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Morina G, Sambataro D, Libra A, Palmucci S, Colaci M, La Rocca G, Ferro F, Carli L, Baldini C, Liuzzo SV, Vancheri C, Sambataro G. Recognition of Idiopathic Inflammatory Myopathies Underlying Interstitial Lung Diseases. Diagnostics (Basel) 2025; 15:275. [PMID: 39941205 PMCID: PMC11817385 DOI: 10.3390/diagnostics15030275] [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: 12/08/2024] [Revised: 01/17/2025] [Accepted: 01/23/2025] [Indexed: 02/16/2025] Open
Abstract
Interstitial Lung Disease (ILD) is one of the most common causes of mortality in idiopathic Inflammatory Myopathies (IIM). Despite these conditions being commonly associated with proximal weakness, skin rashes and arthritis, ILD can be the first or the sole clinical feature in up to 60% of patients, potentially leading to incorrect diagnosis. The early recognition of an underlying IIM in ILD patients can allow for prompt treatment, which could potentially stabilize or even improve the lung disease, also avoiding the development of other clinical features associated with the condition. The objective of this review is to describe the clinical, serological and radiological features associated with IIM-ILD, mainly focusing on dermatomyositis and antisynthetase syndrome.
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Affiliation(s)
- Giulia Morina
- Department of Clinical and Experimental Medicine, Regional Referral Center for Rare Lung Diseases, Policlinico “G.Rodolico-San Marco”, University of Catania, 95123 Catania, Italy; (G.M.); (A.L.); (S.V.L.); (C.V.)
| | - Domenico Sambataro
- Artroreuma S.R.L., Outpatient Clinic Associated with the Regional Health System, Mascalucia, 95030 Catania, Italy;
| | - Alessandro Libra
- Department of Clinical and Experimental Medicine, Regional Referral Center for Rare Lung Diseases, Policlinico “G.Rodolico-San Marco”, University of Catania, 95123 Catania, Italy; (G.M.); (A.L.); (S.V.L.); (C.V.)
| | - Stefano Palmucci
- Unità Operativa Semplice Dipartimentale di Imaging Polmonare e Tecniche Radiologiche Avanzate (UOSD IPTRA), Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”, University Hospital Policlinico “G.Rodolico-San Marco”, University of Catania, 95123 Catania, Italy;
| | - Michele Colaci
- Internal Medicine Unit, Division of Rheumatology, Department of Clinical and Experimental Medicine, Cannizzaro Hospital, University of Catania, 95123 Catania, Italy;
| | - Gaetano La Rocca
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.L.R.); (F.F.); (L.C.); (C.B.)
| | - Francesco Ferro
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.L.R.); (F.F.); (L.C.); (C.B.)
| | - Linda Carli
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.L.R.); (F.F.); (L.C.); (C.B.)
| | - Chiara Baldini
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.L.R.); (F.F.); (L.C.); (C.B.)
| | - Santa Valentina Liuzzo
- Department of Clinical and Experimental Medicine, Regional Referral Center for Rare Lung Diseases, Policlinico “G.Rodolico-San Marco”, University of Catania, 95123 Catania, Italy; (G.M.); (A.L.); (S.V.L.); (C.V.)
| | - Carlo Vancheri
- Department of Clinical and Experimental Medicine, Regional Referral Center for Rare Lung Diseases, Policlinico “G.Rodolico-San Marco”, University of Catania, 95123 Catania, Italy; (G.M.); (A.L.); (S.V.L.); (C.V.)
| | - Gianluca Sambataro
- Department of Medicine and Surgery, University of Enna “Kore”, 94100 Enna, Italy
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Ryan MA, Ermarth A. Inflammatory Causes of Dysphagia in Children. Otolaryngol Clin North Am 2024; 57:669-684. [PMID: 38637195 DOI: 10.1016/j.otc.2024.03.002] [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] [Indexed: 04/20/2024]
Abstract
Gastroesophageal reflux (GER) and eosinophilic esophagitis (EoE) are the most common inflammatory causes of pediatric dysphagia, but several other less prevalent conditions should be considered. These conditions can affect one or several aspects of the swallowing process. In some inflammatory conditions dysphagia may be an early symptom. Esophagoscopy and instrumental swallow studies are often needed to determine the underlying diagnosis and best treatment plan. In some inflammatory conditions dysphagia can portend a worse outcome and need for more aggressive treatment of the underlying condition. Consultations with speech language pathology, gastroenterology, dietetics, allergy/immunology and/or rheumatology are often needed to optimize management.
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Affiliation(s)
- Marisa A Ryan
- Pediatric Otolaryngology, Peak ENT Associates, 1055 North 300 West, Suite 401, Provo, UT 84604, USA.
| | - Anna Ermarth
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Utah School of Medicine, 81 Mario Capecchi Drive, Salt Lake City, UT 84113, USA
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Ma S, Chen Y, Zhou Z, Ma A. Effect of Wei Qi Booster on immune and anti-oxidative function in aged mice. Front Vet Sci 2024; 11:1446770. [PMID: 39113720 PMCID: PMC11303205 DOI: 10.3389/fvets.2024.1446770] [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: 06/10/2024] [Accepted: 07/15/2024] [Indexed: 08/10/2024] Open
Abstract
This research was conducted to examine the impact of Wei Qi Booster (WQB) on immune parameters and anti-oxidative function in aged mice. Fifty aged mice were randomly assigned to five different groups. Group A was designated as the control group. Mice in Group B were receiving Levamisole at 10 mg/kg body weight. Each mouse in groups C, D and E received 0.1, 1, and 2% WQB, respectively. Another ten young mice, designated as group F, were fed regularly. The mice were fed according to the above methods for 28 days. Results showed that relative to the control group, the body weight and immune organs indexes experienced a substantial rise in the group with 1% WQB. In addition, 1% WQB could improve the activity of SOD and reduce the MDA levels. Expressions of CD4 and sIgA increased while CD8 decreased in the jejunum of aged mice treated with WQB. IL2 and IFN-γ levels increased in the 1% WQB group, showing no notable difference compared to the young mice group. The results demonstrated that WQB can elevate immune levels and enhance anti-oxidative functions in aged mice.
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Affiliation(s)
- Shuang Ma
- College of Life Sciences and Food Engineering, Hebei University of Engineering, Handan, Heibei, China
| | - Yuming Chen
- College of Life Sciences and Food Engineering, Hebei University of Engineering, Handan, Heibei, China
| | - Zhilong Zhou
- College of Life Sciences and Food Engineering, Hebei University of Engineering, Handan, Heibei, China
| | - Aituan Ma
- College of Traditional Chinese Veterinary Medicine, Hebei Agricultural University, Baoding, Hebei, China
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Zhang X, Zhang L, Gao Y, Liu Z, Gong K. Identification of hub glycolysis-related genes in acute myocardial infarction and their correlation with immune infiltration using bioinformatics analysis. BMC Cardiovasc Disord 2024; 24:349. [PMID: 38987688 PMCID: PMC11234719 DOI: 10.1186/s12872-024-03989-7] [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: 10/13/2023] [Accepted: 06/19/2024] [Indexed: 07/12/2024] Open
Abstract
PURPOSE Glycolysis and immune metabolism play important roles in acute myocardial infarction (AMI). Therefore, this study aimed to identify and experimentally validate the glycolysis-related hub genes in AMI as diagnostic biomarkers, and further explore the association between hub genes and immune infiltration. METHODS Differentially expressed genes (DEGs) from AMI peripheral blood mononuclear cells (PBMCs) were analyzed using R software. Glycolysis-related DEGs (GRDEGs) were identified and analyzed using the Database for Annotation, Visualization, and Integrated Discovery (DAVID) for functional enrichment. A protein-protein interaction network was constructed using the STRING database and visualized using Cytoscape software. Immune infiltration analysis between patients with AMI and stable coronary artery disease (SCAD) controls was performed using CIBERSORT, and correlation analysis between GRDEGs and immune cell infiltration was performed. We also plotted nomograms and receiver operating characteristic (ROC) curves to assess the predictive accuracy of GRDEGs for AMI occurrence. Finally, key genes were experimentally validated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blotting using PBMCs. RESULTS A total of 132 GRDEGs and 56 GRDEGs were identified on the first day and 4-6 days after AMI, respectively. Enrichment analysis indicated that these GRDEGs were mainly clustered in the glycolysis/gluconeogenesis and metabolic pathways. Five hub genes (HK2, PFKL, PKM, G6PD, and ALDOA) were selected using the cytoHubba plugin. The link between immune cells and hub genes indicated that HK2, PFKL, PKM, and ALDOA were significantly positively correlated with monocytes and neutrophils, whereas G6PD was significantly positively correlated with neutrophils. The calibration curve, decision curve analysis, and ROC curves indicated that the five hub GRDEGs exhibited high predictive value for AMI. Furthermore, the five hub GRDEGs were validated by RT-qPCR and western blotting. CONCLUSION We concluded that HK2, PFKL, PKM, G6PD, and ALDOA are hub GRDEGs in AMI and play important roles in AMI progression. This study provides a novel potential immunotherapeutic method for the treatment of AMI.
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Affiliation(s)
- Xiaoqing Zhang
- Department of Cardiology, Affiliated Hospital of Yangzhou University, No. 368, Hanjiang Middle Road, Yangzhou 225000, Jiangsu, China
- School of Medicine, Yangzhou University, No. 136, Jiang yang Middle Road, Yangzhou 225000, Jiangsu, China
| | - Lina Zhang
- Department of Cardiology, Affiliated Hospital of Nantong University, No.20, Xisi Road, Nantong 226001, Jiangsu, China
| | - Ya Gao
- Department of Cardiology, Affiliated Hospital of Yangzhou University, No. 368, Hanjiang Middle Road, Yangzhou 225000, Jiangsu, China
| | - Zhangyu Liu
- Department of Cardiology, Affiliated Hospital of Yangzhou University, No. 368, Hanjiang Middle Road, Yangzhou 225000, Jiangsu, China
| | - Kaizheng Gong
- Department of Cardiology, Affiliated Hospital of Yangzhou University, No. 368, Hanjiang Middle Road, Yangzhou 225000, Jiangsu, China.
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Shi M, Ma J, Jin S, Wang T, Sui Y, Chen L. Effects of saponins Rb 1 and Re in American ginseng combined intervention on immune system of aging model. Front Mol Biosci 2024; 11:1392868. [PMID: 38606290 PMCID: PMC11007219 DOI: 10.3389/fmolb.2024.1392868] [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: 02/28/2024] [Accepted: 03/18/2024] [Indexed: 04/13/2024] Open
Abstract
Aging is a major risk factor for the development of many pathological processes, such as reduced immunity, cancer, cardiovascular diseases or neurodegenerative diseases, while age-related chronic diseases are the most common causes of death. This paper studies the effects of American ginseng saponin Rb1 and Re alone and combined intervention on the immune system of aging mouse models, by using 30 mg/kg Rb1, 15 mg/kg Re, and Rb1 + Re (30 mg/kg Rb1 and 15 mg/kg Re (co-intervention) was used to intervene in the aging model, and immune indicators such as thymus index, spleen index, interleukin and interferon were detected to evaluate the impact of Rb1 and Re on immune function. The results show that Rb1 and Re intervention alone can increase the spleen index by 7%-12% and the thymus index by 12%-19% in the aging model. After Rb1 or Re alone intervened, the apoptotic cells in the thymus were slightly reduced, and the proportion of apoptotic cells was reduced. The combination of Rb1 + Re can promote the thymus index and spleen index to increase by 23.40% and 25.5% respectively, which is more advantageous than Rb1 or Re alone. In addition, Rb1 and Re intervention can reduce the level of interferon INF to a level comparable to that of young mice. Rb1 + Re can not only reduce the INF content, but also reduce the TNF content. The above results show that American ginseng saponin Rb1 and Re can delay the decline of the immune system in the aging model, and the combined intervention of the two is significantly better than individual intervention in the recovery of the immune system. This paper can provide theoretical basis and data support for the development of American ginseng nutritional supplements and its application in aging groups products to improve immunity.
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Affiliation(s)
- Mao Shi
- Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Jie Ma
- Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Shan Jin
- Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Tienan Wang
- College of Food Science and Engineering, Changchun University, Changchun, China
| | - Yuhan Sui
- College of Food Science and Engineering, Changchun University, Changchun, China
| | - Lina Chen
- College of Food Science and Engineering, Changchun University, Changchun, China
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Wen L, Chen X, Cheng Q, Nie L, Xu J, Yan T, Zhang X, Yang H, Sun W, Liu L, Xue J, Du Y. Myositis-specific autoantibodies and their clinical associations in idiopathic inflammatory myopathies: results from a cohort from China. Clin Rheumatol 2022; 41:3419-3427. [PMID: 35859245 DOI: 10.1007/s10067-022-06291-z] [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: 03/23/2022] [Revised: 06/08/2022] [Accepted: 07/08/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The purpose of this study was to determine the incidence of myositis-specific autoantibodies (MSAs) in a cohort of Chinese patients with idiopathic inflammatory myopathies (IIMs) and to examine their associations with clinical characteristics and long-term prognosis. METHODS Adult patients with confirmed IIMs (n = 515) were studied using the EUROLINE Autoimmune Inflammatory Myopathies 16 Ag (IgG) commercial line blot test to detect MSAs/myositis-associated autoantibodies. We collected the laboratory data and clinical features. The frequencies of MSAs and their associations with clinical phenotypes were evaluated using SPSS 25.0 software. RESULTS At least one MSA was found in 88.2% of the 515 IIM patients studied. The most frequently detected MSAs were anti-MDA5 (25.4%), anti-Jo-1(15.1%), and anti-EJ (9.5%). Autoantibodies against MDA5, TIF1-γ, and NXP2 were significantly correlated with cutaneous involvement (P < 0.001 or P < 0.01). Anti-TIF1-γ-positive patients had an enhanced risk of malignancy (OR = 3.51). Rapidly progressive interstitial lung disease (RP-ILD) was significantly correlated with anti-MDA5 (P < 0.0001). Anti-MDA5-positive patients had increased risks of elevated ferritin and decreased lymphocyte counts (OR = 5.65 and OR = 5.74, respectively). Kaplan-Meier survival revealed that individuals positive for anti-MDA5, especially anti-MDA5 combined with anti-Ro52, had the worst prognosis (P = 0.03). Male, old age, RP-ILD, and elevated ferritin were identified as predictors of poor prognosis in IIM patients. CONCLUSIONS MSAs were present in the majority of the IIM patients. Numerous MSAs were independent factors for identifying exceptional clinical phenotypes. Key Points • This is a large Chinese cohort of IIM patients to analyze possible associations of MSA profiles with clinical characteristics, aiming to provide valuable data for clinical work. • MSAs were present in approximately 90% of IIM patients with distinct clinical subsets. Patients with anti-Jo-1 and non-anti-Jo-1 ASAs exhibited similar characteristics. • The association of anti-TIF1-γ with malignancy was confirmed in adult patients. Patients with IIMs who were positive for both anti-Ro52 and anti-MDA5 had a worse prognosis. • Male, RP-ILD, and heliotrope rash were independent risk factors for a poor prognosis in patients with IIMs.
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Affiliation(s)
- Lihong Wen
- Department of Rheumatology, The Second Affiliate Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Xin Chen
- Department of Rheumatology, The Second Affiliate Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Qi Cheng
- Department of Rheumatology, The Second Affiliate Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Liuyan Nie
- Department of Rheumatology, The Second Affiliate Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Jieying Xu
- Department of Rheumatology, The Second Affiliate Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
- Department of Neurology, Linping District Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, 311199, Zhejiang, China
| | - Tingting Yan
- Department of Rheumatology, The Second Affiliate Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
- Department of Rheumatology, Second Affiliate Hospital, Jiaxing University School of Medicine, Jiaxing, China
| | - Xin Zhang
- Department of Rheumatology, The Second Affiliate Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
- Department of Rheumatology, Ningbo No.6 Hospital, Ningbo, China
| | - Huanhuan Yang
- Department of Rheumatology, The Second Affiliate Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
- Department of Nephrology, Hangzhou 6th People's Hospital, the Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, Hangzhou, China
| | - Wenjia Sun
- Department of Rheumatology, The Second Affiliate Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Lei Liu
- Department of Rheumatology, The Second Affiliate Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Jing Xue
- Department of Rheumatology, The Second Affiliate Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China.
| | - Yan Du
- Department of Rheumatology, The Second Affiliate Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China.
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Underdiagnosis of cardiopulmonary involvement in patients with idiopathic inflammatory myopathies. Reumatologia 2021; 59:276-284. [PMID: 34819701 PMCID: PMC8609382 DOI: 10.5114/reum.2021.110609] [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: 09/21/2021] [Accepted: 10/11/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives In the course of idiopathic inflammatory myopathies internal organs, including heart and lungs, can be involved. Cardiopulmonary complications significantly alter the course of the disease, leading to poorer prognosis. A lack of clear guidelines on the assessment of internal organ involvement in the course of myositis increases the risk of underdiagnosis. The aim of the study was to evaluate the incidence of clinical symptoms indicative of cardiovascular and pulmonary involvement in patients with myositis, and the impact of these ailments on daily living. Material and methods A self-designed online survey was distributed via online support groups and community forums for patients with idiopathic inflammatory myopathies. The questionnaire contained inquiries about demographical data, clinical symptoms, including symptoms indicative of cardiopulmonary involvement, as well as the standardised Health Assessment Questionnaire. Respondents were divided according to concomitant diseases into a subgroup diagnosed with cardiopulmonary diseases and a subgroup without such comorbidities. The prevalence of cardiopulmonary symptoms was compared between the subgroups. The impact of cardiopulmonary symptoms on the degree of disability and daily functioning was assessed. Results In total, 370 patients were included in the study group. The most commonly symptoms included dyspnoea during exercise, palpitations and ankle oedema during daily activities. Cardiopulmonary symptoms were frequent in respondents diagnosed with cardiopulmonary diseases and in patients declaring no comorbidities of the heart and lungs. Intensity of chest pain, tolerance of physical activity, and fatigue were comparable in both of the study subgroups. The degree of disability was higher in respondents with concomitant cardiovascular and/or pulmonary comorbidities, but only dry cough and ankle oedema impacted the results. Conclusions Clinical symptoms indicative of heart and lung involvement occur frequently in patients with idiopathic inflammatory myopathies; however, cardiopulmonary complications seem to be relatively rarely detected. Active screening for cardiopulmonary involvement is recommended.
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Tan W, Dong B, Gu J, Peng Y, Xue R. Chest pain in a mid-aged woman, not simply myopericarditis: a case report of anti-Ku positive polymyositis. BMC Cardiovasc Disord 2021; 21:380. [PMID: 34362296 PMCID: PMC8348807 DOI: 10.1186/s12872-021-02194-0] [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: 06/25/2021] [Accepted: 07/30/2021] [Indexed: 11/18/2022] Open
Abstract
Background Anti-Ku is a rare antibody which can be positive in some rheumatic diseases and it might be related to cardiac involvement. Polymyositis is an inflammatory myopathy, and its cardiac involvement seldom presents as myopericarditis and anti-Ku positive. Case presentation In this case, we report a mid-aged woman with chest pain, upper limbs weakness and fever unrelated with infection. The diagnosis of this case was unquestionably myopericarditis supported by ECG, cardiac MRI and negative findings in coronary arteries. Diagnosis of polymyositis was further clarified by the evidence of persistently increased CK, degeneration of proximal muscle in MRI, muscular dystrophy with lymphocytes infiltration in muscle biopsy. In the analysis of autoantibodies, we surprisingly discovered positive anti-Ku. Glucocorticoid and mycophenolate mofetil were then prescribed for polymyositis. Patient follow-up indicated remission of both myopericarditis and polymyositis. We finally clarified this rare case as a positive anti-Ku polymyositis with myopericarditis as cardiac involvement. Conclusion This report presents a rare case with anti-Ku positive polymyositis and the cardiac involvement of polymyositis was manifested as myopericarditis. Therefore, positive anti-Ku might explain the myopericarditis as cardiac involvement in polymyositis. More cases and longer duration of follow-up is required for the comprehensive understanding of the disease.
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Affiliation(s)
- Weiping Tan
- Department of Respiratory, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Bin Dong
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China
| | - Jincui Gu
- Department of Respiratory, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yang Peng
- Department of Radiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Ruicong Xue
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, China. .,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China.
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Lin CY, Chen HA, Hsu TC, Wu CH, Su YJ, Hsu CY. Time-Dependent Analysis of Risk of New-Onset Heart Failure Among Patients With Polymyositis and Dermatomyositis. Arthritis Rheumatol 2021; 74:140-149. [PMID: 34180158 DOI: 10.1002/art.41907] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 05/30/2021] [Accepted: 06/23/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To determine the risk and time trends of heart failure (HF) leading to hospitalization in individuals newly diagnosed as having polymyositis/dermatomyositis (PM/DM) relative to non-PM/DM controls at the general population level. METHODS A retrospective cohort study was conducted using data from a nationwide insurance database in Taiwan. Patients with incident PM/DM and without a history of HF were selected between 2000 and 2013. Unmatched and propensity score-matched cohorts were established separately. A multivariable Cox proportional hazards regression model was used to estimate the adjusted hazard ratio (HR) for the risk of HF in the unmatched cohort. In the propensity score-matched cohort, general population controls were selected and matched at a 1:1 ratio to the patients with PM/DM based on propensity scores, which accounted for the confounding factors of age, sex, index date (year) of first diagnosis, comorbidities, and medication usage. The cumulative incidence of HF was estimated using the Kaplan-Meier method. A stratified Cox proportional hazards model was used to calculate the HR for the risk of HF events at different follow-up time points among patients with PM/DM compared with non-PM/DM controls in the propensity score-matched cohort. RESULTS In the unmatched cohort, the study assessed 2,025 patients with PM/DM and 196,109 general population controls. Results of multivariable Cox regression analysis, adjusted for age, sex, comorbidities, and medication usage, revealed a greater risk of HF leading to hospitalization in the PM/DM group than in the control group (adjusted HR 3.29, 95% confidence interval [95% CI] 2.60-4.18). After matching based on propensity score, a total of 1,997 pairs of PM/DM patients and general population controls were identified. In this propensity score-matched cohort, the cumulative incidence of HF in patients with PM/DM at 3 years, 5 years, and 10 years was 3.3%, 4.4%, and 7.4%, respectively. The absolute difference in HF risk in the PM/DM group compared with the control group was 1.8% at 3 years, 2.1% at 5 years, and 3.0% at 10 years. Compared with general population controls, patients with PM/DM exhibited an augmented risk of HF (HR 2.06, 95% CI 1.36-3.12). Analyses stratified according to follow-up time point revealed that the increased risk of HF persisted for up to 10 years after the PM/DM diagnosis. CONCLUSION These results indicate that the risk of HF leading to hospitalization was increased in patients with PM/DM throughout the study period, supporting the need for greater vigilance in the monitoring of patients with PM/DM for the development of this potentially lethal complication.
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Affiliation(s)
- Chun-Yu Lin
- Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hung-An Chen
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | | | - Chun-Hsin Wu
- Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Jih Su
- Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chung-Yuan Hsu
- Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, and School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Woelfinger P, Hauptrock B, Kriege O, Wagner W, Heider J, Schwarting A, Birklein F, Theobald M, Wagner-Drouet EM. Alloimmune Myositis as Paraneoplastic Complication of an Oral Squamous Cell Carcinoma After Severe Chronic Graft vs Host Disease or a Manifestation of Chronic Graft vs Host Disease? A Case Report and Literature Discussion. Transplant Proc 2021; 53:1365-1368. [PMID: 33478746 DOI: 10.1016/j.transproceed.2020.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/16/2020] [Indexed: 10/22/2022]
Abstract
A 53-year-old female patient with acute myeloid leukemia developed severe chronic graft vs host disease (cGVHD) of the oral mucosa after allogeneic hematopoietic stem cell transplantation with leukoplakia and relapsing oral squamous cell carcinoma (SCC) of the tongue. cGVHD needed long-lasting immunosuppressive therapy; SCC was treated with radiation and surgery. Acute myeloid leukemia remained in complete remission. The patient developed a myositis with pain of all muscles as well as paraparesis with elevated creatine kinase and C-reactive protein and detection of antiskeletal muscle autoantibodies 3500 days after hematopoietic stem cell transplantation. No other clinical features of chronic GVHD were apparent at this time. Symptoms disappeared after treatment with corticosteroids but relapsed while tapering. Weekly therapy with the B-cell-depleting antibody rituximab was started and administered for 6 weeks. Symptoms disappeared again but partly returned after some weeks, so therapy with azathioprine was started. During therapy with azathioprine slow tapering of corticosteroids was possible and clinical symptoms remained absent. Here we present a case report and review of the literature on alloimmune myositis as paraneoplastic complication of an oral SCC of the tongue after severe chronic GVHD or as late manifestation of chronic GVHD itself.
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Affiliation(s)
- Pascal Woelfinger
- Hematology, Oncology and Pneumology, UCT, University Medical Center Mainz, Mainz, Germany.
| | - Beate Hauptrock
- Hematology, Oncology and Pneumology, UCT, University Medical Center Mainz, Mainz, Germany
| | - Oliver Kriege
- Hematology, Oncology and Pneumology, UCT, University Medical Center Mainz, Mainz, Germany
| | - Wilfried Wagner
- Maxillofacial Surgery, UCT, University Medical Center Mainz, Mainz, Germany
| | - Julia Heider
- Maxillofacial Surgery, UCT, University Medical Center Mainz, Mainz, Germany
| | | | - Frank Birklein
- Neurology, University Medical Center Mainz, Mainz, Germany
| | - Matthias Theobald
- Hematology, Oncology and Pneumology, UCT, University Medical Center Mainz, Mainz, Germany
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Caractéristiques cliniques des myosites associées aux anticorps anti-NXP2 chez l’adulte : étude de 6 cas. Ann Dermatol Venereol 2020; 147:891-897. [DOI: 10.1016/j.annder.2020.09.573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 09/10/2020] [Accepted: 09/25/2020] [Indexed: 11/17/2022]
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Luo G, Wang R, Zhou H, Liu X. ALDOA protects cardiomyocytes against H/R-induced apoptosis and oxidative stress by regulating the VEGF/Notch 1/Jagged 1 pathway. Mol Cell Biochem 2020; 476:775-783. [PMID: 33089381 DOI: 10.1007/s11010-020-03943-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/10/2020] [Indexed: 12/12/2022]
Abstract
Myocardial infarction (MI) is a myocardial necrosis disease caused by continuous ischemia and hypoxia. Abnormal expression of aldolase A (ALDOA) has been reported in cardiac hypertrophy, heart failure and other cardio-cerebrovascular diseases. The present study aims to explore the effects of ALDOA on hypoxia/reperfusion (H/R)-induced oxidative stress, and investigate the underlying mechanisms. ALDOA was expressed at a low level in blood samples from MI patients and H/R-induced H9C2 cardiomyocytes. Overexpression of ALDOA suppressed H/R-induced oxidative stress and apoptosis. Using co-immunoprecipitation and protein blots, we demonstrated that ALDOA modulates the Notch 1-Jagged 1 signalling pathway by upregulating VEGF. Taken together, our data reveal that ALDOA protects cardiomyocytes from H/R-induced oxidative stress through the VEGF/Notch 1/Jagged 1 axis, and should be investigated as a therapeutic target for the treatment of MI in future.
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Affiliation(s)
- Gaiying Luo
- Department of Clinical Laboratory, Xi'an No 5 Hospital, No. 112 West Main Street, Lianhu District, Xi'an, 710082, Shaanxi, China
| | - Rui Wang
- The Five Ward of Internal Medicine, Xi'an No 5 Hospital, Xi'an, 710082, Shaanxi, China
| | - Hui Zhou
- The Five Ward of Internal Medicine, Xi'an No 5 Hospital, Xi'an, 710082, Shaanxi, China
| | - Xiaoling Liu
- Department of Clinical Laboratory, Xi'an No 5 Hospital, No. 112 West Main Street, Lianhu District, Xi'an, 710082, Shaanxi, China.
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Griger Z, Danko K, Nemeth G, Hassan Z, Aszalos Z, Szabo K, Bodoki L, Gesztelyi R, Zsuga J, Szodoray P, Kemeny-Beke A. Anterior segment parameters associated with extramuscular manifestations in polymyositis and dermatomyositis. Int J Ophthalmol 2020; 13:1443-1450. [PMID: 32953585 DOI: 10.18240/ijo.2020.09.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 05/13/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate detailed anterior segment parameters of patients with idiopathic inflammatory myopathies (IIM), including polymyositis (PM), and dermatomyositis (DM), and to clarify the associations between these data and clinical variables of IIM. METHODS Totally 57 PM, 41 DM patients and 62 controls were enrolled in this cross-sectional, observational, case-control study. All study participants underwent Pentacam evaluation. Laboratory investigations consisted of different antibody assays, while extramuscular clinical assessments included Raynaud's phenomenon, dysphagia, interstitial lung disease, arthritis/arthralgia, and weight loss. Objective signs and subjective symptoms of dry eye disease (DED) were also evaluated. RESULTS All pachymetric parameters [center, apex, thinnest and maximal keratometry (Kmax)] and corneal volume (CV) of both sides of PM patients proved to be significantly lower. Some pachymetric data were also noticed as significantly decreased compared to those of controls. Several significant differences were traced between anterior segment values and extramuscular manifestations of myositis, largely in case of arthritis/arthralgia and weight loss, whereas associations between anterior segment parameters and antibodies were weak. Objective clinical tests of DED were also significantly decreased in IIM patients. CONCLUSION The results suggest that all IIM patients have thinner corneas compared with those of controls, and decreased corneal parameters are significantly associated with the occurrence of some extramuscular manifestations. In addition, IIM patients tend to develop objective signs of DED.
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Affiliation(s)
- Zoltan Griger
- Division of Clinical Immunology, Faculty of Medicine, University of Debrecen, Debrecen 4032, Hungary
| | - Katalin Danko
- Division of Clinical Immunology, Faculty of Medicine, University of Debrecen, Debrecen 4032, Hungary
| | - Gabor Nemeth
- Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen 4032, Hungary.,Department of Ophthalmology, Borsod-Abauj-Zemplen County Hospital and University Teaching Hospital, Miskolc 3526, Hungary
| | - Ziad Hassan
- Orbi-Dent Refractive Surgery and Medical Center, Debrecen 4032, Hungary
| | - Zsuzsa Aszalos
- Division of Clinical Immunology, Faculty of Medicine, University of Debrecen, Debrecen 4032, Hungary
| | - Katalin Szabo
- Division of Clinical Immunology, Faculty of Medicine, University of Debrecen, Debrecen 4032, Hungary
| | - Levente Bodoki
- Department of Rheumatology, Institute of Medicine, Faculty of Medicine, University of Debrecen, Debrecen 4032, Hungary
| | - Rudolf Gesztelyi
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Debrecen 4032, Hungary
| | - Judit Zsuga
- Department of Health Systems Management and Quality Management in Health Care, Faculty of Public Health, University of Debrecen, Debrecen 4032, Hungary
| | - Peter Szodoray
- Department of Immunology, Rikshospitalet, Oslo University Hospital, Oslo 0372, Norway
| | - Adam Kemeny-Beke
- Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen 4032, Hungary
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Ultra-efficient sequencing of T Cell receptor repertoires reveals shared responses in muscle from patients with Myositis. EBioMedicine 2020; 59:102972. [PMID: 32891935 PMCID: PMC7484536 DOI: 10.1016/j.ebiom.2020.102972] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/10/2020] [Accepted: 08/10/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Myositis, or idiopathic inflammatory myopathy (IIM), is a group disorders of unknown etiology characterized by the inflammation of skeletal muscle. The role of T cells and their antigenic targets in IIM initiation and progression is poorly understood. T cell receptor (TCR) repertoire sequencing is a powerful approach for characterizing complex T cell responses. However, current TCR sequencing methodologies are complex, expensive, or both, greatly limiting the scale of feasible studies. METHODS Here we present Framework Region 3 AmplifiKation sequencing ("FR3AK-seq"), a simplified multiplex PCR-based approach for the ultra-efficient and quantitative analysis of TCR complementarity determining region 3 (CDR3) repertoires. By using minimal primer sets targeting a conserved region immediately upstream of CDR3, undistorted amplicons are analyzed via short read, single-end sequencing. We also introduce the novel algorithm Inferring Sequences via Efficiency Projection and Primer Incorporation ("ISEPPI") for linking CDR3s to their associated variable genes. FINDINGS We find that FR3AK-seq is sensitive and quantitative, performing comparably to two different industry standards. FR3AK-seq and ISEPPI were used to efficiently and inexpensively characterize the T cell infiltrates of surgical muscle biopsies obtained from 145 patients with IIM and controls. A cluster of closely related TCRs was identified in samples from patients with sporadic inclusion body myositis (IBM). INTERPRETATION The ease and minimal cost of FR3AK-seq removes critical barriers to routine, large-scale TCR CDR3 repertoire analyses, thereby democratizing the quantitative assessment of human TCR repertoires in disease-relevant target tissues. Importantly, discovery of closely related TCRs in muscle from patients with IBM provides evidence for a shared antigen-driven T cell response in this disease of unknown pathogenesis. FUNDING This work was supported by NIH grant U24AI118633 and a Prostate Cancer Foundation Young Investigator Award.
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Opinc AH, Makowski MA, Łukasik ZM, Makowska JS. Cardiovascular complications in patients with idiopathic inflammatory myopathies: does heart matter in idiopathic inflammatory myopathies? Heart Fail Rev 2019; 26:111-125. [PMID: 31867681 DOI: 10.1007/s10741-019-09909-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This review presents a detailed study of original researches and previously published reviews concerning cardiovascular involvement in idiopathic inflammatory myopathies (IIM). We aimed to summarize the current knowledge on the cardiac involvement in IIM, evaluate its impact on mortality and indicate areas still awaiting to be investigated. We searched MEDLINE database (until January 2019) and the reference lists of articles. Selection criteria included only published data, available in English, both original researches and reviews. Articles related to cardiovascular involvement in IIM were selected and analysed. The references were also screened, and relevant articles were included. Cardiovascular involvement is frequent in IIM but typically remains subclinical. Among far less prevalent symptomatic forms, congestive heart failure is the most common. Myocardium and conduction system seems to be predominantly affected. High rate of left ventricular diastolic dysfunction was observed. Non-specific changes of ST-T segment were the most common abnormalities in electrocardiography. Patients with IIM were more frequently affected by atrial fibrillation as compared with other autoimmune diseases. Increased risk of myocardial infarction was observed; furthermore, patients often develop comorbidities that enhance cardiovascular risk. Since cardiovascular disorders remain one of the major causes of death and subclinical involvement is frequent, active screening is justified. Growing availability of the novel imaging techniques may facilitate diagnosis. Correlation between myocardial involvement and the type of autoantibodies and impact of different therapeutic options on the progression of cardiovascular lesions require further studies.
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Affiliation(s)
- Aleksandra Halina Opinc
- Department of Rheumatology, Medical University of Lodz, ul. Pieniny 30, 92-115, Łódź, Poland
| | - Marcin Adam Makowski
- Department of Intensive Care, Cardiology, Medical University of Lodz, ul. Pomorska 251, 92-213, Łódź, Poland
| | | | - Joanna Samanta Makowska
- Department of Rheumatology, Medical University of Lodz, ul. Pieniny 30, 92-115, Łódź, Poland.
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Wang J, Shi K, Xu HY, Zhao Q, Liu X, Gao Y, Yu H, Guo YK, Yang ZG. Left Ventricular Deformation in Patients with Connective Tissue Disease: Evaluated by 3.0T Cardiac Magnetic Resonance Tissue Tracking. Sci Rep 2019; 9:17913. [PMID: 31784546 PMCID: PMC6884516 DOI: 10.1038/s41598-019-54094-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 11/08/2019] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to assess left ventricular (LV) myocardial strain in patients with connective tissue disease (CTD) and compare LV deformation between subgroups of idiopathic inflammatory myopathy (IIM) and non-IIM. Ninety-eight patients with CTD, comprising 56 with IIM and 42 with non-IIM, and 30 healthy subjects were enrolled and underwent 3.0T cardiac magnetic resonance imaging (MRI) scanning. The LV function and strain parameters were measured and assessed. Our result revealed that CTD patients had preserved LV ejection fraction (60.85%) and had significantly decreased global and regional peak strain (PS) in radial, circumferential, and longitudinal directions (all p < 0.05). IIM patients showed significantly reduced global longitudinal PS (GLPS) and longitudinal PS at apical slice, whereas all strain parameters decreased in non-IIM patients. Except GLPS and longitudinal PS at apical slice, all strain parameters in non-IIM patients were lower than those in IIM patients. By Pearson's correlation analysis, the LV global radial and circumferential PS were correlated to N-terminal pro-brain natriuretic peptide level and LV ejection fraction in both IIM and non-IIM patients. This study indicated that CTD patients showed abnormal LV deformation despite with preserved LVEF. The impairment of LV deformation differed between IIM and non-IIM patients.
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Affiliation(s)
- Jin Wang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041 China
| | - Ke Shi
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041 China
| | - Hua-yan Xu
- Department of Radiology, Key Laboratory of Birth Defects and Related Disease of Woman and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Qin Zhao
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041 China
| | - Xi Liu
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041 China
| | - Yue Gao
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041 China
| | - Hong Yu
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041 China
| | - Ying-kun Guo
- Department of Radiology, Key Laboratory of Birth Defects and Related Disease of Woman and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Zhi-gang Yang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041 China
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Alves F, Gonçalo M. Suspected inflammatory rheumatic diseases in patients presenting with skin rashes. Best Pract Res Clin Rheumatol 2019; 33:101440. [PMID: 31585842 DOI: 10.1016/j.berh.2019.101440] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Skin lesions occur, often at very early stages, in many of the most frequent inflammatory rheumatic diseases such as in systemic lupus erythematosus (SLE), dermatomyositis (DM), systemic sclerosis (SSc), Sjögren's syndrome, rheumatoid arthritis (RA), and psoriatic arthritis. It is important to recognize the different specific cutaneous lesions in SLE (e.g., "butterfly" rash in acute, annular or psoriasiform photosensitive lesions in the subacute form, and discoid lesions in the chronic form) for an early diagnosis and to estimate the associated risks of internal disease, whereas nonspecific lesions (exanthema, vasculitis, and alopecia) can be part of SLE flares. Cutaneous lesions in DM (Gottron's papules and sign, heliotrope rash, dystrophic cuticles, and nailfold capillary abnormalities) may occur before any clinically evident muscular or systemic organ involvement and are of utmost importance for early diagnosis. The pattern of cutaneous lesions and associated autoantibodies also allow the distinction of different phenotypes, either more prone to life-threatening interstitial lung disease (MDA-5) or with higher risk for neoplasia (TIF1-γ). Many other skin lesions, although not specific, require further investigation to look for a possible underlying inflammatory rheumatic disease: non-pruritic urticarial lesions in anti-C1q-associated urticarial vasculitis, Still's disease or hereditary auto-inflammatory syndromes, transient macular purpura of vasculitis in Sjögren's syndrome, Behçet's disease, or RA, Raynaud's phenomenon in SSc and mixed connective tissue disease, erythema nodosum or other panniculitis in RA, Behçet's disease and SLE, pustular eruptions in Behçet's disease, psoriasis, and hereditary auto-inflammatory syndromes. After reviewing in detail the cutaneous manifestations of the most frequent inflammatory rheumatic diseases, we describe a topographic and morphological approach to skin rashes, calling attention to facial rashes, hand involvement, scalp, nail, or leg lesions or to some morphological aspects of skin lesions (annular, pustular, urticarial, or exanthematous) that may be the initial manifestations of inflammatory rheumatic diseases. The importance of skin lesions is confirmed by their presence as part of the classification criteria of many inflammatory rheumatic diseases. They also contribute to early diagnosis, to characterize disease phenotypes, to aid in effective patient management, and, ultimately, to impact on disease prognosis.
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Affiliation(s)
- Francisca Alves
- Clinic of Dermatology, University Hospital of Coimbra, Portugal
| | - Margarida Gonçalo
- Clinic of Dermatology, University Hospital of Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
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Temmoku J, Sato S, Fujita Y, Asano T, Suzuki E, Kanno T, Furuya MY, Matsuoka N, Kobayashi H, Watanabe H, Koga T, Shimizu T, Kawakami A, Migita K. Clinical significance of myositis-specific autoantibody profiles in Japanese patients with polymyositis/dermatomyositis. Medicine (Baltimore) 2019; 98:e15578. [PMID: 31096460 PMCID: PMC6531063 DOI: 10.1097/md.0000000000015578] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Myositis-specific autoantibodies, such as anti-melanoma differentiation associated gene 5 (MDA5) and anti-anti-amino acyl-tRNA synthetases (ARS) antibodies, are associated with interstitial lung diseases (ILD), which determine the prognosis of polymyositis/dermatomyositis (PM/DM) patients. However, there is a paucity of data on the clinical correlation between anti-Sjögren syndrome-related antigen A (anti-SSA)/Ro52 antibodies in PM/DM. We investigated the prevalence of myositis-specific autoantibodies including anti-SSA/Ro52 antibody and assessed the clinical significance of these antibodies in patients with PM/DM.We retrospectively reviewed demographic data and clinical outcomes in patients with PM/DM. The study population comprised 24 patients with PM and 60 patients with DM. The presence of anti-myositis-specific antibodies (MDA5, ARS, Jo-1, SSA/Ro52) was determined by immunosorbent assay (ELISA).Anti-MDA5 antibody was detected in 18 patients with DM (n = 60). Anti-ARS/anti-SSA/Ro52 antibodies were detected in 31 and 39 patients with PM/DM (n = 84). Rapidly progressive ILD patients were mainly found in the anti-MDA5 antibody-positive DM group. During the follow-up period, 9 patients died. Kaplan-Meier analysis demonstrated that survival rates seem to be lower in DM patients with anti-MDA5 antibodies compared with those without anti-MDA5 antibodies. Furthermore, dual positivity for anti-SSA/Ro52 and anti-MDA5 antibodies was significantly higher in nonsurviving DM patients compared with survivors.Although the presence of anti-ARS or anti-MDA5 antibodies is a prognostic marker in patients with PM/DM, combined presence of anti-SSA/Ro52 and anti-MDA5 antibodies represent another marker for clinical outcome in DM patients. Our results suggest that anti-SSA/Ro52 antibody positivity in DM patients with anti-MDA5 antibody reveals a subgroup of DM patients with poor prognosis.
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Affiliation(s)
- Jumpei Temmoku
- Department of Rheumatology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima
| | - Shuzo Sato
- Department of Rheumatology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima
| | - Yuya Fujita
- Department of Rheumatology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima
| | - Tomoyuki Asano
- Department of Rheumatology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima
| | - Eiji Suzuki
- Department of Rheumatology, Ohta Nishinouchi General Hospital Foundation, Nishinouchi, Koriyama, Fukushima
| | - Takashi Kanno
- Department of Rheumatology, Ohta Nishinouchi General Hospital Foundation, Nishinouchi, Koriyama, Fukushima
| | - Makiko Yashiro Furuya
- Department of Rheumatology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima
| | - Naoki Matsuoka
- Department of Rheumatology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima
| | - Hiroko Kobayashi
- Department of Rheumatology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima
| | - Hiroshi Watanabe
- Department of Rheumatology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Kiyoshi Migita
- Department of Rheumatology, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima
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The spectrum and clinical significance of myositis-specific autoantibodies in Chinese patients with idiopathic inflammatory myopathies. Clin Rheumatol 2019; 38:2171-2179. [PMID: 30863950 DOI: 10.1007/s10067-019-04503-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/24/2019] [Accepted: 03/05/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The aim of this study is to analyze the prevalence of myositis-specific autoantibodies (MSAs) and to elucidate their associations with clinical features in Chinese patients with polymyositis (PM) and dermatomyositis (DM). METHODS Twelve subsets of MSAs including anti-Mi-2, anti-TIF1-γ, anti-MDA5, anti-NXP2, anti-SAE1, anti-SRP, anti-Jo-1, anti-PL-7, anti-PL-12, anti-EJ, anti-OJ, and anti-HMGCR antibodies were tested. Four hundred and ninety-seven PM/DM patients were enrolled. Clinical features and laboratory data were collected. The frequency of MSAs and the correlations with clinical phenotypes were calculated by SPSS 21.0. RESULTS MSAs were present in 65.4% in PM/DM patients. Anti-TIF1-γ (14.3%), anti-MDA5 (12.5%), and anti-Jo-1 (10.1%) were the three commonest MSAs. Anti-SAE1 (OR 14.877, 95% CI 1.427-155.074), anti-SRP (OR 4.339, 95% CI 1.529-12.312) and anti-TIF1-γ (OR 2.790, 95% CI 1.578-4.935) were associated with dysphagia. In contrast, anti-MDA5 (OR 0.356, 95% CI 0.148-0.856) might decrease the frequency of this manifestation. Interstitial lung disease (ILD) was observed more frequently in patients carrying anti-EJ (OR 14.202, 95% CI 1.696-118.902), anti-Jo-1 (OR 11.111, 95% CI 3.306-37.335), and anti-MDA5 (OR 3.109, 95% CI 1.578-6.128). On the contrary, anti-Mi-2 (OR 0.180, 95% CI 0.055-0.589), anti-TIF1-γ (OR 0.163, 95% CI 0.080-0.333), and anti-HMGCR (OR 0.058, 95% CI 0.007-0.451) were protective factors against developing ILD. Anti-TIF1-γ was an independent risk factor for cancer-associated myositis (OR 4.237, 95% CI 1.712-10.487). CONCLUSIONS PM/DM patients had high frequencies of MSAs. Several MSAs were independent factors in determining unique clinical phenotypes.
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Giriş M, Durmuş H, Yetimler B, Taşli H, Parman Y, Tüzün E. Elevated IL-4 and IFN-γ Levels in Muscle Tissue of Patients with Dermatomyositis. ACTA ACUST UNITED AC 2018; 31:657-660. [PMID: 28652434 DOI: 10.21873/invivo.11108] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 05/02/2017] [Accepted: 05/09/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND/AIM To investigate the contribution of muscle tissue-derived cytokines in dermatomyositis (DM). MATERIALS AND METHODS Muscle homogenates were prepared from deltoid muscle biopsy specimens of 10 patients with DM and eight controls with no pathological signs of myopathy. Interleukin (IL)-4, interferon (IFN)-γ and IL-17 levels were evaluated by enzyme-linked immunosorbent assay (ELISA) and immunoblotting analysis. Muscle strength grades were recorded. RESULTS Patients with DM showed significantly elevated muscle tissue IL-4 and IFN-γ levels, whereas IL-17 levels were comparable between patients with DM and controls. Immunoblotting studies confirmed ELISA results. In DM muscle specimens, IL-4 and IFN-γ levels were positively correlated, while no correlation was observed between IL-17 and the other two cytokines. Moreover, IL-4 and IFN-γ levels were significantly negative correlated with muscle strength grades for the deltoid muscle. CONCLUSION Our results confirm the involvement of T helper (Th) 1-type and Th2-type immunity in DM pathogenesis. Muscle tissue appears to contribute to muscle weakness in DM by producing inflammatory cytokines.
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Affiliation(s)
- Murat Giriş
- Department of Neuroscience, Aziz Sancar Institute for Experimental Medical Research, Istanbul University, Istanbul, Turkey
| | - Hacer Durmuş
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Berrak Yetimler
- Department of Neuroscience, Aziz Sancar Institute for Experimental Medical Research, Istanbul University, Istanbul, Turkey
| | - Hatice Taşli
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Yeşim Parman
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Erdem Tüzün
- Department of Neuroscience, Aziz Sancar Institute for Experimental Medical Research, Istanbul University, Istanbul, Turkey
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Mulroy E, Cleland J, Child N, Pereira J, Anderson NE. A tough one to swallow. Pract Neurol 2018; 18:250-254. [PMID: 29567648 DOI: 10.1136/practneurol-2017-001860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Eoin Mulroy
- Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | - James Cleland
- Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | - Nicholas Child
- Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | - Jennifer Pereira
- Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | - Neil E Anderson
- Department of Neurology, Auckland City Hospital, Auckland, New Zealand
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Sousa Neves J, Santos Faria D, Cerqueira M, Afonso MC, Teixeira F. Relevance of ultrasonography in assessing disease activity in patients with idiopathic inflammatory myopathies. Int J Rheum Dis 2017; 21:233-239. [PMID: 28782262 DOI: 10.1111/1756-185x.13150] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AIM Idiopathic inflammatory myopathies (IIM) comprise a group of rare and heterogeneous diseases difficult to diagnose and follow up. Precise measures for assessing disease activity are not available at the moment. Our objective was to evaluate the usefulness of ultrasonography (US) as a monitoring tool in IIM. METHOD The study evaluated IIM patients diagnosed and followed up from 2005 to 2015 in our department. Fifteen patients with a mean age of 52.2 ± 22.09 years and mean disease duration of 4.6 ± 3.20 years were included. Physical examination including muscle strength tests, laboratorial analysis and a selective muscle US assessment were performed for each patient at a scheduled visit. RESULTS Nine of the 15 patients were in clinical remission and US assessment revealed a preserved muscle pattern. Symmetrical proximal muscle atrophy was found on US in one patient with longstanding polymyositis (PM) with proximal weakness. Inflammation and focal or generalized muscle edema were present on US in the remaining five patients with muscular weakness suggesting active disease. One of these patients in acute flare presented with atrophy changes in addition to edema. Early untreated myositis presented in one patient with moderate power Doppler (PD) signal. CONCLUSION As far as muscle US assessment is concerned, a single specific pattern was not observed in our study. A mixture of muscle edema and atrophy was detected depending on disease activity and duration. US findings seem to correlate well with disease activity, suggested by clinical data, and may be a useful tool to complement patient evaluation.
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Affiliation(s)
- Joana Sousa Neves
- Department of Rheumatology, Hospital Conde de Bertiandos, ULSAM, Ponte de Lima, Portugal
| | - Daniela Santos Faria
- Department of Rheumatology, Hospital Conde de Bertiandos, ULSAM, Ponte de Lima, Portugal
| | - Marcos Cerqueira
- Department of Rheumatology, Hospital Conde de Bertiandos, ULSAM, Ponte de Lima, Portugal
| | - Maria Carmo Afonso
- Department of Rheumatology, Hospital Conde de Bertiandos, ULSAM, Ponte de Lima, Portugal
| | - Filipa Teixeira
- Department of Rheumatology, Hospital Conde de Bertiandos, ULSAM, Ponte de Lima, Portugal
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Generali E, Folci M, Selmi C, Riboldi P. Immune-Mediated Heart Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1003:145-171. [PMID: 28667558 DOI: 10.1007/978-3-319-57613-8_8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The heart involvement in systemic autoimmune diseases represents a growing burden for patients and health systems. Cardiac function can be impaired as a consequence of systemic conditions and manifests with threatening clinical pictures or chronic myocardial damage. Direct injuries are mediated by the presence of inflammatory infiltrate which, even though unusual, is one of the most danger manifestations requiring prompt recognition and treatment. On the other hand, a not well-managed inflammatory status leads to accelerated atherosclerosis that precipitates ischemic disease. All cardiac structures may be damaged with different grades of intensity; moreover, lesions can appear simultaneously or more frequently at a short distance from each other leading to the onset of varied clinical pictures. The pathogenesis of heart damages in systemic autoimmune conditions is not yet completely understood for the great part of situations, even if several mechanisms have been investigated. The principal biochemical circuits refer to the damaging role of autoantibodies on cardiac tissues and the precipitation of immune complexes on endocardium. These events are finally responsible of inflammatory infiltration which leads to subsequent worsening of the previous damage. For these reasons, it appears of paramount importance a regular and deepened cardiovascular assessment to prevent a progressive evolution toward heart failure in patient affected by autoimmune diseases.
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Affiliation(s)
- Elena Generali
- Rheumatology and Clinical Immunology, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Marco Folci
- Allergy, Clinical Immunology and Rheumatology Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Carlo Selmi
- Rheumatology and Clinical Immunology, Humanitas Research Hospital, Rozzano, Milan, Italy.,BIOMETRA Department, University of Milan, Milan, Italy
| | - Piersandro Riboldi
- Allergy, Clinical Immunology and Rheumatology Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy.
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Nailfold videocapillaroscopy and serum VEGF levels in scleroderma are associated with internal organ involvement. AUTOIMMUNITY HIGHLIGHTS 2016; 7:5. [PMID: 26878864 PMCID: PMC4754208 DOI: 10.1007/s13317-016-0077-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 01/23/2016] [Indexed: 11/07/2022]
Abstract
Purpose Nailfold videocapillaroscopy (NVC) identifies the microvascular hallmarks of systemic sclerosis (SSc) and vascular endothelial growth factor (VEGF) and may play
a pivotal role in the associated vasculopathy. The aim of the present study was to compare NVC alterations with clinical subsets, internal organ involvement, and serum VEGF levels in a cohort of selected SSc cases. Methods We studied 44 patients with SSc who were evaluated within 3 months from enrollment by NVC, skin score, severity index, pulmonary function tests, carbon monoxide diffusing capacity (DLCO), echocardiography, pulmonary high-resolution computed tomography (HRCT), gastroesophageal (GE) endoscopy or manometry or X-ray, and serum autoantibodies. Serum VEGF-A levels were determined by ELISA in 72 SSc patients and 31 healthy controls. Results Giant capillaries were inversely correlated with age (p = 0.034, r = −0.34) and to the extent of reticular pattern at HRCT (p = 0.04, r = −0.5). Avascular areas were directly correlated with capillaroscopy skin ulcer risk index (CSURI) (p = 0.006, r = +0.4) and severity index (p = 0.004, r = +0.5). The mean capillary density was directly correlated to the ulcer number (p = 0.02, r = +0.4) and to DLCO/alveolar volume (p = 0.02, r = +0.4) and inversely correlated with severity index (p = 0.01, r = −0.4) and skin score (p = 0.02, r = −0.4). Serum VEGF levels were higher in the SSc population vs controls (p = 0.03) and inversely correlated with DLCO (p = 0.01, r =−0.4) and directly with ground-glass and reticular pattern at HRCT (p = 0.04, r = +0.4 for both). Conclusions Our data suggest the importance of NVC not only for the diagnosis, but also for the global evaluation of SSc patients. Of note, serum VEGF levels may act as a biomarker of interstitial lung involvement.
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