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El Zayat RS, Hassan FM, Aboelkhair NT, Abdelhakeem WF, Abo Hola AS. Serum endocan, asymmetric dimethylarginine and lipid profile in children with familial Mediterranean fever. Pediatr Res 2024:10.1038/s41390-024-03093-8. [PMID: 38396131 DOI: 10.1038/s41390-024-03093-8] [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: 10/19/2023] [Revised: 12/29/2023] [Accepted: 01/15/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Familial Mediterranean fever (FMF) is a chronic inflammatory disease, and it is thought that subclinical inflammation persists even when there are no attacks, eventually causing endothelial dysfunction (ED) and atherosclerosis. Limited data are available about serum endocan, asymmetric dimethylarginine (ADMA) and lipid profile in children with FMF, so we aimed to evaluate these markers in children with FMF during the attack-free period. METHODS A total of 50 patients diagnosed with FMF and 50 age and sex-matched healthy children were recruited. Serum endocan, ADMA and lipid profiles were measured. Also, atherogenic indices (Castelli's risk indices I and II [CRI I and II], atherogenic index of plasma [AIP] and atherogenic coefficient [AC]) were calculated. RESULTS Serum endocan, ADMA levels, low-density lipoprotein cholesterol, triglycerides, CRI II and AIP of the FMF patients were significantly higher than controls (p < 0.001). Unlike serum endocan, serum ADMA showed a positive significant correlation with total cholesterol, non-high density lipoprotein cholesterol, CRI I, AIP and AC (p < 0.001, p < 0.001, p = 0.004, p = 0.028, p = 0.004 respectively). CONCLUSION Serum ADMA and lipid profile might be used as potential markers for endothelial dysfunction and increased cardiovascular risk in FMF patients. IMPACT Theoretically, serum ADMA may affect lipid profiles and serum endocan represents an intriguing biomarker related to inflammation. Coexistence of dyslipidemia represents an additional risk factor that contributes to the onset of early atherosclerosis. A few studies investigated the role of changes in lipid profile and lipid ratios in accelerated atherosclerosis pathogenesis in FMF patients. The relationship between colchicine and lipid profile is contradictory. Although colchicine can cause dyslipidemia, it also has anti-atherosclerosis effects. Elevated ADMA level and atherogenic indices in FMF children reflect their potential role in the early detection of cardiovascular affection in FMF patients.
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Affiliation(s)
- Rania S El Zayat
- Department of Pediatrics, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
| | - Fahima M Hassan
- Department of Pediatrics, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
| | - Noran T Aboelkhair
- Department of Clinical Pathology, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
| | | | - Ahmed S Abo Hola
- Department of Pediatrics, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt.
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Leventoğlu E, Büyükkaragöz B, Sunar Yayla EN, Esmeray Şenol P, Bakkaloğlu SA. Arterial Stiffness and Ambulatory Blood Pressure Measurements in Children With Familial Mediterranean Fever. Clin Pediatr (Phila) 2023:99228231211705. [PMID: 37937548 DOI: 10.1177/00099228231211705] [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] [Indexed: 11/09/2023]
Abstract
Familial Mediterranean fever (FMF) is an autoinflammatory disease which may cause endothelial dysfunction and arterial stiffness. In this study, we evaluated patients with FMF in terms of arterial stiffness indicators and investigated whether there was any difference according to colchicine response. This is a single-center, prospective, case-control study conducted on pediatric patients with FMF. Patients were categorized into 2 groups: patients on colchicine monotherapy (group 1) and patients who used anti-interleukin-1 (IL-1) plus colchicine (group 2). Patient age, mutations in the MEFV gene, overall duration of treatments, and general characteristics of symptoms were recorded. Laboratory values in an attack-free period were noted. Pulse wave velocity (PWV) was measured in all patients. Erythrocyte sedimentation rate and C-reactive protein, nocturnal hypertension, and PWV were higher in group 2. Arterial stiffness develops due to subclinical inflammation in patients with FMF. It is more pronounced in colchicine-resistant patients.
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Affiliation(s)
- Emre Leventoğlu
- Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Bahar Büyükkaragöz
- Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | | | | | - Sevcan A Bakkaloğlu
- Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
- Department of Pediatric Rheumatology, Gazi University, Ankara, Turkey
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Sönmez HE, Bayındır Y, Batu ED. Cardiovascular manifestations of monogenic periodic fever syndromes. Clin Rheumatol 2023; 42:2717-2732. [PMID: 36622520 DOI: 10.1007/s10067-023-06504-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: 08/30/2022] [Revised: 12/23/2022] [Accepted: 01/02/2023] [Indexed: 01/10/2023]
Abstract
Periodic fever syndromes (PFS) are a group of autoinflammatory diseases characterized by repeated febrile episodes and systemic inflammation. The most common monogenic periodic fever syndromes are familial Mediterranean fever, mevalonate kinase deficiency/hyper immunoglobulin D syndrome, cryopyrin-associated periodic syndrome, and tumor necrosis factor receptor-associated periodic syndrome. Although fever is the predominant feature of PFS, other systems, including the cardiovascular system, may be involved in the disease process. This review focuses on cardiovascular risks and issues in monogenic PFS. Cardiovascular involvement may occur as a disease manifestation, association, or result of complications or a drug's adverse effects in monogenic PFS. Pericarditis seems to be a feature of PFS. Patients with recurrent pericarditis or pericarditis resistant to conventional treatment should be evaluated for PFS. Amyloidosis is the most severe complication of PFS, increasing the risk of cardiac morbidity. Furthermore, ongoing inflammation may result in early atherosclerosis. Therefore, assessing cardiovascular risks in PFS patients should be considered a part of routine care. Key points • Pericarditis is the most common cardiac involvement of monogenic periodic fever syndromes (PFS), while some forms may present with myocarditis. • Amyloidosis, the most significant complication of PFS, may lead to deterioration in cardiac functions. • Ongoing inflammation in PFS may result in endothelial dysfunction and atherosclerosis. • Effective control of inflammation and reducing concomitant risk factors such as obesity, diabetes mellitus, and hypertension could improve cardiovascular outcomes in PFS patients.
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Affiliation(s)
- Hafize Emine Sönmez
- Division of Pediatric Rheumatology, Department of Pediatrics, Kocaeli University Faculty of Medicine, Izmit, Kocaeli, Turkey
| | - Yağmur Bayındır
- Division of Pediatric Rheumatology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey
| | - Ezgi Deniz Batu
- Division of Pediatric Rheumatology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey.
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Topcuoglu MA, Ayvacioglu-Cagan C, Arsava EM, Acar-Ozen P, Kalyoncu U, Gocmen R, Akbaba TH, Balcı-Peynircioğlu B, Tuncer MA. Acute stroke in familial Mediterranean fever: An analysis of 23 new cases and systematic review of the literature. Int J Rheum Dis 2023; 26:657-666. [PMID: 36744553 DOI: 10.1111/1756-185x.14588] [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: 07/21/2022] [Revised: 01/08/2023] [Accepted: 01/16/2023] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The nature of neurovascular involvement in cases of familial Mediterranean fever (FMF) has not been adequately clarified. METHODS AND PATIENTS Clinical features, infarct topography, vascular status, and stroke etiology were prospectively determined in 35 acute neurovascular events that occurred in 23 FMF patients. Clinicoradiological features were compared with an age- and gender-matched control group of 115 acute stroke patients. Characteristics of additional FMF and acute stroke cases (6 episodes in 6 patients) identified from a systematic literature review (PROSPERO registration no: CRD420212264820) were also analyzed. RESULTS There were 27 acute ischemic stroke episodes in 19 patients, 7 transient ischemic attack episodes in 3 patients, and 1 patient with a single episode of parietal hematoma in our cohort. Twenty (74%) ischemic stroke episodes in 12 patients were cryptogenic. Ten of these 12 cases had a previous FMF diagnosis and were taking colchicine. There was no significant difference in the FMF group in terms of the presence of vascular risk factors and angiography-documented disease in comparison to controls. Cerebral distal artery involvement was significantly prevalent in FMF (78% vs 45%, P = .002). Especially, midbrain central deep perforating territory involvement was higher (30% vs 1%, P < .001). The long-term prognosis (median 8.5 years) under antiplatelet agents and colchicine is favorable. DISCUSSION The acute stroke phenotype in FMF cases is herein described for the first time. Several clinicoradiological features such as thrombotic lacunar infarcts located in the central mesencephalon seem so typical that we recommend searching for FMF mutations in geographic regions where FMF is common.
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Affiliation(s)
- Mehmet Akif Topcuoglu
- Department of Neurology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey
| | - Cansu Ayvacioglu-Cagan
- Department of Neurology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey
| | - Ethem Murat Arsava
- Department of Neurology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey
| | - Pınar Acar-Ozen
- Department of Neurology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey
| | - Umut Kalyoncu
- Department of Internal Medicine and Rheumatology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey
| | - Rahsan Gocmen
- Department of Radiology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey
| | - Tayfun Hilmi Akbaba
- Department of Medical Biology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Meryem Aslı Tuncer
- Department of Neurology, Faculty of Medicine Hospital, Hacettepe University, Ankara, Turkey
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Romano M, Garcia-Bournissen F, Piskin D, Rodoplu U, Piskin L, Elzagallaai AA, Tuncer T, Sezer S, Ucuncuoglu D, Honca T, Poddighe D, Yavuz I, Stenvinkel P, Yilmaz MI, Demirkaya E. Anti-Inflammatory, Antioxidant, and Anti-Atherosclerotic Effects of Natural Supplements on Patients with FMF-Related AA Amyloidosis: A Non-Randomized 24-Week Open-Label Interventional Study. Life (Basel) 2022; 12:life12060896. [PMID: 35743929 PMCID: PMC9228597 DOI: 10.3390/life12060896] [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: 05/17/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 11/16/2022] Open
Abstract
We aimed to evaluate the effect of a combination of natural products on parameters related to inflammation, endothelial dysfunction, and oxidative stress in a cohort of familial Mediterranean fever (FMF) patients with Serum Amyloid A amyloidosis, in a non-randomized, 24-week open-label interventional study. Morinda citrifolia (anti-atherosclerotic-AAL), omega-3 (anti-inflammatory-AIC), and extract with Alaskan blueberry (antioxidant-AOL) were given to patients with FMF-related biopsy-proven AA amyloidosis. Patients were >18 years and had proteinuria (>3500 mg/day) but a normal estimated glomerular filtration rate (eGFR). Arterial flow-mediated dilatation (FMD), carotid intima media thickness (CIMT), and serum biomarkers asymmetric dimethylarginine (ADMA), high sensitivity C-reactive protein (hs-CRP), pentraxin (PTX3), malondialdehyde (MDA), Cu/Zn-superoxide dismutase (Cu/Zn-SOD), and glutathione peroxidase (GSH-Px) were studied at baseline and after 24 weeks of treatment. A total of 67 FMF-related amyloidosis patients (52 male (77.6%); median age 36 years (range 21−66)) were enrolled. At the end of a 24-week treatment period with AAL, AIC, and AOL combination therapy, ADMA, MDA, PTX3, hsCRP, cholesterol, and proteinuria were significantly decreased compared to baseline, while CuZn-SOD, GSH-Px, and FMD levels were significantly increased. Changes in inflammatory markers PTX3, and hsCRP were negatively correlated with FMD change, and positively correlated with decreases in proteinuria, ADMA, MDA, cholesterol, and CIMT. Treatment with AAL, AIC and AOL combination for 24 weeks were significantly associated with reduction in inflammatory markers, improved endothelial functions, and oxidative state. Efficient control of these three mechanisms can have long term cardiovascular and renal benefits for patients with AA amyloidosis.
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Affiliation(s)
- Micol Romano
- Department of Paediatrics, Division of Paediatric Rheumatology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5W9, Canada; (M.R.); (E.D.)
- Canadian Behcet and Autoinflammatory Disease Center (CAN BE AID), Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5W9, Canada;
| | - Facundo Garcia-Bournissen
- Department of Paediatrics, Division of Paediatric Clinical Pharmacology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5W9, Canada;
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada
| | - David Piskin
- Canadian Behcet and Autoinflammatory Disease Center (CAN BE AID), Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5W9, Canada;
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada
| | - Ulkumen Rodoplu
- Emergency Medicine Association of Turkey of All, 35220 Izmir, Turkey;
| | - Lizzy Piskin
- Robarts Research Institute, University of Western Ontario, London, ON N6A 3K7, Canada;
| | - Abdelbaset A. Elzagallaai
- Schulich School of Medicine & Dentistry, Physiology and Pharmacology, University of Western Ontario, London, ON N6A 3K7, Canada;
| | - Tunc Tuncer
- Unit of Biochemistry, Epigenetic Health Solutions, 06810 Ankara, Turkey;
| | - Siren Sezer
- Division of Nephrology, Faculty of Medicine, Atilim University, 06830 Ankara, Turkey;
| | - Didar Ucuncuoglu
- Department of Food Engineering, Faculty of Engineering, Cankiri Karatekin University, 18100 Cankiri, Turkey;
| | - Tevfik Honca
- Unit of Biochemistry, Gur Life Hospital, 26320 Eskisehir, Turkey;
| | - Dimitri Poddighe
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan 010000, Kazakhstan;
- Clinical Academic Department of Pediatrics, National Research Center of Maternal and Child Health, University Medical Center, Nur-Sultan 010000, Kazakhstan
| | - Izzet Yavuz
- Department of Nephrology, Lokman Hekim University, 06510 Ankara, Turkey;
| | - Peter Stenvinkel
- Department of Renal Medicine M99, Karolinska Institute, Karolinska University Hospital, 17164 Stockholm, Sweden;
| | - Mahmut Ilker Yilmaz
- Unit of Nephrology, Center for Epigenetic Health Solutions, 06810 Ankara, Turkey
- Correspondence:
| | - Erkan Demirkaya
- Department of Paediatrics, Division of Paediatric Rheumatology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5W9, Canada; (M.R.); (E.D.)
- Canadian Behcet and Autoinflammatory Disease Center (CAN BE AID), Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5W9, Canada;
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada
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Sahin S, Romano M, Guzel F, Piskin D, Poddighe D, Sezer S, Kasapcopur O, Appleton CT, Yilmaz I, Demirkaya E. Assessment of Surrogate Markers for Cardiovascular Disease in Familial Mediterranean Fever-Related Amyloidosis Patients Homozygous for M694V Mutation in MEFV Gene. Life (Basel) 2022; 12:life12050631. [PMID: 35629299 PMCID: PMC9146909 DOI: 10.3390/life12050631] [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: 03/05/2022] [Revised: 04/16/2022] [Accepted: 04/21/2022] [Indexed: 11/16/2022] Open
Abstract
Cardiovascular disease (CVD) remains underestimated in familial Mediterranean fever-associated AA amyloidosis (FMF-AA). We aimed to compare early markers of endothelial dysfunction and atherosclerosis in FMF-AA with a homozygous M694V mutation (Group 1 = 76 patients) in the Mediterranean fever (MEFV) gene and in patients with other genotypes (Group 2 = 93 patients). Measures of increased risk for future CVD events and endothelial dysfunction, including flow-mediated dilatation (FMD), pentraxin-3 (PTX3), and carotid intima-media thickness (cIMT), and fibroblast growth factor 23 (FGF23) as a marker of atherosclerotic vascular disease were compared between groups. The frequency of clinical FMF manifestations did not differ between the two groups apart from arthritis (76.3% in Group 1 and 59.1% in Group 2, p < 0.05). FMD was significantly lower in Group 1 when compared with Group 2 (MD [95% CI]: −0.6 [(−0.89)−(−0.31)]). cIMT, FGF23, and PTX3 levels were higher in Group 1 (cIMT MD [95% CI]: 0.12 [0.08−0.16]; FGF23 MD [95% CI]: 12.8 [5.9−19.6]; PTX3 MD [95% CI]: 13.3 [8.9−17.5]). In patients with FMF-AA, M694V homozygosity is associated with lower FMD values and higher cIMT, FGF23, and PTX3 levels, suggesting increased CVD risk profiles. These data suggest that a genotype−phenotype association exists in terms of endothelial dysfunction and atherosclerosis in patients with FMF-AA.
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Affiliation(s)
- Sezgin Sahin
- Department of Paediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul 34098, Turkey;
- Correspondence:
| | - Micol Romano
- Division of Paediatric Rheumatology, Department of Paediatrics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5C1, Canada; (M.R.); (E.D.)
- Canadian Behcet and Autoinflammatory Disease Center (CAN-BE-AID), University of Western Ontario, London, ON N6A 5C1, Canada;
| | - Ferhat Guzel
- Molecular Genetics Laboratories, Genetics Research and Genome Center, Department of Research and Development, Ant Biotechnology, Istanbul 34775, Turkey;
| | - David Piskin
- Lawson Health Research Institute, London Health Sciences Center, London, ON N6C 2R5, Canada;
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5C1, Canada
| | - Dimitri Poddighe
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan 010000, Kazakhstan;
- Clinical Academic Department of Pediatrics, National Research Center of Maternal and Child Health, University Medical Center, Nur-Sultan 010000, Kazakhstan
| | - Siren Sezer
- Division of Nephrology, Atilim University Faculty of Medicine, Ankara 06830, Turkey;
| | - Ozgur Kasapcopur
- Department of Paediatric Rheumatology, Istanbul University-Cerrahpasa, Istanbul 34098, Turkey;
| | - C. Thomas Appleton
- Canadian Behcet and Autoinflammatory Disease Center (CAN-BE-AID), University of Western Ontario, London, ON N6A 5C1, Canada;
- Lawson Health Research Institute, London Health Sciences Center, London, ON N6C 2R5, Canada;
- Division of Rheumatology, Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 5C1, Canada
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 5C1, Canada
| | - Ilker Yilmaz
- Epigenetic Health Solutions, Unit of Nephrology, Ankara 06810, Turkey;
| | - Erkan Demirkaya
- Division of Paediatric Rheumatology, Department of Paediatrics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5C1, Canada; (M.R.); (E.D.)
- Canadian Behcet and Autoinflammatory Disease Center (CAN-BE-AID), University of Western Ontario, London, ON N6A 5C1, Canada;
- Lawson Health Research Institute, London Health Sciences Center, London, ON N6C 2R5, Canada;
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Arici ZS, Romano M, Piskin D, Guzel F, Sahin S, Berard RA, Yilmaz MI, Demirkaya E. Evaluation of E148Q and Concomitant AA Amyloidosis in Patients with Familial Mediterranean Fever. J Clin Med 2021; 10:3511. [PMID: 34441808 PMCID: PMC8397076 DOI: 10.3390/jcm10163511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/23/2021] [Accepted: 08/06/2021] [Indexed: 12/02/2022] Open
Abstract
The aim of the study was to compare the clinical phenotype of patients with familial Mediterranean fever (FMF)-related AA amyloidosis, according to the age of FMF diagnosis and E148Q genotype. Patients with biopsy-confirmed FMF-related AA amyloidosis were included in the study. Tel-Hashomer criteria were applied in the diagnosis of FMF. All patients had detailed baseline assessment of clinical features, renal functions, genetic testing, histopathological diagnosis of amyloidosis, and treatment received. Multiple comparisons were performed according to the age of diagnosis, disease phenotype, mutation, and mortality. Our study included 169 patients with a diagnosis of AA amyloidosis. There were 101 patients diagnosed with FMF < 18 years of age and 68 patients diagnosed who were ≥18 years of age. The three most common clinical manifestations were fever (84.6%), abdominal pain (71.6%), and arthritis (66.9%). The most common allele among FMF patients was M694V (60.6%), followed by E148Q (21.4%), and M680I (10.3%). The most frequent genotypes were M694V/M694V (45.0%), M694V/E148Q (14.8%), and E148Q/E148Q (11.2%) among 169 patients in our cohort. During the follow-up period, 15 patients (10 male, 5 female) died, of whom 14 had M694V homozygous genotype and one was homozygous for E148Q. Clinicians should be aware of patients with homozygous E148Q genotype for close monitoring and further evaluation. The possible relationship between E148Q and AA amyloidosis needs to be confirmed in other ethnicities.
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Affiliation(s)
- Zehra Serap Arici
- Department of Paediatric Rheumatology, Sanliurfa Training and Research Hospital, Sanliurfa 63250, Turkey;
- Clinical Epidemiology, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Micol Romano
- Schulich School of Medicine & Dentistry, Department of Paediatrics, Division of Paediatric Rheumatology, University of Western Ontario, London, ON N6A 5W9, Canada; (M.R.); (D.P.); (R.A.B.)
| | - David Piskin
- Schulich School of Medicine & Dentistry, Department of Paediatrics, Division of Paediatric Rheumatology, University of Western Ontario, London, ON N6A 5W9, Canada; (M.R.); (D.P.); (R.A.B.)
- Lawson Health Research Institute, London Health Sciences Center, London, ON N6C 2R5, Canada
- Schulich School of Medicine & Dentistry, Department of Epidemiology and Biostatistics, University of Western Ontario, London, ON N6A 3K7, Canada
| | - Ferhat Guzel
- Molecular Genetics Laboratories, Genetics Research and Genome Center, Department of Research and Development, Gentera Biotechnology, Istanbul 34406, Turkey;
| | - Sezgin Sahin
- Department of Pediatric Rheumatology, Basaksehir Cam ve Sakura City Hospital, University of Health Sciences, Istanbul 34480, Turkey;
| | - Roberta A. Berard
- Schulich School of Medicine & Dentistry, Department of Paediatrics, Division of Paediatric Rheumatology, University of Western Ontario, London, ON N6A 5W9, Canada; (M.R.); (D.P.); (R.A.B.)
| | - Mahmut I. Yilmaz
- Division of Nephrology, Center for Epigenetic Health Solutions, Ankara 06810, Turkey;
| | - Erkan Demirkaya
- Schulich School of Medicine & Dentistry, Department of Paediatrics, Division of Paediatric Rheumatology, University of Western Ontario, London, ON N6A 5W9, Canada; (M.R.); (D.P.); (R.A.B.)
- Schulich School of Medicine & Dentistry, Department of Epidemiology and Biostatistics, University of Western Ontario, London, ON N6A 3K7, Canada
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Omma A, Armaǧan B, Güven SC, Sandıkçı SC, Çolak S, Yücel Ç, Küçükşahin O, Erden A. Endocan: A Novel Marker for Colchicine Resistance in Familial Mediterranean Fever Patients? Front Pediatr 2021; 9:788864. [PMID: 34912764 PMCID: PMC8667615 DOI: 10.3389/fped.2021.788864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 10/29/2021] [Indexed: 12/13/2022] Open
Abstract
Introduction: Familial Mediterranean fever (FMF) patients had 5-10% colchicine resistance. Although FMF attacks are characterized by acute phase elevation, there are no biomarkers that can show colchicine resistance yet. The serum endocan levels may elevate in inflammatory and auto-inflammatory diseases. Objectives: This study aimed to evaluate serum endocan levels in FMF patients according to whether attack and colchicine resistance or not and also compare them with classical acute phase reactants. Methods: In this single-center and cross-sectional study, a total of 111 FMF patients and 60 healthy individuals were enrolled. All patients' basic demographic and clinical data were recorded and blood samples were collected. Results: A total of 46 (41.4%) FMF patients had colchicine resistance. In comparison to the FMF patients according to colchicine response, colchicine resistance patients had a significantly higher median (IQR) endocan levels than colchicine responsive patients [36.98 ng/ml (97.41) vs. 13.57 ng/ml (27.87), p = 0.007], but there were no differences between in terms of median ESR and CRP levels. Inversely, serum endocan levels were similar during an attack and attack-free period in FMF patients, although ESR and CRP levels were significantly different. Interestingly, the highest serum endocan levels were in the control group. Conclusion: In conclusion, serum endocan levels were higher in colchicine resistance than colchicine responsive patients, but attack state had no effect on serum endocan levels in our study. Unlike ESR and CRP, serum endocan may be a novel biomarker for detection of colchicine resistance and distinguish the FMF attacks.
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Affiliation(s)
- Ahmet Omma
- Department of Rheumatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Berkan Armaǧan
- Clinic of Rheumatology, Ankara City Hospital, Ankara, Turkey
| | | | - Sevinç Can Sandıkçı
- Department of Rheumatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Seda Çolak
- Department of Rheumatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Çiǧdem Yücel
- Department of Clinical Biochemistry, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Orhan Küçükşahin
- Division of Rheumatology, Department of Internal Medicine, Ankara City Hospital, Yildirim Beyazit University, Ankara, Turkey
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9
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Romano M, Piskin D, Berard RA, Jackson BC, Acikel C, Carrero JJ, Lachmann HJ, Yilmaz MI, Demirkaya E. Cardiovascular disease risk assessment in patients with familial Mediterranean fever related renal amyloidosis. Sci Rep 2020; 10:18374. [PMID: 33110219 PMCID: PMC7591897 DOI: 10.1038/s41598-020-75433-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/14/2020] [Indexed: 01/10/2023] Open
Abstract
Chronic inflammation and proteinuria is a risk factor for cardiovascular disease (CVD) in patients with chronic kidney diseases and rheumatologic disorders. Our aim was to investigate the CVD events (CVDEs) and survival between the patients with FMF-related AA amyloidosis and glomerulonephropathies (GN) to define possible predictors for CVDEs. A prospective follow-up study with FMF-amyloidosis and glomerulonephropathy (GN) was performed and patients were followed for CVDEs. Flow-mediated dilatation (FMD), FGF-23, serum lipid, hsCRP levels, BMI and HOMA were assessed. A Cox regression analysis was performed to evaluate the risk factors for CVDEs. There were 107 patients in the FMF-amyloidosis group and 126 patients with GN group. Forty-seven CVDEs were observed during the 4.2-years follow up; all 28 patients in the FMF-amyloidosis group and 14/19 patients with GN developed CVDEs before the age of 40 (p = 0.002). CVD mortality was 2.8 times higher (95% CI 1.02–7.76) in patients with FMF-amyloidosis. Across both groups, FMD and FGF23 (p < 0.001) levels were independently associated with the risk of CVDEs. Patients with FMF-amyloidosis are at increased risk of early CVDEs with premature mortality age. FGF 23, FMD and hsCRP can stratify the risk of early CVD in patients with FMF-related AA amyloidosis.
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Affiliation(s)
- Micol Romano
- Division of Paediatric Rheumatology, Department of Paediatrics, Schulich School of Medicine & Dentistry, University of Western Ontario, 800 Commissioners Rd E. B1-146, London, ON, N6A 5W9, Canada.,Department of Pediatric Rheumatology, ASST G Pini, Milano, Italy
| | - David Piskin
- Lawson Health Research Institute, London Health Sciences Center, London, ON, Canada
| | - Roberta A Berard
- Division of Paediatric Rheumatology, Department of Paediatrics, Schulich School of Medicine & Dentistry, University of Western Ontario, 800 Commissioners Rd E. B1-146, London, ON, N6A 5W9, Canada
| | - Bradley C Jackson
- Division of Paediatric Rheumatology, Department of Paediatrics, Schulich School of Medicine & Dentistry, University of Western Ontario, 800 Commissioners Rd E. B1-146, London, ON, N6A 5W9, Canada
| | | | - Juan J Carrero
- Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet, Stockholm, Sweden
| | - Helen J Lachmann
- Division of Medicine (Royal Free Campus), Centre for Amyloidosis & Acute Phase Proteins, London, UK
| | - Mahmut I Yilmaz
- Unit of Nephrology, Epigenetic Health Solutions, Ankara, Turkey
| | - Erkan Demirkaya
- Division of Paediatric Rheumatology, Department of Paediatrics, Schulich School of Medicine & Dentistry, University of Western Ontario, 800 Commissioners Rd E. B1-146, London, ON, N6A 5W9, Canada. .,Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada.
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Vampertzi O, Papadopoulou-Legbelou K, Triantafyllou A, Douma S, Papadopoulou-Alataki E. Familial Mediterranean fever and atherosclerosis in childhood and adolescence. Rheumatol Int 2019; 40:1-8. [PMID: 31705200 DOI: 10.1007/s00296-019-04457-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/26/2019] [Indexed: 12/17/2022]
Abstract
Familial Mediterranean fever is a chronic inflammatory disease characterized by periodic and self-limited episodes of fever and aseptic polyserositis. Although colchicine treatment has altered the course of the disease, it is believed that subclinical inflammation is still present, leading to endothelial dysfunction and atherosclerosis in the course of time. In this review, following the published recommendations, we queried online databases such as MEDLINE Pubmed, Scopus, and Web of science for peer-reviewed studies and reviews written in English language, using the following keywords: familial Mediterranean fever, children, endothelial dysfunction, atherosclerosis, cardiovascular disease. The objective of this review is to highlight the correlation between familial Mediterranean fever and atherosclerosis, and moreover to describe new serum inflammatory markers and non-invasive methods of endothelial dysfunction, to detect the atherosclerosis process early starting from childhood.
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Affiliation(s)
- Olga Vampertzi
- 4th Department of Pediatrics, "Papageorgiou" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | | | - Areti Triantafyllou
- 3rd Department of Internal Medicine, "Papageorgiou" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stella Douma
- 3rd Department of Internal Medicine, "Papageorgiou" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efimia Papadopoulou-Alataki
- 4th Department of Pediatrics, "Papageorgiou" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Kozan M, Ozan ZT, Demir V, Ede H. The relation of novel cardiovascular risk parameters in patients with familial Mediterranean fever. JRSM Cardiovasc Dis 2019; 8:2048004018823856. [PMID: 30643639 PMCID: PMC6322093 DOI: 10.1177/2048004018823856] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/27/2018] [Accepted: 09/26/2018] [Indexed: 11/17/2022] Open
Abstract
Objective In this study, we aimed at correlating the thickness of epicardial adipose tissue and levels of Vitamin D with cardiac risk in patients with familial Mediterranean fever. Methods Sixty-five patients with familial Mediterranean fever and 38 healthy controls with matching age and sex were included in the study. The patients with a history of familial Mediterranean fever attacks within the previous two weeks or with any history of inflammatory or cardiovascular disease were excluded. Data regarding age, gender, weight, height, waist circumference, body mass index (calculated as weight/height2), pulse wave velocity, serum Vitamin D levels from fasting blood samples, and Homeostatic Model Assessment for insulin resistance were obtained for the patients and controls. The epicardial adipose tissue was visualized as an echo-free space between the outer surface of myocardium and visceral pericardium using two-dimensional echocardiography, and the thickness of epicardial adipose tissue was measured in parasternal long-axis view at the end of diastole. Results The patients with familial Mediterranean fever had significantly higher levels of C-reactive protein, epicardial adipose tissue, and pulse wave velocity (p < 0.001, <0.05, <0.005, respectively) as compared with the control group. However, the serum Vitamin D levels in the two groups were observed to be similar (p = 0.486). Weak but significant positive correlations were observed between epicardial adipose tissue thickness and C-reactive protein (r = 0.302, p < 0.005), epicardial adipose tissue thickness and pulse wave velocity (r = 0.263, p < 0.01), and C-reactive protein and pulse wave velocity (r = 0.235, p < 0.05). Conclusion Thickness of epicardial adipose tissue and pulse wave velocity were observed to increase in patients with familial Mediterranean fever.
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Affiliation(s)
- Mustafa Kozan
- Department of Internal Medicine, Faculty of Medicine, Bozok University, Yozgat, Turkey
| | - Zeynep Tugba Ozan
- Department of Internal Medicine, Faculty of Medicine, Bozok University, Yozgat, Turkey
| | - Vahit Demir
- Department of Cardiology, Faculty of Medicine, Bozok University, Yozgat, Turkey
| | - Hüseyin Ede
- Department of Cardiology, Faculty of Medicine, Bozok University, Yozgat, Turkey
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Yel S, Dursun İ, Çetin F, Baştuğ F, Tülpar S, Düşünsel R, Gündüz Z, Poyrazoğlu H, Yılmaz K. Increased circulating endothelial microparticles in children with FMF. Biomarkers 2018; 23:558-562. [PMID: 29611726 DOI: 10.1080/1354750x.2018.1460764] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Endothelial microparticles (EMPs) are considered as markers of endothelial dysfunction. In this study, we aimed to examine whether there is endothelial dysfunction in children with familial Mediterranean fever (FMF), hypothesizing that endothelial dysfunction would be present especially with acute-phase response in the active period of the disease. METHODS This cross-sectional study included 65 FMF patients (41 attack free, 24 attack period) and 35 healthy controls. Circulating EMPs, serum amyloid A (SAA), and other inflammation markers were measured in all groups. Circulating EMPs were measured using flow cytometry. Study groups were compared for circulating EMP and inflammatory markers. The relationship between EMPs and the activation of the disease was evaluated. RESULTS The levels of CD144+ and CD146+ EMPs in the FMF attack period group were significantly higher than those of the control group (p < 0.05). The levels of inflammation markers in the attack period group were significantly higher than those of the control and attack-free groups (p < 0.05). In the FMF attack group, the CD144+ and CD146+ EMP were significantly correlated with CRP. CONCLUSIONS Our results suggest that endothelial damage is present especially in the active period of the disease in children with FMF. The endothelial dysfunction becomes an overt parallel with inflammation.
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Affiliation(s)
- Sibel Yel
- a Department of Pediatric Nephrology , Kayseri Education and Research Hospital , Kayseri , Turkey
| | - İsmail Dursun
- b Department of Pediatric Nephrology , Erciyes University Faculty of Medicine , Kayseri , Turkey
| | - Feyza Çetin
- c Department of Microbiology , Kayseri Education and Research Hospital , Kayseri , Turkey
| | - Funda Baştuğ
- a Department of Pediatric Nephrology , Kayseri Education and Research Hospital , Kayseri , Turkey
| | - Sebahat Tülpar
- b Department of Pediatric Nephrology , Erciyes University Faculty of Medicine , Kayseri , Turkey
| | - Ruhan Düşünsel
- b Department of Pediatric Nephrology , Erciyes University Faculty of Medicine , Kayseri , Turkey
| | - Zübeyde Gündüz
- b Department of Pediatric Nephrology , Erciyes University Faculty of Medicine , Kayseri , Turkey
| | - Hakan Poyrazoğlu
- b Department of Pediatric Nephrology , Erciyes University Faculty of Medicine , Kayseri , Turkey
| | - Kenan Yılmaz
- b Department of Pediatric Nephrology , Erciyes University Faculty of Medicine , Kayseri , Turkey
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Cardiac disease in familial Mediterranean fever. Rheumatol Int 2017; 38:51-58. [DOI: 10.1007/s00296-017-3853-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/10/2017] [Indexed: 01/19/2023]
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Ozalper V, Kara M, Tanoglu A, Cetındaglı I, Ozturker C, Hancerlı Y, Hıra S, Kara K, Beyazıt Y, Yazgan Y. Evaluation of endothelial dysfunction in patients with familial Mediterranean fever: the relationship between the levels of asymmetric dimethylarginine and endocan with carotid intima-media thickness and endothelium-dependent vasodilation. Clin Rheumatol 2017; 36:2071-2077. [PMID: 28074304 DOI: 10.1007/s10067-016-3532-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 12/04/2016] [Accepted: 12/28/2016] [Indexed: 12/20/2022]
Abstract
It has been suggested that there is an ongoing subclinical inflammation in familial Mediterranean fever (FMF) patients also in attack-free periods as well. Due to this ongoing inflammation, endothelial dysfunction (ED) may develop. Previously, ED has been suggested to increase the risk of the atherosclerosis and cardiovascular disease (CVD). Endocan is recognized as a specific molecule of the endothelium and has been shown to increase in some cases associated with inflammation. However, there is not sufficient data whether those with FMF could develop ED in the early period of life. In this study, we aimed to investigate ED and its relation with endocan in young FMF patients. A total of 57 male patients diagnosed with FMF according to the Tel Hashomer criteria and a total of 33 healthy males with similar characteristics to the patient group were included in this research. Complete blood count, erythrocyte sedimentation rate (ESR), fibrinogen, serum glucose, serum LDL cholesterol (LDL-C) and triglyceride (TG), asymmetric dimethylarginine (ADMA), and endocan levels were tested from fasting blood samples. Moreover, carotid intima-media thickness (CIMT) and flow-mediated dilatation (FMD) were measured. The endocan levels of the FMF patients during an attack-free period were significantly higher than those of the control group (p < 0.001). On the other hand, FMD measurements were significantly lower among FMF patients (p < 0.001). ADMA levels were higher in the patient group; however, this difference was similar (p > 0.05). CIMT values were similar among FMF patients and healthy controls (p > 0.05). These results have suggested that ED may develop in the patients with FMF who have no additional CVD risk, even during young adulthood, and endocan may be a favorable biomarker at demonstration of ED than ADMA among FMF patients.
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Affiliation(s)
- Veysel Ozalper
- Internal Medicine Department, GATA Haydarpasa Training Hospital, Uskudar, 34688, Istanbul, Turkey
| | - Muammer Kara
- Gastroenterology Department, GATA Haydarpasa Training Hospital, Uskudar, 34668, Istanbul, Turkey
| | - Alpaslan Tanoglu
- Gastroenterology Department, GATA Haydarpasa Training Hospital, Uskudar, 34668, Istanbul, Turkey.
| | - Ibrahim Cetındaglı
- Internal Medicine Department, GATA Haydarpasa Training Hospital, Uskudar, 34688, Istanbul, Turkey
| | - Coskun Ozturker
- Radiology Department, GATA Haydarpasa Training Hospital, Uskudar, 34668, Istanbul, Turkey
| | - Yusuf Hancerlı
- Internal Medicine Department, GATA Haydarpasa Training Hospital, Uskudar, 34688, Istanbul, Turkey
| | - Serdar Hıra
- Biochemistry Department, GATA Haydarpasa Training Hospital, Uskudar, 34668, Istanbul, Turkey
| | - Kemal Kara
- Radiology Department, GATA Haydarpasa Training Hospital, Uskudar, 34668, Istanbul, Turkey
| | - Yavuz Beyazıt
- Gastroenterology Department, Canakkale Onsekiz Mart University, 17100, Canakkale, Turkey
| | - Yusuf Yazgan
- Gastroenterology Department, GATA Haydarpasa Training Hospital, Uskudar, 34668, Istanbul, Turkey
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Asymmetric and Symmetric Dimethylarginine as Risk Markers for Total Mortality and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Studies. PLoS One 2016; 11:e0165811. [PMID: 27812151 PMCID: PMC5094762 DOI: 10.1371/journal.pone.0165811] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 10/18/2016] [Indexed: 02/05/2023] Open
Abstract
Background A growing number of studies linked elevated concentrations of circulating asymmetric (ADMA) and symmetric (SDMA) dimethylarginine to mortality and cardiovascular disease (CVD) events. To summarize the evidence, we conducted a systematic review and quantified associations of ADMA and SDMA with the risks of all-cause mortality and incident CVD in meta-analyses accounting for different populations and methodological approaches of the studies. Methods Relevant studies were identified in PubMed until February 2015. We used random effect models to obtain summary relative risks (RR) and 95% confidence intervals (95%CIs), comparing top versus bottom tertiles. Dose-response relations were assessed by restricted cubic spline regression models and potential non-linearity was evaluated using a likelihood ratio test. Heterogeneity between subgroups was assessed by meta-regression analysis. Results For ADMA, 34 studies (total n = 32,428) investigating associations with all-cause mortality (events = 5,035) and 30 studies (total n = 30,624) investigating the association with incident CVD (events = 3,396) were included. The summary RRs (95%CI) for all-cause mortality were 1.52 (1.37–1.68) and for CVD 1.33 (1.22–1.45), comparing high versus low ADMA concentrations. Slight differences were observed across study populations and methodological approaches, with the strongest association of ADMA being reported with all-cause mortality in critically ill patients. For SDMA, 17 studies (total n = 18,163) were included for all-cause mortality (events = 2,903), and 13 studies (total n = 16,807) for CVD (events = 1,534). High vs. low levels of SDMA, were associated with increased risk of all-cause mortality [summary RR (95%CI): 1.31 (1.18–1.46)] and CVD [summary RR (95%CI): 1.36 (1.10–1.68) Strongest associations were observed in general population samples. Conclusions The dimethylarginines ADMA and SDMA are independent risk markers for all-cause mortality and CVD across different populations and methodological approaches.
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Bogdanova MV, Rameev VV, Kozlovskaya LV, Fedorov ES, Salugina SO. [Serum calgranulin C is a highly sensitive autoinflammation activity indicator in patients with familial periodic fevers]. TERAPEVT ARKH 2016; 88:58-64. [PMID: 27296263 DOI: 10.17116/terarkh201688658-64] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
AIM To determine the possibility of using the serum proinflammatory calcium-binding protein, or calgranulin C (S100A12), to assess activity and therapeutic efficiency in patients with periodic disease (PD) and other familial periodic fevers (FPFs). SUBJECTS AND METHODS Thirty-five patients with PD and other FPDs, which were verified by molecular genetic study, were examined. In accordance with the disease activity, the patients were divided into 2 groups. The investigators determined the concentration of S100A12 by solid-phase enzyme immunoassay and that of other acute-phase inflammatory markers (erythrocyte sedimentation rate (ERT), neutrophil counts, and fibrinogen and C-reactive protein (CRP) concentrations). RESULTS The serum concentration of S100A12 in the stage of disease activity was 466.7 (265.22--851.7) ng/ml, which was significantly higher than in remission (244.29 (118.93--409.85) ng/ml (p=0.000002). The highest S100A12 concentrations were noted in the patients with PD; these were 758.95 (434.80--1035.95) ng/ml; the S100A12 level in the majority of PD patients even during remission remained moderately higher. An investigation of the relationship of A100A12 to genetic variants found no differences between the patients homozygous for M694V and those with other genotypes (p=0.37). Estimation of the time course of therapy-induced changes in the serum S100A12 concentration revealed its considerable reduction (р=0.0018). However, normalization of S100A12 levels was not achieved in PD. The remaining increased S100A12 concentration in these patients may be suggestive of the activity of PD despite the absence of its clinical manifestations. S100A12 as a highly sensitive marker allows more exact evaluation of the anti-inflammatory effect of therapy. The S100A12 identification of the subclinical activity of autoinflammatory diseases made all the more important since traditional inflammatory markers, such as ERT, CRP, fibrinogen, and leukocyte counts, are less sensitive for these purposes. In our study, these markers were within the reference range in remission. No differences were found in the S100A12 levels between the groups with and without amyloidosis (p=0.62). CONCLUSION S100A12 is a highly sensitive marker for the activity of autoinflammatory diseases and the efficiency of their therapy. The serum level of S100A12 in PD may be used to diagnose the subclinical activity of inflammation, which is of importance in monitoring the risk of amyloidosis.
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Affiliation(s)
- M V Bogdanova
- M.V. Lomonosov Moscow State University, Moscow, Russia
| | - V V Rameev
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia
| | - L V Kozlovskaya
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia
| | - E S Fedorov
- V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia
| | - S O Salugina
- V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia
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Investigation of the arterial stiffness and associated factors in patients with familial Mediterranean fever. Anatol J Cardiol 2016; 17:132-138. [PMID: 27488756 PMCID: PMC5336751 DOI: 10.14744/anatoljcardiol.2016.6985] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Objective: Because of the ongoing and recurring inflammatory state in familial Mediterranean fever (FMF), patients may experience a high risk of cardiovascular events. Our aim was to investigate the arterial stiffness and associated factors in patients with FMF. Methods: Sixty-nine consecutive FMF patients (including 11 females) and 35 controls (including 5 females) were enrolled in the study. The demographical, clinical, and laboratory data and genetic mutations of the patients were recorded. In the study, FMF patients according to the Tel-Hashomer criteria were included, whereas patients with other known inflammatory rheumatologic disease, atherosclerotic cardiovascular disease, hypertension, diabetes, those under the age of 18 years, or those refusing to participate in the study were excluded. Arterial stiffness measurements were performed using the TensioMed device (TensoMed Ltd, Budapest, Hungary). Results: The patient and control groups were similar in terms of the mean ages, BMIs, gender, systolic blood pressures, and smoking. FMF patients had a higher pulse wave velocity (PWV) (7.73±1.3 and 7.18±1.1 m/s; p=0.03) and lower brachial and aortic augmentation indexes (–64.6±14.6% and –54.6±25.9%, p=0.041 and 4.9±7.4% and 14.0±11.5%, p=0.025, respectively) compared with the controls. Thirty-one (45%) patients were in the “during-attack” state and had higher PWV (8.17±1.6 and 7.38±0.9 m/s; p=0.027) compared with the asymptomatic patients. PWV was correlated to serum CRP, WBC, ESR, fibrinogen, and neutrophil/lymphocyte ratios (r=0.666, 0.429, 0.441, 0.388, and 0.460, respectively). The genetic mutation and predominant attack type had no effect on arterial stiffness. Conclusion: FMF patients have increased arterial stiffness during attacks compared with asymptomatic patients and controls. The impaired arterial stiffness is correlated to the severity of the inflammatory state rather than to the attack type or genetic mutations.
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La Regina M, Orlandini F, Manna R. Autoinflammatory diseases: a possible cause of thrombosis? Thromb J 2015; 13:19. [PMID: 25969671 PMCID: PMC4428094 DOI: 10.1186/s12959-015-0049-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 03/19/2015] [Indexed: 11/24/2022] Open
Abstract
Autoinflammatory diseases are a group of disorders due to acquired or hereditary disfunction of innate immune system and characterized by systemic or localized manifestations. The prototype is Familial Mediterranean Fever, a monogenic hereditary disorder, whose causing gene (MeFV gene) was identified in 1997 and opened the way to a new fascinanting chapter of rheumatology. A growing body of monogenic and poligenic autoinflammatory disorders has been described since then. Arterial and venous thrombosis is a common medical problem, with significant morbidity and mortality. Strong evidences from basic research and clinical epidemiological studies support the theory that inflammation and thrombosis can be associated. Because of their recurrent/chronic inflammatory nature, autoinflammatory diseases are a putative cause of thrombotic manifestations. In the present work, we reviewed the available evidences about monogenic autoinflammatory disorders, complicated by thrombotic manifestations.
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Affiliation(s)
- Micaela La Regina
- Department of Internal Medicine, Ligurian East Hospital, La Spezia, Italy
| | | | - Raffaele Manna
- Centre of Periodic Fevers - Catholic University of Rome, Rome, Italy
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Yuksel M, Yildiz A, Oylumlu M, Turkcu FM, Bilik MZ, Ekinci A, Elbey B, Tekbas E, Alan S. Novel markers of endothelial dysfunction and inflammation in Behçet’s disease patients with ocular involvement: epicardial fat thickness, carotid intima media thickness, serum ADMA level, and neutrophil-to-lymphocyte ratio. Clin Rheumatol 2015; 35:701-8. [DOI: 10.1007/s10067-015-2907-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 02/13/2015] [Accepted: 02/18/2015] [Indexed: 12/30/2022]
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