Among the heterophilic antibodies, IgM RF was associated most closely with interference in the measurement of tryptase (P < 0·0001). We have not assessed the potential interference associated with IgG and IgA RF activity, which may be important. HAMA detected without RF rarely BAY 57-1293 concentration caused interference. Interpretation of laboratory results should always be made in light of the clinical features. Test results are almost worthless without context. We recommend checking IgM RF levels and consider HBT treatment in all specimens where there is doubt about the significance of the MCT result. This may avoid unnecessary invasive investigations for mastocytosis
or inappropriate diagnosis of anaphylaxis. In anaphylaxis, this step may not be necessary provided that there are consecutive samples showing appropriate rise and fall of MCT values in an acute release pattern which cannot be mimicked by stable heterophile check details activity. The positive predicted value (PPV) of a rise and fall of tryptase in the context of an acute allergic reaction will not change, because the pretest probability is high and heterophilic interference is unlikely to change within 24 h. In this study cohort there were 24 raised MCT samples from anaphylaxis, which remained
elevated post-HBT treatment. However, the PPV of a persistently raised MCT > 20 µg/l as a screen for mastocytosis is likely to be impaired significantly. The positive predictive value of raised MCT alone is not as high as generally assumed when used as a surrogate screen for underlying mastocytosis or acute allergic reactions. Tryptase measurement must be interpreted in the clinical context Raised MCT values may be due to heterophile interference from RF rather than mast cell degranulation. All samples with unexplained or incongruous raised MCT values should be re-tested after treatment with heterophile blocking tubes. None. None. “
“Rheumatoid arthritis (RA) is a polyarticular inflammatory, angiogenic disease. Synovial angiogenesis contributes
to inflammation in RA. In Reverse transcriptase this study we have developed an arthritic model in rats using a novel angiogenic protein (NAP), isolated from human synovial fluid of RA patients. We produced anti-NAP monoclonal antibodies (mAbs) and investigated the therapeutic efficacy of the same in adjuvant-induced or NAP-induced arthritis as a model of human RA. The treatment of arthritic rats with anti-NAP mAbs resulted in effective amelioration of paw oedema, radiological arthritic characteristics, serum levels of vascular endothelial growth factor (VEGF) and NAP, compared to that of untreated arthritic animals. Further, profiling of angiogenic markers such as synovial microvessel density, angiogenesis, CD31, VEGF and fms-like tyrosine kinase (Flt1) by immunohistochemistry both in arthritic and anti-NAP mAb-treated animals revealed the efficacy of mAb as an anti-angiogenic functional antibody.