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Qing J, Song W, Tian L, Samuel SB, Li Y. Potential Small Molecules for Therapy of Lupus Nephritis Based on Genetic Effect and Immune Infiltration. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2259164. [PMID: 35502341 PMCID: PMC9056222 DOI: 10.1155/2022/2259164] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/09/2022] [Accepted: 03/30/2022] [Indexed: 02/07/2023]
Abstract
Lupus nephritis (LN) is the most common and significant complication of systemic lupus erythematosus (SLE) due to its poor prognosis and mortality rates in SLE patients. There is a critical need for new drugs as the pathogenesis of LN remains to be elucidated and immunosuppressive therapy comes with many deficiencies. In this study, 23 hub genes (IFI6, PLSCR1, XAF1, IFI16, IFI44, MX1, IFI44L, IFIT3, IFIT2, IFI27, DDX58, EIF2AK2, IFITM1, RTP4, IFITM3, TRIM22, PARP12, IFIH1, OAS1, HERC6, RSAD2, DDX60, and MX2) were identified through bioinformatics and network analysis and are closely related to interferon production and function. Interestingly, immune cell infiltration analysis and correlation analysis demonstrate a positive correlation between the expression of 23 hub genes and monocyte infiltration in glomeruli and M2 macrophage infiltration in the tubulointerstitium of LN patients. Additionally, the CTD database, DsigDB database, and DREIMT database were used to explore the bridging role of genes in chemicals and LN as well as the potential influence of these chemicals on immune cells. After comparison and discussion, six small molecules (Acetohexamide, Suloctidil, Terfenadine, Prochlorperazine, Mefloquine, and Triprolidine) were selected for their potential ability in treating lupus nephritis.
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Affiliation(s)
- Jianbo Qing
- The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Wenzhu Song
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Lingling Tian
- Shanxi University of Traditional Chinese Medicine, Taiyuan, Shanxi 030000, China
| | - Sonia Biju Samuel
- Department of Medicine, Albany Medical Center. 43 New Scotland Ave, Albany, New York 12208, USA
| | - Yafeng Li
- Department of Nephrology, Shanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, Shanxi 030012, China
- Core Laboratory, Shanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, Shanxi 030012, China
- Shanxi Provincial Key Laboratory of Kidney Disease, Shanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, Shanxi 030012, China
- Academy of Microbial Ecology, Shanxi Medical University, Taiyuan, Shanxi 030000, China
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Wang Z, Li M, Ye Z, Li C, Li Z, Li X, Wu L, Liu S, Zuo X, Zhu P, Wang Z, Ma L, Zhang M, Hou Z, Bi L, Wang Y, Zhao J, Wang Q, Tian X, Zeng X. Long-term Outcomes of Patients with Systemic Lupus Erythematosus: A Multicenter Cohort Study from CSTAR Registry. RHEUMATOLOGY AND IMMUNOLOGY RESEARCH 2021; 2:195-202. [PMID: 36465068 PMCID: PMC9524789 DOI: 10.2478/rir-2021-0025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 10/12/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To study the long-term outcomes, in the context of both mortality and organ damage in patients with systemic lupus erythematosus (SLE) in the Chinese SLE Treatment and Research group (CSTAR) registry cohort. METHODS Patients were enrolled from April 2009 to February 2010 and they were followed up. The demographic data, clinical manifestations, labs test results and imaging examinations, disease activity (SLEDAI-2K), damage scores (SLLIC/Damage Index [SDI]), and medications were collected. Data were censored at either the last clinic visit or telephonic interview. Survival rate was analyzed by Kaplan-Meier (KM) method. COX proportional hazard model was adopted to perform the analysis of predicting factors for mortality and organ damage. Logistic regression analysis was employed to discuss the relationship among mortality, organ damage, and flare. RESULTS A total of 2104 patients were recruited at baseline and 1494 patients were followed up. The cumulative 1-year, 3-year, and 5-year survival rates were 98.3%, 96.9%, and 95.7%, respectively. Seventy-eight patients died during follow-up, and the main causes of death were infection (34.6%), active disease (26.9%), cardiovascular and cerebrovascular events (5.13%), and malignancy (5.13%). At entry, 247 patients presented with irreversible organ damage and it increased to 398 patients at the endpoint. The major accumulated organ damages were kidney (25.9%), musculoskeletal disease (20.2%), neuropsychiatric disease (12.2%), and pulmonary damage (10.9%). Cox regression analysis further showed that male, late disease onset, delayed diagnosis (diagnosis from disease onset >1 year), baseline organ damage, and specific organ involvements predicted for higher mortality. In addition, early disease onset was a protecting factor for organ damage, and anti-SSA was an independent predicting factor for new organ damage. Logistic regression analysis showed that flare predicted for more organ damage. CONCLUSION The 5-year survival rate of Chinese SLE patients has improved and is comparable to Caucasians SLE patients. Disease flare impact on prognosis is the increasing risk of damage development. Early diagnosis, prevention for flare and damage to maintain remission, may improve outcome.
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Affiliation(s)
- Ziqian Wang
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Mengtao Li
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Zhizhong Ye
- Department of Rheumatology, The Fourth People’s Hospital of Shenzhen Affiliated to Guangdong Medical College, Shenzhen, China
| | - Caifeng Li
- Department of Rheumatology, Beijing Children Hospital Affiliated to Capital Medical University, Beijing, China
| | - Zhijun Li
- Department of Rheumatology, The Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Xiangpei Li
- Department of Rheumatology, The First Affiliated Hospital of USTC, Anhui Provincial Hospital, Hefei, China
| | - Lijun Wu
- Department of Rheumatology, The People’s Hospital of Xinjiang Autonomous Region, Urumqi, China
| | - Shengyun Liu
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoxia Zuo
- Department of Rheumatology, Xiangya Hospital, Central South University, Changsha, China
| | - Ping Zhu
- Department of Clinical Immunology, PLA Specialized Research Institute of Rheumatology and Immunology, Xijing Hospital, Airforce Military Medical University, Xi’an, China
| | - Zhengang Wang
- Department of Rheumatology, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing, China
| | - Li Ma
- Department of Rheumatology, China-Japan Friendship Hospital Affiliated to the National Health Commission of PRC, Beijing, China
| | - Miaojia Zhang
- Department of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhiduo Hou
- Department of Rheumatology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Liqi Bi
- Department of Rheumatology, Sino-Japanese friendship Hospital of Jilin University, Changchun, China
| | - Yanhong Wang
- Department of Epidemiology and Bio-statistics, Institute of Basic Medical Sciences, China Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiuliang Zhao
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Qian Wang
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Xinping Tian
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Xiaofeng Zeng
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
- E-mail:
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Abstract
Systemic lupus erythematosus is a chronic autoimmune disorder that causes a wide range of mild to life-threatening conditions that require hospitalization and critical care. The morbidity and mortality of systemic lupus erythematosus are associated with the organ system damage caused by intermittent or chronic disease activity and with the complications of long-term and toxic immunosuppressant medication regimens. This article reviews the epidemiologic, clinical, diagnostic, and therapeutic information essential for critical care clinicians who provide care to patients with systemic lupus erythematosus.
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Affiliation(s)
- Erin K Gasser
- Erin K. Gasser is Critical Care Nurse Practitioner at University of California, San Francisco Health, San Francisco, California
| | - Hildy M Schell-Chaple
- Hildy M. Schell-Chaple is Clinical Nurse Specialist at University of California, San Francisco Health and Clinical Professor, UCSF School of Nursing, 505 Parnassus Ave, L-976, San Francisco, CA 94143
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Zhang C, Zhang C, Ji J, Xiong X, Lu Y. Hsa_circ_0012919 regulates expression of MDA5 by miR-125a-3p in CD4+ T cells of systemic lupus erythematous. Lupus 2020; 29:727-734. [PMID: 32321346 DOI: 10.1177/0961203320920706] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Systemic lupus erythematous (SLE) is an autoimmune disease with production of various autoantibodies directed against various autoantigens. But the research on melanoma differentiation-associated gene 5 (MDA5) in SLE is still scarce. Here we try to elucidate the effect of hsa_circ_0012919 on MDA5 and its potential clinical value in SLE. CD4+ T cells from SLE patients and healthy control subjects were isolated. Expression of hsa_circ_0012919 and MDA5, and methylation level of MDA5 promoter were detected. Then expression and methylation level of MDA5 promoter was examined after transfection of hsa_circ_0012919-targeted siRNA and plasmids. Expression of hsa_circ_0012919 and MDA5 were further confirmed to be significantly higher in CD4+ T cells of SLE patients (p < 0.05), methylation level of MDA5 promoter was significantly lower in CD4+ T cells of SLE patients (p < 0.05), and expression of MDA5 mRNA was correlated with SLE parameters (p < 0.05). Downregulation or overexpression of hsa_circ_0012919 regulated (1) the expression of MDA5 in a dose-dependent manner and (2) the DNA methylation of MDA5 promoter in CD4+ T cells of SLE. Finally, hsa_circ_0012919 could regulate MDA5 by miR-125a-3p. Hsa_circ_0012919 regulated the expression and methylation of MDA5 in the CD4+ T cells of SLE patients, and hsa_circ_0012919 could regulate MDA5 by miR-125a-3p.
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Affiliation(s)
- Chengzhong Zhang
- Department of Dermatology, Jiangsu Province Hospital, the First affiliated Hospital with Nanjing Medical University, China.,*These authors contributed equally to this work
| | - Chao Zhang
- Department of Dermatology, Institute of Fudan-Minhang Academic Health System, Minhang Hospital, Fudan University, China.,*These authors contributed equally to this work
| | - Jie Ji
- Department of Dermatology, Jiangsu Province Hospital, the First affiliated Hospital with Nanjing Medical University, China
| | - Xixi Xiong
- Department of Dermatology, Jiangsu Province Hospital, the First affiliated Hospital with Nanjing Medical University, China
| | - Yan Lu
- Department of Dermatology, Jiangsu Province Hospital, the First affiliated Hospital with Nanjing Medical University, China
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Ruiz-Irastorza G, Ruiz-Estevez B, Lazaro E, Ruiz-Arruza I, Duffau P, Martin-Cascon M, Richez C, Ugarte A, Blanco P. Prolonged remission in SLE is possible by using reduced doses of prednisone: An observational study from the Lupus-Cruces and Lupus-Bordeaux inception cohorts. Autoimmun Rev 2019; 18:102359. [DOI: 10.1016/j.autrev.2019.102359] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 02/20/2019] [Indexed: 10/26/2022]
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The down-regulation of hsa_circ_0012919, the sponge for miR-125a-3p, contributes to DNA methylation of CD11a and CD70 in CD4 + T cells of systemic lupus erythematous. Clin Sci (Lond) 2018; 132:2285-2298. [PMID: 30237316 DOI: 10.1042/cs20180403] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Systemic lupus erythematous (SLE) is an autoimmune disease characterized by the production of autoantibodies directed against various autoantigens. But the expression profiles and functions of circular RNAs (circRNAs) in SLE are still scarce. OBJECTIVES To explore the roles of circRNA in SLE and its potential diagnostic potential in SLE. METHODS SLE patients and healthy control subjects were recruited. CD4+ T cells were isolated, circRNA microarray analysis were used to screen for circRNA candidate in CD4+ T cells. Expression of DNMT1, CD11a and CD70, and methylation level of CD11a and CD70 were detected after transfecting hsa_circ_0012919-targetted siRNA. The network analysis of hsa_circ_0012919 was used by bioinformatics. Luciferase reporter assay and fluorescence in situ hybridization (FISH) assay were used for screening for which miRNAs could bind with hsa_circ_0012919. RESULTS Twelve circRNAs were up-regulated and two circRNAs were down-regulated in SLE patients group after circRNA microarray analysis. Hsa_circ_0012919 was further confirmed to be significantly different between healthy control and SLE patients (P<0.05) and associated with SLE characters (P<0.05). Down-regulation of hsa_circ_0012919 (i) increased the expression of DNMT1 and reduced the expression of CD70, CD11a, (ii) reversed the DNA hypomethylation of CD11a and CD70 in CD4+ T cells of SLE, but it could be reversed by down-regulation of DNMT1. Hsa_circ_0012919 regulated KLF13 and RANTES by miR-125a Conclusion: Hsa_circ_0012919 could be regarded as a biomarker for SLE and hsa_circ_0012919 was the competitive endogenous RNA (ceRNA) for miR-125a-3p.
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Soh MC, Nelson-Piercy C, Westgren M, McCowan L, Pasupathy D. Do adverse pregnancy outcomes contribute to accelerated cardiovascular events seen in young women with systemic lupus erythematosus? Lupus 2017; 26:1351-1367. [PMID: 28728509 DOI: 10.1177/0961203317719146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cardiovascular events (CVEs) are prevalent in patients with systemic lupus erythematosus (SLE), and it is the young women who are disproportionately at risk. The risk factors for accelerated cardiovascular disease remain unclear, with multiple studies producing conflicting results. In this paper, we aim to address both traditional and SLE-specific risk factors postulated to drive the accelerated vascular disease in this cohort. We also discuss the more recent hypothesis that adverse pregnancy outcomes in the form of maternal-placental syndrome and resultant preterm delivery could potentially contribute to the CVEs seen in young women with SLE who have fewer traditional cardiovascular risk factors. The pathophysiology of how placental-mediated vascular insufficiency and hypoxia (with the secretion of placenta-like growth factor (PlGF) and soluble fms-tyrosine-like kinase-1 (sFlt-1), soluble endoglin (sEng) and other placental factors) work synergistically to damage the vascular endothelium is discussed. Adverse pregnancy outcomes ultimately are a small contributing factor to the complex pathophysiological process of cardiovascular disease in patients with SLE. Future collaborative studies between cardiologists, obstetricians, obstetric physicians and rheumatologists may pave the way for a better understanding of a likely multifactorial aetiological process.
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Affiliation(s)
- M C Soh
- 1 Women's Health Academic Centre, King's College London, United Kingdom.,3 Faculty of Medical and Health Science, University of Auckland, New Zealand
| | - C Nelson-Piercy
- 1 Women's Health Academic Centre, King's College London, United Kingdom
| | - M Westgren
- 2 Department of Clinical Science, Karolinska Institutet, Sweden
| | - L McCowan
- 3 Faculty of Medical and Health Science, University of Auckland, New Zealand.,4 National Women's Health, South Auckland Clinical School of Medicine and Counties Manukau Health, Auckland, New Zealand
| | - D Pasupathy
- 1 Women's Health Academic Centre, King's College London, United Kingdom.,5 Biomedical Research Centre at Guy's & St Thomas's NHS Foundation Trust and King's College London, United Kingdom
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Borrell H, Narváez J, Alegre JJ, Castellví I, Mitjavila F, Aparicio M, Armengol E, Molina-Molina M, Nolla JM. Shrinking lung syndrome in systemic lupus erythematosus: A case series and review of the literature. Medicine (Baltimore) 2016; 95:e4626. [PMID: 27537601 PMCID: PMC5370827 DOI: 10.1097/md.0000000000004626] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Shrinking lung syndrome (SLS) is a rare and less known complication mainly associated with systemic lupus erythematosus (SLE). In this study, we analyze the clinical features, investigation findings, approaches to management, and outcome in a case series of 9 adult patients with SLE and SLS diagnosed during a 35-year period in 3 referral tertiary care hospitals in Spain. Additionally, we reviewed 80 additional cases previously reported (PubMed 1965-2015). These 80 cases, together with our 9 patients, form the basis of the present analysis.The overall SLS prevalence in our SLE population was 1.1% (9/829). SLS may complicate SLE at any time over its course, and it usually occurs in patients without previous or concomitant major organ involvement. More than half of the patients had inactive lupus according to SELENA-systemic lupus erythematosus disease activity index (SLEDAI) scores. Typically, it presents with progressive exertional dyspnea of variable severity, accompanied by pleuritic chest pain in 76% of the cases.An important diagnostic delay is common. The diagnostic tools that showed better yield for SLS detection are the imaging techniques (chest x-ray and high-resolution computed tomography) along with pulmonary and diaphragmatic function tests. Evaluation of diaphragm dome motion by M-mode ultrasonography and phrenic nerve conduction studies are less useful.There are no standardized guidelines for the treatment of SLS in SLE. The majority of patients were treated with medium or high doses of glucocorticoids. Several immunosuppressive agents have been used in conjunction with steroids either if the patient fails to improve or since the beginning of the treatment. Theophylline and beta-agonists, alone or in combination with glucocorticoids, have been suggested with the intent to increase diaphragmatic strength.The overall long-term prognosis was good. The great majority of patients had significant clinical improvement and stabilization, or mild to moderate improvement on pulmonary function tests. The mortality rate was very low.
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Affiliation(s)
- Helena Borrell
- Department of Rheumatology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona
| | - Javier Narváez
- Department of Rheumatology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona
- Correspondence: Dr Francisco Javier Narváez García, Department of Rheumatology (Planta 10–2), Hospital Universitario de Bellvitge, Feixa Llarga, s/n, Hospitalet de Llobregat, Barcelona 08907, Spain (e-mail: )
| | - Juan José Alegre
- Department of Rheumatology, Hospital Universitario Dr. Peset, Valencia
| | | | | | - María Aparicio
- Department of Rheumatology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona
| | - Eulàlia Armengol
- Department of Rheumatology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona
| | - María Molina-Molina
- Department of Pneumology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona, Spain
| | - Joan M. Nolla
- Department of Rheumatology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona
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