The aim of our work here was to evaluate the immunogenicity of 60 mycobacterial antigens, some of which have not been previously assessed, notably a novel series of in vivo-expressed M.tuberculosis (IVE-TB) antigens. We enrolled 505 subjects and separated them in individuals with and without latent tuberculosis infection (LTBI) versus patients with active tuberculosis. Following an overnight and 7 day stimulation of whole blood with purified recombinant M.tb antigens, interferon-γ (IFN-γ) levels were determined by ELISA. Several antigens could statistically significantly differentiate the groups of individuals. We obtained promising antigens from all studied antigen groups (DosR regulon encoded antigens; resuscitation-promoting factors (Rpf) antigens; IVE-TB antigens; reactivation asociated antigens). Rv1733, which is a probable conserved transmembrane protein encoded in DosR regulon, turned out to be very immunogenic and able to discriminate between the three defined TB status, thus considered a candidate biomarker. Rv2389 and Rv2435n, belonging to Rpf family and IVE-TB group of antigens, respectively, also stood out as LTBI biomarkers. Although more studies are needed to support our findings, the combined use of these antigens would be an interesting approach to tuberculosis immunodiagnosis candidates.

The objective of this study was to describe the demographic, clinical, and immunological manifestations of systemic lupus erythematosus (SLE) in male patients. A cross-sectional, multicenter study was carried out of 3651 patients (353 men, 9.7%, and 3298 women, 90.2%) diagnosed with SLE, included in the Spanish Rheumatology Society SLE Registry (RELESSER). Mean ages (18–92 years) of symptom onset were 37 (SD 17) years (men) and 32 (SD 14) years (women). Male/female ratio was 1/9. Age of onset of symptoms and age at diagnosis were higher in men than in women (p < 0.001). Males were diagnosed earlier than females (p = 0.04) and had more cardiovascular comorbidities (p < 0.001). Two hundred and thirty-six males (68%) with SLE required hospitalization in comparison with 1713 females (53%) (p < 0.001). During follow-up, 208 patients died: 30 men (9.3%) and 178 women (5.9%) (p = 0.02). As regards clinical manifestations, loss of weight (p = 0.01), lymphadenopathies (p = 0.02), and splenomegaly (p = 0.02) were more common in male patients. Female patients were more likely to have inflammatory rash, alopecia, and arthritis (p < 0.05). As for lung involvement, men with SLE had more pleural fibrosis (p < 0.001) and pulmonary embolism (p = 0.01). However, Raynaud’s phenomenon was more common in women (35%) than in men (23.7%) (p < 0.001); lupus nephritis was more common in men, being present in 155 (44.8%) of males versus 933 (29%) of females (p < 0.001). Multivariate analysis showed that SLE patients with a high Charlson index (more than 3 points) and age > 50 years had a higher mortality (odds ratios 3.6 and 2.1, respectively). Furthermore, SLE patients who developed pulmonary hemorrhage, pulmonary hypertension, psychiatric involvement, complement deficiency, and hemophagocytic syndrome also had higher mortality, regardless of gender. Patients with SLE over the age of 50 years have an increased risk of mortality. In Caucasians, age at diagnosis and symptom onset is higher in men than in women. The diagnostic delay is shorter in men. Male SLE patients present more cardiovascular comorbidities, and also more serositis, adenopathies, splenomegaly, renal involvement, convulsion, thrombosis, and lupus anticoagulant positivity than women.

Background: There is no gold standard to diagnose PCD so combination testing is used. High-speed video microscopy analysis (HSV) of ciliary function is highly sensitive but requires expensive equipment and specialists. Ability of non-specialists to diagnose PCD using simple equipment would improve diagnosis in resource-limited countries. Aim: To compare PCD diagnostic decisions of a non-specialist using clinical data and observational light microscopy (OLM), with a specialist multidisciplinary (MDT) service. Methods: 24 nasal brushings were analysed blind by OLM at room temperature (RT) by an ERS Fellow, and by HSV at 37^oC by specialists (normal, abnormal, equivocal, insufficient). Final diagnostic decisions (PCD negative, PCD positive, equivocal) by the Fellow based on OLM and clinical data were compared to MDT decisions using clinical data, nitric oxide, HSV and electron microscopy. Results: Comparing tests: OLM was 42.3% sensitive and 50% specific compared to specialist HSV. Most brushings were equivocal using either tests (13 by OLM at RT and 15 by HSV at 37^oC). When clinical data were added, there were significant differences between final diagnosis by Fellow and MDT (p<0.05). TheMDT9s outcomes were: 14 PCD negative, 7 equivocal and 3 PCD positive. The Fellow identified all 3 positives (all static cilia) but could not exclude PCD in 12/14 negatives as subtle changes were difficult to visualise; and 1 case was miss-diagnosed as positive. Conclusion: PCD diagnosis cannot be reliably made using OLM and clinical data but requires state-of-the-art diagnostics and specialist multidisciplinary assessment.