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עמוד בית
Sat, 20.07.24

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September 2023
Ljudmila Stojanovich PhD, Natasa Stanisavljevic PhD, Aleksandra Djokovic PhD, Milomir Milanovic PHD, Jovica Saponjski PhD, Yehuda Shoenfeld MD FRCP MaACR

Background: Data are scarce on the immunogenicity of coronavirus disease 2019 vaccines in patients with autoimmune rheumatic diseases (ARD).

Objectives: To measure the immunoglobulin G (IgG) response after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunization and to evaluate clinical characteristics associated with seropositivity.

Methods: Samples were collected after the second and third doses of the three different types of vaccines in ARD patients. Seroconversion rates and IgG antibody S1/S2 titers were measured.

Results: The type of ARD diagnosis and previous treatment had no significant impact on the serum IgG antibody levels measured after the second (P = 0.489 and P = 0.330, respectively) and boost dose (P = 0.441 and P = 0.446, respectively). What made a significant difference regarding serum IgG antibody levels after the second dose was the type of SARS-CoV-2 vaccine. The difference was highly statistically significant for all vaccine types (P = 0.001 with the highest odds ratio for the mRNA vaccine). After the boost with the mRNA vaccine, all patients achieved a high level of serum IgG antibody levels (t = 10.31, P = 0.001). No ARD patients experienced serious post-vaccinal reactions. Eight patients developed COVID-19 before the boost dose.

Conclusions: In ARDs patients, the highest level of serum IgG antibody against S1/S2 proteins was achieved with the mRNA vaccine, irrespective of the therapy applied or the type of the disease. We recommend a booster dose with mRNA vaccine in all ARDs for the highest SARS-CoV-2 protection without serious post-vaccinal reactions observed.

November 2022
Ela Giladi MD, Adi Rotkopf MD, Avishay Elis MD

Myelodysplastic syndrome (MDS) is frequently associated with clinical manifestations of autoimmune disorders (AD) and inflammatory responses of the immune system. The biological linkage between MDS clones and the occurrence of autoimmune manifestations is mirrored by the response of the latter to MDS modifying therapeutic approaches [1]. We encountered a rare case of MDS coexisting with antiphospholipid syndrome (APS), which was effectively treated with a hypomethylating agent followed by allogenic bone marrow transplantation.

August 2022
Jozélio Freire de Carvalho MD PhD and Yehuda Shoenfeld MD FRCP MaACR
September 2021
Jozélio Freire de Carvalho MD PhD and Yehuda Shoenfeld MD FRCP MaACR
June 2021
Aviya R. Jacobs MSc, Noam Ben-Yosef MD, Yariv Tiram MD, Elchanan Juravel MD, Akiva Nachshon MD, Anat Scheiman Elazary MD, Auryan Szalat MD, Eran Zimran MD, and Mordechai Muszkat MD
July 2019
June 2017
Luis J Jara MD, Gabriela Medina MD MSc, Polita Cruz-Cruz MD MSc, Javier Olivares-Rivera MD, Carolina Duarte-Salazar MD and Miguel A. Saavedra MD

Obstetric antiphospholipid syndrome (Obs-APS) is one of the most commonly identified causes of recurrent pregnancy loss and its accurate diagnosis is a requirement for optimal treatment. Some patients do not fulfill the revised Sapporo classification criteria, the original APS classification criteria, and are considered to be non-criteria Obs-APS. In these patients with non-criteria, there is controversy about their inclusion within the spectrum of APS and eventually their treatment as having Obs-APS. A subset of patients may also have clinical characteristics of Obs-APS even though lupus anticoagulant (LA), anticardiolipin antibodies, and anti-β2-glycoprotein I (aβ2GPI) antibodies are consistently negative. These patients are recognized as seronegative Obs-APS.

We reviewed evidence of non-criteria Obs-APS and discuss a case of a woman with a diagnosis of active systemic lupus erythematosus (SLE) and non-criteria Obs-APS with four consecutive pregnancy losses. After an accurate diagnosis the patient received prenatal counseling and benefited from the optimal treatment of Obs-APS that led to a successful pregnancy. The applicability of this successful experience about outcomes in women with non-criteria, or seronegative, Obs-APS is also evaluated.

 

March 2017
Francesca Wanda Rossi MD PhD, Antonio Lobasso MD, Carmine Selleri MD PhD, Marco Matucci-Cerinic MD PhD, Felice Rivellese MD PhD, Yehuda Shoenfeld MD FRCP MaACR and Amato de Paulis MD PhD
September 2016
Emmanouil Papadakis, Anastasia Banti and Anna Kioumi

Antiphospholipid syndrome (APS) is an autoimmune systemic disease characterized by vascular thrombosis (arterial or venous) and/or pregnancy complications associated with the occurrence of autoantibodies, specifically lupus anticoagulant, anticardiolipin antibodies, and/or anti-β2 glycoprotein-I antibodies confirmed at least twice over a 12 week period according to the 2006 Sydney criteria. Antiphospholipid antibodies are encountered  in the general population with a reported prevalence of 1% to 5%  However, APS is far more infrequent with a prevalence of 40–50/100,000 persons and an incidence of about 5 new patients/100,000 persons. APS can be diagnosed in patients with no apparent clinical or laboratory pathology (primary APS) or it may be related to numerous other conditions, autoimmune diseases (usually systemic lupus erythematosus), malignancies, infections and drugs (secondary APS). Women are at risk for APS since the disease is encountered in both the primary and the secondary state in females more often than in men. In addition, women in their reproductive years can develop APS (either classical or obstetric), and special attention is warranted in pregnant women with a diagnosis of APS. The benefits of hormonal therapy in the form of contraception or hormone replacement treatment should be carefully weighed against the increased risk for vascular complications in women with APS.

July 2016
Javier Marco-Hernández MD PhD, Sergio Prieto-González MD, Miquel Blasco MD, Pedro Castro MD PhD, Joan Cid MD PhD and Gerard Espinosa MD PhD
September 2015
Dana Ben-Ami Shor MD MHA, Guy A. Weiss MD, Ori Barzilai MD, Maya Ram MD, Juan-Manuel Anaya MD, Yehuda Shoenfeld MD and Yaniv Sherer MD

Background: The association between antiphospholipid antibodies (aPL) and multiple sclerosis (MS) has been suggested previously, but prior studies provided contradicting findings. 

Objectives: To characterize the expression profile of eight classic and non-classic aPL in patients diagnosed with MS.

Methods: Using the BioPlex™ 2200 immunoassay, we measured the levels of serum immunoglobulin (Ig)M and IgG isotypes of three classic aPL and five non-classic aPL in 98 subjects with MS and 237 healthy controls. 

Results: Three non-classic aPL were significantly more prevalent among MS patients in comparison to the control group. These antibodies included IgM and IgG against phosphatidylserine-β2GPI (PS-B2), IgG prothrombin complex (PT-PT) and IgM prothrombin (PT). The positive results according to Bonferroni correction are PS-B2 IgG and PT-PT IgG. The remaining aPL profiles did not differ significantly between the two groups.

Conclusions: An association between certain non-classic aPL and MS has been established. The specific role of these autoantibodies in the pathogenesis of the condition remains uncertain.  

 

October 2014
Carlo Perricone MD, Shunit Rinkevich-Shop PhD, Miri Blank PhD, Natalie Landa-Rouben PhD, Cristiano Alessandri MD, Fabrizio Conti MD, PhD, Jonathan Leor MD, Yehuda Shoenfeld MD FRCP and Guido Valesini MD
Serena Colafrancesco MD, Roberta Priori MD PhD, Cristiano Alessandri MD, Elisa Astorri MD PhD, Carlo Perricone MD, Miri Blank PhD, Nancy Agmon-Levin MD, Yehuda Shoenfeld MD FRCP MaACR and Guido Valesini MD
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