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Cedeno M, Murillo-Saich J, Coras R, Cedola F, Brandy A, Prior A, Pedersen A, Mateo L, Martinez-Morillo M, Guma M. Serum metabolomic profiling identifies potential biomarkers in arthritis in older adults: an exploratory study. Metabolomics 2023; 19:37. [PMID: 37022535 DOI: 10.1007/s11306-023-02004-y] [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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 03/29/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Seronegative elderly-onset rheumatoid arthritis (EORA)neg and polymyalgia rheumatica (PMR) have similar clinical characteristics making them difficult to distinguish based on clinical features. We hypothesized that the study of serum metabolome could identify potential biomarkers of PMR vs. EORAneg. METHODS Arthritis in older adults (ARTIEL) is an observational prospective cohort with patients older than 60 years of age with newly diagnosed arthritis. Patients' blood samples were compared at baseline with 18 controls. A thorough clinical examination was conducted. A Bruker Avance 600 MHz spectrometer was used to acquire Nuclear Magnetic Resonance (NMR) spectra of serum samples. Chenomx NMR suite 8.5 was used for metabolite identification and quantification.Student t-test, one-way ANOVA, binary linear regression and ROC curve, Pearson's correlation along with pathway analyses were conducted. RESULTS Twenty-eight patients were diagnosed with EORAneg and 20 with PMR. EORAneg patients had a mean disease activity score (DAS)-Erythrocyte Sedimentation Rate (ESR) of 6.21 ± 1.00. All PMR patients reported shoulder pain, and 90% reported pelvic pain. Fifty-eight polar metabolites were identified. Of these, 3-hydroxybutyrate, acetate, glucose, glycine, lactate, and o-acetylcholine (o-ACh), were significantly different between groups. Of interest, IL-6 correlated with different metabolites in PMR and EORAneg suggesting different inflammatory activated pathways. Finally, lactate, o-ACh, taurine, and sex (female) were identified as distinguishable factors of PMR from EORAneg with a sensitivity of 90%, specificity of 92.3%, and an AUC of 0.925 (p < 0.001). CONCLUSION These results suggest that EORAneg and PMR have different serum metabolomic profiles that might be related to their pathobiology and can be used as biomarker to discriminate between both diseases.
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Affiliation(s)
- Martha Cedeno
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Jessica Murillo-Saich
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Roxana Coras
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
- Department of Medicine, Autonomous University of Barcelona, Plaça Cívica, Bellaterra, Barcelona, 08193, Spain
| | - Francesca Cedola
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Anahy Brandy
- Department of Rheumatology, Germans Trias i Pujol, University Hospital, Carretera de Canyet, Badalona, 08916, Spain
| | - Agueda Prior
- Department of Rheumatology, Germans Trias i Pujol, University Hospital, Carretera de Canyet, Badalona, 08916, Spain
| | - Anders Pedersen
- Swedish NMR Centre, University of Gothenburg, Gothenburg, 41390, Sweden
| | - Lourdes Mateo
- Department of Rheumatology, Germans Trias i Pujol, University Hospital, Carretera de Canyet, Badalona, 08916, Spain
| | - Melania Martinez-Morillo
- Department of Rheumatology, Germans Trias i Pujol, University Hospital, Carretera de Canyet, Badalona, 08916, Spain.
| | - Monica Guma
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA.
- Department of Medicine, Autonomous University of Barcelona, Plaça Cívica, Bellaterra, Barcelona, 08193, Spain.
- VA Healthcare Service, San Diego, CA, 92161, USA.
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Coras R, Martino C, Gauglitz JM, Cedola F, Tripathi A, Jarmusch AK, Alharthi M, Fernandez‐Bustamante M, Agustin‐Perez M, Singh A, Choi S, Rivera T, Nguyen K, Shekhtman T, Holt T, Lee S, Golshan S, Dorrestein PC, Knight R, Guma M. Baseline microbiome and metabolome are associated with response to ITIS diet in an exploratory trial in patients with rheumatoid arthritis. Clin Transl Med 2022; 12:e959. [PMID: 35802808 PMCID: PMC9269999 DOI: 10.1002/ctm2.959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 01/30/2023] Open
Affiliation(s)
- Roxana Coras
- Department of Medicine, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA,Department of MedicineAutonomous University of BarcelonaBarcelonaSpain
| | - Cameron Martino
- Center for Microbiome Innovation, Joan and Irwin Jacobs School of EngineeringUniversity of California San DiegoSan DiegoCaliforniaUSA,Department of Pediatrics, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA,Bioinformatics and Systems Biology ProgramUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Julia M. Gauglitz
- Department of PharmacologySkaggs School of Pharmacy and Pharmaceutical SciencesUniversity of California San DiegoSan DiegoCaliforniaUSA,Collaborative Mass Spectrometry Innovation CenterUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Francesca Cedola
- Department of Medicine, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Anupriya Tripathi
- Department of Pediatrics, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA,Department of PharmacologySkaggs School of Pharmacy and Pharmaceutical SciencesUniversity of California San DiegoSan DiegoCaliforniaUSA,Graduate Program in Biological Sciences, School of Biological Sciences, UCSDDivision of Biological SciencesUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Alan K. Jarmusch
- Center for Microbiome Innovation, Joan and Irwin Jacobs School of EngineeringUniversity of California San DiegoSan DiegoCaliforniaUSA,Department of Pediatrics, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Maram Alharthi
- Department of Medicine, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA
| | | | - Meritxell Agustin‐Perez
- Department of Medicine, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Abha Singh
- Department of Medicine, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Soo‐In Choi
- Department of Medicine, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Tania Rivera
- Department of Medicine, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Katherine Nguyen
- Department of Medicine, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Tatyana Shekhtman
- Department of PsychiatryUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Tiffany Holt
- Department of PsychiatryUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Susan Lee
- Department of Medicine, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Shahrokh Golshan
- Department of PsychiatryUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Pieter C. Dorrestein
- Center for Microbiome Innovation, Joan and Irwin Jacobs School of EngineeringUniversity of California San DiegoSan DiegoCaliforniaUSA,Department of Pediatrics, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA,Department of PharmacologySkaggs School of Pharmacy and Pharmaceutical SciencesUniversity of California San DiegoSan DiegoCaliforniaUSA,Collaborative Mass Spectrometry Innovation CenterUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Rob Knight
- Center for Microbiome Innovation, Joan and Irwin Jacobs School of EngineeringUniversity of California San DiegoSan DiegoCaliforniaUSA,Department of Pediatrics, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA,Department of Computer Science and EngineeringUniversity of California San DiegoSan DiegoCaliforniaUSA,Department of BioengineeringUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Monica Guma
- Department of Medicine, School of MedicineUniversity of California San DiegoSan DiegoCaliforniaUSA,Department of MedicineAutonomous University of BarcelonaBarcelonaSpain,Department of MedicineVA San Diego Healthcare SystemSan DiegoCaliforniaUSA
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Bustamante MF, Agustín-Perez M, Cedola F, Coras R, Narasimhan R, Golshan S, Guma M. Design of an anti-inflammatory diet (ITIS diet) for patients with rheumatoid arthritis. Contemp Clin Trials Commun 2020; 17:100524. [PMID: 32025586 PMCID: PMC6997513 DOI: 10.1016/j.conctc.2020.100524] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 09/26/2019] [Revised: 01/01/2020] [Accepted: 01/11/2020] [Indexed: 12/17/2022] Open
Abstract
Background Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that affects synovial joints, leading to inflammation, joint destruction, loss of function, and disability. Although recent pharmaceutical advances have improved treatment of RA, patients with RA often inquire about dietary interventions to improve RA symptoms, as they perceive rapid changes in their symptoms after consumption of certain foods. There is evidence that some ingredients have pro- or anti-inflammatory effects. In addition, recent literature has shown a link between diet and microbiome changes. Both diet and the gut microbiome are linked to circulating metabolites that may modulate inflammation. However, evidence of the effects of an anti-inflammatory and probiotic-rich diet in patients with RA is scarce. There is also a need for biological data to support its anti-inflammatory effects. Methods The main goal of this study is to delineate the design process for a diet tailored to our RA population. To achieve this goal, we collected information on diet, supplements, cooking methods, and intake of different ingredients for each patient. Different groups were interviewed, and their feedback was assessed to design a diet that incorporates suggested anti-inflammatory ingredients in a manner that was easy for patients to adopt based on their lifestyles and backgrounds. Results We designed a diet that includes a high intake of potential anti-inflammatory ingredients. Feedback from highly motivated patients was critical in constructing an anti-inflammatory diet (ITIS diet) with elevated adherence. Conclusion In order to tailor our diet, we surveyed our patients on several different parameters. We obtained important feedback on how feasible our ITIS diet is for RA patients. Using this feedback, we made minor improvements and finalized the design of the ITIS diet. This diet is being used in an on-going pilot study to determine their anti-inflammatory effect in pain and joint swelling in RA patients. Trial registration Not applicable.
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Affiliation(s)
- Marta F Bustamante
- Department of Medicine, University of California San Diego, San Diego, CA, USA
| | | | - Francesca Cedola
- Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Roxana Coras
- Department of Medicine, University of California San Diego, San Diego, CA, USA.,Department of Medicine, Autonomous University of Barcelona, Plaça Cívica, 08193, Bellaterra, Barcelona, Spain
| | - Rekha Narasimhan
- Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Shahrokh Golshan
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Monica Guma
- Department of Medicine, University of California San Diego, San Diego, CA, USA.,Department of Medicine, Autonomous University of Barcelona, Plaça Cívica, 08193, Bellaterra, Barcelona, Spain
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Triggianese P, Cesareo M, Guarino MD, Conigliaro P, Chimenti MS, Cedola F, Mazzeo C, Nucci C, Perricone R. Evaluation of retinal microvascular perfusion in hereditary angioedema: a case-control study. Orphanet J Rare Dis 2020; 15:20. [PMID: 31952522 PMCID: PMC6969431 DOI: 10.1186/s13023-019-1263-6] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 11/22/2019] [Indexed: 11/30/2022] Open
Abstract
Evidence supports that hereditary angioedema (HAE) may be considered as a paroxysmal permeability disorder with defective but self-limiting endothelial barrier dysfunction. A potential subclinical abnormal vascular permeability at retinal capillaries could induce damage resulting in retinopathy. We aimed at exploring for the first time the presence of microangiopathy at retinal level from a highly selective cohort of patients with HAE due to C1 esterase inhibitor protein (C1INH) deficiency (type I). We conducted a pilot, prospective, case-control study including 20 type I HAE patients and 20 age−/sex-matched healthy controls (HC). All participants underwent standard ophthalmological examination including visual fields. Superficial and deep capillary plexi in the retina were analyzed by using new optical coherence tomography angiography (OCT-A). A total of 40 eyes from 20 HAE patients and 20 eyes from HC were evaluated. Perimetric indices of visual field were slightly worse in HAE than in controls. OCT-angiograms documented in HAE patients a lower retinal capillary density in both superficial and deep scans and a higher retinal thickness compared to healthy eyes. Our findings firstly documented subclinical abnormalities in retinal microvascular network in type I HAE patients that might be associated with early subtle functional changes. This preliminary evidence supports the hypothesis of a recurrent endothelial barrier failure at retinal level in HAE patients potentially resulting in chronic damage.
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Affiliation(s)
- Paola Triggianese
- Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Rome, Italy.
| | - Massimo Cesareo
- Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Maria Domenica Guarino
- Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Rome, Italy
| | - Paola Conigliaro
- Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Rome, Italy
| | - Maria Sole Chimenti
- Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Rome, Italy
| | - Francesca Cedola
- Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Rome, Italy
| | - Caterina Mazzeo
- Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Roberto Perricone
- Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Rome, Italy
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Chimenti MS, Conigliaro P, Triggianese P, Canofari C, Cedola F, Onali S, Calabrese E, Romeo S, Neri B, De Cristofaro E, Biancone L, Perricone R. Use of synthetic and biological DMARDs in patients with enteropathic spondyloarthritis: a combined gastro-rheumatological approach. Clin Exp Rheumatol 2019; 37:723-730. [PMID: 31172920] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 10/08/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The aim of this 2-year prospective study was to assess the diagnostic and therapeutic effect of a combined gastro-rheumatological approach in enteropathic spondyloarthritis (eSpA) patients. METHODS Inflammatory bowel disease (IBD) patients with joint pain were referred by IBD-dedicated gastroenterologists to a dedicated rheumatologist. At baseline and at 3, 6, 12, 24 months, the following parameters were recorded: clinical and biochemical variables, SpA and IBD activity scores, treatment (conventional synthetic; csDMARDs, biologics; bDMARDs). Associations between treatment and patient characteristics were evaluated by logistic regression (AOR [95% CI]). RESULTS Overall, 229 IBD patients were referred to rheumatologists. eSpA was diagnosed in 147 (64.2%) patients: 96 (65.3%) showing peripheral and 51 (34.7%) axial involvement. IBD included Crohn's disease (CD) in 141 (61.6%) and ulcerative colitis (UC) in 88 (38.4%). bDMARD treatment increased over the follow-up (baseline-24 months: 32.7-60%; AOR 3.45 [1.93-6.2], p<0.001). bDMARD use was less frequent in elderly patients (AOR 0.73 [0.56-0.96], p=0.023), in UC (AOR 0.43 [0.2-0.94], p=0.034) and in patients with peripheral involvement (AOR 0.53 [0.3-1.04], p=0.067). csDMARD use was increased in patients with peripheral involvement (AOR 4.65 [2.09-10.33], p<0.001) and in UC (AOR 2.30 [1.13-4.67], p=0.021). CRP, ESR, ASDAS-ESR levels and BASFI significantly decreased over the follow-up, whereas the pMayo score, BASDAI and HAQ-S were unchanged. CONCLUSIONS In this prospective study in eSpA patients, a multidisciplinary approach was shown to optimise the therapeutic management and outcome (e.g. disease activity scores). bDMARD use paralleled an improvement in disease activity scores and confirmed a good safety profile.
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Affiliation(s)
- Maria Sole Chimenti
- Department of Systems Medicine, Rheumatology, Allergology and Clinical Immunology, University of Rome 'Tor Vergata', Rome, Italy.
| | - Paola Conigliaro
- Department of Systems Medicine, Rheumatology, Allergology and Clinical Immunology, University of Rome 'Tor Vergata', Rome, Italy
| | - Paola Triggianese
- Department of Systems Medicine, Rheumatology, Allergology and Clinical Immunology, University of Rome 'Tor Vergata', Rome, Italy
| | - Claudia Canofari
- Department of Systems Medicine, Rheumatology, Allergology and Clinical Immunology, University of Rome 'Tor Vergata', Rome, Italy
| | - Francesca Cedola
- Department of Systems Medicine, Rheumatology, Allergology and Clinical Immunology, University of Rome 'Tor Vergata', Rome, Italy
| | - Sara Onali
- Department of Systems Medicine, Rheumatology, Allergology and Clinical Immunology, University of Rome 'Tor Vergata', Rome, Italy
| | - Emma Calabrese
- Department of Systems Medicine, Unit of Gastroenterology, University of Rome 'Tor Vergata', Rome, Italy
| | - Samanta Romeo
- Department of Systems Medicine, Unit of Gastroenterology, University of Rome 'Tor Vergata', Rome, Italy
| | - Benedetto Neri
- Department of Systems Medicine, Unit of Gastroenterology, University of Rome 'Tor Vergata', Rome, Italy
| | - Elena De Cristofaro
- Department of Systems Medicine, Unit of Gastroenterology, University of Rome 'Tor Vergata', Rome, Italy
| | - Livia Biancone
- Department of Systems Medicine, Unit of Gastroenterology, University of Rome 'Tor Vergata', Rome, Italy
| | - Roberto Perricone
- Department of Systems Medicine, Rheumatology, Allergology and Clinical Immunology, University of Rome 'Tor Vergata', Rome, Italy
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Triggianese P, Watad A, Cedola F, Perricone C, Amital H, Giambini I, Perricone R, Shoenfeld Y, De Carolis C. Vitamin D deficiency in an Italian cohort of infertile women. Am J Reprod Immunol 2017; 78. [DOI: 10.1111/aji.12733] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 07/11/2017] [Indexed: 12/21/2022] Open
Affiliation(s)
- Paola Triggianese
- Rheumatology, Allergology and Clinical Immunology; Department of “Medicina dei Sistemi”; University of Rome Tor Vergata; Rome Italy
| | - Abdulla Watad
- Department of Medicine ‘B’; Tel-Aviv University; Tel-Aviv Israel
- Zabludowicz center for Autoimmune Diseases; Tel-Aviv University; Tel-Aviv Israel
- Sackler Faculty of Medicine; Tel-Aviv University; Tel-Aviv Israel
| | - Francesca Cedola
- Rheumatology, Allergology and Clinical Immunology; Department of “Medicina dei Sistemi”; University of Rome Tor Vergata; Rome Italy
| | - Carlo Perricone
- Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche; Sapienza Università di Roma; Rome Italy
| | - Howard Amital
- Department of Medicine ‘B’; Tel-Aviv University; Tel-Aviv Israel
- Zabludowicz center for Autoimmune Diseases; Tel-Aviv University; Tel-Aviv Israel
- Sackler Faculty of Medicine; Tel-Aviv University; Tel-Aviv Israel
| | - Ilio Giambini
- Department of Laboratory Medicine; Tor Vergata University Hospital of Rome; Rome Italy
| | - Roberto Perricone
- Rheumatology, Allergology and Clinical Immunology; Department of “Medicina dei Sistemi”; University of Rome Tor Vergata; Rome Italy
| | - Yehuda Shoenfeld
- Department of Medicine ‘B’; Tel-Aviv University; Tel-Aviv Israel
- Zabludowicz center for Autoimmune Diseases; Tel-Aviv University; Tel-Aviv Israel
| | - Caterina De Carolis
- Polymedical Center for Prevention of Recurrent Spontaneous Abortion; Rome Italy
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