Autoantibodies as predictors of disease:

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Autoantibodies as predictors of disease:

Postby Lyon » Mon Jun 11, 2007 4:30 pm

I found this when going through "Autoimmunity Reviews" and, although not specific to MS, hopefully it is of interest.
Bob

Autoantibodies as predictors of disease: The clinical and experimental evidence

Nicola BizzaroCorresponding Author Contact Information, a, E-mail The Corresponding Author
aLaboratorio di Patologia Clinica, Ospedale Civile, via Morgagni, 18, 33028 Tolmezzo, Italy

Available online 30 January 2007.



Abstract

Several studies have shown that autoimmune diseases are preceded by a long pre-clinical phase, and that many autoantibodies can be detected in the serum of asymptomatic subjects years before the clinical manifestations become evident. Tests for these autoantibodies could therefore be used in principle in screening studies on unselected populations to identify individuals predisposed to the development of the disease at an early stage, and start treatment or adopt preventive measures where possible. This aspect has aroused particular interest, as multiplex investigation techniques are already available, and microarray methods are under development, which will probably allow tens or hundreds of autoantibodies to be measured simultaneously. However, as no antibody assay offers 100% specificity, and the results are strongly dependent on the assay method used to measure the autoantibodies, it is essential to use assay methods with high diagnostic specificity, to minimize false positives and obtain a high positive predictive value. This review examines the various autoantibodies for which a role in predicting the development of an autoimmune disease has been demonstrated in long-term prospective studies.

Keywords: Autoantibodies; Predictive value; Prospective studies
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Postby Toyoterry » Mon Jun 11, 2007 6:37 pm

My daughter is ten years old and she had a positive on an Antinuclear Antibodies test. She is totally asymptomatic and for now the Juvenile Arthritis Specialist is just keeping an eye on her because he's not sure what the test results might mean. My wife and I talked about this very thing, that it might be a predictor of future problems. Just for the record, my wife has Rheumatoid Artritis and I have MS.
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Postby Lyon » Mon Jun 11, 2007 7:15 pm

Hi Terry,
Situations like yours, LOTS of situations like yours are why I was pretty surprised when I read the following article which said they found no evidence of increased incidence of autoimmune disease in families of those diagnosed with MS.

Tons of other studies confirm situations like yours
Bob



Autoimmune disease in families with multiple sclerosis: a population-based study

Sreeram Varadharajan Ramagopalan BAa, b, David Alexandre Dyment MDa, b, William Valdar PhDa, Blanca Marcela Herrera BSca, b, Maria Criscuoli BScc, Irene Mei Ling Yee MScc, Prof Adele Dessa Sadovnick PhDc, d, Prof George Cornell Ebers MDa, b,
aWellcome Trust Centre for Human Genetics, Oxford, UK
bDepartment of Clinical Neurology, University of Oxford, Oxford, UK
cDepartment of Medical Genetics, University of British Columbia, Vancouver, Canada
dFaculty of Medicine, Division of Neurology, University of British Columbia, Vancouver, Canada

Available online 7 June 2007.
Summary

Background

Evidence of an association between multiple sclerosis (MS) and other autoimmune diseases would substantiate the hypothesis that MS is an autoimmune disease, and implicate a common mechanism. We aimed to investigate and compare the rate of autoimmune disease in MS patients, in their first-degree relatives, and in their unrelated spouses.

Methods

We used data from a national, multicentre, population-based sample to investigate the rate of autoimmune disease in 5031 MS patients, 30 259 of their first-degree relatives, and 2707 spousal controls. We asked patients and controls whether they had any of ten autoimmune diseases: Crohn's disease, ulcerative colitis, rheumatoid arthritis, type 1 diabetes, psoriasis, pernicious anaemia, systemic lupus erythematosus, autoimmune thyroid disease, vitiligo, and myasthenia gravis. MS probands were also asked whether their first-degree relatives had Crohn's disease, ulcerative colitis, rheumatoid arthritis, or type 1 diabetes.

Findings

After correction for age and sex, we did not identify any increased risk of autoimmune diseases in MS patients compared with their spousal controls (odds ratio [OR]=1·07, 95% CI 0·86–1·23, χ2=0·47, p=0·49), or in the first-degree relatives of MS probands compared with controls (OR=0·89, 0·63–1·17, χ2=1·11, p=0·29). However, the reported frequency of autoimmune diseases did differ according to the sex of the interviewee (female vs male patients χ2=92·2, p<0·0001; female vs male spousal controls χ2=87·1, p<0·0001). MS patients had slightly higher rates of thyroid disease and pernicious anaemia than did controls, which is consistent with MHC associations for these diseases, but this effect disappeared when results were adjusted for sex. For eight other diseases the rates were similar in MS patients and controls. Families with multiple cases of MS were no more likely to report autoimmune diseases than families with single MS cases.

Interpretation

When data were adjusted for sex, no excess of common autoimmune diseases could be identified in MS patients or their families, including multicase pedigrees. Our results suggest that women are more aware of family medical histories than men, which emphasises the potential for ascertainment bias in unstratified data for a sex-limited disease. Family histories should thus be taken from male patients in the presence of a spouse.
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Postby Toyoterry » Tue Jun 12, 2007 12:25 am

I guess all I can say to that is in my family we have psoriasis, Lupus, MS, and RA. Maybe it's just bad luck but I can't help but see some connection to genetics.
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