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Gigante A, Papa S, Rosato E, Badagliacca R, Marra AM. When pulmonary arterial hypertension complicates connective tissue diseases: we still have not found what we are looking for. Intern Emerg Med 2024:10.1007/s11739-024-03598-4. [PMID: 38637488 DOI: 10.1007/s11739-024-03598-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/26/2024] [Indexed: 04/20/2024]
Affiliation(s)
- Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.
| | - Silvia Papa
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Roberto Badagliacca
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Alberto Maria Marra
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
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Gigante A, Pellicano C, De Marco O, Assanto E, Sorato G, Palladini A, Rosato E, Lai S, Muscaritoli M, Cianci R. Changes in renal microcirculation in patients with nephrotic and nephritic syndrome: The role of resistive index. Microvasc Res 2024; 152:104641. [PMID: 38072161 DOI: 10.1016/j.mvr.2023.104641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/03/2023] [Accepted: 12/03/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND Renal Resistive Index (RRI) is an important and non-invasive parameter of renal damage and it is associated with abnormal microcirculation or to a parenchymal injury. The aim of our study was to compare the RRI in a cohort of patients with renal diseases categorized in three groups: nephrotic syndrome (NS), acute nephritic syndrome (ANS) and patients with urinary abnormalities (UA). METHODS Four hundred eighty-two patients with median age of 48 years (IQR 34-62) with indications for kidney disease were included in the study. Biochemical analyses, clinical assessment with detection of NS, ANS and UA and comorbidities were reported. Renal Doppler ultrasound with RRI was evaluated in all patients at the time of enrolment. RESULTS NS was present in 81 (16.8 %) patients while ANS in 81 (16.8 %) and UA in 228 (47.3 %) patients. Patients with ANS showed significant higher RRI compared to both patients with NS [0.71 (IQR 0.67-0.78) vs 0.68 (0.63-0.73), p < 0.001] and UA [0.71 (0.67-0.78) vs 0.65 (0.61-0.71), p < 0.001]; RRI was higher in NS patients than in patients with UA [0.68 (0.63-0.73) vs 0.65 (0.61-0.71), p < 0.001]. Patients with ANS had significantly lower median estimated glomerular filtration rate (eGFR) compared respectively to NS and UA patients [19.7 ml/min vs 54.8 ml/min and vs 72.3 ml/min, p < 0.001], while renal length was significantly higher in patients with NS compared to both patients with ANS and UA [111.88 mm vs 101.98 mm and vs 106.15, p < 0.001]. Patients with ANS had more frequently hematuria and RRI ≥ 0.70 (p < 0.001) compared to both patients with NS and patients with UA. The multiple regression analysis, weighted for age, showed that RRI inversely correlates with eGFR (β coefficient = -0.430, p < 0.001). CONCLUSIONS Higher and pathological RRI were found in ANS than NS and UA. Renal resistive index in ANS reflects changes in intrarenal perfusion and microvascular dysfunction related to disease characteristics.
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Affiliation(s)
- Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
| | - Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Oriana De Marco
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Eleonora Assanto
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Georgia Sorato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Alberto Palladini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Silvia Lai
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Rosario Cianci
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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Costa D, Pellicano C, Mercuri V, D'Ascanio E, Buglione G, Cicolani G, Basile U, Leodori G, Gargiulo P, Rosato E. Role of IL33 in chronic inflammation and microvascular damage as a reflection of organ damage on a cohort of patients with acromegaly. J Endocrinol Invest 2024:10.1007/s40618-024-02305-6. [PMID: 38329608 DOI: 10.1007/s40618-024-02305-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/05/2024] [Indexed: 02/09/2024]
Abstract
AIM Acromegaly is a rare chronic disease, caused by the over-secretion of growth hormone (GH), that creates a pro-inflammatory state, but the exact mechanisms by which GH or insulin-like growth factor 1 (IGF-1) act on inflammatory cells are not fully understood. Aim of the study was to evaluate Interleukin-33 (IL33) and the skin perfusion of hands in patients with acromegaly (AP) and healthy controls (HC). METHODS IL33 have been assessed in 40 AP and 40 HC. IL 33 was determined and skin perfusion of hands was assessed by laser speckle contrast analysis (LASCA) in both populations. RESULTS IL33 was significantly higher in AP compared to HC [45.72 pg/ml (IQR 28.74-60.86) vs 14 pg/ml (IQR 6.5535); p < 0.05]. At LASCA, peripheral blood perfusion (PBP) was significantly lower in AP compared to HC [53.39 pU (IQR 40.94-65.44) vs 87 pU (IQR 80-98) p < 0.001]. The median values of ROI1, ROI2 and ROI3 were significantly lower in AP compared to HC [97.32 pU (IQR 50.89-121.69) vs 131 pU (IQR 108-135); p < 0.001], [58.68 pU (IQR 37.72-84.92) vs 83 pU (IQR 70-89), p < 0.05] and HC [52.16 (34.47-73.78) vs 85 (78-98), p < 0.001], respectively. The proximal-distal gradient (PDG) was observed in 18 of 40 (45%) AP. CONCLUSION Serum IL33 is higher in AP compared to HC; conversely a reduction of PBP of hands was present in AP compared to HC, probably due to endothelial dysfunction, strictly dependent on acromegaly and are not influenced by the choice of treatment.
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Affiliation(s)
- D Costa
- Department of Experimental Medicine, Endocrinology-Pituitary Disease, "Sapienza" University of Rome, Rome, Italy
| | - C Pellicano
- Department of Traslational and Precision Medicine, Sapienza-University of Rome, Rome, Italy
| | - V Mercuri
- Department of Experimental Medicine, Endocrinology-Pituitary Disease, "Sapienza" University of Rome, Rome, Italy
| | - E D'Ascanio
- Department of Experimental Medicine, Endocrinology-Pituitary Disease, "Sapienza" University of Rome, Rome, Italy
| | - G Buglione
- Department of Experimental Medicine, Endocrinology-Pituitary Disease, "Sapienza" University of Rome, Rome, Italy
| | - G Cicolani
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza", University of Rome, Rome, Italy
| | - U Basile
- UOC of Clinical Pathology DEA II Level, Hospital Santa Maria Goretti of Latina-Italy, Latina, Italy
| | - G Leodori
- Department of Traslational and Precision Medicine, Sapienza-University of Rome, Rome, Italy
| | - P Gargiulo
- Department of Experimental Medicine, Endocrinology-Pituitary Disease, "Sapienza" University of Rome, Rome, Italy.
| | - E Rosato
- Department of Traslational and Precision Medicine, Sapienza-University of Rome, Rome, Italy
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Riccieri V, Pellegrino G, Cipolletta E, Giuggioli D, Bajocchi G, Bellando-Randone S, Dagna L, Zanframundo G, Foti R, Cacciapaglia F, Cuomo G, Ariani A, Rosato E, Lepri G, Girelli F, Zanatta E, Bosello SL, Cavazzana I, Ingegnoli F, De Santis M, Murdaca G, Abignano G, Romeo N, Della Rossa A, Caminiti M, Iuliano A, Ciano G, Beretta L, Bagnato G, Lubrano E, De Andres I, Giollo A, Saracco M, Agnes C, Lumetti F, Spinella A, Magnani L, Campochiaro C, De Luca G, Codullo V, Visalli E, Di Vico C, Gigante A, Saccon F, Grazia Lazzaroni M, Franceschini F, Generali E, Mennillo G, Barsotti S, Pagano Mariano G, Calabrese F, Furini F, Vultaggio L, Parisi S, Peroni CL, Bianchi G, Conti F, Cozzi F, D’Angelo S, Doria A, Fusaro E, Govoni M, Guiducci S, Iannone F, Salvarani C, Sebastiani GD, Ferri C, Matucci-Cerinic M, De Angelis R. Practice pattern for the use of intravenous iloprost for the treatment of peripheral vasculopathy in systemic sclerosis: A case-control study from the Italian national multicenter "SPRING" (Systemic Sclerosis Progression InvestiGation) Registry. J Scleroderma Relat Disord 2024; 9:38-49. [PMID: 38333531 PMCID: PMC10848931 DOI: 10.1177/23971983231209809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/28/2023] [Indexed: 02/10/2024]
Abstract
Background Intravenous iloprost has been widely used for the treatment of systemic sclerosis peripheral vasculopathy. No agreement has been found on the regimen and the dosage of intravenous iloprost in different scleroderma subset conditions. This study aimed to evaluate the modalities of intravenous iloprost administration within a large cohort of systemic sclerosis patients from the SPRING Registry and to identify any associated clinical-demographic, instrumental or therapeutic data. Patients and Methods Data of systemic sclerosis patients treated with intravenous iloprost for at least 1 year (case group) were retrospectively analyzed, including different timing and duration of intravenous iloprost session, and compared with those of untreated patients (control group). Results Out of 1895 analyzed patients, 937 (49%) received intravenous iloprost treatment, while 958 (51%) were assigned to the control group. Among cases, about 70% were treated every 4 weeks, 24% with an interval of more than 4 weeks, and only 6% of less than 4 weeks. Most patients receiving the treatment every 4 weeks, or less, underwent infusion cycle for 1 day only, while if it was scheduled with an interval of more than 4 weeks, a total number of 5 consecutive days of infusions was the preferred regimen. The comparison between the two groups revealed that patients treated with intravenous iloprost had a higher frequency of DUs (p < 0.001), pitting scars (p < 0.001), diffuse cutaneous involvement (p < 0.001), interstitial lung disease (p < 0.002), as well as higher rates of anti-topoisomerase I, "late" scleroderma pattern at nailfold videocapillaroscopy. These findings were confirmed by multivariate analysis. Conclusion Our data provide a picture on the Italian use of intravenous iloprost among systemic sclerosis patients and showed that it was usually employed in patients with a more aggressive spectrum of the disease. The disparity of intravenous iloprost treatment strategies in the different centers suggests the need of a rational therapeutical approach based on the clinical characteristics of different patients' subsets.
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Affiliation(s)
- Valeria Riccieri
- Department of Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Greta Pellegrino
- Department of Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
- Department of Rheumatology, IRCCS Ospedale Galeazzi–Sant’Ambrogio, Milan, Italy
| | - Edoardo Cipolletta
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Dilia Giuggioli
- Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Gianluigi Bajocchi
- Rheumatology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Bellando-Randone
- Department of Experimental and Clinical Medicine, Division of Rheumatology, AOUC, University of Florence, Florence, Italy
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milano, Italy
| | | | - Rosario Foti
- Rheumatology Unit, A.O.U Policlinico S. Marco, Catania, Italy
| | - Fabio Cacciapaglia
- Rheumatology Unit, Department of Precision and Regenerative Medicine-Ionian Area, University of Bari “Aldo Moro,” Bari, Italy
| | - Giovanna Cuomo
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Alarico Ariani
- Department of Medicine, Internal Medicine and Rheumatology, Azienda Ospedaliero Universitaria di Parma, Parma, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Gemma Lepri
- Department of Experimental and Clinical Medicine, Division of Rheumatology, AOUC, University of Florence, Florence, Italy
| | - Francesco Girelli
- Department of Medicine, Rheumatology Unit, Ospedale GB Morgagni—L Pierantoni, Forlì, Italy
| | - Elisabetta Zanatta
- Rheumatology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Silvia Laura Bosello
- Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy
| | - Ilaria Cavazzana
- Rheumatology and Clinical Immunology, Department of Clinical and Experimental Sciences, ASST Spedali Civili of Brescia and University of Brescia, Brescia, Italy
| | - Francesca Ingegnoli
- Division of Clinical Rheumatology, ASST Pini, Department of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Research Center for Environmental Health, Università degli Studi di Milano, Milan, Italy
| | - Maria De Santis
- Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Giuseppe Murdaca
- Department of Internal Medicine, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giuseppina Abignano
- Rheumatology Institute of Lucania (IReL) and Rheumatology Department of Lucania, San Carlo Hospital, Potenza, Italy
| | | | | | - Maurizio Caminiti
- Departmental Rheumatology Unit, Grande Ospedale Metropolitano, Reggio Calabria, Italy
| | | | - Giovanni Ciano
- Hospital of Ariano Irpino, Local Health Department, Ariano Irpino, Italy
| | - Lorenzo Beretta
- Referral Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Gianluca Bagnato
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Ennio Lubrano
- Department of Rheumatology, University of Molise, Campobasso, Italy
| | - Ilenia De Andres
- Rheumatology Unit, Azienda Ospedaliera di Rilievo Nazionale ed Alta Specializzazione “Garibaldi,” Catania, Italy
| | - Alessandro Giollo
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | | | | | - Federica Lumetti
- Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Amelia Spinella
- Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Luca Magnani
- Rheumatology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Corrado Campochiaro
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milano, Italy
| | - Giacomo De Luca
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milano, Italy
| | - Veronica Codullo
- Department of Rheumatology, Policlinico San Matteo, Pavia, Italy
| | - Elisa Visalli
- Rheumatology Unit, A.O.U Policlinico S. Marco, Catania, Italy
| | - Claudio Di Vico
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Maria Grazia Lazzaroni
- Rheumatology and Clinical Immunology, Department of Clinical and Experimental Sciences, ASST Spedali Civili of Brescia and University of Brescia, Brescia, Italy
| | - Franco Franceschini
- Rheumatology and Clinical Immunology, Department of Clinical and Experimental Sciences, ASST Spedali Civili of Brescia and University of Brescia, Brescia, Italy
| | - Elena Generali
- Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Gianna Mennillo
- Rheumatology Institute of Lucania (IReL) and Rheumatology Department of Lucania, San Carlo Hospital, Potenza, Italy
| | | | | | - Francesca Calabrese
- Departmental Rheumatology Unit, Grande Ospedale Metropolitano, Reggio Calabria, Italy
| | - Federica Furini
- Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara, Ferrara, Italy
| | - Licia Vultaggio
- Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara, Ferrara, Italy
| | - Simone Parisi
- Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Clara Lisa Peroni
- Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Gerolamo Bianchi
- Rheumatology Unit, Department of Musculoskeletal Sciences, Local Health Trust 3, La Colletta Hospital, Genoa, Italy
| | - Fabrizio Conti
- Department of Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Franco Cozzi
- Department of Medicine, Villa Salus Hospital, Venice, Italy
| | - Salvatore D’Angelo
- Rheumatology Institute of Lucania (IReL) and Rheumatology Department of Lucania, San Carlo Hospital, Potenza, Italy
| | - Andrea Doria
- Rheumatology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Enrico Fusaro
- Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Marcello Govoni
- Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara, Ferrara, Italy
| | - Serena Guiducci
- Department of Experimental and Clinical Medicine, Division of Rheumatology, AOUC, University of Florence, Florence, Italy
| | - Florenzo Iannone
- Rheumatology Unit, Department of Precision and Regenerative Medicine-Ionian Area, University of Bari “Aldo Moro,” Bari, Italy
| | - Carlo Salvarani
- Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Clodoveo Ferri
- Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Matucci-Cerinic
- Department of Experimental and Clinical Medicine, Division of Rheumatology, AOUC, University of Florence, Florence, Italy
| | - Rossella De Angelis
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
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Gigante A, Cianci R, Villa A, Pellicano C, Giannakakis K, Rosato E, Spinelli FR, Basile U, Racco C, Di Virgilio EM, Cerbelli B, Conti F. Kidney Biopsy and Immuno-Rheumatological Diseases: A Retrospective and Observational Study. J Pers Med 2024; 14:92. [PMID: 38248794 PMCID: PMC10819986 DOI: 10.3390/jpm14010092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/28/2023] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
Renal involvement is a common occurrence in patients with immuno-rheumatological diseases (IRDs). Several instances of glomerulonephritis (GN) occur in the setting of IRD and complicate the clinical course of an underlying condition. The aim of this study was to observe the spectrum of nephropathies according to age, kidney function, history of IRD at the time of biopsy, and histopathological kidney diagnosis. We evaluated data relating to 699 consecutive kidney native biopsies (female 52.1%) with a median age of 48 years (IQR 34-62) performed in adult patients collected over 15 years. The study population was divided into three groups: patients with kidney histological findings correlated to underlying IRD (Group 1), patients with kidney histological findings not correlated to underlying IRD (Group 2), and patients with kidney histological findings compatible with "de novo" IRD (absent in personal medical history) (Group 3). Kidney involvement related to IRD was found in 25.2% of patients. Group 1 was mostly represented by lupus nephritis (76.6%), with a younger age than Group 3 (p < 0.001) and by a higher percentage of females than other groups (p < 0.001). Group 3 was the most represented by microscopic polyangiitis (50.8%) when compared with the other two groups (p < 0.001). Acute nephritic syndrome (p < 0.001), acute kidney injury (AKI), and abnormal urinalysis (p < 0.001) were more represented in Group 3 than the other groups. In conclusion, IRDs are characterized by different clinical presentations and heterogeneous histological findings. Kidney biopsy remains fundamental to achieving the correct diagnosis and starting targeted therapy.
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Affiliation(s)
- Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.G.); (R.C.); (A.V.); (C.P.); (E.R.); (E.M.D.V.)
| | - Rosario Cianci
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.G.); (R.C.); (A.V.); (C.P.); (E.R.); (E.M.D.V.)
| | - Annalisa Villa
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.G.); (R.C.); (A.V.); (C.P.); (E.R.); (E.M.D.V.)
| | - Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.G.); (R.C.); (A.V.); (C.P.); (E.R.); (E.M.D.V.)
| | - Konstantinos Giannakakis
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, 00185 Rome, Italy;
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.G.); (R.C.); (A.V.); (C.P.); (E.R.); (E.M.D.V.)
| | - Francesca Romana Spinelli
- Rheumatology Unit, Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy (F.C.)
| | - Umberto Basile
- Department of Clinical Pathology, Santa Maria Goretti Hospital, AUSL Latina, 04100 Latina, Italy;
| | - Cosimo Racco
- Department of Clinical Pathology, Santa Maria Goretti Hospital, AUSL Latina, 04100 Latina, Italy;
| | - Elena Maria Di Virgilio
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.G.); (R.C.); (A.V.); (C.P.); (E.R.); (E.M.D.V.)
| | - Bruna Cerbelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy;
| | - Fabrizio Conti
- Rheumatology Unit, Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy (F.C.)
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Deibel E, Carreira PE, Vonk M, Del Papa N, Bečvář R, Guillén-Del-Castillo A, Campochiaro C, Poormoghim H, Liem S, Lazzaroni MG, Giollo A, Mekinian A, de Vries-Bouwstra J, De Santis M, Balbir-Gurman A, Mihai C, De Luca G, Moiseev S, Zanatta E, Foti R, Rednic S, Denton C, Cutolo M, Belloli L, Airo P, Garzanova L, Moroncini G, İnanç M, Panopoulos S, Tandaipan JL, Chatelus E, Rosato E, Kuwana M, Yavuz S, Alegre-Sancho JJ, Smith V, Szűcs G, Henes J, Rodríguez-Pintó I, Atzeni F, Spierings J, Truchetet ME, Milchert M, Brito de Araujo D, Riemekasten G, Bernardino V, Martin T, Del Galdo F, Vacca A, Mendoza F, Midtvedt Ø, Murdaca G, Santiago T, Codullo V, Cacciapaglia F, Walker U, Brunborg C, Tirelli F, Allanore Y, Furst DE, Matucci M, Gabrielli A, Distler O, Hoffmann-Vold AM. Does the Impact of COVID-19 on Patients With Systemic Sclerosis Change Over Time? Arthritis Care Res (Hoboken) 2024; 76:88-97. [PMID: 37667424 DOI: 10.1002/acr.25226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/04/2023] [Accepted: 08/24/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE The outcome of patients with COVID-19 improved over the pandemic, including patients with systemic rheumatic diseases. However, data on patients with systemic sclerosis (SSc) are lacking. This study aimed to assess the outcome of patients with both SSc and COVID-19 over several waves. METHODS Patients with both SSc and COVID-19 who were registered in the European Scleroderma Trials and Research group (EUSTAR) were collected between April 2020 and April 2021. Patients were assigned to waves 1, 2, or 3 depending on the date of their COVID-19 diagnosis. Primary endpoints were death, intensive care unit stay, or ventilatory support (severe outcome). Subgroup analyses of patients who were hospitalized or died were conducted. General and SSc-specific characteristics and treatment were compared over the waves. Descriptive statistics and multivariate logistic regression were applied. RESULTS A total of 333 patients were included; 57 patients (17%) had a severe outcome, and 30 patients (9%) died. Compared to wave 1, significantly fewer patients with SSc suffered from severe COVID-19 in waves 2 and 3 (28.2% vs 9.8% and 12.7%; P < 0.001), fewer patients required hospitalization (46.7% vs 19.6% and 25.5%; P < 0.001) or ventilatory support (24.0% vs 8.7% and 10.9%; P = 0.001), and fewer patients died (15.7% vs 5.0% and 7.5%; P = 0.011). Patients were significantly younger, more often men, had less frequent arterial hypertension, and less SSc cardiac involvement over waves 1 to 3. Patients received significantly less medium to high doses of corticosteroids as they did SSc treatment. CONCLUSION The outcome of patients with both SSc and COVID-19 improved significantly over time because of intrinsic and extrinsic factors.
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Affiliation(s)
- Elisabeth Deibel
- University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Madelon Vonk
- Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Radim Bečvář
- 1st Medical School, Charles University, Praha, Czech Republic
| | | | | | | | - Sophie Liem
- Leiden University Medical Center, Leiden, The Netherlands
| | | | | | | | | | - Maria De Santis
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy, and Humanitas University, Pieve Emanuele, Milan, Italy
| | | | - Carina Mihai
- University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Sergey Moiseev
- Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | | | - Rosario Foti
- A.O.U. Policlinico S. Marco Catania, Catania, Italy
| | - Simona Rednic
- University of Medicine & Pharmacy "Iuliu Hatieganu" Cluj, Cluj-Napoca, Romania
| | | | | | - Laura Belloli
- ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Paolo Airo
- ASST Spedali Civili of Brescia, University of Brescia, Italy
| | - Liudmila Garzanova
- VA Nasonova Research Institute of Rheumatology, Moscow, Russian Federation
| | - Gianluca Moroncini
- Università Politecnica delle Marche, Polo Didattico, University of Ancona, Ancona, Italy
| | | | | | | | - Emmanuel Chatelus
- Centre National de Référence des Maladies Auto-immunes et Systémiques Rares Est/Sud-Ouest (RESO), Strasbourg, France
| | | | | | | | | | - Vanessa Smith
- Ghent University, Ghent University Hospital, and VIB Inflammation Research Center (IRC), Ghent, Belgium
| | | | - Joerg Henes
- Centre for Interdisciplinary Clinical Immunology, Rheumatology and Auto-inflammatory Diseases (INDIRA), University Hospital Tuebingen, Tuebingen, Germany
| | | | | | | | | | | | | | - Gabriela Riemekasten
- University Clinic Schleswig Holstein Lübeck, University of Lübeck, Lübeck, Germany
| | - Vera Bernardino
- Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal
| | - Thierry Martin
- Centre de Référence des Maladies Autoimmunes Systémiques Rares Est Sud-Ouest (RESO), Nouvel Hôpital Civil, Strasbourg, France
| | - Francesco Del Galdo
- Leeds Institute of Rheumatic and Musculoskeletal Medicine and NIHR Biomedical Research Centre, University of Leeds, Leeds, UK
| | | | | | | | - Giuseppe Murdaca
- University of Genova and IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Tânia Santiago
- Centro Hospital e Universitário de Coimbra, University of Coimbra, Portugal
| | | | | | | | | | - Francesca Tirelli
- University Hospital Zurich, University of Zurich, Zurich, Switzerland, and University of Padova, Padova, Italy
| | | | | | - Marco Matucci
- University of Florence, Florence, Italy and IRCCS San Raffaele Hospital, Milan, Italy
| | - Armando Gabrielli
- Università Politecnica delle Marche, Polo Didattico, University of Ancona, Ancona, Italy
| | - Oliver Distler
- University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Anna-Maria Hoffmann-Vold
- University Hospital Zurich, University of Zurich, Zurich, Switzerland and Oslo University Hospital, Oslo, Norway
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Pellicano C, Vantaggio L, Colalillo A, Pocino K, Basile V, Marino M, Basile U, Rosato E. Type 2 cytokines and scleroderma interstitial lung disease. Clin Exp Med 2023; 23:3517-3525. [PMID: 37392249 PMCID: PMC10618297 DOI: 10.1007/s10238-023-01125-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/21/2023] [Indexed: 07/03/2023]
Abstract
Interstitial lung disease (ILD) is a life-threatening complication of systemic sclerosis (SSc). Type 2 (Th2) cytokines play a pivotal role in airway disease. Study aim was to evaluate serum level of Th2 interleukin (IL) and chemokine in SSc-ILD. Serum levels of IL-4, IL-5, IL-11, IL-13, IL-21, IL-31 and CXCL-13 were measured by Bio-Plex Multiplex Immunoassays in 60 SSc patients and 20 healthy controls (HC). Pulmonary function tests with diffusion lung capacity for carbon monoxide (DLco) and high resolution computed tomography (HRCT) were performed in SSc patients. ILD is defined as fibrotic changes (ground glass, reticular and honeycombing), assessed by Computer-Aided Lung Informatics for Pathology Evaluation and Ratings (CALIPER) software, affecting at least 10% of the lungs. Serum levels of Th2 cytokines were higher in SSc patients than HC. A linear correlation was observed between ground glass and IL-13 (r = 0.342, p < 0.01), IL-21 (r = 0.345, p < 0.01), IL-31 (r = 0.473, p < 0.001), IL-4 (r = 0.863, p < 0.001), IL-5 (r = 0.249, p < 0.05) and peripheral blood eosinophils (r = 0.463, p < 0.001). We found a negative correlation between DLco and IL-4 (r = - 0.511, p < 0.001) and peripheral blood eosinophils (r = - 0.446, p < 0.001). In the logistic regression analysis, IL-4 is associated with DLco ≤ 60% of the predicted [OR 1.039 (CI 95%: 1.015-1.064), p < 0.001], whilst mRSS [OR 1.138 (CI 95%: 1.023-1.266), p < 0.05] and IL-4 [OR 1.017 (CI 95%: 1-1.034), p < 0.05] were associated with ILD. Th2 inflammation could play a key role in early phase of SSc-ILD.
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Affiliation(s)
- Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale Dell'Università 37, 00185, Rome, Italy
| | - Lorenzo Vantaggio
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale Dell'Università 37, 00185, Rome, Italy
| | - Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale Dell'Università 37, 00185, Rome, Italy
| | - Krizia Pocino
- UOC of Clinical Pathology, General Hospital San Pietro Fatebenefratelli, 00189, Rome, Italy
| | - Valerio Basile
- Clinical Pathology Unit and Cancer Biobank, Department of Research and Advanced Technologies, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Mariapaola Marino
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Fondazione Policlinico A. Gemelli IRCCS, 00168, Rome, Italy
| | - Umberto Basile
- UOC Clinical Pathology DEA II Level, Hospital Santa Maria Goretti-ASL Latina, 04100, Latina, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale Dell'Università 37, 00185, Rome, Italy.
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Gigante A, Cianci R, Brigato C, Melena M, Acquaviva E, Toccini L, Pellicano C, Rosato E, Muscaritoli M. Resistant Hypertension and Related Outcomes in a Cohort of Patients with Cardiorenal Multimorbidity Hospitalized in an Internal Medicine Ward. High Blood Press Cardiovasc Prev 2023; 30:585-590. [PMID: 38010537 PMCID: PMC10721656 DOI: 10.1007/s40292-023-00609-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION Resistant hypertension (RH) is characterized by the failure to reach a goal blood pressure despite the administration of three medications at maximally tolerated doses, one of which being a diuretic. RH can be observed in a variety of clinical conditions, such as heart failure and reduced renal function and may confer high cardiovascular risk. AIM To evaluate the prevalence of RH and its association with clinical outcomes; the primary outcome was in-hospital mortality and the composite outcome was all-cause of mortality and morbidity in a cohort of patients with cardiorenal multimorbidity hospitalized in an internal medicine ward. METHODS We conducted a retrospective analysis of consecutive hypertensive patients with cardiorenal multimorbidity. The composite outcome incorporated all-cause of in-hospital mortality and occurrence of sepsis, pulmonary embolism, acute coronary syndrome, stroke and renal replacement therapy. RESULTS We collected data in 141 inpatients with a mean age of 77 years ± 10 (males 65.9 %), estimated glomerular filtration rate of 34 ± 18.6 ml/min with length of stay of 17 ± 12 days. The prevalence of RH was 52.4%. In-hospital mortality was observed in 24 patients (17%) and the composite outcome occurred in 87 patients (61.7%) and among these 74 (85.1%) were patients with RH. Free survival for composite outcome was significantly higher in patients without RH than patients with RH (log rank 7.52, p = 0.006). Resistant hypertension was a risk factor for composite outcome [HR 1.857(C.I. 1.170-2.946, p = 0.009)]. CONCLUSION In patients with cardiorenal multimorbidity there is a high proportion of RH that represents a risk factor for composite outcome but not for in-hospital mortality.
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Affiliation(s)
- Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy.
| | - Rosario Cianci
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | - Claudia Brigato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | - Michele Melena
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | - Erika Acquaviva
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | - Ludovica Toccini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | - Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
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Rosato E, Gigante A, Colalillo A, Pellicano C, Alunni Fegatelli D, Muscaritoli M. GLIM-diagnosed malnutrition predicts mortality and risk of hospitalization in systemic sclerosis: A retrospective study. Eur J Intern Med 2023; 117:103-110. [PMID: 37482470 DOI: 10.1016/j.ejim.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/09/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Malnutrition is a well-known risk factor for morbidity and mortality in many clinical settings and only few studies assessed the role of malnutrition on systemic sclerosis (SSc) patients' outcomes. The aim of this retrospective study was to evaluate the role of malnutrition as a predictive risk factor for mortality and/or hospitalization in SSc patients during a 4-year follow-up. METHODS One hundred and one SSc patients were included in the study. Biochemical analyses, disease activity index, disease severity scale and anthropometric data were recorded at enrollment. Malnutrition was assessed by the Global Leadership Initiative on Malnutrition (GLIM) criteria. RESULTS Malnutrition according to GLIM criteria was found in 22 patients (21.8%). During a 4-year follow-up, 20 (19.8%) SSc patients died or were hospitalized for all causes and 11 of them (55.0%) were malnourished. Kaplan-Meier curves showed that event free-survival for composite end-point of mortality and risk of hospitalization was significantly shorter in malnourished than in non-malnourished patients (p<0.001). The survival probability at 4 years was 0.885 (95% CI=0.818-0.959) in the non-malnourished group and 0.500 (95% CI=0.329-0.759) in the malnourished group (p<0.001). In multivariate analysis, malnutrition [HR=4.380 (95% CI=1.706-11.243), p = 0.002] was the most significant predictive risk factor for the composite end-point. Also, female gender [HR=0.157 (95% CI=0.055-0.449), p<0.001], age [HR=1.0450 (95% CI=1.011-1.090), p = 0.012] and disease severity scale [HR=1.269 (95% CI=1.089-1.479), p = 0.002] were predictive factors for the composite end-point. CONCLUSIONS Malnutrition according to GLIM criteria represents a significant predictive risk factor for composite end-point of mortality and risk of hospitalization in SSc patients.
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Affiliation(s)
- Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy.
| | - Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | | | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
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Gigante A, Lai S, Pellicano C, De Marco O, Rosato E, Giannakakis K, D'Amati G, Muscaritoli M, Ferri C, Cianci R. Nephroangiosclerosis not related to hypertension: A matter to resolve in the era of precision medicine. J Hum Hypertens 2023; 37:931-935. [PMID: 36577802 DOI: 10.1038/s41371-022-00796-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/08/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022]
Abstract
Nephroangiosclerosis (NAS) associated with hypertension continues to be one of the most causes of end stage renal diseases in Europe, but it is still poorly studied. The prevalence of NAS shows a large variability due to the difference among different countries regarding clinical presentations and the indication to perform renal biopsy. The study aimed to investigate the prevalence in biopsy-proven NAS patients and the association with hypertension and/or glomerulonephritis (GN). We included all patients referred for native kidney biopsy between 2003-2021 at Policlinic Umberto I of Rome. From 837 patients who underwent renal biopsy NAS was diagnosed in 80 (10.5%) patients. Serum creatinine was significantly higher in NAS [2.07 mg/dl (IQR 1.13-5.2) vs 1.1 mg/dl (IQR 0.8-2.1), p < 0.001] compared to patients without NAS. Hypertension was present in 45% of patients with NAS. Proteinuria was significantly higher in patients with mild-moderate NAS compared to patients with severe NAS [2.6 g/die (IQR 1-5) vs 1.5 g/die (IQR 0.86-2.3), p < 0.05]. We did not find any significant differences, including histological features, between NAS patients with hypertension and NAS patients without hypertension (p > 0.05). IgA nephropathy, focal segmental glomerulosclerosis and membranous nephropathy were the most frequent GN associated. In conclusion no specific histological features are reported in NAS with and without hypertension. More information on the phenotype, clinical presentation and markers are needed to improve histological and clinical diagnostics.
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Affiliation(s)
- Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Sapienza, Italy
| | - Silvia Lai
- Department of Translational and Precision Medicine, Sapienza University of Rome, Sapienza, Italy
| | - Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Sapienza, Italy
| | - Oriana De Marco
- Department of Translational and Precision Medicine, Sapienza University of Rome, Sapienza, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Sapienza, Italy
| | - Konstantinos Giannakakis
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Sapienza, Italy
| | - Giulia D'Amati
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Sapienza, Italy
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Sapienza, Italy
| | - Claudio Ferri
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, Internal Medicine and Nephrology Unit, ESH Excellence Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Rosario Cianci
- Department of Translational and Precision Medicine, Sapienza University of Rome, Sapienza, Italy.
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Lepri G, Airò P, Distler O, Andréasson K, Braun-Moscovici Y, Hachulla E, Balbir-Gurman A, De Langhe E, Rednic S, Ingegnoli F, Rosato E, Groseanu L, Ionescu R, Bellando-Randone S, Garzanova L, Beretta L, Bellocchi C, Moiseev S, Novikov P, Szabo I, Krasowska D, Codullo V, Walker UA, Manolaraki C, Guiducci S, Truchetet ME, Iannone F, Tofani L, Bruni C, Smith V, Cuomo G, Krusche M, Matucci-Cerinic M, Allanore Y. Systemic sclerosis and primary biliary cholangitis: Longitudinal data to determine the outcomes. J Scleroderma Relat Disord 2023; 8:210-220. [PMID: 37744053 PMCID: PMC10515998 DOI: 10.1177/23971983231155948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/15/2022] [Indexed: 09/26/2023]
Abstract
Background Several studies described the cross-sectional characteristics of systemic sclerosis patients and coexisting primary biliary cholangitis, but longitudinal prognostic data are lacking. Aims To describe the systemic sclerosis-primary biliary cholangitis phenotype, including baseline characteristics and outcomes. Methods We performed a multicentre the European Scleroderma Trials and Research Group study of systemic sclerosis patients with primary biliary cholangitis or with primary biliary cholangitis-specific antibodies, matched with systemic sclerosis controls free from hepatobiliary involvement matched for disease duration and cutaneous subset. Data were recorded at baseline and at the last available visit. Results A total of 261 patients were enrolled (115 primary biliary cholangitis-systemic sclerosis, 161 systemic sclerosis). At baseline, systemic sclerosis-primary biliary cholangitis patients had a higher prevalence of anti-centromere antibodies (p = 0.0023) and a lower prevalence of complete absence of digital ulcers. The milder vascular involvement was confirmed at follow-up when crucial differences emerged in the percentage of patients experiencing digital ulcers; a significantly higher number of patients who never experienced digital ulcers were observed among primary biliary cholangitis-systemic sclerosis patients (p = 0.0015). Moreover, a greater incidence of pulmonary arterial hypertension (p < 0.001) and of conduction blocks (p = 0.0256) was observed in systemic sclerosis patients without primary biliary cholangitis. Patients with primary biliary cholangitis had higher levels of liver enzymes at baseline than systemic sclerosis patients; a significant decrease in liver enzymes was observed at follow-up. Out of 18 patients with cholangitis, one received a liver transplant at follow-up. Conclusion Our data show that systemic sclerosis-primary biliary cholangitis exhibit a mild systemic sclerosis and primary biliary cholangitis phenotype with outcomes being in general favourable.
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Affiliation(s)
- Gemma Lepri
- Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Paolo Airò
- Rheumatology and Clinical Immunology, Spedali Civili of Brescia, Brescia, Italy
| | - Oliver Distler
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Kristofer Andréasson
- Section of Rheumatology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Yolanda Braun-Moscovici
- Rheumatology Department, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Eric Hachulla
- Department of Internal Medicine, Hôpital Claude Huriez, Lille, France
| | - Alexandra Balbir-Gurman
- Rheumatology Department, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Ellen De Langhe
- ERN ReCONNET, Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | - Simona Rednic
- Department of Rheumatology, Emergency County Teaching Hospital, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Francesca Ingegnoli
- Clinical Rheumatology Unit, ASST Pini-CTO, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Laura Groseanu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ruxandra Ionescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Silvia Bellando-Randone
- Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Liudmila Garzanova
- Laboratory of Microcirculation and Inflammation, VA Nasonova Institute of Rheumatology, Moscow, Russian Federation
| | - Lorenzo Beretta
- Scleroderma Unit, Referral Center for Systemic Autoimmune Diseases, La Fondazione IRCCS Ca’ Granda Ospedale Maggiore di Milano Policlinico, Milano, Italy
| | - Chiara Bellocchi
- Scleroderma Unit, Referral Center for Systemic Autoimmune Diseases, La Fondazione IRCCS Ca’ Granda Ospedale Maggiore di Milano Policlinico, Milano, Italy
| | - Sergey Moiseev
- Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Pavel Novikov
- Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Iulia Szabo
- Department of Rheumatology, Emergency County Teaching Hospital, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Dorota Krasowska
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | | | - Ulrich A. Walker
- Department of Rheumatology, Universitätsspital Basel, Basel, Switzerland
| | | | - Serena Guiducci
- Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Florenzo Iannone
- Rheumatology Unit – DETO, School of Medicine, University of Bari, Bari, Italy
| | - Lorenzo Tofani
- Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Cosimo Bruni
- Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Vanessa Smith
- Department of Rheumatology, Ghent University Hospital and Department of Internal Medicine, Ghent University, Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Ghent, Belgium
| | - Giovanna Cuomo
- Department of Precision of Medicine, University of Campania – L. Vanvitelli, Naples, Italy
| | - Martin Krusche
- Division of Rheumatology and Systemic Inflammatory Diseases, University Hospital Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Marco Matucci-Cerinic
- Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Scleroderma Unit, Referral Center for Systemic Autoimmune Diseases, La Fondazione IRCCS Ca’ Granda Ospedale Maggiore di Milano Policlinico, Milano, Italy
| | - Yannick Allanore
- Rheumatology, Cochin Hospital, APHP, Paris Cité University, Paris, France
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Pellicano C, Vaiarello V, Colalillo A, Gigante A, Iannazzo F, Rosato E. Role of kinurenic acid in the systemic sclerosis renal involvement. Clin Exp Med 2023; 23:1713-1719. [PMID: 36436115 DOI: 10.1007/s10238-022-00962-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 11/22/2022] [Indexed: 11/28/2022]
Abstract
Systemic sclerosis (SSc) subclinical renal vasculopathy is characterized by progressive increase of intrarenal stiffness and reduction of parenchymal thickness due to post ischemic fibrosis secondary to the renal Raynaud phenomenon. Aims of this study were to evaluate kinurenic acid (KYNA) serum level in SSc patients and healthy controls (HC) and to assess the role of KYNA in SSc subclinical nephropathy. Serum level of KYNA was evaluated in 52 SSc patients and 20 HC, matched for sex and age. Renal function was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation to estimate glomerular filtration rate (eGFR) and renal doppler ultrasound was performed to evaluate kidneys' morphology and indices of intrarenal stiffness. The parameters registered were renal longitudinal length, atrophy index (AI), renal sinus, parenchymal thickness, renal resistive index (RRI), pulsatile index (PI) and systolic/diastolic ratio (S/D). SSc patients had lower median value of KYNA than HC [54.43 ng/ml (IQR 44.44-63.64) vs 61.94 ng/ml (IQR 55.23-88.75), p < 0.001]. SSc patients with AI ≥ 0.70 had lower KYNA than SSc patients with AI < 0.70 [47.85 ng/ml (IQR 41.16-59.91) vs 55.5 ng/ml (IQR 49.99-67.33), p < 0.05] and a slightly significant negative linear correlation was found between KYNA and AI (r = - 0.249, p < 0.05). SSc patient with RRI ≥ 0.70 had higher KYNA than SSc patients with RRI < 0.70 [58.25 ng/ml (IQR 50.49-69.68) vs 50.07 ng/ml (IQR 42.70-56.31), p < 0.05] and a significant positive correlation was found between KYNA and RRI (r = 0.318, p < 0.05). KYNA may be used as a marker to evaluate the renal involvement in SSc patients.
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Affiliation(s)
- Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University, Viale Dell'Università 37, 00185, Rome, Italy
| | - Valentina Vaiarello
- Department of Translational and Precision Medicine, Sapienza University, Viale Dell'Università 37, 00185, Rome, Italy
| | - Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University, Viale Dell'Università 37, 00185, Rome, Italy
| | - Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University, Viale Dell'Università 37, 00185, Rome, Italy
| | - Francesco Iannazzo
- Department of Translational and Precision Medicine, Sapienza University, Viale Dell'Università 37, 00185, Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University, Viale Dell'Università 37, 00185, Rome, Italy.
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Pellicano C, Colalillo A, Carnazzo V, Redi S, Basile V, Marino M, Basile U, Rosato E. In Systemic Sclerosis Patients, Peripheral Blood CD21 low B Cells and Serum IL-4 and IL-21 Influence Joint Involvement. J Pers Med 2023; 13:1334. [PMID: 37763102 PMCID: PMC10532941 DOI: 10.3390/jpm13091334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Systemic sclerosis (SSc) patients have an increased frequency of CD21low B cells and of serum interleukin-4 (IL-4) and IL-21, each possible markers of joint involvement in inflammatory arthritis. The aim of this study was to investigate the possible influence of CD21low B cells, IL-4, and IL-21 on joint involvement in a cohort of 52 SSc patients. The DAS28-ESR was correlated with CD21low B cells (r = 0.452, p < 0.001), IL-4 (r = 0.478, p < 0.001), and IL-21 (r = 0.415, p < 0.001). SSc patients with a DAS28-ESR > 3.2 had more CD21low B cells (12.65% (IQR: 7.11-13.79) vs. 5.08% (IQR: 3.76-7.45), p < 0.01), higher IL-4 levels (132.98 pg/mL (IQR: 99.12-164.12) vs. 100.80 pg/mL (IQR: 62.78-121.13), p < 0.05), and higher IL-21 levels (200.77 pg/mL (IQR: 130.13-302.41) vs. 98.83 pg/mL (IQR: 35.70-231.55), p < 0.01) than patients with a DAS28-ESR ≤ 3.2. The logistic regression analysis models showed that the DAI (OR: 2.158 (95% CI: 1.120; 4.156), p < 0.05) and CD21low B cells (OR: 1.301 (95% CI: 1.099; 1.540), p < 0.01), the DAI (OR: 2.060 (95% CI: 1.082; 3.919), p < 0.05) and IL-4 level (OR: 1.026 (95% CI: 1.006; 1.045), p < 0.01), and the DAI (OR: 1.743 (95% CI: 1.022; 2.975), p < 0.05) and IL-21 level (OR: 1.006 (95% CI: 1.000; 1.011), p < 0.05) were independently associated with a DAS28-ESR > 3.2. An elevated CD21low B cell percentage, IL-4 level, and IL-21 level was associated with higher articular disease activity in patients, suggesting a possible role in the pathogenesis of SSc joint involvement.
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Affiliation(s)
- Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (C.P.); (A.C.); (E.R.)
| | - Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (C.P.); (A.C.); (E.R.)
| | - Valeria Carnazzo
- UOC of Clinical Pathology DEA II Level, Hospital Santa Maria Goretti-ASL Latina, 04100 Latina, Italy; (V.C.)
| | - Serena Redi
- UOC of Clinical Pathology DEA II Level, Hospital Santa Maria Goretti-ASL Latina, 04100 Latina, Italy; (V.C.)
| | - Valerio Basile
- Clinical Pathology and Cancer Biobank IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy
| | - Mariapaola Marino
- Dipartimento di Medicina e Chirurgia Traslazionale, Sezione di Patologia Generale, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, 00168 Rome, Italy;
| | - Umberto Basile
- UOC of Clinical Pathology DEA II Level, Hospital Santa Maria Goretti-ASL Latina, 04100 Latina, Italy; (V.C.)
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (C.P.); (A.C.); (E.R.)
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14
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Colalillo A, Pellicano C, Ananyeva LP, Hachulla E, Cuomo G, Györfi AH, Czirják L, de Vries-Bouwstra J, Mouthon L, Poormoghim H, Del Galdo F, Hunzelmann N, Spierings J, Kuwana M, Rosato E. Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio and Cardiorenal Syndrome Type 2 in the Systemic Sclerosis EUSTAR Cohort. Arthritis Care Res (Hoboken) 2023. [PMID: 37458105 DOI: 10.1002/acr.25196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate the association between the tricuspid annular plane systolic excursion (TAPSE)/systolic pulmonary artery pressure (sPAP) ratio and estimated glomerular filtration rate (eGFR) and their association with mortality in the European Scleroderma Trials and Research (EUSTAR) cohort. METHODS Patients with systemic sclerosis (SSc) from the EUSTAR database with TAPSE, sPAP, and parameters required to calculate eGFR were included. Logistic regression and Cox regression analysis were performed to evaluate TAPSE/sPAP as a risk factor for chronic kidney disease (CKD) and overall survival. RESULTS A total of 2,370 patients with SSc were included; 284 (12%) patients had CKD stage 3a-5. TAPSE/sPAP (odds ratio [OR] 0.479; 95% CI 0.310-0.743; P < 0.001), arterial hypertension (OR 3.118; 95% CI 2.173-4.475; P < 0.001), diastolic dysfunction (OR 1.670; 95% CI 1.148-2.428; P < 0.01), and N-terminal pro-B-type natriuretic peptide (OR 1.165; 95% CI 1.041-1.304; P < 0.01) were associated with CKD stage 3a-5. TAPSE/sPAP ≤0.32 mm/mm Hg (hazard ratio [HR] 3.589; 95% CI 2.236-5.761; P < 0.001), eGFR <60 mL/min per 1.73 m2 (HR 2.818; 95% CI 1.777-4.468; P < 0.001), and age (HR 1.782; 95% CI 1.348-2.356; P < 0.001) were the most significant predictive factors for all-cause mortality. A total of 276 patients with SSc had pulmonary hypertension (PH) confirmed by right heart catheterization, with 69 (25%) having CKD stage 3a-5. No difference was found in eGFR between patients with PH with reduced or normal cardiac index. CONCLUSION Reduced TAPSE/sPAP ratio is independently associated with CKD. TAPSE/sPAP ratio ≤0.32 mm/mm Hg and eGFR <60 mL/min per 1.73 m2 are prognostic factors for all-cause mortality. In patients with SSc with PH, eGFR is independent by reduced cardiac output.
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Affiliation(s)
| | | | | | - Eric Hachulla
- Hôpital Claude Huriez and University of Lille, Lille, France
| | | | | | | | | | - Luc Mouthon
- Hôpital Cochin, Assistance Publique Hôpitaux de Paris, and Université Paris Cité, Paris, France
| | - Hadi Poormoghim
- Firoozgar Hospital and Iran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Masataka Kuwana
- Nippon Medical School Graduate School of Medicine, Tokyo, Japan
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Costa D, Pellicano C, Mercuri V, Arnone JM, Rizzo F, Leodori G, Gargiulo P, Rosato E. In acromegalic patients the serum levels of interleukin-33 and Resolvin D1 influence skin perfusion of hands: A pilot study. Microvasc Res 2023; 149:104571. [PMID: 37321455 DOI: 10.1016/j.mvr.2023.104571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 06/17/2023]
Abstract
AIM Acromegaly is a rare chronic disease, caused by the over-secretion of growth hormone (GH), that creates a pro-inflammatory state, but the exact mechanisms by which GH or insulin-like growth factor 1 (IGF-I) act on inflammatory cells are not fully understood. Aim of the study was to evaluate Interleukin-33 (IL33) and D-series resolvins 1 (RvD1) and the skin perfusion of hands in patients with acromegaly (AP) and healthy controls (HC). METHODS IL33 and RvD1 have been assessed in 20 AP and 20 HC. Nailfold videocapillaroscopy (NVC) was performed and skin perfusion of hands was assessed by laser speckle contrast analysis (LASCA) in both populations. RESULTS IL33 was significantly higher in AP compared to HC [73.08 pg/ml (IQR 47.11-100.80 pg/ml) vs 41.5 4 pg/ml (IQR 20.16-55.49 pg/ml), p < 0.05] and RvD1 was significantly lower in AP than HC [36.1 pg/ml (IQR 27.88-66.21 pg/ml) vs 60.01 pg/ml (IQR 46.88-74.69 pg/ml), p < 0.05]. At LASCA, peripheral blood perfusion (PBP) was significantly lower in AP compared to HC [56.66 pU (IQR 46.29-65.44 pU) vs 87 pU (IQR 80-98 pU), p < 0.001]. The median values of ROI1 and ROI3 were significantly lower in AP compared to HC [112.81 pU (IQR 83.36-121.69 pU) vs 131 pU (IQR 108-135 pU), p < 0.05] and [59.78 pU (IQR 46.84-79.75 pU) vs 85 pU (IQR 78-98 pU), p < 0.05], respectively. The proximal-distal gradient (PDG) was observed in 8 of 20 (40 %) AP. CONCLUSION Serum IL33 is higher in AP compared to HC; conversely, RvD1 is lower in AP compared to HC. Reduction of PBP of hands was present in AP compared to HC, probably due to endothelial dysfunction.
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Affiliation(s)
- Denise Costa
- Department of Experimental Medicine, Endocrinology-Pituitary Disease, Sapienza University of Rome, Rome, Italy
| | - Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Valeria Mercuri
- Department of Experimental Medicine, Endocrinology-Pituitary Disease, Sapienza University of Rome, Rome, Italy
| | - Jacopo Maria Arnone
- Department of Experimental Medicine, Endocrinology-Pituitary Disease, Sapienza University of Rome, Rome, Italy
| | - Flavio Rizzo
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Giorgia Leodori
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Patrizia Gargiulo
- Department of Experimental Medicine, Endocrinology-Pituitary Disease, Sapienza University of Rome, Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
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Ruaro B, Baron M, Rosato E, Martini R, Confalonieri M. Special Issue "Rheumatic Diseases: Pathophysiology, Targeted Therapy, Focus on Vascular and Pulmonary Manifestations 2022". Pharmaceuticals (Basel) 2023; 16:ph16050652. [PMID: 37242435 DOI: 10.3390/ph16050652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
This Special Issue, titled "Rheumatic Diseases: Pathophysiology, Targeted Therapy, Focus on Vascular and Pulmonary Manifestations", aims to demonstrate recent and new advances and future trends in the field of rheumatic diseases [...].
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Affiliation(s)
- Barbara Ruaro
- Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Murray Baron
- Division of Rheumatology, Jewish General Hospital, McGill University, Montreal, QC 3755, Canada
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Romeo Martini
- Unit of Angiology, AULSS 1 Dolomiti, Ospedale San Martino, 32100 Belluno, Italy
| | - Marco Confalonieri
- Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
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Pellicano C, Colalillo A, Rosato E. Serum kynurenic acid is lower in systemic sclerosis patients with microvascular damage of hands. Microvasc Res 2023; 148:104537. [PMID: 37030527 DOI: 10.1016/j.mvr.2023.104537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 04/10/2023]
Abstract
BACKGROUND Endothelial dysfunction occurs early in systemic sclerosis (SSc), leading to tissue hypoxia, vasoconstriction and fibrosis. It has been demonstrated that endothelial cells (ECs) are able to produce kynurenic acid (KYNA) in response to vascular inflammation, due to its anti-inflammatory and anti-oxidants activity. In SSc patients, blood perfusion of hands, assessed by laser speckle contrast analysis (LASCA), correlated negatively with the extent of the nailfold microvascular damage, scored according to nailfold videocapillaroscopy (NVC) classification. Aim of this study was to evaluate the difference of serum KYNA in SSc patients with different stages of microvascular damage. METHODS Serum KYNA was assessed in 40 SSc patients at the enrolment. NVC was performed to evaluate capillaroscopic patterns (early, active and late). LASCA was performed to evaluate mean peripheral blood perfusion (PBP) of both hands and to evaluate the proximal-distal gradient (PDG). RESULTS Median PDG was significantly lower in SSc patients with late NVC pattern compared to SSc patients with early and active NVC pattern [3.79 pU (IQR -8.55-18.16) vs 23.55 pU (IQR 14.92-43.80), p < 0.01]. Serum KYNA was significantly lower in SSc patients with late NVC pattern compared to SSc patient with early and active NVC pattern [45.19 ng/mL (IQR 42.70-54.74) vs 52.65 ng/mL (IQR 49.99-60.29), p < 0.05]. Moreover, SSc patients without PDG had significantly lower serum KYNA than in SSc patients with PDG [48.03 ng/mL (IQR 43.87-53.68) vs 59.27 ng/mL (IQR 49.15-71.00), p < 0.05]. CONCLUSION KYNA is lower in SSc patients with late NCV pattern and without PDG. KYNA may be associated with early endothelial dysfunction.
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Affiliation(s)
- Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy.
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Colalillo A, Hoffmann-Vold AM, Pellicano C, Romaniello A, Gabrielli A, Hachulla E, Smith V, Simeón-Aznar CP, Castellví I, Airò P, Truchetet ME, Siegert E, Distler O, Rosato E. The role of TAPSE/sPAP ratio in predicting pulmonary hypertension and mortality in the systemic sclerosis EUSTAR cohort. Autoimmun Rev 2023; 22:103290. [PMID: 36746368 DOI: 10.1016/j.autrev.2023.103290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The study aim was to evaluate the predictive role of the echocardiography-derived tricuspid annular plane systolic excursion/systolic pulmonary artery pressure (TAPSE/sPAP) ratio for pulmonary hypertension (PH) diagnosis and mortality in the European Scleroderma Trials and Research (EUSTAR) cohort. METHODS Eligible patients were systemic sclerosis (SSc) patients registered in the EUSTAR database with at least one visit recording TAPSE and sPAP data. Individual centres were required to provide TAPSE and sPAP data at 12 ± 3 months before right heart catheterization (RHC). Logistic regression analysis was applied to analyse the predictive ability of TAPSE/sPAP ratio for PH diagnosis. Cox regression analysis was performed to evaluate TAPSE/sPAP ratio as a predictive factor for all-cause mortality. RESULTS 2555 SSc patients met the inclusion criteria for this study with 355 SSc patients having available RHC data at baseline. PH was confirmed by RHC in 195 SSc patients (54.9%). TAPSE/sPAP ratio < 0.55 mm/mmHg [OR 0.251 (95% CI 0.084-0.753), p < 0.05] and FVC/DLCO [OR 2.568 (95% CI 1.227-5.375), p < 0.05] were significantly associated with PH diagnosis. In logistic regression analysis with echocardiographic parameters at 12 ± 3 months before RHC, TAPSE/sPAP ratio < 0.55 mm/mmHg [OR 0.265 (95% CI 0.102-0.685), p < 0.01] and FVC/DLCO [OR 2.529 (95% CI 1.358-4.711), p < 0.01] were associated with PH diagnosis. In multivariate Cox regression analysis, TAPSE/sPAP ratio ≤ 0.32 mm/mmHg [HR 0.310 (0.164-0.585), p < 0.001] was the most significant predictive factor for death. CONCLUSIONS TAPSE/sPAP ratio < 0.55 mm/mmHg is a predictive risk factor for PH. TAPSE/sPAP ratio ≤ 0.32 mm/mmHg is a predictive risk marker for all-cause mortality.
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Affiliation(s)
- Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Antonella Romaniello
- Division of Cardiology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Armando Gabrielli
- Fondazione di Medicina Molecolare e Terapia Cellulare, Università Politecnica delle Marche, Ancona, Italy
| | - Eric Hachulla
- Department of Internal Medicine and Clinical Immunology, Referral Centre for Centre for rare systemic autoimmune diseases North and North-West of France (CeRAINO), CHU Lille, University of Lille, Inserm, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Vanessa Smith
- Department of Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - Carmen-Pilar Simeón-Aznar
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Ivan Castellví
- Department of Rheumatology, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Paolo Airò
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili of Brescia, Brescia, Italy
| | | | - Elise Siegert
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Berlin, Germany; Berlin Institut of Health at Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Oliver Distler
- Department of Rheumatology, University Hospital Zürich, Zürich, Switzerland
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
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Rosato E, Gigante A, Pellicano C, Colalillo A, Alunni-Fegatelli D, Muscaritoli M. Phase angle, nutritional status, and mortality in systemic sclerosis: An exploratory pilot study. Nutrition 2023; 107:111946. [PMID: 36577164 DOI: 10.1016/j.nut.2022.111946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 12/08/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Systemic sclerosis (SSc) is a rare autoimmune disease characterized by microvascular damage and fibrosis of the skin and internal organs. Among SSc complications, changes in nutritional status have a negative effect on quality of life and predispose patients to malnutrition. The aim of this exploratory pilot study was to examine whether bioelectrical impedance analysis-derived phase angle (PhA) is a parameter of nutritional status and a marker of mortality in patients with SSc. METHODS Consecutive adult patients with SSc were included in the study. Biochemical analyses, anthropometric data, and bioelectrical impedance analysis assessments were recorded at the time of enrollment. The Malnutrition Universal Screening Tool (MUST) and Global Leadership Initiative on Malnutrition (GLIM) were applied to assess nutritional status. RESULTS A total of 104 patients with SSc (88 women; median age: 55 y [interquartile range (IQR), 45.5- 66 y]) were enrolled. In patients with SSc and high malnutrition risk according to MUST, mean values of PhA were significantly lower than those of patients with SSc and low malnutrition risk (4° [IQR, 3.7°-4.4°] vs 4.6° [IQR, 4.2°-5.1°]; P = 0.004). Patients with SSc and malnutrition according to the GLIM criteria showed significantly lower PhA than patients with SSc but without malnutrition (3.8° [IQR, 3.5°-4.3°] vs 4.6° [IQR, 4.2°-5.1°]; P < 0.0001). Kaplan-Meier curves demonstrated that overall survival was significantly shorter (34.57 mo [±13.35] vs 48 mo [±0]; P = 0.001) in patients with SSc and PhA <3.75°. In the multivariate analysis, only PhA was a predictive factor for death (hazard ratio: 0.283; 95% confidence interval, 0.083-0.965; P = 0.044). CONCLUSIONS The data obtained suggest that lower PhA values in patients with SSc are associated with an increased malnutrition risk with MUST, malnutrition with GLIM, and increased mortality. Additional studies are necessary to confirm these preliminary results.
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Affiliation(s)
- Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
| | - Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Danilo Alunni-Fegatelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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De Angelis R, Ferri C, Giuggioli D, Bajocchi G, Dagna L, Bellando-Randone S, Zanframundo G, Foti R, Cacciapaglia F, Cuomo G, Ariani A, Rosato E, Lepri G, Girelli F, Riccieri V, Zanatta E, Bosello SL, Cavazzana I, Ingegnoli F, De Santis M, Murdaca G, Abignano G, Romeo N, Della Rossa A, Caminiti M, Iuliano AM, Ciano G, Beretta L, Bagnato G, Lubrano E, De Andres I, Giollo A, Saracco M, Agnes C, Cipolletta E, Lumetti F, Spinella A, Magnani L, Campochiaro C, De Luca G, Codullo V, Visalli E, Di Vico C, Gigante A, Pellagrino G, Pigatto E, Lazzaroni MG, Franceschini F, Generali E, Mennillo G, Barsotti S, Mariano GP, Furini F, Vultaggio L, Parisi S, Peroni CL, Rozza D, Zanetti A, Carrara G, Landolfi G, Scirè CA, Bianchi G, Fusaro E, Sebastiani GD, Govoni M, D'Angelo S, Cozzi F, Guiducci S, Doria A, Salvarani C, Iannone F, Matucci-Cerinic M. Systemic sclerosis sine scleroderma: clinical and serological features and relationship with other cutaneous subsets in a large series of patients from the national registry 'SPRING' of the Italian Society for Rheumatology. RMD Open 2023; 9:rmdopen-2022-002890. [PMID: 36868782 PMCID: PMC9990652 DOI: 10.1136/rmdopen-2022-002890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/08/2023] [Indexed: 03/05/2023] Open
Abstract
OBJECTIVE To describe demographic, clinical and laboratory features of systemic sclerosis sine scleroderma (ssSSc) in a large multicentre systemic sclerosis (SSc) cohort. METHODS Data involving 1808 SSc patients from Italian Systemic sclerosis PRogression INvestiGation registry were collected. The ssSSc was defined by the absence of any cutaneous sclerosis and/or puffy fingers. Clinical and serological features of ssSSc were compared with limited cutaneous (lcSSc) and diffuse cutaneous (dcSSc) subsets. RESULTS Among patients with SSc, only 61 (3.4%) were classified as having ssSSc (F/M=19/1). Time from Raynaud's phenomenon (RP) onset to diagnosis was longer in ssSSc (3 years, IQR 1-16.5) than lcSSc (2 years, IQR 0-7), and dcSSc (1 year, IQR 0-3) (p<0.001). Clinical ssSSc phenotype was comparable to lcSSc, except for digital pitting scars (DPS) (19.7% vs 42%, p=0.01), but significantly milder than dcSSc, particularly for digital ulcers (DU) (6.6% vs 35.7%, p<0.001), oesophagus (46.2% vs 63.5%, p=0.009), lung (mean diffusion capacity for carbon monoxide 72.2±19.6 vs 62.4±22.8, p=0.009; mean forced vital capacity 105.6±21.7 vs 89.2±20.9, p<0.001) and major videocapillaroscopic alterations (late pattern 8.6% vs 47.6%, p<0.001). Moreover, in ssSSc the percentages of anticentromere and antitopoisomerase were comparable to lcSSc (40% and 18.3% vs 36.7% and 26.6%), but divergent respect to dcSSc (8.6% and 67.4%, p<0.001). CONCLUSION The ssSSc is a quite rare disease variant characterised by clinico-serological features comparable to lcSSc, but significantly different from dcSSc. Overall, longer RP duration, low percentages of DPS and peripheral microvascular abnormalities, and increased anti-centromere seropositivity distinguish ssSSc. Further investigations based on national registries might provide useful insights on the actual relevance of the ssSSc within the scleroderma spectrum.
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Affiliation(s)
- Rossella De Angelis
- Rheumatology Unit - Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Clodoveo Ferri
- Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, Modena, Italy, Modena, Italy
| | - Dilia Giuggioli
- Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, Modena, Italy, Modena, Italy
| | - Gianluigi Bajocchi
- Rheumatology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy, Reggio Emilia, Italy
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy, Milano, Italy
| | - Silvia Bellando-Randone
- Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Florence & Division of Rheumatology AOUC, University of Florence, Florence, Italy
| | | | - Rosario Foti
- Rheumatology Unit, A.O.U Policlinico S. Marco, Catania, Italy, Catania, Italy
| | - Fabio Cacciapaglia
- Rheumatology Unit, Department of Emergency and Organ Transplantations, University of Bari, Bari, Italy
| | - Giovanna Cuomo
- Department of Precision Medicine - University of Campania "Luigi Vanvitelli", Naples, Italy, Caserta, Italy
| | - Alarico Ariani
- Department of Medicine, Internal Medicine and Rheumatology, Azienda Ospedaliero Universitaria di Parma, Parma, Italy, Parma, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Italy, Roma, Italy
| | - Gemma Lepri
- Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Florence & Division of Rheumatology AOUC, University of Florence, Florence, Italy
| | - Francesco Girelli
- Department of Medicine, Rheumatology Unit, Ospedale GB Morgagni - L Pierantoni, Forlì, Italy, Forlì, Italy
| | - Valeria Riccieri
- Department of Rheumatology, Sapienza University of Rome, Rome, Italy, Rome, Italy
| | | | - Silvia Laura Bosello
- Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, Rome, Italy
| | - Ilaria Cavazzana
- Rheumatology and Clinical Immunology, ASST Spedali Civili of Brescia; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy, Brescia, Italy
| | - Francesca Ingegnoli
- Division of Clinical Rheumatology, ASST Pini, Dept. of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Research Center for Environmental Health, Università degli Studi di Milano, Milan, Italy, Milano, Italy
| | - Maria De Santis
- Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, and Humanitas University, Pieve Emanuele, Milan, Italy, Rozzano, Italy
| | - Giuseppe Murdaca
- Research Hospital San Martino, University of Genoa, Genoa, Italy, Genova, Italy
| | - Giuseppina Abignano
- Rheumatology Institute of Lucania (IReL) and Rheumatology Department of Lucania, San Carlo Hospital, Potenza, Italy, Potenza, Italy
| | | | | | - Maurizio Caminiti
- Departmental Rheumatology Unit, Grande Ospedale Metropolitano, Reggio Calabria, Italy, Italy
| | | | - Giovanni Ciano
- Hospital of Ariano Irpino, Local Health Department, Ariano Irpino, Avellino, Italy
| | - Lorenzo Beretta
- Referral Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Gianluca Bagnato
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Ennio Lubrano
- Department of Rheumatology, University of Molise, Campobasso, Italy
| | - Ilenia De Andres
- Rheumatology Unit, Azienda Ospedaliera di Rilievo Nazionale ed Alta Specializzazione "Garibaldi", Catania, Italy
| | - Alessandro Giollo
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Marta Saracco
- Rheumatology Unit, Mauriziano-Umberto I Hospital, Torino, Italy
| | | | - Edoardo Cipolletta
- Rheumatology Unit - Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Federica Lumetti
- Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, Modena, Italy, Modena, Italy
| | - Amelia Spinella
- Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, Modena, Italy, Modena, Italy
| | - Luca Magnani
- Rheumatology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy, Reggio Emilia, Italy
| | - Corrado Campochiaro
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy, Milano, Italy
| | - Giacomo De Luca
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy, Milano, Italy
| | - Veronica Codullo
- Department of Rheumatology, Policlinico San Matteo, Pavia, Italy, Pavia, Italy
| | - Elisa Visalli
- Rheumatology Unit, A.O.U Policlinico S. Marco, Catania, Italy, Catania, Italy
| | - Claudio Di Vico
- Department of Precision Medicine - University of Campania "Luigi Vanvitelli", Naples, Italy, Caserta, Italy
| | - Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Italy, Roma, Italy
| | - Greta Pellagrino
- Department of Rheumatology, Sapienza University of Rome, Rome, Italy, Rome, Italy
| | - Erika Pigatto
- Department of Medicine, Villa Salus Hospital, Venice, Italy
| | - Maria-Grazia Lazzaroni
- Rheumatology and Clinical Immunology, ASST Spedali Civili of Brescia; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy, Brescia, Italy
| | - Franco Franceschini
- Rheumatology and Clinical Immunology, ASST Spedali Civili of Brescia; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy, Brescia, Italy
| | - Elena Generali
- Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, and Humanitas University, Pieve Emanuele, Milan, Italy, Rozzano, Italy
| | - Gianna Mennillo
- Rheumatology Institute of Lucania (IReL) and Rheumatology Department of Lucania, San Carlo Hospital, Potenza, Italy, Potenza, Italy
| | - Simone Barsotti
- Department of Rheumatology, University of Pisa, Pisa, Italy, Italy
| | - Giuseppa Pagano Mariano
- Departmental Rheumatology Unit, Grande Ospedale Metropolitano, Reggio Calabria, Italy, Italy
| | - Federica Furini
- Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara, Ferrara, Italy
| | - Licia Vultaggio
- Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara, Ferrara, Italy
| | - Simone Parisi
- Rheumatology Unit, Città della Salute e della Scienza, Turin, Italy
| | | | - Davide Rozza
- Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy
| | - Anna Zanetti
- Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy
| | - Greta Carrara
- Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy
| | | | - Carlo Alberto Scirè
- Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara, Ferrara, Italy.,Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy
| | - Gerolamo Bianchi
- Rheumatology Unit, Department of Musculoskeletal Sciences, Local Health Trust 3, La Colletta Hospital, Genoa, Italy
| | - Enrico Fusaro
- Rheumatology Unit, Città della Salute e della Scienza, Turin, Italy
| | | | - Marcello Govoni
- Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara, Ferrara, Italy
| | - Salvatore D'Angelo
- Rheumatology Institute of Lucania (IReL) and Rheumatology Department of Lucania, San Carlo Hospital, Potenza, Italy, Potenza, Italy
| | - Franco Cozzi
- Department of Medicine, Villa Salus Hospital, Venice, Italy
| | - Serena Guiducci
- Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Florence & Division of Rheumatology AOUC, University of Florence, Florence, Italy
| | - Andrea Doria
- Department of Rheumatology, University of Padua, Padua, Italy
| | - Carlo Salvarani
- Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, Modena, Italy, Modena, Italy
| | - Florenzo Iannone
- Rheumatology Unit, Department of Emergency and Organ Transplantations, University of Bari, Bari, Italy
| | - Marco Matucci-Cerinic
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy, Milano, Italy.,Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Florence & Division of Rheumatology AOUC, University of Florence, Florence, Italy
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Pellicano C, Colalillo A, Cusano G, Palladino A, Pellegrini M, Callà CAM, Mazzuccato G, Carnazzo V, Pignalosa S, Di Biase L, Marino M, Basile U, Rosato E. Serum Immunoglobulin G (IgG) Subclasses in a Cohort of Systemic Sclerosis Patients. J Pers Med 2023; 13:jpm13020309. [PMID: 36836543 PMCID: PMC9961548 DOI: 10.3390/jpm13020309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/02/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
OBJECTIVES To assess serum immunoglobulin G (IgG) subclasses in a cohort of systemic sclerosis (SSc) patients and to evaluate the influence of IgG subclasses in the main complications of the disease. METHODS The serum level of IgG subclasses was evaluated in 67 SSc patients and 48 healthy controls (HC), matched for sex and age. Serum samples were collected and measured IgG1-4 subclasses by turbidimetry. RESULTS SSc patients had lower median total IgG [9.88 g/l (IQR 8.18-11.42 g/l) vs. 12.09 g/l (IQR 10.24-13.54 g/l), p < 0.001], IgG1 [5.09 g/l (IQR 4.25-6.38 g/l) vs. 6.03 g/l (IQR 5.39-7.90 g/l), p < 0.001], and IgG3 [0.59 g/l (IQR 0.40-0.77 g/l) vs. 0.80 g/l (IQR 0.46-1 g/l), p < 0.05] serum levels compared to HC. The logistic regression analysis showed IgG3 as the only variable associated with the diffusing capacity of the lung for carbon monoxide (DLco) ≤60% of the predicted [OR 9.734 (CI 95%: 1.312-72.221), p < 0.05] and modified Rodnan skin score (mRSS) [OR 1.124 (CI 95%: 1.019-1.240), p < 0.05], anti-topoisomerase I [OR 0.060 (CI 95%: 0.007-0.535), p < 0.05], and IgG3 [OR 14.062 (CI 95%: 1.352-146.229), p < 0.05] as variables associated with radiological interstitial lung disease (ILD). CONCLUSION SSc patients have reduced levels of total IgG and an altered IgG subclass distribution compared to HC. Moreover, SSc patients show different serum IgG subclasses profiles according to the main involvement of the disease.
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Affiliation(s)
- Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell’Università 37, 00185 Rome, Italy
| | - Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell’Università 37, 00185 Rome, Italy
| | - Giuseppina Cusano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell’Università 37, 00185 Rome, Italy
| | - Andrea Palladino
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell’Università 37, 00185 Rome, Italy
| | - Marica Pellegrini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell’Università 37, 00185 Rome, Italy
| | - Cinzia Anna Maria Callà
- Dipartimento di Scienze Laboratoristiche ed Infettivologiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giorgia Mazzuccato
- Dipartimento di Scienze Laboratoristiche ed Infettivologiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Valeria Carnazzo
- Dipartimento di Patologia Clinica, Ospedale Santa Maria Goretti, AUSL Latina, 04100 Latina, Italy
| | - Stefano Pignalosa
- Dipartimento di Patologia Clinica, Ospedale Santa Maria Goretti, AUSL Latina, 04100 Latina, Italy
| | - Luigi Di Biase
- Dipartimento di Patologia Clinica, Ospedale Santa Maria Goretti, AUSL Latina, 04100 Latina, Italy
| | - Mariapaola Marino
- Dipartimento di Medicina e Chirurgia Traslazionale, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Umberto Basile
- Dipartimento di Patologia Clinica, Ospedale Santa Maria Goretti, AUSL Latina, 04100 Latina, Italy
- Correspondence:
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell’Università 37, 00185 Rome, Italy
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22
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Grimaldi MC, Rosato E, D’Angelo A, Cristiano E, Marchitti S, Volpe M, Rubattu S, Romaniello A. The prognostic role of the echocardiographic tricuspid annular plane systolic excursion/systolic pulmonary arterial pressure (TAPSE/sPAP) ratio and its relationship with NT-proANP plasma level in systemic sclerosis. Front Cardiovasc Med 2023; 9:1021048. [PMID: 36733829 PMCID: PMC9887033 DOI: 10.3389/fcvm.2022.1021048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/20/2022] [Indexed: 01/18/2023] Open
Abstract
Background The tricuspid annular plane systolic excursion/systolic pulmonary arterial pressure (TAPSE/sPAP) ratio is an echocardiographic estimation of the right ventricle to pulmonary artery (RV/PA) coupling, with a validated prognostic role in different clinical settings. Systemic sclerosis (SSc) patients without evident cardiovascular involvement frequently display subtle RV impairment. The amino-terminal atrial natriuretic peptide (NT-proANP) plasma level relates to SSc disease progression and mortality. We aimed to assess the prognostic value of the TAPSE/sPAP ratio and its relationship with NT-proANP plasma level in SSc patients without overt cardiovascular involvement. Methods We retrospectively analysed 70 SSc consecutive patients, with no clinical evidence of cardiovascular involvement or pulmonary hypertension (PH), and 30 healthy controls (HC) in a retrospective, single-centre study. All SSc patients underwent recurrent clinical and echocardiographic assessments and NT-proANP plasma level was assessed at baseline. SSc-related cardiovascular events and deaths were extracted during a 6-year follow-up. The complete work-up for the diagnosis, treatment and management of PH performed along the 6 years of follow-up referred to the 2015 European Society of Cardiology guidelines. Results Systemic sclerosis patients showed lower TAPSE/sPAP ratio at baseline compared to HC [SSc median value = 0.71 mm/mmHg, (IQR 0.62-0.88) vs. HC median value = 1.00 mm/mmHg, (IQR 0.96-1.05); p < 0.001]. Multivariable Cox analysis revealed TAPSE/sPAP ratio as an independent predictor for SSc-related cardiovascular events [HR = 3.436 (95% CI 1.577-7.448); p = 0.002] and mortality [HR = 3.653 (95% CI 1.712-8.892); p = 0.014]. The value of TAPSE/sPAP ratio < 0.7 mm/mmHg was identified as an optimal cut-off for predicting adverse outcomes (p < 0.001) by receiver operating characteristic (ROC) analyses. NT-proANP level significantly related to TAPSE/sPAP ratio (r = 0.52, p < 0.001). TAPSE/sPAP ratio combined with NT-proANP showed an overall significant prognostic role in this SSc population, confirmed by Kaplan-Meier analysis (Log rank p < 0.001). Conclusion The TAPSE/sPAP ratio, as an index of RV/PA coupling, is an affordable predictor of cardiovascular events and mortality in SSc and, combined with NT-proANP level, may improve the clinical phenotyping and prognostic stratification of SSc patients.
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Affiliation(s)
- Maria Chiara Grimaldi
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy,Department of Cardiovascular and Pneumological Sciences, Catholic University of Sacred Heart, Rome, Italy,Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy,*Correspondence: Maria Chiara Grimaldi,
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Adriano D’Angelo
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Ernesto Cristiano
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Simona Marchitti
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli, Italy
| | - Massimo Volpe
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy,San Raffaele Pisana Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Speranza Rubattu
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli, Italy
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23
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Tifi P, Pala B, Tempestini F, Cristiano E, Bocci A, Rosato E, Salerno G, Romaniello A. 729 BIOMARKERS FOR EARLY DIAGNOSIS OF CARDIAC INVOLVEMENT IN SYSTEMIC SCLEROSIS. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Introduction
Systemic Sclerosis (SSc) is an autoimmune disease characterized by microvascular damage, immune system dysregulation and fibrosis of skin and internal organs. It is reported that asymptomatic involvement of the heart was found in 70% of SSc patients. The role of biomarkers in the early detection of fibrosis and vascular damage in SSc is not yet completely defined. Serum levels of sST2, Galectin 3, ANP, IL6 are a potential marker of cardiac involvement. In patients with chronic heart failure elevated levels of galectin-3 (>17.8 ng/ml) are a marker of worse prognosis. Moreover, a previous study reported a possible role of galectin-3 as an independent predictor of all-cause and cardiovascular mortality in SSc.
Material and Methods
We enrolled 62 SSc patients (53 females, median age 52 years) who fulfilled inclusion criteria.
35 patients had limited cutaneous SSc and 27 diffuse cutaneous SSc.
30 Healthy Controls (HC) were also enrolled [20 females; median age 50 years].
All SSc patients had normal echocardiographic and cardiac MRI findings.
Results
In SSc patients, the median Galectin value was 16.7 ng/ml, significantly higher than HC median (10,7 ng/Ml).
sST2 and IL-6 median value was 30 ng/mL and 12,3 pg/mL respectively, which resulted significantly higher than the median value of HC patient (21,55 ng/mL and 4,5 pg/mL respectively).
Therefore, there was a significant difference in biomarkers levels in the SSc group compared with controls.
Conclusion
These data suggest that these biomarkers can help identify a subgroup of SSc patients, with normal echocardiographic and RMN findings, who are at risk of developing heart involvement. In fact, all patients are scheduled for yearly echocardiographic re-evaluation as ESC guidelines recommend for earlier detection of pulmonary arterial hypertension (PAH), a leading cause of death in systemic sclerosis (SSc).
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Affiliation(s)
- Priscilla Tifi
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, School Of Medicine And Psychology, Sapienza University , Rome , Italy
| | - Barbara Pala
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, School Of Medicine And Psychology, Sapienza University , Rome , Italy
| | - Federica Tempestini
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, School Of Medicine And Psychology, Sapienza University , Rome , Italy
| | - Ernesto Cristiano
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, School Of Medicine And Psychology, Sapienza University , Rome , Italy
| | - Alessandro Bocci
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, School Of Medicine And Psychology, Sapienza University , Rome , Italy
| | - Edoardo Rosato
- Department Of Translational And Precision Medicine, Scleroderma Unit, Sapienza University Of Rome , Italy
| | - Gerardo Salerno
- Divison Of Neuroscience, Mental Health And Sensory Organs (Nesmos), School Of Medicine And Psychology, Sapienza University Of Rome , Italy
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Elhai M, Sritharan N, Boubaya M, Balbir-Gurman A, Siegert E, Hachulla E, de Vries-Bouwstra J, Riemekasten G, Distler JHW, Rosato E, Del Galdo F, Mendoza FA, Furst DE, de la Puente C, Hoffmann-Vold AM, Gabrielli A, Distler O, Bloch-Queyrat C, Allanore Y. Stratification in systemic sclerosis according to autoantibody status versus skin involvement: a study of the prospective EUSTAR cohort. Lancet Rheumatol 2022; 4:e785-e794. [PMID: 38265945 DOI: 10.1016/s2665-9913(22)00217-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND The current subclassification of systemic sclerosis into cutaneous subtypes does not fully capture the heterogeneity of the disease. We aimed to compare the performances of stratification into LeRoy's cutaneous subtypes versus stratification by autoantibody status in systemic sclerosis. METHODS For this cohort study, we assessed people with systemic sclerosis in the multicentre international European Scleroderma Trials and Research (EUSTAR) database. Individuals positive for systemic-sclerosis autoantibodies of two specificities were excluded, and remaining individuals were classified by cutaneous subtype, according to their systemic sclerosis-specific autoantibodies, or both. We assessed the performance of each model to predict overall survival, progression-free survival, disease progression, and different organ involvement. The three models were compared by use of the area under the curve (AUC) of the receiver operating characteristic and the net reclassification improvement (NRI). Missing data were imputed. FINDINGS We assessed the database on July 26, 2019. Of 16 939 patients assessed for eligibility, 10 711 patients were included: 1647 (15·4%) of 10 709 were male, 9062 (84·6%) were female, mean age was 54·4 (SD 13·8) years, and mean disease duration was 7·9 (SD 8·2) years. Information regarding cutaneous subtype was available for 10 176 participants and antibody data were available for 9643 participants. In the prognostic analysis, there was no difference in AUC for overall survival (0·82, 95% CI 0·81-0·84 for cutaneous only vs 0·84, 0·82-0·85 for antibody only vs 0·84, 0·83-0·86 for combined) or for progression-free survival (0·70, 0·69-0·71 vs 0·71, 0·70-0·72 vs 0·71, 0·70-0·72). However, at 4 years the NRI showed substantial improvement for the antibody-only model compared with the cutaneous-only model in prediction of overall survival (0·57, 0·46-0·71 for antibody only vs 0·29, 0·19-0·39 for cutaneous only) and disease progression (0·36, 0·29-0·46 vs 0·21, 0·14-0·28). The antibody-only model did better than the cutaneous-only model in predicting renal crisis (AUC 0·72, 0·70-0·74 for antibody only vs 0·66, 0·64-0·69 for cutaneous only) and lung fibrosis leading to restrictive lung function (AUC 0·76, 0·75-0·77 vs 0·71, 0·70-0·72). The combined model improved the prediction of digital ulcers and elevated systolic pulmonary artery pressure, but did poorly for cardiac involvement. INTERPRETATION The autoantibody-only model outperforms cutaneous-only subsetting for risk stratifying people with systemic sclerosis in the EUSTAR cohort. Physicians should be aware of these findings at the time of decision making for patient management. FUNDING World Scleroderma Foundation.
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Affiliation(s)
- Muriel Elhai
- INSERM U1016, Cochin Hospital, AP-HP, University of Paris, Paris, France; Department of Rheumatology, University Hospital Zürich, Zürich, Switzerland
| | - Nanthara Sritharan
- Department of Clinical Research, Paris Seine Saint Denis Hospital, AP-HP, Bobigny, France
| | - Marouane Boubaya
- Department of Clinical Research, Paris Seine Saint Denis Hospital, AP-HP, Bobigny, France
| | - Alexandra Balbir-Gurman
- B Shine Rheumatology Institute, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Elise Siegert
- Department of Rheumatology, Charité University Hospital, Berlin, Germany
| | - Eric Hachulla
- Department of Internal Medicine and Clinical Immunology, Referral Centre for Rare Systemic Auto-immune Diseases North and North-West of France, Inserm, CHU Lille, U1286 - INFINITE, University of Lille, Lille, France
| | | | | | - Jörg H W Distler
- Department of Rheumatology and Hiller Research Unit, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesco Del Galdo
- Scleroderma Programme, Institute of Molecular Medicine, Division of Musculoskeletal Diseases, University of Leeds, Leeds, UK
| | - Fabian A Mendoza
- Thomas Jefferson Scleroderma Center Division of Rheumatology and Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| | - Daniel E Furst
- Arthritis Association of Southern California, Los Angeles, CA, USA
| | | | | | - Armando Gabrielli
- Università Politecnica delle Marche, Ancona, Italy; Azienda Ospedali Riuniti, Ancona, Italy
| | - Oliver Distler
- Department of Rheumatology, University Hospital Zürich, Zürich, Switzerland
| | - Coralie Bloch-Queyrat
- Department of Clinical Research, Paris Seine Saint Denis Hospital, AP-HP, Bobigny, France
| | - Yannick Allanore
- INSERM U1016, Cochin Hospital, AP-HP, University of Paris, Paris, France.
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Locatelli M, Covone S, Rosato E, Bonelli M, Savini F, Furton K, Gazioglu I, D'Ovidio C, Kabir A, Tartaglia A. Analysis of seven selected antidepressant drugs in post–mortem samples using fabric phase sorptive extraction followed by high performance liquid chromatography-photodiode array detection. Forensic Chem 2022. [DOI: 10.1016/j.forc.2022.100460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gigante A, Leodori G, Pellicano C, Villa A, Rosato E. Assessment of kidney involvement in systemic sclerosis: From scleroderma renal crisis to subclinical renal vasculopathy. Am J Med Sci 2022; 364:529-537. [PMID: 35537505 DOI: 10.1016/j.amjms.2022.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 10/17/2021] [Accepted: 02/16/2022] [Indexed: 01/25/2023]
Abstract
The spectrum of kidney involvement in systemic sclerosis (SSc) includes scleroderma renal crisis, widely recognized as the most severe renal-vascular complication, but also several forms of chronic renal vasculopathy and reduced renal function are complications of scleroderma. Scleroderma renal crisis, myeloperoxidase-antineutrophil cytoplasmic antibody associated glomerulonephritis, penicillamine-associated renal disease, abnormal urinalysis, alteration of vascular endothelial markers, scleroderma associated-vasculopathy with abnormal renal resistance indices and cardiorenal syndromes type 5 were also reported in SSc patients. A frequent form of renal involvement in SSc patients is a subclinical renal vasculopathy, characterized by vascular damage and normal renal function. Indeed, asymptomatic renal changes, expressed by increase of intrarenal stiffness, are often non-progressive in SSc patients but can lead to a reduction in renal functional reserve. The purpose of this review is to provide an assessment of kidney involvement in SSc, from SRC to subclinical renal vasculopathy.
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Affiliation(s)
- Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Giorgia Leodori
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Annalisa Villa
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
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Leodori G, Pellicano C, Basile V, Colalillo A, Navarini L, Gigante A, Gulli F, Marino M, Basile U, Rosato E. Serum Adiponectin, a Novel Biomarker Correlates with Skin Thickness in Systemic Sclerosis. J Pers Med 2022; 12:jpm12101737. [PMID: 36294874 PMCID: PMC9604668 DOI: 10.3390/jpm12101737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/11/2022] [Accepted: 10/17/2022] [Indexed: 12/03/2022] Open
Abstract
The aim was to evaluate the longitudinal association between basal serum adiponectin and repeated measurements of skin thickness during 12 months of follow-up in systemic sclerosis (SSc) patients. We enrolled SSc patients with disease duration > 2 years in a prospective observational study. Skin thickness was measured at baseline and after 12 months of follow-up with modified Rodnan skin score (mRSS). Baseline serum adiponectin was determined using a commercial ELISA kit. We enrolled 66 female SSc patients (median age 54 years, IQR 42−62 years). The median disease duration was 12 (IQR 8−16) years and median baseline serum adiponectin was 9.8 (IQR 5.6−15.6) mcg/mL. The median mRSS was 10 (IQR 6−18) at baseline and 12 (IQR 7−18) at follow-up. A significant correlation was observed between baseline serum adiponectin and disease duration (r = 0.264, p < 0.05), age (r = 0.515, p < 0.0001), baseline mRSS (r = −0.303, p < 0.05), and mRSS at follow-up (r = −0.322, p < 0.001). In multiple regression analysis, only mRSS at follow-up showed an inverse correlation with baseline serum adiponectin (β = −0.132, p < 0.01). The reduction in serum adiponectin levels is correlated with skin thickness.
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Affiliation(s)
- Giorgia Leodori
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00189 Rome, Italy
| | - Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00189 Rome, Italy
| | - Valerio Basile
- Clinical Pathology Unit and Cancer Biobank, Department of Research and Advanced Technologies, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00189 Rome, Italy
| | - Luca Navarini
- Unit of Allergology, Clinical Immunology and Rheumatology, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00189 Rome, Italy
| | - Francesca Gulli
- Clinical Biochemistry Laboratory, IRCCS “Bambino Gesù” Children’s Hospital, 00165 Rome, Italy
| | - Mariapaola Marino
- Department of Translational Medicine and Surgery, Section of General Pathology, “A. Gemelli” IRCCS, Catholic University of the Sacred Heart, 00168 Rome, Italy
- Correspondence: (M.M.); (U.B.)
| | - Umberto Basile
- Department of Laboratory and Infectious Disease Sciences, “A. Gemelli” IRCCS, Catholic University of the Sacred Heart, 00168 Rome, Italy
- Correspondence: (M.M.); (U.B.)
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00189 Rome, Italy
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Lescoat A, Huscher D, Schoof N, Airò P, de Vries-Bouwstra J, Riemekasten G, Hachulla E, Doria A, Rosato E, Hunzelmann N, Montecucco C, Gabrielli A, Hoffmann-Vold AM, Distler O, Ben Shimol J, Cutolo M, Allanore Y. Systemic sclerosis-associated interstitial lung disease in the EUSTAR database: analysis by region. Rheumatology (Oxford) 2022:6759366. [PMID: 36222557 DOI: 10.1093/rheumatology/keac576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/31/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The prevalence and characteristics of systemic sclerosis-associated interstitial lung disease (SSc-ILD) vary between geographical regions worldwide. The objectives of this study were to explore the differences in terms of prevalence, phenotype, treatment, and prognosis in patients with SSc-ILD from predetermined geographical regions in the EUSTAR database. METHODS Patients were clustered into seven geographical regions. Clinical characteristics and survival of patients with SSc-ILD were compared among these pre-determined regions. RESULTS For baseline analyses, 9260 SSc patients were included, with 6732 for survival analyses. The prevalence of SSc-ILD in the overall population was 50.2%, ranging from 44.0% in "Western Europe & Nordic countries" to 67.5% in "Eastern European, Russia & Baltic countries". In all regions, anti-topoisomerase antibodies were associated with SSc-ILD. Management also significantly differed; mycophenolate mofetil was prescribed at baseline in 31.6% of patients with SSc-ILD in "America (North & South)" and 31.7% in "Middle East" but only 4.3% in "Asia & Oceania" (P < 0.0001). Patients from "America (North & South)" and "Middle East" had the highest survival rate at the end of follow-up (85.8% and 85.2%, respectively). CONCLUSION Our study highlights key differences among regions in terms of clinical presentation and prognosis of SSc-ILD. This work also demonstrates that the management of SSc-ILD is highly variable among the different regions considered, suggesting that efforts are still needed for the standardisation of medical practice in the treatment of this disease.
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Affiliation(s)
- Alain Lescoat
- Department of Internal Medicine and Clinical Immunology, CHU Rennes, University of Rennes 1, Rennes, France.,Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, France, Rennes
| | - Dörte Huscher
- Charité Universitätsmedizin, Institute of Biostatistics and Clinical Epidemiology, Berlin, Germany
| | - Nils Schoof
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | - Paolo Airò
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili of Brescia, Brescia, Italy
| | | | - Gabriela Riemekasten
- Department of Rheumatology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Eric Hachulla
- Univ. Lille, INFINITE-Institute for Translational Research in Inflammation, Lille, France.,Univ. Lille, CHU Lille, Service de Médecine Interne, Centre de Référence des Maladies Auto-immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille, F-59000, France.,Inserm, Lille, U1286, F-59000, France
| | - Andrea Doria
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Nicolas Hunzelmann
- Department of Dermatology, University of Cologne, Koln, Nordrhein-Westfalen, Germany
| | - Carlomaurizio Montecucco
- Rheumatology Department, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Armando Gabrielli
- Dipartimento Di Scienze Cliniche E Molecolari, Clinica Medica, Università Politecnica Delle Marche, Ancona, Italy
| | | | - Oliver Distler
- Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Jennifer Ben Shimol
- Department of Medicine, E. Wolfson Medical Center, Holon, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maurizio Cutolo
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Italy-IRCCS Rheumatology Unit San Martino Polyclinic, Genoa, Italy
| | - Yannick Allanore
- Department of Rheumatology, Cochin Hospital, AP-HP, Paris Descartes University, Paris, France
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Rosato E, Laurendi V, Bachetti P, Agrò EF. Does detrusor overactivity cause detrusor underactivity through muscle exhaustion? results from a urodynamic database. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01273-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Pellicano C, Campagna R, Oliva A, Leodori G, Miglionico M, Colalillo A, Mezzaroma I, Mastroianni CM, Turriziani O, Rosato E. Antibody response to BNT162b2 SARS-CoV-2 mRNA vaccine in adult patients with systemic sclerosis. Clin Rheumatol 2022; 41:2755-2763. [PMID: 35614287 PMCID: PMC9132599 DOI: 10.1007/s10067-022-06219-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Systemic sclerosis (SSc) patients are at risk for a severe disease course during SARS-CoV-2 infection either due to comorbidities or immunosuppression. The availability of SARS-CoV-2 vaccines is crucial for the prevention of this hard-to-treat illness. The aim of this study is to assess the humoral response after mRNA vaccination against SARS-CoV-2 in SSc patients. METHOD Seropositivity rate and serum IgG levels were evaluated 1 month (t1) and 3 months (t3) after the second dose of vaccine in a cohort of SSc patients and healthy controls (HC). Differences were made with Student's or Mann-Whitney's t-test and with the chi-square or Fisher exact test. Logistic regression model including immunosuppressive treatments (corticosteroids, CCS; mycophenolate mofetil, MMF; methotrexate, MTX; rituximab, RTX) was built to assess the predictivity for seropositivity. RESULTS The seropositivity rate was similar in 78 SSc patients compared to 35 HC at t1 but lower at t3. SSc patients had lower serum IgG levels than HC at t1 but not at t3. SSc patients treated with immunosuppressive therapy showed both a lower seropositive rate (t1, 90.3% vs 100%; t3, 87.1% vs 97.9%; p < 0.05) and serum IgG levels than untreated patients both at t1 [851 BAU/ml (IQR 294-1950) vs 1930 BAU/ml (IQR 1420-3020); p < 0.001] and t3 [266 BAU/ml (IQR 91.7-597) vs 706 BAU/ml (IQR 455-1330); p < 0.001]. In logistic regression analysis, only MTX was significant [OR 39.912 (95% CI 1.772-898.728); p < 0.05]. CONCLUSIONS SSc patients treated with MTX had a lower serological response to mRNA vaccine, and even low doses of CCS can adversely affect antibody titer and vaccination response. Key Points • SSc patients are able to produce vaccine-induced antibodies after mRNA vaccination. • In SSc patients, clinical characteristics of disease did not influence seropositivity rate. • In SSc patients, even low doses of CCS can adversely affect antibody titer and vaccination response. • In SSc patients, MTX treatment is mainly associated with reduced seropositivity and lower serum IgG levels.
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Affiliation(s)
- Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | - Roberta Campagna
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Giorgia Leodori
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | - Marzia Miglionico
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | - Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | - Ivano Mezzaroma
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | | | | | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy.
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Pellicano C, Colalillo A, Basile V, Marino M, Basile U, La Gualana F, Mezzaroma I, Visentini M, Rosato E. The Effect of SARS-CoV-2 Vaccination on B-Cell Phenotype in Systemic Sclerosis Patients. J Pers Med 2022; 12:jpm12091420. [PMID: 36143205 PMCID: PMC9500778 DOI: 10.3390/jpm12091420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 01/10/2023] Open
Abstract
Objective: to assess the influence of SARS-CoV-2 mRNA vaccine on B-cell phenotypes in systemic sclerosis (SSc). Methods: peripheral blood B-cell subpopulations were evaluated before (t1) and 3 months (t3) after the second dose of vaccine in 28 SSc patients. Peripheral blood B-cell subpopulations were evaluated in 21 healthy controls (HCs) only at t1. Anti-spike IgG levels were evaluated at t3 in both cohorts. Results: SSc patients presented higher naive, double-negative, and CD21low B cells compared to HCs. IgM-memory and switched-memory B cells were lower in SSc patients than HCs. No differences in anti-spike IgG levels after vaccination were observed between SSc patients and HCs. Anti-spike IgG levels after vaccination were lower in SSc patients with increased CD21low B cells at baseline compared to SSc patients with normal CD21low B cells. A positive correlation was found between IgG levels and naive B cells. A negative linear correlation was shown between IgG levels and IgM-memory, switched-memory, double-negative, and CD21low B cells. Conclusions: SARS-CoV-2 mRNA vaccine response is normal in SSc patients not undergoing immunosuppressive therapy. The normal number of naive B cells is a positive marker of antibody response. The increased percentage of CD21low B cells represents a negative marker of antibody response.
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Affiliation(s)
- Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Valerio Basile
- Clinical Pathology Unit and Cancer Biobank, Department of Research and Advanced Technologies, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Mariapaola Marino
- Department of Translational Medicine and Surgery, Section of General Pathology, “A. Gemelli” IRCCS, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | - Umberto Basile
- Department of Laboratory and Infectious Disease Sciences, “A. Gemelli” IRCCS, Catholic University of the Sacred Heart, 00168 Rome, Italy
- Correspondence:
| | - Francesca La Gualana
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Ivano Mezzaroma
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Marcella Visentini
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
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Iannazzo F, Pellicano C, Colalillo A, Ramaccini C, Romaniello A, Gigante A, Rosato E. Interleukin-33 and soluble suppression of tumorigenicity 2 in scleroderma cardiac involvement. Clin Exp Med 2022:10.1007/s10238-022-00864-7. [PMID: 35877052 DOI: 10.1007/s10238-022-00864-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022]
Abstract
Interleukin (IL)-33 is part of the IL-1 family of cytokines and soluble suppression of tumorigenicity 2 (sST2) is part of the family of IL-1 receptors. In systemic sclerosis (SSc), IL-33 and sST2 are involved in cardiac manifestations such as diastolic dysfunction (DD), autonomic dysfunction (AD) and right ventricular-pulmonary arterial coupling assessed by tricuspid annular plane systolic excursion (TAPSE)/systolic pulmonary artery pressure (sPAP). Serum levels of IL33 and sST2 were assessed in 50 SSc patients and 14 healthy controls (HC). Clinical assessment, echocardiography and heart rate variability (HRV) analysis were performed in SSc patients. Serum levels of IL-33 and sST2 were significantly higher in SSc patients than HC. A linear positive correlation between modified Rodnan skin score and IL33 was observed. Serum values of sST2 were higher in SSc patients with DD than in patients without DD [15403 pg/ml (12,208-19,941) vs 8556 pg/ml (6820-11,036), p < 0.001]. sST2 showed a negative correlation with standard deviation of normal-to-normal RR intervals (SDNN) (r = - 0.281, p < 0.05) and positive correlation with low frequency/high frequency (LF/HF) (r = 0,349, p < 0.01). Negative linear correlation exists between sST2 and TAPSE/sPAP (r = - 0.398, p < 0.01). Serum levels of IL-33 and sST2 are higher in SSc patients than HC. Serum levels of sST2 are a potential marker of DD, AD and right ventricular-pulmonary arterial coupling.
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Affiliation(s)
- Francesco Iannazzo
- Department of Translational and Precision Medicine - Scleroderma Unit, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | - Chiara Pellicano
- Department of Translational and Precision Medicine - Scleroderma Unit, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | - Amalia Colalillo
- Department of Translational and Precision Medicine - Scleroderma Unit, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | - Cesarina Ramaccini
- Department of Translational and Precision Medicine - Scleroderma Unit, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | | | - Antonietta Gigante
- Department of Translational and Precision Medicine - Scleroderma Unit, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine - Scleroderma Unit, Sapienza University of Rome, Viale dell'Università 37, 00185, Rome, Italy.
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Ferri C, De Angelis R, Giuggioli D, Bajocchi G, Dagna L, Zanframundo G, Foti R, Cacciapaglia F, Cuomo G, Ariani A, Rosato E, Guiducci S, Girelli F, Riccieri V, Zanatta E, Bosello S, Cavazzana I, Ingegnoli F, De Santis M, Murdaca G, Abignano G, Romeo N, Rossa AD, Caminiti M, Iuliano A, Ciano G, Beretta L, Bagnato G, Lubrano E, De Andres I, Giollo A, Saracco M, Agnes C, Lumetti F, Spinella A, Magnani L, Campochiaro C, De Luca G, Codullo V, Visalli E, Masini F, Gigante A, Bellando-Randone S, Pellegrino G, Pigatto E, Lazzaroni MG, Franceschini F, Generali E, Mennillo G, Barsotti S, Mariano GP, Calabrese F, Furini F, Vultaggio L, Parisi S, Peroni CL, Rozza D, Zanetti A, Carrara G, Landolfi G, Scirè CA, Bianchi G, Fusaro E, Sebastiani GD, Govoni M, D'Angelo S, Cozzi F, Doria A, Iannone F, Salvarani C, Matucci-Cerinic M. Geographical heterogeneity of clinical and serological phenotypes of systemic sclerosis observed at tertiary referral centres. The experience of the Italian SIR-SPRING registry and review of the world literature. Autoimmun Rev 2022; 21:103159. [DOI: 10.1016/j.autrev.2022.103159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 07/24/2022] [Indexed: 12/18/2022]
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Gigante A, Lai S, Pellicano C, Vezzoli D, Sorato G, Rosato E, Muscaritoli M, Cianci R. Assessment of renal microcirculation in biopsy-proven tubulointerstitial nephritis in patients with and without glomerular disease: the role of resistive index. Microvasc Res 2022; 142:104379. [PMID: 35588888 DOI: 10.1016/j.mvr.2022.104379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/24/2022] [Accepted: 05/11/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Renal resistive index (RRI) measured by Doppler sonography is a marker of microvascular status and it is associated with changes in renal function. Aim of the study was to assess RRI in biopsy-proven tubulointerstitial nephritis (TIN) in patients with and without glomerular disease. METHODS 132 consecutive patients underwent to native renal biopsy with diagnosis of isolated TIN or in association with glomerulonephritis. Estimated glomerular filtration rate (eGFR), 24-hour urinary protein excretion and renal ecocolorDoppler ultrasonography with RRI assessment were performed at time of enrollment. RESULTS Patients with isolated-TIN had significantly higher RRI than both patients with non-immunoglobulin A glomerulonephritis (non-IgA-TIN) [0.73 (0.68-0.77) vs 0.64 (0.60-0.67), p < 0.001] and patients with IgA nephropathy (IgAN) [0.73 (0.68-0.77) vs 0.66 (0.60-0.71), p < 0.01]. Patients with isolated-TIN had mainly RRI ≥ 0.70 (n = 15, 65.2%) with the respect to patients with non-IgA-TIN (n = 7, 12.3%) and patients with IgAN (n = 17, 32.7%). A negative linear correlation was found between RRI and hemoglobin (r = 0.233, p < 0.01) and between RRI and eGFR (r = 0.537, p < 0.001). CONCLUSION Tubulointerstitial damage is the most accurate histological lesion that correlates with eGFR and renal impairment. RRI can be a useful parameter to detect tubulointerstitial lesions.
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Affiliation(s)
- Antonietta Gigante
- Department of Translational and Precision Medicine, "Sapienza", University of Rome, Italy
| | - Silvia Lai
- Department of Translational and Precision Medicine, "Sapienza", University of Rome, Italy
| | - Chiara Pellicano
- Department of Translational and Precision Medicine, "Sapienza", University of Rome, Italy
| | - Debora Vezzoli
- Department of Translational and Precision Medicine, "Sapienza", University of Rome, Italy
| | - Georgia Sorato
- Department of Translational and Precision Medicine, "Sapienza", University of Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, "Sapienza", University of Rome, Italy
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, "Sapienza", University of Rome, Italy
| | - Rosario Cianci
- Department of Translational and Precision Medicine, "Sapienza", University of Rome, Italy.
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Gigante A, Perrotta AM, De Marco O, Rosato E, Lai S, Cianci R. Sonographic evaluation of hypertension: Role of atrophic index and renal resistive index. J Clin Hypertens (Greenwich) 2022; 24:955-957. [PMID: 35652317 PMCID: PMC9278587 DOI: 10.1111/jch.14499] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 11/29/2022]
Abstract
Hypertension can cause structural and functional renal damage. Intrarenal ultrasound parameters have been extensively investigated in hypertensive patients and among the parameters introduced, the renal resistive index (RI) is associated with the progression of chronic kidney disease and hypertension. Atrophic index (AI) is an indirect anatomical ultrasound index that reports the atrophic changes of the renal parenchyma and it is mainly studied in chronic glomerular diseases. The present study aimed to evaluate renal RI and AI in hypertensive patients with normal renal function. AI showed correlations with all parameters associated with renal function reduction (age, creatinine, and intrarenal arterial stiffness). AI, in combination with RI, can represent in hypertensive patients an additional marker for renal damage progression.
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Affiliation(s)
- Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Adolfo Marco Perrotta
- Department of Translational and Precision Medicine, School of Nephrology, "Sapienza" University of Rome, Rome, Italy
| | - Oriana De Marco
- Department of Translational and Precision Medicine, School of Nephrology, "Sapienza" University of Rome, Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Silvia Lai
- Department of Translational and Precision Medicine, School of Nephrology, "Sapienza" University of Rome, Rome, Italy
| | - Rosario Cianci
- Department of Translational and Precision Medicine, School of Nephrology, "Sapienza" University of Rome, Rome, Italy
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Pellegrino G, Colasanti T, Bisconti I, Cadar M, DI Ciommo FR, Reza Beigi DM, Stefanantoni K, Gigante A, Rosato E, Conti F, Riccieri V. POS0475 ROLE OF IL-33/ST2 AXIS IN SYSTEMIC SCLEROSIS PATIENTS WITH ELECTROCARDIOGRAPHIC ABNORMALITIES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundElectrocardiographic (EKG) abnormalities are described in 25-75% Systemic Sclerosis (SSc) patients and they are associated with other systemic manifestations1 as well as with a worse prognosis.2 There is an increasing need for clinical and laboratory biomarkers to ameliorate the diagnostic approaches to patients with EKG abnormalities.3In the last decade, many studies focused on the components of the interleukin (IL)-33/ST2 axis. Under physiological conditions, IL-33 is released by apoptotic cardiac cells, promoting a protective mechanism of cell survival, thanks to the binding with its transmembrane receptor ST2.4 During pathological cardiovascular events, an abnormal secretion of the IL-33 soluble receptor (sST2) by Th2 cells occurs. It binds IL-33 not allowing the physiological mechanism driven by the IL-33/ST2 binding previously described.4 For these reasons, sST2 has been proposed as a biomarker of cardiac injury in a variety of diseases.5ObjectivesAim of this study was to analyse clinical and demographical parameters in a group of SSc patients, trying to define any possible feature associated with EKG abnormalities. Furthermore, the role of IL-33/ST2 axis components as biomarkers of cardiac injury in patients with SSc-related EKG abnormalities was evaluated, also assessing the possible correlation with serum concentration of NT-pro-BNP, a well-known cardiac injury biomarker in SSc.MethodsData from 277 SSc patients, fulfilling the 2013 ACR/EULAR classification criteria,6 attending our Scleroderma Clinic were retrospectively analysed. We selected patients with EKG trace and a blood sample available, collected after the SSc diagnosis. The sera levels of sST2 (ELISA Kit, Abcam), IL-33 (ELISA kit, RayBiotech) and NT-pro-BNP (ELISA Kit, Abcam) were measured. Patients with a history of heart diseases occurring before the diagnosis of SSc or features of secondary cardiac involvement (pulmonary arterial hypertension, severe interstitial lung disease or renal disease) were excluded.ResultsForty-six SSc patients showed significant EKG abnormalities (rhythm and conduction disorders). Thirty-one SSc patients without pathologic finding at EKG traces were recruited as the control group.From the analysis of the clinical characteristic of the disease at the moment of serum collection, patients with EKG anomalies have more frequently both a diffuse form of disease (n°-%: 23-50 vs 7-23; p 0.01), with a mean value of mRSS higher than controls (11±9 vs 6±6; p 0.01), and a scleroderma “late” pattern at the nailfold capillaroscopy (n°-% 23-50 vs 6-19; p 0.027).Significantly higher median values of serum levels of sST2 in SSc patients with EKG disorders compared to the control group (4289pg/mL, IQR 2383 vs 2560 pg/mL, IQR 1455; p 0.0002) were detected, while opposite results were found analyzing serum levels of IL-33 (2.89 pg/mL IQR 101 vs 9 pg/mL IQR 277; p 0.032) (Graph 1). Serum NT-pro-BNP median values were significantly higher in the group of patients with EKG abnormalities than in the control group (149 pg/mL, IQR 354 vs 26 pg/mL, IQR 62; p 0.0007). These values correlated with sST2 serum levels (rho Spearman correlation 0.37; p 0.0006).ConclusionSSc patients with EKG abnormalities showed an increased skin and vascular involvement with respect to the control group. These associations could help clinicians in clinically stratifying SSc patients at risk of EKG abnormalities. To our knowledge, this is the first report evaluating the serum concentration of sST2 in SSc patients. Based on these results, we can speculate on the role of this molecule as potential biomarkers of early cardiac injury during SSc, although further studies involving a larger cohort of patients are needed.References[1]Vacca et al. Rheumatol 2014[2]Tyndall et al. Ann Rheum Dis 2010[3]Muresan et al. Clin Rheumatol 2018[4]Vianello et al. Int J Biochem Cell Biol 2019[5]Dudek et al. Adv Clin Exp Med 2020[6]van den Hoogen et al. Arthritis Rheum 2013Figure 1:Graph 1. Serum sST2 (a) and IL-33 (b) concentrations in patients with EKG abnormalities (EKG+) vs control group (EKG)Disclosure of InterestsNone declared.
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Venneri MA, Franceschini E, Sciarra F, Rosato E, D'Ettorre G, Lenzi A. Human genital tracts microbiota: dysbiosis crucial for infertility. J Endocrinol Invest 2022; 45:1151-1160. [PMID: 35113404 PMCID: PMC9098539 DOI: 10.1007/s40618-022-01752-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/18/2022] [Indexed: 01/12/2023]
Abstract
Human body is colonized by trillions of microbes, influenced by several factors, both endogenous, as hormones and circadian regulation, and exogenous as, life-style habits and nutrition. The alteration of such factors can lead to microbial dysbiosis, a phenomenon which, in turn, represents a risk factor in many different pathologies including cancer, diabetes, autoimmune and cardiovascular disease, and infertility. Female microbiota dysbiosis (vaginal, endometrial, placental) and male microbiota dysbiosis (seminal fluid) can influence the fertility, determining a detrimental impact on various conditions, as pre-term birth, neonatal illnesses, and macroscopic sperm parameters impairments. Furthermore, unprotected sexual intercourse creates a bacterial exchange between partners, and, in addition, each partner can influence the microbiota composition of partner's reproductive tracts. This comprehensive overview of the effects of bacterial dysbiosis in both sexes and how partners might influence each other will allow for better personalization of infertility management.
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Affiliation(s)
- M A Venneri
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
| | - E Franceschini
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - F Sciarra
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - E Rosato
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - G D'Ettorre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
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Elhai M, Boubaya M, Sritharan N, Balbir-Gurman A, Siegert E, Hachulla E, De Vries-Bouwstra J, Riemekasten G, Distler JHW, Veale D, Rosato E, Del Galdo F, Mendoza FA, Furst D, De la Puente Bujidos C, Hoffmann-Vold AM, Gabrielli A, Distler O, Bloch-Queyrat C, Allanore Y. POS0140 PREDICTING OUTCOMES IN SYSTEMIC SCLEROSIS: STRATIFICATION BY AUTO-ANTIBODIES OUTPERFORMS CUTANEOUS SUBSETTING IN THE EUSTAR COHORT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundRisk-stratification is key in a heterogeneous disease like systemic sclerosis (SSc). Until now, SSc patients are stratified according to the extent of skin involvement into limited cutaneous, diffuse cutaneous and sine scleroderma subtypes. However, this classification remains inaccurate to capture disease heterogeneity. Autoantibodies are found in more than 90% of the patients and can be detected before onset of the disease. Among them, three predominant and specific antibodies are used: anti-centromere, anti-Scl70 and RNA polymerase III antibodies.ObjectivesTo compare the performances of stratification into LeRoy’s cutaneous subtypes versus autoantibody status in SSc versus combination of cutaneous subtypes and autoantibodies status.MethodsPatients from the EUSTAR database were classified either as (i) limited cutaneous, diffuse cutaneous or sine scleroderma (based on the recording made by the treating physician) or (ii) according to autoantibodies with the following subclassifications: (1) no specific autoantibodies, (2) isolated ANA, (3) anti-centromere antibodies, (4) anti-Scl70 antibodies and (5) anti-RNA polymerase III antibodies or (iii) according to combination of cutaneous subset and auto-antibodies. The respective performance of each model to predict overall survival (OS), progression-free survival (PFS), disease progression and different organ involvements was assessed and the three models were compared by the area under the receiver operating characteristic curve (AUC 95%CI) and the net reclassification improvement (NRI). Missing data were imputed through multiple imputation using chain equations.ResultsIn all, 10’711 patients were included: 84.6% females, mean age: 54.4±13.8 years, mean disease duration: 7.9±8.2 years. In the prospective analysis (n= 6’467 to 7’829 according to the outcome), after a mean follow-up of 56 months and a mean of three visits per patient, we did not identify any difference in AUC between the cutaneous-based model and the antibody-based model for prediction of OS and disease progression. However, the NRI showed a significant improvement in prediction of OS (0.57 [0.46-0.71] vs. 0.29 [0.19-0.39]) and disease progression (0.36 [0.29-0.46] vs. 0.21 [0.14-0.28]) at 4 years using the antibody-based model. Regarding prediction of each organ involvement in longitudinal analyses, the antibody-based model showed better performance than the cutaneous-one for renal crisis (AUC: 0.719 [0.696-0.742] vs. 0.664 [0.643-0.685]), with the highest association observed with anti-RNA polymerase III (OR: 7.47 [1.63-34.24], p= 0.010). Similarly, the antibody-based model was better than the cutaneous model in predicting lung fibrosis (AUC 0.719 [0.715-724] vs. 0.653 [0.647-0.659]) and restrictive lung fibrosis (AUC 0.759 [0.749-0.766] vs. 0.711 [0.701-0.721]) which were both associated with anti-Scl70 antibodies (OR: 9.29 [8.17-10.55] and 7.92 [5.37-11.69], respectively, p<0.0001 for both). Although there was no difference in the AUC to predict digital ulcers, NRI showed an improvement using the antibody-based model (0.31 [0.29-0.33] vs. 0.24 [0.22-0.26]) with the highest association with anti-Scl70 antibodies (OR: 3.57 [2.68-4.75], p<0.0001). The two models had similar performances in assessing occurrence of intestinal involvement, heart dysfunction or elevated sPAP. Combining both antibody status and cutaneous subtype did not improve the performance of our models. In the exploratory analysis, there was no change using modified Rodnan skin score to define cutaneous form.ConclusionAuto-antibody status outperforms the common cutaneous subsetting to risk-stratify SSc patients in the EUSTAR cohort. This easily performed subclassification using autoantibodies specific status can be used by the clinicians to risk-stratify their patients and to adapt disease monitoring in routine practice.Disclosure of InterestsMuriel Elhai Speakers bureau: BMS outside of the submitted work, Marouane Boubaya: None declared, Nanthara Sritharan: None declared, Alexandra Balbir-Gurman: None declared, Elise Siegert: None declared, Eric Hachulla: None declared, Jeska de Vries-Bouwstra: None declared, Gabriela Riemekasten: None declared, Jörg H.W. Distler: None declared, Douglas Veale: None declared, Edoardo Rosato: None declared, Francesco Del Galdo: None declared, Fabian A Mendoza: None declared, Daniel Furst Consultant of: Abbvie, Novartis, Pfizer, R-Pharm, Grant/research support from: Emerald, Kadmon, PICORI, Pfizer,Prometheus, Talaris, Mitsubishi, Carlos De la Puente Bujidos: None declared, Anna-Maria Hoffmann-Vold Speakers bureau: Actelion, Boehringer Ingelheim, Jansen, Lilly, Medscape, Merck Sharp & Dohme, Roche, Consultant of: Actelion, ARXX, Bayer, Boehringer Ingelheim, Jansen, Lilly, Medscape, Merck Sharp & Dohme, Roche, Grant/research support from: Boehringer Ingelheim, Armando Gabrielli: None declared, Oliver Distler Speakers bureau: Bayer, Boehringer Ingelheim, Janssen, Medscape, Consultant of: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, 4P Science, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur, Grant/research support from: Kymera, Mitsubishi Tanabe, Boehringer Ingelheim, Coralie Bloch-Queyrat: None declared, Yannick Allanore Consultant of: Actelion, Bayer, BMS, Boehringer-Ingelheim, Inventiva, Roche, Sanofi-Aventis, Grant/research support from: Actelion, Bayer, BMS, Boehringer-Ingelheim, Inventiva, Roche, Sanofi-Aventis
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Pellicano C, Romaggioli L, Miglionico M, Colalillo A, Ramaccini C, Gigante A, Muscaritoli M, Rosato E. Maresin1 is a predictive marker of new digital ulcers in systemic sclerosis patients. Microvasc Res 2022; 142:104366. [PMID: 35346718 DOI: 10.1016/j.mvr.2022.104366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/14/2022] [Accepted: 03/22/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Digital ulcers (DUs) are one of the main causes of disability among systemic sclerosis (SSc) patients. The inflammation plays a crucial role in mediating the pathophysiological process underlying SSc. Objective of this study was to evaluate Maresin1 (MaR1) serum levels in SSc patients and in healthy controls (HC). Secondary aims were to evaluate the relationship between MaR and diseases variables and to assess the predictive role of MaR1 in the development of new digital ulcers (DUs) during 18 weeks follow-up. METHODS MaR1 serum level was evaluated in 55 SSc patients and 24 HC. In SSc patients, clinical assessment was performed at baseline and after 18 week follow-up by the same-blinded observer on serum MaR1 levels. RESULTS MaR1 was significantly lower in SSc patients than in HC [367 pg/ml (IQR 304-468.3 pg/ml) vs 467.7 pg/ml (IQR 422-522 pg/ml), p < 0.001]. During follow-up, six patients (10.9%) developed DUs. MaR1 was higher in SSc patients with new DUs than in patients without new DUs [518.2 pg/ml (IQR 468.2-596.5 pg/ml) vs 355 pg/ml (IQR 299.8-444.7 pg/ml), p < 0.01]. Free survival from new DUs is significantly lower in SSc patients with increased MaR1 serum level than in SSc patient with normal MaR1 serum level. In multivariate analysis, serum level of MaR1 > 393.2 pg/ml is a predictive marker for new DUs. CONCLUSION In SSc patients, MaR1 is reduced compared to HC and it is a predictive marker of new DUs.
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Affiliation(s)
- Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Laura Romaggioli
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Marzia Miglionico
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Cesarina Ramaccini
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy.
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Merone G, Tartaglia A, Rossi S, Santavenere F, Bassotti E, D'Ovidio C, Rosato E, de Grazia U, Locatelli M, Boccio PD, Savini F. Fast LC–MS/MS screening method for the evaluation of drugs, illicit drugs, and other compounds in biological matrices. Talanta Open 2022. [DOI: 10.1016/j.talo.2022.100105] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Pellicano C, Iannazzo F, Romaggioli L, Rosato E. IL33 and sST2 serum level in systemic sclerosis microvascular involvement. Microvasc Res 2022; 142:104344. [PMID: 35182578 DOI: 10.1016/j.mvr.2022.104344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 01/28/2022] [Accepted: 02/14/2022] [Indexed: 10/19/2022]
Abstract
AIM Endothelial dysfunction and microvascular damage are hallmarks of systemic sclerosis (SSc). Objective of this study was to evaluate IL33 and ST2 serum levels in SSc patients and healthy controls (HC). Secondary aim was to evaluate the IL33 axis in the SSc microvascular manifestation. METHODS IL33 and sST2 have been assessed in 46 SSc patients and 24 HC matched for sex and age. Main clinimetric indexes were assessed. Skin perfusion of hands was evaluated by Laser Speckle Contrast Analysis (LASCA) and echocolordoppler ultrasound of renal arteries was performed to evaluate subclinical renal involvement. RESULTS SSc patients had higher serum level of IL33 and sST2 than HC. IL33 and sST2 were significantly higher in SSc patient with digital ulcers (DUs) compared to SSc patients without DUs. SSc patients with late nailfold videocapillaroscopy (NVC) pattern had higher serum levels of sST2 than SSc patients with active NVC pattern. SSc patients without proximal-distal gradient (PDG) at LASCA had significantly higher sST2 serum level compared to SSc patients with PDG. SSc patients with renal resistive index (RRI) ≥ 0.70 had higher serum levels of sST2 than SSc patients with RRI < 0.70. A positive linear correlation was shown between sST2 and RRI, between sST2 and intrarenal S/D and between sST2 and PI. Kaplan-Meier curves show a significantly reduced free survival from DUs in patients with increased sST2 (p = 0.025). In multivariate analysis, sST2 is associated with the development of new DUs. CONCLUSION IL33 and sST2 are increased in SSc patients and ST2 might be a marker of microvascular damage.
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Affiliation(s)
- Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesco Iannazzo
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Laura Romaggioli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
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Rosato E, Gigante A, Pellicano C, Villa A, Iannazzo F, Alunni Fegatelli D, Muscaritoli M. Symptoms related to gastrointestinal tract involvement and low muscularity in systemic sclerosis. Clin Rheumatol 2022; 41:1687-1696. [PMID: 35149929 PMCID: PMC9119878 DOI: 10.1007/s10067-022-06059-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/21/2021] [Accepted: 01/09/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION/OBJECTIVES Gastrointestinal tract (GIT) involvement is frequently observed in systemic sclerosis (SSc) and may lead to nutritional impairment. The aim of the study was to assess the prevalence of symptoms related to GIT involvement and to analyze the possible association between gastrointestinal symptoms and low muscularity in SSc patients. METHODS Sixty-nine consecutive patients (60 females, median age 53 (IQR 43-63), body mass index (BMI) 23.2 (IQR 20.9-24.6) kg/m2) with diagnosis of SSc admitted to our Scleroderma Unit were enrolled. Clinical status, anthropometric data, and bioelectrical impedance (Inbody 770, USA) analysis-assessed Fat-Free Mass Index (FFMI) were recorded upon enrollment. UCLA questionnaire was used to quantify GIT involvement with seven specific scales. RESULTS Mean FFMI was 16.2 kg/m2 (IQR 15.2-17.6). The median UCLA total score was 0.53 (IQR 0.19-0.89). FFMI showed a significant negative correlation with UCLA total score (r = -0.29, p = 0.016) and UCLA distention/bloating (r = -0.35, p < 0.01). In 16 patients (23.1%), FFMI was reduced and UCLA distention/bloating was significantly higher (p = 0.039) in SSc patients with lower FFMI [1.75 (IQR 0.75-2.12) vs 0.75 (IQR 0.25-1.75)]. At multiple linear regression model, FFMI showed association with UCLA distention/bloating [beta coefficient - 0.315 (95% CI of beta coefficient: -0.591; -0.039), p = 0.026], BMI [beta coefficient 0.259 (95% CI of beta coefficient: 0.163; 0.355), p = 0.001], and disease duration [beta coefficient - 0.033 (95% CI of beta coefficient: -0.059; -0.007), p = 0.015]. CONCLUSIONS In SSc, low FFMI is associated with symptoms related to GIT involvement, in particular with distension/bloating. Key Points • FFMI is associated with symptoms related to GIT involvement. • Low FFMI is associated with symptoms related to UCLA distention/bloating. • Malnutrition is not associated with symptoms related to GIT involvement.
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Affiliation(s)
- Edoardo Rosato
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Viale dell' Università 37, 00185, Rome, Italy
| | - Antonietta Gigante
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Viale dell' Università 37, 00185, Rome, Italy
| | - Chiara Pellicano
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Viale dell' Università 37, 00185, Rome, Italy
| | - Annalisa Villa
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Viale dell' Università 37, 00185, Rome, Italy
| | - Francesco Iannazzo
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Viale dell' Università 37, 00185, Rome, Italy
| | - Danilo Alunni Fegatelli
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Viale dell' Università 37, 00185, Rome, Italy.
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Pellicano C, Leodori G, Floridia S, Colalillo A, Gigante A, Rosato E, Paoloni M. Reciprocal effects of scleroderma and temporomandibular dysfunction between patient cohorts. Cranio 2021:1-8. [PMID: 34962456 DOI: 10.1080/08869634.2021.2019425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To estimate the prevalence of temporomandibular dysfunction in scleroderma patients according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and to correlate it with disease variables. METHODS Temporomandibular dysfunction was evaluated in 75 scleroderma patients and 74 healthy controls using DC/TMD. Gastrointestinal symptoms were evaluated through the University of California Los Angeles (UCLA) score in scleroderma patients. RESULTS There was no difference of prevalence in temporomandibular dysfunction [30 (40%) vs 30 (40.5%); p > 00.05] between scleroderma patients and healthy controls. Scleroderma patients had a significant reduction in all oral movements compared to healthy controls. Scleroderma patients with temporomandibular dysfunction had a statistically higher score in the UCLA distention/bloating item [1.75 (0.5-2.38) vs 0.75 (0.25-1.75); p < 0.05] than scleroderma patients without temporomandibular dysfunction. DISCUSSION Temporomandibular dysfunction prevalence between scleroderma patients and healthy controls is similar. In scleroderma patients, temporomandibular dysfunction reduces oral mobility and opening, which worsens distension/bloating.
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Affiliation(s)
- Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Giorgia Leodori
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Stefano Floridia
- Department of Anatomy, Histology, Forensic Medicine and Locomotor Sciences, Sapienza University of Rome, Rome, Italy
| | - Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Marco Paoloni
- Department of Anatomy, Histology, Forensic Medicine and Locomotor Sciences, Sapienza University of Rome, Rome, Italy
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Rosato E. The role of 18F-FDG PET-CT in rheumatoid arthritis patients tapering TNFi. Rheumatology (Oxford) 2021; 61:SI1-SI3. [PMID: 34919664 DOI: 10.1093/rheumatology/keab932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 12/11/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome
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Tartaglia A, Romasco T, D'Ovidio C, Rosato E, Ulusoy HI, Furton KG, Kabir A, Locatelli M. Determination of phenolic compounds in human saliva after oral administration of red wine by high performance liquid chromatography. J Pharm Biomed Anal 2021; 209:114486. [PMID: 34847459 DOI: 10.1016/j.jpba.2021.114486] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 01/18/2023]
Abstract
Red wine is a relevant source of bioactive compounds, which contribute to its antioxidant activity and other beneficial advantages for human health. However, the bioavailability of phenols in humans is not well understood, and the inter-individual variability in the production of phenolic compounds has not been comprehensively assessed to date. The present work describes a new method for the extraction and analysis of phenolic compounds including gallic acid (Gal), vanillic acid (Van), caffeic acid (Caf), syringic acid (Sir); (-)-epicatechin (Epi); p-coumaric acid (Cum) and resveratrol (Rsv) in human saliva samples. The target analytes were extracted using Fabric Phase Sorptive Extraction (FPSE), and subsequently analysed by high-performance liquid chromatography (HPLC) coupled with photodiode array detector (PDA). Chromatographic separation was achieved using a Symmetry C18 RP column in gradient elution mode, with methanol and phosphate buffer as the mobile phases. The linearity (intercept, slope, and determination coefficient) was evaluated in the range from 1 to 50 µg/mL. The limit of quantification (LOQ) was 1 µg/mL (LLOQ ≥0.8 µg/mL), whereas limit of detection was 0.25 µg/mL. The intra and inter-day RSD% and BIAS% values were less than± 15%. The analytical performances were further tested on human saliva collected from healthy volunteers after administering red wine. To the best of our knowledge, this is the first FPSE procedure for the analysis of phenols in saliva, using a non-invasive and easy to perform sample collection protocol. The proposed fast and inexpensive approach can be deployed as a reliable tool to study other biological matrices to proliferate understanding of these compounds distribution in human body.
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Affiliation(s)
- A Tartaglia
- Department of Pharmacy, University of Chieti-Pescara "G. d'Annunzio", Via dei Vestini 31, Chieti 66100, Italy
| | - T Romasco
- Department of Pharmacy, University of Chieti-Pescara "G. d'Annunzio", Via dei Vestini 31, Chieti 66100, Italy
| | - C D'Ovidio
- Department of Medicine and Aging Sciences, Section of Legal Medicine, University of Chieti-Pescara "G. d'Annunzio", Chieti 66100, Italy
| | - E Rosato
- Department of Pharmacy, University of Chieti-Pescara "G. d'Annunzio", Via dei Vestini 31, Chieti 66100, Italy
| | - H I Ulusoy
- Department of Analytical Chemistry, Faculty of Pharmacy, Cumhuriyet University, Sivas 58140, Turkey
| | - K G Furton
- International Forensic Research Institute, Department of Chemistry and Biochemistry, Florida International University, 11200 SW 8th St, Miami, FL 33199, USA
| | - A Kabir
- International Forensic Research Institute, Department of Chemistry and Biochemistry, Florida International University, 11200 SW 8th St, Miami, FL 33199, USA
| | - M Locatelli
- Department of Pharmacy, University of Chieti-Pescara "G. d'Annunzio", Via dei Vestini 31, Chieti 66100, Italy.
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Gigante A, Rosato E. Reduced glomerular filtrate rate, end-stage renal disease, scleroderma renal crisis, and risk of mortality in patients with systemic sclerosis. Scand J Rheumatol 2021; 51:246-247. [PMID: 34788189 DOI: 10.1080/03009742.2021.1995983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - E Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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De Angelis R, Giuggioli D, Bajocchi G, Dagna L, Zanframundo G, Foti R, Cacciapaglia F, Cuomo G, Ariani A, Rosato E, Guiducci S, Girelli F, Riccieri V, Zanatta E, Bosello S, Cavazzana I, Ingegnoli F, Santis MD, Murdaca G, Abignano G, Romeo N, Della Rossa A, Caminiti M, Iuliano A, Ciano G, Beretta L, Bagnato G, Lubrano E, De Andres I, Giollo A, Saracco M, Agnes C, Lumetti F, Spinella A, Magnani L, Campochiaro C, De Luca G, Codullo V, Visalli E, Masini F, Gigante A, Bellando-Randone S, Pellegrino G, Pigatto E, Dall'Ara F, Lazzaroni MG, Generali E, Mennillo G, Barsotti S, Mariano GP, Calabrese F, Furini F, Vultaggio L, Parisi S, Peroni CL, Risa AM, Rozza D, Zanetti A, Carrara G, Landolfi G, Scirè CA, Bianchi G, Fusaro E, Sebastiani GD, Govoni M, D'Angelo S, Cozzi F, Doria A, Iannone F, Salvarani C, Matucci-Cerinic M, Ferri C. Sex-related Differences in Systemic Sclerosis: A Multicenter Cross-sectional Study From the National Registry of the Italian Society for Rheumatology. J Rheumatol Suppl 2021; 49:176-185. [PMID: 34782448 DOI: 10.3899/jrheum.210794] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE There is still a great deal to learn about the influence of sex in systemic sclerosis (SSc). In this respect, national registries provide large and homogeneous patient cohorts for analytical studies. We therefore investigated a wide-ranging and well-characterized SSc series with the aim of identifying sex differences in disease expression, with a special focus on demographic, clinical, and serological characteristics. METHODS A multicenter SSc cohort of 2281 patients, including 247 men, was recruited in the Italian Systemic sclerosis PRogression INvestiGation (SPRING) registry. Demographic data, disease manifestations, serological profile, and internal organ involvement were compared. RESULTS The overall female/male ratio was 8.2:1. Female/male ratios for limited cutaneous SSc, diffuse cutaneous SSc, and SSc sine scleroderma subsets were 8.7:1, 4.9:1, and 10.7:1, respectively. A shorter time from onset of Raynaud phenomenon to SSc diagnosis, an increased prevalence of the diffuse cutaneous subset, renal crisis, and digital ulcers were found in males, whereas a significantly higher percentage of sicca syndrome, serum antinuclear antibodies, antiextractable nuclear antigens, anti-La/SSB, and anticentromere protein B was detected in the female group. Males exhibited lower left ventricular ejection fraction, as well as higher prevalence of conduction blocks, arrhythmias, ground glass, and honeycombing. Moreover, forced vital capacity and total lung capacity were medially lower in men than in women. Finally, males were more frequently treated with immunosuppressive drugs. CONCLUSION Our study further supports the presence of several sex-related differences in patients with SSc. These differences were pronounced in the severity of cutaneous, peripheral vascular, and cardiopulmonary involvement for male patients, whereas an increased prevalence of sicca syndrome and a specific autoantibody profile characterized the female sex.
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Affiliation(s)
- Rossella De Angelis
- R. De Angelis, MD, A.M. Risa, MD, Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona;
| | - Dilia Giuggioli
- D. Giuggioli, MD, F. Lumetti, MD, A. Spinella, MD, C. Ferri, MD, Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, Modena
| | - Gianluigi Bajocchi
- G. Bajocchi, MD, L. Magnani, MD, C. Salvarani, MD, Rheumatology Unit, S. Maria Hospital-USL, IRCCS Institute, Reggio Emilia
| | - Lorenzo Dagna
- L. Dagna, MD, C. Campochiaro, MD, G. De Luca, MD, Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan
| | - Giovanni Zanframundo
- G. Zanframundo, MD, V. Codullo, MD, Department of Rheumatology, Policlinico San Matteo, Pavia
| | - Rosario Foti
- R. Foti, MD, E. Visalli, MD, AOU Policlinico Vittorio Emanuele, Catania
| | - Fabio Cacciapaglia
- F. Cacciapaglia, MD, F. Iannone, MD, Rheumatology Unit, Department of Emergency Surgery and Organ Transplantations, University of Bari, Bari
| | - Giovanna Cuomo
- G. Cuomo, MD, F. Masini, MD, Luigi Vanvitelli University, Naples
| | - Alarico Ariani
- A. Ariani, MD, Department of Medicine, Internal Medicine and Rheumatology, Azienda Ospedaliero Universitaria di Parma, Parma
| | - Edoardo Rosato
- E. Rosato, MD, A. Gigante, MD, Department of Translational and Precision Medicine, Sapienza University of Rome
| | - Serena Guiducci
- S. Guiducci, MD, S. Bellando-Randone, MD, Department of Rheumatology, University of Florence, Florence
| | - Francesco Girelli
- F. Girelli, MD, Department of Medicine, Rheumatology Unit, Ospedale GB Morgagni-L Pierantoni, Forlì
| | - Valeria Riccieri
- V. Riccieri, MD, G. Pellegrino, MD, Department of Rheumatology, Sapienza University of Rome, Rome
| | - Elisabetta Zanatta
- E. Zanatta, MD, A. Doria, MD, Department of Rheumatology, University of Padua, Padova
| | - Silvia Bosello
- S. Bosello, MD, Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome
| | - Ilaria Cavazzana
- I. Cavazzana, MD, F. Dall'Ara, MD, M.G. Lazzaroni, MD, Department of Rheumatology, Spedali Civili di Brescia, Brescia
| | - Francesca Ingegnoli
- F. Ingegnoli, MD, Division of Clinical Rheumatology, ASST Pini, Dept. of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Research Center for Environmental Health, Università degli Studi di Milano, Milan
| | - Maria De Santis
- M. De Santis, MD, E.Generali, MD, Humanitas Clinical and Research Center IRCCS, Milan
| | | | - Giuseppina Abignano
- G. Abignano, MD, G. Mennillo, MD, S. D'Angelo, MD, Department of Translational and Precision Medicine, Sapienza University of Rome
| | | | - Alessandra Della Rossa
- A. Della Rossa, MD, S. Barsotti, MD, Department of Rheumatology, University of Pisa, Pisa
| | - Maurizio Caminiti
- M. Caminiti, MD, G. Pagano Mariano, MD, F. Calabrese, MD, Departmental Rheumatology Unit, Grande Ospedale Metropolitano, Reggio Calabria
| | - Annamaria Iuliano
- A. Iuliano, MD, G.D. Sebastiani, MD, Rheumatology Unit, San Camillo-Forlanini Hospital, Rome
| | | | - Lorenzo Beretta
- L. Beretta, MD, Referral Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico di Milano, Milan
| | - Gianluca Bagnato
- G. Bagnato, MD, Department of Clinical and Experimental Medicine, University of Messina, Messina
| | - Ennio Lubrano
- E. Lubrano, MD, Department of Rheumatology, University of Molise, Campobasso
| | - Ilenia De Andres
- I. De Andres, MD, Rheumatology Unit, Azienda Ospedaliera di Rilievo Nazionale ed Alta Specializzazione Garibaldi, Catania
| | - Alessandro Giollo
- A. Giollo, MD, Rheumatology Section, Department of Medicine, University of Verona, Verona
| | - Marta Saracco
- M. Saracco, MD, Rheumatology Unit, Mauriziano-Umberto I Hospital, Turin
| | | | - Federica Lumetti
- D. Giuggioli, MD, F. Lumetti, MD, A. Spinella, MD, C. Ferri, MD, Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, Modena
| | - Amelia Spinella
- D. Giuggioli, MD, F. Lumetti, MD, A. Spinella, MD, C. Ferri, MD, Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, Modena
| | - Luca Magnani
- G. Bajocchi, MD, L. Magnani, MD, C. Salvarani, MD, Rheumatology Unit, S. Maria Hospital-USL, IRCCS Institute, Reggio Emilia
| | - Corrado Campochiaro
- L. Dagna, MD, C. Campochiaro, MD, G. De Luca, MD, Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan
| | - Giacomo De Luca
- L. Dagna, MD, C. Campochiaro, MD, G. De Luca, MD, Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan
| | - Veronica Codullo
- G. Zanframundo, MD, V. Codullo, MD, Department of Rheumatology, Policlinico San Matteo, Pavia
| | - Elisa Visalli
- R. Foti, MD, E. Visalli, MD, AOU Policlinico Vittorio Emanuele, Catania
| | - Francesco Masini
- G. Cuomo, MD, F. Masini, MD, Luigi Vanvitelli University, Naples
| | - Antonietta Gigante
- E. Rosato, MD, A. Gigante, MD, Department of Translational and Precision Medicine, Sapienza University of Rome
| | - Silvia Bellando-Randone
- S. Guiducci, MD, S. Bellando-Randone, MD, Department of Rheumatology, University of Florence, Florence
| | - Greta Pellegrino
- V. Riccieri, MD, G. Pellegrino, MD, Department of Rheumatology, Sapienza University of Rome, Rome
| | - Erika Pigatto
- E. Pigatto, MD, F. Cozzi, MD, Department of Medicine, Villa Salus Hospital, Venice
| | - Francesca Dall'Ara
- I. Cavazzana, MD, F. Dall'Ara, MD, M.G. Lazzaroni, MD, Department of Rheumatology, Spedali Civili di Brescia, Brescia
| | - Maria Grazia Lazzaroni
- I. Cavazzana, MD, F. Dall'Ara, MD, M.G. Lazzaroni, MD, Department of Rheumatology, Spedali Civili di Brescia, Brescia
| | - Elena Generali
- M. De Santis, MD, E.Generali, MD, Humanitas Clinical and Research Center IRCCS, Milan
| | - Gianna Mennillo
- G. Abignano, MD, G. Mennillo, MD, S. D'Angelo, MD, Department of Translational and Precision Medicine, Sapienza University of Rome
| | - Simone Barsotti
- A. Della Rossa, MD, S. Barsotti, MD, Department of Rheumatology, University of Pisa, Pisa
| | - Giuseppa Pagano Mariano
- M. Caminiti, MD, G. Pagano Mariano, MD, F. Calabrese, MD, Departmental Rheumatology Unit, Grande Ospedale Metropolitano, Reggio Calabria
| | - Francesca Calabrese
- M. Caminiti, MD, G. Pagano Mariano, MD, F. Calabrese, MD, Departmental Rheumatology Unit, Grande Ospedale Metropolitano, Reggio Calabria
| | - Federica Furini
- F. Furini, MD, L. Vultaggio, MD, M. Govoni, MD, Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara, Ferrara
| | - Licia Vultaggio
- F. Furini, MD, L. Vultaggio, MD, M. Govoni, MD, Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara, Ferrara
| | - Simone Parisi
- S. Parisi, MD, C.L. Peroni, MD, E. Fusaro, MD, Rheumatology Unit, Città della Salute e della Scienza, Turin
| | - Clara Lisa Peroni
- S. Parisi, MD, C.L. Peroni, MD, E. Fusaro, MD, Rheumatology Unit, Città della Salute e della Scienza, Turin
| | - Anna Maria Risa
- R. De Angelis, MD, A.M. Risa, MD, Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona
| | - Davide Rozza
- D.Rozza, MS, A. Zanetti, MS, G. Carrara, MS, G. Landolfi, MS, Epidemiology Unit, Italian Society for Rheumatology, Milan
| | - Anna Zanetti
- D.Rozza, MS, A. Zanetti, MS, G. Carrara, MS, G. Landolfi, MS, Epidemiology Unit, Italian Society for Rheumatology, Milan
| | - Greta Carrara
- D.Rozza, MS, A. Zanetti, MS, G. Carrara, MS, G. Landolfi, MS, Epidemiology Unit, Italian Society for Rheumatology, Milan
| | - Giampiero Landolfi
- D.Rozza, MS, A. Zanetti, MS, G. Carrara, MS, G. Landolfi, MS, Epidemiology Unit, Italian Society for Rheumatology, Milan
| | - Carlo Alberto Scirè
- C.A. Scirè, MD, Epidemiology Unit, Italian Society for Rheumatology, Milan, and Rheumatology Unit, University of Ferrara-S. Anna Hospital, Ferrara
| | - Gerolamo Bianchi
- G. Bianchi, MD, Rheumatology Unit, Department of Musculoskeletal Sciences, Local Health Trust 3, La Colletta Hospital, Genoa
| | - Enrico Fusaro
- S. Parisi, MD, C.L. Peroni, MD, E. Fusaro, MD, Rheumatology Unit, Città della Salute e della Scienza, Turin
| | | | - Marcello Govoni
- F. Furini, MD, L. Vultaggio, MD, M. Govoni, MD, Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria S. Anna di Ferrara, Ferrara
| | - Salvatore D'Angelo
- G. Abignano, MD, G. Mennillo, MD, S. D'Angelo, MD, Department of Translational and Precision Medicine, Sapienza University of Rome
| | - Franco Cozzi
- E. Pigatto, MD, F. Cozzi, MD, Department of Medicine, Villa Salus Hospital, Venice
| | - Andrea Doria
- E. Zanatta, MD, A. Doria, MD, Department of Rheumatology, University of Padua, Padova
| | - Florenzo Iannone
- F. Cacciapaglia, MD, F. Iannone, MD, Rheumatology Unit, Department of Emergency Surgery and Organ Transplantations, University of Bari, Bari
| | - Carlo Salvarani
- G. Bajocchi, MD, L. Magnani, MD, C. Salvarani, MD, Rheumatology Unit, S. Maria Hospital-USL, IRCCS Institute, Reggio Emilia
| | - Marco Matucci-Cerinic
- M. Matucci-Cerinic, MD, Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, and Department of Rheumatology, University of Florence, Florence, Italy
| | - Clodoveo Ferri
- D. Giuggioli, MD, F. Lumetti, MD, A. Spinella, MD, C. Ferri, MD, Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, Modena
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Concistrè A, Alessandri F, Rosato E, Pugliese F, Muscaritoli M, Letizia C. A case of chronic systemic capillary leak syndrome (SCLS) exacerbated during SARS-CoV2 infection. Eur Rev Med Pharmacol Sci 2021; 25:5922-5927. [PMID: 34661250 DOI: 10.26355/eurrev_202110_26868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Systemic capillary leak syndrome (SCLS) is a very rare and lethal disease characterized by hemoconcentration and hypoalbuminemia caused by reversible plasma extravasation. The underlying cause for SCLS remains largely unknown and acute treatment has remained mainly supportive. Prophylaxis with intravenous immunoglobulin (IVIG) has been shown to successfully prevent further episodes in affected patients. We reported a case of SCLS in a patient who presented to our hospital with COVID-19 and developed profound shock.
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Affiliation(s)
- A Concistrè
- Department of Translational and Precision Medicine, University "Sapienza", Rome, Italy.
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Colalillo A, Grimaldi MC, Vaiarello V, Pellicano C, Leodori G, Gigante A, Romaniello A, Rosato E. In systemic sclerosis TAPSE/sPAP ratio can be used in addition to the DETECT algorithm for pulmonary arterial hypertension diagnosis. Rheumatology (Oxford) 2021; 61:2450-2456. [PMID: 34605890 DOI: 10.1093/rheumatology/keab748] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/23/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Early detection of pulmonary arterial hypertension (PAH) is crucial to improve patient outcomes. The aim of this study was to compare the positive predictive value (PPV) between the echocardiography-derived tricuspid annular plane systolic excursion/systolic pulmonary artery pressure (TAPSE/sPAP) ratio and the DETECT algorithm for PAH screening in a cohort of systemic sclerosis (SSc) patients. METHODS 51 SSc patients were screened for PAH using DETECT algorithm and echocardiography. RESULTS Echocardiography was recommended by the DETECT algorithm step 1 in 34 patients (66.7%). Right heart catheterization (RHC) was recommended by the DETECT algorithm step 2 in 16 patients (31.4%). PAH was confirmed by RHC in 5 patients. DETECT algorithm positive predictive value (PPV) was 31.3%.TAPSE/sPAP ratio was higher in SSc patients not referred for RHC than in SSc patients referred for RHC according to DETECT algorithm step 2 [0.83 (0.35-1.40) mm/mmHg vs 0.74 (0.12-1.09) mm/mmHg, p < 0.05]. Using a cut-off of 0.60 mm/mmHg, 8 (15.7%) SSc patients had a TAPSE/sPAP ratio ≤0.60 mm/mmHg. PAH was confirmed by RHC in 5 patients. PPV of TAPSE/sPAP was 62.5%.In multiple regression analysis, TAPSE/sPAP was associated with age (β coefficient = -0.348 [95% CI, -0.011 to -0.003]; p < 0.01), DETECT algorithm step 1 (β coefficient = 1.023 [95% CI, 0.006-0.024]; p < 0.01) and DETECT algorithm step 2 (β coefficient = -1.758 [95% CI, -0.059 to -0.021]; p < 0.0001). CONCLUSION In SSc patients with a DETECT algorithm step 2 total score >35 the TAPSE/sPAP ratio can be used to further select patients requiring RHC to confirm PAH diagnosis.
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Affiliation(s)
- Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | | | - Valentina Vaiarello
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Giorgia Leodori
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | | | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
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Hernández J, Jordan S, Dobrota R, Iudici M, Hasler P, Ribi C, Villiger P, Vlachoyiannopoulos P, Vacca A, Garzanova L, Giollo A, Rosato E, Kötter I, Carreira PE, Doria A, Henes J, Müller-Ladner U, Smith V, Distler J, Gabrielli A, Hoffman-Vold AM, Walker U, Distler O. The burden of systemic sclerosis in Switzerland - the Swiss systemic sclerosis EUSTAR cohort. Swiss Med Wkly 2021; 151:w20528. [PMID: 34283895 DOI: 10.4414/smw.2021.20528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Characteristics of Swiss patients with systemic sclerosis have not been described so far. The aim of the current study was to identify unmet needs in comparison with other European countries that could inform specific interventions to improve the care of systemic sclerosis patients. METHODS We analysed Swiss and other European systemic sclerosis patients registered in European Scleroderma Trials And Research (EUSTAR) and the Very Early Diagnosis Of Systemic Sclerosis (VEDOSS) cohort. Demographics, clinical profiles, organ involvement and survival of established, early/mild and very early / very mild systemic sclerosis patients were described and compared between the cohorts. RESULTS We included 679 Swiss and 8793 European systemic sclerosis patients in the analysis. Over 95% of patients in both cohorts were Caucasian, disease subsets were similar, and no age difference was found. The Swiss cohort had more male patients (25% vs 16% European, p = 0.005) and higher prevalence of early/mild and very early / very mild patients (26.1 vs 8.5% European and 14.9% vs 6.7% European, respectively, both p <0.0001). Disease duration in established systemic sclerosis patients at first presentation was numerically shorter but not significant in the Swiss cohort: 5.0 years (1–12) Swiss vs 6.0 years (2–12) years European, p = 0.055). Despite the earlier referral of Swiss patients to systemic sclerosis expert centres, they showed evidence of more severe disease, particularly in the limited cutaneous systemic sclerosis subset, but no differences in overall survival on longitudinal follow-up were observed. CONCLUSION This is the first report of the national Swiss EUSTAR cohort. It identifies earlier referral to systemic sclerosis expert centres, before major organ damage occurs, and when outcome can still be modified, as a priority to improve care of patients with systemic sclerosis.
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Affiliation(s)
- Jasmin Hernández
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Switzerland
| | - Suzana Jordan
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Switzerland
| | - Rucsandra Dobrota
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Switzerland
| | - Michele Iudici
- Rheumatology Unit, Geneva University Hospitals, Geneva, Switzerland
| | - Paul Hasler
- Department of Rheumatology, Kantonsspital Aarau, Switzerland
| | - Camillo Ribi
- Department of Clinical Immunology and Allergy, Lausanne, Switzerland
| | - Peter Villiger
- Department of Rheumatology and Clinical Immunology/Allergology, Inselspital, University of Bern, Switzerland
| | | | - Alessandra Vacca
- Rheumatology Unit, University Hospital of Cagliari, Monserrato (CA), Italy
| | - Ludmila Garzanova
- Laboratory of microcirculation and inflammation, VA Nasonova Institute of Rheumatology, Moscow, Russian Federation
| | - Alessandro Giollo
- Rheumatology Section, Department of Medicine, University of Verona, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Ina Kötter
- Asklepios Clinic Altona, Medical Department, Rheumatology, Immunology, Nephrology, Hamburg, Germany
| | | | - Andrea Doria
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padova, Italy
| | - Jörg Henes
- University Hospital Tuebingen, Centre for Interdisciplinary Clinical Immunology, Rheumatology and Auto-inflammatory Diseases and Department of Internal Medicine II (Haematology, Oncology, Immunology and Rheumatology), Germany
| | - Ulf Müller-Ladner
- Department of Rhumatology and Clinical Immunology, Justus-Liebig-University Giessen, Kerckhoff-Clinic Bad Nauheim, Germany
| | - Vanessa Smith
- Department of Rheumatology, University of Ghent, Belgium
| | - Jörg Distler
- Department of Internal Medicine 3, University Clinic Erlangen, Germany
| | - Armando Gabrielli
- Marche Polytechnic University, Institute of Clinical Medicine, University of Ancona, Italy
| | | | - Ulrich Walker
- Department of Rheumatology, University Hospital Basel, Switzerland
| | - Oliver Distler
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Switzerland
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