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Expert Review of Clinical Immunology Sep 2020Patients with autoimmune connective tissue disease (ACTD) may have anti-thyroid peroxidase antibody (TPOAb) and anti-thyroglobulin antibody (TgAb). This study aimed to... (Meta-Analysis)
Meta-Analysis
AIM
Patients with autoimmune connective tissue disease (ACTD) may have anti-thyroid peroxidase antibody (TPOAb) and anti-thyroglobulin antibody (TgAb). This study aimed to compare the prevalence of thyroid autoantibodies in ACTD patients and controls.
METHODS
All case-control studies published between 1980 and 2019 in English were searched from Medline, Embase, Web of Science, PubMed databases for meta-analysis and subgroup analyses.
RESULTS
Total 10,321 ACTD cases and 12,949 healthy controls were included, and the prevalence of thyroid autoantibody positivity was higher in ACTD patients than in controls. Subgroup analysis revealed positive association between TgAb and ACTD in populations from all continents including European, Asian, African, and American. In addition, we found positive association between TgAb positivity and most ACTD cases including RA, SLE, pSS, and UCTD, positive association between TPOAb positivity and all ACTD cases including RA, SLE, pSS, SSc, and UCTD, and positive association between TPOAb positivity and ACTD in European, Asian, and African but not in American populations.
CONCLUSION
Thyroid autoantibodies are more prevalent in ACTD patients than in healthy controls. It is important to screen patients with ACTD for the presence of thyroid autoimmunity, and perform thyroid function tests in clinical evaluation of ACTD patients.
Topics: Africa; Asia; Autoantibodies; Autoantigens; Autoimmune Diseases; Connective Tissue Diseases; Europe; Humans; Iodide Peroxidase; Population Groups; Prevalence
PubMed: 32811198
DOI: 10.1080/1744666X.2020.1811089 -
BMC Pregnancy and Childbirth Jul 2020Thyroid dysfunction during pregnancy is associated with adverse outcomes for both mother and fetus. The present meta-analysis was conducted to evaluate thyroid... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Thyroid dysfunction during pregnancy is associated with adverse outcomes for both mother and fetus. The present meta-analysis was conducted to evaluate thyroid dysfunction in Iranian pregnant women.
METHODS
We registered this review at PROSPERO (registration number: CRD42020166655). The research steps in this systematic review and meta-analysis were performed according to the MOOSE protocol, and finally, reports were provided based on the PRISMA guidelines. The literature search was performed in October 2019 using the international online databases, including Web of Science, Ovid, Science Direct, Scopus, EMBASE, PubMed/Medline, Cochrane Library, EBSCO, CINAHL, Google Scholar as well as national databases were reviewed. Data were extracted after applying the inclusion and exclusion criteria and qualitative evaluation of the studies. I index and Q test were used to assess differences in studies. All analyses were performed using Comprehensive Meta-Analysis Software. P-value less than 0.05 was considered statistically significant. We identified 1261 potential articles from the databases, and 426 articles remained after removing the duplicate and unrelated studies. After evaluating the full text, 52 articles were removed.
RESULTS
Finally, 19 eligible studies including 17,670 pregnant women included for meta-analysis. The prevalence of thyroid dysfunction in Iranian pregnant women was 18.10% (95%CI: 13.89-23.25). The prevalence of hypothyroidism, clinical hypothyroidism, and subclinical hypothyroidism in Iranian pregnant women was respectively estimated to be 13.01% (95%CI: 9.15-18.17), 1.35% (95%CI: 0.97-1.86) and 11.90% (95%CI: 7.40-18.57). The prevalence of hyperthyroidism, clinical hyperthyroidism, and subclinical hyperthyroidism in Iranian pregnant women was respectively estimated to be 3.31% (95%CI: 1.62-6.61), 1.06% (95%CI: 0.61-1.84) and 2.56% (95%CI: 0.90-7.05). The prevalence of anti-thyroperoxidase antibody was estimated to be 11.68% (95%CI: 7.92-16.89).
CONCLUSION
The results of this meta-analysis showed a high prevalence of thyroid disorders, especially hypothyroidism. The decision to recommend thyroid screening during pregnancy for all women is still under debate, because the positive effects of treatment on pregnancy outcomes must be ensured. On the other hand, evidence about the effect of thyroid screening and treatment of thyroid disorders on pregnancy outcomes is still insufficient. Nevertheless, a large percentage of general practitioners, obstetricians and gynecologists perform screening procedures in Iran.
Topics: Adult; Autoantigens; Female; Humans; Hypothyroidism; Iodide Peroxidase; Iran; Iron-Binding Proteins; Pregnancy; Pregnancy Complications; Thyroid Diseases
PubMed: 32664874
DOI: 10.1186/s12884-020-03040-5 -
Breast Cancer (Tokyo, Japan) Sep 2020Thyroid autoimmunity might be in relation to other autoimmune endocrine disease or non-endocrine disorders and there are innate and adaptive immune cells in breast... (Meta-Analysis)
Meta-Analysis
PURPOSE
Thyroid autoimmunity might be in relation to other autoimmune endocrine disease or non-endocrine disorders and there are innate and adaptive immune cells in breast cancer. Because autoimmune factors are common characteristics of both thyroid autoimmunity and breast cancer, these two types of diseases may occur concurrently in certain patients. The chief goal of this meta-analysis is to perform a combined analysis of the raw data from all included studies, and thereby obtain a reliable conclusion concerning whether TgAb or TPOAb positivity and breast cancer are indeed correlated.
METHODS
To determine whether a correlation exists between TgAb or TPOAb positivity and breast cancer, this study performed a review of the literature that began by searching for articles in Chinese or English from the Medline, Embase, Web of Science core, Wanfang, Weipu and SinoMed databases, published during the time span extending from January 1980 to December 2017. On the basis of these raw data, we calculated odds ratio (OR) values, 95% confidence interval (CI) values, and P values.
RESULTS
A total of 11 studies were included in this study. By combining the raw data from the retrieved studies, we were able to perform a meta-analysis. The results of this meta-analysis support the hypothesis that patients with breast cancer have a higher TgAb or TPOAb positive rate than the non-breast disease control group (TgAb: OR = 2.71, 95% CI = 1.81-4.05, P < 0.001; TPOAb: OR = 2.86, 95% CI = 2.17-3.77, P < 0.001, respectively). Testing for publication bias indicated that no significant publication bias was present in this meta-analysis, and sensitivity analysis indicated that the results of analysis were stable and reliable.
CONCLUSIONS
The results of this meta-analysis suggest strongly that, the TgAb or TPOAb positive rate among patients with breast cancer should be higher than among the non-breast disease control group.
Topics: Autoantibodies; Autoantigens; Breast Neoplasms; Female; Humans; Iodide Peroxidase; Iron-Binding Proteins; Prevalence; Thyroiditis, Autoimmune
PubMed: 32279180
DOI: 10.1007/s12282-020-01078-z -
Multiple Sclerosis and Related Disorders Jul 2020Recent reports have suggested that seizures may be a component of the clinical presentation in myelin oligodendrocyte glycoprotein antibody (MOG-Ab)-associated disease.... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Recent reports have suggested that seizures may be a component of the clinical presentation in myelin oligodendrocyte glycoprotein antibody (MOG-Ab)-associated disease. We aimed to conduct a systematic review and meta-analysis to comprehensively evaluate the occurrence of epileptic seizures in the disease.
METHODS
We searched PubMed, MEDLINE and EMBASE for studies reporting the occurrence of acute symptomatic seizures in MOG-Ab-associated disease. Fixed or random effects model was used to pool results across studies with a meta-analysis.
RESULTS
A total of 14 studies met the inclusion criteria. Overall, acute symptomatic seizures were observed in 20.5% (95% confidence interval [CI] 13.7%-30.7%, I=60.6%) patients with MOG-Ab-associated disease, and in a similar proportion of children respectively (20.0%; 95% CI 14.3%-27.8%, I=7.0%). The pooled probability of seizure occurrence in males was 30.1% (95% CI 17.5%-52%, I=0.0%) while that in females was much lower (12.0%; 95% CI 5.5%-26.4%, I=0.0%). Furthermore, when we focused on those with acute disseminated encephalomyelitis-like phenotype, 37.3% patients experienced seizures (95% CI 21.0%-66.3%, I=55.8%).
CONCLUSIONS
Our study suggested that epileptic seizures were common in MOG-Ab-associated disease and offered insight into associated factors that contribute to the occurrence of seizures. Future studies with explicit evaluation are required.
Topics: Autoantibodies; Child; Encephalomyelitis, Acute Disseminated; Epilepsy; Female; Humans; Male; Myelin-Oligodendrocyte Glycoprotein; Seizures
PubMed: 32222694
DOI: 10.1016/j.msard.2020.102057 -
World Journal of Gastroenterology Jan 2020Non-invasive criteria are needed for Crohn's disease (CD) diagnosis, with several biomarkers being tested. Results of individual diagnostic test accuracy studies... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Non-invasive criteria are needed for Crohn's disease (CD) diagnosis, with several biomarkers being tested. Results of individual diagnostic test accuracy studies assessing the diagnostic value of pancreatic autoantibodies-to-glycoprotein-2 (anti-GP2) tests for the diagnosis of CD appear promising.
AIM
To systematically review and meta-analyze evidence on the diagnostic accuracy of anti-GP2 tests in patients with suspected/confirmed CD.
METHODS
An electronic search was conducted on PubMed, Cochrane-CENTRAL and grey literature (CRD42019125947). The structured research question in PICPTR format was "Population" including patients with symptoms akin to CD, the "Index test" being anti-GP2 testing, the "Comparator" involved standard CD diagnosis, the "Purpose of test" being diagnostic, "Target disorder" was CD, and the "Reference standard" included standard clinical, radiological, endoscopical, and histological CD diagnostic criteria. Quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool and hierarchical models were employed to synthesize the data.
RESULTS
Out of 722 studies retrieved, 15 were meta-analyzed. Thirteen studies had industry-related conflicts-of-interest, and most included healthy donors as controls (spectrum bias). For the combination of IgA and/or IgG anti-GP2 test, the summary sensitivity was 20% (95% confidence interval: 10%-29%) at a median specificity of 97%. If the test was applied in 10000 suspected patients, 9669 would be true negatives and in 26, the diagnosis would be missed. In this hypothetical cohort, the anti-GP2 would fail to produce a diagnosis for 81.3% of the positive cases. Low summary points of sensitivity and high specificity were estimated for the IgG or IgA anti-GP2 test. Analogous results were observed when the analyses were restricted using specific cut-offs, or when ulcerative colitis patients were used as comparators.
CONCLUSION
Anti-GP2 tests demonstrate low sensitivity and high specificity. These results indicate that caution is required before relying on its diagnostic value. Additionally, the need for improving the methodology of diagnostic test accuracy studies is evident.
Topics: Autoantibodies; Autoantigens; Biomarkers; Crohn Disease; Humans; Membrane Glycoproteins; Sensitivity and Specificity
PubMed: 31988587
DOI: 10.3748/wjg.v26.i2.246 -
Journal of the College of Physicians... Jan 2020The postpericardiotomy syndrome (PPS) is an important cause of morbidity and mortality following heart operation. This systematic review reviewed the literature...
The postpericardiotomy syndrome (PPS) is an important cause of morbidity and mortality following heart operation. This systematic review reviewed the literature regarding PPS. It was found to occur on day 18.3 ±15.9 after cardiac operations, most often after coronary artery bypass grafting, and mitral valve replacement. The most common symptoms were new/worsening pericardial effusions, pleuritic chest pain, and fever. The inflammation markers, such as C-reactive protein and erythrocyte sedimentation rate, were found to increase significantly in each patient who had these parameters examined. The subjects were managed conservatively in 472 (83.5%) patients, by surgical pericardial drainage in 85 (15.0%) patients, by thora-/pericardio-centesis in 3 (0.5%) patients, and were under surveillance without being treated in 5 (0.9%) patients. Conservative treatment was likely to be associated with a higher recovery rate. Surgical trauma and cardiopulmonary bypass trigger the systemic inflammatory response, which results in antiheart autoantigen release, and the deposited immune complex could be found in the pericardial, pleural, and lung tissues, thereby provoking the occurrence of PPS. Therapeutic options for the refractory cases are long-term oral corticoids or pericardiectomy. Surgical intervention was warranted in 2.6% of the cases due to cardiac tamponade.
Topics: Humans; Postpericardiotomy Syndrome
PubMed: 31931935
DOI: 10.29271/jcpsp.2020.01.62 -
Immunology Letters Oct 2019Chronic Obstructive Pulmonary Disease (COPD) is a major cause of death worldwide in which the involvement of autoimmunity has been widely investigated and debated. The...
Chronic Obstructive Pulmonary Disease (COPD) is a major cause of death worldwide in which the involvement of autoimmunity has been widely investigated and debated. The role of autoantibodies in COPD has been extensively researched in recent years. The aim of this systematic review is to assess the association between autoantibodies and COPD and analyse whether autoantibody levels correlate with disease severity and/or phenotype. PubMed, Embase, OpenGrey and the reference lists of articles were searched. The strongest evidence for an association between autoantibodies and COPD lies with anti-endothelial/epithelial cell autoantibodies (7 studies, all positive), rheumatoid factor autoantibodies (4 studies, all positive), anti-cytokeratin autoantibodies (3 studies, all positive), anti-nuclear autoantibodies (8 studies, 7 positive) and anti-collagen autoantibodies (10 studies, 6 positive). This review also identifies several other autoantibodies which had both positive and negative associations with COPD, however the evidence for these was not as strong and/or the number of studies is low, and further research is required. In particular, a clear case can be made for the potential importance of autoantibodies to carbonylated proteins. The relationship between autoantibody levels and disease severity requires further research with only 17/43 studies investigating this; however, 12 of the studies did show a positive association, making it a promising area for future research. There was also not enough evidence available on the relationship between autoantibody levels and disease phenotype to draw any conclusions, with only 2 studies investigating it (1 positive and 1 negative). This review has shown very promising evidence for the association of several autoantibodies in COPD and has identified those autoantibodies which require further research.
Topics: Antibody Specificity; Autoantibodies; Autoantigens; Epithelial Cells; Humans; Pulmonary Disease, Chronic Obstructive
PubMed: 31472176
DOI: 10.1016/j.imlet.2019.08.007 -
Seminars in Arthritis and Rheumatism Apr 2020ImmunoglobulinG4-related disease (IgG4-RD) is a recently recognized disease and, as such, there is a pressing need to identify biomarkers for diagnosis, monitoring...
OBJECTIVE
ImmunoglobulinG4-related disease (IgG4-RD) is a recently recognized disease and, as such, there is a pressing need to identify biomarkers for diagnosis, monitoring disease activity, and predicting prognosis and response to therapy. Here, we review the recent development and identification of biomarkers for IgG4-RD.
METHODS
Through extensive literature review and analysis, we updated the biomarkers for IgG4-RD and further put forward our own viewpoints.
RESULTS
In addition to traditional biomarkers, such as serum IgG4 concentration and typical histological characteristics, several novel indicators, including IgG2, serum soluble IL-2 receptor (sIL2R), and cc-chemokine ligand 18 (CCL18), indicate inflammation and fibrosis and can be used to accurately diagnose and predict treatment response. Studies to identify target autoantigens in IgG4-RD have shed light on the unmet need for biomarkers that can identify this disorder. Additionally, both serological and histopathologic immune cells involved in antigen-induced responses, innate immune cells (macrophages, mast cells, and the I-IFN/ IL-33 pathway), as well as subsequent acquired immune cells (T and B cell subsets), may also serve as new biomarkers for IgG4-RD. Since IgG4-RD often clinically manifests with multiple organs involvement, non-invasive PET-CT can improve diagnosis and antidiastole levels.
CONCLUSION
These novel biomarkers provide information to help diagnose IgG4-RD, monitor disease activity, as well as predict prognosis and response to therapy.
Topics: Biomarkers; Chemokines, CC; Humans; Immunoglobulin G; Immunoglobulin G4-Related Disease; Receptors, Interleukin-2
PubMed: 31280934
DOI: 10.1016/j.semarthrit.2019.06.018 -
Journal of Neurology Oct 2019To characterize the clinical symptoms and magnetic resonance imaging (MRI) findings of unilateral cortical FLAIR-hyperintense Lesions in Anti-MOG-associated Encephalitis...
OBJECTIVE
To characterize the clinical symptoms and magnetic resonance imaging (MRI) findings of unilateral cortical FLAIR-hyperintense Lesions in Anti-MOG-associated Encephalitis with Seizures (FLAMES).
METHODS
This is a case report and systematic review of the literature to identify cases of unilateral cortical FLAMES. Cases were reviewed to determine the frequency of clinical symptoms (seizures, headache, fever and cortical symptoms referable to FLAMES location), and to determine whether MRI abnormalities are restricted to the unilateral cortex in this syndrome.
RESULTS
We identified 20 cases of unilateral cortical FLAMES for review. Among them, 17/20 (85%) had seizures, 14/20 (70%) had headache, 13/20 (65%) had fever, 11/20 (55%) reported cortical symptoms referable to the FLAMES location, and 19/20 (95%) reported at least two of these four findings. On MRI 4/20 (20%) had some contralateral hemispheric cortical signal abnormality, and 6/20 (30%) had MRI findings concerning for meningeal inflammation.
CONCLUSIONS
In patients with unilateral cortical FLAMES, the clinical symptoms of seizures, headache, fever and cortical symptoms referable to the FLAMES location are frequent. Although initially described as a unilateral cortical encephalitis, bilateral cortical involvement and possible meningeal inflammation could indicate a broader disease spectrum. Recognition of this distinct clinico-radiographic syndrome may facilitate prompt diagnosis and treatment.
Topics: Adolescent; Adult; Autoimmune Diseases of the Nervous System; Child; Encephalitis; Female; Headache; Humans; Male; Middle Aged; Myelin-Oligodendrocyte Glycoprotein; Seizures; Young Adult
PubMed: 31243540
DOI: 10.1007/s00415-019-09440-8 -
Immunologic Research Feb 2019The coexistence of pemphigus and systemic lupus erythematosus (SLE) had been reported anecdotally. Anti-desmoglein (Dsg)1 and anti-Dsg3 antibodies were detected... (Meta-Analysis)
Meta-Analysis
The coexistence of pemphigus and systemic lupus erythematosus (SLE) had been reported anecdotally. Anti-desmoglein (Dsg)1 and anti-Dsg3 antibodies were detected concomitantly with antinuclear autoantibodies among blood donors. The aim of the current study was to study the association between pemphigus and SLE in Israeli patients and to synthesize existing data on this association in the current literature. The current study included two sections. Initially, a cross-sectional study was performed to compare pemphigus patients with age-, sex-, and ethnicity-matched control subjects regarding the prevalence of SLE using a real-life large-scale computerized database. Next, a systematic review and meta-analysis of similar observational studies in Medline, Embase, and Web of Science (1823-2017) was conducted. As for the cross-sectional study, a total of 1985 patients with pemphigus and 9874 controls were included in the study. The prevalence of SLE was slightly higher among patients with pemphigus as compared to controls (OR, 1.85; 95% CI, 0.89-3.82). In a sensitivity analysis that included patients who received pemphigus-related treatments, the association between pemphigus and SLE had been substantiated and was statistically significant (OR, 2.10; 95% CI, 1.00-4.48). In the meta-analysis section, three eligible studies, comprising 10,389 pemphigus patients met the eligibility criteria. The overall pooled multivariate OR was 2.50 (95% CI 1.54-4.07, I = 44.19%, P = 0.167) across all studies. In conclusion, the meta-analysis provides epidemiologic evidence that these B cell-driven diseases are significantly associated. Further research is required to elucidate the molecular mechanism underlying this association.
Topics: Aged; Aged, 80 and over; Antibodies, Antinuclear; Autoantibodies; B-Lymphocytes; Comorbidity; Cross-Sectional Studies; Desmoglein 1; Desmoglein 3; Female; Humans; Israel; Lupus Erythematosus, Systemic; Male; Middle Aged; Pemphigus; Prevalence
PubMed: 30637663
DOI: 10.1007/s12026-019-9065-4