International Conference on Autoimmunity October 13-14, 2016 Manchester, UK

Vinay Khanna has completed his MBBS and MD Microbiology from Kasturba Medical College, Manipal University, Karnataka, India. He is presently working as an Associate Professor in Department of Microbiology, Kasturba Medical College, India. He has published 18 papers in indexed national and international journals.

Background & Aim: Usually molecular methods, such as the detection of viral RNA or proviral DNA are the most sensitive methods for early diagnosis of HIV type-1; these methods involve complex and expensive technologies and thus have remained largely unavailable in resource-poor settings in the developing world. In this study, we tried to employ new less sensitive HIV- 1 immunoassay using avidity method in conjunction with the sensitive enzyme immunoassay to differentiate persons with recent and long-standing HIV-1 infections. Methods: This study was conducted in tertiary care center in south India. Consecutive serum samples (n=261) obtained from HIV seropositive patients of more than 15 years of age. Written informed consent, Epidemiological, clinical and laboratory details were obtained from all participants. All cases of HIV-1 infection was tested with standard ELISA and confirmed by western blot test. These samples were further tested by avidity index method and affinity studies to distinguish patients with recent from established HIV-1. Avidity index ≤0.9 were taken as cut off value for recent HIV infection with duration of HIV for less than 6 months. Results: Out of 261 patients, 26 patients were found with avidity test value of less than or equals to 0.9 and were classified as recent seroconvertors with antibodies appeared in serum for ≤6 months and 235 patients with avidity value of >0.9 were placed as long term cases with antibodies circulated for >6 months of duration. Out of 26 cases of recent infection one case was misclassified as recently infected using avidity immunoassay method while clinical history were suggestive of long term infection. Conclusions: The avidity index immunoassay was developed for easy performance characteristics, inexpensive, time-saving and does not need sophisticated laboratory requirements. This technique can also be performed in field setting for identifying recent infections, although there are chances of misclassification is possible in individual who had long-standing infection. The identification of recent infections based on the combination of other methods needs further investigation to reduce misclassification and to find out true incidence of HIV at the earliest.

Rheumatoid arthritis (RA) is systematic autoimmune inflammatory disease characterized by chronic joint inflammation and generalized bone destruction. Although some classical and novel therapies influence positively the course of the disease, there is a great need for more effective approaches. Berberine is an isoquinoline alkaloid with a broad spectrum of biological activities, including inhibition of RANKL-mediated osteoclast differentiation. In the present study we have investigated its influence on the joint destructive processes in a mouse model of erosive arthritis, induced by intraarticular injection of zymosan. Berberine was administered intraperitoneally under two different schemes at a dose of 10 mg/kg. Histopathological results showed that the substance ameliorated cartilage and joint erosion expressed through less PG and GAG loss and less pannus formation. Berberine inhibited MCSF+RANKL-induced and IL-1-induced osteoclast differentiation of bone marrow cells. Additionally, it changed the expression of CD68, RANKL, TRAIL and DR5 by bone marrow cells stimulated with M-CSF+RANKL. Immunohistochemical analysis showed that the substance influenced TGF-β expression in the joints. Our data proved the potential suppressive effect of berberine on the chronification of joint inflammation in correlation with the late events connected with bone remodeling. Successful inhibition of erosive processes in this experimental model described, so far encourages further investigations leading to elucidation of detailed mechanisms of berberin’s action.

Ruchee Khanna has completed her MBBS and MD Pathology from Saurashtra University, India. She is presently working as an Associate Professor in Department of Pathology, Kasturba Medical College, India. She has published 15 papers in indexed international journals.

Background: CD4 count is the primary clinical parameter used for the initiation of HAART (Highly Active Anti-Retroviral Therapy) and prophylaxis against opportunistic infections in HIV infection. The utility of Absolute Lymphocyte Count (ALC) in lieu of CD4 count in such patients has been a long-standing topic of debate, especially in resource-constrained settings. Aim: To find the relationship between CD4 count and Absolute Lymphocyte Count (ALC) and interpret the clinical utility of ALC as a surrogate marker for CD4 count. Materials & Methods: A total of 455 EDTA blood samples from HIV-infected patients were analyzed for their ALC and CD4 counts, over a period of 6 months from January 2015 to June 2015 in Clinical Laboratory, Kasturba Hospital, Manipal. Correlation analysis between ALC and CD4 count and receiver operating characteristic (ROC) analysis at CD4 count ≤200/μL and CD4 count ≤350/μL were conducted as proposed by WHO guidelines. Results: The male to female ratio among our subjects was 2:1 and their age ranged from 11 to 78 years. The median ALC was 1600/μL and the median CD4 count was 258.58/μL. A strong positive correlation (Pearson coefficient, r=0.741) was obtained between CD4 count and ALC. Areas under the ROC curve for ALC and CD4 count ≤200/μL and CD4 count ≤350/μL were 0.901 (95% CI, 0.872-0.929) and 0.911 (95% CI, 0.885-0.937), respectively, both of which showed an excellent correlation. Also, from the ROC analysis, the ALC cut off at CD4 count ≤200/μL (Sensitivity-83.87%, specificity-81.41%, PPV-75.73%, NPV- 87.95%) and CD4 count ≤350/μL (Sensitivity-80.22%, specificity-86.44%, PPV-90.28%, NPV-73.56%) was determined to be ≤1450/μL and ≤1650/μL, respectively. Conclusion: ALC was found to have a strong correlation with CD4 count and the ALC cut offs corresponding to CD4 counts ≤200/μL and CD4 count ≤350/μL was found to be ≤1450/μL and ≤1650/μL, respectively. Hence, ALC can be considered as a clinically plausible substitute marker for CD4 count

Einas Mobaruk Al-Harbi has done her Ph.D. in Molecular Medicine, Specialized in Medical Genetics, from Molecular Genetics Department, Princess Al-Jawhara Center for Molecular Medicine, Genetics and Inherited Disorders, Arabian Gulf University, Bahrain. She is currently working at Medical Genetics Senior Specialist,Kuwait Medical Genetics Center-MOH. She has over 16 research publications.

Crohn’s Disease (CD) is an autoimmune disease affect the whole gastrointestinal tract, but the most involved areas are the ileum and colon. The inflammation in CD is discontinuous and affects the full thickness of the intestinal tract wall. Activation of inflammatory T helper cells are a prominent feature in CD. It is likely that genetic susceptibility to CD is associated with Human Leukocyte antigens (HLA) class II molecule play an important role in the disease process, with certain allelic combinations conferring disease susceptibility or resistance. We report here, the first study in Kuwait to investigate the distributions of HLA-DR and -DQ among 23 unrelated patients with CD and 28 healthy controls from Kuwait. The HLADRB1* and –DQB1* genotypes were determined by Polymerase Chain Reaction-sequence-specific priming PCR-SSP). The following alleles showed the strongest association with CD among patients versus controls according to their frequencies: DRB1*04:01:01 (19.6% versus 3.6 %; P = 0.021), DQB1*03:02:01 (17.4% versus 3.6%; P = 0.04). These results are consistent with most reported studies confirming the association of HLA class II alleles with the risk of CD development among different population; however, the current study was performed on a small sample size of the population and therefore, it is required to be confirmed by a larger sample size study.