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DRA2 Anti-3-nitrotyrosine antibodies in rheumatoid arthritis: a correlation with disease activity
Indian Journal of Rheumatology 2007 September Volume 2, Number 3 (Suppl); pp. S5–S28
Abstracts
Abstracts of papers presented in IRACON-2007 DRA Young Investigator Award Session DRA1
Wegener’s granulomatosis: experience at a tertiary care centre YP Singh, PK Sarma, V Agarwal, A Lawrence, A Aggarwal, R Misra Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Introduction: Data about Wegener’s granulomatosis (WG) from India is scarce. We report our experience with WG at a tertiary care referral hospital in north India. Methods: Retrospective analysis of medical records of patients diagnosed as WG (as per ACR 1990) from 1996 to 2006 was carried out. Details of demographic data, clinical presentation, treatment and outcome were recorded. Results: There were 26 patients (17 male) with median age 44.1 years (range, 21–71) and mean disease duration 5.8 months (range, 1–24). Renal involvement was the commonest presentation (n = 22) followed by joint pains (n = 19), constitutional features (n = 17), lower respiratory tract (n = 17), ear nose and throat (n = 16), cutaneous (n = 15), eyes (n = 12) and nervous system (n = 8) involvement. Majority of the patients received induction therapy, cyclophosphamide 750 mg/m2 I.V. every 4 weekly for 6 months alongwith prednisolone 1 mg/kg/day for 6–12 weeks and gradual taper thereafter, followed by maintenance with azathioprine or methotrexate. At a median follow up of 17 months (range, 0–120), 17 patients were in remission, six had died and three were lost to follow up. Of four relapses (median disease duration 14.7 months; range, 9–24), three achieved remission and one died. Of six deaths, five were due to disease activity (3) and sepsis (2) while on immunosuppression and one was unrelated. Conclusion: Despite being a rare disease, WG is associated with considerable risk of mortality and its management remains challenging.
DRA2
Anti-3-nitrotyrosine antibodies in rheumatoid arthritis: a correlation with disease activity Khursheed Alam, Kiran Dixit, M Asad Khan Department of Biochemistry, Faculty of Medicine, AMU, Aligarh, India.
Introduction: Peroxynitrite is a known oxidant and a powerful nitrating species. It reacts with a variety of biomolecules including proteins, lipids and DNA. 3-Nitrotyrosine (3-NT), a marker for oxidative and nitrosative protein damage has been found in the blood of rheumatoid arthritis (RA) patients. However, very low levels of 3-NT have been reported in normal subjects and early stage RA. Methods: Commercially available histone H2A was exposed to peroxynitrite resulting in the formation of 3-nitrotyrosine. Serum antibodies from 50 RA patients were analyzed for their recognition of 3-NT by ELISA. Results: In direct binding assay preferential recognition of 3-NT was observed with serum antibodies in RA patients. Higher binding was seen in the case of patients with second and third stage RA as compared to the first stage, indicating elevated levels of 3-NT with increased disease activity. In competitive ELISA, Protein A-sepharose purified IgG of RA patients exhibited increased binding with 3-NT, as compared to the IgG from human subjects. Higher binding specificity of RA antibodies for 3-NT was further confirmed by band shift assay. Conclusion: The study correlates 3-NT levels with disease activity. Quantitative 3-NT estimation may form a suitable probe for disease severity and therapeutic prognosis.
DRA3
Outcome of critically ill patients of systemic lupus erythematosus (SLE) admitted in intensive care unit (ICU) Pratibha Seshadri*, D Danda, JV Peter *Medical ICU and Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India.
Background: To determine clinical profile and outcome of critically ill patients with SLE admitted to medical ICU. Methods: Of the 753 inpatients with SLE between July 2002 and June 2007, 50 were in the ICU. Retrospective, cross-sectional study of case records of 42 of them were done to identify predictors of mortality.
Abstracts
Abstracts of papers presented in IRACON-2007 DRA Young Investigator Award Session DRA1
Wegener’s granulomatosis: experience at a tertiary care centre YP Singh, PK Sarma, V Agarwal, A Lawrence, A Aggarwal, R Misra Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Introduction: Data about Wegener’s granulomatosis (WG) from India is scarce. We report our experience with WG at a tertiary care referral hospital in north India. Methods: Retrospective analysis of medical records of patients diagnosed as WG (as per ACR 1990) from 1996 to 2006 was carried out. Details of demographic data, clinical presentation, treatment and outcome were recorded. Results: There were 26 patients (17 male) with median age 44.1 years (range, 21–71) and mean disease duration 5.8 months (range, 1–24). Renal involvement was the commonest presentation (n = 22) followed by joint pains (n = 19), constitutional features (n = 17), lower respiratory tract (n = 17), ear nose and throat (n = 16), cutaneous (n = 15), eyes (n = 12) and nervous system (n = 8) involvement. Majority of the patients received induction therapy, cyclophosphamide 750 mg/m2 I.V. every 4 weekly for 6 months alongwith prednisolone 1 mg/kg/day for 6–12 weeks and gradual taper thereafter, followed by maintenance with azathioprine or methotrexate. At a median follow up of 17 months (range, 0–120), 17 patients were in remission, six had died and three were lost to follow up. Of four relapses (median disease duration 14.7 months; range, 9–24), three achieved remission and one died. Of six deaths, five were due to disease activity (3) and sepsis (2) while on immunosuppression and one was unrelated. Conclusion: Despite being a rare disease, WG is associated with considerable risk of mortality and its management remains challenging.
DRA2
Anti-3-nitrotyrosine antibodies in rheumatoid arthritis: a correlation with disease activity Khursheed Alam, Kiran Dixit, M Asad Khan Department of Biochemistry, Faculty of Medicine, AMU, Aligarh, India.
Introduction: Peroxynitrite is a known oxidant and a powerful nitrating species. It reacts with a variety of biomolecules including proteins, lipids and DNA. 3-Nitrotyrosine (3-NT), a marker for oxidative and nitrosative protein damage has been found in the blood of rheumatoid arthritis (RA) patients. However, very low levels of 3-NT have been reported in normal subjects and early stage RA. Methods: Commercially available histone H2A was exposed to peroxynitrite resulting in the formation of 3-nitrotyrosine. Serum antibodies from 50 RA patients were analyzed for their recognition of 3-NT by ELISA. Results: In direct binding assay preferential recognition of 3-NT was observed with serum antibodies in RA patients. Higher binding was seen in the case of patients with second and third stage RA as compared to the first stage, indicating elevated levels of 3-NT with increased disease activity. In competitive ELISA, Protein A-sepharose purified IgG of RA patients exhibited increased binding with 3-NT, as compared to the IgG from human subjects. Higher binding specificity of RA antibodies for 3-NT was further confirmed by band shift assay. Conclusion: The study correlates 3-NT levels with disease activity. Quantitative 3-NT estimation may form a suitable probe for disease severity and therapeutic prognosis.
DRA3
Outcome of critically ill patients of systemic lupus erythematosus (SLE) admitted in intensive care unit (ICU) Pratibha Seshadri*, D Danda, JV Peter *Medical ICU and Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India.
Background: To determine clinical profile and outcome of critically ill patients with SLE admitted to medical ICU. Methods: Of the 753 inpatients with SLE between July 2002 and June 2007, 50 were in the ICU. Retrospective, cross-sectional study of case records of 42 of them were done to identify predictors of mortality.