis patients) were studied by the combined use of Western immunoblotting with beef heart mitochondria and an enzyme linked immunosorbent assay (ELISA) with beef heart submitochondrial particles. Forty seven sera (10 without autoantibodies and 37 with different auto-antibodies) were included as controls. By immunoblotting, seven mitochondrial peptides reacting with antimitochondrial antibody positive sera were detected. These were of molecular weight 74 kD, 58 kD, 55 kD, 52 kD, 51 kD, 46 kD, and 43 kD. All primary biliary cirrhosis sera and 71% of antimitochondrial antibody-positive non-primary biliary cirrhosis sera reacted with one or more of these peptides, while none of the 47 antimitochondrial antibody negative sera reacted in immunoblotting. The 74 kD band was the most frequently detected (84% of primary biliary cirrhosis and 57% of non-primary biliary cirrhosis cases). All the primary biliary cirrhosis sera which failed to react with this peptide, showed a positive reaction with that of molecular weight 52 kD. 67/77 (87%) immunofluorescence antimitochondrial antibody positive sera reacted in the ELISA test (93% of primary biliary cirrhosis and 71% of non-primary biliary cirrhosis cases). All the 47 immunofluorescence antimitochondrial antibody negative sera were confirmed negative by ELISA. The ELISA values correlated with the immunofluorescence titres (p less than 0.05). By comparison of the results obtained by these two techniques, it emerged that the ELISA test (using our preparation of submitochondrial particles) was not able to detect the antibody directed against the mitochondrial peptide of 52 kD, which thus seems to be different from the other specificities. [ABSTRACT FROM PUBLISHER]

Serum samples of 16 children, treated with allogeneic bone marrow grafts for either aplastic anaemia or leukaemia, were investigated longitudinally for the presence of pentameric (19S) and low molecular weight (LMW)(7S) IgM. From 2 months following grafting, serum IgM increased in all patients, gradually in seven cases and with a transient overshoot in the other nine. In eight patients. LMW-IgM was detected transiently in the serum within the period when total IgM was increasing, either with (live patients) or without (three patients) overshoot. These data indicate that, at a certain stage of the immunological reconstitution after transplantation as in normal ontogeny, rather immature cells of the B cell lineage are able to produce and secrete LMW-IgM. [ABSTRACT FROM AUTHOR]

Serum rosette inhibitory factors (IF) were detected in 61% of 18 sera from HBsAg negative and in 78% of 14 sera from HBsAg positive chronic active liver disease (CALD) patients, who were not under immunosuppressive treatment. In CALD patients, who were under treatment for at least 6 months, IF were detected in 66% of the HBsAg positive patients and only in 18% of the HBsAg negative ones. After precipitation of the serum gamma-globulins by ammonium sulphate, IF were found in the supernatant only in HBsAg positive sera, while completely disappeared in HBsAg negative ones. A significant correlation between serum IF and factors reacting in immunofluorescence (IFL) with a T enriched preparation of lymphocytes was documented only in HBsAg negative cases. No correlation was found between serum IF and circulating immune complexes (IC) or lymphocytotoxins in any of the sera tested. From all these data it is concluded that serum IF detectable in HBsAg negative CALD cases are probably immunoglobulins. Our data would favour the hypothesis that they are anti-T lymphocytes antibodies, since no correlation was found between serum IF and circulating IC. Similar factors, detectable in HBsAg positive sera, are, at least in part, different. The role of such factors in the modulation of the immune response in CALD patients is discussed. [ABSTRACT FROM AUTHOR]

Examines the incidence of cerebrospinal fluid (CSF) leak and the outcomes of its treatment in a group of patients who underwent surgery for different pathology of the cerebellopontine angle. Various options in managing the CSF leak; Rates of CSF leak; Percentage of patients cured using a continuous lumbar cerebrospinal fluid drainage (CLCFD); Extradural repair of the CSF leak.

Rheumatoid arthritis rarely involves the cricoarytenoid joint. The possible consequent symptom includes hoarseness, dysphagia, odynophagia, dysfunctional dysphonia, and acute dyspnea. Etiologic diagnosis is possible with high-resolution computed tomography, which can show spacing of the articular cartilage, density and volume alterations, and subluxation of the cartilage. However, these radiologic signs are not pathognomonic for rheumatoid arthritis, and they should be combined with anamnestic data. [ABSTRACT FROM AUTHOR]