Background- Inappropriate inflammation is a key mechanism in the development of atherosclerosis. ANTIBODIES against components of the atherosclerotic lesion, in particular, oxidized low density lipoprotein, have been described. The prevalence of systemic autoimmune reactions as characterized by the presence of high titers of serum ANTINUCLEAR ANTIBODIES have also been reported in patients with advanced coronary atherosclerosis. This study was performed to determine whether or not a systemic autoimmune response, characterized by the presence of high titers of ANTINUCLEAR ANTIBODIES, is associated with the presence of coronary atherosclerosis. Methods- In this case-control study, serum was prepared from 55 subjects (aged 59±9.3) with at least 50% stenoses of three main coronary arteries (3VD subjects), and 41 subjects (aged 52.6±7.6)with no evidence of coronary atherosclerosis (NCA subjects) as determined by coronary angiography. The presence of ANTINUCLEAR ANTIBODIES (ANA) was determined by HEp-2 cell as the substrate using DAKO kits (FITC conjugated rabbit anti-human ANTIBODIES) for IgA, IgG, IgM and IgK. The titers of 1/40 or more were considered positive. Observers who graded the test results were unaware of the angiograms.Results- Ninety-six subjects (mean age 55.8±9.3 years, 40-76 years old) entered the study. Demographic and clinical variables were matched among case and control groups except for age and gender. 3VD groups were older (59±9.3 vs. 52.6±7.6, p<0.001) and most of them were male (57.3% vs. 42.7%, p<0.02). Among the NCA group, 11 of 41 subjects (27%) were ANA positive and among 3VD patients, 15 of 55 subjects (26.2%) were ANA positive (p=0.978).Conclusion- The presence of ANA, commonly associated with autoimmune diseases, is not substantially more prevalent among subjects with severe coronary atherosclerosis than those with normal coronary arteries. There is no evidence of autoimmune and systemic markers in both groups. This association does not merit further assessment as a potentially useful indicator of increased risk of coronary heart disease.

Several studies reported the appearance of asthma and autoimmune conditions in the same patient, but the clinical significance of this association was not yet assessed.One hundred asthmatic patients were observed for one year evolution with death, severe exacerbations, intake of > 1000 micrograms of beclometasone or equivalent (high ICS) and FEV1 decline >100 ml, in relation with ANA (ELISA), sputum and blood eosinophilia (EO), NSAID intolerance, BMI >25, chronic rhinosinusitis, smoking status and FEV1 <30% predicted (low FEV1).After 1 year of observation, there were 5 deaths, 28 severe asthma exacerbations requiring hospitalisations, 24 cases requiring high inhaled corticosteroid intake, and 19 patients with fast FEV1 decline (>100 ml/year). Multiple regression analysis pointed out several different independent risk factors for severe asthma evolution: for death presence of ANA (P=0.037), NSAID intolerance (P<0.001) and low FEV1 (P=0.021); for evolution with severe exacerbations ANA (p=0.011), sputum EO (P<0.001), smoking (P=0.044) and NSAID intolerance (P=0.022); for high ICS intake ANA (P=0.036), sputum EO (P=0.026) and low FEV1 (P=0.006); for FEV1 decline >100 ml ANA (P=0.006), sputum EO (P=0.037), BMI>25 (P=0.046) and NSAID intolerance (P=0.017).The presence of ANA is an independent risk factor in asthma for evolution with death, severe exacerbations, high inhaled corticosteroid intake and FEV1 decline >100 ml.

Graves’ disease is an autoimmune disorder characterized by presence of ANTIBODIES directed against thyroid stimulating hormone (TSH) receptor or nearby region. Other serological abnormalities like ANTIBODIES to double stranded DNA (ds–DNA) and ANTINUCLEAR ANTIBODIES (ANA) have also been observed. We studied ANTIBODIES to ds-DNA and ANA in our patients with Graves’ disease and compared them with control group. Sera of 84 patients (29 males, 55 females) with diagnosis of Graves’ disease were prepared and level of ANTIBODIES to ds-DNA and ANA were measured and compared with 41 healthy persons (15 males, 26 females). The level of ANTIBODIES to ds-DNA and ANA in patients and control group did not show any significant difference. Our results were different from other studies in other countries. The difference may be explained by difference in our method of antibody measurement or genetic background which needs to be confirmed by HLA studies of our population.

Background: ANTINUCLEAR ANTIBODIES (ANAs) in women with recurrent miscarriage have been reported. The presence of moderate to high titers of these ANTIBODIES represents an autoimmune condition that can endanger the health of the fetus in pregnant women.Objective: In this study, we evaluated the prevalence of ANAs in Iranian women with a history of two or more unexplained abortion.Materials and Methods: 560 women with unexplained recurrent miscarriage and 560 healthy controls accounted for this study over a period of 13 months. ANAs were detected by indirect immunofluorescence technique.Results: ANAs were detected in 74 of 560 (13.21%) patient with recurrent miscarriage, and in only 5 of 560 (0.9%) controls (p<0.001). ANA positivity was generally found with low-positive results (1.40-1.80) in about 38% of positive cases, whereas moderate titres (1.160-1.320) and high titres (>1.640) were seen in about 46% and 16% of cases respectively. Finally evaluating of microscopic ANA patterns revealed that about half of positive cases had ANTIBODIES against DNA- histone complex, associated with systemic lupus erythematosus disease.Conclusion: ANTINUCLEAR ANTIBODIES are not uncommon in women with unexplained recurrent miscarriage, suggesting the possible role of an autoimmune disorder on abortion, at least in a subgroup of patients.

Background and Aim: Pemphigus vulgaris (PV) is an autoimmune blistering disease which is specific for skin and mucosal membranes. Its association with connective tissue diseases has already been reported. Considering this association, presence of Anti Nuclear ANTIBODIES (ANAs) in PV patients will not be surprising. The aim of this study was to compare the frequency of ANA positive cases in patients suffering PV with a control group.Methods: In this case-control study, the cases were selected from the patients with PV whom were hospitalized at Razi Hospital, Tehran. The controls were chosen from patients who did not have PV. The data were collected using a questionnaire, which was designed for gathering information on participants' age, sex, PV phenotypes, and the result of ANA test. ANA positivity was assessed using indirect immunofluorescence, HEP2.Results: In 8 (26.7%) of 30 PV patients and 3 (10.0%) of 30 controls ANA was positive (P=0.095). The most common ANA positive patterns among cases and controls were homogeneous and speckled patterns, respectively (P=0.26).Conclusion: Although in this study the frequency of positive ANA result among controls was similar to what were reported in previous studies, the frequency of this finding among PV patients was different from the previous reports. Differences in the sensitivity of the laboratory kits used in different studies as well as in the threshold for ANA positivity, and differences in the patients' eligibility criteria in different studies may explain the observed discrepancies. Clinical follow up of the PV and requesting an ANA test in the case of appearance of the signs of connective tissue diseases is recommended.

Fetal loss and recurrent abortion are responsible for significant emotional distress for couples desiring children. Regarding the etiologic importance, this study has been carried out to determine the prevalence of anticardiolipin antibody (ACLA) and ANTINUCLEAR antibody (ANA) in women with recurrent miscarriage. This descriptive study was carried out in shariatee hospital of Bandar Abbas university of Medical Sciences, during 2000 - 2001. 109 women with definite diagnosis of recurrent abortion or fetal loss as patients and 220 matched women with at least two successful deliveries and negative history of miscarriage as controls were studied. The sera of the patients and the controls were tested by ELISA method for determining ACLA and ANA.. There was a significant difference between results of this study suggest that autoANTIBODIES play a significant (P < 0.001). The miscarriage. Further studies are needed to explore the role of autoANTIBODIES in fetal loss and spontaneous abortion.    

Objective: Although headache is a common complaint among patients with lupus, no universally accepted explanation was available until the International Headaches Society adopted Lupus headache as a Nomenclature in its classification recently. Few studies indicate that lupus patients with positive anti-nuclear antibody (ANA) and positive antiphospholipid ANTIBODIES (aPL) experience more frequent headaches. The aim of this study was to determine the correlation between headache frequencies and ANA, anti-double strand DNA (anti-ds-DNA) and aPL positivity.Material & Methods: In this prospective multicenter study were enrolled 55 children, 45 girls and 10 boys (F/M ratio:4.5), aged 3-16 years (mean 11.5 years), with neuropsychiatric lupus complaining of headache, that where followed-up for 5 years.. Whether lupus headache is a sign of progressive nature of the disease and how it should be treated is not clear yet. Those with active disease, hypertension, or tension headache were not included in this study.Findings: We studied 55 children with definite lupus. Twenty three (43%) of our patients developed new or significantly worse, persistent headaches that sometimes were similar to migraine in the early course of their disease. However their headaches were not accompanied with disease flare up and the headaches were not found to be related to hypertension or use of other medications either. Accordingly, we came to a diagnosis of lupus headache for these patients. Among them 19/55 cases (35%) had a positive aPL and 53/55 cases (96%) had a positive ANA.Conclusion: Lupus headaches are most likely multifactorial, and probably only a small proportion of them truly represent active lupus. The above data highlights probable correlation between aPL, ANA, an anti-ds-DNA and lupus headache. However, more research is required to find better treatments and to establish a definitive correlation among them.

Indirect immunofluorescence on HEp-2 cell-line (HEp-2-IIF) remains the “gold standard” method for detection of ANTINUCLEAR ANTIBODIES (ANA) (1). ANA is an operative definition, showing the possibility of autoANTIBODIES (Aab) to bind nucleus and cytoplasmic antigen. One of the major examples is represent by anti-mitochondrial ANTIBODIES (AMA), which target proteins of the inner and outer mitochondrial membranes, located in the cytoplasm. In routinely lab-life the AC-21 pattern and the presence of related AMA can be confirm by commercial line-immunoblotting, ELISA, CLIA/FEIA assays and the standard IIF on rodent kidney/stomach/liver tissue sections. Several studies showed the use of other commercial assays and home made tests to detect AMA as immunoprecipitation and immunoblotting. However the use of IP or IP-WB in a routinely laboratory is difficult to apply, because of numerous cases to process and the related troubles. The routinely lab experience also teach that commercial kits can not always detected and define specific AMA. Where find confirmation of AC-21 pattern if line-immunoblot and other routinely methods (ELISA, CLIA/FEIA assays) fail? We review AC-21 AMA-like sera from our patinets (year 2022) and purpose a revised diagnostic algorithm based on the combined use of IIF on Hep-2 cells, line immunoblot and IIF on rodent tissue as third line method. We showed that the use of IFI on rodent tissues became diriment to confirm AMAs presence, expecially when second level assay failed