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Zheng XJ, Chen Y, Yao L, Li XL, Sun D, Li YQ. Identification of new hub- ferroptosis-related genes in Lupus Nephritis. Autoimmunity 2024; 57:2319204. [PMID: 38409788 DOI: 10.1080/08916934.2024.2319204] [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: 10/26/2023] [Accepted: 02/11/2024] [Indexed: 02/28/2024]
Abstract
Background: Lupus Nephritis (LN) is the primary causation of kidney injury in systemic lupus erythematosus (SLE). Ferroptosis is a programmed cell death. Therefore, understanding the crosstalk between LN and ferroptosis is still a significant challenge. Methods: We obtained the expression profile of LN kidney biopsy samples from the Gene Expression Omnibus database and utilised the R-project software to identify differentially expressed genes (DEGs). Then, we conducted a functional correlation analysis. Ferroptosis-related genes (FRGs) and differentially expressed genes (DEGs) crossover to select FRGs with LN. Afterwards, we used CIBERSORT to assess the infiltration of immune cells in both LN tissues and healthy control samples. Finally, we performed immunohistochemistry on LN human renal tissue. Results: 10619 DEGs screened from the LN biopsy tissue were identified. 22 hub-ferroptosis-related genes with LN (FRGs-LN) were screened out. The CIBERSORT findings revealed that there were significant statistical differences in immune cells between healthy control samples and LN tissues. Immunohistochemistry further demonstrated a significant difference in HRAS, TFRC, ATM, and SRC expression in renal tissue between normal and control groups. Conclusion: We developed a signature that allowed us to identify 22 new biomarkers associated with FRGs-LN. These findings suggest new insights into the pathology and therapeutic potential of LN ferroptosis inhibitors and iron chelators.
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Affiliation(s)
- Xiao-Jie Zheng
- Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ying Chen
- Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Li Yao
- Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiao-Li Li
- Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Da Sun
- Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yan-Qiu Li
- Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang, China
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Zhang L, Zhu W, Ye J. Psychological status is associated with the perceived illness stigma in Chinese systemic lupus erythematosus patients. PSYCHOL HEALTH MED 2024; 29:1035-1043. [PMID: 37840241 DOI: 10.1080/13548506.2023.2270511] [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: 04/19/2022] [Accepted: 10/04/2023] [Indexed: 10/17/2023]
Abstract
Systemic lupus erythematosus (SLE) might affect all aspects of life including perceived stigma, but research on perceived stigma is still in its infancy among SLE patients. The objective of this study was to assess the relationships among socioeconomic status, clinical parameters, disease activity, quality of life, depression, and the perceived stigma in Chinese patients with SLE. A total of 133 SLE patients (mean age: 39.36 ± 12.91 years) were included in this cross-sectional study. All data were collected consecutively by face-to-face questionnaires from January 2021 to January 2022. SLE patients completed questionnaires for demographic or clinical variables, the 10-cm Visual Analog Scale for pain, the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) for disease activity, the patient health questionnaire-9 (PHQ-9) for depression, the Perceived Devaluation Discrimination (PDD) Scale for the perceived stigma, and the Short Form 12 health survey (SF-12) for quality of life. Independent sample t-test, Spearman or Pearson correlations analysis, and the multivariable linear regression model were used to analyze these data. The mean PDD scale score in the SLE patients was 2.79 ± 0.33, which were statistically significant compared with the midpoint (2.50 ± 0.38) of the scale (P < 0.05). The perceived stigma was significantly correlated with income, pain, disease activity, depression, and quality of life. The SF-12 mental composite summaries (MCS) score and depression were the important predictors of the perceived stigma by the multivariable linear regression. This study demonstrates that psychological status is significantly associated with the perceived illness stigma in Chinese SLE patients; dealing with this stigma may be important in promoting optimal coping for these patients.
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Affiliation(s)
- Lijuan Zhang
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiyi Zhu
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junna Ye
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Li Y, Zhou Q, Meng X. Acute myocardial infarction due to spontaneous coronary artery dissection in a young male with systemic lupus erythematosus: A case report. Exp Ther Med 2024; 27:246. [PMID: 38655037 PMCID: PMC11036367 DOI: 10.3892/etm.2024.12534] [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: 10/21/2023] [Accepted: 02/20/2024] [Indexed: 04/26/2024] Open
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease which typically presents in young women. Patients with SLE exhibit features of accelerated atherosclerosis. Here, the present study reported a rare case of acute myocardial infarction (AMI) in a male patient diagnosed with SLE. A 29-year-old male with no cardiovascular history was diagnosed with AMI and underwent coronary angiography, which showed a long-extended spiral-shaped dissection of the right coronary artery (RCA). The patient's autoimmune panel tested positive for antinuclear, anti-nuclear ribonucleoprotein/Smith and anti-Sjogren's syndrome A antibodies. The patient was diagnosed with SLE and was administered prednisone, hydroxychloroquine and calcium carbonate therapy. At the 3-month follow-up, a repeat coronary angiography showed no dissection in the RCA. Intravascular ultrasound and optical coherence tomography also showed an isolated atherosclerotic lesion without arterial dissection in the RCA. To the best of our knowledge, this is the first reported case of a male patient with SLE who developed myocardial infarction caused by spontaneous coronary artery dissection (SCAD). The present report may provide new insights into possible future treatments for SCAD. SCAD should be considered in patients with SLE and AMI, particularly in young patients without cardiovascular risk factors. Early diagnosis of SCAD is important to provide accurate therapy that differs from the treatment of AMI caused by atherosclerosis.
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Affiliation(s)
- Yunyi Li
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Quan Zhou
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Xiao Meng
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, P.R. China
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DeQuattro K, Trupin L, Patterson S, Rush S, Gordon C, Greenlund KJ, Barbour KE, Lanata C, Criswell LA, Dall'Era M, Yazdany J, Katz PP. Positive psychosocial factors may protect against perceived stress in people with systemic lupus erythematosus with and without trauma history. Lupus Sci Med 2024; 11:e001060. [PMID: 38754905 PMCID: PMC11097884 DOI: 10.1136/lupus-2023-001060] [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: 09/23/2023] [Accepted: 04/20/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVE Trauma history is associated with SLE onset and worse patient-reported outcomes; perceived stress is associated with greater SLE disease activity. Stress perceptions vary in response to life events and may be influenced by psychosocial factors. In an SLE cohort, we examined whether stressful events associated with perceived stress, whether psychosocial factors affected perceived stress, and whether these relationships varied by prior trauma exposure. METHODS This is a cross-sectional analysis of data from the California Lupus Epidemiology Study, an adult SLE cohort. Multivariable linear regression analyses controlling for age, gender, educational attainment, income, SLE damage, comorbid conditions, glucocorticoids ≥7.5 mg/day and depression examined associations of recent stressful events (Life Events Inventory) and positive (resilience, self-efficacy, emotional support) and negative (social isolation) psychosocial factors with perceived stress. Analyses were stratified by lifetime trauma history (Brief Trauma Questionnaire (BTQ)) and by adverse childhood experiences (ACEs) in a subset. RESULTS Among 242 individuals with SLE, a greater number of recent stressful events was associated with greater perceived stress (beta (95% CI)=0.20 (0.07 to 0.33), p=0.003). Positive psychosocial factor score representing resilience, self-efficacy and emotional support was associated with lower perceived stress when accounting for number of stressful events (-0.67 (-0.94 to -0.40), p<0.0001); social isolation was associated with higher stress (0.20 (0.14 to 0.25), p<0.0001). In analyses stratified by BTQ trauma and ACEs, associations of psychosocial factors and perceived stress were similar between groups. However, the number of recent stressful events was significantly associated with perceived stress only for people with BTQ trauma (0.17 (0.05 to 0.29), p=0.0077) and ACEs (0.37 (0.15 to 0.58), p=0.0011). CONCLUSION Enhancing positive and lessening negative psychosocial factors may mitigate deleterious perceived stress, which may improve outcomes in SLE, even among individuals with a history of prior trauma who may be more vulnerable to recent stressful events.
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Affiliation(s)
| | - Laura Trupin
- University of California San Francisco, San Francisco, California, USA
| | - Sarah Patterson
- University of California San Francisco, San Francisco, California, USA
| | - Stephanie Rush
- University of California San Francisco, San Francisco, California, USA
| | - Caroline Gordon
- Rheumatology Research Group, University of Birmingham, Birmingham, UK
| | - Kurt J Greenlund
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kamil E Barbour
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Lindsey A Criswell
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Maria Dall'Era
- University of California San Francisco, San Francisco, California, USA
| | - Jinoos Yazdany
- University of California San Francisco, San Francisco, California, USA
| | - Patricia P Katz
- University of California San Francisco, San Francisco, California, USA
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Rajagopal V, Bains A, Kannan K, Bhardwaj A, Elhence P. Uncommon toxic epidermal necrolysis -like presentation of cutaneous lupus erythematosus: A series of 6 cases. Lupus 2024:9612033241255266. [PMID: 38745410 DOI: 10.1177/09612033241255266] [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: 05/16/2024]
Abstract
TEN like Lupus erythematosus is an uncommon life-threatening variant of Lupus erythematosus. It is usually associated with flares of systemic lupus erythematosus and also because of widespread skin erosions, it can cause acute skin failure. It is often confused with drug induced TEN, however the management of both the diseases is different and hence correct diagnosis becomes crucial. In this study we aimed to assess the clinical characteristics and outcome of TEN like LE in the Indian population. All patients satisfying ACR/EULAR 2019 criteria for SLE and clinically diagnosed with TEN like LE were retrospectively reviewed. A total of 6 patients were identified. All patients were female. Except 1 patient who presented de-novo, the others had pre-existing symptoms of connective tissue disease. Half of the patients had palmoplantar involvement. Mucosal involvement was only mild. Majority had systemic involvement in the form of nephritis followed by arthralgia, autoimmune hepatitis and autoimmune hemolytic anemia.
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Affiliation(s)
| | - Anupama Bains
- Department of Dermatology, AIIMS Jodhpur, Jodhpur, India
| | | | | | - Poonam Elhence
- Department of Pathology and Lab Medicine, AIIMS Jodhpur, Jodhpur, India
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6
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Sener S, Sag E, Han X, Bilginer Y, Zhou Q, Ozen S. Detection of genetic mutations underlying early-onset systemic lupus erythematosus. Lupus 2024:9612033241255011. [PMID: 38739464 DOI: 10.1177/09612033241255011] [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: 05/16/2024]
Abstract
OBJECTIVE We aimed to investigate the presence of monogenic causes of systemic lupus erythematosus (SLE) in our early-onset SLE patients. METHODS Fifteen pediatric SLE cases who had early disease onset (≤6 years) were enrolled in this study. All patients fulfilled the Systemic Lupus International Collaborating Clinics (SLICC) criteria. Genomic DNA was used for whole exome sequencing (WES). Pathogenic variants were confirmed by Sanger sequencing. RESULTS The median age at diagnosis of 15 early-onset SLE patients included in the study was 4 (2-6) years (F/M = 12/3). Significant gene mutations were detected in five of these patients (33.3%). Patients 1 and 2 with homozygous DNASE1L3 mutations [c.320+4_320+7del and G188 A (c.563 G>C) variants] had skin involvement and oral ulcers. One of them (patient 1) had arthritis and nephritis, and another (patient 2) had nonscarring alopecia and thrombocytopenia. They are currently clinically inactive but have positive serological findings. Patient 3 with homozygous pathogenic ACP5 mutation [G109 R (c.325 G>A) variant] had arthritis, nephritis, short stature, and skeletal dysplasia. Patient 4 with a heterozygote novel IFIH1 mutation [L809 F (c.2425 C>T) variant] had skin findings and leukopenia. Patient 5 with novel C1S variant [homozygous C147 W (c.441 C>G) variant] had marked skin findings, oral ulcers, nonscarring alopecia, pancytopenia, and low total hemolytic complement CH50 level. All patients have responded to the treatments and have low Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores, on therapy. CONCLUSION Genetic causes should be investigated in early-onset SLE, for better management and genetic counseling. On the other hand, multicenter studies may help to further define genotype-phenotype associations.
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Affiliation(s)
- Seher Sener
- Department of Pediatrics, Division of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Erdal Sag
- Department of Pediatrics, Division of Rheumatology, Ankara Research and Training Hospital, University of Health Sciences, Ankara, Turkey
| | - Xu Han
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Life Sciences Institute, Zhejiang University, Hangzhou, China
| | - Yelda Bilginer
- Department of Pediatrics, Division of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Qing Zhou
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Life Sciences Institute, Zhejiang University, Hangzhou, China
| | - Seza Ozen
- Department of Pediatrics, Division of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Saavedra MÁ, Gracia-Aréchiga TS, Miranda-Hernández D, Sánchez A, Arrucha-Cozaya M, Cruz-Domínguez MDP. Active but not quiescent lupus nephritis during pregnancy is associated with a higher rate of adverse obstetric outcomes: Analysis of a prospective cohort. Int J Gynaecol Obstet 2024. [PMID: 38736284 DOI: 10.1002/ijgo.15601] [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: 08/06/2023] [Revised: 04/08/2024] [Accepted: 04/28/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE To compare the maternal-fetal/neonatal outcome in patients with systemic lupus erythematosus (SLE) with and without lupus nephritis (LN) in remission or with active disease. METHODS A prospective cohort of pregnant patients with SLE (ACR 1997 criteria) was studied from January 2009 to December 2021. Demographic, clinical, biochemical, and immunological variables as well as the usual maternal-fetal/neonatal complications were recorded. We compared four groups according to the status of SLE during pregnancy: patients with quiescent SLE without lupus nephritis, patients with active SLE without lupus nephritis, patients with quiescent lupus nephritis, and patients with active lupus nephritis. Statistical analysis included descriptive statistics, bivariate analysis, and Cox regression analysis. RESULTS A total of 439 pregnancies were studied, with a median age of 28 ± 6, SLE duration of 60 months (interquartile range 36-120). A higher frequency of maternal and fetal/neonatal complications was observed in patients with active SLE with or without lupus nephritis. Multivariate analysis showed that active LN was a risk factor for gestational hypertension (hazard ratios [HR] 1.95; 95% confidence intervals [CI]: 1.01-6.39), premature rupture of membranes (HR 3.56; 95% CI: 1.79-16.05) and more frequent cesarean section (HR 1.82; 95% CI: 1.13-2.94). CONCLUSION LN is associated with a higher frequency of maternal complications, especially in those patients with active disease during pregnancy, and those maternal complications had an impact on poor fetal/neonatal outcomes. Strict control and timely care of LN could improve the obstetric prognosis.
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Affiliation(s)
- Miguel Ángel Saavedra
- División de Investigación en Salud, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Tayde Sarahí Gracia-Aréchiga
- Departamento de Reumatología, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Dafhne Miranda-Hernández
- Departamento de Reumatología, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Antonio Sánchez
- Departamento de Reumatología, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - María Del Pilar Cruz-Domínguez
- Dirección de Educación e Investigación en Salud, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, México City, Mexico
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Li X, Sun W, Huang M, Gong L, Zhang X, Zhong L, Calderon V, Bian Z, He Y, Suh WK, Li Y, Song T, Zou Y, Lian ZX, Gu H. Deficiency of CBL and CBLB ubiquitin ligases leads to hyper T follicular helper cell responses and lupus by reducing BCL6 degradation. Immunity 2024:S1074-7613(24)00228-0. [PMID: 38761804 DOI: 10.1016/j.immuni.2024.04.023] [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: 09/10/2023] [Revised: 02/01/2024] [Accepted: 04/24/2024] [Indexed: 05/20/2024]
Abstract
Recent evidence reveals hyper T follicular helper (Tfh) cell responses in systemic lupus erythematosus (SLE); however, molecular mechanisms responsible for hyper Tfh cell responses and whether they cause SLE are unclear. We found that SLE patients downregulated both ubiquitin ligases, casitas B-lineage lymphoma (CBL) and CBLB (CBLs), in CD4+ T cells. T cell-specific CBLs-deficient mice developed hyper Tfh cell responses and SLE, whereas blockade of Tfh cell development in the mutant mice was sufficient to prevent SLE. ICOS was upregulated in SLE Tfh cells, whose signaling increased BCL6 by attenuating BCL6 degradation via chaperone-mediated autophagy (CMA). Conversely, CBLs restrained BCL6 expression by ubiquitinating ICOS. Blockade of BCL6 degradation was sufficient to enhance Tfh cell responses. Thus, the compromised expression of CBLs is a prevalent risk trait shared by SLE patients and causative to hyper Tfh cell responses and SLE. The ICOS-CBLs axis may be a target to treat SLE.
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Affiliation(s)
- Xin Li
- Medical Research Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, China; Montreal Clinical Research Institute, Montreal, QC H2W 1R7, Canada; Division of Experimental Medicine, McGill University, Montreal, QC H3A 0G4, Canada.
| | - Weili Sun
- Montreal Clinical Research Institute, Montreal, QC H2W 1R7, Canada; Division of Experimental Medicine, McGill University, Montreal, QC H3A 0G4, Canada
| | - Mengxing Huang
- Medical Research Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, China
| | - Liying Gong
- Montreal Clinical Research Institute, Montreal, QC H2W 1R7, Canada; Division of Experimental Medicine, McGill University, Montreal, QC H3A 0G4, Canada
| | - Xiaochen Zhang
- Montreal Clinical Research Institute, Montreal, QC H2W 1R7, Canada; Department of Microbiology, Infectiology, and Immunology, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Li Zhong
- Montreal Clinical Research Institute, Montreal, QC H2W 1R7, Canada; Division of Experimental Medicine, McGill University, Montreal, QC H3A 0G4, Canada
| | | | - Zhenhua Bian
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou International Campus, Guangzhou, Guangdong 511442, China
| | - Yi He
- Department of Rheumatology and Immunology, The Third Affiliated Hospital, Southern Medical University, Guangzhou 510630, China
| | - Woong-Kyung Suh
- Montreal Clinical Research Institute, Montreal, QC H2W 1R7, Canada; Division of Experimental Medicine, McGill University, Montreal, QC H3A 0G4, Canada
| | - Yang Li
- Department of Rheumatology and Immunology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, China
| | - Tengfei Song
- The Feinstein Institute for Medical Research, Manhasset, NY 11030, USA
| | - Yongrui Zou
- The Feinstein Institute for Medical Research, Manhasset, NY 11030, USA
| | - Zhe-Xiong Lian
- Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, China.
| | - Hua Gu
- Montreal Clinical Research Institute, Montreal, QC H2W 1R7, Canada; Division of Experimental Medicine, McGill University, Montreal, QC H3A 0G4, Canada; Department of Microbiology, Infectiology, and Immunology, University of Montreal, Montreal, QC H3T 1J4, Canada.
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Abbas A, Almarzooqi N, Harhara T. First presentation of Graves' thyroid storm complicated by catastrophic antiphospholipid antibody syndrome: A case report. SAGE Open Med Case Rep 2024; 12:2050313X241252809. [PMID: 38737564 PMCID: PMC11088809 DOI: 10.1177/2050313x241252809] [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: 12/11/2023] [Accepted: 04/18/2024] [Indexed: 05/14/2024] Open
Abstract
Catastrophic antiphospholipid antibody syndrome is a rare and severe subtype of antiphospholipid syndrome with multisystemic organ failure due to thromboembolic events, resulting in high mortality rates. The association between catastrophic antiphospholipid antibody syndrome and autoimmune thyroid diseases is rarely reported in the literature. We report a case of a 35-year-old previously healthy female with Graves' thyroid storm, positive lupus antibodies, and probable catastrophic antiphospholipid antibody syndrome. Her hospital course was complicated by extensive venous thromboembolism, superior vena cava syndrome, thromboembolic strokes, and Takotsubo cardiomyopathy. Eventually, this led to an unfortunate death secondary to profound shock after 8 days despite emergent treatment. Our case report discusses the link between autoimmune thyroid disorders and catastrophic antiphospholipid antibody syndrome. We emphasize the difficulty in diagnosing catastrophic antiphospholipid antibody syndrome in extremely ill patients and stress the significance of considering it as a possible cause in thyrotoxicosis patients with multiple organ failure and hypercoagulability. Early recognition and prompt management are crucial in improving outcomes in these patients.
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Affiliation(s)
- Aymen Abbas
- Department of Education, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Noura Almarzooqi
- Department of Education, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Thana Harhara
- Department of Education, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
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10
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Chen YC, Liu TY, Lu HF, Huang CM, Liao CC, Tsai FJ. Multiple polygenic risk scores can improve the prediction of systemic lupus erythematosus in Taiwan. Lupus Sci Med 2024; 11:e001035. [PMID: 38724181 PMCID: PMC11086529 DOI: 10.1136/lupus-2023-001035] [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: 08/30/2023] [Accepted: 04/13/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE To identify new genetic variants associated with SLE in Taiwan and establish polygenic risk score (PRS) models to improve the early diagnostic accuracy of SLE. METHODS The study enrolled 2429 patients with SLE and 48 580 controls from China Medical University Hospital in Taiwan. A genome-wide association study (GWAS) and PRS analyses of SLE and other three SLE markers, namely ANA, anti-double-stranded DNA antibody (dsDNA) and anti-Smith antibody (Sm), were conducted. RESULTS Genetic variants associated with SLE were identified through GWAS. Some novel genes, which have been previously reported, such as RCC1L and EGLN3, were revealed to be associated with SLE in Taiwan. Multiple PRS models were established, and optimal cut-off points for each PRS were determined using the Youden Index. Combining the PRSs for SLE, ANA, dsDNA and Sm yielded an area under the curve of 0.64 for the optimal cut-off points. An analysis of human leucocyte antigen (HLA) haplotypes in SLE indicated that individuals with HLA-DQA1*01:01 and HLA-DQB1*05:01 were at a higher risk of being classified into the SLE group. CONCLUSIONS The use of PRSs to predict SLE enables the identification of high-risk patients before abnormal laboratory data were obtained or symptoms were manifested. Our findings underscore the potential of using PRSs and GWAS in identifying SLE markers, offering promise for early diagnosis and prediction of SLE.
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Affiliation(s)
- Yu-Chia Chen
- Million-Person Precision Medicine Initiative, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Ting-Yuan Liu
- Million-Person Precision Medicine Initiative, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Hsing-Fang Lu
- Million-Person Precision Medicine Initiative, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chung-Ming Huang
- Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Chi-Chou Liao
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Departments of Medical Genetics and Medical Research, China Medical University Hospital, Taichung, Taiwan
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11
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Gómez-Bañuelos E, Goldman DW, Andrade V, Darrah E, Petri M, Andrade F. Uncoupling interferons and the interferon signature explains clinical and transcriptional subsets in SLE. Cell Rep Med 2024:101569. [PMID: 38744279 DOI: 10.1016/j.xcrm.2024.101569] [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: 11/16/2023] [Revised: 02/06/2024] [Accepted: 04/22/2024] [Indexed: 05/16/2024]
Abstract
Systemic lupus erythematosus (SLE) displays a hallmark interferon (IFN) signature. Yet, clinical trials targeting type I IFN (IFN-I) have shown variable efficacy, and blocking IFN-II failed to treat SLE. Here, we show that IFN type levels in SLE vary significantly across clinical and transcriptional endotypes. Whereas skin involvement correlated with IFN-I alone, systemic features like nephritis associated with co-elevation of IFN-I, IFN-II, and IFN-III, indicating additive IFN effects in severe SLE. Notably, while high IFN-II/-III levels without IFN-I had a limited effect on disease activity, IFN-II was linked to IFN-I-independent transcriptional profiles (e.g., OXPHOS and CD8+GZMH+ cells), and IFN-III enhanced IFN-induced gene expression when co-elevated with IFN-I. Moreover, dysregulated IFNs do not explain the IFN signature in 64% of patients or clinical manifestations including cytopenia, serositis, and anti-phospholipid syndrome, implying IFN-independent endotypes in SLE. This study sheds light on mechanisms underlying SLE heterogeneity and the variable response to IFN-targeted therapies in clinical trials.
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Affiliation(s)
| | - Daniel W Goldman
- Division of Rheumatology, The Johns Hopkins School of Medicine, Baltimore, MD 21224
| | - Victoria Andrade
- Division of Rheumatology, The Johns Hopkins School of Medicine, Baltimore, MD 21224
| | - Erika Darrah
- Division of Rheumatology, The Johns Hopkins School of Medicine, Baltimore, MD 21224
| | - Michelle Petri
- Division of Rheumatology, The Johns Hopkins School of Medicine, Baltimore, MD 21224
| | - Felipe Andrade
- Division of Rheumatology, The Johns Hopkins School of Medicine, Baltimore, MD 21224.
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Ruiz-Ballesteros AI, Betancourt-Núñez A, Meza-Meza MR, Rivera-Escoto M, Mora-García PE, Pesqueda-Cendejas K, Vizmanos B, Parra-Rojas I, Campos-López B, Montoya-Buelna M, Cerpa-Cruz S, De la Cruz-Mosso U. Relationship of serum and dietary vitamin D with high cardiometabolic risk in Mexican systemic lupus erythematosus patients: A cross-sectional study. Lupus 2024:9612033241252060. [PMID: 38709772 DOI: 10.1177/09612033241252060] [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: 05/08/2024]
Abstract
Objetive: Serum and dietary vitamin D could influence clinical disease activity and cardiometabolic outcomes in systemic lupus erythematosus (SLE). This study aimed to assess the relationship of serum and dietary vitamin D with cardiometabolic risk in Mexican SLE patients and healthy subjects (HS).Methods: 224 SLE patients and 201 HS were included in this cross-sectional study. Serum calcidiol was measured using a competitive enzyme-linked immunosorbent assay (ELISA). Vitamin D dietary intake was assessed by collecting three 24h food records. Dietary patterns (DPs) were identified using principal component analysis (PCA). Cardiometabolic status was analyzed through biochemical measurements and cardiometabolic indexes.Results: Calcidiol deficiency (<20 ng/mL) was associated with 1.66-fold higher risk of excess weight by body mass index (BMI) (≥25 kg/m2) (p = .02), 2.25-fold higher risk to low high-density lipoprotein-cholesterol (HDL-C) (<40 mg/dL) (p < .001), and 1.74-fold higher risk to high triglycerides (TG) ≥150 mg/dL (p = .02). Inadequate vitamin D dietary intake was associated with 1.92-fold higher risk of presenting non-healthy waist circumference (WC) (>80 cm) (p < .01), 2.05-fold higher risk of android waist to hip ratio (WHR ≥85) (p < .01), and 1.72-fold higher risk to excess weight (p = .02). Non-adherence to a DP rich in vitamin D food sources was associated with higher WC, WHR, triglycerides, and lower high-density lipoprotein-cholesterol (HDL-C); furthermore, in HS, non-adherence to the DP rich in vitamin D food sources provided 2.11-fold higher risk to calcidiol deficiency.In Cconclusion: A pattern of Calcidiol deficiency, inadequate vitamin D dietary intake, and non-adherence to a DP rich in vitamin D food sources was related to high cardiometabolic risk in SLE patients and HS.
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Affiliation(s)
- Adolfo I Ruiz-Ballesteros
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
- Instituto de Neurociencias Traslacionales, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Alejandra Betancourt-Núñez
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
- Cuerpo Académico UDG-454, Alimentación y Nutrición en el proceso Salud Enfermedad, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Mónica R Meza-Meza
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
- Instituto de Neurociencias Traslacionales, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Melissa Rivera-Escoto
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
- Instituto de Neurociencias Traslacionales, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Paulina E Mora-García
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Karen Pesqueda-Cendejas
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
- Instituto de Neurociencias Traslacionales, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Barbara Vizmanos
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
- Cuerpo Académico UDG-454, Alimentación y Nutrición en el proceso Salud Enfermedad, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Isela Parra-Rojas
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
- Laboratorio de Investigación en Obesidad y Diabetes, Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Mexico
| | - Bertha Campos-López
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
- Instituto de Neurociencias Traslacionales, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Margarita Montoya-Buelna
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
- Laboratorio de Inmunología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Sergio Cerpa-Cruz
- Departamento de Reumatología, O.P.D. Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico
| | - Ulises De la Cruz-Mosso
- Red de Inmunonutrición y Genómica Nutricional en las Enfermedades Autoinmunes, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
- Instituto de Neurociencias Traslacionales, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
- Cuerpo Académico UDG-454, Alimentación y Nutrición en el proceso Salud Enfermedad, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
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Contreras-Valero JF, Ruíz-Ordóñez I, Pinilla-Monsalve GD, Bautista-Vargas M, Ocampo-Piraquive V, Aguirre-Valencia D. Cytomegalovirus infection and disease in systemic lupus erythematosus patients at a high-complexity hospital in southwestern Colombia. Lupus 2024:9612033241247103. [PMID: 38709545 DOI: 10.1177/09612033241247103] [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: 05/07/2024]
Abstract
Cytomegalovirus (CMV) infection and disease is a condition usually described in immunocompromised patients, but among them, those with connective tissue diseases are poorly represented. Here we present the clinical, laboratory characteristics, management and outcomes of systemic lupus erythematosus (SLE) patients who presented with a CMV infection/disease to a high complexity hospital in southwestern Colombia between 2011 and 2020. 16 SLE patients were found to have a CMV infection. SLE was predominantly characterized by renal involvement (10 patients; 62.50%), and 14 patients (87.5%) were receiving steroids previous to the CMV infection. The entire sample required hospital admission, mainly related to acute kidney injury, and nine patients were admitted to the intensive care unit (ICU). Gastrointestinal organ damage was the most common CMV disease manifestation. All patients received ganciclovir, five of them (31.25%) suffered from septic shock, and seven (43.75%) died. Age ≥38 years and the presence of septic shock at admission were correlated to the mortality outcome. To our knowledge, this is the first publication evaluating SLE patients with CMV infection/disease in a Colombian population.
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Affiliation(s)
- Juan Fernando Contreras-Valero
- Division of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Ingrid Ruíz-Ordóñez
- GIRAT: Grupo de Investigación en Reumatología, Inmunología y Medicina Traslacional, School of Medicine, Fundación Valle del Lili, Universidad Icesi, Cali, Colombia
- Facultad de Ciencias de la Salud, Universidad de Caldas, Manizales, Colombia
| | | | - Mario Bautista-Vargas
- Unidad de Reumatología, Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
| | - Vanessa Ocampo-Piraquive
- GIRAT: Grupo de Investigación en Reumatología, Inmunología y Medicina Traslacional, School of Medicine, Fundación Valle del Lili, Universidad Icesi, Cali, Colombia
- Unidad de Reumatología, Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
| | - David Aguirre-Valencia
- GIRAT: Grupo de Investigación en Reumatología, Inmunología y Medicina Traslacional, School of Medicine, Fundación Valle del Lili, Universidad Icesi, Cali, Colombia
- Unidad de Reumatología, Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
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14
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Umeda M, Kojima K, Michitsuji T, Tsuji Y, Shimizu T, Fukui S, Sumiyoshi R, Koga T, Kawashiri SY, Naoki I, Iagawa T, Tamai M, Origuchi T, Furuyama M, Tsuboi M, Matsuoka N, Okada A, Aramaki T, Kawakami A. Successful treatment of systemic lupus erythematosus with residual disease activity by switching from belimumab to anifrolumab. Mod Rheumatol 2024:roae038. [PMID: 38756072 DOI: 10.1093/mr/roae038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/23/2024] [Indexed: 05/18/2024]
Affiliation(s)
- Masataka Umeda
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Research Unit for Preventive and Clinical Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kanako Kojima
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toru Michitsuji
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yoshika Tsuji
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shoichi Fukui
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Remi Sumiyoshi
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shin-Ya Kawashiri
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Iwamoto Naoki
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takashi Iagawa
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mami Tamai
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomoki Origuchi
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masako Furuyama
- Department of Rheumatology, Nagasaki Kita Hospital, Nagasaki, Japan
| | | | - Naoki Matsuoka
- Nagasaki Medical Hospital of Rheumatology, Nagasaki, Japan
| | - Akitomo Okada
- Department of Rheumatology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | | | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Research Unit for Preventive and Clinical Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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15
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Zandieh A, Seeger SK, Tunnell EC, Wheeler SK. A rare case of lupus cerebritis presenting as ictal epileptic headache: A case report. Headache 2024. [PMID: 38700260 DOI: 10.1111/head.14712] [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: 09/25/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 05/05/2024]
Abstract
Ictal epileptic headache, characterized by headache as the sole symptom of a seizure attack, is a rare condition. In this case report, we present a 52-year-old female with a history of systemic lupus erythematosus who sought medical attention at the headache clinic due to a new type of headache. The headache was described as an intense painful wave followed by a dull headache, without autonomic symptoms or migrainous features. Magnetic resonance imaging revealed an enhancing lesion in the left hippocampus in addition to two other lesions in the corpus callosum and left parieto-occipital lobe. Electroencephalography during the headache episodes showed epileptic discharges originating from the left fronto-temporal region. The patient was initiated on levetiracetam, which resulted in the resolution of both the epileptic discharges and the headaches. This case underscores the significance of considering ictal epileptic headache as a potential secondary cause for headaches, particularly in patients with underlying conditions that may predispose them to epilepsy, such as systemic lupus erythematosus.
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Affiliation(s)
- Ali Zandieh
- Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Susanne K Seeger
- Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Evelyn C Tunnell
- Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Shawna K Wheeler
- Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin, USA
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16
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de Souza RR, Barreto MDS, Teston EF, Salci MA, Vieira VCDL, Marcon SS. Pregnancy loss in women with systemic lupus erythematosus: Grounded Theory. Rev Bras Enferm 2024; 77:e20230225. [PMID: 38716908 PMCID: PMC11067933 DOI: 10.1590/0034-7167-2023-0225] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 11/25/2023] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE to learn the meanings attributed to pregnancy loss by women with Lupus. METHOD qualitative research, based on Symbolic Interactionism and Grounded Theory. Data collection took place between January and August 2022 through in-depth interviews. Data analysis went through the stages of initial and focused coding. RESULTS seventeen women participated. The central phenomenon "The climb to motherhood: falls and overcoming" was constructed, consisting of three categories: "Falling to the ground during the climb: the experience of pregnancy loss"; "Getting up and following the path: new attempts to conceive"; and "Remembering the journey: meanings attributed to pregnancy losses". FINAL CONSIDERATIONS experiencing pregnancy is, analogously, like climbing a mountain, where obstacles need to be overcome to reach the summit. The experience of pregnancy loss is seen as complex, especially when there is fragility in healthcare and a lack of awareness regarding feelings of loss and grief.
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Affiliation(s)
| | | | - Elen Ferraz Teston
- Universidade Federal do Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul, Brazil
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17
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Sun YS, Huang DF, Chang FP, Chen WS, Liao HT, Chen MH, Tsai HC, Tsai MT, Tsai CY, Lai CC, Yu Yang C. Interstitial fibrosis increases the risk of end-stage kidney disease in patients with lupus nephritis. Rheumatology (Oxford) 2024:keae226. [PMID: 38696753 DOI: 10.1093/rheumatology/keae226] [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: 12/01/2023] [Revised: 03/27/2024] [Accepted: 04/06/2024] [Indexed: 05/04/2024] Open
Abstract
OBJECTIVE To evaluate the risk of end-stage kidney disease (ESKD) in lupus nephritis (LN) patients using tubulointerstitial lesion scores. METHODS Clinical profiles and histopathological presentations of 151 biopsy-proven LN patients were retrospectively examined. Risk factors of ESKD based on characteristics and scoring of their tubulointerstitial lesions (e.g. interstitial inflammation [II], tubular atrophy [TA], and interstitial fibrosis [IF]) were analyzed. RESULTS The mean age of 151 LN patients was 36 years old, and 136 (90.1%) were female. The LN cases examined included: class I/II (n = 3, 2%), class III/IV (n = 119, 78.8%), class V (n = 23, 15.2%), and class VI (n = 6, 4.0%). The mean serum creatinine level was 1.4 mg/dl. Tubulointerstitial lesions were recorded in 120 (79.5%) patients. Prior to receiving renal biopsy, 9 (6.0%) patients developed ESKD. During the follow-up period (mean, 58 months), an additional 47 patients (31.1%) progressed to ESKD. Multivariate analyses identified serum creatinine (hazard ratio [HR]: 1.7, 95% confidence interval [CI]: 1.42-2.03, p < 0.001) and IF (HR: 3.2, 95% CI: 1.58-6.49, p = 0.001) as independent risk factors of ESKD. Kaplan-Meier analysis further confirmed a heightened risk of ESKD associated with IF. CONCLUSION Tubulointerstitial involvement is commonly observed in histopathological presentation of LN. However, IF, rather than II, or TA, was found to increase the risk of ESKD in our cohort. Therefore, to predict renal outcome in LN patients prior to adjusting immunosuppressive treatment, degree of IF should be reviewed.
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Affiliation(s)
- Yi-Syuan Sun
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Taipei Veterans General Hospital
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - De-Feng Huang
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Taipei Veterans General Hospital
| | - Fu-Pang Chang
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Department of Pathology, Taipei Veterans General Hospital
| | - Wei-Sheng Chen
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Taipei Veterans General Hospital
- Faculty of Medicine, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Hsien-Tzung Liao
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Taipei Veterans General Hospital
- Faculty of Medicine, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Ming-Han Chen
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Taipei Veterans General Hospital
- Faculty of Medicine, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Hung-Cheng Tsai
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Taipei Veterans General Hospital
- Faculty of Medicine, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Ming-Tsun Tsai
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital
| | - Chang-Youh Tsai
- Division of Rheumatology, Department of Medicine, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
| | - Chien-Chih Lai
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Taipei Veterans General Hospital
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Chih- Yu Yang
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital
- Center for Intelligent Drug Systems and Smart Bio-devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Stem Cell Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
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18
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Yuan S, Wang C, Zeng Y, Li J, Li W, He Z, Ye J, Li F, Chen Y, Lin X, Xu Y, Yu N, Cai X. Aberrant phenotypes of circulating γδ-T cells may be involved in the onset of systemic lupus erythematosus. Lupus 2024; 33:587-597. [PMID: 38506324 DOI: 10.1177/09612033241240864] [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] [Indexed: 03/21/2024]
Abstract
OBJECTIVE Human gamma-delta T cells (γδ-T cells) play crucial roles in both innate and adaptive immune responses. However, much less is known about the immune status of γδT cells in systemic lupus erythematosus (SLE) patients. The objective of this study was to explore potential relationships between the frequency of γδ-T-cell subpopulations and disease activity, autoantibody titres and renal involvement in patients with SLE. METHODS Circulating γδ-T cells and their subsets (Vδ1+ T cells, Vδ2+ T cells and γδ-T-cell subpopulations defined by expression of surface receptors, including NKG2D, NKp30, NKp46 and PD-1), were identified via flow cytometry. Sixty active SLE patients were selected, including 41 new-onset and 19 relapsing cases. One hundred healthy controls (HCs) were enrolled as the control group. Percentages of these cell subsets in SLE patients and HCs and their relationships with disease activity were analysed. Twenty-two of the 41 new-onset SLE patients were assessed before and after treatment. Changes in the frequencies of these cell subsets and their relationships with renal involvement were also analysed. RESULTS Compared with that in HCs, the percentage of total γδ-T cells among CD3+ T cells in SLE patients was significantly lower. An imbalance in the proportions of Vδ1+ and Vδ2+ T cells among γδ-T cells was observed. The proportion of Vδ1+ T cells among γδ-T cells was significantly greater in SLE patients than in HCs, while the proportion of Vδ2+ T cells was significantly lower. Expression levels of PD-1, NKG2D, NKp30 and NKp46 in Vδ1+ T cells and Vδ2+ T cells from SLE patients were generally significantly increased, except for expression of NKG2D in Vδ2+ T cells. Moreover, Vδ2+ T cells, Vδ1+ T cells and Vδ1+PD-1+ T cells were associated with disease activity, and an increase in Vδ2+ T-cell frequency and a decrease in PD-1 expression by γδ-T cells might be associated with effective treatment. Interestingly, our results indicated that Vδ2+ T cells and their Vδ2+NKp30+ T-cell subpopulation might be associated with renal involvement in SLE. CONCLUSION A broad range of anomalies in the proportions of γδ-T-cell subsets and γδ-T cells in SLE patients may be involved in the pathogenesis of SLE. There is a strong association between Vδ2+ T cells and their Vδ2+NKp30+ T-cell subpopulation and LN occurrence. Our results indicate that γδ-T cells and their subpopulations might be key players in disease immunopathology and renal involvement in SLE.
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Affiliation(s)
- Shiwen Yuan
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Cuicui Wang
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Yanting Zeng
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Jiawei Li
- Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai Institute of Translational Medicine Zhuhai People's Hospital Affiliated with Jinan University, Jinan University, Zhuhai, China
- The Biomedical Translational Research Institute, Faculty of Medical Science, Jinan University, Guangzhou, China
| | - Weinian Li
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Zhixiang He
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Jinghua Ye
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Fangfei Li
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Yi Chen
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Xiaojun Lin
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Yan Xu
- Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai Institute of Translational Medicine Zhuhai People's Hospital Affiliated with Jinan University, Jinan University, Zhuhai, China
- The Biomedical Translational Research Institute, Faculty of Medical Science, Jinan University, Guangzhou, China
| | - Na Yu
- Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xiaoyan Cai
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
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Patel A, Krishnapura Lakshminarayana S, Kumble D, Kariyappa M, Ramkumar G, Anilkumar H, Bhattad S. Enteritis: a window to the diagnosis of systemic lupus erythematosus in an adolescent girl: case report. Paediatr Int Child Health 2024; 44:42-47. [PMID: 38184810 DOI: 10.1080/20469047.2023.2299581] [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: 04/29/2023] [Accepted: 12/20/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Enteritis is one of the rare systemic manifestations in childhood-onset systemic lupus erythematosus and its diagnosis is very challenging. This is a rare case of an adolescent girl with recurrent non-specific gastro-intestinal symptoms which were later diagnosed to be owing to lupus enteritis, the only presenting manifestation of an active flare. CASE REPORT A 15-year-old girl was admitted with recurrent episodes of abdominal pain, vomiting and loose stools. She had diffuse abdominal tenderness. Abdominal ultrasonography demonstrated moderate ascites. A contrast-enhanced abdominal computerised tomography scan revealed thickening of the small bowel wall. On colonoscopy, there were rectal erosions, and microscopic examination of the biopsy specimens demonstrated mild inflammation. Non-specific enteritis was diagnosed and she was given antibiotics and supportive care. She was re-admitted 6months later with abdominal pain. An abdominal contrast-enhanced computerised tomography scan revealed thickening of the bowel wall and the target sign and comb sign in the small intestine. The anti-nuclear antibody was positive. Renal biopsy demonstrated grade 2 lupus nephritis. Lupus enteritis was diagnosed and the case satisfied the 2019 EULAR-ACR criteria and SLICC criteria. She was treated with methylprednisolone, cyclophosphamide and hydroxychloroquine. She improved with treatment and has remained asymptomatic during follow-up. CONCLUSION This case emphasises the need for healthcare providers to be alert to the possibility of lupus enteritis. It also highlights the importance of close follow-up of cases who have non-specific gastro-intestinal symptoms. Lupus enteritis should be considered in the differential diagnosis of recurrent non-specific gastro-intestinal symptoms in children, especially adolescents, to ensure timely diagnosis and treatment.Abbreviations: ACR American College of Rheumatology; ANA anti-nuclear antibody; CRP: C-reactive protein; CT: computerised tomography; CECT: contrast-enhanced computerised tomography; EULAR: European League Against Rheumatism; GI: gastro-intestinal; LE: lupus enteritis; SLE systemic lupus erythematosis; SLICC: Systemic Lupus International Collaborating Clinics; SLEDAI: SLE disease activity index.
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Affiliation(s)
- Ashray Patel
- Department of Paediatrics, Vani Vilas Hospital, Bangalore Medical College and Research Institute, Bengaluru, India
| | | | - Dhanalakshmi Kumble
- Department of Paediatrics, Vani Vilas Hospital, Bangalore Medical College and Research Institute, Bengaluru, India
| | - Mallesh Kariyappa
- Department of Paediatrics, Vani Vilas Hospital, Bangalore Medical College and Research Institute, Bengaluru, India
| | - Gautham Ramkumar
- Department of Paediatrics, Vani Vilas Hospital, Bangalore Medical College and Research Institute, Bengaluru, India
| | - H Anilkumar
- Department of Paediatrics, Vani Vilas Hospital, Bangalore Medical College and Research Institute, Bengaluru, India
| | - Sagar Bhattad
- Division of Paediatric Immunology and Rheumatology, Department of Paediatrics, Aster CMI Hospital, Bengaluru, India
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20
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Zhang R, Zhao Y, Chen X, Zhuang Z, Li X, Shen E. Low-dose IL-2 therapy in autoimmune diseases: An update review. Int Rev Immunol 2024; 43:113-137. [PMID: 37882232 DOI: 10.1080/08830185.2023.2274574] [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: 03/22/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023]
Abstract
Regulatory T (Treg) cells are essential for maintaining self-immune tolerance. Reduced numbers or functions of Treg cells have been involved in the pathogenesis of various autoimmune diseases and allograft rejection. Therefore, the approaches that increase the pool or suppressive function of Treg cells in vivo could be a general strategy to treat different autoimmune diseases and allograft rejection. Interleukin-2 (IL-2) is essential for the development, survival, maintenance, and function of Treg cells, constitutively expressing the high-affinity receptor of IL-2 and sensitive response to IL-2 in vivo. And low-dose IL-2 therapy in vivo could restore the imbalance between autoimmune response and self-tolerance toward self-tolerance via promoting Treg cell expansion and inhibiting follicular helper T (Tfh) and IL-17-producing helper T (Th17) cell differentiation. Currently, low-dose IL-2 treatment is receiving extensive attention in autoimmune disease and transplantation treatment. In this review, we summarize the biology of IL-2/IL-2 receptor, the mechanisms of low-dose IL-2 therapy in autoimmune diseases, the application in the progress of different autoimmune diseases, including Systemic Lupus Erythematosus (SLE), Type 1 Diabetes (T1D), Rheumatoid Arthritis (RA), Autoimmune Hepatitis (AIH), Alopecia Areata (AA), Immune Thrombocytopenia (ITP) and Chronic graft-versus-host-disease (GVHD). We also discuss the future directions to optimize low-dose IL-2 treatments.
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Affiliation(s)
- Ruizhi Zhang
- Sino-French Hoffmann Institute, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, China
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Yuyang Zhao
- Sino-French Hoffmann Institute, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, China
- The Second Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, Guangdong Provincial Key Laboratory of Allergy & Clinical Immunology, Guangzhou Medical University, Guangzhou, China
| | - Xiangming Chen
- Sino-French Hoffmann Institute, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, China
- The Second Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, Guangdong Provincial Key Laboratory of Allergy & Clinical Immunology, Guangzhou Medical University, Guangzhou, China
| | - Zhuoqing Zhuang
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Xiaomin Li
- Sino-French Hoffmann Institute, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, China
| | - Erxia Shen
- Sino-French Hoffmann Institute, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, China
- The Second Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, Guangdong Provincial Key Laboratory of Allergy & Clinical Immunology, Guangzhou Medical University, Guangzhou, China
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Protein Modification and Degradation, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, China
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21
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Wu Q, Zhao MX, Huang XS, Lin CS, Xu Q. The use of belimumab on patients with both systemic lupus erythematosus and immune thrombocytopenia: A retrospective cohort study. Lupus 2024; 33:608-614. [PMID: 38518059 DOI: 10.1177/09612033241241576] [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] [Indexed: 03/24/2024]
Abstract
OBJECTIVE The objective of this study is to provide a description of a group of retrospective cohort outcomes in patients with systemic lupus erythematosus (SLE) complicated with immune thrombocytopenia (ITP) receiving belimumab. METHODS This study reports on the treatment of 10 female patients (mean age 34.3 ± 14.0 years, mean weight 58.7 ± 18.2 kg) with both SLE and ITP who received belimumab in addition to basic drug therapy. The belimumab treatment regimen consisted of a dosage of 10 mg/kg, with an initial infusion every 2 weeks for the first 3 doses, followed by an infusion every 4 weeks. RESULTS Ten patients were included in the study. The overall response rate of thrombocytopenia was 90% after treatment. The parameters such as platelet count, lymphocyte count, erythrocyte count, hemoglobin, dsDNA, C3, and C4 were significantly improved (p < .05). The SLE Disease Activity Index (SLEDAI), British Islet lupus Assessment Group 2004 (BILAG-2004), and Physician Global assessment (PGA) scores were significantly decreased (p < .05). There were no significant differences in glutamic pyruvic transaminase (ALT), glutamic oxaloacetic transaminase (AST), and serum creatinine (Scr) before and after treatment (p > .05). CONCLUSION Belimumab shows promising clinical outcomes in the treatment on patients with both SLE and ITP. Further studies are needed to validate these findings in larger patient populations and compare the efficacy of belimumab with other treatments for SLE complicated with ITP. Long-term response rates and adverse events associated with belimumab treatment also warrant further investigation.
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Affiliation(s)
- Qi Wu
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ming-Xue Zhao
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- The Third Hospital of Mianyang (Sichuan Mental Health Center), Mianyang, China
| | - Xiao-Shan Huang
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chang-Song Lin
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qiang Xu
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
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22
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Xing C, Trivedi J, Bitencourt N, Burns DK, Reisch JS, Cai C. Myxovirus resistance protein A (MxA) expression in myositides: Sarcoplasmic expression is common in both dermatomyositis and lupus myositis. Muscle Nerve 2024; 69:548-555. [PMID: 38372203 DOI: 10.1002/mus.28066] [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: 07/20/2023] [Revised: 01/26/2024] [Accepted: 02/03/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION/AIMS Myxovirus resistance protein A (MxA) is a type I interferon (IFN1) pathway activation marker and MxA sarcoplasmic expression is currently recognized as a highly specific marker for dermatomyositis (DM). However, we have frequently observed endothelial tubuloreticular inclusions (TRI), another surrogate IFN1 activation marker, in a variety of overlap myositides. The aim of this study was to examine MxA expression in those myositides. METHODS We retrospectively performed MxA immunostaining on a wide range of myositides. RESULTS MxA sarcoplasmic expression was present in DM (94.4%, 17/18), active lupus myositis (LM, 80%,16/20), inactive LM (36%, 4/11), antisynthetase syndrome (ASyS, 20%, 2/10), systemic sclerosis (13%, 2/15), Sjogren's syndrome (7.7%, 1/13), and human immunodeficiency virus (HIV) myositis (5.6%, 1/18) and was absent in immune-mediated necrotizing myopathy (IMNM, 0/16) and hydroxychloroquine myopathy (0/5). The sensitivity and specificity of MxA sarcoplasmic expression for LM and DM combined compared with all other myositides were 84.6% (95% CI: 69.5-94.1) and 92.1 (95% CI: 83.6-97.0), respectively, and superior to TRIs. MxA capillary expression was nonspecific. Histologically, 35% of LM cases demonstrated a unique panfascicular necrotizing myopathy pattern. The remainder of the LM cases had significant morphological overlap with DM/ASyS (20%), IMNM (20%), or polymyositis (15%). DISCUSSION MxA sarcoplasmic expression is highly prevalent in LM and DM and is a useful marker in differentiating DM and LM from other myositides. LM can manifest in various pathology patterns that need to be differentiated from DM, IMNM, ASyS, and polymyositis.
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Affiliation(s)
- Changhong Xing
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Jaya Trivedi
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Nicole Bitencourt
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Dennis K Burns
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Joan S Reisch
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Chunyu Cai
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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23
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Wi D, Palermo TM, Walsh E, Ward TM. Temporal Daily Relationships Between Sleep and Pain in Adolescents With Systemic Lupus Erythematosus. J Pediatr Health Care 2024; 38:365-373. [PMID: 38149951 PMCID: PMC11065602 DOI: 10.1016/j.pedhc.2023.11.016] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 11/26/2023] [Accepted: 11/30/2023] [Indexed: 12/28/2023]
Abstract
INTRODUCTION Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterized by recurrent episodes of pain. This study aimed to describe the temporal daily relationships between sleep and pain in adolescents with SLE. METHOD Twenty-three adolescents with SLE recruited from a pediatric hospital wore actigraphy and completed diaries. Generalized estimating equation models were used. RESULTS On average, evening pain negatively predicted subsequent sleep quality that night, and, on average, sleep quality negatively predicted morning pain. Shorter total sleep time significantly predicted higher morning pain (95% confidence intervals [CI], -0.38 to -0.03, p = .02), whereas sleep efficiency and sleep quality were not significantly associated with morning pain (95% CI, -0.03 to 0.03; 95% CI, -0.08 to 0.06, respectively). Subsequent evening pain did not predict daily nighttime sleep DISCUSSION: Our findings suggest that sleep is a target for pain interventions to include among adolescents with SLE.
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Affiliation(s)
- Dahee Wi
- School of Nursing, University of Washington, Seattle, Washington, United States of America
| | - Tonya M. Palermo
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington, United States of America
- Seattle Children’s Research Institute, Seattle, Washington, United States of America
| | - Elaine Walsh
- School of Nursing, University of Washington, Seattle, Washington, United States of America
| | - Teresa M. Ward
- School of Nursing, University of Washington, Seattle, Washington, United States of America
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24
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Babgi E, Al Marri M, Al-Mayouf SM, Shehata R, Majeed M, Alsufyani K, Batouk E, Bakri R, AlE'ed A, Yateem M, Akbar L, Gari S, Alghamdi W, Asiri A, Al Rowais A. Comparison of systemic lupus international collaborating clinics 2012 classification criteria and European league against rheumatism/American college of rheumatology 2019 classification criteria for early detection of childhood onset systemic lupus erythematosus (multi-center study). Lupus 2024; 33:629-637. [PMID: 38533912 DOI: 10.1177/09612033241240830] [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] [Indexed: 03/28/2024]
Abstract
OBJECTIVE To assess the performance of the new EULAR/ACR criteria, particularly for early detection of cSLE, in comparison to the SLICC criteria among the pediatric population in multiple centers in Saudi Arabia. METHODS We conducted a retrospective study that enrolled pediatric patients up to the age of 14 years who've been diagnosed with SLE and followed in pediatric rheumatology clinics at 9 multi-tertiary hospitals in Saudi Arabia from 2010 to 2021 as a case group and were compared to a similar group of pediatric patients who've had defined rheumatological diseases other than SLE with a positive ANA titer (≥1:80) as controls. In total, 245 patients were included and distributed as 129 cases (diagnosed by expert pediatric rheumatologists) versus 116 patients in the control group. All relevant clinical information, including history, physical examination findings, and laboratory tests, was documented at the initial presentations. Then, the two sets of SLE classification criteria were applied to both groups to define who's going to meet both or either one of them. The exclusion criteria included those who had insufficient data or had overlapping or undifferentiated diseases. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), receiver operating curve (ROC), and accuracy were calculated for SLICC 2012 and EULAR/ACR 2019 criteria (total scores≥ 10 and ≥ 13). We performed a Chi-squared test to compare sensitivity and specificity of SLICC 2012 and EULAR/ACR 2019. RESULTS For SLICC (cut-off ≥4 criteria), the sensitivity was found to be 96.9% (95% CI 92.6%-99.4%) and the specificity was 94.8% (95% CI 89.6%-98.32%), with PPV and NPV of 95.4% and 96.5%, respectively. The ROC for it was 0.96 (95% CI 0.93-0.99), and this criterion had an accuracy of 95%. Regarding EULAR/ACR (total score ≥ 10), the performance measure showed a sensitivity of 99.2% and a specificity of 86.2%. Similarly, PPV was 88.9%; while NPV was a little higher (99.0%) than SLICC. The ROC for EULAR/ACR (total score ≥ 10) was 0.93 (95% CI 0.89-0.96), and this criterion had an accuracy of 93%. However, there was no statistically significant difference between the sensitivity and specificity of either using SLICC or EULAR/ACR (total score ≥ 10), as reflected by a p-value of 0.86 using the Chi-squared test. Although applying the EULAR/ACR with a total score of ≥ 13 revealed lower sensitivity (93.8%) than both the SLICC and the EULAR/ACR (total score ≥ 10), the specificity for it was found to increase up to 91.4% (85.7-96.2%) compared to the (86.2%) specificity of the EULAR/ACR (total score ≥ 10). CONCLUSION In this cohort among the Saudi population with childhood-onset SLE, the new EULAR/ACR 2019 criteria efficiently enable early detection of SLE, although a more frequent rate of false positives was observed with them. Escalating the total score from ≥ 10 to ≥ 13 in the cSLE population improved the specificity close to that of SLICC 2012. Further prospective studies in pediatrics need to be done for the validation of a cut- off score of ≥ 13 in cSLE rather than the traditional score of ≥ 10 in aSLE.
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Affiliation(s)
- Esraa Babgi
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Munira Al Marri
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Sulaiman M Al-Mayouf
- Pediatric Rheumatology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Rawia Shehata
- Department of Pediatrics, King Abdulaziz Hospital, Jeddah, Saudi Arabia
| | - Mahmoud Majeed
- Department of Pediatrics, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Khayriah Alsufyani
- Department of Pediatrics, Maternity and Children Hospital, Makkah, Saudi Arabia
| | - Entesar Batouk
- Department of Pediatrics, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Reema Bakri
- Department of Pediatrics, East Jeddah Hospital, Jeddah, Saudi Arabia
| | - Ashwaq AlE'ed
- Department of Pediatrics, College of Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Mada Yateem
- Department of Pediatrics, King Fahad Central Hospital, Jazan, Saudi Arabia
| | - Lujayn Akbar
- Pediatric Rheumatology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Shahad Gari
- Department of Pediatrics, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Wafa Alghamdi
- Department of Pediatrics, East Jeddah Hospital, Jeddah, Saudi Arabia
| | - Abdularahman Asiri
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdulaziz Al Rowais
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Rogers JL, Clowse MEB, McKenna K, Starling S, Swezey T, Molokwu N, Corneli A, Pisetsky DS, Sun K, Criscione-Schreiber LG, Sadun RE, Maheswaranathan M, Burshell D, Doss J, Eudy AM. Patient and Physician Perspectives of Systemic Lupus Erythematosus Flare: A Qualitative Study. J Rheumatol 2024; 51:488-494. [PMID: 38101916 PMCID: PMC11065621 DOI: 10.3899/jrheum.2023-0721] [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] [Accepted: 12/01/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE Systemic lupus erythematosus (SLE) flares are associated with increased damage and decreased health-related quality of life. We hypothesized that there is discordance between physicians' and patients' views of SLE flare. In this study, we aimed to explore patient and physician descriptions of SLE flares. METHODS We conducted a qualitative descriptive study using in-depth interviews with a purposeful sample of patients with SLE (who met 1997 American College of Rheumatology or Systemic Lupus International Collaborating Clinics criteria) and practicing rheumatologists. Interviews were audio-recorded, transcribed, and analyzed using applied thematic analysis. RESULTS Forty-two patient participants with SLE, representing a range of SLE activity, completed interviews. The majority described flare symptoms as joint pain, fatigue, and skin issues lasting several days. Few included objective signs or laboratory measures, when available, as features of flare. We interviewed 13 rheumatologists from 10 academic and 3 community settings. The majority defined flare as increased or worsening SLE disease activity, with slightly more than half requiring objective findings. Around half of the rheumatologists included fatigue, pain, or other patient-reported symptoms. CONCLUSION Patients and physicians described flare differently. Participants with SLE perceived flares as several days of fatigue, pain, and skin issues. Providers defined flares as periods of increased clinical SLE activity. Our findings suggest the current definition of flare may be insufficient to integrate both perceptions. Further study is needed to understand the pathophysiology of patient flares and the best way to incorporate patients' perspectives into clinical assessments.
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Affiliation(s)
- Jennifer L Rogers
- J.L. Rogers, MD, M.E.B. Clowse, MD, MPH, K. Sun, MD, MS, L.G. Criscione-Schreiber, MD, MEd, R.E. Sadun, MD, PhD, M. Maheswaranathan, MD, D. Burshell, MPH, J. Doss, MD, MPH, A.M. Eudy, PhD, Division of Rheumatology and Immunology, Duke University School of Medicine
| | - Megan E B Clowse
- J.L. Rogers, MD, M.E.B. Clowse, MD, MPH, K. Sun, MD, MS, L.G. Criscione-Schreiber, MD, MEd, R.E. Sadun, MD, PhD, M. Maheswaranathan, MD, D. Burshell, MPH, J. Doss, MD, MPH, A.M. Eudy, PhD, Division of Rheumatology and Immunology, Duke University School of Medicine
| | - Kevin McKenna
- K. McKenna, MPH, S. Starling, DrPH, MPH, T. Swezey, PhD, N. Molokwu, MSW, A. Corneli, PhD, MPH, Population Health Sciences, Duke University School of Medicine
| | - Summer Starling
- K. McKenna, MPH, S. Starling, DrPH, MPH, T. Swezey, PhD, N. Molokwu, MSW, A. Corneli, PhD, MPH, Population Health Sciences, Duke University School of Medicine
| | - Teresa Swezey
- K. McKenna, MPH, S. Starling, DrPH, MPH, T. Swezey, PhD, N. Molokwu, MSW, A. Corneli, PhD, MPH, Population Health Sciences, Duke University School of Medicine
| | - Nneka Molokwu
- K. McKenna, MPH, S. Starling, DrPH, MPH, T. Swezey, PhD, N. Molokwu, MSW, A. Corneli, PhD, MPH, Population Health Sciences, Duke University School of Medicine
| | - Amy Corneli
- K. McKenna, MPH, S. Starling, DrPH, MPH, T. Swezey, PhD, N. Molokwu, MSW, A. Corneli, PhD, MPH, Population Health Sciences, Duke University School of Medicine
| | - David S Pisetsky
- D.S. Pisetsky, MD, PhD, Division of Rheumatology and Immunology, Duke University School of Medicine, and Durham VA Medical Center, Durham, North Carolina, USA
| | - Kai Sun
- J.L. Rogers, MD, M.E.B. Clowse, MD, MPH, K. Sun, MD, MS, L.G. Criscione-Schreiber, MD, MEd, R.E. Sadun, MD, PhD, M. Maheswaranathan, MD, D. Burshell, MPH, J. Doss, MD, MPH, A.M. Eudy, PhD, Division of Rheumatology and Immunology, Duke University School of Medicine
| | - Lisa G Criscione-Schreiber
- J.L. Rogers, MD, M.E.B. Clowse, MD, MPH, K. Sun, MD, MS, L.G. Criscione-Schreiber, MD, MEd, R.E. Sadun, MD, PhD, M. Maheswaranathan, MD, D. Burshell, MPH, J. Doss, MD, MPH, A.M. Eudy, PhD, Division of Rheumatology and Immunology, Duke University School of Medicine
| | - Rebecca E Sadun
- J.L. Rogers, MD, M.E.B. Clowse, MD, MPH, K. Sun, MD, MS, L.G. Criscione-Schreiber, MD, MEd, R.E. Sadun, MD, PhD, M. Maheswaranathan, MD, D. Burshell, MPH, J. Doss, MD, MPH, A.M. Eudy, PhD, Division of Rheumatology and Immunology, Duke University School of Medicine
| | - Mithu Maheswaranathan
- J.L. Rogers, MD, M.E.B. Clowse, MD, MPH, K. Sun, MD, MS, L.G. Criscione-Schreiber, MD, MEd, R.E. Sadun, MD, PhD, M. Maheswaranathan, MD, D. Burshell, MPH, J. Doss, MD, MPH, A.M. Eudy, PhD, Division of Rheumatology and Immunology, Duke University School of Medicine
| | - Dana Burshell
- J.L. Rogers, MD, M.E.B. Clowse, MD, MPH, K. Sun, MD, MS, L.G. Criscione-Schreiber, MD, MEd, R.E. Sadun, MD, PhD, M. Maheswaranathan, MD, D. Burshell, MPH, J. Doss, MD, MPH, A.M. Eudy, PhD, Division of Rheumatology and Immunology, Duke University School of Medicine
| | - Jayanth Doss
- J.L. Rogers, MD, M.E.B. Clowse, MD, MPH, K. Sun, MD, MS, L.G. Criscione-Schreiber, MD, MEd, R.E. Sadun, MD, PhD, M. Maheswaranathan, MD, D. Burshell, MPH, J. Doss, MD, MPH, A.M. Eudy, PhD, Division of Rheumatology and Immunology, Duke University School of Medicine
| | - Amanda M Eudy
- J.L. Rogers, MD, M.E.B. Clowse, MD, MPH, K. Sun, MD, MS, L.G. Criscione-Schreiber, MD, MEd, R.E. Sadun, MD, PhD, M. Maheswaranathan, MD, D. Burshell, MPH, J. Doss, MD, MPH, A.M. Eudy, PhD, Division of Rheumatology and Immunology, Duke University School of Medicine;
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Matarneh AS, Salameh O, Sardar S, Karasinski A, Channapragada T, Abdulbasit M, Washburn E, Ghahramani N. A rare case of non-lupus full house nephropathy in a transplanted kidney, case report. Clin Case Rep 2024; 12:e8886. [PMID: 38707603 PMCID: PMC11066189 DOI: 10.1002/ccr3.8886] [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: 01/22/2024] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 05/07/2024] Open
Abstract
Key Clinical Message Non-lupus full house nephropathy is a rare entity that is still poorly understood. It can complicate post-transplant kidneys and result in a de novo process. Treatment is difficult but can be possibly achieved with optimization of immune suppression. Abstract Non-lupus full house nephropathy is a rare entity with an unclear incidence. It describes the kidney biopsy findings of positive deposits for IgG, IgA, IgM, C3, and C1q on immunofluorescence in the absence of the classical diagnostic features of systemic lupus nephritis. This disease entity is becoming more recognized but further studies are still needed to evaluate the incidence, etiologies, and management of this condition. Transplant glomerulopathy is a major cause for renal graft loss. It can present with a wide variety of manifestations; it can cause AKI, CKD, or glomerular inflammations through an immune complex or autoimmune-mediated damage.
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Affiliation(s)
- Ahmad Samir Matarneh
- Department of NephrologyPenn State Milton S Hershey Medical CenterHersheyPennsylvaniaUSA
| | - Omar Salameh
- Department of Internal MedicinePenn State Milton S Hershey Medical CenterHersheyPennsylvaniaUSA
| | - Sundus Sardar
- Department of NephrologyPenn State Milton S Hershey Medical CenterHersheyPennsylvaniaUSA
| | - Amanda Karasinski
- Department of NephrologyPenn State Milton S Hershey Medical CenterHersheyPennsylvaniaUSA
| | - Theja Channapragada
- Department of Internal MedicinePenn State Milton S Hershey Medical CenterHersheyPennsylvaniaUSA
| | - Muhammad Abdulbasit
- Department of NephrologyPenn State Milton S Hershey Medical CenterHersheyPennsylvaniaUSA
| | - Erik Washburn
- Department of PathologyPenn State Milton S Hershey Medical CenterHersheyPennsylvaniaUSA
| | - Nasrollah Ghahramani
- Department of NephrologyPenn State Milton S Hershey Medical CenterHersheyPennsylvaniaUSA
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Bahabayi A, Zhang YH, Yuan Z, Wang Y, Zhang Z, Zeng X, Guan Z, Wang P, Liu C. FCRL3 expression is upregulated and closely correlates with TIGIT expression in regulatory T cells of patients with systemic lupus erythematosus. Eur J Immunol 2024; 54:e2350739. [PMID: 38461541 DOI: 10.1002/eji.202350739] [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: 08/28/2023] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/12/2024]
Abstract
Using data from single-cell RNA sequencing and flow cytometry, we initially examined the expression of FCRL3, finding it to be elevated and positively associated with TIGIT expression in the regulatory T cells of patients with systemic lupus erythematosus. This also suggests that the co-expression of FCRL3 and TIGIT warrants further attention.
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Affiliation(s)
- Ayibaota Bahabayi
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China
| | - Ya-Hui Zhang
- School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Zihang Yuan
- School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Yiying Wang
- School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Zhonghui Zhang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China
| | - Xingyue Zeng
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China
| | - Zhao Guan
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China
| | - Pingzhang Wang
- Department of Immunology, NHC Key Laboratory of Medical Immunology (Peking University), Medicine Innovation Center for Fundamental Research on Major Immunology-related Diseases, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
- Peking University Center for Human Disease Genomics, Peking University Health Science Center, Beijing, China
| | - Chen Liu
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China
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Darmawan G, Liman LMS, Wibowo SAK, Hamijoyo L, Apriani L, Atik N, Alisjahbana B, Sahiratmadja E. Global tuberculosis disease and infection in systemic lupus erythematosus patients: A systematic review and meta-analysis. Lupus 2024; 33:555-573. [PMID: 38490946 DOI: 10.1177/09612033241239504] [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] [Indexed: 03/17/2024]
Abstract
BACKGROUND Tuberculosis (TB) is one of the most common infections among systemic lupus erythematosus (SLE) patients. We aimed to evaluate the global prevalence of TB infection and disease, its type, and medication risk factors in SLE patients. METHODS We searched PubMed, Science Direct, EBSCO, and Web of Science databases from inception to April 30, 2023, and included studies assessing TB among SLE patients. We estimated the prevalence of TB disease (including type of TB disease), TB infection, and SLE medication as TB risk factors. Meta-analysis was performed using Stata 14.2 and Review Manager 5.3. RESULTS Twenty-seven studies met the eligibility criteria. The global prevalence of TB disease was 4% (95% confidence interval (CI): 3-4%, n = 25) and TB infection was 18% (95% CI: 10-26%, n = 3). The pooled prevalence of pulmonary TB, extrapulmonary TB, and disseminated TB were 2% (95% CI: 2-3%, n = 20), 1% (95% CI: 1-2%, n = 17), and 1% (95% CI: 0-1%, n = 6), respectively. The 1-year cumulative glucocorticoid (GC) dose in SLE patients contracting TB was higher than in those without TB, having a mean difference of 2.56 (95% CI: 0.22-4.91, p < .00001, n = 3). The odd ratio of TB was 2.11 (95% CI: 1.01-4.41, p = .05, n = 3) in SLE patients receiving methylprednisolone (MP) pulse therapy as compared to those without MP pulse therapy. Other immunosuppressive agents were not significantly associated with TB. CONCLUSION TB prevalence in SLE was relatively high and associated with GC. Awareness of TB and lowering GC dose are warranted to alleviate the TB burden in SLE.
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Affiliation(s)
- Guntur Darmawan
- Doctoral Study Program, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Department of Internal Medicine, Faculty of Medicine, Krida Wacana Christian University, Jakarta, Indonesia
| | | | - Suryo Anggoro Kusumo Wibowo
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Laniyati Hamijoyo
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Lika Apriani
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Nur Atik
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Bachti Alisjahbana
- Division of Infectious and Tropical Disease, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia
| | - Edhyana Sahiratmadja
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
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Gouda W, Alsaqabi F, Almurshed M, Mostafa AA, Albasri A, Negm A, Islam MA, Kamal M. Kikuchi-Fujimoto disease, simultaneously diagnosed with systemic lupus erythematosus in an Arabic female: an agonizing combination. J Int Med Res 2024; 52:3000605241248884. [PMID: 38713457 PMCID: PMC11080725 DOI: 10.1177/03000605241248884] [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: 10/19/2023] [Accepted: 03/28/2024] [Indexed: 05/08/2024] Open
Abstract
Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare, benign condition affecting young Oriental-Asian females. It is characterized by fever and tender cervical lymphadenopathy with an unclear aetiology, and in most longitudinal reviews, KFD occurs before systemic lupus erythematosus (SLE). Herein, the case of a 28-year-old Kuwaiti female without any relevant past medical history, who was simultaneously diagnosed with KFD and SLE following an Ebstein-Barr virus infection, is reported. The patient was treated with oral prednisolone, hydroxychloroquine, cyclosporin, and belimumab and her response was clinically and biochemically favourable. Although KFD is prevalent in Asian populations, it may affect all races. Early diagnosis of KFD is difficult, particularly when simultaneously diagnosed with SLE, but crucial to preventing inappropriate therapy. Clinicians need to know about this rare disease, especially when patients present with fever and swollen lymph nodes, due to a risk of misdiagnosis with tuberculosis or lymphoma, as these are more often thought to be the cause of such symptoms.
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Affiliation(s)
- Wesam Gouda
- Department of Rheumatology, Faculty of Medicine, Al Azhar University, Egypt
- Rheumatology Unit, Al‐Sabah Hospital, Kuwait
| | | | | | - Ashraf A. Mostafa
- Department of Rheumatology, Faculty of Medicine, Al Azhar University, Egypt
| | | | - Ahmed Negm
- Department of Rheumatology, Faculty of Medicine, Al Azhar University, Egypt
- Rheumatology Unit, Medical Affairs Department, Dubai Hospital, Dubai, UAE
| | - Md Asiful Islam
- WHO Collaborating Centre for Global Women’s Health, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Mohamed Kamal
- Department of Rheumatology, Faculty of Medicine, Al Azhar University, Egypt
- Faculty of Medicine, Taibah University, Medina, Saudi Arabia
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Abdallah K, Udaipuria S, Murden R, McKinnon II, Erving CL, Fields N, Moore R, Booker B, Burey T, Dunlop-Thomas C, Drenkard C, Johnson DA, Vaccarino V, Lim SS, Lewis TT. Financial Hardship and Sleep Quality Among Black American Women With and Without Systemic Lupus Erythematosus. Psychosom Med 2024; 86:315-323. [PMID: 38724039 PMCID: PMC11090455 DOI: 10.1097/psy.0000000000001296] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/15/2024]
Abstract
OBJECTIVE To compare dimensions of financial hardship and self-reported sleep quality among Black women with versus without systemic lupus erythematosus (SLE). METHODS Participants were 402 Black women (50% with validated diagnosis of SLE) living in Georgia between 2017 and 2020. Black women with SLE were recruited from a population-based cohort established in Atlanta, and Black women without SLE were recruited to be of comparable age and from the same geographic areas as SLE women. Financial hardship was measured using three different scales: financial adjustments, financial setbacks, and financial strain. Sleep was assessed continuously using the Pittsburgh Sleep Quality Index (PSQI) scale. Each dimension of financial hardship was analyzed separately in SLE-stratified multivariable linear regression models and adjusted by sociodemographic and health status factors. RESULTS Dimensions of financial hardship were similarly distributed across the two groups. Sleep quality was worse in Black women with, versus without, SLE (p < .001). Among Black women with SLE, financial adjustment was positively associated with a 0.40-unit increase in poor sleep quality (95% CI = 0.12-0.67, p = .005). When accounting for cognitive depressive symptoms, financial setbacks and strain were somewhat attenuated for Black women with SLE. Overall, no associations between financial hardships and sleep quality were observed for the women without SLE. CONCLUSIONS Black women with SLE who experience financial hardships may be more at risk for poor sleep quality than Black women without SLE. Economic interventions targeting this population may help improve their overall health and quality of life.
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Affiliation(s)
- Khadijah Abdallah
- From the Department of Epidemiology (Abdallah, Udaipuria, Murden, McKinnon, Fields, Booker, Burey, Dunlop-Thomas, Drenkard, Johnson, Vaccarino, Lim, Lewis), Rollins School of Public Health, Emory University, Atlanta, Georgia; Department of Sociology (Erving), Population Research Center, University of Texas, Austin, Texas; Dornsife School of Public Health (Moore), Drexel University, Philadelphia, Pennsylvania; Division of Rheumatology (Drenkard), Emory University; and Division of Rheumatology (Lim), Grady Health System, Atlanta, Georgia
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Sasi S, Eltahir M, Ibrahim E, Padmakumari A, Kolleri J, Abdallah T, Shehatta AL, Hadwan N, Jaouni H, Al‐Maslamani M. Hepatic micro-abscesses as an unusual initial presentation of systemic lupus erythematosus: A case report. Clin Case Rep 2024; 12:e8586. [PMID: 38681037 PMCID: PMC11043084 DOI: 10.1002/ccr3.8586] [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: 01/18/2024] [Revised: 02/12/2024] [Accepted: 02/20/2024] [Indexed: 05/01/2024] Open
Abstract
Key Clinical Message Hepatic micro-abscesses can be a rare initial presentation of systemic lupus erythematosus (SLE). This case highlights the importance of considering autoimmune etiologies when infectious causes are ruled out and emphasizes the need for early recognition and appropriate treatment of atypical hepatic manifestations in SLE to achieve favorable outcomes. Abstract Systemic lupus erythematosus (SLE) is an autoimmune disease that affects multiple organs, including the liver. While hepatic involvement in SLE is typically subclinical or associated with mild liver enzyme elevations, rare manifestations such as hepatic micro-abscesses and hepatic vasculitis have been reported. We report the case of a 27-year-old female who presented with persistent high-grade fever, bilateral exudative lymphocytic pleural effusion, hepatic micro-abscesses, anemia, and lymphopenia. Despite extensive investigations and antibiotic therapy, the patient's condition continued to worsen. The diagnosis of hepatic vasculitis, a rare manifestation of SLE, was ultimately made based on clinical suspicion, positive autoimmune markers, and negative septic workup. The patient responded well to high-dose corticosteroid therapy and intravenous immunoglobulin, with resolution of liver lesions and clinical improvement. Hepatic involvement in SLE is diverse, and atypical presentations can pose diagnostic challenges. Hepatic vasculitis, although rare, should be considered in SLE patients presenting with liver lesions. The management involves immunosuppressive therapy, and prompt diagnosis is crucial to prevent further vascular damage. Hepatic micro-abscesses, another rare manifestation of SLE, are thought to result from immune complex deposition. The exact pathogenesis remains unclear. Hepatic micro-abscesses can have both infectious and non-infectious causes, and it is very important to rule out common microbial pathogens. Treatment focuses on managing the underlying SLE activity with immunosuppressive agents. This case highlights the diagnostic challenges and management considerations in atypical hepatic manifestations of SLE. Awareness of rare presentations and collaboration among multiple specialties are essential for accurate diagnosis and appropriate treatment.
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Affiliation(s)
- Sreethish Sasi
- Department of Infectious DiseasesCommunicable Diseases Center, Hamad Medical CorporationDohaQatar
| | - Mugahid Eltahir
- Department of Critical CareHamad Medical CorporationDohaQatar
| | | | | | - Jouhar Kolleri
- Department of Clinical ImagingHamad Medical CorporationDohaQatar
| | - Tasneem Abdallah
- Department of Infectious DiseasesCommunicable Diseases Center, Hamad Medical CorporationDohaQatar
| | | | - Nawal Hadwan
- Department of RheumatologyHamad Medical CorporationDohaQatar
| | - Hani Jaouni
- Department of Critical CareHamad Medical CorporationDohaQatar
| | - Muna Al‐Maslamani
- Department of Infectious DiseasesCommunicable Diseases Center, Hamad Medical CorporationDohaQatar
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de Arruda JAA, Villarroel-Dorrego M, Freire CH, Molina-Ávila I, Pimentel-Solá JM, Gilligan G, Piemonte E, Panico R, Panico JCR, Aranda-Romo S, Tejeda-Nava FJ, Israel MS, Cunha JLS, de Medeiros VA, Nonaka CFW, Alves PM, Cavalcante IL, Ventura JVL, de Lima FS, Drumond VZ, Abreu LG, Silva TA, Fonseca FP, Mesquita RA, Martínez-Flores R, Cordero-Torres K, Ahumada-Ossandón R, Guzmán J, Toro R, Xavier-Júnior JCC, Sousa-Neto SS, Arantes DAC, Mendonça EF, Palma VDM, de Oliveira MG, Visioli F, Ortega KL, Tenório JR, de Andrade BAB. Oral lesions of systemic lupus erythematosus: A collaborative Latin American study. Lupus 2024:9612033241252042. [PMID: 38686816 DOI: 10.1177/09612033241252042] [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: 05/02/2024]
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease that may affect the oral mucosa. The variable spectrum of oral lesions observed in SLE can pose challenges in diagnosis, particularly when the lesions occur in isolation. The aim of this study was to describe the oral lesions occurring in patients with SLE from Latin America. METHODS This collaborative record-based study involving 11 oral and maxillofacial pathology and medicine services across Venezuela, Argentina, Chile, Brazil, and Mexico describes the clinicopathological profile of SLE-related oral lesions. RESULTS Seventy patients with SLE and oral lesions were included in the study. The majority were females (75.7%; female/male ratio: 3.1:1) and white (62.1%), with a mean age of 38.4 years (range: 11-77 years). The most common site of oral lesions was the hard/soft palate (32.0%). Clinically, oral lesions predominantly presented as ulcers (26.6%), erosions (26.6%), and white lesions (23.4%). Isolated oral lesions occurred in 65.2% of individuals, while cutaneous manifestations occurred in 80.3%. The main clinical diagnostic hypothesis in 71.4% of cases was an immune-mediated disease. Oral biopsies followed by histopathological analysis were performed in 50 cases. CONCLUSION Oral lesions of SLE exhibit a variety of clinical and histopathological features. A key point in diagnosis is that unusual oral changes without an obvious local cause may indicate a possible systemic condition presenting with oral lesions. A multidisciplinary approach, which includes regular oral examination, is warranted to identify oral lesions and provide treatment.
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Affiliation(s)
- José Alcides Almeida de Arruda
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Clara Herrera Freire
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Gerardo Gilligan
- Department of Oral Medicine, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Eduardo Piemonte
- Department of Oral Medicine, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - René Panico
- Department of Oral Medicine, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Juan Cruz Romero Panico
- Department of Oral Medicine, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Saray Aranda-Romo
- Diagnostic Clinic, School of Dentistry, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | | | - Mônica Simões Israel
- Department of Diagnosis and Therapeutics, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - John Lennon Silva Cunha
- Department of Dentistry, School of Dentistry, Universidade Estadual da Paraíba, Campina Grande, Brazil
| | - Vanessa Alves de Medeiros
- Department of Dentistry, School of Dentistry, Universidade Estadual da Paraíba, Campina Grande, Brazil
| | | | - Pollianna Muniz Alves
- Department of Dentistry, School of Dentistry, Universidade Estadual da Paraíba, Campina Grande, Brazil
| | - Israel Leal Cavalcante
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Dentistry, Universidade de Fortaleza, Fortaleza, Brazil
| | - José Victor Lemos Ventura
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernanda Silva de Lima
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - René Martínez-Flores
- Department of Oral Medicine and Oral Pathology, School of Dentistry, Universidad Andres Bello, Viña del Mar, Chile
| | - Karina Cordero-Torres
- Department of Oral Pathology and Diagnosis, School of Dentistry, Universidad de Valparaíso, Valparaíso, Chile
| | - Richard Ahumada-Ossandón
- Department of Oral Pathology and Diagnosis, School of Dentistry, Universidad de Valparaíso, Valparaíso, Chile
| | - Jorge Guzmán
- Department of Oral Medicine, School of Dentistry, Universidad Central de Venezuela, Caracas, Venezuela
| | - Raiza Toro
- Department of Oral Medicine, School of Dentistry, Universidad Central de Venezuela, Caracas, Venezuela
| | - José Cândido Caldeira Xavier-Júnior
- School of Medicine, Centro Universitário Católico Unisalesiano Auxilium, Araçatuba, Brazil
- Pathology Institute of Araçatuba, Araçatuba, Brazil
- Botucatu Medical School, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, Brazil
| | - Sebastião Silvério Sousa-Neto
- Department of Oral Diagnosis, Piracicaba School of Dentistry, Universidade Estadual de Campinas, Piracicaba, Brazil
- Department of Stomatology (Oral Pathology), School of Dentistry, Universidade Federal de Goiás, Goiânia, Brazil
| | - Diego Antônio Costa Arantes
- Department of Stomatology (Oral Pathology), School of Dentistry, Universidade Federal de Goiás, Goiânia, Brazil
| | | | - Victor de Mello Palma
- Department of Oral Pathology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Fernanda Visioli
- Department of Oral Pathology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Karem L Ortega
- Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Jefferson R Tenório
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Xu D, Wu B. Investigating the causal association between systemic lupus erythematosus and migraine using Mendelian randomization analysis. Headache 2024. [PMID: 38679912 DOI: 10.1111/head.14723] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/09/2024] [Accepted: 02/24/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE To assess whether systemic lupus erythematosus (SLE) may be genetically causally associated with migraine, including the two primary subtypes: migraine with aura (MWA) and migraine without aura (MWoA). BACKGROUND The association between SLE and migraine has been investigated extensively. Previous studies have shown a higher prevalence of migraine in patients with SLE, although the exact relationship remains unclear. This study investigated the potential causal association between SLE and migraine using the powerful analytical tool of Mendelian randomization (MR). METHODS We performed two-sample MR analysis of publicly available summary statistic datasets using inverse variance-weighted (IVW), weighted median, and MR-Egger methods based on an SLE genome-wide association study (GWAS; 5201 cases; 9066 controls; the exposure frequency is 36.5%) as an exposure and migraine GWAS (15,905 cases; 264,662 controls) in individuals with European ancestry as outcomes, focusing on the two migraine subtypes MWA (6780 cases; 264,662 controls) and MWoA (5787 cases; 264,662 controls). Thepleiotropy and heterogeneity were performed. RESULTS We selected 42 single-nucleotide polymorphisms from SLE GWAS as instrumental variables (IVs) for SLE on migraine, and 41 SNP IVs for SLE on MWA or MWoA. The IVW (odds ratio [OR] = 1.01, 95% confidence interval [CI] = [0.99, 1.03], p = 0.271), weighted median (OR = 1.00, 95% CI = [0.97, 1.03], p = 0.914), and MR-Egger (OR = 1.04, 95% CI = [0.99, 1.09], p = 0.153) methods showed no causal effect of SLE on migraine. A causal effect of SLE was observed on MWA (IVW: OR = 1.05, 95% CI = [1.02, 1.08], p = 0.001; weighted median: OR = 1.05, 95% CI = [1.01, 1.10], p = 0.018; MR-Egger: OR = 1.07, 95% CI = [1.01, 1.14], p = 0.035 and pIVW < 0.017 [Bonferroni correction]) but not MWoA (IVW: OR = 0.99, 95% CI = [0.96, 1.02], p = 0.331; weighted median: OR = 0.98, 95% CI = [0.94, 1.03], p = 0.496; MR-Egger: OR = 1.02, 95% CI = [0.95, 1.09], p = 0.652). The results showed no significant pleiotropy or heterogeneity. CONCLUSION Our MR analysis demonstrated the complex relationship between SLE and migraine, suggesting a potential effect of SLE on the risk of MWA but not MWoA. These findings can aid in the development of improved subtype-specific management of migraine in patients with SLE.
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Affiliation(s)
- Danfeng Xu
- Shaoxing Central Hospital, The Hospital Affiliated to Shaoxing University, Shaoxing, China
- Central Laboratory, The Central Hospital of Shaoxing University, Shaoxing, China
| | - Bing Wu
- Shaoxing Central Hospital, The Hospital Affiliated to Shaoxing University, Shaoxing, China
- Central Laboratory, The Central Hospital of Shaoxing University, Shaoxing, China
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Yang B, Ma D, Zhu X, Wu Z, An Q, Zhao J, Gao X, Zhang L. Roles of TRP and PIEZO receptors in autoimmune diseases. Expert Rev Mol Med 2024; 26:e10. [PMID: 38659380 DOI: 10.1017/erm.2023.23] [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] [Indexed: 04/26/2024]
Abstract
Autoimmune diseases are pathological autoimmune reactions in the body caused by various factors, which can lead to tissue damage and organ dysfunction. They can be divided into organ-specific and systemic autoimmune diseases. These diseases usually involve various body systems, including the blood, muscles, bones, joints and soft tissues. The transient receptor potential (TRP) and PIEZO receptors, which resulted in David Julius and Ardem Patapoutian winning the Nobel Prize in Physiology or Medicine in 2021, attracted people's attention. Most current studies on TRP and PIEZO receptors in autoimmune diseases have been carried out on animal model, only few clinical studies have been conducted. Therefore, this study aimed to review existing studies on TRP and PIEZO to understand the roles of these receptors in autoimmune diseases, which may help elucidate novel treatment strategies.
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Affiliation(s)
- Baoqi Yang
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China
| | - Dan Ma
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China
| | - Xueqing Zhu
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China
| | - Zewen Wu
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China
| | - Qi An
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China
| | - Jingwen Zhao
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China
| | - Xinnan Gao
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China
| | - Liyun Zhang
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China
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Balog JÁ, Zvara Á, Bukovinszki V, Puskás LG, Balog A, Szebeni GJ. Comparative single-cell multiplex immunophenotyping of therapy-naive patients with rheumatoid arthritis, systemic sclerosis, and systemic lupus erythematosus shed light on disease-specific composition of the peripheral immune system. Front Immunol 2024; 15:1376933. [PMID: 38726007 PMCID: PMC11079270 DOI: 10.3389/fimmu.2024.1376933] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/03/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Systemic autoimmune diseases (SADs) are a significant burden on the healthcare system. Understanding the complexity of the peripheral immunophenotype in SADs may facilitate the differential diagnosis and identification of potential therapeutic targets. Methods Single-cell mass cytometric immunophenotyping was performed on peripheral blood mononuclear cells (PBMCs) from healthy controls (HCs) and therapy-naive patients with rheumatoid arthritis (RA), progressive systemic sclerosis (SSc), and systemic lupus erythematosus (SLE). Immunophenotyping was performed on 15,387,165 CD45+ live single cells from 52 participants (13 cases/group), using an antibody panel to detect 34 markers. Results Using the t-SNE (t-distributed stochastic neighbor embedding) algorithm, the following 17 main immune cell types were determined: CD4+/CD57- T cells, CD4+/CD57+ T cells, CD8+/CD161- T cells, CD8+/CD161+/CD28+ T cells, CD8dim T cells, CD3+/CD4-/CD8- T cells, TCRγ/δ T cells, CD4+ NKT cells, CD8+ NKT cells, classic NK cells, CD56dim/CD98dim cells, B cells, plasmablasts, monocytes, CD11cdim/CD172dim cells, myeloid dendritic cells (mDCs), and plasmacytoid dendritic cells (pDCs). Seven of the 17 main cell types exhibited statistically significant frequencies in the investigated groups. The expression levels of the 34 markers in the main populations were compared between HCs and SADs. In summary, 59 scatter plots showed significant differences in the expression intensities between at least two groups. Next, each immune cell population was divided into subpopulations (metaclusters) using the FlowSOM (self-organizing map) algorithm. Finally, 121 metaclusters (MCs) of the 10 main immune cell populations were found to have significant differences to classify diseases. The single-cell T-cell heterogeneity represented 64MCs based on the expression of 34 markers, and the frequency of 23 MCs differed significantly between at least twoconditions. The CD3- non-T-cell compartment contained 57 MCs with 17 MCs differentiating at least two investigated groups. In summary, we are the first to demonstrate the complexity of the immunophenotype of 34 markers over 15 million single cells in HCs vs. therapy-naive patients with RA, SSc, and SLE. Disease specific population frequencies or expression patterns of peripheral immune cells provide a single-cell data resource to the scientific community.
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Affiliation(s)
- József Á. Balog
- Laboratory of Functional Genomics, Institute of Genetics, HUN-REN Biological Research Centre, Szeged, Hungary
- Core Facility, HUN-REN Biological Research Centre, Szeged, Hungary
| | - Ágnes Zvara
- Laboratory of Functional Genomics, Institute of Genetics, HUN-REN Biological Research Centre, Szeged, Hungary
- Core Facility, HUN-REN Biological Research Centre, Szeged, Hungary
| | - Vivien Bukovinszki
- Department of Rheumatology and Immunology, Faculty of Medicine, Albert Szent-Gyorgyi Health Centre, University of Szeged, Szeged, Hungary
| | - László G. Puskás
- Laboratory of Functional Genomics, Institute of Genetics, HUN-REN Biological Research Centre, Szeged, Hungary
- Core Facility, HUN-REN Biological Research Centre, Szeged, Hungary
| | - Attila Balog
- Department of Rheumatology and Immunology, Faculty of Medicine, Albert Szent-Gyorgyi Health Centre, University of Szeged, Szeged, Hungary
| | - Gábor J. Szebeni
- Laboratory of Functional Genomics, Institute of Genetics, HUN-REN Biological Research Centre, Szeged, Hungary
- Core Facility, HUN-REN Biological Research Centre, Szeged, Hungary
- Department of Internal Medicine, Hematology Centre, Faculty of Medicine University of Szeged, Szeged, Hungary
- Astridbio Technologies Ltd., Szeged, Hungary
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Anutraungkool T, Padungkiatsagul T, Jindahra P, Vanikieti K. Prevalences of Other Non-Thyroid Autoimmune Diseases and Factor Associated with Their Presence in Ocular Myasthenia Gravis. Clin Ophthalmol 2024; 18:1125-1132. [PMID: 38686013 PMCID: PMC11057627 DOI: 10.2147/opth.s458979] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024] Open
Abstract
Purpose To report the prevalences of other non-thyroid autoimmune diseases and identify factors associated with their presence in ocular myasthenia gravis (OMG) subjects. Subjects and Methods A total of 208 subjects with OMG diagnosis were included. Demographic data, clinical characteristics, the ice-pack test, the acetylcholine receptor (AChR) antibody test, electrophysiology tests (single-fiber electromyography and repetitive nerve stimulation), the presence of thymoma, generalized myasthenia gravis conversion, and the presence of other non-thyroid autoimmune diseases (defined as the presence of at least one other non-thyroid autoimmune disease) were retrospectively reviewed. Factors associated with the presence of other non-thyroid autoimmune diseases were analyzed by univariate and multivariate logistic regression. Results Of the total 208 subjects, 21 (10.10%) exhibited the presence of other non-thyroid autoimmune diseases (19 subjects (9.14%) and 2 subjects (0.96%) had one and two other non-thyroid autoimmune diseases, respectively), and systemic lupus erythematosus (SLE) was diagnosed in 9 subjects, followed by Sjogren's syndrome (7 subjects), rheumatoid arthritis (6 subjects), and ankylosing spondylitis (1 subject). Therefore, the prevalences of SLE, Sjogren's syndrome, rheumatoid arthritis, and ankylosing spondylitis in OMG subjects were estimated to be 4.33% (95% confidence interval (CI): 2.29-8.02%), 3.37% (95% CI: 1.64-6.79%), 2.88% (95% CI: 1.33-6.14%), and 0.48% (95% CI: 0.08-2.67%), respectively. Positivity of the AChR antibody was the only significant factor associated with the presence of other non-thyroid autoimmune diseases (odds ratio 4.10, 95% CI: 1.11-15.21, p = 0.035). Conclusions The presence of other non-thyroid autoimmune diseases was found in approximately 10% of OMG patients, with SLE displaying the highest prevalence. We recommend screening and monitoring for other non-thyroid autoimmune diseases in OMG patients, particularly those with positivity of the AChR antibody.
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Affiliation(s)
- Thanathon Anutraungkool
- Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tanyatuth Padungkiatsagul
- Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Panitha Jindahra
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kavin Vanikieti
- Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Nossent JC, Keen HI, Preen DB, Inderjeeth CA. Long-term incidence, risk factors and complications for venous thromboembolism in patients with systemic lupus erythematosus. Lupus 2024:9612033241247359. [PMID: 38655753 DOI: 10.1177/09612033241247359] [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: 04/26/2024]
Abstract
AIM To compare frequency, incidence rates (IR), risk factors and outcomes of a first venous thromboembolic event (VTE) between patients with systemic lupus erythematosus (SLE) and controls. METHODS Using state-wide longitudinal hospital data from Western Australia (WA), we recorded venous thrombosis (VT) and pulmonary embolism (PE) in patients with SLE (n = 1854, median age 40, 86% female) and matched hospitalised controls (n = 12,107, median age 40 years, females 88.6%) in the period 1985-2015. Results presented are medians, frequency, IR per 1000 person years (PY) and odds, rate, or adjusted hazard ratios (OR/RR/a-HR) with 95% confidence intervals (CI). RESULTS Patients with SLE had significantly higher odds (12.8 vs 3.3%; OR 4.26, CI 3.60-5.05) and IR for a first VTE (10.09 vs 1.52; RR 6.64; CI 5.56-7.79). Over the three study decades, the IR for PE declined in patients with SLE from 7.74 to 3.75/1000 PY (p < .01) with no changes observed for VT or in controls. VTE recurred more frequently in patients with SLE (24.1% vs 10.2 %) (p < .01). Antiphospholipid antibodies (aPL) (a-HR 4.24, CI 2.50-7.19), serositis (a-HR 2.70, CI 1.86-3.91), lupus nephritis (a-HR 1.75 CI 1.25-2.33) and thrombocytopenia (a-HR 1.65 (1.10-2.49) were the strongest disease risk factors for VTE only in patients with SLE, while arterial hypertension, smoking and obesity were independent VTE risk factors for both groups. VTE was not associated with an increased risk for arterial events, but PE increased the risk for pulmonary hypertension (PH) in both patients with SLE (a-HR 6.47, CI 3.73-11.23) and controls (a-HR 9.09, CI 3.50-23.63). VTE increased the risk of death in both patients with SLE (a-HR 2.02, CI 1.50-2.70) and controls (a-HR 6.63, CI 5.21-8.42) after 10 years of follow-up. CONCLUSIONS VTE affected 12.8% of patients with SLE at six times the VTE rate in controls with aPL as the strongest, but not the only risk factor in SLE. The risk of PH was increased in both groups following PE, but VTE did not associate with an increased risk of arterial events.
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Affiliation(s)
- Johannes Cornelis Nossent
- Medical School, The University of Western Australia, Perth, Australia
- Rheumatology, Sir Charles Gairdner Hospital, Perth, Australia
| | - Helen Isobel Keen
- Medical School, The University of Western Australia, Perth, Australia
- Rheumatology, Fiona Stanley Hospital, Perth, Australia
| | - David Brian Preen
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Charles Anoukpar Inderjeeth
- Medical School, The University of Western Australia, Perth, Australia
- Rheumatology, Sir Charles Gairdner Hospital, Perth, Australia
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Gu X, Chen H, Li R, Guo D. Roles of mir155hg and TNF-α in evaluation of prognosis of patients with systemic lupus erythematosus. J Med Biochem 2024; 43:265-272. [PMID: 38699702 PMCID: PMC11062337 DOI: 10.5937/jomb0-45870] [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: 06/15/2023] [Accepted: 10/07/2023] [Indexed: 05/05/2024] Open
Abstract
Background Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease characterized by multi-organ multi-system inflammation, causing severe damage to various organs or systems. Recent studies have shown that miR-155 can affect the progression of Lupus Nephritis via regulating TNF-a. The present study aims to explore the roles of MIR155HG and TNF-a in the evaluation of prognosis of patients with SLE, so as to provide a basis for clinical work. Methods A total of 130 patients with SLE admitted to our hospital were selected, were selected from June 2015 to December 2017., and the SLE disease activity index (SLEDAI) score was given. The expressions of MIR155HG and TNF-a were detected via quantitative reverse transcription-polymerase chain reaction (qRT-PCR), the incidence of complications during treatment was observed, and the associations of MIR155HG and TNF-a with SLEDAI before treatment and complications were analyzed. All patients were followed up after discharge, and the related factors to the prognosis of patients were analyzed via Cox regression analysis. Results The levels of MIR155HG and TNF-a were higher in patients with an SLEDAI score of 10-14 points than those in patients with an SLEDAI score of 5-9 points and 0-4 points. MIR155HG and TNF-a were positively correlated with the incidence of infection, renal damage and cardiac damage (r=0.623, 0.533 and 0.621; r=0.431, 0.498 and 0.552) (P<0.05). Moreover, there was also a positive correlation (r=0.3398, P<0.001) between the expressions of serum MIR155HG and TNF-a in SLE patients. SLEDAI score ≥10 points, complications during hospitalization, and highly-expressed MIR155HG and TNFa were risk factors related to the prognosis of patients. Conclusions MIR155HG and TNF-a affect the activity of SLE, and the high expressions of them promote the occurrence of such complications as infection, renal damage and cardiac damage, harming the prognosis.
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Affiliation(s)
- Xiaojing Gu
- The First Affiliated Hospital of Gannan Medical College, Department of Rheumatology and Immunology, Ganzhou, China
| | - Hu Chen
- The First Affiliated Hospital of Gannan Medical College, Department of Rheumatology and Immunology, Ganzhou, China
| | - Rongping Li
- The First Affiliated Hospital of Gannan Medical College, Department of Rheumatology and Immunology, Ganzhou, China
| | - Dibin Guo
- The First Affiliated Hospital of Gannan Medical College, Department of Rheumatology and Immunology, Ganzhou, China
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Ramirez P, Giglio A, Verdugo J, Gutierrez F. Induction treatment for lupus nephritis at a high-complexity hospital in Chile. Lupus 2024:9612033241249574. [PMID: 38652826 DOI: 10.1177/09612033241249574] [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: 04/25/2024]
Abstract
INTRODUCTION Systemic lupus erythematosus (SLE) causes kidney compromise in up to 40% of patients, contributing significantly to morbidity. Lupus nephritis (LN), an early onset manifestation in most patients, is histologically classified into six types, with types III, IV, and V requiring treatment with induction therapies, usually glucocorticoids with mycophenolate mofetil (MMF) or intravenous cyclophosphamide (IVC). However, up to 60% of patients fail to achieve complete remission, and 27%-66% have subsequent flares. There is scarce literature on the superiority of IVC or MMF in the Latin population. METHODOLOGY A retrospective cohort study of 72 LN patients at a high-complexity hospital in Chile between 2016 and 2021 was conducted. Demographics, urine studies, creatinine levels, complement levels, antibody profiles, biopsy results, and response to treatment were analysed. RESULTS The median age of the cohort was 29 years, with women representing 90% of patients. At diagnosis, 87.5% of the patients presented with proteinuria, 55% had haematuria, and 49% had acute kidney injury. The most common LN type was type IV. For induction therapy, half of the patients were treated with IVC, and the other half with MMF. The response to treatment did not differ significantly between the two. DISCUSSION This is one of the few studies to focus on the Latin American population, specifically Chile. These results are consistent with the current understanding of LN treatment. Despite its limitations, this study provides valuable insights into the treatment effectiveness of IVC and MMF in this population. CONCLUSION This study did not find significant differences in the clinical response to IVC or MMF at 6 months. Future prospective studies are required to determine the optimal induction therapy for LN, especially in Latin populations.
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Affiliation(s)
- Paulina Ramirez
- Rheumatology Unit, Complejo Asistencial Dr Sótero del Río, Puente Alto, Chile
- Internal Medicine Department, Complejo Asistencial, Dr Sótero del Río, Puente Alto, Chile
| | - Andres Giglio
- Critical Care Department, Finis Terrae University, Santiago, Chile
- Critical Care Department, Clínica Las Condes Hospital, Las Condes, Chile
| | - Jorge Verdugo
- Internal Medicine Department, Complejo Asistencial, Dr Sótero del Río, Puente Alto, Chile
| | - Francisco Gutierrez
- Rheumatology Unit, Complejo Asistencial Dr Sótero del Río, Puente Alto, Chile
- Internal Medicine Department, Complejo Asistencial, Dr Sótero del Río, Puente Alto, Chile
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Akdogan MR, Melikoglu MA. A potential biomarker of disease activity in systemic lupus erythematosus, systemic immune-inflammation index. North Clin Istanb 2024; 11:115-119. [PMID: 38757099 PMCID: PMC11095327 DOI: 10.14744/nci.2023.90132] [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: 11/16/2022] [Accepted: 05/10/2023] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVE Biomarkers using routine laboratory tests accurately presenting systemic lupus erythematosus (SLE) disease activity may have important practical values in clinical settings. The primary purpose of this study was to investigate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII; neutrophil X platelet/lymphocyte) as potential biomarkers of disease activity in cases with SLE. METHODS In this case-control observational study, cases with SLE and demographically similar healthy controls were included. For clinical evaluation demographic features, disease duration and drugs were recorded. SLE clinical disease activity was assessed with SLEDAI scores. For laboratory assessments; erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and C3-C4 levels and anti-dsDNA positivity were recorded. Based on the simultaneous complete blood count (CBC) of the participants NLR, PLR and SII were calculated. The correlation between clinical and laboratory data was analyzed. RESULTS 68 cases with SLE (64 women, 8 men) and 69 controls (65 women, 4 men) were included in this investigation. The demographic features of the cases and controls were similar. ESR, CRP, NLR, PLR and SII scores were statistically higher in cases with SLE than controls (p<0.000). Statistically significant positive correlations between SLEDAI and NLR, PLR and SII scores were demonstrated (p=0.01, r=0.505; 0.414; 0.698, respectively). We determined a cut-off value of SII as 681,3 presenting 77% sensitivity and 76% specificity to discriminate no-mild disease activity and moderate-higher SLE disease activity status. The SII cut-off value was determined as 681,3 presenting 77% sensitivity and 76% specificity (p<0.000, and AUC=0.930). CONCLUSION CBC indices were shown to be higher in cases with SLE than healthy controls in our study. By presenting a strong correlation with disease activity and discriminating ability of disease status, SII might serve as a biomarker supporting clinical evaluation in SLE.
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Affiliation(s)
- Muhammed Recai Akdogan
- Division of Rheumatology, Department of Internal Medicine, Ataturk University Faculty of Medicine, Erzurum, Turkiye
| | - Meltem Alkan Melikoglu
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Ataturk University Faculty of Medicine, Erzurum, Turkiye
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Yu H, Xie Y, Zuo M, Xu J, Jiang L, Liu T, Wang R, Hu D, Cha Z. Mapping theme evolution and identifying hotspots in biomarkers of systemic lupus erythematosus based on global research. Biomark Med 2024. [PMID: 38648095 DOI: 10.2217/bmm-2023-0774] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
Objective: To perform a bibliometric analysis in the field of biomarkers for systemic lupus erythematosus. Methods: Publications were from Web of Science. Microsoft Excel, VOSviewer, Science Mapping Analysis software Tool, CiteSpace and Tableau were used for analysis. Results: A total of 1112 publications were identified; 1503 institutions from 69 countries contributed, with the highest outputs from China and Karolinska University Hospital. Petri had a tremendous impact. Academic collaborations were localized. Lupus and Arthritis & Rheumatology were the top two journals in terms of publications and citations. Lymphocyte, autoantibody, type I interferon, genetic polymorphisms and urinary biomarkers have been high-frequency themes. Conclusion: Global collaboration needs to be further strengthened. Immune cell, cytokine and gene-level research as a whole and noninvasive tests are the future trends.
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Affiliation(s)
- Haitao Yu
- Department of Laboratory Medicine, The First Hospital of Lanzhou University, The First Clinical Medical College of Lanzhou University, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Yafei Xie
- West China School of Medicine/West China Hospital of Sichuan University, Sichuan University, Chengdu, Sichuan, 610041, China
- The First Clinical Medical College of Lanzhou University, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Meiying Zuo
- The First Clinical Medical College of Lanzhou University, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Jianguo Xu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Lili Jiang
- School of Material Science & Technology, Lanzhou University of Technology, Lanzhou, Gansu, 730050, China
| | - Ting Liu
- Department of Laboratory Medicine, Traditional Chinese Medicine Hospital of Yunyang County, Chongqing, 404500, China
| | - Renmei Wang
- The First Clinical Medical College of Lanzhou University, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Dexuan Hu
- The First Clinical Medical College of Lanzhou University, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Zhenglei Cha
- The First Clinical Medical College of Lanzhou University, Lanzhou University, Lanzhou, Gansu, 730000, China
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Fijałkowska A, Kądziela M, Żebrowska A. The Spectrum of Cutaneous Manifestations in Lupus Erythematosus: A Comprehensive Review. J Clin Med 2024; 13:2419. [PMID: 38673692 PMCID: PMC11050979 DOI: 10.3390/jcm13082419] [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: 03/03/2024] [Revised: 04/13/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Lupus erythematosus (LE) is an autoimmune inflammatory disease with complex etiology. LE may present as a systemic disorder affecting multiple organs or be limited solely to the skin. Cutaneous LE (CLE) manifests with a wide range of skin lesions divided into acute, subacute and chronic subtypes. Despite classic forms of CLE, such as malar rash or discoid LE, little-known variants may occur, for instance hypertrophic LE, chilblain LE and lupus panniculitis. There are also numerous non-specific manifestations including vascular abnormalities, alopecia, pigmentation and nail abnormalities or rheumatoid nodules. Particular cutaneous manifestations correlate with disease activity and thus have great diagnostic value. However, diversity of the clinical picture and resemblance to certain entities delay making an accurate diagnosis The aim of this review is to discuss the variety of cutaneous manifestations and indicate the clinical features of particular CLE types which facilitate differential diagnosis with other dermatoses. Although in diagnostically difficult cases histopathological examination plays a key role in the differential diagnosis of LE, quick and accurate diagnosis ensures adequate therapy implementation and high quality of life for patients. Cooperation between physicians of various specialties is therefore crucial in the management of patients with uncommon and photosensitive skin lesions.
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Affiliation(s)
| | | | - Agnieszka Żebrowska
- Department of Dermatology and Venereology, Medical University of Lodz, Haller sq. 1, 90-647 Lodz, Poland; (A.F.); (M.K.)
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Jiang L, Qi A, Yang H, Wang S, Wang F, Bai X, Ren J. LncRNA SNHG1 serves as a biomarker for systemic lupus erythematosus and participates in the disease progression. APMIS 2024. [PMID: 38644557 DOI: 10.1111/apm.13410] [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: 12/25/2023] [Accepted: 03/20/2024] [Indexed: 04/23/2024]
Abstract
LncRNAs play an important role in autoimmune diseases. The purpose of this study was to explore the role of lncRNA SNHG1 in systemic lupus erythematosus (SLE), and laid a theoretical foundation for the study of SLE. The basic clinical information of all subjects was first collected for statistical analysis, and SNHG1 expression in the serum of all subjects was detected by RT-qPCR. The value of SNHG1 in the diagnosis of SLE was assessed by ROC. The correlation between SNHG1 and each blood sample index was analyzed by Pearson correlation analysis. The role of SNHG1 in primary peripheral blood mononuclear cells (PBMCs) apoptosis was explored. SNHG1 expression is relatively upregulated in patients with SLE compared to healthy people. SNHG1 expression was positively correlated with SLEDAI score, IgG, CRP, and ESR, and negatively correlated with C3 and C4. ROC indicated that SNHG1 has the potential to assist in the diagnosis of SLE. PBMCs apoptosis in SLE was higher than that in control group, the knockdown and overexpression of SNHG1 could correspondingly inhibit and promote PBMCs apoptosis. SNHG1 has the potential to be a diagnosis marker for SLE and may be involved in regulating PBMCs apoptosis.
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Affiliation(s)
- Linsen Jiang
- Department of Nephrology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Anning Qi
- Department of Laboratory, Nanjing LuHe People's Hospital, Nanjing, China
| | - Hongyu Yang
- Department of Clinical Laboratory, Affiliated Hospital of PanZhiHua University, Panzhihua, China
| | - Shuping Wang
- Department of Clinical Laboratory, Affiliated Hospital of PanZhiHua University, Panzhihua, China
| | - Fei Wang
- Department of Clinical Laboratory, Affiliated Hospital of PanZhiHua University, Panzhihua, China
| | - Xuemei Bai
- Department of Clinical Laboratory, Affiliated Hospital of PanZhiHua University, Panzhihua, China
| | - Juan Ren
- Department of Clinical Laboratory, Affiliated Hospital of PanZhiHua University, Panzhihua, China
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Sun J, Huang L, Wang J, Hu Y, Wang W, Zhu H. Programmed cell death in autoimmune diseases: ferroptosis. Ann Biol Clin (Paris) 2024; 82:33-42. [PMID: 38638017 DOI: 10.1684/abc.2024.1866] [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] [Indexed: 04/20/2024]
Abstract
Ferroptosis is an iron dependent cell death driven by lipid peroxidation. Over the past decade, increasing evidence has confirmed that ferroptosis plays an irreplaceable role in the occurrence and development of many diseases, including various cancers, neurodegenerative diseases, cardiovascular diseases and autoimmune diseases. Autoimmune disease is an inflammatory disease characterized by the breakdown of immune tolerance. Nowadays, accumulating evidence indicates that ferroptosis is closely related to the pathogenesis of autoimmune diseases. Therefore, this review briefly introduced the mechanism of ferroptosis, and focused on the related research of ferroptosis in multiple autoimmune diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), multiple sclerosis (MS), ankylosing spondylitis (AS). In addition, we also presented the idea of targeting ferroptosis as a potential therapeutic target for patients with autoimmune diseases, which may provide a direction for the development of new therapeutic strategies.
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Affiliation(s)
- Jiantao Sun
- Rheumatology and Immunology Department, Haining Kanghua Hospital, No. 2299, Jiangnan Avenue, Jiaxing, China
| | - Lujuan Huang
- Rheumatology and Immunology Department, Haining Kanghua Hospital, No. 2299, Jiangnan Avenue, Jiaxing, China
| | - Jiawei Wang
- Rheumatology and Immunology Department, Haining Kanghua Hospital, No. 2299, Jiangnan Avenue, Jiaxing, China
| | - Yelang Hu
- Biological Medicine Research and Development Center, Yangtze Delta of Zhejiang, China
| | - Wenmin Wang
- Biological Medicine Research and Development Center, Yangtze Delta of Zhejiang, China
| | - Haihong Zhu
- Rheumatology and Immunology Department, Haining Kanghua Hospital, No. 2299, Jiangnan Avenue, Jiaxing, China
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45
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Yang H, Wang S, Wang F, Bai X, Ren J. Serum long non-coding Ribonucleic Acid H19 serves as a biomarker for systemic lupus erythematosus and participates in the disease progression. Lupus 2024:9612033241243175. [PMID: 38634475 DOI: 10.1177/09612033241243175] [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: 04/19/2024]
Abstract
AIM This study aimed to investigate the expression of H19 and its possible molecular mechanism in systemic lupus erythematosus (SLE). METHODS The expression of H19 and miR-19b in serum and peripheral blood mononuclear cells (PBMCs) were detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR). Receiver operator characteristic (ROC) curve was constructed to evaluate the diagnostic value of serum H19 in SLE. Pearson correlation coefficient was used to analyze the correlation between serum levels of H19 and miR-19b. Flow cytometry and Cell counting kit-8 (CCK-8) assay were performed to detect cell apoptosis and viability. The levels of pro-inflammatory and anti-inflammatory factors were measured by enzyme-linked immunosorbent assay (ELISA). Luciferase reporter gene assay was conducted to verify the interaction between H19 and miR-19b. RESULTS The expression of H19 and miR-19b in SLE group were up-regulated and down-regulated, respectively. Serum H19 has certain clinical diagnostic value in SLE. In in vitro studies, overexpression of H19 can significantly inhibit the viability of PBMCs and promote apoptosis and inflammatory response of PBMCs by interacting with miR-19b. CONCLUSIONS The expression of H19 is upregulated in patients with SLE and plays a role in cell function and inflammation by targeting miR-19b in PBMCs, which may be one of the pathological mechanisms of SLE.
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Affiliation(s)
- Hongyu Yang
- Department of Clinical Laboratory, Affiliated Hospital of Panzhihua University, Panzhihua, China
| | - Shuping Wang
- Department of Clinical Laboratory, Affiliated Hospital of Panzhihua University, Panzhihua, China
| | - Fei Wang
- Department of Clinical Laboratory, Affiliated Hospital of Panzhihua University, Panzhihua, China
| | - Xuemei Bai
- Department of Clinical Laboratory, Affiliated Hospital of Panzhihua University, Panzhihua, China
| | - Juan Ren
- Department of Clinical Laboratory, Affiliated Hospital of Panzhihua University, Panzhihua, China
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Gönüllü Ö, Kahraman FC, Yıldırım UM. Leg Ulcers in a Patient With Systemic Lupus Erythematosus and Successful Treatment With Anticoagulant Therapy. INT J LOW EXTR WOUND 2024:15347346241248260. [PMID: 38632946 DOI: 10.1177/15347346241248260] [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: 04/19/2024]
Abstract
Among specific skin manifestations of systemic lupus erythematosus such as leukocytoclastic vasculitis, and vasculopathy, the development of leg ulcers is rare and frequently seen in patients with antiphospholipid antibody positivity. Here we report the rapid healing of a leg ulcer without antiphospholipid antibody positivity in a patient with lupus in response to anticoagulant therapy. As in our case, when immunosuppressive agents are inadequate in lupus patients who develop leg ulcers, it may be beneficial to support the treatment with anticoagulants.
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Affiliation(s)
- Öykü Gönüllü
- Department of Dermatology and Venerology, Göztepe Süleyman Yalçın Şehir Hastanesi, Istanbul Medeniyet University, Istanbul, Turkey
| | - Filiz C Kahraman
- Deparment of Dermatology and Venerology, Sultan 2, Abdülhamid Han Eğitim ve Araştırma Hastanesi, Sağlık Bilimleri University, Istanbul, Turkey
| | - Umut Mert Yıldırım
- Department of Dermatology and Venerology, Göztepe Süleyman Yalçın Şehir Hastanesi, Istanbul Medeniyet University, Istanbul, Turkey
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Lin Y, Wu X, Yang Y, Wu Y, Xiang L, Zhang C. The multifaceted role of autophagy in skin autoimmune disorders: a guardian or culprit? Front Immunol 2024; 15:1343987. [PMID: 38690268 PMCID: PMC11058840 DOI: 10.3389/fimmu.2024.1343987] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 04/01/2024] [Indexed: 05/02/2024] Open
Abstract
Autophagy is a cellular process that functions to maintain intracellular homeostasis via the degradation and recycling of defective organelles or damaged proteins. This dynamic mechanism participates in various biological processes, such as the regulation of cellular differentiation, proliferation, survival, and the modulation of inflammation and immune responses. Recent evidence has demonstrated the involvement of polymorphisms in autophagy-related genes in various skin autoimmune diseases. In addition, autophagy, along with autophagy-related proteins, also contributes to homeostasis maintenance and immune regulation in the skin, which is associated with skin autoimmune disorders. This review aims to provide an overview of the multifaceted role of autophagy in skin autoimmune diseases and shed light on the potential of autophagy-targeting therapeutic strategies in dermatology.
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Affiliation(s)
| | | | | | | | | | - Chengfeng Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
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48
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Ueda Y, Sakai T, Yamada K, Arita K, Ishige Y, Hoshi D, Yanagisawa H, Iwao-Kawanami H, Kawanami T, Mizuta S, Fukushima T, Yamada S, Yachie A, Masaki Y. Fatal hemophagocytic lymphohistiocytosis with intravascular large B-cell lymphoma following coronavirus disease 2019 vaccination in a patient with systemic lupus erythematosus: an intertwined case. Immunol Med 2024:1-8. [PMID: 38619098 DOI: 10.1080/25785826.2024.2338594] [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: 11/06/2023] [Accepted: 03/31/2024] [Indexed: 04/16/2024] Open
Abstract
Hemophagocytic lymphohistiocytosis (HLH) has been recognized as a rare adverse event following the coronavirus disease 2019 (COVID-19) vaccination. We report a case of neuropsychiatric symptoms and refractory HLH in a woman with systemic lupus erythematosus (SLE) after receiving her COVID-19 vaccine treated with belimumab, later found to have intravascular large B-cell lymphoma (IVLBCL) at autopsy. A 61-year-old woman with SLE was referred to our hospital because of impaired consciousness and fever. One month prior to consulting, she received her second COVID-19 vaccine dose. Afterward, her consciousness level decreased, and she developed a high fever. She tested negative for SARS-CoV-2. Neuropsychiatric SLE was suspected; therefore, glucocorticoid pulse therapy was initiated on day 1 and 8. She had thrombocytopenia, increased serum ferritin levels and hemophagocytosis. The patient was diagnosed with HLH and treated with etoposide, dexamethasone and cyclosporine. Despite treatment, the patient died on day 75; autopsy report findings suggested IVLBCL as the underlying cause of HLH. Differentiating comorbid conditions remains difficult; however, in the case of an atypical clinical presentation, other causes should be considered. Therefore, we speculate that the COVID-19 vaccination and her autoimmune condition may have expedited IVLBCL development.
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Affiliation(s)
- Yusuke Ueda
- Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan
| | - Tomoyuki Sakai
- Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan
| | - Kazunori Yamada
- Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan
- Department of Medical Education, Kanazawa Medical University, Uchinada, Japan
| | - Kotaro Arita
- Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan
| | - Yoko Ishige
- Department of Respiratory Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Daisuke Hoshi
- Department of Oncologic Pathology, Kanazawa Medical University, Uchinada, Japan
| | - Hiroto Yanagisawa
- Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan
| | - Haruka Iwao-Kawanami
- Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan
| | - Takafumi Kawanami
- Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan
| | - Shuichi Mizuta
- Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan
| | - Toshihiro Fukushima
- Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan
| | - Sohsuke Yamada
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Akihiro Yachie
- Division of Medical Safety, Kanazawa University Hospital, Kanazawa, Japan
| | - Yasufumi Masaki
- Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan
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49
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Sudhakar M, Kocheril AP, George AS, Vettiyil GI, Jasper A, Kumar S. Idiopathic intracranial hypertension as the initial presenting manifestation of systemic lupus erythematosus in a child. Lupus 2024:9612033241247358. [PMID: 38607271 DOI: 10.1177/09612033241247358] [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: 04/13/2024]
Abstract
Idiopathic intracranial hypertension (IIH) is a diagnosis of exclusion characterized by features of raised intracranial pressure (ICP) in the absence of brain parenchymal lesion, vascular malformations, hydrocephalus, or central nervous system (CNS) infection. Commonly used other terms for this entity include benign intracranial hypertension (BIH) or pseudotumor cerebri. Few case reports of systemic lupus erythematosus (SLE) presenting as IIH are available in the literature. We report a 12-year-old girl presented with chronic holocranial headache and occasional episodes of projectile vomiting for the last 6 months and then developed blurring of vision for the last month. She fulfilled the criteria for IIH. Subsequent evaluation revealed a diagnosis of SLE. The occurrence of IIH in SLE is not coincidental and is reported in 1%-5.4% of patients with SLE. Though corticosteroids have not been widely used in IIH, underlying SLE warranted administering corticosteroids with subsequent complete resolution of IIH. Pediatricians, neurologists, intensivists, and ophthalmologists should consider SLE as a differential diagnosis in children presenting with IIH.
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Affiliation(s)
- Murugan Sudhakar
- Pediatric Rheumatology, Pediatrics Unit II, Department of Pediatrics, Christian Medical College, Vellore, India
| | - Anu P Kocheril
- Pediatric Rheumatology, Pediatrics Unit II, Department of Pediatrics, Christian Medical College, Vellore, India
| | - Anish S George
- Pediatric Rheumatology, Pediatrics Unit II, Department of Pediatrics, Christian Medical College, Vellore, India
| | - George I Vettiyil
- Pediatric Rheumatology, Pediatrics Unit II, Department of Pediatrics, Christian Medical College, Vellore, India
| | - Anitha Jasper
- Department of Radiology, Christian Medical College, Vellore, India
| | - Sathish Kumar
- Pediatric Rheumatology, Pediatrics Unit II, Department of Pediatrics, Christian Medical College, Vellore, India
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50
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Liu Y, Dong M, Chu Y, Zhou L, You Y, Pang X, Yang S, Zhang L, Chen L, Zhu L, Xiao J, Wang W, Qin C, Tian D. Dawn of CAR-T cell therapy in autoimmune diseases. Chin Med J (Engl) 2024; 137:00029330-990000000-01039. [PMID: 38613216 PMCID: PMC11101238 DOI: 10.1097/cm9.0000000000003111] [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: 12/18/2023] [Indexed: 04/14/2024] Open
Abstract
ABSTRACT Chimeric antigen receptor (CAR)-T cell therapy has achieved remarkable success in the treatment of hematological malignancies. Based on the immunomodulatory capability of CAR-T cells, efforts have turned toward exploring their potential in treating autoimmune diseases. Bibliometric analysis of 210 records from 128 academic journals published by 372 institutions in 40 countries/regions indicates a growing number of publications on CAR-T therapy for autoimmune diseases, covering a range of subtypes such as systemic lupus erythematosus, multiple sclerosis, among others. CAR-T therapy holds promise in mitigating several shortcomings, including the indiscriminate suppression of the immune system by traditional immunosuppressants, and non-sustaining therapeutic levels of monoclonal antibodies due to inherent pharmacokinetic constraints. By persisting and proliferating in vivo, CAR-T cells can offer a tailored and precise therapeutics. This paper reviewed preclinical experiments and clinical trials involving CAR-T and CAR-related therapies in various autoimmune diseases, incorporating innovations well-studied in the field of hematological tumors, aiming to explore a safe and effective therapeutic option for relapsed/refractory autoimmune diseases.
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Affiliation(s)
- Yuxin Liu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Minghao Dong
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Yunhui Chu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Luoqi Zhou
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Yunfan You
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Xiaowei Pang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Sheng Yang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Luyang Zhang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Lian Chen
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Lifang Zhu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Jun Xiao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Wei Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Chuan Qin
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Daishi Tian
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
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