Papers by Mariangela Manfredi
Polymyalgia rheumatica (PMR) is an inflammatory disease that affects people aged > 50 years, a... more Polymyalgia rheumatica (PMR) is an inflammatory disease that affects people aged > 50 years, and is characterised by pain and morning stiffness in the shoulder and pelvic girdle with synovitis of the proximal joints and extra-articular synovial structures. It is currently mainly treated with glucocorticoids (GCs). The aim of the study was to evaluate changes in inflammatory markers and their correlations with cortisol levels after treatment with 6-methylprednisolone (6-MP) or modified-release prednisone (MR-P) in patients with "early" PMR. The study involved 81 GC-naïve with "early" PMR diagnosed on the basis of the 2012 EULAR/ACR criteria: 38 treated with 6-MP at a starting dose of 12 mg at 8.00 a.m, gradually tapered to 8, 4 and 2 mg/day, and 43 treated with MR-P at a starting dose of 10 mg at 10 p.m, tapered to 7, 5, 3, 2 and 1 mg. The markers of inflammation (ESR mm/h, CRP mg/dL and fibrinogen mg/dL), the circulating serum levels of cytokines (TNFa and IL-...
Journal of Allergy and Clinical Immunology, 2004
RationaleImmediate adverse reactions to quinolones (IARQ) like urticaria, angioedema and shock ar... more RationaleImmediate adverse reactions to quinolones (IARQ) like urticaria, angioedema and shock are observed with increasing frequency. Our aim was to assess if these reactions are IgE-mediated.
Annals of the Rheumatic Diseases, 2013
ABSTRACT Background Anti-TNF drugs have changed the clinical course of rheumatoid arthritis (RA),... more ABSTRACT Background Anti-TNF drugs have changed the clinical course of rheumatoid arthritis (RA), but the survival rate and the resistance to the therapy showed that about 30% of RA patients fail to respond to these drugs. Objectives The aim of our study was to evaluate the correlation between the development of anti-drug antibodies and specific IgG-4 antibodies against TNF inhibitors and the resistance to this therapy in RA patients. Methods The retrospective study involved 130 established RA patients [98 females and 32 males, mean age 56,7±12,3 years, disease duration 6,3±1.2] who fail to respond to conventional DMARDs treated with anti-TNF agents [32 pts with INF, 58 pts. with ETN, 40 pts with ADA] with a baseline DAS28 range between 3.2-5.6. After 6 months of treatment according to DAS28 values the patients were classified in remission for DAS28 <2.6 (R) and having low disease activity (LDA) for DAS28 range between 2.6-3.2 or non responder (NR)>3.2. The patients were tested for serum anti-drugs antibodies (Anti TNF-α Blocker ELISA kit Immundiagnostik AG, Bensheim - Listarfish, Milan, Italy) and IgG4 specific antibodies against TNF- inhibitors (ImmunoCAP® Assay fluoroenzyme immuno assay Kit for ImmunoCAP250, Phadia, Uppsala, Sweden). Results After a mean of 6 months in IFN group: 15.65% of the patients were in remission (R ), 31.2 % in LDA and 53.12% NRs; in ETN group 22.41% of the patients in R, 41.37% in LDA, 36.20% NRs, in ADA group 30% of the patients in R, 25% in LDA and 45% NRs. In the INF group the anti-drug antibodies were detected in 21. 87% of the patients and specific IgG-4 antibodies in18%, in ETN group the anti-drug antibodies were detected in 10.34% and specific IgG-4 antibodies in 8.67%, in ADA group the anti-drugs antibodies in 25% and specific IgG-4 antibodies in 5%. The presence of anti-drug antibodies in INF e ADA group correlate with the high percentage of NRs (R:0.032 ;R:0.039). No correlation with the specific IgG-4 antibodies against TNF and clinical response was observed. Conclusions In patients with RA the presence of all anti-drug antibodies but not the specific IgG-4 antibodies against TNF could influence the activity of TNFblockers in particular in INF and ADA group. This study also confirmed the low immunogenecity of ETN. Disclosure of Interest None Declared
Annals of the Rheumatic Diseases, 2013
ABSTRACT Background Polymyalgia rheumatica (PM) is a common inflammatory disease that affects eld... more ABSTRACT Background Polymyalgia rheumatica (PM) is a common inflammatory disease that affects elderly patients in Western countries, and is usually treated using glucocorticoid (GC) therapy that still play the major role in the treatment of the disease by rapidly recunding and suppressing inflammation within a few week. The circadian administration of prednisone in rheumatoid arthritis showed that optimizing the timing of GC administration with low-dose modified-release prednisone (MR-P)improves the benefit ratio of long-term GC treatment (CAPRA 1-2 studies). Objectives To compare changes in inflammation markers and their correlations with cortisol levels in PM patients treated with the new MR-P tablet or 6-methylprednisolone (6-MP). Methods The 42 enrolled patients fulfilled the 2012 EULAR/ACR criteria for PM: 17 were treated with 6-MP 12 mg at 8.00 a.m. then gradually tapered to 2 mg/daily (group A: 10 females; mean age 72.5 years), and 25 were treated with MR-P10 mg at 10.00 p.m, tapered to 1 mg (group B: 14 females; mean age 74.6 years). Their erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), fibrinogen, cortisol levels, cytokine (TNF-α and IL6)were measured at baseline and after six months. Circulating cytokine levels were determined using Human IL-6 Instant ELISA Bioscience, Bender, MedSystems, GmbH (Vienna, Austria) and Human TNFa Quantikine immunoassay RD System INC.(Minneapolis, USA). Results The baseline laboratory parameters in group A and B were respectively: ESR 30.6±18.2 vs33.3±17.6 mm/h (p=n.s.); CRP 1.5±1.8 vs2.5±3.6 mg/dL (p=n.s.); fibrinogen 456±161 vs482±160 mg/dL (p=n.s.); cortisol 16.1±7.2 vs11.2±6.2 μg/dL (p=n.s.) and TNF-α1.0±0.6 vs1.2±0.7 pg/mL (p=n.s.). Baseline IL6 values were lower in group A 1.7±1.1 vs4.5±5.0 pg/mL in group B, p<0.01) and abnormal IL6 values at baseline were in eight (47%) group A vs twenty(84%) group B patients (p<0.05). After the first month oftreatment, the decrease in IL-6 levels in group A and B were respectively 50% and 85.7% (p <0.001). After six months of treatment, the same parameters were: ESR 18.2±15.6 vs20.5±16.5 mm/h (p=n.s.); CRP 0.7±0.6 vs0.6±0.8 mg/dL (p=n.s.); fibrinogen 441±101 vs372±85 mg/dL (p=n.s.); cortisol 14.1±5.4 vs11,7±4.8 μg/dL (p=n.s.); TNF-α2.9±7.2 vs3.6±11.4 pg/mL (p=n.s.); and IL-6 1.2±0.5 vs1.6±1.4 pg/mL (p=n.s.). After six months of treatment, there wasn’t a statistically significant difference in the GC dose between group A and group B (3.9±1.8 mg vs3.5±1.8 mg). Conclusions In this non-randomized prospective observational study the response of inflammation markers to low-dose GC was similar in patients with PM treated with 6-MP or MR-P, and morning cortisol levels were unaffected. However, the patients treated with MR-P showed a greater decrease in IL-6 levels after the first month. Disclosure of Interest None Declared
Annals of the Rheumatic Diseases, 2013
ABSTRACT Background Ro-52 is an interferon (IFN)-inducible protein of the tripartite motif (TRIM)... more ABSTRACT Background Ro-52 is an interferon (IFN)-inducible protein of the tripartite motif (TRIM) family. Antibodies against Ro-52 have been described in patients with different autoimmune diseases such as systemic lupus erythematosus (SLE) and Sjogren’s syndrome (SS), which are often associated with anti-Ro-60 antibodies. However, in inflammatory myositis, anti-Ro-52 antibodies are frequently present without anti-Ro-60 antibodies. Ro-52 autoantigen is extraordinarily antigenic and its autoantibodies are directed againstboth linear and conformational epitopes. Objectives The first aim of the study was to evaluate antibodies against the full length of the Ro-52 antigen (Ro-52) and its five fragments, and their association with serological and clinical data. The second aim was to assess the prevalence of anti-full-length Ro-52 and its five fragments in different systemic autoimmune rheumatic diseases (SARDs). Methods Serum samples were obtained from 78 SARDs patients and 68 controls (50 healthy donors and 18 patients with other autoimmune diseases). Ro-52 antibodies were measured using four different Methods: Bioplex2200 Multiplex-Biorad (Laboratories Inc. Hercules, CA, USA), ANA Profile3-Blot, Profile Autoimmune Liver Diseases-Blot, and Myositis Profile3-Blot EUROIMMUN AG. (EUROIMMUN AG, Lubeck, Germany). Serum was considered positive for anti-Ro-52 when at least one of these methods revealed their presence. Full-length Ro-52 antigen was expressed in insect cells using the baculovirus system, and five recombinant Ro-52 antigen fragments [Ro-52-1, Ro-52-2, Ro-52-3, Ro-52-4 (partly overlapping Ro-52-1 and -2) and Ro-52-5 (partly overlapping Ro-52-2 and -3)] expressed in E. coli, were coated onto nitrocellulose membranes in a line immunoassay system. Sera were incubated in accordance with the manufacturers standard protocol (30 min serum, 30 min anti-human IgG/alkaline phosphatase, 10 min NBT/BCIP substrate). Prevalence and reaction intensities were automatically evaluated using the commercial computer programme EUROLineScan from EUROIMMUN AG. Results All of the samples obtained from the SARDs patients were positive for antibodies against the full-length Ro52 and fragment 2, except those obtained from the myositis patients. None of the sera samples of the patients and controls were positive for anti-Ro-52-3. Moreover, all of the control samples were negative for the full-length Ro52 and all of the fragments. Myositis group (n=3) gave an isolated but very weak reaction with the full length Ro-52 and displayed no reaction with the fragments. In the SARDs patients, the fragment prevalence rates were Ro-52-1= 4/82 (4.9%), Ro-52-2= 79/82 (96.3%), Ro-52-3= 0/82 (0%), Ro-52-4= 6/82 (7.3%) and Ro-52-5= 22/82 (26.8%). Conclusions The main epitope is localised on fragment 2, and all diseases have antibodies that target this fragment. Antibody positivity for full-length Ro52 and negativity for all five fragments suggests a diagnosis of myositis. As all of the samples were positive for fragment 2, and only some for fragments 5 or 4, it seems that the target epitope is localized in the middle of fragment 2 or in the area between fragments 4 and 5. Further studies involving a large number of patients are suggested to confirm our findings. Disclosure of Interest None Declared
The open rheumatology journal, 2013
The use of tumour necrosis factor (TNF) antagonists (infliximab [IFN], etanercept [ETN], adalimum... more The use of tumour necrosis factor (TNF) antagonists (infliximab [IFN], etanercept [ETN], adalimumab [ADA]) has changed the course of many rheumatic diseases, including rheumatoid arthritis (RA). However, some questions concerning their safety have emerged since their approval because they can trigger immunisation, induce rare type I and III hypersensitivity, and cause acute and delayed reactions. The aim of this study was to evaluate the correlations between hypersensitivity reactions to biological agents, disease activity and the development of class-specific IgA and IgM antibodies against the three anti-TNF agents in patients with RA. This longitudinal observational study involved consecutive outpatients with active RA who started treatment with IFN (n=30), ETN (n=41) or ADA (n=28). Clinical data and systemic and local side effects were collected prospectively at baseline and after six months of anti-TNF treatment. Serum samples were taken at the same time points in order to measu...
Clinical and experimental rheumatology
Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases, 2009
Systemic Mastocytosis (SM) comprises a heterogeneous group of disorders of mast cell proliferatio... more Systemic Mastocytosis (SM) comprises a heterogeneous group of disorders of mast cell proliferation. Infiltration, including skin and bone, of multiple mast cells may occur as cutaneous and systemic variants. A rare form of osteoporosis has been also described as expression of the skeletal involvement. Here, we describe a case of a 57-years-old woman with SM and, according to the clinical diagnosis, evaluate the possible mechanism underlying osteoporosis. Moreover, a review of the literature, particularly regarding the use of bisphosphonates in this rare disease is also presented.
International journal of immunopathology and pharmacology
Several smaller retrospective case series have concluded that leflunomide (LEF) in combination wi... more Several smaller retrospective case series have concluded that leflunomide (LEF) in combination with anti-TNF-alpha blocking agents appears to be effective and safe. Prospective case series and cohort studies have generally confirmed the efficacy of this combination. Overall, there is currently no evidence from controlled trials that an anti-TNF-alpha combination with LEF is as effective as an anti-TNF-alpha combination with methotrexate (MTX). We compared the effectiveness and safety of a therapeutic regimen associating subcutaneous anti-TNF-alpha agents, etanercept (ETN) and adalimumab (ADA), with leflunomide (LEF) or methotrexate (MTX), in a two year open-label study performed in clinical practice. We evaluated 96 patients with active rheumatoid arthritis undergoing therapy with ADA at the dose of 40 mg every other week, or with ETN at the dose of 50 mg/week for two years added to prednisolone (PDN) at the mean dose of 5.2±2.6 mg/day. Fifty-four of these patients were also undergo...
Recenti progressi in medicina
Since anti-TNFalpha treatments were introduced in the therapy of rheumatoid arthritis, some cases... more Since anti-TNFalpha treatments were introduced in the therapy of rheumatoid arthritis, some cases of patients with drugs induced Lupus during clinical trials with infliximab treatment for rheumatoid arthritis (RA) were reported. We report three cases with history of refractory RA (two patients) and of psoriatic arthritis (one patient) with a diagnosis of Drug Induced Lupus, after treatment with infliximab, with different clinical features such as pericardial and pleural effusion, skin lesions and piastrinopenia and with autoantibody assessment. We also reviewed the development of anti nuclear and anti double-strand DNA antibodies and drug induced lupus in patients treated with anti-TNFalpha agents (infliximab, etanercept and adalimumab).
Clinical and experimental rheumatology
Recenti progressi in medicina, 2006
TNF-alpha role in RA is confirmed by the improvement on joint inflammation and physical function ... more TNF-alpha role in RA is confirmed by the improvement on joint inflammation and physical function and by the slowing of radiographic damage induced by TNF-alpha blockers, that also reduce Rheumatoid Factor (RF) and anti-CC-P titres. (1) To evaluate the effects of 3 TNF-alpha blockers on (a) disability (HAQ), disease activity (DAS28), acute phase reactants (ERS, CRP); (b) autoantibodies: IgM RF, anti-CCP abs. (2) To evaluate if anti-CCP abs could be useful for testing the efficacy of anti-TNF-alpha agents in the follow-up of RA patients. 34 patients with RA (25 F, 9 M; mean age: 59.1 +/- 12.1 years, mean disease duration: 9.6 +/- 2.3 years; 23/34 positive for anti-CCP abs, 19/34 for IgM RF) were enrolled: 18 received Etanercept (25 mg twice weekly subcutaneously), 8 received Infliximab (3 mg/kg intravenously every 8 weeks) and 8 Adalimumab (40 mg every 14 days). All the patients were evaluated for the above mentioned parameters at baseline (t0) and after 6 months of therapy (t6). Anti...
Recenti progressi in medicina
Almost 30-50% of patients on long-term therapy with glucocorticoids (GC), especially those affect... more Almost 30-50% of patients on long-term therapy with glucocorticoids (GC), especially those affected by rheumatic diseases, develop glucocorticoid induced osteoporosis (GIOP) and osteoporosis-related fractures. To assess the effects of neridronate versus placebo on markers of bone resorption in rheumatic patients affected by GIOP (as defined by a T Score reduction > 2.5; mean BMD L2-L4), sixty-two female patients [age: 68.89 +/- 9.45 (mean +/- SD)] affected by different rheumatic diseases, like rheumatoid arthritis, polymyalgia rheumatica, Sjögren syndrome in treatment with a mean prednisone-equivalent daily dose of 6.44 +/- 2.4 mg/day, were enrolled in an open trial. The patients were divided in 2 groups: group A (26 patients) assuming daily calcium 1 g and vitamin D 800 UI and group B (36 patients) assuming daily calcium (1000 mg) and vitamin D (800 UI) and neridronate (25 mg im /30 days). The patients were evaluated for serum and urinary bone markers, basely (T0) and after 6 mo...
Clinical and experimental rheumatology
Clinica Chimica Acta, 2014
ACPA (anti-citrullinated protein antibody) tests are today systematically added to clinical and r... more ACPA (anti-citrullinated protein antibody) tests are today systematically added to clinical and radiological investigations when diagnosing rheumatoid arthritis (RA), and the inclusion of ACPA positivity in the new 2010 RA criteria underlines their importance. The aim of this study was to determine the sensitivity and specificity of different ACPA assays and IgA, IgG and IgM isotypes of rheumatoid factor (RF) in a cohort of patients with early RA in order to assess the value of combining the tests. The serum samples were obtained from 46 RA patients, 80 patients with systemic rheumatic disease, and 20 blood donors. ACPAs were measured using five different commercial kits. The receiver operating characteristic (ROC) curves of the anti-ACPA tests had area under the curve (AUC) values of 0.60-0.83. The diagnostic accuracy of the Bio-Rad multiplex flow immunoassay, a new technology for ACPA testing, was very similar to that of the other widely used commercial immunoassays. The EliA CCP-Phadia test was the most specific, and had the best positive likelihood ratio and positive predictive values, whereas the anti-CCP Inova 3.1 test was the most sensitive, and had the best negative likelihood ratio and negative predictive values. The best combination to use for early RA screening was an ACPA test together with IgM and IgA RF.
Current Rheumatology Reviews, 2015
Serum cartilage oligomeric matrix protein (COMP) level is a new marker of joint destruction in pa... more Serum cartilage oligomeric matrix protein (COMP) level is a new marker of joint destruction in patients with rheumatoid arthritis (RA), and a new means of identifying patients with progressive joint damage. To evaluate the effect of tocilizumab (TCZ) on serum COMP levels, and whether there is any difference in this effect between patients failing on anti-TNF treatment and those failing on disease-modifying anti-rheumatic drugs (DMARDs). Fifty-one patients with long-standing RA (42 F, 9 M; mean age 62±14 years; disease duration 4.5±1.2 years) unresponsive to DMARDs and anti-TNF drugs were treated with TCZ 8 mg/kg/month. Serum COMP levels were measured by means of an ELISA at baseline and after six months of TCZ treatment; the patents' DAS28 scores and levels of RF (IgM, IgG, IgA), anti-CCP autoantibodies, ESR, CRP and IL-6 were evaluated at the same times. After six months of TCZ treatment, there was a significant decrease from baseline in ESR (46.1 [28.7-68.9] vs 34.3 [4.1- 58.8] mm/h, P <0.0001), CRP (2.2 [0.8-4.4] vs 1.3 [0.7-3.8] mg/dL, P <0.0001), TNF-α (21.3 [7.6-29.8] vs 17.4 [3.4-28.6] pg/mL, P=0.0408), IL-6 (6.9 [3.5-9.6] vs 3.4 [3.0-9.6] pg/mL, p<0.0001); anti-CCP (55.1 [30.2-273.0] vs 54.7 [30.1- 269.8] IU/mL, P=0.9683), RF-IgM (142.0 [48.0-260.0] vs 138.0 [42.0-243.0] IU/mL, P=0.4828), RF-IgA (81.0 [20-140] vs 108.0 [20-175] U/mL, P=0.0003), and RF-IgG (65.2 [30-158] vs 58.3 [38.0-158.0] U/mL, P=0.2671). There was also a significant decrease in DAS28 scores (4.3 [3.2-5.9] vs 3.7 [2.3-5.4], P <0.0001), and a non-significant decrease in serum COMP levels (0.95 [0.04-2.90] vs 0.98 [0.05-2.36] μg/mL; P = 0.9856). A decrease in serum COMP levels was observed in the patients failing on anti-TNF treatment or anti-DMARDs without any difference. TCZ therapy in patients with long-standing RA is associated with a significant decrease in ESR, CRP, IL-6, TNF and DAS28 values, and a decrease in serum COMP levels, particularly in patients failing on previous anti-TNF therapy. These findings suggest that TCZ has an effect on cartilage joint destruction after only six months of treatment.
The Open Rheumatology Journal, 2012
The use of TNF-alpha antagonists (infliximab, etanercept, adalimumab) has changed the course of m... more The use of TNF-alpha antagonists (infliximab, etanercept, adalimumab) has changed the course of many rheumatic diseases including rheumatoid arthritis (RA). Since their approval, some questions regarding their safety including infections have been observed. The aim of the study was to evaluate the changes in cytokines levels and cells subsets in patients with RA during anti TNF blocking agents treatment and the possible effect on infections' development. We evaluated in 89 RA patients [39 treated with etanercept (ETN), 29 with adalimumab (ADA) and 21 with infliximab (IFN)] at baseline and after 6 months the following parameters: procalcitonin, ESR, CRP, cytokines as TNF, IL-6, IL-10, IL-8 and the TNF/IL-10 ratio, and peripheral mononuclear cells as CD3+, CD3+/CD4+, CD3+/CD8+, CD19+, CD3-/CD16+/56+, CD14+HLADR+, CD20+, CD19+/CD38+. Peripheral mononuclear cells were detected by flow cytometric system Cytomics FC500 and cytokines circulating levels by a quantitative sandwich enzyme immunoassay technique (Human IL-8 Instant ELISAe Bioscience, Human IL-6 Instant ELISA e Bioscience, Human IL-10 Instant ELISAe Bioscience and Human TNF-a Quantikine immunoassay RD system). A lower reduction of CD14+HLADR+ in ADA group 54.6±10.4% vs ETA 48.4±15.7% vs INF 40.7±16.5%, p<0.039 was found. No differences in all three groups on peripheral mononuclear cells CD3+, CD3+/CD4+, CD3+/CD8+, CD19+, CD 20+, CD19+/CD38+, CD3-/CD16+/56+, and cytokine circulating levels were found. The number of infections at 6 months was: 10.3% in ADA group, 12.8% in ETN group and 19.04% in IFN group. A correlation was found between the reduction in CD14+HLADR+ cells and IFN treatment. Our data showed that the level of CD14+HLADR+ cells was reduced during therapy with IFN. ADA and ETN don't reduce lymphocyte populations and their subsets such as CD14+HLADR+ cells that play an important role host defence.
Clinical and experimental rheumatology
To evaluate the correlation between improvement of HAQ scores and steroids sparing with rituximab... more To evaluate the correlation between improvement of HAQ scores and steroids sparing with rituximab (RTX) treatment in patients with RA. Methods: 304 patients with active RA were treated with RTX after DMARDs or anti-TNF therapy failure. All of the patients who had received at least one cycle of RTX was studied. Disease activity at baseline and after six and 12 months was assessed using the DAS28, and quality of the life was evaluated by HAQ. Results: The analysis included 304 patients on database, of whom with established RA [F 255 (83.89%); M 49 (16.12%),]. At baseline, 213 patients (70,07%) were receiving corticosteroids (mean dosage 7.35 mg, range 5-25 mg), baseline DAS-28 values was 6.06±1.21 and HAQ score available in 284 was 1.67±0.69. At 6-month, evaluation was available in 219 patients; a HAQ improvement was seen in 165/219 (mean HAQ decrease -0.69±0,52; p<0,05) the tapered in steroids dosage was seen in 117/213 (mean steroids decrease -0,32±0,48 p<0,05). At 12-month ev...
Journal of Immunology Research, 2015
Introduction. The objective of the present study was to compare QUANTA Flash dsDNA, a chemilumine... more Introduction. The objective of the present study was to compare QUANTA Flash dsDNA, a chemiluminescent immunoassay (CIA) on the BIO-FLASH, a rapid-response chemiluminescent analyzer, to three other anti-dsDNA antibody assays and to Crithidia luciliae indirect immunofluorescence test (CLIFT). Methods. In the first part of the study, 161 samples, 61 from patients suffering from systemic lupus erythematosus (SLE) and 100 from a disease control group, were tested by QUANTA Flash dsDNA CIA, QUANTA Lite dsDNA SC ELISA, BioPlex 2200 multiplex flow immunoassay (MFI), ImmuLisa dsDNA ELISA, and NOVA Lite CLIFT. A second cohort of 69 SLE patients was then tested by QUANTA Flash dsDNA and CLIFT to expand the study. Results. The overall qualitative agreements varied between 77.0% (NOVA Lite CLIFT versus QUANTA Lite) and 89.4% (ImmuLisa versus NOVA Lite CLIFT). The clinical sensitivities for the anti-dsDNA antibody tests varied from 8.2% (NOVA Lite CLIFT) to 54.1% (QUANTA Lite), while the clinical specificities varied from 88.0% (BioPlex 2200) to 100.0% (NOVA Lite CLIFT). Good correlation was found between QUANTA Flash dsDNA and NOVA Lite CLIFT. Conclusion. Significant variations among dsDNA methods were observed. QUANTA Flash dsDNA provides a good combination of sensitivity and specificity for the diagnosis of SLE and good agreement to CLIFT.
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Papers by Mariangela Manfredi