Papers by Elisa Menegatti
European Journal of Cancer, 1995
Chromosome 3p allele loss is frequent in ovarian and testicular tumours. The von Hippel-Lindau (V... more Chromosome 3p allele loss is frequent in ovarian and testicular tumours. The von Hippel-Lindau (VHL) disease tumour suppressor gene maps to chromosome 3~25. Gonadal turnouts may occur in patients with VHL disease, so somatic VHL gene mutations might be involved in the pathogenesis of sporadic gonadal tumours. To investigate this hypothesis, we screened 60 gonadal tumours (36 ovarian and 24 testicular) for VEIL gene mutations and chromosome 3p allele loss. Although 38% (10/26) of informative ovarian and 54% (7/13) of testicular tumours demonstrated 3p allele loss, no somatic VHL gene mutations were detected in the 60 gonadal tumours analysed. This suggested that chromosome 3p tumour suppressor gene(s) other than VHL are involved in gonadal tumorigenesis.
Autoimmunity Reviews, 2020
Patients with antiphospholipid syndrome (APS) present with clinical features of recurrent thrombo... more Patients with antiphospholipid syndrome (APS) present with clinical features of recurrent thrombosis and pregnancy morbidity and persistently test positive for the presence of antiphospholipid antibodies (aPL). At least one clinical (vascular thrombosis or pregnancy morbidity) and one lab-based (positive test result for lupus anticoagulant, anticardiolipin antibodies and/or anti-β2-glycoprotein 1 antibodies) criterion have to be met for a patient to be classified as having APS. Nevertheless, the clinical variety of APS encompasses additional signs and symptoms, potentially affecting any organ, that cannot be explained exclusively by a prothrombotic state. Those manifestations, also known as extra-criteria manifestations, include haematologic (thrombocytopenia and haemolytic anaemia), neurologic (chorea, myelitis and migraine) manifestations as well as the presence of livedo reticularis, nephropathy and valvular heart disease. The growing body of evidence describing the clinical aspect of the syndrome has been paralleled over the years by emerging research interest focusing on the development of novel biomarkers that might improve the diagnostic accuracy for APS when compared to the current aPL tests. This review will focus on the clinical utility of extra-criteria aPL specificities.Besides, the promising role of a new technology using particle based multi-analyte testing that supports aPL panel algorithm testing will be discussed. Diagnostic approaches to difficult cases, including real-world case studies investigatingthe diagnostic added value of extra criteria aPL, particularly anti-phosphatidylserine/prothrombin,will also be examined.
International Journal of Molecular Sciences, 2020
As in many autoimmune diseases, the pathogenesis of the antiphospholipid syndrome (APS) is the re... more As in many autoimmune diseases, the pathogenesis of the antiphospholipid syndrome (APS) is the result of a complex interplay between predisposing genes and triggering environmental factors, leading to a loss of self-tolerance and immune-mediated tissue damage. While the first genetic studies in APS focused primarily on the human leukocytes antigen system (HLA) region, more recent data highlighted the role of other genes in APS susceptibility, including those involved in the immune response and in the hemostatic process. In order to join this intriguing debate, we analyzed the single-nucleotide polymorphisms (SNPs) derived from the whole exome sequencing (WES) of two siblings affected by APS and compared our findings with the available literature. We identified genes encoding proteins involved in the hemostatic process, the immune response, and the phospholipid metabolism (PLA2G6, HSPG2, BCL3, ZFAT, ATP2B2, CRTC3, and ADCY3) of potential interest when debating the pathogenesis of the...
Abstracts, 2019
1 was an 11-year-old girl who presented with fever, rash and generalized body swelling for 3 mont... more 1 was an 11-year-old girl who presented with fever, rash and generalized body swelling for 3 months. Physical examinations revealed heart rate 148/min, respiratory rate 30/min, and blood pressure (BP) 100/80 mmHg. She had pallor, malar rash, hepatomegaly and gallop rhythm. Investigations are detailed in the table. She received intravenous immunoglobulin and initiated on pulse methylprednisolone and followed by pulse intravenous cyclophosphamide. She was discharged on oral prednisolone and subsequently tapered. Patient 2 was a 9-year-old girl presented with fever and rash for 3 months with lethargy for 1 day. She had pallor, malar rash, hepatomegaly. Physical examinations revealed heart rate 132/min, respiratory rate 32/min, feeble peripheral pulses and BP 100/80 mmHg. She received intravenous cyclophosphamide monthly for 6 months along with oral prednisolone in tapering dose. Patient 3 was a 12-year-old girl, who was known to have SLE for 2 months, presented with fever, malar rash, and photosensitivity. She had stopped taking steroids for 2 weeks. On examination, she had heart rate 122/min, respiratory rate 28/min and BP 100/72 mmHg. She had pallor, alopecia, oral ulcers, malar rash, gallop rhythm and tender hepatomegaly. She was given pulse methylprednisolone and furosemide therapy followed by oral prednisolone in gradually tapering dose. Patient 4 was an 11 year-old-girl who was known to have SLE for 6 months, presented with pain in the small joints, low grade fever, and cough for 1 month. She had stopped steroids on her own. On examination, she was found to have anasarca, malar rash and oral ulcers. She had heart rate 128/min, respiratory rate 32/min, BP 108/
Frontiers in Immunology, 2019
becoming even more evident (+65%) when analyzing patients on VKA. In patients treated with VKA, w... more becoming even more evident (+65%) when analyzing patients on VKA. In patients treated with VKA, we observed a good correlation for aPS/PT IgG testing (Cohen's kappa coefficients = 0.81-1; Spearman rho 0.86). Conclusion: Despite the progress in the standardization of aPL testing, we observed up to 45% of overall discrepant results for LA, even higher in patients on VKA. The introduction of aPS/PT testing might represent a further diagnostic tool, especially when LA testing is not available or the results are uncertain.
Autoimmunity reviews, 2018
Rheumatoid Arthritis (RA) is a complex systemic autoimmune disease in which various cell types ar... more Rheumatoid Arthritis (RA) is a complex systemic autoimmune disease in which various cell types are involved. Among them, neutrophils have been recognized as important players in the onset and the progression of RA. The pathogenic role of neutrophils in RA lies in the alteration of several processes, including increased cell survival and migratory capacity, abnormal inflammatory activity, elevated oxidative stress and an exacerbated release of neutrophil extracellular traps. Through these mechanisms, neutrophils can activate other immune cells, thus perpetuating inflammation and leading to the destruction of the cartilage and bone of the affected joint. Given the considerable contribution of neutrophils to the pathophysiology of RA, several studies have attempted to clarify the effects of various therapeutic agents on this subtype of leukocyte. To date, recent studies have envisaged the role of new molecules on the pathogenic profile of neutrophils in RA, which could represent novel ...
Oncotarget, Jan 22, 2018
Minimal change disease (MCD) accounts for 15% of adult nephrotic syndrome (NS) cases. Adult-MCD p... more Minimal change disease (MCD) accounts for 15% of adult nephrotic syndrome (NS) cases. Adult-MCD patients may have more severe clinical features than pediatric patients. In children, Rituximab (RTX) has been used since 2006 to treat frequently relapsing NS. In adults, data about the efficacy of RTX for MCD are limited. We report our experience on the use of RTX in adult biopsy-proven MCD. Our series includes 6 adult patients (2 males and 4 females), age 45-73 years, treated with RTX (4 weekly doses of 375 mg/m). Proteinuria decreased from 11,2 (23-4.8) g/24 hours to 0.6 (0-2) g/24 hours after 6 months, and to 0.4 (0-1, 4) g/24 h in the 4 pts with the longer follow-up. Creatinine decreased from 1.95 (0.5-5) mg/dl to 0.88 (0.6-1.3) mg/l. Five patients achieved a complete renal remission, while in 1 pt proteinuria decreased by 75%. RTX successfully depleted CD19 lymphocytes in 100% of pts for at least 6 months. No clinically relevant adverse events have been observed. This case series s...
BMJ Open, 2017
Objectives We aim to evaluate the safety of performing percutaneous native kidney biopsy (PKB) as... more Objectives We aim to evaluate the safety of performing percutaneous native kidney biopsy (PKB) as an outpatient procedure (implying an observation period of 6 hours) compared with the traditional inpatient policy. Design, setting, participants and measurements Group I, in whom PKB was performed in the outpatient department (2012-2016) and followed by 6 hours' observation period and then by regular outpatient visits and group II, in whom PKB was performed and followed by at least 1 day hospital admission. Group II included retrospectively retrieved patients who underwent PKB in our Institution between January 2000 and November 2012 as an inpatient procedure. All biopsies were performed by a single nephrologist following a structured protocol. Results 462 biopsies were reviewed, 210 (45.5%) of patients were women and the mean age was 54.7±17.9 years. One hundred and twenty-nine (27.9%) of these biopsies were performed in outpatients. A total of 36 (7.8%) of patients developed a complication, and of those, 9 (1.9%) suffered for a major complication (arteriovenous fistula (six cases, 1.2%), ischaemic stroke (2; 0.4%), thromboembolic pulmonary embolism (1; 0.2%)) and 27 (5.8%) for minor(macroscopic haematuria (12 cases, 2.6%), haematomas on sonography not requiring intervention (15 cases, 3.2%)). When comparing the complication rate between groups I and II, no statical difference was observed. When analysing together both groups, after multivariate analysis, serum creatinine >3 mg/dL (OR 2.03, 95% CI 1.18 to 6.81) and known severe hypertension (OR 2.01, 95% CI 1.2 to 4.7) were found to be independent risk factors for minor and major complications, respectively. Conversely, we found no association of risk with the number of biopsy passes, gender, age, diagnosis, presence of haematuria before the kidney biopsy nor the degree of proteinuria. Conclusions Outpatient biopsy could be a valuable, safe and perhaps cost-effective method of obtaining diagnostic renal tissue in the majority of patients.
Oncotarget, 2017
Background: ANCA associated vasculitides (AAV) often present with a chronic relapsing course. Rel... more Background: ANCA associated vasculitides (AAV) often present with a chronic relapsing course. Relapse leads to increased immunosuppressive exposure and consequent toxicity. While two randomized controlled trials have shown rituximab (RTX) to be the most effective induction treatment in patients with relapsing disease, the optimal treatment duration and RTX dose remain debated. Whether to administer a maintenance dose to every patient, at a fixed time interval or on the basis of B cell count and ANCA titre or only when disease manifestations do occur is still debated as well. Methods: 11 patients (5 with granulomatosis with polyangiitis, 4 with microscopic polyangiitis-MPA-, and 2 with eosinophilic granulomatosis with polyangiitis-EGPA-) intolerant or refractory to conventional therapies including cyclophosphamide were enrolled. All patients received the so called "improved 4+2" RTX scheme as a rescue therapy. Following RTX administration, immunosuppressive drugs were rapidly tapered and no immunosuppressive maintenance therapy had been given. Results: After a mean follow-up of 85 months since the "4+2" RTX protocol: four out of 11 patients (37%, 1 EGPA and 3 MPA, all MPO-positive) remained in remission after one cycle of "4+2" RTX infusion protocol with no relapse for a median 66 months [60-108]). Seven relapsing patients were retreated once with RTX (again as monotherapy with the same protocol) after a median of 54 months (24-96). Following re-treatment, they again showed complete remission over a median of 32 months (12-96) of observation. Conclusion: In one of the longest-term observation (85 months) studies, sustained clinical remission without immunosuppressive maintenance therapy (and a negligible dose of prednisone since the 5 th month) was obtained by the "4 + 2" RTX infusion protocol in patients with ANCA-associated vasculitis intolerant or refractory to conventional therapy.
American Journal of Nephrology, 2017
Background: A beneficial effect of rituximab (RTX) on focal segmental glomerulosclerosis (FSGS) i... more Background: A beneficial effect of rituximab (RTX) on focal segmental glomerulosclerosis (FSGS) in pediatric patients or in transplant recipients has been reported in isolated cases. However, the use of RTX in adult patients with idiopathic FSGS needs further investigation. Methods: Eight patients who had biopsy-proven FSGS (63.9 ± 14.0, range 40-81 years, 4 women, 4 men) with major risk factors precluding corticosteroids or conventional immunosuppression were treated with a high dose of RTX (8 weekly doses of 375 mg/m2) and prospectively followed up for at least 2 years (29.1 ± 8.8 months, range 24-42 months). Results: RTX failed to improve proteinuria in 7 out of 8 patients, who had persistent nephrotic proteinuria. In one case, a rapidly deteriorating renal function was also observed. Only one patient showed an improvement in renal function and a remarkable reduction in proteinuria. There were no differences in clinical or laboratory characteristics or in the CD20 B lymphocyte co...
Oncotarget, Jan 9, 2017
Mixed cryoglobulinemia syndrome (MC) is a systemic vasculitis involving kidneys, joints, skin, an... more Mixed cryoglobulinemia syndrome (MC) is a systemic vasculitis involving kidneys, joints, skin, and peripheral nerves. While many autoimmune, lymphoproliferative, and neoplastic disorders have been associated with this disorder, hepatitis C virus (HCV) is known to be the etiologic agent in the majority of patients. Therefore, clinical research has focused on anti-viral drugs and, more recently, on the new, highly potent Direct-acting Antiviral Agents (DAAs). These drugs assure sustained virologic response (SVR) rates >90%. Nevertheless, data on their efficacy in patients with HCV-associated cryoglobulinemic vasculitis are disappointing, possibly due to the inability of the drugs to suppress the immune-mediated process once it has been triggered.Despite the potential risk of exacerbation of the infection, immunosuppression has traditionally been regarded as the first-line intervention in cryoglobulinemic vasculitis, especially if renal involvement is severe. Biologic agents have ra...
Autoimmunity Reviews, 2015
(AAM) is copyrighted and published by Elsevier. It is posted here by agreement between Elsevier a... more (AAM) is copyrighted and published by Elsevier. It is posted here by agreement between Elsevier and the University of Turin. Changes resulting from the publishing process-such as editing, corrections, structural formatting, and other quality control mechanisms-may not be reflected in this version of the text. The definitive version of the text was subsequently published in AUTOIMMUNITY REVIEWS, None, 2015, 10.1016/j.autrev.2015.07.017. You may download, copy and otherwise use the AAM for non-commercial purposes provided that your license is limited by the following restrictions: (1) You may use this AAM for non-commercial purposes only under the terms of the CC-BY-NC-ND license. (2) The integrity of the work and identification of the author, copyright owner, and publisher must be preserved in any copy.
Blood transfusion = Trasfusione del sangue, 2014
Nephrology Dialysis Transplantation, 2011
Background. B cells play a central role in systemic lupus erythematosus (SLE). Rituximab is expec... more Background. B cells play a central role in systemic lupus erythematosus (SLE). Rituximab is expected to induce apoptosis of all the CD20-positive B cells. A proportion of patients are refractory or intolerant to standard immunosuppression. These are candidate to new therapeutic options. Methods. Eight patients [six women, two men, mean age 41year-old (27-51), with severe multiorgan involvement (kidney, skin, nervous system, polyarthritis, polyserositis, antiphospholipid antibody syndrome)] were considered eligible for an intensive combination therapy including rituximab. Rituximab was administered (dose 375 mg/m 2) on Days #2, 8, 15 and 22. Two more doses were administered 1 and 2 months following the last weekly infusion. This treatment was combined with two pulses of 750 mg cyclophosphamide (Days #4 and 17) and three pulses of 15 mg/kg (Days #1, 4 and 8) methylprednisolone followed by oral prednisone, 50 mg for 2 weeks rapidly tapered until 5 mg in 2 months. Response was evaluated by assessing the changes in clinical signs and symptoms [Systemic Lupus Erythematosus Disease Activity Index (SLEDAI score)] and laboratory parameters for at least 12 months. Results. Levels of erythrocyte sedimentation rate and antidouble-strand DNA antibodies significantly decreased (P < 0.01 at 12 months), whereas C3 and mainly C4 values increased at 6 months (P < 0.01 for C4). Proteinuria improved in the cases with renal involvement (P < 0.01 at 3, 6 and 12 months). SLEDAI score improved moving from the mean 17.3 (12-27) before therapy to 3.1 (1-5) after rituximab treatment. Constitutional symptoms including arthralgia, weakness and fever disappeared in all the previously affected patients; paresthesia improved in the four patients with polyneuropathy and skin lesions gradually resolved in the patients with necrotizing skin ulcers at presentation. Drug side effects were negligible. Conclusions. Long-lasting remissions were obtained in patients with severe SLE and major organ involvement by this intensive administration of rituximab combined with low doses of intravenous cyclophosphamide and methylprednisolone pulses followed by a rapid tapering of prednisone to 5 mg/day as a sole maintenance therapy.
Nephrology Dialysis Transplantation, 1997
intradialytic blood levels of nitric oxide (NO), in patients undergoing chronic haemodialysis. Th... more intradialytic blood levels of nitric oxide (NO), in patients undergoing chronic haemodialysis. This was done by detection of nitrosylhaemoglobin by a sensitive technique of spin trap electron paramag-Introduction netic resonance at 0, 5, 15, 60, 180 and 240 min Vascular endothelial cells [1 ] and several other cell of a 4-h standard bicarbonate dialysis, using the same lines, including phagocytes [2], synthesize and release dose (6000 U) of heparin and different dialysis memnitric oxide (NO). NO counterbalances the vasoconbranes. The study group included 12 patients treated strictor action of endothelin (ET-1) and inhibits ET-1 with cellulose-derived dialysis membranes (nine with production via a cGMP-dependent pathway [3,4]. cuprophan and three with cellulose triacetate) Evidence of a role for NO in diverse physiologic and and 10 patients treated with synthetic membranes (five pathologic processes is emerging [2 ]. The capability of with polysulfone and five with polymethylmethacrylthis molecule to oxidize critical compounds, i.e. thiols, ate). Control groups included 11 normal subjects haeme groups and iron sulphurs, sustains its involveand six patients with end-stage renal failure who were ment in different biological processes. Besides vasodilreceiving intermittent peritoneal dialysis. Basal blood atation, its functions include inhibition of platelet levels of nitrosylhaemoglobin in haemodialysis patients aggregation and modulation of inflammatory and were significantly higher than normals, but similar immune processes [2,5,6 ]. to peritoneal dialysis patients. A significant increase Plasma concentrations of arginine, the endogenous (P<0.01) in nitrosylhaemoglobin level was detected substrate of NO synthase, have been reported to be at 15 min of haemodialysis irrespective of the memlower [7 ] or higher [8] than normal in uraemia. brane used. A decrease to basal levels at 180 min Moreover, it has been reported that uraemic plasma was observed in all but two cuprophan-treated patients contains an endogenous compound, NG, NG-dimethylwho, in contrast to the others, had a symptomatic arginine, able to inhibit NO synthesis by interfering hypotension at the end of the session and a further with the -arginine/NO pathway [9]. However, expoincrease in blood nitric oxide. Patients undergoing sure of cultured human endothelial cells to uraemic peritoneal dialysis did not show any change in blood plasma results in potent induction of NO formation levels of nitrosylhaemoglobin during the first 180 [8]. Besides an increased availability of substrate, min of the procedure. Thus, a constant increase in which is still a matter of debate [7,8], it has been nitrosylhaemoglobin levels was observed early in proposed that high plasma levels of cytokines, as a haemodialysis, but not in peritoneal dialysis patients. consequence of monocyte activation by dialysis mem-Very preliminary evidence was obtained for a role of brane [10 ], enhance NO formation contributing to nitric oxide in the vascular instability at the end of haemodialysis (HD) hypotension. The involvement of haemodialysis in a few patients who had hypotensive NO production in haemodialysis-induced hypotension episodes. was eventually confirmed by detecting NO 2 and NO 3 [11]. However, no data on intradialytic fluctuations of NO blood levels in HD patients have been reported to date. Therefore, 22 patients, carefully selected for absence of intercurrent illnesses, entered a study aimed to detect basal values and intradialytic profiles of nitrosylhaemoglobin, as a surrogate marker of NO
Laboratory Investigation, 2002
Uteroglobin (UG) is a multifunctional protein with anti-inflammatory/immunomodulatory properties.... more Uteroglobin (UG) is a multifunctional protein with anti-inflammatory/immunomodulatory properties. The UG gene is located on the long arm of chromosome 11 (11q12.3-q13.1) in a region linked to some immune disorders. A guanine-adenine substitution at position 38 (A38G) has been found in the noncoding region of exon 1 that is significantly correlated with an increased risk of developing immune-mediated diseases. Recently an experimental model of UG knockout mice showed that in mice, UG deficiency causes severe glomerulopathy with mesangial deposition of IgA-fibronectin complexes. To detect the presence of polymorphisms in the UG coding sequence, the DNA of 109 patients with IgA nephropathy (IgAN), and 32 patients with systemic lupus erythematosus (SLE) were tested for the nucleotide sequence of all three UG exons by heteroduplex analysis. We detected heterozygous DNA only for exon 1 due to the A38G substitution, as confirmed by sequencing. We tested for A38G polymorphism, by restriction endonuclease digestion (Sau96I), both in SLE patients and in IgAN patients. Twenty patients with either membranous nephropathy (12) or focal and segmental glomerular sclerosis and 120 healthy subjects served as controls. Compared with both healthy controls and non-IgA control patients, the frequency of the 38A allele was significantly higher in SLE patients (38 of 64 alleles versus 89 of 240 alleles, p ϭ 0.002, and versus 7 of 40 alleles, p Ͻ 0.001). IgAN patients showed an allelic distribution similar to both control groups. A subgroup of 18 IgAN patients undergoing renal replacement therapy because of end-stage renal disease showed a significant increase in 38A allele frequency (5 of 36 38G alleles versus 31 of 36 38A alleles, p Ͻ 0.001). UG is an immunomodulatory agent that is able to (a) inhibit the activity of several phospholipase A2 (PLA2s), (b) interfere with the function of both neutrophils and monocytes, and (c) prevent immune recognition, perhaps by masking surface antigens. This could account for the role this molecule plays in SLE. The A38G polymorphism is located within a region corresponding to the rat minimal promoter that proved to be important in the transcriptional regulation of UG. Although the significance of any alterations in the UG exon 1 noncoding region in humans has yet to be clarified, initial evidence suggests that it may alter the control of immune response and of inflammation.
Journal of Neurology, 2009
Type II mixed cryoglobulinemia is sustained by an oligoclonal production of IgM sharing rheumatoi... more Type II mixed cryoglobulinemia is sustained by an oligoclonal production of IgM sharing rheumatoid activity and can be associated with renal, cutaneous, rheumatologic or neurological manifestations. Peripheral neuropathy is a major cause of morbidity in hepatitis C virus-associated mixed cryoglobulinemia and is often refractory to any treatment. Rituximab induces a selective depletion of IgM-producing B cells, and both case reports on monoclonal IgM-related polyneuropathy as well as studies on small series of patients with interferon a-resistant mixed cryoglobulinemia have suggested that it may be beneficial. Thirteen patients affected by type II mixed cryoglobuline-mia with polyneuropathy were treated. Rituximab was administered intravenously at a dose of 375 mg/m2 on days 1, 8, 15 and 22. Two more doses were given 1 and 2 months later. No other immunosuppressive drugs were added. Response was evaluated by assessing the changes in the clinical neurological condition, in electromyographic indices and in laboratory parameters (including cryocrit, viral load, complement levels and rheumatoid factor) over at least 12 months. Sensory symptoms disappeared or improved following treatment. A significant improvement in the clinical neuropathy disability score was observed. Electro-myography examination revealed that the amplitude of compound motor action potential had increased. Viral load did not significantly change. Side effects were negligible. In this open prospective study, rituximab appeared to be effective and safe in the treatment of patients with type II cryoglobulinemia-associated neuropathy.
Inflammation Research, 2012
To test the inflammation and oxidative stress hypothesis in antiphospholipid syndrome (APS) patie... more To test the inflammation and oxidative stress hypothesis in antiphospholipid syndrome (APS) patients and to identify possible associations with clinical and laboratory features of the disease. Methods Serum amyloid A (SAA), C-reactive protein (CRP), 8-isoprostane and prostaglandin E2 (PGE) were assayed in the sera of 45 APS patients and then compared to control groups made up of 15 antiphospholipid antibody (aPL) negative patients with systemic lupus erythematosus, 15 aPL negative subjects with pregnancy-related morbidity, 15 aPL negative patients with thrombosis, 15 subjects with persistently positive aPL with no signs or symptoms of APS, and 15 healthy volunteers from among the hospital staff. Results APS patients showed significantly higher CRP (p = 0.01), SAA (p < 0.01), 8-isoprostane (p = 0.05) and PGE2 (p = 0.001) plasma levels as compared to controls. Among APS subjects, significantly higher 8-isoprostane and PGE2 levels were observed in patients with triple positivity for aPL (lupus anticoagulant, anticardiolipin and anti-beta2-glycoprotein I antibodies) compared to APS patients with single or double aPL positivity. Conclusion Both inflammation and oxidative stress, as measured by SAA, CRP, 8-isoprostane and PGE2, occur in APS and seem to be related to triple positivity for aPL.
Uploads
Papers by Elisa Menegatti