Olli Vainio

International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti-nuclear antibodies

Anti-nuclear antibodies (ANA) are fundamental for the diagnosis of autoimmune diseases, and have been determined by indirect immunofluorescence assay (IIFA) for decades. As the demand for ANA testing increased, alternative techniques were developed challenging the classic IIFA. These alternative platforms differ in their antigen profiles, sensitivity and specificity, raising uncertainties regarding standardisation and interpretation of incongruent results. Therefore, an international group of experts has created recommendations for ANA testing by different methods. Two groups of experts participated in this initiative. The European autoimmunity standardization initiative representing 15 European countries and the International Union of Immunologic Societies/World Health Organization/Arthritis Foundation/Centers for Disease Control and Prevention autoantibody standardising committee. A three-step process followed by a Delphi exercise with closed voting was applied. Twenty-five recommendations for determining ANA (1–13), anti-double stranded DNA antibodies (14–18), specific antibodies (19–23) and validation of methods (24–25) were created. Significant differences between experts were observed regarding recommendations 24–25 (p<0.03). Here, we formulated recommendations for the assessment and interpretation of ANA and associated antibodies. Notably, the roles of IIFA as a reference method, and the importance of defining nuclear and cytoplasmic staining, were emphasised, while the need to incorporate alternative automated methods was acknowledged. Various approaches to overcome discrepancies between methods were suggested of which an improved bench-to-bedside communication is of the utmost importance. These recommendations are based on current knowledge and can enable harmonisation of local algorithms for testing and evaluation of ANA and related autoantibodies. Last but not least, new more appropriate terminologies have been suggested.

Nomenclature for chicken major histocompatibility (B) complex.

1 Department of Biological Sciences, Northern Illinois University, DeKalb, Illinois 60115 z Houghton Poultry Research Station, Huntingdon, Cambs PE17 2DA, United Kingdom 3 The Wistar Institute, Thirty-Sixth Street at Spruce, Philadelphia, Pennsylvania 19104 4 Department of Microbiology, New York University School of Medicine, 550 First Avenue, New York, New York 10016 5 College de France, Laboratoire de M6dicine Exp6rimentale, 11, Place Marcelin-Berthelot, 75231 Paris, Cedex 05, France 6 Institute for General and Experimental Pathology, University of Innsbruck, Fritz-Pregl-Strasse 3, A-6020 Innsbruck, Austria 7 Institute for Experimental Immunology, University of Copenhagen, N0rre Alle 71, DK-2100 Copenhagen 0, Denmark s Department of Immunology and MRC Group of Immunoregulation, University of Alberta, Edmonton, Alberta, Canada 9 Department of Animal Science, Iowa State University, Ames, Iowa 50011 10 Basel Institute for Immunology, Grenzacherstrasse 487, CH-4005 Basel, Switzerland ~1 Department of Avian Medicine, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605 a Department of Medical Microbiology, Turku University, Turku, Finland 20520

Mannose-binding lectin concentrations, MBL2 polymorphisms, and susceptibility to respiratory tract infections in young men.

BACKGROUND Mannose-binding lectin (MBL) is an important component of innate immunity, and its deficiency is associated with susceptibility to recurrent infections. METHODS This exploratory study investigated the association of serum MBL concentrations and MBL2 gene polymorphisms with respiratory tract infections in young men. We genotyped 6 single-nucleotide polymorphisms (SNPs) in the promoter region (alleles H/L, X/Y, and P/Q) and exon 1 (variant alleles B, C, and D and wild-type allele A) of the MBL2 gene by real-time polymerase chain reaction and measured serum MBL concentrations in 111 Finnish military recruits with asthma and 362 without. RESULTS An MBL level below the median concentration was a significant risk factor for infections (asthma status-adjusted odds ratio [OR], 2.5 [95% confidence interval {CI}, 1.4-4.5]). Among the 6 SNPs, there was a significant association between the promoter Y/Y genotype and infections (OR, 2.3 [95% CI, 1.2-4.4]) and a borderline significant association between exon 1 variant alleles and infections (OR, 1.7 [95% CI, 0.9-3.1]), after adjustment for asthma status. CONCLUSION These preliminary results suggest, for the first time, an association between MBL level and respiratory tract infections in young men and a possible association between infections and MBL2 polymorphisms.

Characterization of Chicken CD8-Specific Monoclonal Antibodies Recognizing Novel Epitopes

CDS is a heterodimeric cell surface glycoprotein expressed primarily on thymocytes and a subpopulation of mature T lymphocytes. It binds to the invariant part of the major histocompatibility complex class I molecule and participates in antigen recognition by the major histocompatibility complex class I restricted T cells. As in mammalian species, the majority of chicken thymocytes express both CD4 and CD8, whereas peripheral T cells are either CD4‐ or CD8‐positive. We have created a panel of mouse monoclonal antibodies detecting different cell surface epitopes on chicken CD8. The antibodies precipitate a 32–34 kDa dimeric protein from surface labelled thymocytes under reducing conditions. The identical N‐deglycosylation pattern confirms that these MoAb precipitate the same heterodimeric molecule from chicken thymocyte lysates. Binding of 11–38 and 11–39 MoAb to peripheral blood T cells is totally inhibited by 11–39 and previously characterized CT8 and EP72 MoAb, further confirming their CD8 specificity. CD8α‐chain specificity of MoAb 11–39, 11–38, 11–30 and 11–13 is conclusively proven by staining COS‐cells transfected with a plasmid containing CD8α cDNA. However, MoAb 11–13, 11–30 and 11–38 do not compete with MoAb 11–39 in binding to CD8. These results demonstrate recognition of different epitopes by these MoAb. Monoclonal antibodies detecting novel epitopes on chicken CD8 provide a valuable tool for further studies on T cell development.

B-L Antigens (Class II) of the Chicken Major Histocompatibility Complex Control T-B Cell Interaction*

The detailed study of the genetic control of T-B cell interactions in the chicken has been hampered by the lack of defined major histocompatibility complex (MHC) recombinant chicken lines. In the present study we have used some recently described MHC recombinant chicken lines separating regions encoding antigens that are homologous to class I and class II antigens of mammals in adoptive bursa cell transfer experiments, in which bursa cells from newly hatched chicks were transplanted into cyclophosphamide (Cy)-treated chicks. Subsequent immunizations of the recipients with a thymus-dependent antigen (SRBC) and a thymus-independent antigen (Brucella abortus) showed that the generation of germinal centers in the spleen and the production of antibodies to SRBC required identity between donor and recipient class II antigens (B-L antigens), whereas response to Brucella antigen did not require identity at any of the known MHC loci of the chicken. The results thus reveal that also in the chicken class II (B-L) region genes encode cell-surface glycoproteins that serve as restriction elements in T-B cell cooperation.

Proliferation of chicken peripheral blood leukocytes in response to pokeweed mitogen is macrophage dependent

Chicken peripheral blood leukocytes (PBL) proliferate in vitro in response to a wide range of pokeweed mitogen (PWM) concentrations. The PWM response was not influenced by the major histocompatibility complex (MHC) haplotype nor by the intrinsic responsiveness of the PBL to concanavalin A (Con A). The results indicate that PWM under our conditions stimulates B-lineage cells, although a T-cell subset is also clearly induced to division. The PBL from B-cell-depleted animals gave substantially lower responses than those from normal controls. Pokeweed mitogen stimulation of PBL was adherent cell dependent. Thus the low PWM response of adherent cell-depleted PBL was reconstituted by the addition of irradiated unseparated PBL. Furthermore, purified irradiated adherent cells containing greater than 90% macrophages were also able to reconstitute PWM responses. Finally, we have shown that PWM was able to induce large numbers of B cells to produce cytoplasmic immunoglobulin. However, only a minor proportion of such cells were induced to immunoglobulin secretion.

Pneumococcal carriage is more common in asthmatic than in non-asthmatic young men.

Introduction:  The aim was to investigate the prevalence of oropharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Neisseria meningitidis and beta‐haemolytic streptococci among asthmatic and non‐asthmatic young Finnish men and to identify putative risk factors.

Central nervous system-related symptoms and findings are common in acute Puumala hantavirus infection.

Abstract Background. Puumala hantavirus (PUUV) causes a hemorrhagic fever with renal syndrome (HFRS) also called nephropathia epidemica (NE). Recent case reports and retrospective studies suggest that NE may damage the pituitary gland. Based on these observations, our goal was to explore the nature of this complication prospectively. Methods. A total of 58 hospitalized patients with acute NE volunteered to participate. Central nervous system (CNS) symptoms were recorded, cerebrospinal fluid (CSF) samples were collected, human leukocyte antigen (HLA) haplotype was analyzed, brain magnetic resonance imaging (MRI) was acquired, and electroencephalography (EEG) was recorded. Patients with abnormal pituitary MRI finding were examined by an endocrinologist. Results. Most patients experienced CNS symptoms, and half of the CSF samples were positive for PUUV IgM, elevated protein level, or leukocyte count. CSF of patients negative for DR15(2)-DQ6 haplotype was less frequently affected. MRI revealed pituitary hemorrhage in two patients; these two patients suffered sudden loss of vision associated with headache, and they both developed hypopituitarism. Only one patient required long-term hormonal replacement therapy. Conclusion. CNS-related symptoms and inflammation in the CSF are common in acute NE. Genetic properties of the host may predispose to CNS involvement. It does seem that pituitary injury and subsequent hormonal insufficiency may complicate the recovery.

Polymorphism of chicken CD8-alpha, but not CD8-beta

Abstract We report here the structural basis of CD8 polymorphism in the chicken. Three chicken strains (RPRL Line 7, H.B15.H7, and H.B15.H12) have 14 nucleotide differences in the CD8A cDNA sequence causing eight amino acid replacements in the extracellular part of the molecule. Only two amino acid replacements and four silent mutations were observed in the CD8B cDNA sequence in one (H7) of the strains. Substitutions in CD8α were solely responsible for the binding of CD8-specific monoclonal antibodies, as detected by cDNA expression in COS cells. The majority of the amino acid substitutions are located in the immunoglobulin V-like domain and three of the changes (residues 30, 34, and 58) are situated in the putative major histocompatibility complex class I binding CDR1 and CDR2 regions of the chicken CD8α. CD8A polymorphism has not been reported in other species and this suggests that CD8A and CD8B have evolved under different selective pressures in the chicken.

All Known Human Rhinovirus Species Are Present in Sputum Specimens of Military Recruits During Respiratory Infection

Human rhinoviruses (HRV) are known to cause common cold as well as more complicated respiratory infections. HRV species -A, -B and -C have all been associated with lower respiratory infections and exacerbations of asthma. However, the type distribution of strains connected to different kinds of lower respiratory conditions is not clearly known. We have analysed the presence of HRV in sputum specimens derived from military recruits with and without pre-diagnosed asthma at times of acute respiratory infection (CIAS Study, 2004–2005). The analysis was performed with HRV and HEV real-time RT-PCR assays. Subsequently we studied type distribution of HRV strains by genetic typing in the VP4/VP2 genomic region. In total 146 (38.8%) specimens were HRV-positive and 36 (9.3%) HEV-positive. No difference was found in HRV detection between the asthmatic vs. non-asthmatic patients. Most of the genetically typed strains, 18 (62.1%), belonged to HRV-A, while HRV-B strains constituted five (17.2%) of the HRV-positive strains. HRV-C strain was typed four times from the HRV-positive cases and a HEV-D strain twice. We further typed six HEV positive strains in the partial VP1 region. Three of these belonged to HRV-A and three to HEV-D. HRV-A strains were discovered throughout the study period, while HRV-C strains originated from winter and spring specimens. Interestingly, four out of five typed HRV-B strains originated from the summer season specimens.