1
|
Gonzalez Diaz I, Gutierrez Riart M, Martin-Arranz MD, Plasencia Rodriguez C, Suarez Ferrer C. Incidence and Course of Joint Inflammation Associated with Inflammatory Bowel Disease in Patients Undergoing Treatment with Vedolizumab/ Ustekinumab: The VEDUSTAR Study. J Clin Med 2024; 13:1076. [PMID: 38398390 PMCID: PMC10889195 DOI: 10.3390/jcm13041076] [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: 01/11/2024] [Revised: 02/10/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The role of ustekinumab (UST) and vedolizumab (VDZ) in the extraintestinal joint manifestations of inflammatory bowel disease (IBD) remain unclear, and most existing studies are retrospective. The aim of this prospective study was to analyze the incidence of new-onset joint disease or the worsening of pre-existing IBD-associated joint disease in patients treated with UST and VDZ. METHODS The study population comprised IBD patients with previous spondyloarthritis (SpA) or new-onset arthropathy undergoing treatment with VDZ or UST. RESULTS Eighty patients were referred to rheumatology because of previous SpA or onset of symptoms. Most patients (90%) were anti-TNF experienced. Two patients with previous SpA (2/22; 9%) experienced a flare-up (one with UST and one with VDZ), and two patients with VDZ developed SpA during follow-up (2/58; 3%). Only one of these four patients did not have gastrointestinal symptoms, and VDZ was discontinued because of joint symptoms. The other three patients had concomitant intestinal activity, and treatment was not discontinued. CONCLUSION Our experience shows that treatment with UST and VDZ did not worsen joint disease in patients with SpA. Most remained stable or improved. In addition, poor control of IBD in patients with joint flare-ups could be the main cause of worsening SpA.
Collapse
Affiliation(s)
- Irene Gonzalez Diaz
- Gastroenterology Department, La Paz University Hospital, 28046 Madrid, Spain;
| | - Mariana Gutierrez Riart
- Rheumatology Department, La Paz University Hospital, 28046 Madrid, Spain; (M.G.R.); (C.P.R.)
| | - Maria Dolores Martin-Arranz
- Gastroenterology Department, La Paz University Hospital, 28046 Madrid, Spain;
- Hospital La Paz Institute for Health Research, La Paz University Hospital, 28046 Madrid, Spain
- Faculty of Medicine, Universidad Autónoma, 28046 Madrid, Spain
| | | | - Cristina Suarez Ferrer
- Gastroenterology Department, La Paz University Hospital, 28046 Madrid, Spain;
- Hospital La Paz Institute for Health Research, La Paz University Hospital, 28046 Madrid, Spain
| | | |
Collapse
|
2
|
Globig AM, Sommer NP, Wild K, Schardey J, Zoldan K, Thomann AK, Schulte LA, Schreiner R, Reindl W, Klaus J, Schempp CM, Hofmann M, Thimme R, Boettler T, Hasselblatt P. Ustekinumab Inhibits T Follicular Helper Cell Differentiation in Patients With Crohn's Disease. Cell Mol Gastroenterol Hepatol 2020; 11:1-12. [PMID: 32679193 PMCID: PMC7593584 DOI: 10.1016/j.jcmgh.2020.07.005] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS The pathogenesis of chronic inflammatory bowel diseases (Crohn's disease [CD] and ulcerative colitis) involves dysregulated TH1 and TH17 cell responses, which can be targeted therapeutically by the monoclonal antibody Ustekinumab directed against the joint p40 subunit of IL-12 and IL-23. These cytokines may also regulate the differentiation of T follicular helper (TFH) cells, which promote B cell function in germinal centers. However, the role of TFH cells in CD pathogenesis and impact of Ustekinumab therapy on TFH cell fate in patients are poorly defined. METHODS Lymphocytes were isolated from peripheral blood (n=45) and intestinal biopsies (n=15) of CD patients or healthy controls (n=21) and analyzed by flow cytometry to assess TFH cell phenotypes and functions ex vivo. In addition, TFH cell differentiation was analyzed in the presence of Ustekinumab in vitro. RESULTS TFH cell frequencies in the intestine as well as peripheral blood were associated with endoscopic as well as biochemical evidence of CD activity. CD patients with clinical response to Ustekinumab, but not those with response to anti-TNF antibodies, displayed reduced frequencies of circulating TFH cells in a concentration-dependent manner while the TFH phenotype was not affected by Ustekinumab therapy. In keeping with this notion, TFH cell differentiation was inhibited by Ustekinumab in vitro while TFH cell maintenance was not affected. Moreover, Ustekinumab therapy resulted in reduced germinal center activity in CD patients in vivo. CONCLUSIONS These data implicate TFH cells in the pathogenesis of CD and indicate that Ustekinumab therapy affects TFH cell differentiation, which may influence TFH-mediated immune functions in UST-treated CD patients.
Collapse
Affiliation(s)
- Anna-Maria Globig
- Department of Medicine II, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany,Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nikola Patricia Sommer
- Department of Medicine II, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina Wild
- Department of Medicine II, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Josefine Schardey
- Department of Medicine II, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina Zoldan
- Department of Medicine II, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anne Kerstin Thomann
- Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Rupert Schreiner
- Medical Care Center Dr. Limbach and Colleagues, Heidelberg, Germany
| | - Wolfgang Reindl
- Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jochen Klaus
- Department of Medicine I, University Hospital Ulm, Ulm, Germany
| | - Christoph Mathis Schempp
- Department of Dermatology and Venerology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maike Hofmann
- Department of Medicine II, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Robert Thimme
- Department of Medicine II, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tobias Boettler
- Department of Medicine II, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Peter Hasselblatt
- Department of Medicine II, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany,Correspondence Address requests for correspondence to: Peter Hasselblatt, MD, Department of Medicine II, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, D-79106 Freiburg, Germany. fax: ++49 761 270 33530.
| |
Collapse
|
3
|
Perez-Liva M, Udías JM, Camacho J, Merčep E, Deán-Ben XL, Razansky D, Herraiz JL. Speed of sound ultrasound transmission tomography image reconstruction based on Bézier curves. Ultrasonics 2020; 103:106097. [PMID: 32078843 DOI: 10.1016/j.ultras.2020.106097] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 01/09/2020] [Accepted: 01/09/2020] [Indexed: 02/07/2023]
Abstract
Speed of Sound (SoS) maps from ultrasound tomography (UST) provide valuable quantitative information for soft tissue characterization and identification of lesions, making this technique interesting for breast cancer detection. However, due to the complexity of the processes that characterize the interaction of ultrasonic waves with matter, classic and fast tomographic algorithms such as back-projection are not suitable. Consequently, the image reconstruction process in UST is generally slow compared to other more conventional medical tomography modalities. With the aim of facilitating the translation of this technique into real clinical practice, several reconstruction algorithms are being proposed to make image reconstruction in UST to be a fast and accurate process. The geometrical acoustic approximation is often used to reconstruct SoS with less computational burden in comparison with full-wave inversion methods. In this work, we propose a simple formulation to perform on-the-flight reconstruction for UST using geometrical acoustics with refraction correction based on quadratic Bézier polynomials. Here we demonstrate that the trajectories created with these polynomials are an accurate approximation to reproduce the refracted acoustic paths connecting the emitter and receiver transducers. The method is faster than typical acquisition times in UST. Thus, it can be considered a step towards real-time reconstructions, which may contribute to its future clinical translation.
Collapse
Affiliation(s)
- Mailyn Perez-Liva
- Grupo de Física Nuclear and IPARCOS, Univ. Complutense de Madrid, CEI Moncloa, Spain; Université de Paris, PARCC, INSERM, F-75015 Paris, France.
| | - José Manuel Udías
- Grupo de Física Nuclear and IPARCOS, Univ. Complutense de Madrid, CEI Moncloa, Spain; Instituto de Investigación Biomédica, Hospital General Universitario Carlos III, Madrid, Spain
| | - Jorge Camacho
- Ultrasound Systems and Technology Group (GSTU), Spanish National Research Council (CSIC), Madrid, Spain
| | - Elena Merčep
- iThera Medical GmbH, Munich, Germany; Faculty of Medicine, Technical University of Munich, Germany
| | - Xosé Luís Deán-Ben
- Faculty of Medicine and Institute of Pharmacology and Toxicology, University of Zurich, Switzerland; Institute for Biomedical Engineering and Department of Information Technology and Electrical Engineering, ETH Zurich, Switzerland
| | - Daniel Razansky
- Faculty of Medicine and Institute of Pharmacology and Toxicology, University of Zurich, Switzerland; Institute for Biomedical Engineering and Department of Information Technology and Electrical Engineering, ETH Zurich, Switzerland
| | - Joaquín L Herraiz
- Grupo de Física Nuclear and IPARCOS, Univ. Complutense de Madrid, CEI Moncloa, Spain; Instituto de Investigación Biomédica, Hospital General Universitario Carlos III, Madrid, Spain
| |
Collapse
|
4
|
Guignet D, Jenkins R, Ranson M, Walsh P. Contamination and Incomplete Information:: Bounding Implicit Prices using High-Profile Leaks. J Environ Econ Manage 2018; 88:259-282. [PMID: 30996495 PMCID: PMC6463534 DOI: 10.1016/j.jeem.2017.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Incomplete information can lead households to underprice environmental disamenities in the housing market. To bound true implicit prices, researchers sometimes turn to high-profile cases involving significant media and community attention. However, prior research also finds that high-profile cases can lead to "stigma" effects that may confound interpretation of implicit prices. This study compares these opposing effects at the highest profile underground storage tank releases across the United States over the last thirty years. We utilize covariate matching and estimate difference-in-differences hedonic regressions at each site, and then conduct a cross-site meta-analysis to estimate the average treatment effects. We find an average housing price depreciation of 2% to 6% upon discovery of a release, which is an upper bound on the implicit price of contamination at more typical sites. Following cleanup, we find a housing price appreciation of a similar magnitude, suggesting that even in high-profile cases, surrounding neighborhoods do not experience persistent stigma.
Collapse
Affiliation(s)
- Dennis Guignet
- National Center for Environmental Economics, U.S. EPA
- Corresponding Author National Center for Environmental Economics, US Environmental Protection Agency, Mail Code 1809 T, 1200 Pennsylvania Avenue, N.W., Washington, DC 20460, USA, Phone: +1-202-566-1573,
| | - Robin Jenkins
- National Center for Environmental Economics, U.S. EPA
| | | | | |
Collapse
|
5
|
Salpietro V, Ruggieri M, Mankad K, Di Rosa G, Granata F, Loddo I, Moschella E, Calabro MP, Capalbo A, Bernardini L, Novelli A, Polizzi A, Seidler DG, Arrigo T, Briuglia S. A de novo 0.63 Mb 6q25.1 deletion associated with growth failure, congenital heart defect, underdeveloped cerebellar vermis, abnormal cutaneous elasticity and joint laxity. Am J Med Genet A 2015; 167A:2042-51. [PMID: 25940952 DOI: 10.1002/ajmg.a.37118] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Accepted: 02/20/2015] [Indexed: 11/09/2022]
Abstract
Deletions of the long arm of chromosome 6 are rare and are characterized by great clinical variability according to the deletion breakpoint. We report a on 6-year-old girl with a de novo 0.63 Mb deletion on chromosome 6q25.1 who demonstrated multiple congenital anomalies including a ventricular septal defect and an underdeveloped cerebellar vermis. She presented with severe pre- and post-natal growth failure, hyperextensible small joints (Beighton scores = 8/9; with normal parental scores), and an abnormally elastic, redundant skin. Abnormally high upper/lower segment ratio (i.e., 1.34 = > 3SD), mild dysmorphic facial features and developmental delay were also present. The girl's phenotype was compared with: (i) two girls, each previously reported by Bisgaard et al. and Caselli et al. with similar albeit larger (2.6-7.21 Mb) deletions; (ii) seven additional individuals (6 M; 1 F) harboring deletions within the 6q25.1 region reported in the literature; and (iii) ten further patients (5 M; 4 F; 1 unrecorded sex) recorded in the DECIPHER 6.0 database. We reported on the present girl as her findings could contribute to advance the phenotype of 6q deletions. In addition, the present deletion is the smallest so far recorded in the 6q25 region encompassing eight known genes [vs. 41 of Bisgaard et al., and 23 of Caselli et al.,], including the TAB2 (likely responsible for the girl's congenital heart defect), LATS1 gene, and the UST gene (a regulator of the homeostasis of proteoglycans, which could have played a role in the abnormal dermal and cartilage elasticity).
Collapse
Affiliation(s)
- Vincenzo Salpietro
- Department of Paediatric Neurology, Chelsea and Westminster Hospital, London, United Kingdom.,Unit of Genetics and Paediatric Immunology, Department of Paediatrics, University of Messina, Messina, Italy
| | - Martino Ruggieri
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Kshitij Mankad
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Gabriella Di Rosa
- Unit of Infantile Neuropsychiatry, Department of Paediatrics, University of Messina, Messina, Italy
| | - Francesca Granata
- Unit of Neuroradiology, Department of Biomedical Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Italia Loddo
- Unit of Genetics and Paediatric Immunology, Department of Paediatrics, University of Messina, Messina, Italy
| | - Emanuela Moschella
- Unit of Genetics and Paediatric Immunology, Department of Paediatrics, University of Messina, Messina, Italy
| | - Maria Pia Calabro
- Unit of Pediatric Cardiology, Department of Paediatrics, University of Messina, Messina, Italy
| | - Anna Capalbo
- Institute of Medical Genetics, "CSS-Mendel" Institute, Rome, Italy
| | - Laura Bernardini
- Institute of Medical Genetics, "CSS-Mendel" Institute, Rome, Italy
| | | | - Agata Polizzi
- Institute of Neurological Sciences, National Research Council, Catania, Italy.,National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Daniela G Seidler
- Institute for Physiological Chemistry and Pathobiochemistry, University of Munster, Munster, Germany
| | - Teresa Arrigo
- Unit of Genetics and Paediatric Immunology, Department of Paediatrics, University of Messina, Messina, Italy
| | - Silvana Briuglia
- Unit of Genetics and Paediatric Immunology, Department of Paediatrics, University of Messina, Messina, Italy
| |
Collapse
|