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Espinosa G. Behçet syndrome. Med Clin (Barc) 2025; 165:106983. [PMID: 40378634 DOI: 10.1016/j.medcli.2025.106983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2024] [Revised: 01/31/2025] [Accepted: 02/04/2025] [Indexed: 05/19/2025]
Abstract
Behçet's syndrome (BS) is a systemic vasculitis that affects vessels of all calibers. It has several defining characteristics, such as its tendency for remission over time and a typical geographical distribution. Clinically, the association of venous thrombosis with arterial aneurysms, inflammatory parenchymal brain involvement, the classic pattern of posterior uveitis with retinal vasculitis, and the well-known triad of bipolar ulcers and erythema nodosum are distinctive features of this condition. Despite some advances in the pathogenesis of BS and the use of biological drugs that have improved prognosis, certain aspects remain controversial, such as the role of the pathergy test or the determination of HLA-B*51 in the diagnosis of the disease, or the actual value of anticoagulation in patients with BS and vascular thrombosis.
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Affiliation(s)
- Gerard Espinosa
- Servicio de Enfermedades Autoinmunes, Centro de Referencia (UEC/CSUR) en Enfermedades Autoinmunes Sistémicas, Vasculitis y Enfermedades Autoinflamatorias; Miembro de ERN-ReCONNET/RITA; Hospital Clínic, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Facultat de Medicina i Ciències de la Salut; Universitat de Barcelona, Barcelona, España.
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Kang HL, Várkonyi Á, Csonka Á, Szász A, Várkonyi T, Pósa A, Kupai K. Endothelial-Mesenchymal Transition and Possible Role of Cytokines in Streptozotocin-Induced Diabetic Heart. Biomedicines 2025; 13:1148. [PMID: 40426976 PMCID: PMC12109261 DOI: 10.3390/biomedicines13051148] [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: 02/10/2025] [Revised: 05/04/2025] [Accepted: 05/07/2025] [Indexed: 05/29/2025] Open
Abstract
Background: Although endothelial mesenchymal transition (EndMT) has been characterized as a basic process in embryogenesis, EndMT is the mechanism that accelerates the development of cardiovascular diseases, including heart failure, aging, and complications of diabetes or hypertension as well. Endothelial cells lose their distinct markers and take on a mesenchymal phenotype during EndMT, expressing distinct products. Methods: In this study, type 1 Diabetes mellitus (T1DM) was induced in rats with streptozotocin (STZ) by intraperitoneal injection at a 60 mg/kg dose. Diabetic rats were randomly divided into two groups, namely, control and diabetic rats, for 4 weeks. Heart, aorta, and plasma samples were collected at the end of 4 weeks. Sequentially, biochemical parameters, cytokines, reactive oxygen species (ROS), protein expression of EndMT markers (Chemokine C-X-C motif ligand-1 (CXCL-1), vimentin, citrullinated histone H3 (H3Cit), α-smooth muscle actin (α-SMA), and transforming growth factor beta (TGF-β) and versican), components of the extracellular matrix (matrix metalloproteinase 2 (MMP-2), tissue inhibitor of metalloproteinase-1(TIMP-1), and discoidin domain tyrosine kinase receptor 2 (DDR-2)) were detected by ELISA or Western blot, respectively. Results: Cytokines and ROS were increased in diabetic hearts, which induced partial EndMT. Among EndMT markers, histone citrullination, α-SMA, and CXCL-1 were increased; vimentin was decreased in DM. The endothelial marker endothelin-1 was significantly higher in the aortas of DM rats. Interestingly, TGF-β showed a significant decrease in the diabetic heart, plasma, and aorta. Additionally, MMP-2/TIMP-1 levels also decreased in DM. Conclusions: To sum up, the identification of molecules and regulatory pathways involved in EndMT provided novel therapeutic approaches for cardiac pathophysiological conditions.
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Affiliation(s)
- Hsu Lin Kang
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6703 Szeged, Hungary (Á.V.); (A.S.); (A.P.)
| | - Ákos Várkonyi
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6703 Szeged, Hungary (Á.V.); (A.S.); (A.P.)
| | - Ákos Csonka
- Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6703 Szeged, Hungary; (Á.C.); (T.V.)
| | - András Szász
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6703 Szeged, Hungary (Á.V.); (A.S.); (A.P.)
| | - Tamás Várkonyi
- Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6703 Szeged, Hungary; (Á.C.); (T.V.)
| | - Anikó Pósa
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6703 Szeged, Hungary (Á.V.); (A.S.); (A.P.)
| | - Krisztina Kupai
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6703 Szeged, Hungary (Á.V.); (A.S.); (A.P.)
- Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6703 Szeged, Hungary; (Á.C.); (T.V.)
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Fominykh V, Shadrin AA, Jaholkowski P, Fuhrer J, Parker N, Wiström ED, Frei O, Smeland OB, Sanner H, Djurovic S, Andreassen OA. Mapping the genetic landscape of immune-mediated disorders: potential implications for classification and therapeutic strategies. Front Immunol 2025; 16:1543781. [PMID: 40406108 PMCID: PMC12094916 DOI: 10.3389/fimmu.2025.1543781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Accepted: 04/04/2025] [Indexed: 05/26/2025] Open
Abstract
Objectives Based on clinical, biomarker, and genetic data, McGonagle and McDermott suggested that autoimmune and autoinflammatory disorders can be classified as a disease continuum from purely autoimmune to autoinflammatory with mixed diseases in between. However, the genetic architecture of this spectrum has not been systematically described. Here, we investigate the continuum of polygenic immune-mediated disorders using genome-wide association studies (GWAS) and statistical genetics methods. Methods We mapped the genetic landscape of 15 immune-mediated disorders using GWAS summary statistics and methods including genomic structural equation modeling (genomic SEM), linkage disequilibrium score regression, Local Analysis of [co]Variant Association, and Gaussian causal mixture modeling (MiXeR). We performed enrichment analyses of tissues and biological gene sets using MAGMA. Results Genomic SEM suggested a continuum structure with four underlying latent factors from autoimmune diseases at one end to autoinflammatory on the opposite end. Across disorders, we observed a balanced mixture of negative and positive local genetic correlations within the major histocompatibility complex, while outside this region, local genetic correlations were predominantly positive. MiXeR analysis showed large genetic overlap in accordance with the continuum landscape. MAGMA analysis implicated genes associated with known monogenic immune diseases for prominent autoimmune and autoinflammatory component. Conclusions Our findings support a polygenic continuum across immune-mediated disorders, with four genetic clusters. The "polygenic autoimmune" and "polygenic autoinflammatory" clusters reside on margins of this continuum. These findings provide insights and lead us to hypothesize that the identified clusters could inform future therapeutical strategies, with patients in the same clusters potentially responding similarly to specific therapies.
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Affiliation(s)
- Vera Fominykh
- Centre for Precision Psychiatry, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Alexey A. Shadrin
- Centre for Precision Psychiatry, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- K.G. Jebsen Centre for Neurodevelopmental Disorders, University of Oslo and Oslo University Hospital, Oslo, Norway
- Section for Precision Psychiatry, Oslo University Hospital, Oslo, Norway
| | - Piotr Jaholkowski
- Centre for Precision Psychiatry, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Julian Fuhrer
- Centre for Precision Psychiatry, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nadine Parker
- Centre for Precision Psychiatry, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erik D. Wiström
- Section for Precision Psychiatry, Oslo University Hospital, Oslo, Norway
| | - Oleksandr Frei
- Centre for Precision Psychiatry, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Section for Precision Psychiatry, Oslo University Hospital, Oslo, Norway
| | - Olav B. Smeland
- Centre for Precision Psychiatry, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Section for Precision Psychiatry, Oslo University Hospital, Oslo, Norway
| | - Helga Sanner
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
- Institute for Health, Oslo New University College, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Srdjan Djurovic
- Centre for Precision Psychiatry, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- K.G. Jebsen Centre for Neurodevelopmental Disorders, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Ole A. Andreassen
- Centre for Precision Psychiatry, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- K.G. Jebsen Centre for Neurodevelopmental Disorders, University of Oslo and Oslo University Hospital, Oslo, Norway
- Section for Precision Psychiatry, Oslo University Hospital, Oslo, Norway
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Abacar K, Macleod T, Direskeneli H, McGonagle D. Takayasu arteritis: a geographically distant but immunologically proximal MHC-I-opathy. THE LANCET. RHEUMATOLOGY 2025; 7:e290-e302. [PMID: 39855247 DOI: 10.1016/s2665-9913(24)00307-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 10/03/2024] [Accepted: 10/07/2024] [Indexed: 01/27/2025]
Abstract
Takayasu arteritis, a granulomatosis vasculitis with a pathogenesis that is poorly defined but known to be associated with HLA-B*52, shares many features with other MHC-I-opathies. In addition to the shared clinical features of inflammatory bowel diseases, cutaneous inflammation, and HLA-B*52, is shared association of an IL12B single- nucleotide polymorphism encoding the common IL-12 and IL-23 p40 subunit, which might affect not only type 17 cytokine responses, but also IFNγ and TNF production-the cardinal type 1 cytokines in granuloma formation. Considering the translational context of responses to TNF inhibition in Takayasu arteritis, in this Personal View we propose Takayasu arteritis as a type 1 MHC-I-opathy. Additionally, type 1 and type 17 T-cell immune responses show immune plasticity, which connects the overlapping features of Takayasu arteritis and spondyloarthritis spectrum disorders, providing a basis for shared anti-TNF responses, and points to p40 and IFNγ cytokine antagonism and potential selective CD8 T-cell repertoire ablation.
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Affiliation(s)
- Kerem Abacar
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK; Division of Rheumatology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Türkiye
| | - Tom Macleod
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK
| | - Haner Direskeneli
- Division of Rheumatology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Türkiye
| | - Dennis McGonagle
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK.
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