Antiphospholipid antibodies: detection and clinical relevance
In the laboratory, what classically defines Antiphospholipid Syndrome (APS) is the persistent presence of so-called antiphospholipid antibodies. These constitute a heterogeneous family of autoantibodies that are directed against proteins that intervene in the coagulation cascade and that have an affinity for phospholipids on cell surfaces. Antibodies with the greatest clinical relevance are those included in the laboratory requirements of the APS classification criteria. These antibodies, called classical antiphospholipid antibodies, are anti-cardiolipin and anti-β2-glycoprotein I of isotype IgG and IgM and lupus anticoagulant. In addition to these antibodies included in the classification criteria, antibodies against other phospholipids and cofactors, against specific domains of the cofactors or IgA isotype have also been described. These new antibodies, or non-classical antiphospholipid antibodies, have clinical significance yet to be established and their possible etiopathogenic role is much less known. Below we will review detection and relevance of these antibodies.
Methodology to avoid Daratumumab interference on Proteinogram interpretation.
Multiple Myeloma (MM) is the second most common blood malignancy and accounts for 1% of all types of cancer. Among the new drugs used in the treatment of this pathology are monoclonal antibodies. Since the appearance of therapies with these biological drugs, such as Daratumumab as the first line of action. It has been found interference caused by the use of these monoclonal antibodies making laboratory tests a bit more challenging.
Below we explain how we solve this interference in Catlab to achieve a correct interpretation and evaluation of the results.
Detection of Gluten immunogenic peptides
Strict gluten-free diet is the only way to control coeliac disease, since classical serological markers show little effectiveness to specific changes in the diet and do not always correlate with the state of the intestinal villi. Evaluating the excretion of gluten immunogenic peptides (GIP) constitutes specific evidence of gluten consumption, allowing both the control and diagnosis of complex cases.
At Catlab GIP detection is carried out by immunochromatographic method in stool sample. This test shows a detection limit of 0.15 μg GIP / g of sample and has the ability to specifically detect the toxic fraction of prolamins with a specificity close to 100%.
Immune response and COVID-19
The clinical presentations of COVID-19 range from asymptomatic forms to a syndrome with cytokine release, respiratory failure, and death. People over 60 years old and those with comorbidities, are more susceptible to developing a deficient immune response, unable to eliminate the virus, and responsible for cytokine release syndrome.
However, other host factors, some still unknown, and some likely genetic in nature, appear to confer susceptibility to complications.
IMMUNOLOGY - Diagnostic utility of the Kappa Index in Multiple Sclerosis
Today there are still no optimal biomarkers to identify all those affected by Multiple Sclerosis (MS). Numerous studies show that the quantitative analysis of kappa free chains can be of great help in predicting Isolated Neurological Syndrome, which is usually the first clinical outbreak that leads to the diagnosis of MS. In our laboratory, in addition to the kappa light chains in CSF and serum, we also have the determination of the Kappa Index.
IMMUNOLOGY - Microarray-specific IgE Detection.
Since July, we have in Catlab a Microarray to detect specific IgE. It is a miniaturized solid phase immunoassay based on modern biochip technology, where the allergic components are immobilized in a microarray. This modern technology allows the simultaneous measurement of IgE antibodies against a fixed panel of 112 components of more than 50 allergic sources (food, pollen, latex, epithelia ...), using only 30 μl of serum or plasma.
IMMUNOLOGY - Review of Prenatal Screening in Catlab
Since September 2015, the first-trimester prenatal screening for Down syndrome and Edwards syndrome, is done with a new method and a new calculation program. A comparative between the previous program Lifecycle Perkin Elmer and the new Ssdwlab6 Roche was made satisfactorily. And minimum requirements for imprecision and inaccuracy for biochemical markers were established with the new method of electrochemiluminescence with optimum results.
IMMUNOLOGY - Fecal calprotectin as a marker of inflammatory bowel disease
The clinical suspicion of organic bowel disease motivates a diagnostic colonoscopy that generates a high rate of false positives, because the markers are not very specific. Next january, in Catlab, we will do Fecal Calprotectin (FCP), a protein found in the cytoplasm of neutrophils and in the membrane of activated monocytes and macrophages. The FCP is reliable in discriminating patients likely to suffer inflammatory bowel disease, and to detect endoscopic inflammatory activity. It is also useful to monitor response to treatment and predict the risk of recurrence.
IMMUNOLOGY - Anti-nuclear antibodies (ANA). A step towards standardization
Anti-nuclear antibodies (ANA) are present in the serum of patients with autoimmune diseases. In Catlab the ANA is performed with the technique of indirect immunofluorescence (IFI). The main disadvantage of the IFI, is the difficult to standardize methodology and the high degree of subjectivity. Catlab has incorporated the GSIGHT®, an analyzer that enables automated reading of the ANA. It increases sensitivity and objectivity of the technique.
IMMUNOLOGY - Identification and utility of onconeuronal antibodies
Paraneoplastic Neurological Syndrome (SNPN) is an heterogeneous group of neurological disorders that present some of the cancer patients. Developing the autoimmune response to tumor antigens affect the nervous system. The SNPN considered preceding forms of cancer, and thus may help predict a hidden cancer.
IMMUNOLOGY - New in Prenatal Biochemical Screening
To provide information as soon as possible to the gynecologist or midwife, Catlab together with the calculation program provider has developed an application, that allows to enter ecographies data directly into the program and get the IR and inform the pregnant while she is still in the medical office.
IMMUNOLOGY - Change in method Immunofluorescence ANA
New procedure for the determination of ANA by immunofluorescence. Replacing the substrate HEp-2 cells by the new cell line transfected HEp-2000.
IMMUNOLOGY–Tests incorporated in Catlab for the diagnosis of DM type 1. Diabetis Mellitus (DM) type 1 is a chronic autoimmune disease. In a secondary immune response, antibodies ICA, anti-GAD, anti-IA2 and anti IAA are generated.
IMMUNOLOGY - Request proteinograms and diagnostic utility
At present, the main and almost unique application of protein electrophoresis study is monoclonal gammopathies them being essential to detect oligo or monoclonal immunoglobulins increases