INDEX autoimmunity

We (K1) attempted to develop a noncompetitive assay based on the anti-idiotype antibodies for a conjugated bile acid metabolite, ursodeoxycholic acid 7-A-acetyl-glucosaminide (UDCA 7-NAG), which is expected to serve as a diagnostic index for an autoimmune disease, primary biliary cirrhosis. In our assay, the hapten UDCA 7-NAG, a /3-type antibody, and a biotin-labeled a-type antibody were simultaneously added to a microtiter plate coated with an F(ab )2 fragment of a specific anti-UDCA 7-NAG antibody, then incubated at room temperature for 8 h. Bound biotin was then detected with HRP-labeled streptavidin, whose enzyme activity was measured using o-phenylenediamine/H202 as a substrate. This noncompetitive assay system provided a subfemtomole-order sensitivity (detection limit 118 amol) that was 7 times lower than the competitive immunoassay using the same anti-hapten antibody (K2), even with a common colorimetric detection (Fig. 13). Somewhat improved specificity was also obtained namely, better... 

The risk for infectious arthritis is high in patients with autoimmune diseases with compromised immunity. Acute bacterial arthritis mostly results from hematogenous spread in the elderly and in the less than 15 years. Acute monarthritis should raise a high index of suspicion of joint infection. 

Ehrlich provided a quantitative measure to accompany the concept that a therapeutic dose must be evaluated relative to a toxic dose. Although Ehrlich s chemotherapeutic index has been displaced by more precise measures of effectiveness and toxicity, the spirit of Equation 1.1 remains a central idea of modern drug discovery. Ehrlich s work in the field of medicine, especially in the area of autoimmune disorders, resulted in his sharing of the Nobel Prize in Medicine in 1908. 

Osteoporosis is also common in those on long-term corticosteroid therapy (for example patients with autoimmune hepatitis or coexisting inflammatory bowel disease). Patients with chronic liver disease may also have other risk factors for osteoporosis related to their disease state. These include vitamin D deficiency, excessive alcohol consumption, poor diet, physical inactivity and low body mass index. Oestrogen deficiency in the postmenopausal stage further increases the risk. 

In addition to its use for rheumatoid arthritis, azathoiprine is employed for its steroid-sparing effect in many autoimmune diseases, as an immxmo-suppressant, e.g. after organ transplant, and to maintain remission in the treatment of vasculitis. Other aspects of azathiopurine are discussed elsewhere in the book (see Index). 

Hayes, J. D., Glutathione S-transferase levels in autoimmune chronic active hepatitis A more sensitive index of hepatocellular damage than aspartate aminotransferase. Clin. Chim. Acta 172, 211-216 (1988). 

In general, the incidence of autoimmune thyroid disease is not strikingly different among the various areas in Japan. Similarly, postpartum thyroiditis, which can be considered as a good index to compare the incidence of autoimmune thyroid.disorder in a population, is present with the same frequency in different Japanese areas. Finally, concerning hyperthyroidism in relation to high iodine intake, I must say that I have never seen a single case of Jod-Basedow in Japan. 

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