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Guo R, Yang L, Pan Y, Shen J, Zhao F. Association between threat-related adverse childhood experiences and chronic lung diseases in a middle and older aged population: A cross-sectional and longitudinal study in China. J Psychosom Res 2024; 182:111692. [PMID: 38735102 DOI: 10.1016/j.jpsychores.2024.111692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVES We investigated the association between threat-related adverse childhood experiences (ACEs) and the risk of chronic lung diseases (CLDs). METHODS The data used for this study were extracted from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey of respondents recruited from 450 villages/urban communities in 28 provinces. Threat-related ACEs were constructed using five adverse factors: household substance abuse, physical abuse, domestic violence, unsafe neighbourhood, and bullying). Participants were divided into three groups according to their number of threat-related ACEs at baseline and at follow-up. The association between threat-related ACEs and CLD prevalence in the cross-sectional study was calculated using logistic regression models. The association between threat-related ACEs and CLD onset was evaluated using Cox proportional regression models in the cohort study. Potential confounders were considered in both the cross-sectional and cohort studies. RESULTS The CLD prevalence in the total population, no exposure group, exposure to one threat-related ACE, and exposure to at least two threat-related ACEs were 10.07% (1320/13104), 9.20% (665/7232), 10.89% (421/3865), and 11.66% (234/2007), respectively. Exposure to one threat-related ACE (OR: 1.23, 95% CI: 1.07-1.41) and exposure to at least two threat-related ACEs (OR: 1.31, 95% CI: 1.11-1.55) were significantly associated with higher CLD prevalence rates. The cohort study included 11,645 participants. During the 7-year follow-up, 738 CLD incidents were identified. Similarly, exposure to one threat-related ACE (HR: 1.20, 95% CI: 1.01-1.43) and at least two threat-related ACEs (HR: 1.64, 95% CI: 1.35-2.00) were significantly associated with a higher CLD incidence risk. CONCLUSIONS Exposure to threat-related ACEs was significantly associated with a higher CLD prevalence risk and onset. It is crucial to identify individuals who have encountered childhood threats and prioritise the monitoring of their pulmonary function.
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Affiliation(s)
- Run Guo
- Department of General Medicine, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, China
| | - Lihong Yang
- Department of General Medicine, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, China
| | - Yunfei Pan
- Department of General Medicine, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, China
| | - Jiaying Shen
- Department of General Medicine, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, China
| | - Feimin Zhao
- Department of General Medicine, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, China.
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Xu F, Xie L, He J, Huang Q, Shen Y, Chen L, Zeng X. Detection of common pathogenesis of rheumatoid arthritis and atherosclerosis via microarray data analysis. Heliyon 2024; 10:e28029. [PMID: 38628735 PMCID: PMC11019104 DOI: 10.1016/j.heliyon.2024.e28029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/28/2024] [Accepted: 03/11/2024] [Indexed: 04/19/2024] Open
Abstract
Despite extensive research reveal rheumatoid arthritis (RA) is related to atherosclerosis (AS), common pathogenesis between these two diseases still needs to be explored. In current study, we explored the common pathogenesis between rheumatoid arthritis (RA) and atherosclerosis (AS) by identifying 297 Differentially Expressed Genes (DEGs) associated with both diseases. Through KEGG and GO functional analysis, we highlighted the correlation of these DEGs with crucial biological processes such as the vesicle transport, immune system process, signaling receptor binding, chemokine signaling and many others. Employing Protein-Protein Interaction (PPI) network analysis, we elucidated the associations between DEGs, revealing three gene modules enriched in immune system process, vesicle, signaling receptor binding, Pertussis, and among others. Additionally, through CytoHubba analysis, we pinpointed 11 hub genes integral to intergrin-mediated signaling pathway, plasma membrane, phosphotyrosine binding, chemokine signaling pathway and so on. Further investigation via the TRRUST database identified two key Transcription Factors (TFs), SPI1 and RELA, closely linked with these hub genes, shedding light on their regulatory roles. Finally, leveraging the collective insights from hub genes and TFs, we proposed 10 potential drug candidates targeting the molecular mechanisms underlying RA and AS pathogenesis. Further investigation on xCell revealed that 14 types of cells were all different in both AS and RA. This study underscores the shared pathogenic mechanisms, pivotal genes, and potential therapeutic interventions bridging RA and AS, offering valuable insights for future research and clinical management strategies.
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Affiliation(s)
- Fan Xu
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, Fujian Province, China
| | - Linfeng Xie
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Fujian Medical University, Fuzhou, Fujian Province, China
| | - Jian He
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Fujian Medical University, Fuzhou, Fujian Province, China
| | - Qiuyu Huang
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, Fujian Province, China
| | - Yanming Shen
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Fujian Medical University, Fuzhou, Fujian Province, China
| | - Liangwan Chen
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, Fujian Province, China
| | - Xiaohong Zeng
- Department of Rheumatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China
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Purohit R, Bhaskar N, Jehu T, Camargo Macias K, Chalise S, Bhanusali N. Patient-reported outcomes of curcumin supplementation in rheumatoid arthritis and psoriatic arthritis: a cross-sectional survey. Rheumatol Int 2024:10.1007/s00296-024-05577-6. [PMID: 38625384 DOI: 10.1007/s00296-024-05577-6] [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: 12/15/2023] [Accepted: 03/06/2024] [Indexed: 04/17/2024]
Abstract
Curcumin is suggested to possess potent anti-inflammatory properties. This study focuses on determining the prevalence and perceived efficacy of curcumin supplementation in rheumatoid arthritis (RA) and psoriatic arthritis (PsA) population. We conducted a cross-sectional study on patients with RA and PsA who visited a rheumatology outpatient clinic from October 2019 to March 2020. A brief, voluntary, and anonymous Qualtrics survey of specific questions regarding curcumin use, source, form, method, dosage, side effects, and perceived efficacy was distributed to the patients. Descriptive and correlation analyses were performed. Among the 291 patients included, 46.4% of patients reported taking curcumin supplementation. Majority patients supplemented once a day (53.4%) and took dosages ranging from less than 200 mg/day to around 1000 mg/day of curcumin. Pain scores decreased significantly after starting curcumin therapy (p < 0.0001). Patients who were taking curcumin for years reported better symptomatic control when compared with patients taking it for months (p 0.01), weeks (p 0.02), or days (p 0.02). There was a significant difference in symptom improvement in patients taking 200-1000 mg compared to patients taking less than 200 mg (p 0.01). Patients taking curcumin once or twice a day reported significant symptom improvement compared to patients taking it sporadically. Symptomatic improvement was reported as pain (35.7%), swelling (25%), stiffness (23.21%), and fatigue (16.07%). An interesting correlation exists between the symptom relief and the frequency, dosages (200-1000 mg), and duration (years) of curcumin supplementation. Our study indicates that curcumin supplementation positively influenced outcomes in 46.4% of individuals with RA and PsA, reducing pain, swelling, stiffness, and fatigue. This suggests curcumin's potential as an adjunct therapy for these conditions.
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Affiliation(s)
| | - Neha Bhaskar
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - Tara Jehu
- University of Alabama, Birmingham, AL, USA
| | - Kathlyn Camargo Macias
- Department of Rheumatology, University of Central Florida College of Medicine, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Sweta Chalise
- Department of Rheumatology, University of Central Florida College of Medicine, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Neha Bhanusali
- Department of Rheumatology, University of Central Florida College of Medicine, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA.
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Alfatlawi H, Alharbi A, Shah M, Nawras Y, Altorok N. The impact of Libman-sacks endocarditis on inpatient outcomes with systemic lupus erythematosus: A retrospective study. Lupus 2024:9612033241243179. [PMID: 38564733 DOI: 10.1177/09612033241243179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
INTRODUCTION The existing literature offers limited insights into the influence of Libman-Sacks Endocarditis (LSE) on inpatient outcomes in individuals with Systemic Lupus Erythematosus (SLE). This study aimed to explore the characteristics and prognosis of SLE patients with LSE and the impact of LSE in patients with SLE on inpatient outcomes including inpatient mortality, length of stay, acute heart failure, atrial fibrillation, and cerebrovascular accidents (CVA). METHODS This study included adult patients who were hospitalized with SLE between the years 2019 and 2020, using the National Inpatient Sample (NIS) database. The total number of patients with a diagnosis of SLE in the years 2019 and 2020 in the NIS database was 150,411. Of those, 349 had a diagnosis of LSE. The study population was divided into two groups: one group with SLE and LSE, and another group with SLE but without LSE. RESULTS Caucasians made up 54.9% of the patients with a diagnosis of SLE in our patient population, while African Americans made up 26.9% and the Hispanics accounted for 12.2%. Of patients with LSE, Caucasians and African Americans represented 42.9% each. Patients with a diagnosis of LSE had a higher inpatient mortality than those with SLE without LSE (aOR: 9.74 CI 1.12-84.79, p 0.04). Patients with SLE with LSE were more likely to have acute heart failure than those without LSE, although this was not statistically significant (aOR 1.18 CI 0.13-11.07, p 0.88). Similarly, patients with SLE with LSE were more likely to have atrial fibrillation than those without LSE (aOR 4.45 CI: 0.77-25.57, p 0.10). CVAs were significantly higher in SLE patients with LSE than those without LSE (aOR 141.43 CI 16.59-1205.52, p < .01). DISCUSSION Patients who develop LSE were found to have significantly higher risks of inpatient mortality and cerebrovascular accidents. Early and precise detection of LSE in such patients may ensure timely intervention and prevention of the associated adverse outcomes. Further studies may attempt to develop screening methods for detection of LSE to effectively reduce morbidity and mortality associated with SLE.
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Affiliation(s)
- Halah Alfatlawi
- Department of Internal Medicine, The University of Toledo, Toledo, Ohio, USA
| | - Abdulmajeed Alharbi
- Department of Internal Medicine, The University of Toledo, Toledo, Ohio, USA
| | - Momin Shah
- Department of Internal Medicine, The University of Toledo, Toledo, Ohio, USA
| | - Yusuf Nawras
- The University of Toledo College of Medicine & Life Sciences, Toledo, Ohio, USA
| | - Nezam Altorok
- Department of Rheumatology, The University of Toledo, Toledo, Ohio, USA
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Pojskic M, Bisson E, Oertel J, Takami T, Zygourakis C, Costa F. Lumbar disc herniation: Epidemiology, clinical and radiologic diagnosis WFNS spine committee recommendations. World Neurosurg X 2024; 22:100279. [PMID: 38440379 PMCID: PMC10911853 DOI: 10.1016/j.wnsx.2024.100279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/01/2024] [Indexed: 03/06/2024] Open
Abstract
Objective To formulate the most current, evidence-based recommendations regarding the epidemiology, clinical diagnosis, and radiographic diagnosis of lumbar herniated disk (LDH). Methods A systematic literature search in PubMed, MEDLINE, and CENTRAL was performed from 2012 to 2022 using the search terms "herniated lumbar disc", "epidemiology", "prevention" "clinical diagnosis", and "radiological diagnosis". Screening criteria resulted in 17, 16, and 90 studies respectively that were analyzed regarding epidemiology, clinical diagnosis, and radiographic diagnosis of LDH. Using the Delphi method and two rounds of voting at two separate international meetings, ten members of the WFNS (World Federation of Neurosurgical Societies) Spine Committee generated eleven final consensus statements. Results The lifetime risk for symptomatic LDH is 1-3%; of these, 60-90% resolve spontaneously. Risk factors for LDH include genetic and environmental factors, strenuous activity, and smoking. LDH is more common in males and in 30-50 year olds. A set of clinical tests, including manual muscle testing, sensory testing, Lasegue sign, and crossed Lasegue sign are recommended to diagnose LDH. Magnetic resonance imaging (MRI) is the gold standard for confirming suspected LDH. Conclusions These eleven final consensus statements provide current, evidence-based guidelines on the epidemiology, clinical diagnosis, and radiographic diagnosis of LDH for practicing spine surgeons worldwide.
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Affiliation(s)
- Mirza Pojskic
- Department of Neurosurgery, University of Marburg, Germany
| | - Erica Bisson
- Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA
| | - Joachim Oertel
- Department of Neurosurgery, Saarland University Medical Centre, Homburg, Saarland, Germany
| | - Toshihiro Takami
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Japan
| | - Corinna Zygourakis
- Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, USA
| | - Francesco Costa
- Spine Surgery Unit (NCH4) - Department of Neurosurgery - Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Liu PW, Zhang H, Werley CA, Pichler M, Ryan SJ, Lewarch CL, Jacques J, Grooms J, Ferrante J, Li G, Zhang D, Bremmer N, Barnett A, Chantre R, Elder AE, Cohen AE, Williams LA, Dempsey GT, McManus OB. A phenotypic screening platform for chronic pain therapeutics using all-optical electrophysiology. Pain 2024; 165:922-940. [PMID: 37963235 PMCID: PMC10950549 DOI: 10.1097/j.pain.0000000000003090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 08/30/2023] [Indexed: 11/16/2023]
Abstract
ABSTRACT Chronic pain associated with osteoarthritis (OA) remains an intractable problem with few effective treatment options. New approaches are needed to model the disease biology and to drive discovery of therapeutics. We present an in vitro model of OA pain, where dorsal root ganglion (DRG) sensory neurons were sensitized by a defined mixture of disease-relevant inflammatory mediators, here called Sensitizing PAin Reagent Composition or SPARC. Osteoarthritis-SPARC components showed synergistic or additive effects when applied in combination and induced pain phenotypes in vivo. To measure the effect of OA-SPARC on neural firing in a scalable format, we used a custom system for high throughput all-optical electrophysiology. This system enabled light-based membrane voltage recordings from hundreds of neurons in parallel with single cell and single action potential resolution and a throughput of up to 500,000 neurons per day. A computational framework was developed to construct a multiparameter OA-SPARC neuronal phenotype and to quantitatively assess phenotype reversal by candidate pharmacology. We screened ∼3000 approved drugs and mechanistically focused compounds, yielding data from over 1.2 million individual neurons with detailed assessment of functional OA-SPARC phenotype rescue and orthogonal "off-target" effects. Analysis of confirmed hits revealed diverse potential analgesic mechanisms including ion channel modulators and other mechanisms including MEK inhibitors and tyrosine kinase modulators. Our results suggest that the Raf-MEK-ERK axis in DRG neurons may integrate the inputs from multiple upstream inflammatory mediators found in osteoarthritis patient joints, and MAPK pathway activation in DRG neurons may contribute to chronic pain in patients with osteoarthritis.
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Affiliation(s)
- Pin W. Liu
- Quiver Bioscience, Cambridge, MA, United States
| | | | | | | | | | | | | | | | | | - Guangde Li
- Quiver Bioscience, Cambridge, MA, United States
| | - Dawei Zhang
- Quiver Bioscience, Cambridge, MA, United States
| | | | | | | | | | - Adam E. Cohen
- Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA, United States
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Patel AV, Morgan SL, Green R, Danila MI, Merriman TR, Wanzeck K, Ahmed H, Gaffo AL. Vitamin B12 status and hyperhomocysteinemia in patients with Rheumatoid arthritis treated with methotrexate and folic acid. Am J Med Sci 2024:S0002-9629(24)01147-9. [PMID: 38561045 DOI: 10.1016/j.amjms.2024.03.020] [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: 05/23/2023] [Revised: 03/04/2024] [Accepted: 03/27/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is an inflammatory arthritis in which the immune system targets synovial joints. Methotrexate serves as the mainstay of treatment for RA due to its efficacy. However, patients treated with methotrexate are uniquely at risk for vitamin B12 deficiency and hyperhomocysteinemia due to coincident disease risk factors and the fact that methotrexate use is associated with malabsorption. The objective of this study was to assess for vitamin B12 deficiency among patients with RA treated with methotrexate and folic acid. METHODS This cross-sectional study included 50 patients with RA treated with methotrexate and folic acid and 49 patients with RA treated with other therapies. Patients were matched by age, sex, race, renal function, and disease activity. We compared plasma vitamin B12, methylmalonic acid, and homocysteine levels between these two groups utilizing quantitative and categorical analyses. RESULTS Thirty-seven (74 %) RA patients on methotrexate and folic acid had elevated plasma homocysteine levels compared with only 27 (55 %) RA patients receiving other therapies (P < 0.05). The proportion of patients with low vitamin B12 and high methylmalonic acid levels did not differ between the two groups. CONCLUSIONS Our data show high plasma homocysteine levels among RA patients treated with methotrexate and folic acid. While plasma vitamin B12 levels were similar between the two groups, high plasma homocysteine is also a sensitive marker of vitamin B12 deficiency. Additional studies should evaluate for the presence of clinical features of vitamin B12 deficiency and hyperhomocysteinemia among RA patients treated with methotrexate and folic acid.
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Affiliation(s)
- Aakash V Patel
- Tinsley Harrison Internal Medicine Residency Program, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Sarah L Morgan
- Division of Rheumatology and Clinical Immunology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ralph Green
- Department of Pathology and Laboratory Medicine, University of California Davis, Davis, CA, United States of America
| | - Maria I Danila
- Division of Rheumatology and Clinical Immunology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Tony R Merriman
- Division of Rheumatology and Clinical Immunology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Keith Wanzeck
- Division of Rheumatology and Clinical Immunology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Hamdy Ahmed
- Division of Rheumatology, University of South Alabama, Mobile, AL, United States of America
| | - Angelo L Gaffo
- Division of Rheumatology and Clinical Immunology, University of Alabama at Birmingham and Birmingham VA Medical Center, Birmingham, AL, United States of America.
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Song F, Nakatani H, Sugiyama E, Hirata S. Development of a nursing practice scale for rheumatoid arthritis treatment with biological disease-modifying anti-rheumatic drugs. Mod Rheumatol 2024; 34:479-487. [PMID: 37340867 DOI: 10.1093/mr/road064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/05/2023] [Accepted: 06/19/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVE The objective of the study was to develop a nursing practice scale for rheumatoid arthritis treatment with biological disease-modifying anti-rheumatic drugs. METHODS An anonymous self-administered questionnaire survey was administered to 1826 nurses, 960 of whom were Certified Nurses by Japan Rheumatism Foundation (CNJRFs) and 866 were registered nurses (RNs). Using exploratory factor analysis, criterion validity, and known-groups technique, we assessed the reliability and validity of the self-created 19-item nursing practice scale to evaluate the care provided to patients with rheumatoid arthritis receiving biological disease-modifying anti-rheumatic drugs based on the nurse's role as clarified from a literature review of relevant studies. RESULTS A total of 698 (38.4%) responses were collected from 407 CNJRFs and 291 RNs. Exploratory factor analysis was conducted on 18 items to examine three factors: 'nursing to enhance patients' capacity for self-care', 'nursing in which patients participate in decision-making', and 'nursing in which team medical care is promoted'. Cronbach's α was .95. The Spearman's coefficient was ρ = .738 for criterion validity. Using the known-groups technique, CNJRFs had higher total scale scores than RNs (P < .05). CONCLUSIONS The results confirmed the reliability, criterion validity, and construct validity of the scale.
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Affiliation(s)
- Fang Song
- Graduate School of Biomedical and Health Sciences, Hiroshima University,Hiroshima, Japan
| | - Hisae Nakatani
- Graduate School of Biomedical and Health Sciences, Hiroshima University,Hiroshima, Japan
| | - Eiji Sugiyama
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
| | - Shintaro Hirata
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
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Cotter EJ, Weissman AC, Yazdi AA, Muth SA, Cole BJ. Arthroscopic Debridement of Mild and Moderate Knee Osteoarthritis Results in Clinical Improvement at Short-Term Follow-Up: A Systematic Review. Arthroscopy 2024:S0749-8063(24)00204-4. [PMID: 38508289 DOI: 10.1016/j.arthro.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 02/28/2024] [Accepted: 03/06/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE To report the clinical outcomes of arthroscopic debridement for the treatment of Kellgren-Lawrence (KL) grade I and II (mild) and III (moderate) knee osteoarthritis (OA) at a minimum 1-year follow-up. METHODS A systematic review of primary literature was performed in concordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using the Medline, Embase, and Cochrane databases for studies regarding arthroscopic debridement/chondroplasty for management of knee OA at a minimum 1-year follow-up. Studies were included if they included KL grades I to III or dichotomized clinical outcomes by KL grade. The primary outcome was patient-reported outcome measures (PROMs) at the final follow-up. Bias was assessed using the Methodological Index for Non-Randomized Studies (MINORS) score. RESULTS Eight studies including a total of 773 patients met inclusion criteria (range of patients in each study, 31-214). Mean age of patients ranged from 35.5 to 64 years, with most studies having a mean patient age of 55 to 65 years. Mean follow-up ranged from 1.5 to 10 years. Seven of the 8 (87.5%) studies reported good to excellent PROMs at a minimum 1- to 4-year follow-up after arthroscopic debridement. Improvements in PROMs were superior in patients with less severe knee OA (KL I-II) in comparison to KL III in most studies. Conversion to arthroplasty ranged from 7.6% to 50% in KL III patients compared with 0% to 4.5% in KL I-II patients after arthroscopic debridement. Two of the 3 studies with at least a 4-year clinical follow-up reported that clinical improvements diminished with time (improvements no longer significant in total Western Ontario and McMaster Universities Osteoarthritis Index score). The lone randomized controlled trial was the only investigation that did not find a benefit of arthroscopic debridement over quality nonoperative care. MINORS scores ranged from 6 to 10 (mean, 8.0) for the 5 nonrandomized studies without controls. CONCLUSIONS Arthroscopic debridement for the management of mild to moderate knee OA is effective at short-term follow-up in patients who have exhausted conservative care. There is limited evidence demonstrating the durability of improvement following arthroscopic debridement after 2 years. LEVEL OF EVIDENCE Level IV, systematic review of Level I to IV studies.
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Affiliation(s)
- Eric J Cotter
- Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Alexander C Weissman
- Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Allen A Yazdi
- Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Sarah A Muth
- Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Brian J Cole
- Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A..
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10
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Lei C, Chen H, Zheng S, Pan Q, Xu J, Li Y, Liu Y. The efficacy and safety of hydrotherapy in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials. Int J Surg 2024; 110:1711-1722. [PMID: 38051935 PMCID: PMC10942168 DOI: 10.1097/js9.0000000000000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/20/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Currently, there is poor evidence of the effect of hydrotherapy on patients with knee osteoarthritis (OA). The authors performed a meta-analysis from randomized controlled trials to determine the efficacy and safety of a hydrotherapy program on measures of pain and knee function in individuals living with knee OA. METHODS A literature review included PubMed, EMBASE, Cochrane Library, Science Citation Index, ScienceDirect, and Ovid. Studies evaluating the efficacy of hydrotherapy for knee OA up to August 2023 were included. The research was reported based on the preferred reporting items for systematic reviews and meta-analysis guidelines to ensure the reliability and verity of results. Statistical analysis was performed using Stata/SE version 15.0. RESULTS A total of six randomized controlled trials were included for data extraction and meta-analysis. The present study revealed that there were significant differences between the two groups regarding the pain intensity at 1 week (WMD=-0.429; 95% CI: -0.679 to -0.179; P =0.001), 4 week (WMD=-0.308; 95% CI: -0.587 to -0.030; P =0.030) and 8 week (WMD=-0.724; 95% CI: -1.099 to -0.348, P <0.001). Furthermore, hydrotherapy was associated with improved outcome of the Western Ontario and McMaster Universities Arthritis index at 1 week (WMD=-3.314; 95% CI: -6.484 to -0.145, P =0.040), 4 week (WMD= -3.630; 95% CI: -6.893 to -0.366, P =0.029) and 8 week (WMD=-3.775; 95% CI: -7.315 to -0.235; P =0.037). No serious adverse events were observed in all patients who received hydrotherapy. CONCLUSION Hydrotherapy is efficacious and safe for reducing pain and improving functional status in individuals with knee OA, without increasing the risk of adverse effects.
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Affiliation(s)
| | - Haiting Chen
- Department of Emergency Medical Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, People’s Republic of China
| | | | - Qingyun Pan
- Department of Endocrine, The Fifth Hospital of Wuhan, Wuhan
| | - Jing Xu
- Department of Neurorehabilitation Ward 2, Taihe Hospital (Affiliated Hospital of Hubei University of Medical), Shiyan, Hubei
| | - Yuan Li
- Department of General Surgery
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Igoe A, Merjanah S, Harley ITW, Clark DH, Sun C, Kaufman KM, Harley JB, Kaelber DC, Scofield RH. Association between systemic lupus erythematosus and myasthenia gravis: A population-based National Study. Clin Immunol 2024; 260:109810. [PMID: 37949200 DOI: 10.1016/j.clim.2023.109810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 10/11/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) and myasthenia gravis (MG) are autoimmune diseases. Previous case reports and case series suggest an association may exist between these diseases, as well as an increased risk of SLE after thymectomy for MG. We undertook this study to determine whether SLE and MG were associated in large cohorts. METHODS We searched the IBM Watson Health Explorys platform and the Department of Veterans Affairs Million Veteran Program (MVP) database for diagnoses of SLE and MG. In addition, we examined subjects enrolled in the Lupus Family Registry and Repository (LFRR) as well as controls for a diagnosis of MG. RESULTS Among 59,780,210 individuals captured in Explorys, there were 25,750 with MG and 65,370 with SLE. 370 subjects had both. Those with MG were >10 times more likely to have SLE than those without MG. Those with both diseases were more likely to be women, African American, and at a younger age than MG subjects without SLE. In addition, the MG patients who underwent thymectomy had an increased risk of SLE compared to MG patients who had not undergone thymectomy (OR 3.11, 95% CI: 2.12 to 4.55). Autoimmune diseases such as pernicious anemia and miscellaneous comorbidities such as chronic kidney disease were significantly more common in MG patients who developed SLE. In the MVP, SLE and MG were also significantly associated. Association of SLE and MG in a large SLE cohort with rigorous SLE classification confirmed the association of SLE with MG at a similar level. CONCLUSION While the number of patients with both MG and SLE is small, SLE and MG are strongly associated together in very large databases and a large SLE cohort.
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Affiliation(s)
- Ann Igoe
- OhioHealth Hospital, Rheumatology Department, Mansfield, OH 44903, USA
| | - Sali Merjanah
- Boston University Medical Center, Section of Rheumatology, Department of Medicine, Boston, MA 02118, USA
| | - Isaac T W Harley
- Division of Rheumatology, Departments of Medicine and Immunology/Microbiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Medicine Service, Rheumatology Section, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO 80045, USA
| | - Dennis H Clark
- Research Service, US Department of Veterans Affairs Medical Center, Cincinnati, OH, USA
| | - Celi Sun
- Research Service, US Department of Veterans Affairs Medical Center, Oklahoma City, OK 73104, USA
| | - Kenneth M Kaufman
- Research Service, US Department of Veterans Affairs Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - John B Harley
- Research Service, US Department of Veterans Affairs Medical Center, Cincinnati, OH, USA; Cincinnati Education and Research for Veterans Foundation, Cincinnati, OH, USA
| | - David C Kaelber
- Departments of Internal Medicine, Pediatrics, and Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine and The Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, OH 44109, USA
| | - R Hal Scofield
- Research Service, US Department of Veterans Affairs Medical Center, Oklahoma City, OK 73104, USA; Department of Medicine, University of Oklahoma Health Sciences Center, Arthritis & Clinical Immunology Program, Oklahoma Medical Research Foundation, and Medical/Research Service, and Medicine Service, US Department of Veterans Affairs Medical Center, Oklahoma City, OK 73104, USA.
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12
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Rufino AT, Freitas M, Proença C, Ferreira de Oliveira JMP, Fernandes E, Ribeiro D. Rheumatoid arthritis molecular targets and their importance to flavonoid-based therapy. Med Res Rev 2024; 44:497-538. [PMID: 37602483 DOI: 10.1002/med.21990] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/18/2023] [Accepted: 08/05/2023] [Indexed: 08/22/2023]
Abstract
Rheumatoid arthritis (RA) is a progressive, chronic, autoimmune, inflammatory, and systemic condition that primarily affects the synovial joints and adjacent tissues, including bone, muscle, and tendons. The World Health Organization recognizes RA as one of the most prevalent chronic inflammatory diseases. In the last decade, there was an expansion on the available RA therapeutic options which aimed to improve patient's quality of life. Despite the extensive research and the emergence of new therapeutic approaches and drugs, there are still significant unwanted side effects associated to these drugs and still a vast number of patients that do not respond positively to the existing therapeutic strategies. Over the years, several references to the use of flavonoids in the quest for new treatments for RA have emerged. This review aimed to summarize the existing literature about the flavonoids' effects on the major pathogenic/molecular targets of RA and their potential use as lead compounds for the development of new effective molecules for RA treatment. It is demonstrated that flavonoids can modulate various players in synovial inflammation, regulate immune cell function, decrease synoviocytes proliferation and balance the apoptotic process, decrease angiogenesis, and stop/prevent bone and cartilage degradation, which are all dominant features of RA. Although further investigation is necessary to determine the effectiveness of flavonoids in humans, the available data from in vitro and in vivo models suggest their potential as new disease-modifying anti-rheumatic drugs. This review highlights the use of flavonoids as a promising avenue for future research in the treatment of RA.
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Affiliation(s)
- Ana T Rufino
- LAQV, REQUIMTE, Laboratory of Applied Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Marisa Freitas
- LAQV, REQUIMTE, Laboratory of Applied Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Carina Proença
- LAQV, REQUIMTE, Laboratory of Applied Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - José M P Ferreira de Oliveira
- LAQV, REQUIMTE, Laboratory of Applied Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Eduarda Fernandes
- LAQV, REQUIMTE, Laboratory of Applied Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Daniela Ribeiro
- LAQV, REQUIMTE, Laboratory of Applied Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Faculty of Agrarian Sciences and Environment, University of the Azores, Açores, Portugal
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13
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Lee YH, Hong SJ, Lee GJ, Shin SI, Hong JY, Chung SW, Lee YA. Investigation of periodontitis, halitosis, xerostomia, and serological characteristics of patients with osteoarthritis and rheumatoid arthritis and identification of new biomarkers. Sci Rep 2024; 14:4316. [PMID: 38383594 PMCID: PMC10881463 DOI: 10.1038/s41598-024-55004-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/19/2024] [Indexed: 02/23/2024] Open
Abstract
Rheumatoid arthritis (RA) and osteoarthritis (OA) are two different types of arthritis. Within RA, the subsets between seronegative RA (snRA) and seropositive RA (spRA) represent distinct disease entities; however, identifying clear distinguishing markers between them remains a challenge. This study investigated and compared the oral health conditions in patients with RA and OA to clarify the differences from healthy controls. In addition, we investigated the serological characteristics of the patients, the factors that distinguished patients with RA from those with OA, and the main factors that differentiated between snRA and spRA patients. A total of 161 participants (mean age: 52.52 ± 14.57 years, 32 males and 129 females) were enrolled in this study and categorized as: normal (n = 33), OA (n = 31), and RA (n = 97). Patients with RA were divided into the following two subtypes: snRA (n = 18) and spRA (n = 79). Demographics, oral health, and serological characteristics of these patients were compared. The prevalence of periodontal diseases was significantly higher in patients with OA (100%) and RA (92.8%) than in healthy controls (0.0%). However, the presence of periodontal diseases was not utilized as a distinguishing factor between OA and RA. Xerostomia occurred more frequently in patients with RA (84.5%) than in patients with OA (3.2%) and healthy controls (0.0%) (all p < 0.001). ROC analysis revealed that periodontal disease was a very strong predictor in the diagnosis of OA compared to healthy controls, with an AUC value of 1.00 (p < 0.001). Additionally, halitosis (AUC = 0.746, 95% CI 0.621-0.871, p < 0.001) and female sex (AUC = 0.663, 95% CI 0.529-0.797, p < 0.05) were also significant predictors of OA. The strongest predictors of RA diagnosis compared to healthy controls were periodontal diseases (AUC = 0.964), followed by xerostomia (AUC = 0.923), age (AUC = 0.923), female sex (AUC = 0.660), and halitosis (AUC = 0.615) (all p < 0.05). Significant serological predictors of RA were anti-CCP Ab (AUC = 0.808), and RF (AUC = 0.746) (all p < 0.05). In multiple logistic regression analysis, xerostomia (odds ratio, OR: 8124.88, 95% CI 10.37-6368261.97, p-value = 0.008) and Anti-CCP Ab (OR: 671.33, 95% CI 2.18-207,074.02, p = 0.026) were significant predictors for RA compared to OA. When diagnosing spRA compared to snRA, anti-CCP Ab (AUC = 1.000, p < 0.001) and RF (AUC = 0.910, 95%CI 0.854-0.967, p < 0.001) had outstanding predictive performances. Therefore, clinicians and researchers should thoroughly evaluate the oral status of both OA and RA patients, alongside serological factors, and consider these elements as potential predictors.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, Korea.
| | - Seung-Jae Hong
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Gi-Ja Lee
- Department of Biomedical Engineering, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Seung-Il Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Ji-Youn Hong
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Sang Wan Chung
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Yeon-Ah Lee
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea.
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14
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Fazal ZA, Avina-Galindo AM, Marozoff S, Kwan J, Lu N, Avina-Zubieta JA. Risk of venous thromboembolism in patients with rheumatoid arthritis: a meta-analysis of observational studies. BMC Rheumatol 2024; 8:5. [PMID: 38308337 PMCID: PMC10836002 DOI: 10.1186/s41927-024-00376-9] [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: 09/19/2023] [Accepted: 01/21/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Thrombotic events, such as venous thromboembolism (VTE) are a major health complication linked to rheumatoid arthritis (RA). We performed a meta-analysis to evaluate the risk of VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE), in adults with RA compared to the general population. METHODS MEDLINE and EMBASE databases were searched from inception to April 2022 to identify publications meeting the following criteria: (1) prospective and retrospective original data from cohort or case-control studies; (2) pre-specified RA definition; (3) clearly defined VTE outcomes; (4) reported risk estimate and 95% confidence intervals (95% CIs); (5) at least sex- and age-matched to comparison group; and (6) English language. Of 372 studies screened, 14 were included (602,760 RA patients, 123,076 VTE events) and their quality was assessed by an adaptation of the STROBE quality scoring scale. RESULTS The pooled risk ratios of VTE, DVT and PE in patients with RA were 1.57 (95% CI 1.41-1.76), 1.58 (95% CI 1.26-1.97) and 1.57 (95% CI 1.30-1.88), respectively. The I2 value of 92%, 94% and 92% for VTE, DVT and PE analyses, suggesting considerable heterogeneity. There were no significant differences in risk estimates among the five subgroup analyses: quality score (P = 0.35, I2 = 0%); sex (P = 0.31, I2 = 1.7%); study year (P = 0.81, I2 = 0%); population source (P = 0.35, I2 = 0%); study design (P = 0.62, I2 = 0%). CONCLUSIONS Results show that patients with RA are at a higher risk of VTE, DVT and PE compared to the general population.
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Affiliation(s)
- Zahra A Fazal
- Arthritis Research Canada, 230-2238 Yukon Street, BC, V5Y 3P2, Vancouver, Canada
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, Canada
| | | | - Shelby Marozoff
- Arthritis Research Canada, 230-2238 Yukon Street, BC, V5Y 3P2, Vancouver, Canada
| | - Jessie Kwan
- Arthritis Research Canada, 230-2238 Yukon Street, BC, V5Y 3P2, Vancouver, Canada
- Faculty of Science, University of British Columbia, Vancouver, Canada
| | - Na Lu
- Arthritis Research Canada, 230-2238 Yukon Street, BC, V5Y 3P2, Vancouver, Canada
| | - J Antonio Avina-Zubieta
- Arthritis Research Canada, 230-2238 Yukon Street, BC, V5Y 3P2, Vancouver, Canada.
- Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, Canada.
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15
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Yan Y, Zhang LB, Ma R, Wang MN, He J, Wang PP, Tao QW, Xu Y. Jolkinolide B ameliorates rheumatoid arthritis by regulating the JAK2/STAT3 signaling pathway. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 124:155311. [PMID: 38199156 DOI: 10.1016/j.phymed.2023.155311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/03/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Jolkinolide B (JB), an ent‑abietane-type diterpenoid in Euphorbia plants, has various pharmacological activities, including anticancer, anti-inflammatory, and anti-tuberculosis activities. However, no previous studies have proven whether JB can be regarded as a targeted drug for the treatment of rheumatoid arthritis (RA). PURPOSE This study aimed to evaluate the anti-RA effects of JB and explore the potential mechanisms. METHODS Components and targets of JB and RA were identified in different databases, and potential targets and pathways were predicted by protein-protein interaction (PPI) network analysis and pathway enrichment analysis. Then, molecular docking and surface-plasmon resonance (SPR) were used to confirm the predict. The anti-arthritic effects of JB were studied in vivo with collagen-induced arthritis (CIA) rat model and in vitro with lipopolysaccharide (LPS) and interleukin-6 (IL-6)-induced RAW264.7 macrophage. Potential mechanisms were further verified by in vivo and in vitro experiments. RESULTS The Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that Th17 cell differentiation, prolactin signaling pathway, and JAK/STAT signaling pathway might be associated with anti-RA effects of JB. Molecular docking and SPR results showed that JB bound effectively to JAK2. JB significantly decreased body weight loss, arthritis index, paw thickness, and synovial thickness in CIA rats. Histomorphological results suggested the protective effects of JB on CIA rats with ankle joint injury. Molecular biology analysis indicated that JB suppressed the mRNA expression of inflammatory factors in ankle joints for CIA rats and reduced the concentration of these factors in LPS- induced RAW264.7 macrophage. The protein expression level of the JAK2/STAT3 pathway was also significantly decreased by JB. CONCLUSION JB had a novel inhibitory effect on inflammation and bone destruction in CIA rats, and the mechanism might be related to the JAK2/STAT3 signaling pathway.
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Affiliation(s)
- Yu Yan
- Department of TCM Rheumatism, Department of Pharmacy & Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, 2 Yinghuayuan East Street, Chaoyang District, Beijing 100029, PR China
| | - Liu-Bo Zhang
- China-Japan Friendship Clinical Medical College & School of Life Sciences, Beijing University of Chinese Medicine, Beijing 100029, PR China
| | - Ru Ma
- Clinical Pharmacy Department & Xi'an Public Health Center, Xi'an 710200, PR China
| | - Man-Ni Wang
- China-Japan Friendship Clinical Medical College & School of Life Sciences, Beijing University of Chinese Medicine, Beijing 100029, PR China
| | - Jun He
- Department of TCM Rheumatism, Department of Pharmacy & Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, 2 Yinghuayuan East Street, Chaoyang District, Beijing 100029, PR China
| | - Pei-Pei Wang
- China-Japan Friendship Clinical Medical College & School of Life Sciences, Beijing University of Chinese Medicine, Beijing 100029, PR China
| | - Qing-Wen Tao
- Department of TCM Rheumatism, Department of Pharmacy & Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, 2 Yinghuayuan East Street, Chaoyang District, Beijing 100029, PR China
| | - Yuan Xu
- Department of TCM Rheumatism, Department of Pharmacy & Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, 2 Yinghuayuan East Street, Chaoyang District, Beijing 100029, PR China.
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16
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Al-Baldawi S, Zúñiga Salazar G, Zúñiga D, Balasubramanian S, Mehmood KT. Interstitial Lung Disease in Rheumatoid Arthritis: A Review. Cureus 2024; 16:e53632. [PMID: 38449991 PMCID: PMC10917126 DOI: 10.7759/cureus.53632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder. Although the joints are typically the first area affected in RA, it can also involve extra-articular regions. This article provides an overview on rheumatoid arthritis-associated interstitial lung disease (RA-ILD), a component of the disease manifestations leading to significant morbidity and mortality. Managing these pulmonary symptoms in people with RA poses a number of difficulties for medical professionals. In this review article, we shed light on the prevalence of RA-ILD and the common pulmonary manifestations of RA, while focusing on the evolving pathogenesis concepts that link them to RA's autoimmune cascade. We also address the diagnostic challenges and the available screening modalities that aid in the early recognition and effective management of these pulmonary complications. Furthermore, glucocorticoids, disease-modifying antirheumatic medications, immunosuppressive medications, and biological agents are among the pharmacological approaches that have been explored in this review study.
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Affiliation(s)
- Shahad Al-Baldawi
- Department of Rheumatology, Al-Yarmouk Teaching Hospital, Baghdad, IRQ
| | | | - Diego Zúñiga
- Department of Medicine, Universidad Católica de Santiago de Guayaquil, Guayaquil, ECU
| | | | - Khawar Tariq Mehmood
- Department of Internal Medicine, Aster Hospital Br of Aster Dm Healthcare FZC, Dubai, ARE
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17
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Webb J, Emmert R, Reddy A, Sajjadi NB, Greiner B, Bray N, Hartwell M. Social determinants of health in patients with arthritis: a cross-sectional analysis of the 2017 Behavioral Risk Factor Surveillance System. J Osteopath Med 2024; 124:69-75. [PMID: 37860841 DOI: 10.1515/jom-2022-0162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/18/2023] [Indexed: 10/21/2023]
Abstract
CONTEXT Social determinants of health (SDOH) are economic, social, and political conditions that affect a person's overall health or the health of a group of people. Researchers have investigated the effects of SDOH on various diseases, such as asthma, obesity, and chronic stress, but few publications have been made regarding its effects on arthritis. OBJECTIVES Our primary objective was to analyze the implications of SDOH on disease severity relating to pain levels and limitations experienced among people with diagnosed arthritis. METHODS We performed a cross-sectional analysis of the 2017 Behavioral Risk Factor Surveillance System (BRFSS). We included individuals who reported having arthritis, were over the age of 45, and who also completed the SDOH module. Pain scores from the four-question Arthritis Burden Module were correlated to question responses pertaining to SDOH to determine their associations. RESULTS For the analysis, our sample size was 25,682, with response rates varying slightly among the SDOH questions. Individuals diagnosed with arthritis were more likely to report functional limitations if they experienced food insecurity (χ2=234.0, p<0.001), financial instability (χ2=149.7, p<0.001), or frequent stress (χ2=297.6, p<0.001). Further, we found that individuals with arthritis experiencing any domain of SDOH reported higher mean pain scores than those not experiencing that domain, with the highest pain score difference among those reporting frequent stress (Coefficient: 1.93, CI=1.74-2.13, t=19.43, p<0.001). CONCLUSIONS Our results show that SDOH profoundly impact pain levels and limitations experienced by patients with arthritis. Although work has already begun to help alleviate burdens associated with SDOH, more research and actions are required to create equitable health throughout the population.
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Affiliation(s)
- Jason Webb
- College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, OK, USA
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, OK, USA
| | - Ryan Emmert
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, OK, USA
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Arjun Reddy
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Nicholas B Sajjadi
- Department of Orthopedic Surgery & Rehabilitation , University of Oklahoma College of Medicine, Oklahoma City, OK, USA
| | - Ben Greiner
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Natasha Bray
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, OK, USA
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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18
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Zhu L, Moreland LW, Ascherman D. Cross-sectional association between social and demographic factors and disease activity in rheumatoid arthritis. BMC Rheumatol 2024; 8:2. [PMID: 38238799 PMCID: PMC10797737 DOI: 10.1186/s41927-023-00371-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/23/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND This study aimed to assess the association between social factors, demographic parameters, and disease activity among rheumatoid arthritis (RA) patients. METHODS The University of Pittsburgh Rheumatoid Arthritis Comparative Effectiveness Research (RACER) registry was used for this study and included patients meeting 1987 ACR criteria for RA enrolled between 2010-2015. The registry collected clinical and laboratory data at each visit, permitting the calculation of disease activity measures that included Disease Activity 28-C Reactive Protein (DAS28-CRP). The current study was conducted as a cross-sectional study in which baseline data were used to construct multiple logistic regression models assessing the relationship between disease activity measures (DAS28-CRP), functional capacity (health assessment questionnaire (HAQ)), selected demographic and social factors (occupation, education, income, marital status, race, gender, age, and BMI), and clinical/laboratory variables. RESULTS The analyses included 729 patients with baseline DAS28-CRP and social/demographic data. The mean age at enrollment was 59.5 (Standard Deviation (SD) = 12.7) years, 78% were female, and the median RA disease duration was 9.8 (Interquartile Range (IQR): 3.7, 19.1) years. We dichotomized the DAS28-CRP score and defined scores above or below 3.1 as high versus low RA disease activity. Most patients with high RA disease activity (N = 326, 45%) had less than a college degree (70%), were not working/retired/disabled (71%), and had an annual income under $50 K (55%). We found that higher body mass index (BMI) (Odds Ratio (OR) = 1.04, 95% CI: 1.01-1.08), longer disease duration (> 2 and < 10 years versus ≤ 2 years of disease) (OR = 0.45, 95% CI: 0.25-0.78), and being retired (OR = 1.74, 95% CI: 1.02-2.98) were associated with RA disease activity. CONCLUSION Increased RA activity may be associated with various social factors, potentially leading to more severe and debilitating disease outcomes. These findings provide evidence to support efforts to monitor disparities and achieve health equity in RA.
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Affiliation(s)
- Lei Zhu
- Division of Rheumatology and Clinical Immunology, School of Medicine, University of Pittsburgh, BST S723, 200 Lothrop Street, Pittsburgh, PA, 15261, USA
- Microbial Genomic Epidemiology Laboratory, Center for Genomic Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
- Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Larry W Moreland
- Division of Rheumatology, School of Medicine, and Orthopedics, University of Colorado, Aurora, CO, USA
| | - Dana Ascherman
- Division of Rheumatology and Clinical Immunology, School of Medicine, University of Pittsburgh, BST S723, 200 Lothrop Street, Pittsburgh, PA, 15261, USA.
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19
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Shen Y, Voigt A, Goranova L, Abed M, Kleiner DE, Maldonado JO, Beach M, Pelayo E, Chiorini JA, Craft WF, Ostrov DA, Ramiya V, Sukumaran S, Brown AN, Hanrahan KC, Tuanyok A, Warner BM, Nguyen CQ. Evidence of a Sjögren's disease-like phenotype following COVID-19 in mice and humans. JCI Insight 2023; 8:e166540. [PMID: 37676726 PMCID: PMC10807711 DOI: 10.1172/jci.insight.166540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 09/05/2023] [Indexed: 09/09/2023] Open
Abstract
Sjögren's Disease (SjD) is a systemic autoimmune disease characterized by lymphocytic inflammation of the lacrimal and salivary glands (SG), dry eyes and mouth, and systemic symptoms. SARS-CoV-2 may trigger the development or progression of autoimmune diseases. To test this, we used a mouse model of SARS-CoV-2 infection and convalescent patients' blood and SG in order to understand the development of SjD-like autoimmunity after infection. First, SARS-CoV-2-infected human angiotensin-converting enzyme 2 (ACE2) transgenic mice exhibited decreased salivation, elevated antinuclear antibodies (ANA), and lymphocytic infiltration in the lacrimal and SG. The sera from patients with COVID-19 sera showed increased ANA (i.e., anti-SSA [Sjögren's-syndrome-related antigen A]/anti-Ro52 and anti-SSB [SS-antigen B]/anti-La). Male patients showed elevated anti-SSA compared with female patients, and female patients exhibited diverse ANA patterns. SG biopsies from convalescent COVID-19 patients were microscopically similar to SjD SG with focal lymphocytic infiltrates in 4 of 6 patients and 2 of 6 patients exhibiting focus scores of at least 2. Lastly, monoclonal antibodies produced in recovered patients blocked ACE2/spike interaction and cross-reacted with nuclear antigens. Our study shows a direct association between SARS-CoV-2 and SjD. Hallmark features of SjD-affected SGs were histologically indistinguishable from convalescent COVID-19 patients. The results implicate that SARS-CoV-2 could be an environmental trigger for SjD.
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Affiliation(s)
- Yiran Shen
- Department of Infectious Diseases and Immunology, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Alexandria Voigt
- Department of Infectious Diseases and Immunology, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Laura Goranova
- Department of Infectious Diseases and Immunology, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Mehdi Abed
- Salivary Disorder Unit, National Institute of Dental and Craniofacial Research, NIH, Bethesda, Maryland, USA
| | - David E. Kleiner
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Jose O. Maldonado
- Salivary Disorder Unit, National Institute of Dental and Craniofacial Research, NIH, Bethesda, Maryland, USA
- AAV Biology Section, National Institute of Dental and Craniofacial Research, NIH, Bethesda, Maryland, USA
- Center for Oral Health Integration, HealthPartners Institute, Bloomington, MN, USA
| | - Margaret Beach
- Salivary Disorder Unit, National Institute of Dental and Craniofacial Research, NIH, Bethesda, Maryland, USA
| | - Eileen Pelayo
- Salivary Disorder Unit, National Institute of Dental and Craniofacial Research, NIH, Bethesda, Maryland, USA
| | - John A. Chiorini
- AAV Biology Section, National Institute of Dental and Craniofacial Research, NIH, Bethesda, Maryland, USA
| | - William F. Craft
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, and
| | - David A. Ostrov
- Department of Pathology, Immunology & Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Vijay Ramiya
- LifeSouth Community Blood Centers, Gainesville, Florida, USA
| | | | - Ashley N. Brown
- Institute for Therapeutic Innovation, Department of Medicine, University of Florida College of Medicine, Orlando, Florida, USA
| | - Kaley C. Hanrahan
- Institute for Therapeutic Innovation, Department of Medicine, University of Florida College of Medicine, Orlando, Florida, USA
| | - Apichai Tuanyok
- Department of Infectious Diseases and Immunology, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Blake M. Warner
- Salivary Disorder Unit, National Institute of Dental and Craniofacial Research, NIH, Bethesda, Maryland, USA
| | - Cuong Q. Nguyen
- Department of Infectious Diseases and Immunology, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
- Department of Oral Biology, College of Dentistry and
- Center of Orphaned Autoimmune Diseases, University of Florida, Gainesville, Florida, USA
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20
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Yang Y, Huang XX, Huo RX, Lin JY. Sexual health in women with Sjogren's syndrome: A review. Eur J Obstet Gynecol Reprod Biol 2023; 291:1-9. [PMID: 37801781 DOI: 10.1016/j.ejogrb.2023.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 09/07/2023] [Accepted: 09/25/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Rheumatic diseases, mainly affecting women, including rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus, etc., are chronic, inflammatory, autoimmune disorders that may involve multiple organs or systems and are closely related to sexual health, which is an important aspect of human physical and mental health. Sjogren's syndrome (SS) is the second most common rheumatic illnesses after rheumatoid arthritis with a female predominance. At present, the research on sexual health of female SS patients is still scarce and difficult to summarize. OBJECTIVES The objective of our study was to systematically review the literature for the influence of maternal SS on sexual health, such as sexual function, sex hormones, fertility, and pregnancy outcomes. METHODS We performed a comprehensive literature search based on PubMed and Web of science databases from inception to 1 November 2022. Outcomes were divided into 4 categories: sex hormones, sexual function, fertility, and pregnancy and offspring outcomes. RESULTS A total of 756 potentially eligible papers were retrieved. After eliminating duplicate articles and reviewing the titles and abstracts to exclude records, we read the remaining 92 articles in full for further evaluation, and selected 42 studies. Results on sex hormones, sexual function, fertility and pregnancy and offspring outcomes were reported in 13, 12, 3 and 14 SS-related articles, respectively. The levels of some sex hormones in SS patients may have undergone changes. Female patients with SS have a high prevalence of sexual dysfunction compared with controls. Most studies suggested SS had an adverse impact on maternal and fetal outcomes following pregnancy. However, there is insufficient evidence that directly indicating the fertility of SS women is diminished. CONCLUSIONS In summary, certain aspects of sexual health (sexual function, sex hormones and pregnancy outcomes) are impaired in SS women. Screening for sexual health problems in SS female should become an integral part of medical clinical practice. Rheumatologists should be aware of this association and collaborate with gynecologists, obstetricians, psychologists, and other experts on this issue to determine appropriate therapeutic approaches.
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Affiliation(s)
- Yang Yang
- Department of Rheumatology and Immunology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xin-Xiang Huang
- Department of Rheumatology and Immunology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Rong-Xiu Huo
- Department of Rheumatology and Immunology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jin-Ying Lin
- Department of Rheumatology and Immunology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
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21
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Pedersen C, Tai S, Valley E, Henry K, Duarte-García A, Singla S, Putman M. Unpublished clinical trials of common rheumatic diseases. Rheumatology (Oxford) 2023; 62:3811-3818. [PMID: 36971599 DOI: 10.1093/rheumatology/kead141] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/18/2023] [Indexed: 12/03/2023] Open
Abstract
OBJECTIVES Randomized controlled trials (RCTs) provide high-quality evidence for treatment efficacy, but many RCTs remain unpublished. The objective of this study was to describe the proportion of unpublished RCTs in five rheumatic diseases and to identify factors associated with publication. METHODS Registered RCTs for five rheumatic diseases (SLE, vasculitis, spondyloarthritis, SS and PsA) with over 30 months since study completion were identified using ClinicalTrials.gov. Index publications were identified by NCT ID numbers and structured text searches of publication databases. The results of unpublished studies were identified in abstracts and press releases; reasons for non-publication were assessed by surveying corresponding authors. RESULTS Out of 203 studies that met eligibility criteria, 17.2% remained unpublished, representing data from 4281 trial participants. Higher proportions of published trials were phase 3 RCTs (57.1% vs 28.6% unpublished, P < 0.05) or had a positive primary outcome measure (64.9% vs 25.7% unpublished, P < 0.001). In a multivariable Cox proportional hazards model, a positive outcome was independently associated with publication (hazard ratio 1.55; 95% CI: 1.09, 2.22). Corresponding authors of 10 unpublished trials cited ongoing preparation of the manuscript (50.0%), sponsor/funder issues (40.0%) and unimportant/negative result (20.0%) as reasons for lack of publication. CONCLUSIONS Nearly one in five RCTs in rheumatology remain unpublished 2 years after trial completion, and publication is associated with positive primary outcome measures. Efforts to encourage universal publication of rheumatology RCTs and reanalysis of previously unpublished trials should be undertaken.
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Affiliation(s)
- Connor Pedersen
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Shannon Tai
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Erin Valley
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kathryn Henry
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Shikha Singla
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Michael Putman
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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22
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Huang CH, James K, Lanois C, Corrigan P, Yen SC, Stefanik J. Inter-joint coordination variability is associated with pain severity and joint loading in persons with knee osteoarthritis. J Orthop Res 2023; 41:2610-2616. [PMID: 37132504 PMCID: PMC10622325 DOI: 10.1002/jor.25592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/14/2023] [Accepted: 05/01/2023] [Indexed: 05/04/2023]
Abstract
As the lower extremity is a linked-joint system, the contribution of movements at the hip and ankle, in addition to the knee, to gait patterns should be considered for persons with knee osteoarthritis (OA). However, the relationships of joint coordination variability to OA symptoms, particularly knee pain, and joint loading is unknown. The purpose of this study was to determine the relationship of joint coordination variability to knee pain severity and joint loading in persons with knee OA. Thirty-four participants with knee OA underwent gait analysis. Vector coding was used to assess coordination variability during the early, mid, and late stance phase. Hip-knee coupling angle variability (CAV) during midstance was associated with Knee Injury and Osteoarthritis Outcome Score (KOOS) pain (r = -0.50, p = 0.002) and Visual Analog Scale pain (r = 0.36, p = 0.04). Knee-ankle CAV during midstance was associated with KOOS pain (r = -0.34, p = 0.05). Hip-knee CAV during early and midstance were associated with knee flexion moment (KFM) impulses (r = -0.46, p = 0.01). Knee-ankle CAV during early and midstance were associated with peak KFM (r = -0.51, p < 0.01; r = -0.70, p < 0.01). Moreover, knee-ankle CAV during early, mid, and late stance phase were associated with KFM impulses (r = -0.53, p < 0.01; r = -0.70, p < 0.01; r = -0.54, p < 0.01). These findings suggest that joint coordination variability may be a factor that influences pain and knee joint loading in persons with knee OA. Statement of Clinical Significance: Movement coordination of the hip, knee, and ankle should be considered in the clinical management and future research related to knee OA.
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Affiliation(s)
- Chun-Hao Huang
- Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University
| | - Khara James
- Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University
| | - Corey Lanois
- Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University
| | - Patrick Corrigan
- Department of Physical Therapy and Athletic Training, Saint Louis University
| | - Sheng-Che Yen
- Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University
| | - Joshua Stefanik
- Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University
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23
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Lee J, Martindale J, Makris UE, Singh N, Yung R, Bynum JPW. Initiation of Disease-Modifying Antirheumatic Drugs in Older Medicare Beneficiaries With New Diagnosis of Late-Onset Rheumatoid Arthritis. ACR Open Rheumatol 2023; 5:694-700. [PMID: 37872884 PMCID: PMC10716804 DOI: 10.1002/acr2.11625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/29/2023] [Accepted: 10/05/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVE Older adults with rheumatoid arthritis (RA) account for up to one-third of the RA population and are less likely to receive optimal treatment. For the subgroup of older adults with late-onset RA (LORA), who experience more symptomatic and progressive disease, suboptimal treatment could be more consequential than the general population who age with RA. We evaluated use of disease-modifying antirheumatic drugs (DMARDs) in older adults with a new diagnosis of LORA. METHODS In this retrospective observational study, we identified adults 66 years of age or older with a new diagnosis of LORA using Medicare data from 2008 to 2017. Information on baseline patient characteristics and DMARD initiation during the first 12 months after LORA diagnosis were collected. We also assessed concomitant use of glucocorticoids (GCs). RESULTS We identified 33,373 older adults with new diagnosis of LORA. Average age at LORA diagnosis was 76.7 (SD 7.6); 75.4% were female, 76.9% were White, and 35.6% had low-income subsidy (LIS). Less than one-third were initiated on a DMARD (28.9%). In multivariable analyses, DMARD initiation was associated with younger age, fewer comorbidities, and absence of LIS status. Concomitant long-term (>3 months) GC use was higher among those on any DMARD (44.3%) compared with those without (15.2%). CONCLUSIONS DMARD initiation after new diagnosis of LORA is low despite current clinical practice guidelines recommending early aggressive initiation of treatment. Long-term GC use is common among those on any DMARDs, raising concern for suboptimal DMARD use. Further studies are needed to understand drivers of DMARD use in older adults.
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Affiliation(s)
| | | | - Una E. Makris
- University of Texas Southwestern Medical Center and VA North Texas Health Care SystemDallasTexas
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24
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Parks CG, Pettinger M, de Roos AJ, Tindle HA, Walitt BT, Howard BV. Life Events, Caregiving, and Risk of Autoimmune Rheumatic Diseases in the Women's Health Initiative Observational Study. Arthritis Care Res (Hoboken) 2023; 75:2519-2528. [PMID: 37230960 PMCID: PMC10798355 DOI: 10.1002/acr.25164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Growing evidence suggests psychosocial stressors may increase risk of developing autoimmune disease. We examined stressful life events and caregiving in relation to incident rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) in the Women's Health Initiative Observational Study cohort. METHODS The sample of postmenopausal women included 211 incident RA or SLE cases reported within 3 years after enrollment, confirmed by use of disease-modifying antirheumatic drugs (i.e., probable RA/SLE), and 76,648 noncases. Baseline questionnaires asked about life events in the past year, caregiving, and social support. We used Cox regression models to calculate hazard ratios (HR) and 95% confidence intervals (95% CIs), adjusting for age, race/ethnicity, occupational class, education, pack-years of smoking and BMI. RESULTS Incident RA/SLE was associated with reporting 3 or more life events (e.g., age-adjusted HR 1.70 [95% CI 1.14, 2.53]; P for trend = 0.0026). Elevated HRs were noted for physical (HR 2.48 [95% CI 1.02, 6.04]) and verbal (HR 1.34 [0.89, 2.02]) abuse (P for trend = 0.0614), 2 or more interpersonal events (HR 1.23 [95% CI 0.87, 1.73]; P for trend = 0.2403), financial stress (HR 1.22 [95% CI 0.90, 1.64]), and caregiving 3 or more days per week (HR 1.25 [95% CI 0.87, 1.81]; P for trend = 0.2571). Results were similar, excluding women with baseline symptoms of depression or moderate-to-severe joint pain in the absence of diagnosed arthritis. CONCLUSION Our findings support the idea that diverse stressors may increase risk of developing probable RA or SLE in postmenopausal women, supporting the need for further studies in autoimmune rheumatic diseases, including childhood adverse events, life event trajectories, and modifying psychosocial and socioeconomic factors.
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Affiliation(s)
- Christine G. Parks
- National Institute of Environmental Health Sciences, National Institute of Health, Research Triangle Park, NC
| | - Mary Pettinger
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA
| | - Anneclaire J. de Roos
- Department of Environmental & Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, PA
| | - Hilary A. Tindle
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN
- Geriatric Research Education and Clinical Centers, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN
| | - Brian T. Walitt
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD
| | - Barbara V. Howard
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA; MedStar Health Research Institute, Hyattsville, MD, USA
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25
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Kılıççıoğlu A, Oncel D, Celebi ARC. Autoimmune Disease-Related Dry Eye Diseases and Their Placement Under the Revised Classification Systems: An Update. Cureus 2023; 15:e50276. [PMID: 38196419 PMCID: PMC10775916 DOI: 10.7759/cureus.50276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2023] [Indexed: 01/11/2024] Open
Abstract
Dry eye disease (DED) is a chronic and progressive disorder involving the ocular surface, characterized by disturbances in tear film composition, instability of the tear film, and inflammation of the ocular surface. There are two forms of DED: aqueous-deficient dry eye (ADDE) and evaporative dry eye (EDE). Autoimmune diseases are systemic disorders involving multiple organs, including the eyes, and have a significant impact on DED. There have been multiple studies demonstrating the relation between autoimmune diseases and DED. This article reviews the current knowledge regarding the epidemiological characteristics, pathogenesis, and treatments of autoimmune disease-related DED.
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Affiliation(s)
- Alara Kılıççıoğlu
- Neurology, Szeged University, Szeged, HUN
- Ophthalmology, Acibadem University, Istanbul, TUR
| | - Deniz Oncel
- Ophthalmology, Stritch School of Medicine, Loyola University Chicago, Chicago, USA
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26
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Dar E, Mobashar A, Shabbir A, Mushtaq MN, Anjum I, Z. Gaafar AR, Nafidi HA, Bourhia M. Mechanistic Evaluation of Antiarthritic Effects of Citronellol in CFA-Induced Arthritic Rats. ACS OMEGA 2023; 8:44955-44963. [PMID: 38046326 PMCID: PMC10688163 DOI: 10.1021/acsomega.3c06374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 12/05/2023]
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease characterized by systemic inflammation, joint tissue damage, pain, and synovitis. It leads to deformity of joints, disability, and even premature death. Markers of inflammation are highly expressed in synovium fluid and serum of arthritic patients and play an important role in the pathophysiology of RA. These transcription factors promote the fabrication of type I interferons and inflammatory cytokines. In RA, degradation of synovial cartilage and bone results from stimulation of proinflammatory cytokines. Citronellol (Ct), a monoterpene alcohol, is found in citrus fruits and essential oils of many aromatic plants. It possesses numerous pharmacological properties such as antioxidant activity and potential antinociceptive and anti-inflammatory effects. Keeping in view the significant anti-inflammatory role of Ct, a trial of 28 days was conducted. Ct was administered orally at three different doses (25, 50, and 100) mg/kg in Freund's adjuvant-induced arthritic rats, and the results were compared with piroxicam, chosen as the standard drug. The antiarthritic activity of the compound was evaluated through measurements of arthritic scoring and plethysmometry before and after treatment. The blood biochemical and hematological parameters and histopathological analyses were performed. Additionally, qPCR was conducted to analyze the mRNA expression levels of TNF-α, IL-1β, NF-κB, MMP3, IL-6, and IL-4 in the blood. ELISA was performed to evaluate the levels of PGE2. The results demonstrated that Ct showed significant results at all doses, but the highest dose proved to be most significant in terms of decreasing arthritic scoring and paw edema, indicating the antiarthritic potential of Ct. Furthermore, the compound was found to downregulate all the proinflammatory cytokines (TNF-α, IL-1β, NF-κB, MMP3, and IL-6) and upregulate the anti-inflammatory cytokine (IL-4). The levels of PGE2 were also reduced which further supported the antiarthritic effects of Ct and validated it as a potential antiarthritic candidate.
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Affiliation(s)
- Eshwa Dar
- Department
of Pharmacology, Faculty of Pharmacy, The
University of Lahore, Lahore 55150, Pakistan
| | - Aisha Mobashar
- Department
of Pharmacology, Faculty of Pharmacy, The
University of Lahore, Lahore 55150, Pakistan
| | - Arham Shabbir
- Department
of Pharmacology, Institute of Pharmacy, Faculty of Pharmaceutical
and Allied Health Sciences, Lahore College
for Women University, Jail Road, 54000 Lahore, Pakistan
| | - Muhammad Naveed Mushtaq
- Department
of Pharmacology, Faculty of Pharmacy, The
University of Lahore, Lahore 55150, Pakistan
| | - Irfan Anjum
- Department
of Basic Medical Sciences, Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University, Islamabad 44000, Pakistan
| | - Abdel-Rhman Z. Gaafar
- Department
of Botany and Microbiology, College of Science, King Saud University, P.O. Box 11451, Riyadh 11451, Saudi Arabia
| | - Hiba-Allah Nafidi
- Department
of Food Science, Faculty of Agricultural and Food Sciences, Laval University, 2325, Quebec City, Quebec G1 V 0A6, Canada
| | - Mohammed Bourhia
- Department
of Chemistry and Biochemistry, Faculty of Medicine and Pharmacy, Ibn Zohr University, Laayoune 70000, Morocco
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27
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Xu M, Fang L, Xue Q, Zhang X, He Y. The Nrf2 Pathway Alleviates Overloading Force-Induced TMJ Degeneration by Downregulating Oxidative Stress Reactions. J Inflamm Res 2023; 16:5601-5612. [PMID: 38046402 PMCID: PMC10691432 DOI: 10.2147/jir.s434799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/10/2023] [Indexed: 12/05/2023] Open
Abstract
Objective Oxidative stress is involved in the mechanisms associated with temporomandibular joint (TMJ) diseases. Nuclear factor erythroid 2-related factor 2 (Nrf2) is a crucial oxidative stress marker, but the specific mechanisms of its regulation in the early stages of mandibular condylar cartilage (MCC) degeneration remain unclear. This study aimed to explore the regulatory role of Nrf2 and its related oxidative stress signaling pathway in the early stage of MCC degeneration. Materials and Methods Overloading force-induced MCC degeneration was performed in wild-type and Nrf2 knockout mice, as well as in mice after treatment with the Nrf2 activator cardamonin. Changes in MCC degeneration and the expression of oxidative stress markers in the corresponding situations were observed. Results Nrf2 and NADPH oxidase 2 (NOX2) expression were elevated during early MCC degeneration induced by an overloading force. MCC degeneration was aggravated when Nrf2 was knocked out, accompanied by increased NOX2 and superoxide dismutase 2 (SOD2) expression. The MCC degeneration process was alleviated after cardamonin treatment, with activation of the Nrf2 pathway and decreased NOX2 and SOD2 expression. Conclusion Early MCC degeneration is accompanied by mild oxidative stress progression. Activated Nrf2 and related pathways could alleviate the degeneration of MCC.
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Affiliation(s)
- Minglu Xu
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Chongqing Key Laboratory of Oral Disease and Biomedical Sciences, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Lingli Fang
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Chongqing Key Laboratory of Oral Disease and Biomedical Sciences, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qin Xue
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Chongqing Key Laboratory of Oral Disease and Biomedical Sciences, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xuyang Zhang
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Chongqing Key Laboratory of Oral Disease and Biomedical Sciences, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yao He
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
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28
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Akgul A, Freguia CF, Maddaloni M, Hoffman C, Voigt A, Nguyen CQ, Fanger NA, Fanger GR, Pascual DW. Treatment with a Lactococcus lactis that chromosomally express E. coli cfaI mitigates salivary flow loss in a Sjögren's syndrome-like disease. Sci Rep 2023; 13:19489. [PMID: 37945636 PMCID: PMC10636062 DOI: 10.1038/s41598-023-46557-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023] Open
Abstract
Sjögren's Syndrome (SjS) results in loss of salivary and lacrimal gland excretion due to an autoimmune attack on these secretory glands. Conventional SjS treatments address the symptoms, but not the cause of disease. Recognizing this deficit of treatments to reverse SjS disease, studies were pursued using the fimbriae from enterotoxigenic E. coli, colonization factor antigen I (CFA/I), which has anti-inflammatory properties. To determine if CFA/I fimbriae could attenuate SjS-like disease in C57BL/6.NOD-Aec1Aec2 (SjS) females, the Lactococcus lactis (LL) 301 strain was developed to chromosomally express the cfaI operon. Western blot analysis confirmed CFA/I protein expression, and this was tested in SjS females at different stages of disease. Repeated dosing with LL 301 proved effective in mitigating salivary flow loss and in reducing anti-nuclear antibodies (ANA) and inflammation in the submandibular glands (SMGs) in SjS females and in restoring salivary flow in diseased mice. LL 301 treatment reduced proinflammatory cytokine production with concomitant increases in TGF-β+ CD25+ CD4+ T cells. Moreover, LL 301 treatment reduced draining lymph and SMG follicular T helper (Tfh) cell levels and proinflammatory cytokines, IFN-γ, IL-6, IL-17, and IL-21. Such evidence points to the therapeutic capacity of CFA/I protein to suppress SjS disease and to have restorative properties in combating autoimmune disease.
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Affiliation(s)
- Ali Akgul
- Department of Infectious Diseases and Immunology, University of Florida, Gainesville, FL, USA
| | | | - Massimo Maddaloni
- Department of Infectious Diseases and Immunology, University of Florida, Gainesville, FL, USA
| | - Carol Hoffman
- Department of Infectious Diseases and Immunology, University of Florida, Gainesville, FL, USA
| | - Alexandria Voigt
- Department of Infectious Diseases and Immunology, University of Florida, Gainesville, FL, USA
| | - Cuong Q Nguyen
- Department of Infectious Diseases and Immunology, University of Florida, Gainesville, FL, USA
| | | | | | - David W Pascual
- Department of Infectious Diseases and Immunology, University of Florida, Gainesville, FL, USA.
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29
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Jin Y, Liu J, Desai RJ, Kim SC. Real-World Treatment Effectiveness of Disease-Modifying Antirheumatic Drugs by Serostatus Among Patients With Rheumatoid Arthritis. ACR Open Rheumatol 2023; 5:571-580. [PMID: 37775970 PMCID: PMC10642251 DOI: 10.1002/acr2.11548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/29/2023] [Accepted: 03/29/2023] [Indexed: 10/01/2023] Open
Abstract
OBJECTIVE The objective of this study was to compare the clinical effectiveness of biologic disease-modifying antirheumatic drugs (bDMARDs) or Janus kinase inhibitors (JAKi) among seropositive versus seronegative patients with rheumatoid arthritis (RA) in a real-world setting. METHODS We used Optum's deidentified Clinformatics Data Mart Database (January 1, 2004, to March 31, 2021) linked with outpatient laboratory test results. The study population was adult patients with RA who initiated a bDMARD or JAKi. The index date was the dispensing of the first-ever study drug. At least 1-year continuous enrollment before and after the index date was required. Disenrollment due to death after the index date was allowed. Serostatus was defined using laboratory test results or the International Classification of Diseases, 10th Revision code M05x or M06.0x any time prior to the index date. Treatment effectiveness was measured based on a claims-based composite endpoint at 1-year post index, including nonoccurrence of any of the following: addition of conventional synthetic DMARDs, addition of or switching to new bDMARDs/JAKi, initiation of glucocorticoids, increased glucocorticoid dose, or death. Log-binomial regression models were constructed to estimate the risk ratio (RR) with 95% confidence interval (CI) comparing seropositive patients with seronegative patients, adjusting for more than 60 baseline covariates. RESULTS We identified a total of 7813 seropositive patients and 4202 seronegative patients. The mean (±SD) age was 56.7 (±14.0) years; 77.9% were female. The risk of 1-year treatment effectiveness was 70.2% among seropositive patients and 69.8% among seronegative patients. The adjusted RR (95% CI) was 1.00 (0.98-1.02). CONCLUSION In this real-world cohort study, seropositive and seronegative patients with RA had similar 1-year treatment effectiveness after initiating a bDMARD/JAKi.
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Affiliation(s)
- Yinzhu Jin
- Brigham and Women's Hospital and Harvard Medical SchoolBostonMassachusetts
| | - Jun Liu
- Brigham and Women's Hospital and Harvard Medical SchoolBostonMassachusetts
| | - Rishi J. Desai
- Brigham and Women's Hospital and Harvard Medical SchoolBostonMassachusetts
| | - Seoyoung C. Kim
- Brigham and Women's Hospital and Harvard Medical SchoolBostonMassachusetts
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Asante K, Racsa P, Bloomfield A, Cornett D, Schwab P. Comparison of a second TNFi vs other biologic or targeted synthetic DMARD following an initial TNFi. J Manag Care Spec Pharm 2023; 29:1109-1118. [PMID: 37776118 PMCID: PMC10541628 DOI: 10.18553/jmcp.2023.29.10.1109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
BACKGROUND: Patients with rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, or ulcerative colitis may require treatment with a biologic or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD). Often, a tumor necrosis factor inhibitor (TNFi) is the initial b/tsDMARD. The TNFi may not be effective or may not be well tolerated, so patients will opt for a different TNFi or switch to a non-TNFi b/tsDMARD. No preference for a TNFi or non-TNFi has been established and guidelines are unclear. OBJECTIVE: To evaluate effectiveness by comparing patients using a second TNFi vs a non-TNFi after initial use of TNFi based on treatment patterns and health care utilization. METHODS: This retrospective analysis used Medicare Advantage prescription drug (MAPD) plan, Medicaid, and commercial plan claims data from Humana's Research Database (Louisville, KY). The first claim for TNFi or non-TNFi (July 1, 2016, to June 30, 2018) following earlier TNFi was the index date. Patients were required to have pre-index enrollment of 6 months and 12 months post-index along with diagnosis of rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, or psoriasis. During the 12-month follow-up, persistence to the index TNFi or non-TNFi was measured as continued therapy without a gap exceeding 45 days (81 days for intravenous infusions). Adherence was proportion of days covered at least 0.8. Addition of a nonbiologic DMARD or corticosteroid was also identified. Inpatient admissions and emergency department visits were observed. Inverse probability of treatment weights was used to balance cohorts. Logistic regression models were fit to TNFi vs non-TNFI on treatment and utilization measures. RESULTS: Of identified patients, 1,022 were indexed to a second TNFi and 1,024 were indexed to non-TNFi. Weighted cohorts were balanced, with mean age 56.5 vs 56.4 years, 70.5% vs 70.7% female sex, and 68.0% vs 67.9% MAPD plan. No differences were observed on persistence or adherence, with adjusted odds ratios (OR) of 1.05 (95% CI = 0.91-1.20) and 1.04 (0.91-1.20), respectively. No differences were observed for changes in therapy via switching to another TNFi/non-TNFi (OR = 0.93; 95% CI = 0.54-1.62), via nonbiologic DMARD addition (OR = 0.95; 95% CI = 0.83-1.11), or corticosteroid addition (OR = 1.09; 95% CI = 0.92-1.88). No differences were observed for hospitalization (OR = 1.16; 95% CI = 0.99-1.37) or emergency department visits (OR = 1.02; 95% CI = 0.89-1.18). CONCLUSIONS: No differences were found between a second TNFi vs a non-TNFi. As a result, choice of TNFi or non-TNFi following an initial TNFi may be driven by relevant patient-specific considerations. At the population level, policies that prefer either TNFi or non-TNFi appear reasonable. DISCLOSURES: The study was funded by Humana Inc. Mr Racsa is an employee of Humana Healthcare Research, Inc., a subsidiary of Humana Inc. Drs Asante and Bloomfield are employees of Humana Inc. Dr Schwab was an employee of Humana Healthcare Research, Inc., a subsidiary of Humana Inc., and is now an employee of RTI Health Solutions. Dr Cornett was an employee of Humana Inc. and is now an employee of ImmunoGen Inc.
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Affiliation(s)
- Kori Asante
- Humana Pharmacy Solutions, Humana, Louisville, KY
| | | | | | | | - Phil Schwab
- Humana Healthcare Research, Humana, Louisville, KY
- RTI Health Solutions, Research Triangle Park, NC
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Trier NH, Houen G. Antibody Cross-Reactivity in Auto-Immune Diseases. Int J Mol Sci 2023; 24:13609. [PMID: 37686415 PMCID: PMC10487534 DOI: 10.3390/ijms241713609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Autoimmunity is defined by the presence of antibodies and/or T cells directed against self-components. Although of unknown etiology, autoimmunity commonly is associated with environmental factors such as infections, which have been reported to increase the risk of developing autoimmune diseases. Occasionally, similarities between infectious non-self and self-tissue antigens may contribute to immunological cross-reactivity in autoimmune diseases. These reactions may be interpreted as molecular mimicry, which describes cross-reactivity between foreign pathogens and self-antigens that have been reported to cause tissue damage and to contribute to the development of autoimmunity. By focusing on the nature of antibodies, cross-reactivity in general, and antibody-antigen interactions, this review aims to characterize the nature of potential cross-reactive immune reactions between infectious non-self and self-tissue antigens which may be associated with autoimmunity but may not actually be the cause of disease onset.
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Affiliation(s)
- Nicole Hartwig Trier
- Department of Neurology, Rigshospitalet Glostrup, Valdemar Hansens Vej 1-23, 2600 Glostrup, Denmark
| | - Gunnar Houen
- Department of Neurology, Rigshospitalet Glostrup, Valdemar Hansens Vej 1-23, 2600 Glostrup, Denmark
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
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Abughazaleh N, Boldt K, Rios JL, Mattiello SM, Collins KH, Seerattan RA, Herzog W. Aerobic and Resistance Training Attenuate Differently Knee Joint Damage Caused by a High-Fat-High-Sucrose Diet in a Rat Model. Cartilage 2023:19476035231193090. [PMID: 37655800 DOI: 10.1177/19476035231193090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVE Obesity and associated low-level local systemic inflammation have been linked to an increased rate of developing knee osteoarthritis (OA). Aerobic exercise has been shown to protect the knee from obesity-induced joint damage. The aims of this study were to determine (1) if resistance training provides beneficial metabolic effects similar to those previously observed with aerobic training in rats consuming a high-fat/high-sucrose (HFS) diet and (2) if these metabolic effects mitigate knee OA in a diet-induced obesity model in rats. DESIGN Twelve-week-old Sprague-Dawley rats were randomized into 4 groups: (1) a group fed an HFS diet subjected to aerobic exercise (HFS+Aer), (2) a group fed an HFS diet subjected to resistance exercise (HFS+Res), (3) a group fed an HFS diet with no exercise (HFS+Sed), and (4) a chow-fed sedentary control group (Chow+Sed). HFS+Sed animals were heavier and had greater body fat, higher levels of triglycerides and total cholesterol, and more joint damage than Chow+Sed animals. RESULTS The HFS+Res group had higher body mass and body fat than Chow+Sed animals and higher OA scores than animals from the HFS+Aer group. Severe bone lesions were observed in the HFS+Sed and Chow+Sed animals at age 24 weeks, but not in the HFS+Res and HFS+Aer group animals. CONCLOSION In summary, aerobic training provided better protection against knee joint OA than resistance training in this rat model of HFS-diet-induced obesity. Exposing rats to exercise, either aerobic or resistance training, had a protective effect against the severe bone lesions observed in the nonexercised rats.
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Affiliation(s)
- Nada Abughazaleh
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Department of Biomedical Engineering, University of Calgary, Calgary, AB, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
| | - Kevin Boldt
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Jaqueline Lourdes Rios
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
- Regenerative Medicine Center Utrecht, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Kelsey H Collins
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Ruth-Anne Seerattan
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Walter Herzog
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Department of Biomedical Engineering, University of Calgary, Calgary, AB, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
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VanSchaik JT, Jain P, Rajapuri A, Cheriyan B, Thyvalikakath TP, Chakraborty S. Using transfer learning-based causality extraction to mine latent factors for Sjögren's syndrome from biomedical literature. Heliyon 2023; 9:e19265. [PMID: 37809371 PMCID: PMC10558331 DOI: 10.1016/j.heliyon.2023.e19265] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 10/10/2023] Open
Abstract
Understanding causality is a longstanding goal across many different domains. Different articles, such as those published in medical journals, disseminate newly discovered knowledge that is often causal. In this paper, we use this intuition to build a model that leverages causal relations to unearth factors related to Sjögren's syndrome from biomedical literature. Sjögren's syndrome is an autoimmune disease affecting up to 3.1 million Americans. Due to the uncommon nature of the illness, symptoms across different specialties coupled with common symptoms of other autoimmune conditions such as rheumatoid arthritis, it is difficult for clinicians to diagnose the disease timely. Due to the lack of a dedicated dataset for causal relationships built from biomedical literature, we propose a transfer learning-based approach, where the relationship extraction model is trained on a wide variety of datasets. We conduct an empirical analysis of numerous neural network architectures and data transfer strategies for causal relation extraction. By conducting experiments with various contextual embedding layers and architectural components, we show that an ELECTRA-based sentence-level relation extraction model generalizes better than other architectures across varying web-based sources and annotation strategies. We use this empirical observation to create a pipeline for identifying causal sentences from literature text, extracting the causal relationships from causal sentences, and building a causal network consisting of latent factors related to Sjögren's syndrome. We show that our approach can retrieve such factors with high precision and recall values. Comparative experiments show that this approach leads to 25% improvement in retrieval F1-score compared to several state-of-the-art biomedical models, including BioBERT and Gram-CNN. We apply this model to a corpus of research articles related to Sjögren's syndrome collected from PubMed to create a causal network for Sjögren's syndrome. The proposed causal network for Sjögren's syndrome will potentially help clinicians with a holistic knowledge base for faster diagnosis.
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Affiliation(s)
- Jack T. VanSchaik
- Luddy School of Informatics, Computing, and Engineering, Indiana University Indianapolis, Indianapolis, 46202, IN, USA
| | - Palak Jain
- Luddy School of Informatics, Computing, and Engineering, Indiana University Indianapolis, Indianapolis, 46202, IN, USA
| | - Anushri Rajapuri
- Indiana University School of Dentistry, Indianapolis, 46202, IN, USA
| | - Biju Cheriyan
- Luddy School of Informatics, Computing, and Engineering, Indiana University Indianapolis, Indianapolis, 46202, IN, USA
| | - Thankam P. Thyvalikakath
- Luddy School of Informatics, Computing, and Engineering, Indiana University Indianapolis, Indianapolis, 46202, IN, USA
- Indiana University School of Dentistry, Indianapolis, 46202, IN, USA
- Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, 46202, IN, USA
| | - Sunandan Chakraborty
- Luddy School of Informatics, Computing, and Engineering, Indiana University Indianapolis, Indianapolis, 46202, IN, USA
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Bryant MJ, Munt R, Black RJ, Reynolds A, Hill CL. Joining forces to understand what matters most: qualitative insights into the patient experience of outpatient rheumatology care. Rheumatol Adv Pract 2023; 7:rkad068. [PMID: 37724315 PMCID: PMC10505502 DOI: 10.1093/rap/rkad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/10/2023] [Indexed: 09/20/2023] Open
Abstract
Objective People with rheumatic diseases are frequent, long-term attenders of health-care services. Their care experiences are central to improving services. The aim of this study was to explore real-world experiences and priorities of people attending outpatient rheumatology care and those of health-care professionals (HCPs) providing care. Methods This qualitative study consisted of five semi-structured focus groups. Participants included rheumatology outpatients (n = 16) of two tertiary teaching hospitals and HCPs (n = 14; rheumatologists, rheumatology trainees, physiotherapists, a specialty nurse and a pharmacist). Participants explored priorities when attending outpatient services, real experiences and aspirations for improving future care. Transcripts were coded using inductive and deductive thematic analysis. Results Seven key themes were identified: smooth flow of technical processes, care coordination, individualized care, information sharing, clinical excellence, patient empowerment and comprehensive care. The findings were aligned conceptually with quality standards in Australia and worldwide. Different sub-themes and prioritization of concerns emerged from patient and HCP subgroups. Highly prioritized themes for patients pertained to processes and technical aspects of care. HCPs focused on themes relating to non-technical aspects of service provision: information sharing, individualization of care, patient advocacy and empowerment. Conclusion This study captured valuable insights into the current experience of outpatient rheumatology care from the perspective of patients and HCPs. It informs a collective understanding of differing and shared priorities, positives of current care and areas requiring change. Themes derived from the study data can be conceptualized in terms of the process, content and impact of care. Such domains can be measured longitudinally by routine implementation of validated patient-reported experience measures in rheumatology.
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Affiliation(s)
- Madeleine J Bryant
- Rheumatology Unit, The Queen Elizabeth Hospital, Central Adelaide Local Health Network,, Woodville South, SA, Australia
- Rheumatology Unit, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA, Australia
- School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Rebecca Munt
- Nursing Education, Central Adelaide Local Health Network, Adelaide, SA, Australia
- Adelaide Nursing School, Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Rachel J Black
- Rheumatology Unit, The Queen Elizabeth Hospital, Central Adelaide Local Health Network,, Woodville South, SA, Australia
- Rheumatology Unit, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA, Australia
- School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Amy Reynolds
- Patient Research Partner
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, Bedford Park, SA, Australia
| | - Catherine L Hill
- Rheumatology Unit, The Queen Elizabeth Hospital, Central Adelaide Local Health Network,, Woodville South, SA, Australia
- Rheumatology Unit, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA, Australia
- School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia
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Wei J, Baptista-Hon DT, Wang Z, Li G, Herrler T, Dai C, Liu K, Yu B, Chen X, Yang M, Han D, Gao Y, Huang RL, Guo L, Zhang K, Li Q. Bioengineered human tissue regeneration and repair using endogenous stem cells. Cell Rep Med 2023; 4:101156. [PMID: 37586324 PMCID: PMC10439273 DOI: 10.1016/j.xcrm.2023.101156] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 04/30/2023] [Accepted: 07/19/2023] [Indexed: 08/18/2023]
Abstract
We describe a general approach to produce bone and cartilaginous structures utilizing the self-regenerative capacity of the intercostal rib space to treat a deformed metacarpophalangeal joint and microtia. Anatomically precise 3D molds were positioned on the perichondro-periosteal or perichondral flap of the intercostal rib without any other exogenous elements. We find anatomically precise metacarpal head and auricle constructs within the implanted molds after 6 months. The regenerated metacarpal head was used successfully to surgically repair the deformed metacarpophalangeal joint. Auricle reconstructive surgery in five unilateral microtia patients yielded good aesthetic and functional results. Long-term follow-up revealed the auricle constructs were safe and stable. Single-cell RNA sequencing analysis reveal early infiltration of a cell population consistent with mesenchymal stem cells, followed by IL-8-stimulated differentiation into chondrocytes. Our results demonstrate the repair and regeneration of tissues using only endogenous factors and a viable treatment strategy for bone and tissue structural defects.
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Affiliation(s)
- Jiao Wei
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Daniel T Baptista-Hon
- University Hospital and Center for Biomedicine and Innovations, Faculty of Medicine, Macau University of Science and Technology, Taipa 999078, Macau, China; Zhuhai International Eye Center, Zhuhai People's Hospital and the First Affiliated Hospital of Faculty of Medicine, Macau University of Technology, Zhuhai, Guangdong, China; Department of Bioinformatics and AI, Guangzhou Laboratory, Guangzhou, China; School of Medicine, University of Dundee, Dundee, UK
| | - Zi Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Gen Li
- Department of Bioinformatics and AI, Guangzhou Laboratory, Guangzhou, China; Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Tanja Herrler
- Department of Hand Surgery, Trauma Center Murnau, 82418 Murnau, Germany
| | - Chuanchang Dai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Kai Liu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Baofu Yu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Xiaoxue Chen
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Mei Yang
- Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Dong Han
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Yuanxu Gao
- University Hospital and Center for Biomedicine and Innovations, Faculty of Medicine, Macau University of Science and Technology, Taipa 999078, Macau, China
| | - Ru-Lin Huang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Lifei Guo
- Division of Plastic Surgery, Lahey Hospital and Medical Center, Burlington, VT 01808, USA.
| | - Kang Zhang
- University Hospital and Center for Biomedicine and Innovations, Faculty of Medicine, Macau University of Science and Technology, Taipa 999078, Macau, China; Zhuhai International Eye Center, Zhuhai People's Hospital and the First Affiliated Hospital of Faculty of Medicine, Macau University of Technology, Zhuhai, Guangdong, China; Department of Bioinformatics and AI, Guangzhou Laboratory, Guangzhou, China.
| | - Qingfeng Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
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Iqbal M, Khan QA, Belay NF, Azeem M, Amatul‐Hadi F, Afzal M, Pande H, Shah SY, Ahmed R, Iram S, Verma R. A case report of hypokalemic periodic muscular weakness secondary to Sjögren's syndrome with distal renal tubular acidosis. Clin Case Rep 2023; 11:e7769. [PMID: 37575466 PMCID: PMC10421972 DOI: 10.1002/ccr3.7769] [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: 05/03/2023] [Revised: 06/14/2023] [Accepted: 07/25/2023] [Indexed: 08/15/2023] Open
Abstract
Key Clinical Message An underlying autoimmune condition should be suspected in patients who presented with periodic muscular weakness secondary to distal RTA that leads to hypokalemia because distal RTA is commonly associated with autoimmune disorders such as Sjögren's syndrome. Abstract A 22-year-old female presented with a sudden onset of bilateral weakness in both upper and lower limbs. The patient had a history of muscular weakness secondary to hypokalemia and dryness of the eyes for the last 3 years. Laboratory investigations revealed decreased potassium and metabolic acidosis. Further investigations confirmed distal renal tubular acidosis (RTA) and Sjögren's syndrome. A diagnosis of distal RTA secondary to Sjögren's syndrome was made. Her potassium levels were replaced, and she was discharged with oral potassium supplements, steroids, and artificial tears.
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Abstract
The spondyloarthritides are a diverse group of distinct yet interrelated disease processes with overlapping clinical features. They are ankylosing spondylitis, reactive arthritis, inflammatory bowel disease-associated arthritis, and psoriatic arthritis. Genetically, these disease processes have been linked by the presence of HLA-B27. They manifest with axial and peripheral symptoms, such as inflammatory back pain, enthesitis, oligoarthritis, and dactylitis. The onset of symptoms can begin before the age of 45; however, because of the wide range of signs and symptoms, diagnosis can be delayed, leading to unchecked inflammation, structural damage, and later, restriction in physical mobility.
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Affiliation(s)
- Hope A Taitt
- Department of Emergency Medicine, Kings County Hospital, SUNY Downstate Medical Center, Kings County Hospital Center, Room CG65, 451 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Rithvik Balakrishnan
- Department of Emergency Medicine, Kings County Hospital, SUNY Downstate Medical Center, Kings County Hospital Center, Room CG65, 451 Clarkson Avenue, Brooklyn, NY 11203, USA.
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Felix Gomez GG, Hugenberg ST, Zunt S, Patel JS, Wang M, Rajapuri AS, Lembcke LR, Rajendran D, Smith JC, Cheriyan B, Boyd LJ, Eckert GJ, Grannis SJ, Srinivasan M, Zero DT, Thyvalikakath TP. Characterizing clinical findings of Sjögren's Disease patients in community practices using matched electronic dental-health record data. PLoS One 2023; 18:e0289335. [PMID: 37523369 PMCID: PMC10389720 DOI: 10.1371/journal.pone.0289335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 07/17/2023] [Indexed: 08/02/2023] Open
Abstract
Established classifications exist to confirm Sjögren's Disease (SD) (previously referred as Sjögren's Syndrome) and recruit patients for research. However, no established classification exists for diagnosis in clinical settings causing delayed diagnosis. SD patients experience a huge dental disease burden impairing their quality of life. This study established criteria to characterize Indiana University School of Dentistry (IUSD) patients' SD based on symptoms and signs in the electronic health record (EHR) data available through the state-wide Indiana health information exchange (IHIE). Association between SD diagnosis, and comorbidities including other autoimmune conditions, and documentation of SD diagnosis in electronic dental record (EDR) were also determined. The IUSD patients' EDR were linked with their EHR data in the IHIE and queried for SD diagnostic ICD9/10 codes. The resulting cohorts' EHR clinical findings were characterized and classified using diagnostic criteria based on clinical experts' recommendations. Descriptive statistics were performed, and Chi-square tests determined the association between the different SD presentations and comorbidities including other autoimmune conditions. Eighty-three percent of IUSD patients had an EHR of which 377 patients had a SD diagnosis. They were characterized as positive (24%), uncertain (20%) and negative (56%) based on EHR clinical findings. Dry eyes and mouth were reported for 51% and positive Anti-Ro/SSA antibodies and anti-nuclear antibody (ANA) for 17% of this study cohort. One comorbidity was present in 98% and other autoimmune condition/s were present in 53% respectively. Significant differences were observed between the three SD clinical characteristics/classifications and certain medical and autoimmune conditions (p<0.05). Sixty-nine percent of patients' EDR did not mention SD, highlighting the huge gap in reporting SD during dental care. This study of SD patients diagnosed in community practices characterized three different SD clinical presentations, which can be used to generate SD study cohorts for longitudinal studies using EHR data. The results emphasize the heterogenous SD clinical presentations and the need for further research to diagnose SD early in community practice settings where most people seek care.
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Affiliation(s)
- Grace Gomez Felix Gomez
- Dental Informatics, Department of Cariology, Operative Dentistry & Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, United States of America
- Center for Biomedical Informatics, Regenstrief Institute Inc., Indianapolis, Indiana, United States of America
| | - Steven T. Hugenberg
- Indiana University School of Medicine, Indianapolis, Indiana, United States of America
- Indiana University Health, Indianapolis, Indiana, United States of America
| | - Susan Zunt
- Department of Oral Pathology, Medicine and Radiology, Indiana University School of Dentistry, Indianapolis, Indiana, United States of America
| | - Jay S. Patel
- Dental Informatics, Department of Cariology, Operative Dentistry & Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, United States of America
- Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Mei Wang
- Dental Informatics, Department of Cariology, Operative Dentistry & Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, United States of America
| | - Anushri Singh Rajapuri
- Dental Informatics, Department of Cariology, Operative Dentistry & Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, United States of America
- Center for Biomedical Informatics, Regenstrief Institute Inc., Indianapolis, Indiana, United States of America
| | - Lauren R. Lembcke
- Regenstrief Data Services, Regenstrief Institute Inc, Indianapolis, Indiana, United States of America
| | - Divya Rajendran
- Dental Informatics, Department of Cariology, Operative Dentistry & Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, United States of America
- Innovation Associates iA, Indianapolis, Indiana, United States of America
| | - Jonas C. Smith
- Regenstrief Data Services, Regenstrief Institute Inc, Indianapolis, Indiana, United States of America
- Med Shield, Inc., Indianapolis, Indiana, United States of America
| | - Biju Cheriyan
- Dental Informatics, Department of Cariology, Operative Dentistry & Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, United States of America
| | - LaKeisha J. Boyd
- Department of Biostatistics and Health Data Sciences, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - George J. Eckert
- Department of Biostatistics and Health Data Sciences, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Shaun J. Grannis
- Center for Biomedical Informatics, Regenstrief Institute Inc., Indianapolis, Indiana, United States of America
- Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Mythily Srinivasan
- Department of Oral Pathology, Medicine and Radiology, Indiana University School of Dentistry, Indianapolis, Indiana, United States of America
| | - Domenick T. Zero
- Dental Informatics, Department of Cariology, Operative Dentistry & Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, United States of America
| | - Thankam P. Thyvalikakath
- Dental Informatics, Department of Cariology, Operative Dentistry & Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, United States of America
- Center for Biomedical Informatics, Regenstrief Institute Inc., Indianapolis, Indiana, United States of America
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Lites TD, Foster AL, Boring MA, Fallon EA, Odom EL, Seth P. Arthritis Among Children and Adolescents Aged <18 Years - United States, 2017-2021. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2023; 72:788-792. [PMID: 37471260 PMCID: PMC10360652 DOI: 10.15585/mmwr.mm7229a3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Arthritis affects persons of all ages, including younger adults, adolescents, and children; however, recent arthritis prevalence estimates among children and adolescents aged <18 years are not available. Previous prevalence estimates among U.S. children and adolescents aged <18 years ranged from 21 to 403 per 100,000 population depending upon the case definition used. CDC analyzed aggregated 2017-2021 National Survey of Children's Health data to estimate the national prevalence of parent-reported arthritis diagnosed among children and adolescents aged <18 years. An estimated 220,000 (95% CI = 187,000-260,000) U.S. children and adolescents aged <18 years (305 per 100,000) had diagnosed arthritis. Arthritis prevalence among non-Hispanic Black or African American children and adolescents was twice that of non-Hispanic White children and adolescents. Co-occurring conditions, including depression, anxiety, overweight, physical inactivity, and food insecurity were associated with higher prevalences of arthritis. These findings highlight that children and adolescents should be prioritized for arthritis prevention and treatments by identifying risk factors for arthritis, developing self-management interventions to improve arthritis, physical activity or weight control, and screening and linking to mental health services. Health systems and payors can take steps to ensure equitable access to therapies (e.g., physical therapies and medications).
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Ozdel S, Sönmez HE, Çağlayan Ş, Akgün Ö, Aydın T, Baba Ö, Bağrul İ, Yener GO, Öztürk K, Demir F, Yıldırım DG, Karadağ ŞG, Bağlan E, Çakan M, Kalyoncu M, Makay BB, Ünsal ŞE, Bakkaloğlu S, Bülbül M, Sözeri B, Ayaz NA. How common is remission in rheumatoid factor-positive juvenile idiopathic arthritis patients? The multicenter Pediatric Rheumatology Academy (PeRA) research group experience. Pediatr Rheumatol Online J 2023; 21:72. [PMID: 37475055 PMCID: PMC10360344 DOI: 10.1186/s12969-023-00860-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/17/2023] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVE Rheumatoid factor (RF)-positive polyarthritis is the least common type of juvenile idiopathic arthritis (JIA). Functional disability in RF-positive polyarthritis patients is much more severe than in patients with other subtypes; but data on this subtype alone is limited. This study aimed to analyze clinical features, long-term follow-up, treatment response, and remission status in a large multicenter cohort of RF-positive polyarthritis patients. METHODS This retrospective study included RF-positive polyarthritis patients that were followed up for ≥ 6 months between 2017 and 2022 by the Pediatric Rheumatology Academy (PeRA)-Research Group (RG). Data on patient demographics, clinical and laboratory characteristics were obtained from medical charts. JIA treatments and duration of treatment were also recorded. The patients were divided into 2 groups based on methotrexate (MTX) response, as follows: group 1: MTX responsive, group 2: MTX unresponsive. Clinical and laboratory findings were compared between the 2 groups. RESULTS The study included 56 (45 female and 11 male) patients. The median age at onset of RF-positive polyarthritis was 13.2 years [(interquartile range) (IQR): 9.0-15.0 years] and the median duration of follow-up was 41.5 months (IQR: 19.5-75.7 months). Symmetrical arthritis affecting the metacarpophalangeal and proximal interphalangeal joints of the hands was commonly observed. Subcutaneous MTX was the preferred initial treatment; however, it was ineffective in 39 (69.6%) of the patients. Of 25 patients followed for 24 months, 56% still had active disease at 24 months. CONCLUSION During 2 years of treatment, 44% of RF-positive polyarthritis patients have inactive disease, and they should be considered as a distinct and important clinical entity requiring aggressive and early treatment.
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Affiliation(s)
- Semanur Ozdel
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey.
- Department of Pediatric Rheumatology, Etlik City Hospital, Ankara, Turkey.
| | - Hafize Emine Sönmez
- Department of Pediatric Rheumatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Şengül Çağlayan
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Özlem Akgün
- Department of Pediatric Rheumatology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tuncay Aydın
- Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Özge Baba
- Department of Pediatric Rheumatology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - İlknur Bağrul
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Gülçin Otar Yener
- Department of Pediatric Rheumatology, Medicalpark Hospital, Gaziantep, Turkey
| | - Kübra Öztürk
- Department of Pediatric Rheumatology, Istanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Ferhat Demir
- Department of Pediatric Rheumatology, Acıbadem Healthcare Group, Istanbul, Turkey
| | - Deniz Gezgin Yıldırım
- Department of Pediatric Rheumatology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Şerife Gül Karadağ
- Department of Pediatric Rheumatology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Esra Bağlan
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Mustafa Çakan
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Mukaddes Kalyoncu
- Department of Pediatric Rheumatology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Balahan Bora Makay
- Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Şevket Erbil Ünsal
- Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Sevcan Bakkaloğlu
- Department of Pediatric Rheumatology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Bülbül
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Betül Sözeri
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Nuray Aktay Ayaz
- Department of Pediatric Rheumatology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Zibetti MVW, Menon RG, de Moura HL, Zhang X, Kijowski R, Regatte RR. Updates on Compositional MRI Mapping of the Cartilage: Emerging Techniques and Applications. J Magn Reson Imaging 2023; 58:44-60. [PMID: 37010113 PMCID: PMC10323700 DOI: 10.1002/jmri.28689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/06/2023] [Accepted: 03/06/2023] [Indexed: 04/04/2023] Open
Abstract
Osteoarthritis (OA) is a widely occurring degenerative joint disease that is severely debilitating and causes significant socioeconomic burdens to society. Magnetic resonance imaging (MRI) is the preferred imaging modality for the morphological evaluation of cartilage due to its excellent soft tissue contrast and high spatial resolution. However, its utilization typically involves subjective qualitative assessment of cartilage. Compositional MRI, which refers to the quantitative characterization of cartilage using a variety of MRI methods, can provide important information regarding underlying compositional and ultrastructural changes that occur during early OA. Cartilage compositional MRI could serve as early imaging biomarkers for the objective evaluation of cartilage and help drive diagnostics, disease characterization, and response to novel therapies. This review will summarize current and ongoing state-of-the-art cartilage compositional MRI techniques and highlight emerging methods for cartilage compositional MRI including MR fingerprinting, compressed sensing, multiexponential relaxometry, improved and robust radio-frequency pulse sequences, and deep learning-based acquisition, reconstruction, and segmentation. The review will also briefly discuss the current challenges and future directions for adopting these emerging cartilage compositional MRI techniques for use in clinical practice and translational OA research studies. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Marcelo V. W. Zibetti
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Rajiv G. Menon
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Hector L. de Moura
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Xiaoxia Zhang
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Richard Kijowski
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Ravinder R. Regatte
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
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Fu Y, Batushansky A, Kinter M, Huebner JL, Kraus VB, Griffin TM. Effects of Leptin and Body Weight on Inflammation and Knee Osteoarthritis Phenotypes in Female Rats. JBMR Plus 2023; 7:e10754. [PMID: 37457883 PMCID: PMC10339097 DOI: 10.1002/jbm4.10754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/22/2023] [Accepted: 04/13/2023] [Indexed: 07/18/2023] Open
Abstract
Leptin is a proinflammatory adipokine that contributes to obesity-associated osteoarthritis (OA), especially in women. However, the extent to which leptin causes knee OA separate from the effect of increased body weight is not clear. We hypothesized that leptin is necessary to induce knee OA in obese female rats but not sufficient to induce knee OA in lean rats lacking systemic metabolic inflammation. The effect of obesity without leptin signaling was modeled by comparing female lean Zucker rats to pair fed obese Zucker rats, which possess mutant fa alleles of the leptin receptor gene. The effect of leptin without obesity was modeled in female F344BN F1 hybrid rats by systemically administering recombinant rat leptin versus saline for 23 weeks via osmotic pumps. Primary OA outcomes included cartilage histopathology and subchondral bone micro-computed tomography. Secondary outcomes included targeted cartilage proteomics, serum inflammation, and synovial fluid inflammation following an acute intra-articular challenge with interleukin-1β (IL-1β). Compared to lean Zucker rats, obese Zucker rats developed more severe tibial osteophytes and focal cartilage lesions in the medial tibial plateau, with modest changes in proximal tibial epiphysis trabecular bone structure. In contrast, exogenous leptin treatment, which increased plasma leptin sixfold without altering body weight, caused mild generalized cartilage fibrillation and reduced Safranin O staining compared to vehicle-treated animals. Leptin also significantly increased subchondral and trabecular bone volume and bone mineral density in the proximal tibia. Cartilage metabolic and antioxidant enzyme protein levels were substantially elevated with leptin deficiency and minimally suppressed with leptin treatment. In contrast, leptin treatment induced greater changes in systemic and local inflammatory mediators compared to leptin receptor deficiency, including reduced serum IL-6 and increased synovial fluid IL-1β. In conclusion, rat models that separately elevate leptin or body weight develop distinct OA-associated phenotypes, revealing how obesity increases OA pathology through both leptin-dependent and independent pathways. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Yao Fu
- Aging and Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOklahomaUSA
| | - Albert Batushansky
- Aging and Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOklahomaUSA
| | - Michael Kinter
- Aging and Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOklahomaUSA
- Oklahoma Center for GeroscienceUniversity of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
| | - Janet L. Huebner
- Duke Molecular Physiology InstituteDuke University, School of Medicine, Duke UniversityDurhamNorth CarolinaUSA
| | - Virginia B. Kraus
- Duke Molecular Physiology InstituteDuke University, School of Medicine, Duke UniversityDurhamNorth CarolinaUSA
- Division of Rheumatology, Department of MedicineDuke University, School of Medicine, Duke UniversityDurhamNorth CarolinaUSA
| | - Timothy M. Griffin
- Aging and Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOklahomaUSA
- Oklahoma Center for GeroscienceUniversity of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
- Department of Biochemistry and Molecular BiologyUniversity of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
- Veterans Affairs Medical CenterOklahoma CityOklahomaUSA
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Nowell WB, Venkatachalam S, Gavigan K, George MD, Withers JB, Stradford L, Rivera E, Curtis JR. Patient Perceptions of Rheumatoid Arthritis Blood Work: A Cross-Sectional Survey in the ArthritisPower Registry. Arthritis Care Res (Hoboken) 2023. [PMID: 37386276 DOI: 10.1002/acr.25187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/14/2023] [Accepted: 06/27/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE To examine how patients with rheumatoid arthritis (RA) perceive RA-related laboratory testing and the potential utility of a blood test to predict treatment response to a new RA medication. METHODS ArthritisPower members with RA were invited to participate in a cross-sectional survey on reasons for laboratory testing plus a choice-based conjoint analysis exercise to determine how patients value different attributes of a biomarker-based test to predict treatment response. RESULTS Most patients perceived that their doctors ordered laboratory tests to check for active inflammation (85.9%) or assess medication side effects (81.2%). The most commonly ordered blood tests used to monitor RA were complete blood counts, liver function tests, and those measuring C-reactive protein (CRP) and erythrocyte sedimentation rate. Patients felt CRP was most helpful in understanding their disease activity. Most worried their current RA medication would eventually stop working (91.4%) and they would waste time trying a new RA medication that may not work for them (81.7%). For patients who would require a future change in RA treatment, a majority (89.2%) reported that they would be very/extremely interested in a blood test that could help predict whether such new medication would be effective. Highly accurate test results (improving the chance RA medication will work from 50% to 85-95%) were more important to patients than low out-of-pocket cost (<$20) or minimal wait time (<7 days). CONCLUSIONS Patients consider RA-related blood work important for monitoring of inflammation and medication side effects. They worry about treatment effectiveness and would undergo testing to accurately predict treatment response.
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Affiliation(s)
| | | | - Kelly Gavigan
- Global Healthy Living Foundation, Upper Nyack, New York
| | | | | | | | | | - Jeffrey R Curtis
- University of Alabama at Birmingham and the Foundation for Advancing Science, Technology, Education and Research, Birmingham
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Alcaide-Ruggiero L, Cugat R, Domínguez JM. Proteoglycans in Articular Cartilage and Their Contribution to Chondral Injury and Repair Mechanisms. Int J Mol Sci 2023; 24:10824. [PMID: 37446002 DOI: 10.3390/ijms241310824] [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: 05/31/2023] [Revised: 06/17/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
Proteoglycans are vital components of the extracellular matrix in articular cartilage, providing biomechanical properties crucial for its proper functioning. They are key players in chondral diseases, specifically in the degradation of the extracellular matrix. Evaluating proteoglycan molecules can serve as a biomarker for joint degradation in osteoarthritis patients, as well as assessing the quality of repaired tissue following different treatment strategies for chondral injuries. Despite ongoing research, understanding osteoarthritis and cartilage repair remains unclear, making the identification of key molecules essential for early diagnosis and effective treatment. This review offers an overview of proteoglycans as primary molecules in articular cartilage. It describes the various types of proteoglycans present in both healthy and damaged cartilage, highlighting their roles. Additionally, the review emphasizes the importance of assessing proteoglycans to evaluate the quality of repaired articular tissue. It concludes by providing a visual and narrative description of aggrecan distribution and presence in healthy cartilage. Proteoglycans, such as aggrecan, biglycan, decorin, perlecan, and versican, significantly contribute to maintaining the health of articular cartilage and the cartilage repair process. Therefore, studying these proteoglycans is vital for early diagnosis, evaluating the quality of repaired cartilage, and assessing treatment effectiveness.
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Affiliation(s)
- Lourdes Alcaide-Ruggiero
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Córdoba, Hospital Clínico Veterinario, Campus de Rabanales, Ctra. Madrid-Cádiz Km 396, 14014 Córdoba, Spain
- Fundación García-Cugat, Plaza Alfonso Comín 5-7, 08023 Barcelona, Spain
| | - Ramón Cugat
- Fundación García-Cugat, Plaza Alfonso Comín 5-7, 08023 Barcelona, Spain
- Instituto Cugat y Mutualidad de Futbolistas Españoles, Delegación Catalana, 08023 Barcelona, Spain
| | - Juan Manuel Domínguez
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Córdoba, Hospital Clínico Veterinario, Campus de Rabanales, Ctra. Madrid-Cádiz Km 396, 14014 Córdoba, Spain
- Fundación García-Cugat, Plaza Alfonso Comín 5-7, 08023 Barcelona, Spain
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Shen Y, Voigt A, Leng X, Rodriguez AA, Nguyen CQ. A current and future perspective on T cell receptor repertoire profiling. Front Genet 2023; 14:1159109. [PMID: 37408774 PMCID: PMC10319011 DOI: 10.3389/fgene.2023.1159109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 06/12/2023] [Indexed: 07/07/2023] Open
Abstract
T cell receptors (TCR) play a vital role in the immune system's ability to recognize and respond to foreign antigens, relying on the highly polymorphic rearrangement of TCR genes. The recognition of autologous peptides by adaptive immunity may lead to the development and progression of autoimmune diseases. Understanding the specific TCR involved in this process can provide insights into the autoimmune process. RNA-seq (RNA sequencing) is a valuable tool for studying TCR repertoires by providing a comprehensive and quantitative analysis of the RNA transcripts. With the development of RNA technology, transcriptomic data must provide valuable information to model and predict TCR and antigen interaction and, more importantly, identify or predict neoantigens. This review provides an overview of the application and development of bulk RNA-seq and single-cell (SC) RNA-seq to examine the TCR repertoires. Furthermore, discussed here are bioinformatic tools that can be applied to study the structural biology of peptide/TCR/MHC (major histocompatibility complex) and predict antigenic epitopes using advanced artificial intelligence tools.
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Affiliation(s)
- Yiran Shen
- Department of Infectious Diseases and Immunology, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Alexandria Voigt
- Department of Infectious Diseases and Immunology, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Xuebing Leng
- Department of Microbiology and Immunology, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Amy A. Rodriguez
- Department of Infectious Diseases and Immunology, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Cuong Q. Nguyen
- Department of Infectious Diseases and Immunology, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, United States
- Center of Orphaned Autoimmune Diseases, University of Florida, Gainesville, FL, United States
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Lin X, Bell RD, Catheline SE, Takano T, McDavid A, Jonason JH, Schwarz EM, Xing L. Targeting Synovial Lymphatic Function as a Novel Therapeutic Intervention for Age-Related Osteoarthritis in Mice. Arthritis Rheumatol 2023; 75:923-936. [PMID: 36625730 PMCID: PMC10238595 DOI: 10.1002/art.42441] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 12/16/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The synovial lymphatic system (SLS) removes catabolic factors from the joint. Vascular endothelial growth factor C (VEGF-C) and its receptor, VEGFR-3, are crucial for lymphangiogenesis. However, their involvement in age-related osteoarthritis (OA) is unknown. This study was undertaken to determine whether the SLS and the VEGF-C/VEGFR-3 pathway contribute to the development and progression of age-related OA, using a murine model of naturally occurring joint disease. METHODS SLS function was assessed in the knees of young (3-month-old) and aged (19-24-month-old) male and female C57BL/6J mice via a newly established in vivo IVIS-dextran imaging approach, which, in addition to histology, was used to assess the effects of VEGF-C treatment on SLS function and OA pathology in aged mice. RNA-sequencing of synovial tissue was performed to explore molecular mechanisms of the disease in the mouse knee joints. RESULTS Results showed that aged mice had impaired SLS function, including decreases in joint clearance (mean T1/2 of signal intensity clearance, 2.8 hours in aged mice versus 0.5 hours in young mice; P < 0.0001), synovial influx (mean ± SD 1.7 ± 0.8% in aged mice versus 4.1 ± 1.9% in young mice; P = 0.0004), and lymph node draining capacity (mean ± SD epifluorescence total radiant intensity ([photons/second]/[μW/cm2 ]) 1.4 ± 0.8 in aged mice versus 3.7 ± 1.2 in young mice; P < 0.0001). RNA-sequencing of the synovial tissue showed that Vegf-c and Vegfr3 signaling genes were decreased in the synovium of aged mice. VEGF-C treatment resulted in improvements in SLS function in aged mice, including increased percentage of signal intensity joint clearance (mean ± SD 63 ± 9% in VEGF-C-treated aged mice versus 52 ± 15% in vehicle-treated aged mice; P = 0.012), increased total articular cartilage cross-sectional area (mean ± SD 0.38 ± 0.07 mm2 in VEGF-C-treated aged mice versus 0.26 ± 0.07 mm2 in vehicle-treated aged mice; P < 0.0001), and decreased percentage of matrix metallopeptidase 13-positive staining area within total synovial area in 22-month-old VEGF-C-treated mice versus 22-month-old vehicle-treated mice (mean ± SD decrease 7 ± 2% versus 4 ± 1%; P = 0.0004). CONCLUSION SLS function is reduced in the knee joints of aged mice due to decreased VEGF-C/VEGFR-3 signaling. VEGF-C treatment attenuates OA joint damage and improves synovial lymphatic drainage in aged mice. The SLS and VEGF-C/VEGFR-3 signaling represent novel physiopathologic mechanisms that could potentially be used as therapeutic targets for age-related OA.
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Affiliation(s)
- Xi Lin
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Richard D. Bell
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Sarah E. Catheline
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Takahiro Takano
- Department of Pharmacology and Physiology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Andrew McDavid
- Department of Biostatistics and computational biology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Jennifer H. Jonason
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Edward M. Schwarz
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Lianping Xing
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY 14642, USA
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Reyes JM, Gutierrez MV, Madariaga H, Otero W, Guzman R, Izquierdo J, Abello M, Velez P, Castillo D, Ponce de Leon D, Lukic T, Amador L. Patient-reported outcomes in RA patients treated with tofacitinib or bDMARDs in real-life conditions in two Latin American countries. REUMATOLOGIA CLINICA 2023; 19:319-327. [PMID: 37286268 DOI: 10.1016/j.reumae.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 02/03/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To describe efficacy, safety, and patient-reported outcomes (PROs) in patients with rheumatoid arthritis (RA) with an inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) treated with tofacitinib or biological DMARDs (bDMARDs) in real-life conditions. METHODS A noninterventional study was performed between March 2017 and September 2019 at 13 sites in Colombia and Peru. Outcomes measured at baseline and at the 6-month follow-up were disease activity (RAPID3 [Routine Assessment of Patients Index Data] score), functional status (HAQ-DI [Health Assessment Questionnaire] score), and quality of life (EQ-5D-3L [EuroQol Questionnaire]). The Disease Activity Score-28 (DAS28-ESR) and frequency of adverse events (AEs) were also reported. Unadjusted and adjusted differences from baseline were estimated and expressed as the least squares mean difference (LSMD). RESULTS Data from 100 patients treated with tofacitinib and 70 patients with bDMARDs were collected. At baseline, the patients' mean age was 53.53 years (SD 13.77), the mean disease duration was 6.31 years (SD 7.01). The change from baseline at month 6 was not statistically significant different in the adjusted LSMD [SD] for tofacitinib vs. bDMARDs for RAPID3 score (-2.55[.30] vs. -2.52[.26]), HAQ-DI score (-.56[.07] vs. -.50[.08]), EQ-5D-3L score (.39[.04] vs. .37[.04]) and DAS28-ESR (-2.37[.22] vs. -2.77[.20]). Patients from both groups presented similar proportions of nonserious and serious AEs. No deaths were reported. CONCLUSION Changes from baseline were not statistically significantly different between tofacitinib and bDMARDs in terms of RAPID3 scores and secondary outcomes. Patients from both groups presented similar proportions of nonserious and serious AEs. CLINICAL TRIAL NUMBER NCT03073109.
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Affiliation(s)
| | | | - H Madariaga
- Centro Especializado de enfermedades neoplásicas (CEEN), Arequipa, Peru
| | - W Otero
- Centro Servimed, Bucaramanga, Colombia
| | - R Guzman
- Instituto de Enfermedades Autoinmunes Renato Guzmán (IDEARG), Bogota, Colombia
| | | | - M Abello
- Centro Integral de Reumatología Circaribe, Barranquilla, Colombia
| | - P Velez
- Centro de Investigación en Reumatología y Especialidades Médicas (CIREEM), Bogota, Colombia
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Abbasi-Perez A, Alvarez-Mon MA, Donat-Vargas C, Ortega MA, Monserrat J, Perez-Gomez A, Alvarez-Mon M. Using Twitter Data Analysis to Understand the Perceptions, Beliefs, and Attitudes about Pharmacotherapy Used in Rheumatology: An Observational Study. Healthcare (Basel) 2023; 11:healthcare11111526. [PMID: 37297665 DOI: 10.3390/healthcare11111526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/18/2023] [Accepted: 05/20/2023] [Indexed: 06/12/2023] Open
Abstract
Twitter has become an important platform for disseminating information about rheumatology drugs by patients, health professionals, institutions, and other users. The aim of this study was to analyze tweets related to 16 drugs used in rheumatology, including their volume, content, and type of user (patients, patients' relatives, health professionals, health institutions, pharmaceutical industry, general press, scientific journals and patients' associations), and to detect inappropriate medical content. A total of 8829 original tweets were obtained, with a random sample of 25% of the total number of tweets for each drug (at least 100 tweets) analyzed. Methotrexate (MTX) accounted for a quarter of all tweets, and there were significant differences in the proportion of tweets issued according to the type of user. Patients and their relatives mainly tweeted about MTX, while professionals, institutions, and patient associations posted more about TNF inhibitors. In contrast, the pharmaceutical industry focused on IL-17 inhibitors. Medical content prevailed in all drugs except anti-CD20 and IL-1 inhibitors and the most discussed medical topic was efficacy, followed by posology and adverse effects. Inappropriate or fake content was found to be very low. In conclusion, the majority of the tweets were about MTX, which is a first-line treatment for several diseases. The distribution of medical content varied according to the type of user. In contrast to other studies, the amount of medically inappropriate content was very low.
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Affiliation(s)
- Adrian Abbasi-Perez
- Service of Internal Medicine, Rheumatology and Autoimmune Diseases, University Hospital "Príncipe de Asturias", 28805 Alcala de Henares, Spain
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, 28805 Alcala de Henares, Spain
| | - Miguel Angel Alvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, 28805 Alcala de Henares, Spain
- Institute Ramon y Cajal for Health Research (IRYCIS), 28034 Madrid, Spain
| | - Carolina Donat-Vargas
- Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, 17177 Stockholm, Sweden
- IMDEA-Food Institute, Campus of International Excellence, Universidad Autónoma de Madrid, Consejo Superior de Investigaciones Científicas, 28049 Madrid, Spain
| | - Miguel A Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, 28805 Alcala de Henares, Spain
- Institute Ramon y Cajal for Health Research (IRYCIS), 28034 Madrid, Spain
| | - Jorge Monserrat
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, 28805 Alcala de Henares, Spain
- Institute Ramon y Cajal for Health Research (IRYCIS), 28034 Madrid, Spain
| | - Ana Perez-Gomez
- Service of Internal Medicine, Rheumatology and Autoimmune Diseases, University Hospital "Príncipe de Asturias", 28805 Alcala de Henares, Spain
| | - Melchor Alvarez-Mon
- Service of Internal Medicine, Rheumatology and Autoimmune Diseases, University Hospital "Príncipe de Asturias", 28805 Alcala de Henares, Spain
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, 28805 Alcala de Henares, Spain
- Institute Ramon y Cajal for Health Research (IRYCIS), 28034 Madrid, Spain
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Wu Q, Xie M, Li S, Li S, Tian L, Jie Y. Mapping the research on Sjögren's syndrome-related dry eye disease: a bibliometric network analysis of the past 20 years. Int Ophthalmol 2023:10.1007/s10792-023-02711-4. [PMID: 37133578 DOI: 10.1007/s10792-023-02711-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 04/09/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE Our study aimed to make a bibliometric analysis on Sjögren's syndrome-related dry eye disease (SS-DED), explore its potential research hotspots, and provide critical information for future research interest and undeveloped topics in this field, which can benefit clinicians and researchers. METHODS We extracted all publications relating to SS-DED from 2003 to 2022 from the Web of Science Core Collection database. Original articles and reviews in English were included. The contributions of different countries, institutions, journals, and authors were compared, and the research hotspots were visualized for network analysis through GraphPad Prism, CiteSpace, and VOSviewer. RESULTS We enrolled a total of 987 publications. The United States contributed the most publications (281, 28.5%), followed by China (157, 15.9%) and Japan (80, 8.11%). Publications from the United States were cited more frequently (13,060 citations), with the highest H-index of 57. China ranked second in the total number of publications, the papers were not cited frequently (3790 citations), and the H-index ranked second (H-index = 31). PLoS One (32, 3.24%) published the most papers, and the University of California system had the highest number of publications (45, 4.56%). Bootsma H from the Netherlands published the most papers. The trend of research hotspots evolved mainly from the basic manifestation to pathogenesis and treatment of SS-DED and paid more attention to distinguishing SS-DED from that dry eye disease without SS. CONCLUSIONS Based on the bibliometric, co-citation, and network analyses in this study, we obtained the annual publications and citations, the growth trends of publications, the productivity of countries, organizations, journals, and authors, high-quality publications, and the emerging hotspots of SS-DED, which may open new doors for promising research directions.
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Affiliation(s)
- Qianru Wu
- Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People's Republic of China
| | - Minyue Xie
- Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People's Republic of China
| | - Siyuan Li
- Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People's Republic of China
| | - Shang Li
- Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People's Republic of China
| | - Lei Tian
- Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People's Republic of China
| | - Ying Jie
- Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People's Republic of China.
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50
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Liu T, Xu C, Driban JB, Liang GY, Zhang XH, Hu FB, McAlindon T, Lu B. Whole grain consumption and risk of radiographic knee osteoarthritis: a prospective study from the Osteoarthritis Initiative. Rheumatology (Oxford) 2023; 62:1834-1840. [PMID: 36130461 PMCID: PMC10152291 DOI: 10.1093/rheumatology/keac517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/30/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To assess the association of whole grain consumption with the risk of incident knee OA. MATERIAL AND METHODS We followed 2846 participants in the Osteoarthritis Initiative ages 45-79 years. Participants were free from radiographic knee OA (Kellgren-Lawrence grade <2) in at least one knee at baseline. Dietary data from baseline were obtained using the Block Brief Food Frequency Questionnaire. We defined radiographic knee OA incidence as a Kellgren-Lawrence grade ≥2 during the subsequent 96 months. Cox proportional hazards models were used to assess the association between whole grain food intake and the risk of incident knee OA. RESULTS During the 96 month follow-up, 518 participants (691 knees) developed incident radiographic knee OA. Higher total whole grain consumption was significantly associated with a lower knee OA risk [hazard ratio (HR)quartile 4vs1 = 0.66 (95% CI 0.52, 0.84), P for trend < 0.01] after adjusting for demographic and socio-economic factors, clinical factors and other dietary factors related to OA. Consistently, a significant inverse association of dark bread consumption with knee OA risk was observed [HRquartile 4vs1 = 0.68 (95% CI 0.53, 0.87), P for trend < 0.01). In addition, we observed a significant inverse association between higher cereal fibre intake and reduced knee OA risk [HRquartile 4vs1 = 0.61 (95% CI 0.46, 0.81), P for trend < 0.01). CONCLUSIONS Our findings revealed a significant inverse association of whole grain consumption with knee OA risk. These findings provide evidence that eating a diet rich in whole grains may be a potential nutritional strategy to prevent knee OA.
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Affiliation(s)
- Tong Liu
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Chang Xu
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, New Brunswick, NJ, USA
| | - Jeffery B Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA, USA
| | - Ge-yu Liang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Xue-hong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Timothy McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA, USA
| | - Bing Lu
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Family Medicine, the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Public Health Sciences, University of Connecticut Health Center, Farmington, CT, USA
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