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Hsieh MR, Chen YF, Chang CT, Yu KH, Fang YF. Clinical and serological factors associated with lupus pericarditis: a case-control study. Clin Rheumatol 2023; 42:1061-1067. [PMID: 36495382 DOI: 10.1007/s10067-022-06469-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Lupus pericarditis, a common manifestation of systemic lupus erythematosus (SLE), can be fatal. We examined the prevalence of lupus pericarditis and its associated factors in a Taiwanese SLE cohort. METHODS Patients with SLE treated at Change Gung Memorial Hospital between January 2005 and December 2012 were included, and their age, sex, SLE disease duration, SLE disease activity index (SLEDAI) score, laboratory test results, comorbidities, and treatment regimen were noted. Factors related to lupus pericarditis were examined using univariate and multivariate logistic regression analyses. RESULTS Of the 689 patients, 88.7% were women; age at diagnosis (± standard deviation (SD)) was 40.78 ± 15.59 years, and disease duration at study entry was 11.93 ± 8.21 years. The prevalence of lupus pericarditis was 16.4% (n = 113). Notably, older age at diagnosis (p = 0.0165), longer disease duration (p = 0.009), higher SLEDAI score (p < 0.0001), renal disorder (p = 0.003), lymphocytopenia (p < 0.0001), thrombocytopenia (p = 0.004), and anti-phospholipid antibody (aPL) seropositivity (p = 0.002) were significantly associated with lupus pericarditis. In multivariate analysis, adjusted for sex, SLE disease duration, age, and SLEDAI score, patients with lymphocytopenia and aPL seropositivity were related to a twofold (odds ratio (OR) 2.015, 95% confidence interval (CI) 1.091-3.858) and 1.5-fold (OR 1.569, 95% CI 1.017-2.421) greater prevalence of lupus pericarditis, respectively. CONCLUSIONS Lupus pericarditis occurred in approximately one fifth of patients in this cohort. Patients with SLE with lymphocytopenia or anti-phospholipid antibody seropositivity were associated with a higher rate of lupus pericarditis. Key Points • Lupus pericarditis is a common manifestation of SLE that occurred in one-fifth patients in this study. • Lymphocytopenia and aPL antibody seropositivity are associated with a higher likelihood of developing lupus pericarditis. • Patients with lupus pericarditis should be identify early and treated with caution to prevent further morbidity and mortality.
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Affiliation(s)
- Meng-Ru Hsieh
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, No. 5, Fu-Shin St., Kuei-Shan, 333, Taoyuan City, Taiwan
| | - Yen-Fu Chen
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, No. 5, Fu-Shin St., Kuei-Shan, 333, Taoyuan City, Taiwan
| | - Che-Tzu Chang
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, No. 5, Fu-Shin St., Kuei-Shan, 333, Taoyuan City, Taiwan
| | - Kuang-Hui Yu
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, No. 5, Fu-Shin St., Kuei-Shan, 333, Taoyuan City, Taiwan.,Chang Gung University, 333, Taoyuan City, Taiwan
| | - Yao-Fan Fang
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, No. 5, Fu-Shin St., Kuei-Shan, 333, Taoyuan City, Taiwan.
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Lim YZ, Cicuttini FM, Wluka AE, Jones G, Hill CL, Forbes AB, Tonkin A, Berezovskaya S, Tan L, Ding C, Wang Y. Effect of atorvastatin on skeletal muscles of patients with knee osteoarthritis: Post-hoc analysis of a randomised controlled trial. Front Med (Lausanne) 2022; 9:939800. [PMID: 36091679 PMCID: PMC9452814 DOI: 10.3389/fmed.2022.939800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/05/2022] [Indexed: 12/03/2022] Open
Abstract
Objective Populations with knee osteoarthritis (KOA) are at increased risk of cardiovascular disease, due to higher prevalence of risk factors including dyslipidaemia, where statins are commonly prescribed. However, the effect of statins on muscles and symptoms in this population is unknown. Thus, this study examined the effect of atorvastatin on muscle properties in patients with symptomatic KOA. Design Post-hoc analysis of a 2-year multicentre randomised, double-blind, placebo-controlled trial. Setting Australian community. Participants Participants aged 40–70 years (mean age 55.7 years, 55.6% female) with KOA who met the American College of Rheumatology clinical criteria received atorvastatin 40 mg daily (n = 151) or placebo (n = 153). Main outcome measures Levels of creatinine kinase (CK), aspartate transaminase (AST), and alanine transaminase (ALT) at 1, 6, 12, and 24 months; muscle strength (by dynamometry) at 12 and 24 months; vastus medialis cross-sectional area (CSA) on magnetic resonance imaging at 24 months; and self-reported myalgia. Results There were no significant between-group differences in CK and AST at all timespoints. The atorvastatin group had higher ALT than placebo group at 1 (median 26 vs. 21, p = 0.004) and 6 (25 vs. 22, p = 0.007) months without significant between-group differences at 12 and 24 months. Muscle strength increased in both groups at 24 months without between-group differences [mean 8.2 (95% CI 3.5, 12.9) vs. 5.9 (1.3, 10.4), p = 0.49]. Change in vastus medialis CSA at 24 months favoured the atorvastatin group [0.11 (−0.10, 0.31) vs. −0.23 (−0.43, −0.03), p = 0.02] but of uncertain clinical significance. There was a trend for more myalgia in the atorvastatin group (8/151 vs. 2/153, p = 0.06) over 2 years, mostly occurring within 6 months (7/151 vs. 1/153, p = 0.04). Conclusions In those with symptomatic KOA, despite a trend for more myalgia, there was no clear evidence of an adverse effect of atorvastatin on muscles, including those most relevant to knee joint health.
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Affiliation(s)
- Yuan Z. Lim
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Flavia M. Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Anita E. Wluka
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Catherine L. Hill
- The Queen Elizabeth Hospital, University of Adelaide, Woodville, SA, Australia
- Department of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Andrew B. Forbes
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Andrew Tonkin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Sofia Berezovskaya
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Lynn Tan
- Alfred Hospital, Melbourne, VIC, Australia
| | - Changhai Ding
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- *Correspondence: Yuanyuan Wang,
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Dong YQ, Wang W, Li J, Ma MS, Zhong LQ, Wei QJ, Song HM. Characterization of microbiota in systemic-onset juvenile idiopathic arthritis with different disease severities. World J Clin Cases 2019; 7:2734-2745. [PMID: 31616689 PMCID: PMC6789395 DOI: 10.12998/wjcc.v7.i18.2734] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/17/2019] [Accepted: 07/27/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Systemic-onset juvenile idiopathic arthritis (SoJIA) is one of most serious subtypes of juvenile idiopathic arthritis. Although the pathogenesis of SoJIA remains unclear, several studies have suggested a correlation between gut dysbiosis and JIA. Further understanding of the intestinal microbiome may help to establish alternative ways to treat, or even prevent, the disease.
AIM To explore alterations in fecal microbiota profiles in SoJIA patients and to evaluate the correlations between microbiota and clinical parameters.
METHODS We conducted an observational single-center study at the Pediatric Department of Peking Union Medical College Hospital. Children who were diagnosed with SoJIA at our institution and followed for a minimum period of six months after diagnosis were recruited for the study. Healthy children were recruited as a control group (HS group) during the same period. Clinical data and stool samples were collected from SoJIA patients when they visited the hospital.
RESULTS The SoJIA group included 17 active and 15 inactive consecutively recruited children; the control group consisted of 32 children. Firmicutes and Bacteroidetes were the two most abundant phyla among the total sample of SoJIA children and controls. There was a significant difference among the three groups in observed species, which was the highest in the Active-SoJIA group, followed by the Inactive-SoJIA group and then HS group (Active-SoJIA vs HS: P = 0.000; and Inactive-SoJIA vs HS: P = 0.005). We observed a lower Firmicutes/Bacteroidetes ratio in SoJIA patients (3.28 ± 4.47 in Active-SoJIA, 5.36 ± 8.39 in Inactive-SoJIA, and 5.67 ± 3.92 in HS). We also observed decreased abundances of Ruminococcaceae (14.9% in Active-SoJIA, 17.3% in Inactive-SoJIA, and 22.8% in HS; Active-SoJIA vs HS: P = 0.005) and Faecalibacterium (5.1% in Active-SoJIA, 9.9% in Inactive-SoJIA, and 13.0% in HS; Active-SoJIA vs HS: P = 0.000) in SoJIA compared with HS. By contrast, the abundance of Bacteroidaceae was the highest in the Active-SoJIA group, followed by the Inactive-SoJIA and HS groups (16.5% in Active-SoJIA, 12.8% in Inactive-SoJIA, and 9.7% in HS; Active-SoJIA vs HS: P = 0.03). The Spearman correlation analysis revealed a negative correlation between Proteobacteria or Enterobacteriaceae and juvenile arthritis disease activity score on 27 joints (JADAS-27).
CONCLUSION The composition of the intestinal microbiota is different in SoJIA patients compared with healthy children. The dysbiosis presents partial restoration in inactive status patients.
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Affiliation(s)
- Yan-Qing Dong
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Wei Wang
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Ji Li
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Ming-Sheng Ma
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Lin-Qing Zhong
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Qi-Jiao Wei
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Hong-Mei Song
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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Frantz C, Auffray C, Avouac J, Allanore Y. Regulatory T Cells in Systemic Sclerosis. Front Immunol 2018; 9:2356. [PMID: 30374354 PMCID: PMC6196252 DOI: 10.3389/fimmu.2018.02356] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/24/2018] [Indexed: 12/16/2022] Open
Abstract
In recent years, accumulating evidence suggest that regulatory T cells (Tregs) are of paramount importance for the maintenance of immunological self-tolerance and immune homeostasis, even though they represent only about 5-10% of the peripheral CD4+ T cells in humans. Their key role is indeed supported by the spontaneous development of autoimmune diseases after Tregs depletion in mice. Moreover, there is also a growing literature that investigates possible contribution of Tregs numbers and activity in various autoimmune diseases. The contribution of Tregs in autoimmune disease has opened up a new therapeutic avenue based on restoring a healthy balance between Tregs and effector T-cells, such as Treg-based cellular transfer or low-dose IL-2 modulation. These therapies hold the promise of modulating the immune system without immunosuppression, while several issues regarding efficacy and safety need to be addressed. Systemic sclerosis (SSc) is an orphan connective tissue disease characterized by extensive immune abnormalities but also microvascular injury and fibrosis. Recently, data about the presence and function of Tregs in the pathogenesis of SSc have emerged although they remain scarce so far. First, there is a general agreement in the medical literature with regard to the decreased functional ability of circulating Tregs in SSc. Second the quantification of Tregs in patients have led to contradictory results; although the majority of the studies report reduced frequencies, there are conversely some indications suggesting that in case of disease activity circulating Tregs may increase. This paradoxical situation could be the result of a compensatory, but inefficient, amplification of Tregs in the context of inflammation. Nevertheless, these results must be tempered with regards to the heterogeneity of the studies for the phenotyping of the patients and of the most importance for Tregs definition and activity markers. Therefore, taking into account the appealing developments of Tregs roles in autoimmune diseases, together with preliminary data published in SSc, there is growing interest in deciphering Tregs in SSc, both in humans and mice models, to clarify whether the promises obtained in other autoimmune diseases may also apply to SSc.
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Affiliation(s)
- Camelia Frantz
- INSERM U1016, UMR8104, Cochin Institute, Paris Descartes University, Paris, France
| | - Cedric Auffray
- INSERM U1016, UMR8104, Cochin Institute, Paris Descartes University, Paris, France
| | - Jerome Avouac
- INSERM U1016, UMR8104, Cochin Institute, Paris Descartes University, Paris, France
| | - Yannick Allanore
- INSERM U1016, UMR8104, Cochin Institute, Paris Descartes University, Paris, France
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