1
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Lin JY, Bai BX. SAPHO syndrome after COVID-19 vaccination complicated with thyroid function abnormalities: a case report and literature review. Immunol Res 2023; 71:781-784. [PMID: 37079220 PMCID: PMC10117263 DOI: 10.1007/s12026-023-09381-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 04/01/2023] [Indexed: 04/21/2023]
Affiliation(s)
- Jia-Ying Lin
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang, Harbin, 150000, China
| | - Bing-Xue Bai
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang, Harbin, 150000, China.
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2
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Zhang X, Zhang S, Wu R, Li S, Su Y, Zhang P. Prevalence of autoimmune thyroid disease in patients with psoriasis: a meta-analysis. BMJ Open 2022; 12:e055538. [PMID: 35105646 PMCID: PMC8804708 DOI: 10.1136/bmjopen-2021-055538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Psoriasis is a chronic inflammatory disease with autoimmune aetiology. A possible link between psoriasis and autoimmune thyroid disease (AITD) has been suggested in some studies with inconsistent findings. This meta-analysis aims to determine the association between psoriasis and AITD. DESIGN A meta-analysis of observational studies. DATA SOURCES PubMed, EMBASE, Scopus and the Cochrane Library were searched up to 1 November 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included non-randomised studies, each with over 50 cases in every group, focusing on the rate of comorbidity between psoriasis and AITD. DATA EXTRACTION AND SYNTHESIS Two independent reviewers screened the articles and extracted data. The restricted maximum-likelihood was applied to perform the meta-analysis. OR and 95% CIs were pooled to compare the prevalence of AITD in psoriasis and control groups. Heterogeneity was assessed with I2 statistic. The Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality were applied for quality assessment. The risk of bias was assessed with Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I). RESULTS Eleven available studies with data on 253 313 patients with psoriasis and 1 376 533 controls were included. Meta-analysis showed that patients with psoriasis had a higher prevalence of AITD (OR 1.76, 95% CI 1.35 to 2.28, Z=4.25, p<0.01), especially loss-of-function disorder of the thyroid gland. Both thyroglobulin antibodies positive rate (OR 1.98, 95% CI 1.27 to 3.10, Z=3.00, p<0.01) and thyroid peroxidase antibodies positive rate (OR 2.15, 95% CI 1.31 to 3.52, Z=3.05, p<0.01) were also increased in the psoriasis group compared with the control group. CONCLUSIONS Our study indicates that the rate of co-occurring AITD was significantly increased in patients with psoriasis. It suggests that the increased risk of AITD should be concerned in patients with psoriasis. PROSPERO REGISTRATION NUMBER CRD42020206005.
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Affiliation(s)
- Xiaochao Zhang
- Dermatology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Suhan Zhang
- Dermatology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ruifang Wu
- Dermatology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Siying Li
- Dermatology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yuwen Su
- Dermatology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Peng Zhang
- Dermatology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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3
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Lupoli GA, Tasso M, Costa L, Caso F, Scarpa R, Del Puente A, Peluso R. Coeliac disease is a risk factor for the development of seronegative arthritis in patients with autoimmune thyroid disease. Rheumatology (Oxford) 2021; 60:2440-2447. [PMID: 33197262 DOI: 10.1093/rheumatology/keaa640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/16/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Hashimoto's thyroiditis is known to cluster with other systemic autoimmune disorders. Rheumatic manifestations, such as a seronegative non-erosive polyarthritis have been described. The aim of this study was to evaluate the characteristics and the prevalence of rheumatic features in thyroiditis patients, and to ascertain whether the association with systemic autoimmune disorders improved the arthritis manifestations. METHODS In total, 180 thyroiditis patients were enrolled. Major clinical and demographic characteristics have been recorded. Patients underwent a rheumatological clinical assessment and extra-articular manifestations allowing for a differential diagnosis with systemic autoimmune diseases and spondyloarthropathy. Presence of systemic autoimmune diseases was recorded. RESULTS A total of 8.33% of thyroiditis patients shown a peripheral inflammatory arthritis (P = 0.002). Female gender (P = 0.042) and thyroid peroxidase (TPOAbs) positivity (P = 0.001) were more frequent. In total, 37 patients had systemic autoimmune diseases (P = 0.0003). A significant high prevalence of coeliac disease and Addison disease was found (P = 0.034 and P = 0.049, respectively). In patients with coeliac disease, the articular manifestations were more frequent (21.21%) (P = 0.001) and the risk to develop joint involvement was 2.96. CONCLUSION Although we found an articular involvement in about one-third of thyroiditis patients, the prevalence of inflammatory arthropathy was only 8.33%. The prevalence of other coexisting autoimmune disorders was 34.26% with a significant prevalence of coeliac disease (7.41%). Thyroiditis patients with coeliac disease have an articular involvement more frequently than those without. In these patients, we have found a high risk of developing arthritis than patients with only thyroiditis, suggesting cumulative autoimmune effects in the developing articular involvement.
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Affiliation(s)
| | - Marco Tasso
- Department of Clinical Medicine and Surgery, Rheumatology Unit, Federico II University of Naples, Naples, Italy
| | - Luisa Costa
- Department of Clinical Medicine and Surgery, Rheumatology Unit, Federico II University of Naples, Naples, Italy
| | - Francesco Caso
- Department of Clinical Medicine and Surgery, Rheumatology Unit, Federico II University of Naples, Naples, Italy
| | - Raffaele Scarpa
- Department of Clinical Medicine and Surgery, Rheumatology Unit, Federico II University of Naples, Naples, Italy
| | - Antonio Del Puente
- Department of Clinical Medicine and Surgery, Rheumatology Unit, Federico II University of Naples, Naples, Italy
| | - Rosario Peluso
- Department of Clinical Medicine and Surgery, Rheumatology Unit, Federico II University of Naples, Naples, Italy
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4
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Pörings AS, Lowin T, Dufner B, Grifka J, Straub RH. A thyroid hormone network exists in synovial fibroblasts of rheumatoid arthritis and osteoarthritis patients. Sci Rep 2019; 9:13235. [PMID: 31519956 PMCID: PMC6744488 DOI: 10.1038/s41598-019-49743-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 08/28/2019] [Indexed: 01/08/2023] Open
Abstract
While patients with rheumatoid arthritis (RA) sometimes demonstrate thyroidal illness, the role of thyroid hormones in inflamed synovial tissue is unknown. This is relevant because thyroid hormones stimulate immunity, and local cells can regulate thyroid hormone levels by deiodinases (DIO). The study followed the hypothesis that elements of a thyroid hormone network exist in synovial tissue. In 12 patients with RA and 32 with osteoarthritis (OA), we used serum, synovial fluid, synovial tissue, and synovial fibroblasts (SF) in order to characterize the local thyroid hormone network using ELISAs, immunohistochemistry, imaging methods, tissue superfusion studies, cell-based ELISAs, flow cytometry, and whole genome expression profiling. Serum/synovial fluid thyroid hormone levels were similar in RA and OA (inclusion criteria: no thyroidal illness). The degradation product termed reverse triiodothyronine (reverse T3) was much lower in serum compared to synovial fluid indicating biodegradation of thyroid hormones in the synovial environment. Superfusion experiments with synovial tissue also demonstrated biodegradation, particularly in RA. Cellular membrane transporters of thyroid hormones, DIOs, and thyroid hormone receptors were present in tissue and SF. Density of cells positive for degrading DIOs were higher in RA than OA. TNF increased protein expression of degrading DIOs in RASF and OASF. Gene expression studies of RASF revealed insignificant gene regulation by bioactive T3. RA and OA synovial tissue/SF show a local thyroid hormone network. Thyroid hormones undergo strong biodegradation in synovium. While bioactive T3 does not influence SF gene expression, SF seem to have a relay function for thyroid hormones.
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Affiliation(s)
- Anna-Sophia Pörings
- Laboratory of Experimental Rheumatology and Neuroendocrine Immunology, Dept. of Internal Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Torsten Lowin
- Laboratory of Experimental Rheumatology and Neuroendocrine Immunology, Dept. of Internal Medicine, University Hospital Regensburg, Regensburg, Germany.,W. & B. Hiller Research Center of Rheumatology, Life Science Center, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Bianca Dufner
- Laboratory of Experimental Rheumatology and Neuroendocrine Immunology, Dept. of Internal Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Joachim Grifka
- Department of Orthopedic Surgery, University Hospital Regensburg, Asklepios Clinic Bad Abbach, Bad Abbach, Germany
| | - Rainer H Straub
- Laboratory of Experimental Rheumatology and Neuroendocrine Immunology, Dept. of Internal Medicine, University Hospital Regensburg, Regensburg, Germany.
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5
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Hansen P, Isaksen JL, Jemec GB, Ellervik C, Kanters JK. Thyroid function in psoriasis. Br J Dermatol 2019; 181:206-207. [DOI: 10.1111/bjd.17622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- P.R. Hansen
- Department of Cardiology Herlev and Gentofte Hospital DK‐2900 Hellerup Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - J. Lynggaard Isaksen
- Laboratory for Experimental Cardiology, Department of Biomedical Sciences Panum Institute DK‐2200 Copenhagen N Denmark
- Department of Health Science and Technology Aalborg University DK‐9220 Aalborg Oest Denmark
| | - G. Borut Jemec
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
- Department of Dermatology Zealand University Hospital DK‐4000 Roskilde Denmark
| | - C. Ellervik
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
- Department of Laboratory Medicine Boston Children's Hospital Harvard Medical School Boston MA U.S.A
- Department of Production Research and Innovation Region Zealand DK‐4180 Sorø Denmark
| | - J. Kim Kanters
- Laboratory for Experimental Cardiology, Department of Biomedical Sciences Panum Institute DK‐2200 Copenhagen N Denmark
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6
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Baldini E, Odorisio T, Tuccilli C, Persechino S, Sorrenti S, Catania A, Pironi D, Carbotta G, Giacomelli L, Arcieri S, Vergine M, Monti M, Ulisse S. Thyroid diseases and skin autoimmunity. Rev Endocr Metab Disord 2018; 19:311-323. [PMID: 29948572 DOI: 10.1007/s11154-018-9450-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The skin is the largest organ of the body, at the boundary with the outside environment. Primarily, it provides a physical and chemical barrier against external insults, but it can act also as immune organ because it contains a whole host of immune-competent cells of both the innate and the adaptive immune systems, which cooperate in eliminating invading pathogens following tissue injury. On the other hand, improper skin immune responses lead to autoimmune skin diseases (AISD), such as pemphigus, bullous pemphigoid, vitiligo, and alopecia. Although the interplay among genetic, epigenetic, and environmental factors has been shown to play a major role in AISD etiology and progression, the molecular mechanisms underlying disease development are far from being fully elucidated. In this context, epidemiological studies aimed at defining the association of different AISD with other autoimmune pathologies revealed possible shared molecular mechanism(s) responsible for disease progression. In particular, over the last decades, a number of reports have highlighted a significant association between thyroid diseases (TD), mainly autoimmune ones (AITD), and AISD. Here, we will recapitulate the epidemiology, clinical manifestations, and pathogenesis of the main AISD, and we will summarize the epidemiological evidence showing the associations with TD as well as possible molecular mechanism(s) underlying TD and AISD pathological manifestations.
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Affiliation(s)
- Enke Baldini
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Teresa Odorisio
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | - Chiara Tuccilli
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | | | - Salvatore Sorrenti
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Antonio Catania
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Daniele Pironi
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Giovanni Carbotta
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Laura Giacomelli
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Stefano Arcieri
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Massimo Vergine
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Massimo Monti
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Salvatore Ulisse
- Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy.
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Ramírez J, Nieto-González JC, Curbelo Rodríguez R, Castañeda S, Carmona L. Prevalence and risk factors for osteoporosis and fractures in axial spondyloarthritis: A systematic review and meta-analysis. Semin Arthritis Rheum 2017; 48:44-52. [PMID: 29290311 DOI: 10.1016/j.semarthrit.2017.12.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 11/24/2017] [Accepted: 12/05/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To describe the prevalence of osteoporosis, the prevalence and incidence of fractures, and the frequency of risk factors for low bone mineral density (BMD) in axial spondyloarthritis (Ax-SpA). METHODS A systematic review and meta-analysis of observational studies was conducted. Medline, Embase, and Cochrane Library databases were searched with a sensitive strategy. Large cross-sectional and longitudinal studies published in the last 10 years (January 2006-2016) with representative samples of patients with Ax-SpA estimating the frequency of osteoporosis, risk factors or fractures were selected. RESULTS After screening 3597 titles and abstracts, 46 studies were reviewed in detail, of which 35 studies had a cross-sectional design, 5 were prospective and 6 retrospective; 21 studies compared Ax-SpA patients with a control group-either healthy individuals (18 studies) or subjects with other diseases (6 studies). The prevalence of osteoporosis varied from 11.7% to 34.4% and that of fractures from 11% to 24.6%. Alcohol intake (58-61%), use of corticosteroids (11.7-66.9%), and 25-OH vitamin D deficiency (26-76%) were unexpectedly high in Ax-SpA patients. CONCLUSION The prevalence of osteoporosis and fractures in Ax-SpA varies between 11.7% and 34.4% and 11-24.6%, respectively. Alcohol intake, steroid use, and low levels of 25-OH-vitamin D should be taken into account in osteoporosis assessment in patients with Ax-SpA. Inconsistent results, lack of bone quality assessment, and high likelihood of bias of the published studies confirm the need for performing well-designed studies.
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Affiliation(s)
- Julio Ramírez
- Rheumatology Department, Arthritis Unit, Hospital Clinic and IDIBAPS, Barcelona, Spain.
| | | | | | - Santos Castañeda
- Rheumatology Department, Hospital Universitario La Princesa, IIS-Princesa, Madrid, Spain
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8
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Proekt I, Miller CN, Lionakis MS, Anderson MS. Insights into immune tolerance from AIRE deficiency. Curr Opin Immunol 2017; 49:71-78. [PMID: 29065385 PMCID: PMC5705335 DOI: 10.1016/j.coi.2017.10.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 09/25/2017] [Accepted: 10/03/2017] [Indexed: 01/07/2023]
Abstract
AIRE is a well-established master regulator of central tolerance. It plays an essential role in driving expression of tissue-specific antigens in the thymus and shaping the development of positively selected T-cells. Humans and mice with compromised or absent AIRE function have markedly variable phenotypes that include a range of autoimmune manifestations. Recent evidence suggests that this variability stems from cooperation of autoimmune susceptibilities involving both central and peripheral tolerance checkpoints. Here we discuss the broadening understanding of the factors that influence Aire expression, modify AIRE function, and the impact and intersection of AIRE with peripheral immunity. This rapidly expanding body of knowledge will force a reexamination of the definition and clinical management of APS-1 patients as well as provide a foundation for the development of immunomodulatory strategies targeting central tolerance.
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Affiliation(s)
- Irina Proekt
- Diabetes Center, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Corey N Miller
- Diabetes Center, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Michail S Lionakis
- Laboratory of Clinical Immunology & Microbiology, National Institute of Allergy & Infectious Diseases (NIAID), NIH, Bethesda, MD 20892, USA.
| | - Mark S Anderson
- Diabetes Center, University of California, San Francisco, San Francisco, CA 94143, USA.
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9
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Posselt RT, Coelho VN, Pigozzo DC, Guerrer MI, Fagundes MDC, Nisihara R, Skare TL. Prevalence of thyroid autoantibodies in patients with systematic autoimmune rheumatic diseases. Cross-sectional study. SAO PAULO MED J 2017; 135:535-540. [PMID: 29267515 PMCID: PMC10016010 DOI: 10.1590/1516-3180.2017.0089110617] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 06/11/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Thyroid autoimmunity is more common in patients with rheumatic diseases than in healthy populations. The degree of association seems subject to influence from patients' geographical location. Here, we aimed to ascertain the prevalence of thyroid autoantibodies in a cohort of patients with systemic rheumatic disease and the degree of association between its presence and inflammatory activity. DESIGN AND SETTING Cross-sectional observational study in a rheumatology unit. METHODS 301 patients with systemic lupus erythematosus (SLE), 210 with rheumatoid arthritis (RA), 58 with scleroderma (SSc) and 80 with spondyloarthritis (SpA) were studied regarding thyroid function (TSH and T4), anti-thyroglobulin (TgAb) and anti-thyroperoxidase (TPOab) and compared with 141 healthy controls. Disease activity in patients with rheumatic disease was assessed through appropriate indexes. RESULTS There were more antithyroid antibodies in SLE patients with hypothyroidism (P = 0.01; odds ratio, OR 2.7; 95% confidence interval, CI: 1.20-6.26) and in those without hypothyroidism (P = 0.06; OR 2.4; 95% CI: 1.28-4.55) than in controls. SSc patients also showed: P = 0.03 both with antithyroid antibodies and hypothyroidism (OR 3.4; 95% CI: 1.06-10.80) and without hypothyroidism (OR 3.1; 95% CI: 1.11-0.13). RA and SpA patients had the same prevalence as controls (P not significant). Presence of autoantibodies with and without hypothyroidism was not associated with the activity or functional indexes evaluated. CONCLUSION SLE and SSc were associated with higher prevalence of thyroid autoantibodies in patients with and without hypothyroidism, unlike SpA and RA. There was no link between thyroid autoantibody presence and disease activity or functional impairment.
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Affiliation(s)
- Rayana Taques Posselt
- Medical Student, Medicine Department, Faculdade Evangélica do Paraná, Curitiba (PR), Brazil.
| | | | - Danieli Cristina Pigozzo
- MD. Attending Physician, Medicine Department, Faculdade Evangélica do Paraná, Curitiba (PR), Brazil.
| | - Marcela Idalia Guerrer
- MD. Attending Physician, Medicine Department, Faculdade Evangélica do Paraná, Curitiba (PR), Brazil.
| | - Marília da Cruz Fagundes
- MD. Attending Physician, Medicine Department, Faculdade Evangélica do Paraná, Curitiba (PR), Brazil.
| | - Renato Nisihara
- PhD. Professor, Medicine Department, Faculdade Evangélica do Paraná and Universidade Positivo, Curitiba (PR), Brazil.
| | - Thelma Larocca Skare
- PhD. Rheumatologist and Professor, Medicine Department, Rheumatology Unit, Hospital Universitário Evangélico de Curitiba (HUEC), Curitiba (PR), Brazil.
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10
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Khan SR, Bano A, Wakkee M, Korevaar TIM, Franco OH, Nijsten TEC, Peeters RP, Chaker L. The association of autoimmune thyroid disease (AITD) with psoriatic disease: a prospective cohort study, systematic review and meta-analysis. Eur J Endocrinol 2017; 177:347-359. [PMID: 28747386 DOI: 10.1530/eje-17-0397] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/13/2017] [Accepted: 07/26/2017] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Autoimmune thyroid disease (AITD) and psoriatic disease share auto-immunological components. Few studies have investigated the link between both, yielding inconclusive results. DESIGN We assessed the association of AITD with psoriatic disease in a prospective cohort study and performed a systematic review and meta-analysis. METHODS 8214 participants of the Rotterdam Study (RS) with thyroid peroxidase antibodies (TPO-Abs), thyroid-stimulating hormone (TSH) and/or free thyroxine (FT4) measurements and information on psoriatic disease were included. We performed logistic and Cox regression analyses and a systematic literature search in several electronic databases on AITD and psoriatic disease. We pooled odds ratios (ORs) of included studies using the Mantel-Haenszel method, while adding RS data on prevalent psoriatic disease. RESULTS Within the RS, we found no association between TPO-Ab positivity and psoriatic disease. There was a positive trend between TSH and prevalent psoriatic disease, and between FT4 and incident psoriatic disease, although not significant. Out of 1850 articles identified, seven were included in the systematic review and four in the meta-analysis. The risk of psoriatic disease (pooled OR) was 1.71 (confidence interval (CI): 1.27-2.31) for TPO-Ab positivity, 1.25 (CI: 1.14-1.37) for AITD and 1.34 (CI: 1.16-1.54) respectively, and 1.17 (CI: 1.03-1.32) for hypothyroidism and hyperthyroidism. CONCLUSIONS Our meta-analysis suggests that TPO-Ab positivity, hypothyroidism and hyperthyroidism might be associated with prevalent psoriatic disease. However, there are only few studies with large heterogeneity regarding psoriatic disease definition and indication of publication bias. Additional prospective data are needed to assess the association of AITD with incident psoriatic disease.
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Affiliation(s)
- Samer R Khan
- Department of Epidemiology
- Academic Center for Thyroid Diseases
| | - Arjola Bano
- Department of Epidemiology
- Academic Center for Thyroid Diseases
| | | | - Tim I M Korevaar
- Department of Epidemiology
- Academic Center for Thyroid Diseases
- Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | | | - Robin P Peeters
- Department of Epidemiology
- Academic Center for Thyroid Diseases
- Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Layal Chaker
- Department of Epidemiology
- Academic Center for Thyroid Diseases
- Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
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11
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Proekt I, Miller CN, Jeanne M, Fasano KJ, Moon JJ, Lowell CA, Gould DB, Anderson MS, DeFranco AL. LYN- and AIRE-mediated tolerance checkpoint defects synergize to trigger organ-specific autoimmunity. J Clin Invest 2016; 126:3758-3771. [PMID: 27571405 PMCID: PMC5087700 DOI: 10.1172/jci84440] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 07/22/2016] [Indexed: 01/07/2023] Open
Abstract
Studies of the genetic factors associated with human autoimmune disease suggest a multigenic origin of susceptibility; however, how these factors interact and through which tolerance pathways they operate generally remain to be defined. One key checkpoint occurs through the activity of the autoimmune regulator AIRE, which promotes central T cell tolerance. Recent reports have described a variety of dominant-negative AIRE mutations that likely contribute to human autoimmunity to a greater extent than previously thought. In families with these mutations, the penetrance of autoimmunity is incomplete, suggesting that other checkpoints play a role in preventing autoimmunity. Here, we tested whether a defect in LYN, an inhibitory protein tyrosine kinase that is implicated in systemic autoimmunity, could combine with an Aire mutation to provoke organ-specific autoimmunity. Indeed, mice with a dominant-negative allele of Aire and deficiency in LYN spontaneously developed organ-specific autoimmunity in the eye. We further determined that a small pool of retinal protein-specific T cells escaped thymic deletion as a result of the hypomorphic Aire function and that these cells also escaped peripheral tolerance in the presence of LYN-deficient dendritic cells, leading to highly destructive autoimmune attack. These findings demonstrate how 2 distinct tolerance pathways can synergize to unleash autoimmunity and have implications for the genetic susceptibility of autoimmune disease.
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Affiliation(s)
| | | | - Marion Jeanne
- Departments of Ophthalmology and Anatomy, Institute for Human Genetics, UCSF, San Francisco, California, USA
| | | | - James J. Moon
- Center for Immunology and Inflammatory Diseases and Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Douglas B. Gould
- Departments of Ophthalmology and Anatomy, Institute for Human Genetics, UCSF, San Francisco, California, USA
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12
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Thurner L, Zaks M, Preuss KD, Fadle N, Regitz E, Ong MF, Pfreundschuh M, Assmann G. Progranulin antibodies entertain a proinflammatory environment in a subgroup of patients with psoriatic arthritis. Arthritis Res Ther 2014; 15:R211. [PMID: 24321127 PMCID: PMC3978758 DOI: 10.1186/ar4406] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 11/22/2013] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Psoriatic arthritis (PsA) is a distinctive inflammatory arthritis which may typically develop in a subgroup of individuals suffering from psoriasis. We recently described progranulin autoantibodies (PGRN-Abs) in the sera of patients with different autoimmune diseases including seronegative polyarthritis. In the present study we investigated the occurrence of PGRN-Abs in PsA. METHODS PGRN-Abs were determined in 260 patients with PsA, 100 patients with psoriasis without arthritic manifestations (PsC) and 97 healthy controls using a recently described ELISA. PGRN plasma levels were determined from subgroups by a commercially available ELISA-kit. Possible functional effects of PGRN-antibodies were analysed in vitro by tumour necrosis factor (TNF)-α mediated cytotoxicity assays using WEHI-S and HT1080 cells. RESULTS PGRN-Abs were detected with relevant titres in 50/260 (19.23%) patients with PsA, but in 0/100 patients with psoriasis without arthritic manifestations (P = 0.0001). All PGRN-Abs belonged to immunoglobulin G (IgG). PGRN-Abs were significantly more frequent in PsA patients with enthesitis or dactylitis. PGRN-Abs were also more frequent in PsA patients receiving treatment with TNF-α-blockers than in patients treated without TNF-α-blockers (20.8% versus 17.4%; P = 0.016). PGRN plasma levels were significantly lower in PGRN-Ab-positive patients with PsA than in healthy controls and patients with psoriasis without arthritic manifestations (P < 0.001), indicating a neutralizing effect of PGRN-Abs. Moreover cytotoxicity assays comparing PGRN-antibody positive with negative sera from matched patients with PsA, clearly showed a proinflammatory effect of PGRN antibodies. CONCLUSION Neutralizing PGRN-Abs occur with relevant titres in a subgroup of patients with PsA, but not in patients without arthritic manifestations (PsC). PGRN-Ab-positive patients had more frequent enthesitis or dactylitis. TNF-α-induced cytotoxicity assays demonstrated that the protective effects of progranulin were inhibited by serum containing PGRN-Abs. This suggests that PGRN-Ab might not only be useful as a diagnostic and prognostic marker, but may provide a proinflammatory environment in a subgroup of patients with PsA.
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Peluso R, Iervolino S, Vitiello M, Bruner V, Ambrosino P, Manguso F, Castiglione F, Di Minno M. Articular and other Immune-Mediated Extra-Intestinal Manifestations in Inflammatory Bowel Diseases. EUR J INFLAMM 2014. [DOI: 10.1177/1721727x1401200204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The articular involvement in patients with inflammatory bowel diseases is included in the group of immune-mediated extra-intestinal manifestations, occurring approximately in a range from 6.2–36% of the patients. This group is also made up of the skin and eyes manifestations, that usually but not invariably are correlated with intestinal inflammatory disease activity. Rheumatic manifestations are the most frequent extra-intestinal findings of this group with a prevalence from 20–50%. They are divided into two different clinical subsets: peripheral and axial joint involvement (including sacroiliitis with or without spondylitis). Peripheral arthritis is the most frequent finding in both Crohn's disease and ulcerative colitis, occurring with a frequency ranging from 17–20%, and it is more common in Crohn's disease. Axial involvement is more common in Crohn's disease (5–22%) than in ulcerative colitis (2–6%) and generally the prevalence of sacroiliitis (asymptomatic and symptomatic) is between 12–20% and of spondylitis is between 2–16%. The IBD is also associated with other rheumatic diseases such as rheumatoid arthritis, Sjogren syndrome, Takayasu arteritis and fibromyalgia. The management of patients with EA requires an active cooperation between gastroenterologists and rheumatologists.
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Affiliation(s)
- R. Peluso
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - S. Iervolino
- Rheumatology and Rehabilitation Research Unit “Salvatore Maugeri” Foundation, Telese Terme (BN), Italy
| | - M. Vitiello
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - V. Bruner
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - P. Ambrosino
- Regional Reference Center for Coagulation Disorders, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - F. Manguso
- Complex Operating Unit of Gastroenterology, AORN “A. Cardarelli”, Naples, Italy
| | - F. Castiglione
- Gastroenterology Research Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - M.N.D. Di Minno
- Regional Reference Center for Coagulation Disorders, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
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Ankylosing Spondylitis: Chinese Perspective, Clinical Phenotypes, and Associated Extra-articular Systemic Features. Curr Rheumatol Rep 2013; 15:344. [DOI: 10.1007/s11926-013-0344-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Abstract
PURPOSE OF REVIEW Musculoskeletal complaints are a feature of several endocrine diseases. This review will update clinicians on their association, presentation, and treatment. RECENT FINDINGS To update clinicians on the recent literature as it is related to pathophysiology, genetic, and clinical findings on the association of these diseases and musculoskeletal complaints. SUMMARY Rheumatologists in the clinic are faced with different presentations of various musculoskeletal complaints every day. Every new patient encounter requires the differential diagnosis of these complaints. The first task is usually to decide with what disease in internal medicine these complaints are associated. The endocrinopathies are a group of illnesses that either present initially or exhibit sometime during the course of the disease as a variety of musculoskeletal complaints. Rheumatic manifestations may often be the initial presentation of an endocrine disorder. Each endocrine disorder may also have its own arthritic complaints, which can present as a definitive rheumatic disease such as calcium pyrophosphate dihydrate deposition disease or as a rheumatic symptom such as diffuse arthralgia. The rheumatologist as well as the primary care physician should be knowledgeable about the ways in which muscles, tendons, ligaments, and joints are affected by diseases of the endocrine system.
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Peluso R, Di Minno MND, Iervolino S, Manguso F, Tramontano G, Ambrosino P, Esposito C, Scalera A, Castiglione F, Scarpa R. Enteropathic spondyloarthritis: from diagnosis to treatment. Clin Dev Immunol 2013; 2013:631408. [PMID: 23690825 PMCID: PMC3649644 DOI: 10.1155/2013/631408] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 03/25/2013] [Indexed: 02/08/2023]
Abstract
Enteropathic arthritis (EA) is a spondyloarthritis (SpA) which occurs in patients with inflammatory bowel diseases (IBDs) and other gastrointestinal diseases. Diagnosis is generally established on the medical history and physical examination. It was, generally, made according to the European Spondyloarthropathy Study Group (ESSG) criteria. Rheumatic manifestations are the most frequent extraintestinal findings of IBD with a prevalence between 17% and 39%, and IBD is associated, less frequently, with other rheumatic disease such as rheumatoid arthritis, Sjogren syndrome, Takayasu arteritis, and fibromyalgia. Although the pathogenesis of EA has not been plainly clarified, the most popular theory supposes that joint inflammation occurs in genetically predisposed subjects with bacterial gut infections, provided an important evidence for a possible relationship between inflammation of the gut mucosa and arthritis. The management of patients with EA requires an active cooperation between the gastroenterologist and rheumatologist.
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Affiliation(s)
- Rosario Peluso
- Rheumatology Research Unit, University Federico II, 80131 Naples, Italy.
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Current world literature. Curr Opin Rheumatol 2012; 24:435-40. [PMID: 22653148 DOI: 10.1097/bor.0b013e3283556515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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