Kerri Wachter

BUDAPEST, HUNGARY – Children with autism spectrum disorders appear to have immune responses different from those of healthy children, according to data presented at the 4th International Congress on Autoimmunity.

“There is evidence now for an immune dysregulation in children with autism, compared with children in the general population,” said Paul Ashwood, Ph.D., of the University of California, Davis.

In a study of 31 children ASD and 19 typically developing control children aged 2–5 years, the children with ASD had abnormal levels of several cytokines in response to stimulation with three antigens, compared with the control children.

The study adds weight to the idea that autism has an immune component. There are several previous reports of both increased autoimmunity and immune response deficits in children with autism spectrum disorders (ASD). “However, a lot of these reports are conflicting, and there is no consensus so far,” Dr. Ashwood said.

Dr. Ashwood and colleagues isolated and stimulated peripheral blood mononuclear cells for 48 hours with phytohemagglutinin, lipopolysaccharide, and vaccine antigens. Analysis was performed for 18 cytokines. At baseline, cytokine levels were similar in the children with ASD and the control children.

Following stimulation with phytohemagglutinin, the children with ASD had statistically significantly lower levels of IL-2, IL-6, IL-10, and IL-12 than the control children. There was also a trend toward higher levels of IL-13 and granulocyte macrophage-colony stimulating among the children with ASD than the control children. A similar pattern was seen after stimulation with lipopolysaccharide. Children with ASD had lower levels IL-12 and a slight increase in granulocyte macrophage-colony stimulating factor, compared with the control children.

BUDAPEST, HUNGARY – Children with autism spectrum disorders appear to have immune responses different from those of healthy children, according to data presented at the 4th International Congress on Autoimmunity.

“There is evidence now for an immune dysregulation in children with autism, compared with children in the general population,” said Paul Ashwood, Ph.D., of the University of California, Davis.

In a study of 31 children ASD and 19 typically developing control children aged 2–5 years, the children with ASD had abnormal levels of several cytokines in response to stimulation with three antigens, compared with the control children.

The study adds weight to the idea that autism has an immune component. There are several previous reports of both increased autoimmunity and immune response deficits in children with autism spectrum disorders (ASD). “However, a lot of these reports are conflicting, and there is no consensus so far,” Dr. Ashwood said.

Dr. Ashwood and colleagues isolated and stimulated peripheral blood mononuclear cells for 48 hours with phytohemagglutinin, lipopolysaccharide, and vaccine antigens. Analysis was performed for 18 cytokines. At baseline, cytokine levels were similar in the children with ASD and the control children.

Following stimulation with phytohemagglutinin, the children with ASD had statistically significantly lower levels of IL-2, IL-6, IL-10, and IL-12 than the control children. There was also a trend toward higher levels of IL-13 and granulocyte macrophage-colony stimulating among the children with ASD than the control children. A similar pattern was seen after stimulation with lipopolysaccharide. Children with ASD had lower levels IL-12 and a slight increase in granulocyte macrophage-colony stimulating factor, compared with the control children.

BUDAPEST, HUNGARY – Children with autism spectrum disorders appear to have immune responses different from those of healthy children, according to data presented at the 4th International Congress on Autoimmunity.

“There is evidence now for an immune dysregulation in children with autism, compared with children in the general population,” said Paul Ashwood, Ph.D., of the University of California, Davis.

In a study of 31 children ASD and 19 typically developing control children aged 2–5 years, the children with ASD had abnormal levels of several cytokines in response to stimulation with three antigens, compared with the control children.

The study adds weight to the idea that autism has an immune component. There are several previous reports of both increased autoimmunity and immune response deficits in children with autism spectrum disorders (ASD). “However, a lot of these reports are conflicting, and there is no consensus so far,” Dr. Ashwood said.

Dr. Ashwood and colleagues isolated and stimulated peripheral blood mononuclear cells for 48 hours with phytohemagglutinin, lipopolysaccharide, and vaccine antigens. Analysis was performed for 18 cytokines. At baseline, cytokine levels were similar in the children with ASD and the control children.

Following stimulation with phytohemagglutinin, the children with ASD had statistically significantly lower levels of IL-2, IL-6, IL-10, and IL-12 than the control children. There was also a trend toward higher levels of IL-13 and granulocyte macrophage-colony stimulating among the children with ASD than the control children. A similar pattern was seen after stimulation with lipopolysaccharide. Children with ASD had lower levels IL-12 and a slight increase in granulocyte macrophage-colony stimulating factor, compared with the control children.

BUDAPEST, HUNGARY — Children with autism spectrum disorders appear to have immune responses different from those of healthy children, according to data presented at the 4th International Congress on Autoimmunity.

“There is evidence now for an immune dysregulation in children with autism, compared with children in the general population,” said Paul Ashwood, Ph.D., of the University of California, Davis.

In a study of 31 children with autism spectrum disorders (ASD) and 19 typically developing control children aged 2–5 years, the children with ASD had abnormal levels of several cytokines in response to stimulation with three antigens, compared with the control children.

The study adds weight to the idea that autism has an immune component. There are several previous reports of both increased autoimmunity and immune response deficits in children with ASD. “However, a lot of these reports are conflicting, and there is no consensus so far,” Dr. Ashwood said.

In this study, Dr. Ashwood and colleagues isolated and stimulated peripheral blood mononuclear cells for 48 hours with phytohemagglutinin, lipopolysaccharide, and vaccine antigens from tetanus and MMR. Analysis was performed for 18 cytokines. At baseline, cytokine levels were similar in the children with ASD and the control children.

Following stimulation with phytohemagglutinin, the children with ASD had statistically significantly lower levels of IL-2, IL-6, IL-10, and IL-12 than the control children. There was also a trend toward higher levels of IL-13 and granulocyte macrophage-colony stimulating factor—which stimulates the precursor cells of granulocytes, macrophages, and eosinophils—among the children with ASD than the control children.

A similar pattern was seen after stimulation with lipopolysaccharide. Children with ASD had lower levels of IL-12 and a slight increase in granulocyte macro-phage-colony stimulating factor, compared with the control children.

Stimulation with tetanus antigens resulted in lower levels of IFN-γ, IL-1-β, IL-12, and granulocyte macrophage-colony stimulating factor in the children with ASD, compared to the control children.

Although there was no difference after stimulation with MMR vaccine antigens the researchers are planning to investigate the response to individual components of the MMR vaccine.

BUDAPEST, HUNGARY — Children with autism spectrum disorders appear to have immune responses different from those of healthy children, according to data presented at the 4th International Congress on Autoimmunity.

“There is evidence now for an immune dysregulation in children with autism, compared with children in the general population,” said Paul Ashwood, Ph.D., of the University of California, Davis.

In a study of 31 children with autism spectrum disorders (ASD) and 19 typically developing control children aged 2–5 years, the children with ASD had abnormal levels of several cytokines in response to stimulation with three antigens, compared with the control children.

The study adds weight to the idea that autism has an immune component. There are several previous reports of both increased autoimmunity and immune response deficits in children with ASD. “However, a lot of these reports are conflicting, and there is no consensus so far,” Dr. Ashwood said.

In this study, Dr. Ashwood and colleagues isolated and stimulated peripheral blood mononuclear cells for 48 hours with phytohemagglutinin, lipopolysaccharide, and vaccine antigens from tetanus and MMR. Analysis was performed for 18 cytokines. At baseline, cytokine levels were similar in the children with ASD and the control children.

Following stimulation with phytohemagglutinin, the children with ASD had statistically significantly lower levels of IL-2, IL-6, IL-10, and IL-12 than the control children. There was also a trend toward higher levels of IL-13 and granulocyte macrophage-colony stimulating factor—which stimulates the precursor cells of granulocytes, macrophages, and eosinophils—among the children with ASD than the control children.

A similar pattern was seen after stimulation with lipopolysaccharide. Children with ASD had lower levels of IL-12 and a slight increase in granulocyte macro-phage-colony stimulating factor, compared with the control children.

Stimulation with tetanus antigens resulted in lower levels of IFN-γ, IL-1-β, IL-12, and granulocyte macrophage-colony stimulating factor in the children with ASD, compared to the control children.

Although there was no difference after stimulation with MMR vaccine antigens the researchers are planning to investigate the response to individual components of the MMR vaccine.

BUDAPEST, HUNGARY — Children with autism spectrum disorders appear to have immune responses different from those of healthy children, according to data presented at the 4th International Congress on Autoimmunity.

“There is evidence now for an immune dysregulation in children with autism, compared with children in the general population,” said Paul Ashwood, Ph.D., of the University of California, Davis.

In a study of 31 children with autism spectrum disorders (ASD) and 19 typically developing control children aged 2–5 years, the children with ASD had abnormal levels of several cytokines in response to stimulation with three antigens, compared with the control children.

The study adds weight to the idea that autism has an immune component. There are several previous reports of both increased autoimmunity and immune response deficits in children with ASD. “However, a lot of these reports are conflicting, and there is no consensus so far,” Dr. Ashwood said.

In this study, Dr. Ashwood and colleagues isolated and stimulated peripheral blood mononuclear cells for 48 hours with phytohemagglutinin, lipopolysaccharide, and vaccine antigens from tetanus and MMR. Analysis was performed for 18 cytokines. At baseline, cytokine levels were similar in the children with ASD and the control children.

Following stimulation with phytohemagglutinin, the children with ASD had statistically significantly lower levels of IL-2, IL-6, IL-10, and IL-12 than the control children. There was also a trend toward higher levels of IL-13 and granulocyte macrophage-colony stimulating factor—which stimulates the precursor cells of granulocytes, macrophages, and eosinophils—among the children with ASD than the control children.

A similar pattern was seen after stimulation with lipopolysaccharide. Children with ASD had lower levels of IL-12 and a slight increase in granulocyte macro-phage-colony stimulating factor, compared with the control children.

Stimulation with tetanus antigens resulted in lower levels of IFN-γ, IL-1-β, IL-12, and granulocyte macrophage-colony stimulating factor in the children with ASD, compared to the control children.

Although there was no difference after stimulation with MMR vaccine antigens the researchers are planning to investigate the response to individual components of the MMR vaccine.

CHICAGO — Uterine artery embolization appears to have a slight edge over myomectomy in terms of recovery after treatment of uterine fibroids, according to data presented during the annual meeting of the Radiological Society of North America.

Uterine artery embolization (UAE) was “superior in terms of adverse events, time off from work, time until the resumption of normal activities, and hospital stay,” said Scott C. Goodwin, M.D., who is the chief of imaging services at Greater Los Angeles Veterans Affairs Medical Center.

UAE was superior for hospital stay, time off, and time to resume activities by a roughly three to one margin.

In the prospective study, 149 patients underwent UAE and 60 underwent myomectomy. Embolization was performed with Contour PVA particles.

Patients were included in the study if they were older than 30 years and had symptomatic fibroids. Women in the UAE group did not desire to become pregnant. The researchers collected overall and fibroid specific quality of life scores (QOLs) before the procedures were undertaken.

Women in the UAE group were older, more likely to have been previously pregnant, and to have had longer periods than those in the myomectomy group. Myomectomy patients were more likely to have a miscellaneous pelvic abnormality or a tubal ligation and to have had more fibroids than UAE patients.

“In terms of the QOLs, we did not find an overall difference [between the two groups], though if you look specifically at the 36–40 age group, there were some differences in terms of sleep, mental health, and restricted activity in favor of the UAE group,” Dr. Goodwin said at the meeting.

There was also no significant difference in terms of reduction of uterine volume or in bleeding score reduction.

Though the major efficacy outcomes were similar between the two groups, the study was not powered sufficiently to determine whether there were actually any statistically significant differences between groups in terms of efficacy, Dr. Goodwin said.

The adverse event rate (UTI and vaginal discharge, among others) in the UAE group was 22%, compared with 40% in the myomectomy group (UTI, hemorrhage, and others).

The major adverse event rate was 4% in the UAE group, compared with 1.7% in the myomectomy group.

Major adverse events included significant postembolization syndrome—described as flu-like symptoms—enlargement of a multicystic adnexal mass, excessive vaginal discharge, and a ruptured appendix (not related to the procedure).

Due to study design, among the women in the UAE group, 19% were considered failures (including 4 patients who withdrew consent, 10 who were lost to follow-up, and 8 who failed to meet QOL criteria, among others).

In comparison, the failure rate was 25% in the myomectomy group (including five patients who failed to meet QOL criteria, one patient requiring a hysterectomy, and three patients who were lost to follow-up, among others).

Despite the findings, not all women are good candidates for UAE.

Dr. Goodwin does not recommend that women undergo the procedure if they are not symptomatic. Instead, he advises them to watch and wait, he told this newspaper.

Fertility is also a consideration. There is some risk of premature ovarian failure following embolization, though this varies with age.

He estimated that a woman under 35 years has very little chance of this occurring, while a woman under 40 has a roughly 1% chance. Over the age of 50 the risk goes up to 30%–40%.

“So if you have a 45-year-old woman—who has not had children—who is really trying to get her last shot at having a baby, she would probably be better served by a myomectomy,” Dr. Goodwin said.

Uterine artery embolization is also contraindicated in women with a severe allergy to the contrast dye used in imaging and in women who have poor renal function, he said.

The uterine artery is shown before UAE.

This angiogram shows the same artery after UAE. Photos courtesy Dr. Scott C. Goodwin

CHICAGO — Uterine artery embolization appears to have a slight edge over myomectomy in terms of recovery after treatment of uterine fibroids, according to data presented during the annual meeting of the Radiological Society of North America.

Uterine artery embolization (UAE) was “superior in terms of adverse events, time off from work, time until the resumption of normal activities, and hospital stay,” said Scott C. Goodwin, M.D., who is the chief of imaging services at Greater Los Angeles Veterans Affairs Medical Center.

UAE was superior for hospital stay, time off, and time to resume activities by a roughly three to one margin.

In the prospective study, 149 patients underwent UAE and 60 underwent myomectomy. Embolization was performed with Contour PVA particles.

Patients were included in the study if they were older than 30 years and had symptomatic fibroids. Women in the UAE group did not desire to become pregnant. The researchers collected overall and fibroid specific quality of life scores (QOLs) before the procedures were undertaken.

Women in the UAE group were older, more likely to have been previously pregnant, and to have had longer periods than those in the myomectomy group. Myomectomy patients were more likely to have a miscellaneous pelvic abnormality or a tubal ligation and to have had more fibroids than UAE patients.

“In terms of the QOLs, we did not find an overall difference [between the two groups], though if you look specifically at the 36–40 age group, there were some differences in terms of sleep, mental health, and restricted activity in favor of the UAE group,” Dr. Goodwin said at the meeting.

There was also no significant difference in terms of reduction of uterine volume or in bleeding score reduction.

Though the major efficacy outcomes were similar between the two groups, the study was not powered sufficiently to determine whether there were actually any statistically significant differences between groups in terms of efficacy, Dr. Goodwin said.

The adverse event rate (UTI and vaginal discharge, among others) in the UAE group was 22%, compared with 40% in the myomectomy group (UTI, hemorrhage, and others).

The major adverse event rate was 4% in the UAE group, compared with 1.7% in the myomectomy group.

Major adverse events included significant postembolization syndrome—described as flu-like symptoms—enlargement of a multicystic adnexal mass, excessive vaginal discharge, and a ruptured appendix (not related to the procedure).

Due to study design, among the women in the UAE group, 19% were considered failures (including 4 patients who withdrew consent, 10 who were lost to follow-up, and 8 who failed to meet QOL criteria, among others).

In comparison, the failure rate was 25% in the myomectomy group (including five patients who failed to meet QOL criteria, one patient requiring a hysterectomy, and three patients who were lost to follow-up, among others).

Despite the findings, not all women are good candidates for UAE.

Dr. Goodwin does not recommend that women undergo the procedure if they are not symptomatic. Instead, he advises them to watch and wait, he told this newspaper.

Fertility is also a consideration. There is some risk of premature ovarian failure following embolization, though this varies with age.

He estimated that a woman under 35 years has very little chance of this occurring, while a woman under 40 has a roughly 1% chance. Over the age of 50 the risk goes up to 30%–40%.

“So if you have a 45-year-old woman—who has not had children—who is really trying to get her last shot at having a baby, she would probably be better served by a myomectomy,” Dr. Goodwin said.

Uterine artery embolization is also contraindicated in women with a severe allergy to the contrast dye used in imaging and in women who have poor renal function, he said.

The uterine artery is shown before UAE.

This angiogram shows the same artery after UAE. Photos courtesy Dr. Scott C. Goodwin

CHICAGO — Uterine artery embolization appears to have a slight edge over myomectomy in terms of recovery after treatment of uterine fibroids, according to data presented during the annual meeting of the Radiological Society of North America.

Uterine artery embolization (UAE) was “superior in terms of adverse events, time off from work, time until the resumption of normal activities, and hospital stay,” said Scott C. Goodwin, M.D., who is the chief of imaging services at Greater Los Angeles Veterans Affairs Medical Center.

UAE was superior for hospital stay, time off, and time to resume activities by a roughly three to one margin.

In the prospective study, 149 patients underwent UAE and 60 underwent myomectomy. Embolization was performed with Contour PVA particles.

Patients were included in the study if they were older than 30 years and had symptomatic fibroids. Women in the UAE group did not desire to become pregnant. The researchers collected overall and fibroid specific quality of life scores (QOLs) before the procedures were undertaken.

Women in the UAE group were older, more likely to have been previously pregnant, and to have had longer periods than those in the myomectomy group. Myomectomy patients were more likely to have a miscellaneous pelvic abnormality or a tubal ligation and to have had more fibroids than UAE patients.

“In terms of the QOLs, we did not find an overall difference [between the two groups], though if you look specifically at the 36–40 age group, there were some differences in terms of sleep, mental health, and restricted activity in favor of the UAE group,” Dr. Goodwin said at the meeting.

There was also no significant difference in terms of reduction of uterine volume or in bleeding score reduction.

Though the major efficacy outcomes were similar between the two groups, the study was not powered sufficiently to determine whether there were actually any statistically significant differences between groups in terms of efficacy, Dr. Goodwin said.

The adverse event rate (UTI and vaginal discharge, among others) in the UAE group was 22%, compared with 40% in the myomectomy group (UTI, hemorrhage, and others).

The major adverse event rate was 4% in the UAE group, compared with 1.7% in the myomectomy group.

Major adverse events included significant postembolization syndrome—described as flu-like symptoms—enlargement of a multicystic adnexal mass, excessive vaginal discharge, and a ruptured appendix (not related to the procedure).

Due to study design, among the women in the UAE group, 19% were considered failures (including 4 patients who withdrew consent, 10 who were lost to follow-up, and 8 who failed to meet QOL criteria, among others).

In comparison, the failure rate was 25% in the myomectomy group (including five patients who failed to meet QOL criteria, one patient requiring a hysterectomy, and three patients who were lost to follow-up, among others).

Despite the findings, not all women are good candidates for UAE.

Dr. Goodwin does not recommend that women undergo the procedure if they are not symptomatic. Instead, he advises them to watch and wait, he told this newspaper.

Fertility is also a consideration. There is some risk of premature ovarian failure following embolization, though this varies with age.

He estimated that a woman under 35 years has very little chance of this occurring, while a woman under 40 has a roughly 1% chance. Over the age of 50 the risk goes up to 30%–40%.

“So if you have a 45-year-old woman—who has not had children—who is really trying to get her last shot at having a baby, she would probably be better served by a myomectomy,” Dr. Goodwin said.

Uterine artery embolization is also contraindicated in women with a severe allergy to the contrast dye used in imaging and in women who have poor renal function, he said.

The uterine artery is shown before UAE.

This angiogram shows the same artery after UAE. Photos courtesy Dr. Scott C. Goodwin

BUDAPEST, HUNGARY — Children with autism spectrum disorders appear to have immune responses different from those of healthy children, according to data presented at the 4th International Congress on Autoimmunity.

“There is evidence now for an immune dysregulation in children with autism, compared with children in the general population,” said Paul Ashwood, Ph.D., of the University of California, Davis.

In a study of 31 children with autism spectrum disorders (ASD) and 19 typically developing control children aged 2-5 years, the children with ASD had abnormal levels of several cytokines in response to stimulation with three antigens, compared with the control children.

The study adds weight to the idea that autism has an immune component. There are several previous reports of both increased autoimmunity and immune response deficits in children with autism spectrum disorders.

“However, a lot of these reports are conflicting, and there is no consensus so far,” Dr. Ashwood said.

In this study, Dr. Ashwood and colleagues isolated and stimulated peripheral blood mononuclear cells for 48 hours with phytohemagglutinin, lipopolysaccharide, and vaccine antigens from tetanus and MMR. Analysis was performed for 18 cytokines. At baseline, cytokine levels were similar in the children with ASD and the control children.

Following stimulation with phytohemagglutinin, the children with ASD had statistically significantly lower levels of IL-2, IL-6, IL-10, and IL-12 than the control children.

There was also a trend toward higher levels of IL-13 and granulocyte macrophage-colony stimulating factor—which stimulates the precursor cells of granulocytes, macrophages, and eosinophils—among the children with ASD than the control children.

A similar pattern was seen after stimulation with lipopolysaccharide. Children with ASD had lower levels of IL-12 and a slight increase in granulocyte macrophage-colony stimulating factor, compared with the control children.

Stimulation with tetanus antigens resulted in lower levels of IFN-γ, IL-1-β, IL-12, and granulocyte macrophage-colony stimulating factor in the children with ASD, compared to the control children.

There was no difference between the groups after stimulation with MMR vaccine antigens. The researchers are planning to investigate cytokine and chemokine response to individual components of the MMR vaccine.

BUDAPEST, HUNGARY — Children with autism spectrum disorders appear to have immune responses different from those of healthy children, according to data presented at the 4th International Congress on Autoimmunity.

“There is evidence now for an immune dysregulation in children with autism, compared with children in the general population,” said Paul Ashwood, Ph.D., of the University of California, Davis.

In a study of 31 children with autism spectrum disorders (ASD) and 19 typically developing control children aged 2-5 years, the children with ASD had abnormal levels of several cytokines in response to stimulation with three antigens, compared with the control children.

The study adds weight to the idea that autism has an immune component. There are several previous reports of both increased autoimmunity and immune response deficits in children with autism spectrum disorders.

“However, a lot of these reports are conflicting, and there is no consensus so far,” Dr. Ashwood said.

In this study, Dr. Ashwood and colleagues isolated and stimulated peripheral blood mononuclear cells for 48 hours with phytohemagglutinin, lipopolysaccharide, and vaccine antigens from tetanus and MMR. Analysis was performed for 18 cytokines. At baseline, cytokine levels were similar in the children with ASD and the control children.

Following stimulation with phytohemagglutinin, the children with ASD had statistically significantly lower levels of IL-2, IL-6, IL-10, and IL-12 than the control children.

There was also a trend toward higher levels of IL-13 and granulocyte macrophage-colony stimulating factor—which stimulates the precursor cells of granulocytes, macrophages, and eosinophils—among the children with ASD than the control children.

A similar pattern was seen after stimulation with lipopolysaccharide. Children with ASD had lower levels of IL-12 and a slight increase in granulocyte macrophage-colony stimulating factor, compared with the control children.

Stimulation with tetanus antigens resulted in lower levels of IFN-γ, IL-1-β, IL-12, and granulocyte macrophage-colony stimulating factor in the children with ASD, compared to the control children.

There was no difference between the groups after stimulation with MMR vaccine antigens. The researchers are planning to investigate cytokine and chemokine response to individual components of the MMR vaccine.

BUDAPEST, HUNGARY — Children with autism spectrum disorders appear to have immune responses different from those of healthy children, according to data presented at the 4th International Congress on Autoimmunity.

“There is evidence now for an immune dysregulation in children with autism, compared with children in the general population,” said Paul Ashwood, Ph.D., of the University of California, Davis.

In a study of 31 children with autism spectrum disorders (ASD) and 19 typically developing control children aged 2-5 years, the children with ASD had abnormal levels of several cytokines in response to stimulation with three antigens, compared with the control children.

The study adds weight to the idea that autism has an immune component. There are several previous reports of both increased autoimmunity and immune response deficits in children with autism spectrum disorders.

“However, a lot of these reports are conflicting, and there is no consensus so far,” Dr. Ashwood said.

In this study, Dr. Ashwood and colleagues isolated and stimulated peripheral blood mononuclear cells for 48 hours with phytohemagglutinin, lipopolysaccharide, and vaccine antigens from tetanus and MMR. Analysis was performed for 18 cytokines. At baseline, cytokine levels were similar in the children with ASD and the control children.

Following stimulation with phytohemagglutinin, the children with ASD had statistically significantly lower levels of IL-2, IL-6, IL-10, and IL-12 than the control children.

There was also a trend toward higher levels of IL-13 and granulocyte macrophage-colony stimulating factor—which stimulates the precursor cells of granulocytes, macrophages, and eosinophils—among the children with ASD than the control children.

A similar pattern was seen after stimulation with lipopolysaccharide. Children with ASD had lower levels of IL-12 and a slight increase in granulocyte macrophage-colony stimulating factor, compared with the control children.

Stimulation with tetanus antigens resulted in lower levels of IFN-γ, IL-1-β, IL-12, and granulocyte macrophage-colony stimulating factor in the children with ASD, compared to the control children.

There was no difference between the groups after stimulation with MMR vaccine antigens. The researchers are planning to investigate cytokine and chemokine response to individual components of the MMR vaccine.

BUDAPEST, HUNGARY — Infliximab, in combination with methotrexate, shows promising results in reducing the severity of psoriatic spondyloarthropathy, based on the results of a 2-year open-label study presented at the 4th International Congress on Autoimmunity.

Most of the 16 patients in the study showed improvement on several measures, according to Juan J. Scali, M.D., of Durand Hospital, Buenos Aires.

The patients in the study—nine men and seven women with a mean age of 38 years—had severe manifestations of the disease, little or no response to methotrexate, and a mean disease duration of 16 years. Seven patients were positive for HLA-B27, which is associated with ankylosing spondylitis.

Patients were given 5 mg of infliximab (Remicade) per kg of body weight as an intravenous infusion at baseline, at 2 and 6 weeks, and then once a month. They were continued on methotrexate 15 mg/wk.

Patients were evaluated using the psoriatic arthritis response criteria (PsARC) and the American College of Rheumatology (ACR) response criteria (20, 50, and 70). With PsARC, a patient must show improvement in two of the four measures—at least 30% reduction of tender joint count, at least a 30% reduction of swollen joint count, a decrease of at least 1 point on the physician global assessment, and a decrease of at least 1 point on the patient global assessment on a visual analog scale—to be a considered a responder. When the ACR response criteria are used, the patient must show a 20%, 50%, or 70% improvement in tender joint count, swollen joint count, and three of five other measures—patient assessment, physician assessment, erythrocyte sedimentation rate, pain scale, or functional questionnaire.

At the end of 24 months, 88%, 56%, and 31% of patients responded to treatment using the ACR 20, 50, and 70. With PsARC, 88% of patients had improvement at the end of the first year and 74% at the end of the second year.

Psoriasis activity was also measured using the Psoriasis Area and Severity Index (PASI). Patients were considered to have active disease with a PASI score of 16 or greater. At 1 year, 90% of patients showed an improvement in PASI scores, which dropped to 80% at 2 years. Also, 70% of patients had a favorable opinion of their response at the end of 2 years. Infliximab had good safety overall; no patients had allergic reactions or adverse events, he said.

Dr. Scali noted that the best results were seen at around 20 months. He recommended 6–12 months of infliximab therapy, followed by methotrexate alone.

BUDAPEST, HUNGARY — Infliximab, in combination with methotrexate, shows promising results in reducing the severity of psoriatic spondyloarthropathy, based on the results of a 2-year open-label study presented at the 4th International Congress on Autoimmunity.

Most of the 16 patients in the study showed improvement on several measures, according to Juan J. Scali, M.D., of Durand Hospital, Buenos Aires.

The patients in the study—nine men and seven women with a mean age of 38 years—had severe manifestations of the disease, little or no response to methotrexate, and a mean disease duration of 16 years. Seven patients were positive for HLA-B27, which is associated with ankylosing spondylitis.

Patients were given 5 mg of infliximab (Remicade) per kg of body weight as an intravenous infusion at baseline, at 2 and 6 weeks, and then once a month. They were continued on methotrexate 15 mg/wk.

Patients were evaluated using the psoriatic arthritis response criteria (PsARC) and the American College of Rheumatology (ACR) response criteria (20, 50, and 70). With PsARC, a patient must show improvement in two of the four measures—at least 30% reduction of tender joint count, at least a 30% reduction of swollen joint count, a decrease of at least 1 point on the physician global assessment, and a decrease of at least 1 point on the patient global assessment on a visual analog scale—to be a considered a responder. When the ACR response criteria are used, the patient must show a 20%, 50%, or 70% improvement in tender joint count, swollen joint count, and three of five other measures—patient assessment, physician assessment, erythrocyte sedimentation rate, pain scale, or functional questionnaire.

At the end of 24 months, 88%, 56%, and 31% of patients responded to treatment using the ACR 20, 50, and 70. With PsARC, 88% of patients had improvement at the end of the first year and 74% at the end of the second year.

Psoriasis activity was also measured using the Psoriasis Area and Severity Index (PASI). Patients were considered to have active disease with a PASI score of 16 or greater. At 1 year, 90% of patients showed an improvement in PASI scores, which dropped to 80% at 2 years. Also, 70% of patients had a favorable opinion of their response at the end of 2 years. Infliximab had good safety overall; no patients had allergic reactions or adverse events, he said.

Dr. Scali noted that the best results were seen at around 20 months. He recommended 6–12 months of infliximab therapy, followed by methotrexate alone.

BUDAPEST, HUNGARY — Infliximab, in combination with methotrexate, shows promising results in reducing the severity of psoriatic spondyloarthropathy, based on the results of a 2-year open-label study presented at the 4th International Congress on Autoimmunity.

Most of the 16 patients in the study showed improvement on several measures, according to Juan J. Scali, M.D., of Durand Hospital, Buenos Aires.

The patients in the study—nine men and seven women with a mean age of 38 years—had severe manifestations of the disease, little or no response to methotrexate, and a mean disease duration of 16 years. Seven patients were positive for HLA-B27, which is associated with ankylosing spondylitis.

Patients were given 5 mg of infliximab (Remicade) per kg of body weight as an intravenous infusion at baseline, at 2 and 6 weeks, and then once a month. They were continued on methotrexate 15 mg/wk.

Patients were evaluated using the psoriatic arthritis response criteria (PsARC) and the American College of Rheumatology (ACR) response criteria (20, 50, and 70). With PsARC, a patient must show improvement in two of the four measures—at least 30% reduction of tender joint count, at least a 30% reduction of swollen joint count, a decrease of at least 1 point on the physician global assessment, and a decrease of at least 1 point on the patient global assessment on a visual analog scale—to be a considered a responder. When the ACR response criteria are used, the patient must show a 20%, 50%, or 70% improvement in tender joint count, swollen joint count, and three of five other measures—patient assessment, physician assessment, erythrocyte sedimentation rate, pain scale, or functional questionnaire.

At the end of 24 months, 88%, 56%, and 31% of patients responded to treatment using the ACR 20, 50, and 70. With PsARC, 88% of patients had improvement at the end of the first year and 74% at the end of the second year.

Psoriasis activity was also measured using the Psoriasis Area and Severity Index (PASI). Patients were considered to have active disease with a PASI score of 16 or greater. At 1 year, 90% of patients showed an improvement in PASI scores, which dropped to 80% at 2 years. Also, 70% of patients had a favorable opinion of their response at the end of 2 years. Infliximab had good safety overall; no patients had allergic reactions or adverse events, he said.

Dr. Scali noted that the best results were seen at around 20 months. He recommended 6–12 months of infliximab therapy, followed by methotrexate alone.

ATLANTA — Diabetes appears to be a predictor for identifying which patients with Staphylococcus aureus-infected wounds will develop severe complications or even die as a result, according to a study presented at the annual meeting of the Wound Healing Society.

“The presence of diabetes was the strongest predictor of severe outcome,” said Lisa Tibor, M.D., of the University of California, San Francisco.

To assess potential clinical predictors of outcome, the researchers reviewed charts of patients identified with S. aureus infection during routine care. Investigators studied wound type and location, relevant comorbidities (diabetes and peripheral arterial disease), antibiotic resistance as reported for treatment protocol, and outcome. Severe outcomes were defined as amputation, sepsis, or death.

Overall, 38 strains of S. aureus were identified from wounds of patients at the University of Tübingen (Germany) hospital, from September to November 2001.

Almost 60% of diabetic patients had severe outcomes. In comparison, no nondiabetic patients with peripheral arterial disease had severe outcomes.

The researchers also looked at possible bacterial markers for poor outcomes. In particular, they evaluated antibiotic resistance and a molecular marker called the S. aureus repeat (STAR) element. The STAR elements are variable-length nucleotide regions on the bacterial chromosome. Select STAR element groups were used as markers for methicillin resistance in this study.

The researchers hypothesized that infections caused by methicillin-resistant S. aureus strains (identified by STAR group) are bacterial indicators of poor patient outcome.

Antibiotic resistance of each strain was tested by plating the strains on antibiotic-coated agar. Polymerase chain reaction was used to identify STAR element groups for each strain.

There was a trend suggesting methicillin resistance was associated with severe outcome. About 40% of patients with methicillin-resistant S. aureus strains and 20% of patients with methicillin-susceptible strains that were resistant to other antibiotics had severe outcomes. Dr. Tibor noted that one patient with an apparently nonresistant strain had a severe outcome. However, there was no clear association between STAR group and severe outcome.

This study was part of a larger one to characterize strains of S. aureus at the molecular level.

ATLANTA — Diabetes appears to be a predictor for identifying which patients with Staphylococcus aureus-infected wounds will develop severe complications or even die as a result, according to a study presented at the annual meeting of the Wound Healing Society.

“The presence of diabetes was the strongest predictor of severe outcome,” said Lisa Tibor, M.D., of the University of California, San Francisco.

To assess potential clinical predictors of outcome, the researchers reviewed charts of patients identified with S. aureus infection during routine care. Investigators studied wound type and location, relevant comorbidities (diabetes and peripheral arterial disease), antibiotic resistance as reported for treatment protocol, and outcome. Severe outcomes were defined as amputation, sepsis, or death.

Overall, 38 strains of S. aureus were identified from wounds of patients at the University of Tübingen (Germany) hospital, from September to November 2001.

Almost 60% of diabetic patients had severe outcomes. In comparison, no nondiabetic patients with peripheral arterial disease had severe outcomes.

The researchers also looked at possible bacterial markers for poor outcomes. In particular, they evaluated antibiotic resistance and a molecular marker called the S. aureus repeat (STAR) element. The STAR elements are variable-length nucleotide regions on the bacterial chromosome. Select STAR element groups were used as markers for methicillin resistance in this study.

The researchers hypothesized that infections caused by methicillin-resistant S. aureus strains (identified by STAR group) are bacterial indicators of poor patient outcome.

Antibiotic resistance of each strain was tested by plating the strains on antibiotic-coated agar. Polymerase chain reaction was used to identify STAR element groups for each strain.

There was a trend suggesting methicillin resistance was associated with severe outcome. About 40% of patients with methicillin-resistant S. aureus strains and 20% of patients with methicillin-susceptible strains that were resistant to other antibiotics had severe outcomes. Dr. Tibor noted that one patient with an apparently nonresistant strain had a severe outcome. However, there was no clear association between STAR group and severe outcome.

This study was part of a larger one to characterize strains of S. aureus at the molecular level.

ATLANTA — Diabetes appears to be a predictor for identifying which patients with Staphylococcus aureus-infected wounds will develop severe complications or even die as a result, according to a study presented at the annual meeting of the Wound Healing Society.

“The presence of diabetes was the strongest predictor of severe outcome,” said Lisa Tibor, M.D., of the University of California, San Francisco.

To assess potential clinical predictors of outcome, the researchers reviewed charts of patients identified with S. aureus infection during routine care. Investigators studied wound type and location, relevant comorbidities (diabetes and peripheral arterial disease), antibiotic resistance as reported for treatment protocol, and outcome. Severe outcomes were defined as amputation, sepsis, or death.

Overall, 38 strains of S. aureus were identified from wounds of patients at the University of Tübingen (Germany) hospital, from September to November 2001.

Almost 60% of diabetic patients had severe outcomes. In comparison, no nondiabetic patients with peripheral arterial disease had severe outcomes.

The researchers also looked at possible bacterial markers for poor outcomes. In particular, they evaluated antibiotic resistance and a molecular marker called the S. aureus repeat (STAR) element. The STAR elements are variable-length nucleotide regions on the bacterial chromosome. Select STAR element groups were used as markers for methicillin resistance in this study.

The researchers hypothesized that infections caused by methicillin-resistant S. aureus strains (identified by STAR group) are bacterial indicators of poor patient outcome.

Antibiotic resistance of each strain was tested by plating the strains on antibiotic-coated agar. Polymerase chain reaction was used to identify STAR element groups for each strain.

There was a trend suggesting methicillin resistance was associated with severe outcome. About 40% of patients with methicillin-resistant S. aureus strains and 20% of patients with methicillin-susceptible strains that were resistant to other antibiotics had severe outcomes. Dr. Tibor noted that one patient with an apparently nonresistant strain had a severe outcome. However, there was no clear association between STAR group and severe outcome.

This study was part of a larger one to characterize strains of S. aureus at the molecular level.

WASHINGTON – Maternal asthma and allergic disorders may somehow be linked with autism spectrum disorders, according to preliminary research presented at a meeting of the Centers for Disease Control and Prevention's National Center for Birth Defects and Developmental Disabilities.

Mothers of autistic children were more likely to have asthma or allergic disorders than the mothers of healthy control children in a study of 2,500 children, said Lisa Croen, Ph.D., a researcher at Kaiser Permanente Northern California, Oakland.

Immune function abnormalities have been widely reported in association with autism, though the evidence has been largely anecdotal.

For the study, the researchers identified 407 children in an outpatient database (for Northern California) who were born between January 1995 and June 1999 and were diagnosed with an autism spectrum disorder. As controls, healthy children (2,095) were randomly sampled and frequency-matched on birth year, gender, and birth hospital.

Maternal disease status was determined based on diagnoses in the period 2 years prior to and 2 years after giving birth. The researchers specifically looked at diagnoses of 44 autoimmune diseases, such as psoriasis and type 1 diabetes; asthma; and allergic disorders, such as allergic rhinitis, conjunctivitis, atopic eczema, angioedema, anaphylaxis, and urticaria.

The group of autistic children was predominantly male (82%). Children in the autism group were more likely to be twins. Mothers of autistic children were slightly older than the mothers of control children. There was a strong association between increasing maternal education and autism.

The researchers found that 16% of the mothers of autistic children were diagnosed with asthma during the 5-year period surrounding their pregnancies, compared with 11% of the mothers of healthy children. Likewise, one-quarter of the mothers with autistic children had an allergic disease, compared with 18% of the control mothers. “Allergic rhinitis was the particular finding that drove the allergy finding,” Dr. Croen said.

Whether the mother was diagnosed with asthma or allergy made no difference in terms of the child's risk of autism. Mothers diagnosed with asthma at any time prior to, during, and after pregnancy, always had a greater risk of having a child with autism than healthy mothers. Although the same was true for mothers with allergic disorders, the associations were not as strong.

The researchers also looked for associations between medications that mothers were taking and the frequency of autism in the children, to see if this could account in part for the association between maternal asthma/allergy and autism. They found no correlation between asthma or allergy medication use and an increased frequency of autism. The researchers also noted that the association between maternal asthma or allergy and autism was greater for autistic children who had one or more autistic siblings than for those with healthy siblings.

Maternal autoimmune diseases did not appear to be associated with a greater risk of autism. Mothers of children in the control group were just about as likely as mothers of autistic children to have any of the 44 autoimmune diseases–10% vs. 8%, respectively.

The researchers have postulated several biologic mechanisms for the association. First, it could be because of maternal immune response during pregnancy. In particular, they hypothesize that maternal antibodies may cross the placenta and disrupt fetal neurodevelopment by crossreacting with fetal brain antigens, through a process called molecular mimicry. The second hypothesis is that asthma and allergy share environmental risk factors with autism spectrum disorders. Another possibility is that asthma and allergy share genetic susceptibility with autism spectrum disorders–in other words, the diseases share common genes.

WASHINGTON – Maternal asthma and allergic disorders may somehow be linked with autism spectrum disorders, according to preliminary research presented at a meeting of the Centers for Disease Control and Prevention's National Center for Birth Defects and Developmental Disabilities.

Mothers of autistic children were more likely to have asthma or allergic disorders than the mothers of healthy control children in a study of 2,500 children, said Lisa Croen, Ph.D., a researcher at Kaiser Permanente Northern California, Oakland.

Immune function abnormalities have been widely reported in association with autism, though the evidence has been largely anecdotal.

For the study, the researchers identified 407 children in an outpatient database (for Northern California) who were born between January 1995 and June 1999 and were diagnosed with an autism spectrum disorder. As controls, healthy children (2,095) were randomly sampled and frequency-matched on birth year, gender, and birth hospital.

Maternal disease status was determined based on diagnoses in the period 2 years prior to and 2 years after giving birth. The researchers specifically looked at diagnoses of 44 autoimmune diseases, such as psoriasis and type 1 diabetes; asthma; and allergic disorders, such as allergic rhinitis, conjunctivitis, atopic eczema, angioedema, anaphylaxis, and urticaria.

The group of autistic children was predominantly male (82%). Children in the autism group were more likely to be twins. Mothers of autistic children were slightly older than the mothers of control children. There was a strong association between increasing maternal education and autism.

The researchers found that 16% of the mothers of autistic children were diagnosed with asthma during the 5-year period surrounding their pregnancies, compared with 11% of the mothers of healthy children. Likewise, one-quarter of the mothers with autistic children had an allergic disease, compared with 18% of the control mothers. “Allergic rhinitis was the particular finding that drove the allergy finding,” Dr. Croen said.

Whether the mother was diagnosed with asthma or allergy made no difference in terms of the child's risk of autism. Mothers diagnosed with asthma at any time prior to, during, and after pregnancy, always had a greater risk of having a child with autism than healthy mothers. Although the same was true for mothers with allergic disorders, the associations were not as strong.

The researchers also looked for associations between medications that mothers were taking and the frequency of autism in the children, to see if this could account in part for the association between maternal asthma/allergy and autism. They found no correlation between asthma or allergy medication use and an increased frequency of autism. The researchers also noted that the association between maternal asthma or allergy and autism was greater for autistic children who had one or more autistic siblings than for those with healthy siblings.

Maternal autoimmune diseases did not appear to be associated with a greater risk of autism. Mothers of children in the control group were just about as likely as mothers of autistic children to have any of the 44 autoimmune diseases–10% vs. 8%, respectively.

The researchers have postulated several biologic mechanisms for the association. First, it could be because of maternal immune response during pregnancy. In particular, they hypothesize that maternal antibodies may cross the placenta and disrupt fetal neurodevelopment by crossreacting with fetal brain antigens, through a process called molecular mimicry. The second hypothesis is that asthma and allergy share environmental risk factors with autism spectrum disorders. Another possibility is that asthma and allergy share genetic susceptibility with autism spectrum disorders–in other words, the diseases share common genes.

WASHINGTON – Maternal asthma and allergic disorders may somehow be linked with autism spectrum disorders, according to preliminary research presented at a meeting of the Centers for Disease Control and Prevention's National Center for Birth Defects and Developmental Disabilities.

Mothers of autistic children were more likely to have asthma or allergic disorders than the mothers of healthy control children in a study of 2,500 children, said Lisa Croen, Ph.D., a researcher at Kaiser Permanente Northern California, Oakland.

Immune function abnormalities have been widely reported in association with autism, though the evidence has been largely anecdotal.

For the study, the researchers identified 407 children in an outpatient database (for Northern California) who were born between January 1995 and June 1999 and were diagnosed with an autism spectrum disorder. As controls, healthy children (2,095) were randomly sampled and frequency-matched on birth year, gender, and birth hospital.

Maternal disease status was determined based on diagnoses in the period 2 years prior to and 2 years after giving birth. The researchers specifically looked at diagnoses of 44 autoimmune diseases, such as psoriasis and type 1 diabetes; asthma; and allergic disorders, such as allergic rhinitis, conjunctivitis, atopic eczema, angioedema, anaphylaxis, and urticaria.

The group of autistic children was predominantly male (82%). Children in the autism group were more likely to be twins. Mothers of autistic children were slightly older than the mothers of control children. There was a strong association between increasing maternal education and autism.

The researchers found that 16% of the mothers of autistic children were diagnosed with asthma during the 5-year period surrounding their pregnancies, compared with 11% of the mothers of healthy children. Likewise, one-quarter of the mothers with autistic children had an allergic disease, compared with 18% of the control mothers. “Allergic rhinitis was the particular finding that drove the allergy finding,” Dr. Croen said.

Whether the mother was diagnosed with asthma or allergy made no difference in terms of the child's risk of autism. Mothers diagnosed with asthma at any time prior to, during, and after pregnancy, always had a greater risk of having a child with autism than healthy mothers. Although the same was true for mothers with allergic disorders, the associations were not as strong.

The researchers also looked for associations between medications that mothers were taking and the frequency of autism in the children, to see if this could account in part for the association between maternal asthma/allergy and autism. They found no correlation between asthma or allergy medication use and an increased frequency of autism. The researchers also noted that the association between maternal asthma or allergy and autism was greater for autistic children who had one or more autistic siblings than for those with healthy siblings.

Maternal autoimmune diseases did not appear to be associated with a greater risk of autism. Mothers of children in the control group were just about as likely as mothers of autistic children to have any of the 44 autoimmune diseases–10% vs. 8%, respectively.

The researchers have postulated several biologic mechanisms for the association. First, it could be because of maternal immune response during pregnancy. In particular, they hypothesize that maternal antibodies may cross the placenta and disrupt fetal neurodevelopment by crossreacting with fetal brain antigens, through a process called molecular mimicry. The second hypothesis is that asthma and allergy share environmental risk factors with autism spectrum disorders. Another possibility is that asthma and allergy share genetic susceptibility with autism spectrum disorders–in other words, the diseases share common genes.

BUDAPEST, HUNGARY — Serologic testing can be a useful adjunct to intestinal mucosal biopsy in the diagnosis of celiac disease under certain conditions, said Pekka Collin, M.D., a gastroenterologist at the University of Tampere (Finland).

Antitissue transglutaminase IgA antibody and serum antiendomysial IgA antibody tests are sensitive and specific, Dr. Collin said at the 4th International Congress on Autoimmunity.

“What we do now in clinical practice is, we use serum screening tests for all kinds of risk groups,” he said. The most typical risk group is first-degree relatives of a patient with celiac disease, for whom the risk of having the disease is about 10%–15%. Patients with other autoimmune conditions make up another risk group, with a roughly 5% risk of also having celiac disease.

“Then we also take antibodies—and subsequently, biopsies, in positive cases—when a patient has atypical symptoms,” said Dr. Collin, a member of the Celiac Disease Study Group at the university. These atypical symptoms include infertility, osteoporosis, and neurologic symptoms, such as polyneuropathy, ataxia, epilepsy, and posterior cerebral calcification.

By focusing on patients with a high index of suspicion based on clinical symptoms and by screening patients in high-risk groups, Dr. Collin finds a prevalence of 0.7% for celiac disease among his patients. It's estimated that the true prevalence of the disease among the general population is 1%.

BUDAPEST, HUNGARY — Serologic testing can be a useful adjunct to intestinal mucosal biopsy in the diagnosis of celiac disease under certain conditions, said Pekka Collin, M.D., a gastroenterologist at the University of Tampere (Finland).

Antitissue transglutaminase IgA antibody and serum antiendomysial IgA antibody tests are sensitive and specific, Dr. Collin said at the 4th International Congress on Autoimmunity.

“What we do now in clinical practice is, we use serum screening tests for all kinds of risk groups,” he said. The most typical risk group is first-degree relatives of a patient with celiac disease, for whom the risk of having the disease is about 10%–15%. Patients with other autoimmune conditions make up another risk group, with a roughly 5% risk of also having celiac disease.

“Then we also take antibodies—and subsequently, biopsies, in positive cases—when a patient has atypical symptoms,” said Dr. Collin, a member of the Celiac Disease Study Group at the university. These atypical symptoms include infertility, osteoporosis, and neurologic symptoms, such as polyneuropathy, ataxia, epilepsy, and posterior cerebral calcification.

By focusing on patients with a high index of suspicion based on clinical symptoms and by screening patients in high-risk groups, Dr. Collin finds a prevalence of 0.7% for celiac disease among his patients. It's estimated that the true prevalence of the disease among the general population is 1%.

BUDAPEST, HUNGARY — Serologic testing can be a useful adjunct to intestinal mucosal biopsy in the diagnosis of celiac disease under certain conditions, said Pekka Collin, M.D., a gastroenterologist at the University of Tampere (Finland).

Antitissue transglutaminase IgA antibody and serum antiendomysial IgA antibody tests are sensitive and specific, Dr. Collin said at the 4th International Congress on Autoimmunity.

“What we do now in clinical practice is, we use serum screening tests for all kinds of risk groups,” he said. The most typical risk group is first-degree relatives of a patient with celiac disease, for whom the risk of having the disease is about 10%–15%. Patients with other autoimmune conditions make up another risk group, with a roughly 5% risk of also having celiac disease.

“Then we also take antibodies—and subsequently, biopsies, in positive cases—when a patient has atypical symptoms,” said Dr. Collin, a member of the Celiac Disease Study Group at the university. These atypical symptoms include infertility, osteoporosis, and neurologic symptoms, such as polyneuropathy, ataxia, epilepsy, and posterior cerebral calcification.

By focusing on patients with a high index of suspicion based on clinical symptoms and by screening patients in high-risk groups, Dr. Collin finds a prevalence of 0.7% for celiac disease among his patients. It's estimated that the true prevalence of the disease among the general population is 1%.

BUDAPEST, HUNGARY — Chloroquine therapy for patients with rheumatoid arthritis may lower levels of antibodies to oxidized low-density lipoprotein, and thus reduce the risk of cardiovascular disease, C.L.P. Mangueira, M.D., reported at the 4th International Congress on Autoimmunity.

Oxidized low-density lipoprotein (oxLDL) induces antibody production and the inflammatory process.

These antibodies (anti-oxLDL) are also considered risk factors for cardiovascular disease.

In a study of 66 rheumatoid arthritis (RA) patients and 66 age-matched healthy controls, “we found an apparent association between the use of chloroquine and low levels of the antibodies to oxidized LDL,” said Dr. Mangueira of Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Brazil.

This association is compelling because almost 50% of deaths among RA patients are due to cardiovascular causes and the onset of heart disease in RA patients has also been shown to start a decade earlier compared with those without RA.

The researchers evaluated the levels of anti-oxLDL by two different methods and compared them with those of the controls.

Anti-oxLDL was measured by an immunoassay that uses copper-oxidized LDL as antigen and another immunoassay that uses synthetic peptides derived from the fragmentation of apolipoprotein B as antigen. Both assays were developed by Dr. Mangueira's group.

RA patients were using methotrexate, prednisone, sulfasalazine, chloroquine, and leflunomide.

“We found higher levels of anti-oxLDL in rheumatoid patients compared with the control group,” using both methods, Dr. Mangueira said. There was no statistical correlation between anti-oxLDL levels and disease severity, which was assessed using the Modified Disease Activity Score system, the erythrocyte sedimentation rate, and C-reactive protein.

The 22 chloroquine patients had lower levels of anti-ox-LDL than did RA patients with no chloroquine use. In addition, the RA patients taking chloroquine had lower levels of anti-apolipoprotein B peptides than did those not taking the drug.

“We know that chloroquine has a cholesterol-lowering effect,” he said. In fact, chloroquine use has been suggested to reduce lipoprotein synthesis induced by corticosteroids in rheumatoid and lupus patients.

BUDAPEST, HUNGARY — Chloroquine therapy for patients with rheumatoid arthritis may lower levels of antibodies to oxidized low-density lipoprotein, and thus reduce the risk of cardiovascular disease, C.L.P. Mangueira, M.D., reported at the 4th International Congress on Autoimmunity.

Oxidized low-density lipoprotein (oxLDL) induces antibody production and the inflammatory process.

These antibodies (anti-oxLDL) are also considered risk factors for cardiovascular disease.

In a study of 66 rheumatoid arthritis (RA) patients and 66 age-matched healthy controls, “we found an apparent association between the use of chloroquine and low levels of the antibodies to oxidized LDL,” said Dr. Mangueira of Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Brazil.

This association is compelling because almost 50% of deaths among RA patients are due to cardiovascular causes and the onset of heart disease in RA patients has also been shown to start a decade earlier compared with those without RA.

The researchers evaluated the levels of anti-oxLDL by two different methods and compared them with those of the controls.

Anti-oxLDL was measured by an immunoassay that uses copper-oxidized LDL as antigen and another immunoassay that uses synthetic peptides derived from the fragmentation of apolipoprotein B as antigen. Both assays were developed by Dr. Mangueira's group.

RA patients were using methotrexate, prednisone, sulfasalazine, chloroquine, and leflunomide.

“We found higher levels of anti-oxLDL in rheumatoid patients compared with the control group,” using both methods, Dr. Mangueira said. There was no statistical correlation between anti-oxLDL levels and disease severity, which was assessed using the Modified Disease Activity Score system, the erythrocyte sedimentation rate, and C-reactive protein.

The 22 chloroquine patients had lower levels of anti-ox-LDL than did RA patients with no chloroquine use. In addition, the RA patients taking chloroquine had lower levels of anti-apolipoprotein B peptides than did those not taking the drug.

“We know that chloroquine has a cholesterol-lowering effect,” he said. In fact, chloroquine use has been suggested to reduce lipoprotein synthesis induced by corticosteroids in rheumatoid and lupus patients.

BUDAPEST, HUNGARY — Chloroquine therapy for patients with rheumatoid arthritis may lower levels of antibodies to oxidized low-density lipoprotein, and thus reduce the risk of cardiovascular disease, C.L.P. Mangueira, M.D., reported at the 4th International Congress on Autoimmunity.

Oxidized low-density lipoprotein (oxLDL) induces antibody production and the inflammatory process.

These antibodies (anti-oxLDL) are also considered risk factors for cardiovascular disease.

In a study of 66 rheumatoid arthritis (RA) patients and 66 age-matched healthy controls, “we found an apparent association between the use of chloroquine and low levels of the antibodies to oxidized LDL,” said Dr. Mangueira of Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Brazil.

This association is compelling because almost 50% of deaths among RA patients are due to cardiovascular causes and the onset of heart disease in RA patients has also been shown to start a decade earlier compared with those without RA.

The researchers evaluated the levels of anti-oxLDL by two different methods and compared them with those of the controls.

Anti-oxLDL was measured by an immunoassay that uses copper-oxidized LDL as antigen and another immunoassay that uses synthetic peptides derived from the fragmentation of apolipoprotein B as antigen. Both assays were developed by Dr. Mangueira's group.

RA patients were using methotrexate, prednisone, sulfasalazine, chloroquine, and leflunomide.

“We found higher levels of anti-oxLDL in rheumatoid patients compared with the control group,” using both methods, Dr. Mangueira said. There was no statistical correlation between anti-oxLDL levels and disease severity, which was assessed using the Modified Disease Activity Score system, the erythrocyte sedimentation rate, and C-reactive protein.

The 22 chloroquine patients had lower levels of anti-ox-LDL than did RA patients with no chloroquine use. In addition, the RA patients taking chloroquine had lower levels of anti-apolipoprotein B peptides than did those not taking the drug.

“We know that chloroquine has a cholesterol-lowering effect,” he said. In fact, chloroquine use has been suggested to reduce lipoprotein synthesis induced by corticosteroids in rheumatoid and lupus patients.

WASHINGTON — Exercise, and to a lesser extent even daily activity, appears to be key to maintaining mobility in older adults, according to data presented at the annual meeting of the Gerontological Society of America.

“It's very clear that in these people—well-functioning people at baseline—physical inactivity increases the risk of functional mobility limitation about twofold versus those who exercise,” said Marjolein Visser, M.D., of Vrije University Medical Center, Amsterdam. There is an intermediate risk for those who are active in daily living but do not regularly participate in structured exercise. “There is some benefit but not as great a benefit as for exercise.”

In a study including 2,987 individuals aged 70–79 years, physical activity during the last 7 days was assessed using a questionnaire that addressed duration and intensity of exercise, as well as daily living activity.

The data came from the Health, Aging, and Body Composition study, sponsored by the National Institute on Aging. To be included in this study, volunteers had to be free of disabilities affecting daily living and free of functional limitations. “This is important because it indicates that they were very likely to be physically capable of being physically active,” Dr. Visser said.

Participants were categorized according to activity level. The exercise group (474 men, 251 women) got at least 1,000 kcal/wk of structured exercise. The active lifestyle group (666 men, 899 women) got about the same amount of total physical activity as those in the exercise group, but less than 1,000 kcal/wk came from structured exercise. The inactive group (303 men, 394 women) got little or no structured exercise and were not active in terms of daily living.

Patients were followed for an average of 4.5 years through an annual clinical exam and self-reports of level of difficulty walking a quarter of a mile and walking up 10 steps. Difficulty had to persist over at least two reports to result in a change of status. Mobility limitation was reported by 34% of men and 47% of women.

The inactive group had the most mobility limitation during follow-up, with the intermediate group showing greater mobility, and the exercise group had the greatest mobility.

After adjusting for demographic, lifestyle, and health factors, inactive men and women had twice the risk of mobility limitation during follow-up, compared with those who exercised. Those with an active lifestyle had an intermittent risk.

The researchers also looked at associations between walking and mobility limitation among only the subjects who got little or no exercise

In this walking subgroup analysis, those who rarely walked (440 men, 649 women) had the highest risk of mobility limitation. Occasional walkers (247 men, 378 women) had an intermediate risk, while frequent walkers (282 men, 266 women) had the lowest risk.

The researchers also wanted to examine the relationship between activity and mobility is mediated muscle parameters. by muscle mass (at midthigh), strength (knee extension), and muscle fat (midthigh attenuation on a CT scan).

Those who recieved structured exercise had more muscle mass, less fat in their muscle, and more muscle strength than those with an active lifestyle. Inactive participants had the least muscle mass, the most fat in their muscle, and the least muscle strength. There was no association between walking activity and the muscle parameters.

WASHINGTON — Exercise, and to a lesser extent even daily activity, appears to be key to maintaining mobility in older adults, according to data presented at the annual meeting of the Gerontological Society of America.

“It's very clear that in these people—well-functioning people at baseline—physical inactivity increases the risk of functional mobility limitation about twofold versus those who exercise,” said Marjolein Visser, M.D., of Vrije University Medical Center, Amsterdam. There is an intermediate risk for those who are active in daily living but do not regularly participate in structured exercise. “There is some benefit but not as great a benefit as for exercise.”

In a study including 2,987 individuals aged 70–79 years, physical activity during the last 7 days was assessed using a questionnaire that addressed duration and intensity of exercise, as well as daily living activity.

The data came from the Health, Aging, and Body Composition study, sponsored by the National Institute on Aging. To be included in this study, volunteers had to be free of disabilities affecting daily living and free of functional limitations. “This is important because it indicates that they were very likely to be physically capable of being physically active,” Dr. Visser said.

Participants were categorized according to activity level. The exercise group (474 men, 251 women) got at least 1,000 kcal/wk of structured exercise. The active lifestyle group (666 men, 899 women) got about the same amount of total physical activity as those in the exercise group, but less than 1,000 kcal/wk came from structured exercise. The inactive group (303 men, 394 women) got little or no structured exercise and were not active in terms of daily living.

Patients were followed for an average of 4.5 years through an annual clinical exam and self-reports of level of difficulty walking a quarter of a mile and walking up 10 steps. Difficulty had to persist over at least two reports to result in a change of status. Mobility limitation was reported by 34% of men and 47% of women.

The inactive group had the most mobility limitation during follow-up, with the intermediate group showing greater mobility, and the exercise group had the greatest mobility.

After adjusting for demographic, lifestyle, and health factors, inactive men and women had twice the risk of mobility limitation during follow-up, compared with those who exercised. Those with an active lifestyle had an intermittent risk.

The researchers also looked at associations between walking and mobility limitation among only the subjects who got little or no exercise

In this walking subgroup analysis, those who rarely walked (440 men, 649 women) had the highest risk of mobility limitation. Occasional walkers (247 men, 378 women) had an intermediate risk, while frequent walkers (282 men, 266 women) had the lowest risk.

The researchers also wanted to examine the relationship between activity and mobility is mediated muscle parameters. by muscle mass (at midthigh), strength (knee extension), and muscle fat (midthigh attenuation on a CT scan).

Those who recieved structured exercise had more muscle mass, less fat in their muscle, and more muscle strength than those with an active lifestyle. Inactive participants had the least muscle mass, the most fat in their muscle, and the least muscle strength. There was no association between walking activity and the muscle parameters.

WASHINGTON — Exercise, and to a lesser extent even daily activity, appears to be key to maintaining mobility in older adults, according to data presented at the annual meeting of the Gerontological Society of America.

“It's very clear that in these people—well-functioning people at baseline—physical inactivity increases the risk of functional mobility limitation about twofold versus those who exercise,” said Marjolein Visser, M.D., of Vrije University Medical Center, Amsterdam. There is an intermediate risk for those who are active in daily living but do not regularly participate in structured exercise. “There is some benefit but not as great a benefit as for exercise.”

In a study including 2,987 individuals aged 70–79 years, physical activity during the last 7 days was assessed using a questionnaire that addressed duration and intensity of exercise, as well as daily living activity.

The data came from the Health, Aging, and Body Composition study, sponsored by the National Institute on Aging. To be included in this study, volunteers had to be free of disabilities affecting daily living and free of functional limitations. “This is important because it indicates that they were very likely to be physically capable of being physically active,” Dr. Visser said.

Participants were categorized according to activity level. The exercise group (474 men, 251 women) got at least 1,000 kcal/wk of structured exercise. The active lifestyle group (666 men, 899 women) got about the same amount of total physical activity as those in the exercise group, but less than 1,000 kcal/wk came from structured exercise. The inactive group (303 men, 394 women) got little or no structured exercise and were not active in terms of daily living.

Patients were followed for an average of 4.5 years through an annual clinical exam and self-reports of level of difficulty walking a quarter of a mile and walking up 10 steps. Difficulty had to persist over at least two reports to result in a change of status. Mobility limitation was reported by 34% of men and 47% of women.

The inactive group had the most mobility limitation during follow-up, with the intermediate group showing greater mobility, and the exercise group had the greatest mobility.

After adjusting for demographic, lifestyle, and health factors, inactive men and women had twice the risk of mobility limitation during follow-up, compared with those who exercised. Those with an active lifestyle had an intermittent risk.

The researchers also looked at associations between walking and mobility limitation among only the subjects who got little or no exercise

In this walking subgroup analysis, those who rarely walked (440 men, 649 women) had the highest risk of mobility limitation. Occasional walkers (247 men, 378 women) had an intermediate risk, while frequent walkers (282 men, 266 women) had the lowest risk.

The researchers also wanted to examine the relationship between activity and mobility is mediated muscle parameters. by muscle mass (at midthigh), strength (knee extension), and muscle fat (midthigh attenuation on a CT scan).

Those who recieved structured exercise had more muscle mass, less fat in their muscle, and more muscle strength than those with an active lifestyle. Inactive participants had the least muscle mass, the most fat in their muscle, and the least muscle strength. There was no association between walking activity and the muscle parameters.