Pub Date : 2024-03-31eCollection Date: 2024-03-01DOI: 10.1515/rir-2024-0007
Nevin Hammam, Passant N El-Husseiny, Suzan S Al-Adle, Nermeen Samy, Nora Y Elsaid, Dina F El-Essawi, Eman F Mohamed, Samar M Fawzy, Samah A El Bakry, Maha Nassr, Samah I Nasef, Hanan M El-Saadany, Shereen Elwan, Nada M Gamal, Abdelhfeez Moshrif, Osman Hammam, Rawhya R El Shereef, Faten Ismail, Samar Tharwat, Doaa Mosad Mosa, Mervat I Abd Elazeem, Enas A Abdelaleem, Tamer A Gheita
Background and objectives: Rheumatoid factor (RF) and anti-cyclic citrullinated protein (anti-CCP) have been used to improve the diagnosis and prognosis of rheumatoid arthritis (RA). However, their association with RA disease phenotypes, individually and in combination, is not well studied. The aim of the study was to compare patients' and disease characteristics, activity and severity in double seronegative (DNRA), single seropositive RF, single seropositive anti-CCP and double seropositive (DPRA) patients.
Methods: Adults subjects with RA from Egyptian College of Rheumatology (ECR) database who had RF and anti-CCP results available were included. Demographic, clinical features, disease activity score 28 (DAS28), Health Assessment Questionnaire (HAQ) and laboratory data were collected and compared among different RA groups.
Results: 5268 RA patients with mean age of 44.9±11.6 years, and 4477 (85%) were females. 2900 (55%) had DPRA, 892 (16.9%) had single positive RF, 597 (11.3%) had single positive anti-CCP while 879 (16.7%) had DNRA. Patients with DPRA had significantly high percentage of metabolic syndrome (19.3%, P < 0.001), and functional impairment using HAQ (P = 0.01). Older age (RRR [relative risk ratio]: 1.03, 95%CI: 1.0, 1.0, P = 0.029), greater DAS28 (RRR: 1.51, 95%CI: 1.2, 1.9, P < 0.001), higher steroid use (RRR: 2.4, 95%CI: 1.36, 4.25, P = 0.002) were at higher risk of DPRA while longer disease duration (RRR: 1.08, 95%CI: 1.01, 1.16, P = 0.017) and fibromyalgia syndrome (RRR: 2.54, 95%CI: 1.10, 5.88, P = 0.028) were associated with higher odds of single positive RF status.
Conclusion: Dual antibody-positive status has higher disease activity and severity, and higher chance of development of metabolic syndrome; highlighting the implicated role of inflammation, atherogenesis and cardiovascular disease risk in RA.
背景和目的:类风湿因子(RF)和抗环瓜氨酸蛋白(anti-CCP)已被用于改善类风湿性关节炎(RA)的诊断和预后。然而,对它们单独或联合使用与 RA 疾病表型的关系研究不多。本研究旨在比较双血清阴性(DNRA)、单血清阳性 RF、单血清阳性抗CCP 和双血清阳性(DPRA)患者的病情特征、活动性和严重程度:方法:纳入埃及风湿病学会(ECR)数据库中具有RF和抗CCP结果的成人RA患者。收集人口统计学、临床特征、疾病活动度评分 28(DAS28)、健康评估问卷(HAQ)和实验室数据,并对不同 RA 组别进行比较:结果:5268 名 RA 患者,平均年龄为(44.9±11.6)岁,其中 4477 名(85%)为女性。2900例(55%)为DPRA,892例(16.9%)为RF单项阳性,597例(11.3%)为抗CCP单项阳性,879例(16.7%)为DNRA。DPRA 患者患有代谢综合征(19.3%,P < 0.001)和 HAQ 功能障碍(P = 0.01)的比例明显较高。年龄越大(RRR [相对风险比]:1.03,95%CI:1.0,1.0,P = 0.029)、DAS28 越高(RRR:1.51,95%CI:1.2,1.9,P < 0.001)、使用类固醇越多(RRR:2.4,95%CI:1.36,4.25,P = 0.002)患 DPRA 的风险较高,而病程较长(RRR:1.08,95%CI:1.01,1.16,P = 0.017)和纤维肌痛综合征(RRR:2.54,95%CI:1.10,5.88,P = 0.028)与 RF 单项阳性状态的几率较高相关:结论:双重抗体阳性者的疾病活动度和严重程度较高,患代谢综合征的几率也较高;这突出表明了炎症、动脉粥样硬化和心血管疾病风险在RA中的作用。
{"title":"Clinical implications of seropositive and seronegative autoantibody status in rheumatoid arthritis patients: A comparative multicentre observational study.","authors":"Nevin Hammam, Passant N El-Husseiny, Suzan S Al-Adle, Nermeen Samy, Nora Y Elsaid, Dina F El-Essawi, Eman F Mohamed, Samar M Fawzy, Samah A El Bakry, Maha Nassr, Samah I Nasef, Hanan M El-Saadany, Shereen Elwan, Nada M Gamal, Abdelhfeez Moshrif, Osman Hammam, Rawhya R El Shereef, Faten Ismail, Samar Tharwat, Doaa Mosad Mosa, Mervat I Abd Elazeem, Enas A Abdelaleem, Tamer A Gheita","doi":"10.1515/rir-2024-0007","DOIUrl":"https://doi.org/10.1515/rir-2024-0007","url":null,"abstract":"<p><strong>Background and objectives: </strong>Rheumatoid factor (RF) and anti-cyclic citrullinated protein (anti-CCP) have been used to improve the diagnosis and prognosis of rheumatoid arthritis (RA). However, their association with RA disease phenotypes, individually and in combination, is not well studied. The aim of the study was to compare patients' and disease characteristics, activity and severity in double seronegative (DNRA), single seropositive RF, single seropositive anti-CCP and double seropositive (DPRA) patients.</p><p><strong>Methods: </strong>Adults subjects with RA from Egyptian College of Rheumatology (ECR) database who had RF and anti-CCP results available were included. Demographic, clinical features, disease activity score 28 (DAS28), Health Assessment Questionnaire (HAQ) and laboratory data were collected and compared among different RA groups.</p><p><strong>Results: </strong>5268 RA patients with mean age of 44.9±11.6 years, and 4477 (85%) were females. 2900 (55%) had DPRA, 892 (16.9%) had single positive RF, 597 (11.3%) had single positive anti-CCP while 879 (16.7%) had DNRA. Patients with DPRA had significantly high percentage of metabolic syndrome (19.3%, <i>P</i> < 0.001), and functional impairment using HAQ (<i>P</i> = 0.01). Older age (RRR [relative risk ratio]: 1.03, 95%CI: 1.0, 1.0, <i>P</i> = 0.029), greater DAS28 (RRR: 1.51, 95%CI: 1.2, 1.9, <i>P</i> < 0.001), higher steroid use (RRR: 2.4, 95%CI: 1.36, 4.25, <i>P</i> = 0.002) were at higher risk of DPRA while longer disease duration (RRR: 1.08, 95%CI: 1.01, 1.16, <i>P</i> = 0.017) and fibromyalgia syndrome (RRR: 2.54, 95%CI: 1.10, 5.88, <i>P</i> = 0.028) were associated with higher odds of single positive RF status.</p><p><strong>Conclusion: </strong>Dual antibody-positive status has higher disease activity and severity, and higher chance of development of metabolic syndrome; highlighting the implicated role of inflammation, atherogenesis and cardiovascular disease risk in RA.</p>","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"5 1","pages":"57-65"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10985701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-31eCollection Date: 2024-03-01DOI: 10.1515/rir-2024-0002
Xinping Tian, Xiaofeng Zeng
Takayasu's arteritis (TAK) is a chronic granulomatous inflammatory disease that involves aorta and its primary branches. It is characterized by wall thickening, stenosis/obliteration or aneurysm formation of the involved arteries. In order to standardize the diagnosis and treatment of TAK in China, a clinical practice guideline with an evidence-based approach is developed under the leadership of National Clinical Medical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID). Eleven recommendations for 11 clinical questions that are important to the diagnosis and treatment of TAK are developed based on the latest evidence and expert opinions combined with real clinical practice in China.
高安氏动脉炎(TAK)是一种累及主动脉及其主要分支的慢性肉芽肿性炎症性疾病。其特征是受累动脉的管壁增厚、狭窄/闭塞或动脉瘤形成。为了规范中国 TAK 的诊断和治疗,国家皮肤性病与免疫性疾病临床医学研究中心(NCRC-DID)牵头制定了循证医学临床实践指南。该指南根据最新证据和专家意见,结合中国的实际临床实践,针对TAK诊断和治疗中的11个重要临床问题提出了11条建议。
{"title":"Chinese guideline for the diagnosis and treatment of Takayasu's arteritis (2023).","authors":"Xinping Tian, Xiaofeng Zeng","doi":"10.1515/rir-2024-0002","DOIUrl":"https://doi.org/10.1515/rir-2024-0002","url":null,"abstract":"<p><p>Takayasu's arteritis (TAK) is a chronic granulomatous inflammatory disease that involves aorta and its primary branches. It is characterized by wall thickening, stenosis/obliteration or aneurysm formation of the involved arteries. In order to standardize the diagnosis and treatment of TAK in China, a clinical practice guideline with an evidence-based approach is developed under the leadership of National Clinical Medical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID). Eleven recommendations for 11 clinical questions that are important to the diagnosis and treatment of TAK are developed based on the latest evidence and expert opinions combined with real clinical practice in China.</p>","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"5 1","pages":"5-26"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10985707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-31eCollection Date: 2024-03-01DOI: 10.1515/rir-2024-0004
Joe Berry, Jessica Tarn, Dennis Lendrem, John Casement, Wan-Fai Ng
In Sjögren's Syndrome (SS), clinical heterogeneity and discordance between disease activity measures and patient experience are key obstacles to effective therapeutic development. Patient reported outcome measures (PROMs) are useful tools for understanding the unmet needs from the patients' perspective and therefore they are key for the development of patient centric healthcare systems. Initial concern about the subjectivity of PROMs has given way to methodological rigour and clear guidance for the development of PROMs. To date, several studies of patient stratification using PROMs have identified similar symptom-based subgroups. There is evidence to suggest that these subgroups may represent different disease endotypes with differing responses to therapeutic interventions. Stratified medicine approaches, alongside sensitive outcome measures, have the potential to improve our understanding of SS pathobiology and therapeutic development. The inclusion of PROMs is important for the success of such approaches. In this review we discuss the opportunities of using PROMs in understanding the pathogenesis of and therapeutic development for SS.
在斯琼格伦综合症(SS)中,临床异质性以及疾病活动测量和患者体验之间的不一致是有效开发疗法的主要障碍。患者报告结果测量(PROMs)是从患者角度了解未满足需求的有用工具,因此是发展以患者为中心的医疗保健系统的关键。最初人们对 PROMs 的主观性感到担忧,但现在,人们对 PROMs 的开发方法和明确指导有了严格的认识。迄今为止,一些使用 PROMs 对患者进行分层的研究已经确定了类似的基于症状的亚组。有证据表明,这些亚组可能代表不同的疾病内型,对治疗干预措施的反应也不尽相同。分层医学方法与敏感的结果测量相结合,有可能提高我们对 SS 病理生物学和治疗发展的认识。纳入 PROMs 对此类方法的成功非常重要。在本综述中,我们将讨论使用 PROMs 了解 SS 发病机制和治疗发展的机会。
{"title":"What can patients tell us in Sjögren's syndrome?","authors":"Joe Berry, Jessica Tarn, Dennis Lendrem, John Casement, Wan-Fai Ng","doi":"10.1515/rir-2024-0004","DOIUrl":"https://doi.org/10.1515/rir-2024-0004","url":null,"abstract":"<p><p>In Sjögren's Syndrome (SS), clinical heterogeneity and discordance between disease activity measures and patient experience are key obstacles to effective therapeutic development. Patient reported outcome measures (PROMs) are useful tools for understanding the unmet needs from the patients' perspective and therefore they are key for the development of patient centric healthcare systems. Initial concern about the subjectivity of PROMs has given way to methodological rigour and clear guidance for the development of PROMs. To date, several studies of patient stratification using PROMs have identified similar symptom-based subgroups. There is evidence to suggest that these subgroups may represent different disease endotypes with differing responses to therapeutic interventions. Stratified medicine approaches, alongside sensitive outcome measures, have the potential to improve our understanding of SS pathobiology and therapeutic development. The inclusion of PROMs is important for the success of such approaches. In this review we discuss the opportunities of using PROMs in understanding the pathogenesis of and therapeutic development for SS.</p>","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"5 1","pages":"34-41"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10985711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-19eCollection Date: 2023-12-01DOI: 10.2478/rir-2023-0031
Lidan Zhao, Fengchun Zhang
We report a case of a 68-year-old woman with chronic and severely destructive arthritis for 8 years with imaging features mimicking psoriatic arthritis (PsA) but serological evidence of systemic lupus erythematosus. Both the lupus panniculitis-like rash and the presence of interstitial lung disease were considered manifestations of systemic involvement of SLE.
{"title":"Lupus hands mimicking psoriatic arthritis.","authors":"Lidan Zhao, Fengchun Zhang","doi":"10.2478/rir-2023-0031","DOIUrl":"https://doi.org/10.2478/rir-2023-0031","url":null,"abstract":"<p><p>We report a case of a 68-year-old woman with chronic and severely destructive arthritis for 8 years with imaging features mimicking psoriatic arthritis (PsA) but serological evidence of systemic lupus erythematosus. Both the lupus panniculitis-like rash and the presence of interstitial lung disease were considered manifestations of systemic involvement of SLE.</p>","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"4 4","pages":"216-218"},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138835950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-19eCollection Date: 2023-12-01DOI: 10.2478/rir-2023-0028
Cong-Qiu Chu
Glucocorticoids (GC) remains the mainstay for management of large vessel vasculitis (LVV). Recent introduction of interleukin-6 signaling blocker, tocilizumab has substantially changed the practice in management of patients with LVV, in particular, giant cell arteritis (GCA). Benefit of tocilizumab to patients with Takayasu arteritis (TAK) is supported by observational studies, but randomized clinical trials are lacking. Addition of tocilizumab enables reduction of the total amount of GC in patients with GCA, but GC burden remains high and to be further reduced. Ongoing studies aim at minimal use of GC or even GC-free. Tumor necrosis factor inhibitors appear to be beneficial to TAK despite their ineffectiveness to GCA. Randomized clinical trials are undergoing to target other inflammatory cytokines in both GCA and TAK. Janus kinase inhibitors alone or in combination with conventional disease modifying anti-rheumatic drugs showed promising results in treatment of TAK.
糖皮质激素(GC)仍是治疗大血管炎(LVV)的主要药物。最近白细胞介素-6信号传导阻断剂托西珠单抗的问世大大改变了大血管炎患者的治疗方法,尤其是巨细胞动脉炎(GCA)患者。观察性研究证实了托珠单抗对高安动脉炎(TAK)患者的益处,但缺乏随机临床试验。添加替西利珠单抗可减少 GCA 患者的 GC 总量,但 GC 负担仍然很高,有待进一步减少。正在进行的研究旨在尽量少用 GC,甚至不用 GC。肿瘤坏死因子抑制剂似乎对 TAK 有益,尽管对 GCA 无效。针对 GCA 和 TAK 的其他炎症细胞因子的随机临床试验正在进行中。Janus 激酶抑制剂单独使用或与传统的疾病调整抗风湿药物联合使用在治疗 TAK 方面显示出良好的效果。
{"title":"Advances and challenges in management of large vessel vasculitis.","authors":"Cong-Qiu Chu","doi":"10.2478/rir-2023-0028","DOIUrl":"10.2478/rir-2023-0028","url":null,"abstract":"<p><p>Glucocorticoids (GC) remains the mainstay for management of large vessel vasculitis (LVV). Recent introduction of interleukin-6 signaling blocker, tocilizumab has substantially changed the practice in management of patients with LVV, in particular, giant cell arteritis (GCA). Benefit of tocilizumab to patients with Takayasu arteritis (TAK) is supported by observational studies, but randomized clinical trials are lacking. Addition of tocilizumab enables reduction of the total amount of GC in patients with GCA, but GC burden remains high and to be further reduced. Ongoing studies aim at minimal use of GC or even GC-free. Tumor necrosis factor inhibitors appear to be beneficial to TAK despite their ineffectiveness to GCA. Randomized clinical trials are undergoing to target other inflammatory cytokines in both GCA and TAK. Janus kinase inhibitors alone or in combination with conventional disease modifying anti-rheumatic drugs showed promising results in treatment of TAK.</p>","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"4 4","pages":"188-195"},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-19eCollection Date: 2023-12-01DOI: 10.2478/rir-2023-0032
Felice Galluccio, Angelo Cassisa, Marco Matucci-Cerinic
{"title":"Role of ultrasound in guiding the biopsy site in eosinophilic fasciitis.","authors":"Felice Galluccio, Angelo Cassisa, Marco Matucci-Cerinic","doi":"10.2478/rir-2023-0032","DOIUrl":"https://doi.org/10.2478/rir-2023-0032","url":null,"abstract":"","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"4 4","pages":"219-221"},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138835952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-19eCollection Date: 2023-12-01DOI: 10.2478/rir-2023-0027
Abhimanyu Amarnani, Gregg J Silverman
The gut microbiome represents a potential promising therapeutic target for autoimmune diseases. This review summarizes the current knowledge on the links between the gut microbiome and several autoimmune rheumatic diseases including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) spondyloarthropathies (SpA), Sjogren's syndrome (SS), and systemic sclerosis (SSc). Evidence from studies of RA and SLE patients suggests that alterations in the gut microbiome composition and function contribute to disease development and progression through increased gut permeability, with microbes and microbial metabolites driving an excessive systemic activation of the immune system. Also, there is growing evidence that gut dysbiosis and subsequent immune cell activation may contribute to disease pathogenesis in SpA and SS. For SSc, there are fewer, but these are still informative, reports on alterations in the gut microbiome. In general, the complex interplay between the microbiome and the immune system is still not fully understood. Here we discuss the current knowledge of the link between the gut microbiome and autoimmune rheumatic diseases, highlighting potentially fertile areas for future research and make considerations on the potential benefits of strategies that restore gut microbiome homeostasis.
肠道微生物组是治疗自身免疫性疾病的潜在靶点。本综述总结了目前有关肠道微生物组与几种自身免疫性风湿病之间联系的知识,包括类风湿性关节炎(RA)、系统性红斑狼疮(SLE)、脊柱关节病(SpA)、斯约格伦综合征(SS)和系统性硬化症(SSc)。对风湿性关节炎和系统性红斑狼疮患者的研究证据表明,肠道微生物组组成和功能的改变通过增加肠道的通透性来促进疾病的发生和发展,微生物和微生物代谢产物推动了免疫系统的过度全身性激活。此外,越来越多的证据表明,肠道菌群失调和随后的免疫细胞激活可能会导致 SpA 和 SS 的发病机制。对于 SSc,有关肠道微生物组改变的报道较少,但仍具有参考价值。总的来说,微生物组与免疫系统之间复杂的相互作用仍未被完全理解。在此,我们讨论了目前有关肠道微生物组与自身免疫性风湿病之间联系的知识,强调了未来研究的潜在肥沃领域,并对恢复肠道微生物组平衡的策略的潜在益处进行了思考。
{"title":"Understanding the roles of the microbiome in autoimmune rheumatic diseases.","authors":"Abhimanyu Amarnani, Gregg J Silverman","doi":"10.2478/rir-2023-0027","DOIUrl":"10.2478/rir-2023-0027","url":null,"abstract":"<p><p>The gut microbiome represents a potential promising therapeutic target for autoimmune diseases. This review summarizes the current knowledge on the links between the gut microbiome and several autoimmune rheumatic diseases including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) spondyloarthropathies (SpA), Sjogren's syndrome (SS), and systemic sclerosis (SSc). Evidence from studies of RA and SLE patients suggests that alterations in the gut microbiome composition and function contribute to disease development and progression through increased gut permeability, with microbes and microbial metabolites driving an excessive systemic activation of the immune system. Also, there is growing evidence that gut dysbiosis and subsequent immune cell activation may contribute to disease pathogenesis in SpA and SS. For SSc, there are fewer, but these are still informative, reports on alterations in the gut microbiome. In general, the complex interplay between the microbiome and the immune system is still not fully understood. Here we discuss the current knowledge of the link between the gut microbiome and autoimmune rheumatic diseases, highlighting potentially fertile areas for future research and make considerations on the potential benefits of strategies that restore gut microbiome homeostasis.</p>","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"4 4","pages":"177-187"},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: We aimed to evaluate the correlations among the neutrophil-to-lymphocyte ratio (NLR), lupus nephritis (LN) clinical characteristics, and renal prognosis of patients with LN.
Methods: We enrolled 122 patients who were diagnosed with LN at the Rheumatology Department of the People's Hospital, Xinjiang Uygur Autonomous Region from January 2013 to April 2022. We determined the occurrence of renal adverse events in patients with LN by reviewing medical records and follow-up data. Correlations were analyzed using the Spearman test, and the quartile method was applied to classify all of the 122 patients who had completed follow-up into low, medium, and high NLR groups. The Kaplan-Meier survival curve was used to conduct survival analysis, and Cox regression analyses were used to explore possible potential risk factors.
Results: The baseline NLR of patients with LN was positively correlated with C-reactive protein (CRP), serum creatinine, blood urea nitrogen, and systemic lupus erythematosus disease activity index scores (P < 0.05) and negatively correlated with estimated glomerular filtration rate (eGFR) and serum albumin (P < 0.05). Patients who completed follow-up were divided into three NLR groups based on their NLR values: 30 in the low (NLR ≤ 2.21), 62 in the medium (NLR > 2.21 and NLR ≤ 6.17), and 30 in the high NLR group (NLR > 6.17). The patient survival time before developing poor renal prognosis was significantly different among the three groups (P < 0.05). High NLR (hazard ratio [HR] = 3.453, 95% confidence interval [CI]: 1.260-9.464), CRP (HR = 1.009, 95% CI: 1.002-1.017), eGFR (HR = 0.979, 95% CI: 0.963-0.995), and 24-h proteinuria values (HR = 1.237, 95% CI: 1.025-1.491) as well as anti-double stranded DNA antibody positivity (HR = 3.056, 95% CI:1.069-8.736) were independent risk factors associated with a poor renal prognosis for patients with LN.
Conclusion: The baseline NLR in peripheral blood can be used as a reference index for evaluating renal function and disease activity in patients with LN, and a high NLR has predictive value for the prognosis of patients with LN.
{"title":"Correlations of baseline neutrophil-lymphocyte ratio with prognosis of patients with lupus nephritis: A single-center experience.","authors":"Yi Chen, Xue Wu, Xiaomei Chen, Mengmeng Li, Cainan Luo, Yamei Shi, Jing Li, Lijun Wu","doi":"10.2478/rir-2023-0029","DOIUrl":"https://doi.org/10.2478/rir-2023-0029","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to evaluate the correlations among the neutrophil-to-lymphocyte ratio (NLR), lupus nephritis (LN) clinical characteristics, and renal prognosis of patients with LN.</p><p><strong>Methods: </strong>We enrolled 122 patients who were diagnosed with LN at the Rheumatology Department of the People's Hospital, Xinjiang Uygur Autonomous Region from January 2013 to April 2022. We determined the occurrence of renal adverse events in patients with LN by reviewing medical records and follow-up data. Correlations were analyzed using the Spearman test, and the quartile method was applied to classify all of the 122 patients who had completed follow-up into low, medium, and high NLR groups. The Kaplan-Meier survival curve was used to conduct survival analysis, and Cox regression analyses were used to explore possible potential risk factors.</p><p><strong>Results: </strong>The baseline NLR of patients with LN was positively correlated with C-reactive protein (CRP), serum creatinine, blood urea nitrogen, and systemic lupus erythematosus disease activity index scores (<i>P</i> < 0.05) and negatively correlated with estimated glomerular filtration rate (eGFR) and serum albumin (<i>P</i> < 0.05). Patients who completed follow-up were divided into three NLR groups based on their NLR values: 30 in the low (NLR ≤ 2.21), 62 in the medium (NLR > 2.21 and NLR ≤ 6.17), and 30 in the high NLR group (NLR > 6.17). The patient survival time before developing poor renal prognosis was significantly different among the three groups (<i>P</i> < 0.05). High NLR (hazard ratio [HR] = 3.453, 95% confidence interval [CI]: 1.260-9.464), CRP (HR = 1.009, 95% CI: 1.002-1.017), eGFR (HR = 0.979, 95% CI: 0.963-0.995), and 24-h proteinuria values (HR = 1.237, 95% CI: 1.025-1.491) as well as anti-double stranded DNA antibody positivity (HR = 3.056, 95% CI:1.069-8.736) were independent risk factors associated with a poor renal prognosis for patients with LN.</p><p><strong>Conclusion: </strong>The baseline NLR in peripheral blood can be used as a reference index for evaluating renal function and disease activity in patients with LN, and a high NLR has predictive value for the prognosis of patients with LN.</p>","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"4 4","pages":"196-203"},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Recently, the role of long non-coding RNA (lncRNA) in rheumatic immune diseases has attracted widespread attention. However, knowledge of lncRNA in connective tissue disease-associated interstitial lung disease (CTD-ILD) is limited. This study explored the expression profile and possible mechanisms of lncRNA and mRNA in peripheral blood mononuclear cells (PBMCs) of CTD-ILD patients, especially systemic sclerosis (SSc)-ILD and rheumatoid arthritis (RA)-ILD.
Methods: LncRNA microarray analysis identified 240 diferentially expressed lncRNAs and 218 diferentially expressed mRNA in the CTD-ILD group and the connective tissue disease without associated interstitial lung disease (CTD-NILD) group. The bioinformatics analysis of diferential genes has identified several important biological processes and signal pathways, including nuclear factor kappa B (NF-kappa B) signaling pathway, interleukin 17 (IL-17) signaling pathway, B cell receptor signaling pathway. Relative expression levels of five diferentially expressed lncRNAs and one mRNA in 120 SSc and RA patients with or without ILD were detected by quantitative reverse-transcription (PCR).
Results: The ENST00000604692 expression level was significantly higher in the ILD than the without interstitial lung disease (NILD) group; T311354 and arginase-1 were significantly higher in SSc than RA group.
Conclusion: These data suggest that the specific profile of lncRNA in PBMCs of CTD-ILD patients and the potential signal pathways related to the pathogenesis of CTD-ILD, which may provide newfound insights for the diagnosis and treatment of CTD-ILD patients.
{"title":"Identification and functional prediction of long non-coding RNA and mRNA related to connective tissue disease-associated interstitial lung diseases.","authors":"Fei Dai, Yixi He, Tianyi Lei, Yi Jiang, Quanbo Zhang, Yufeng Qing","doi":"10.2478/rir-2023-0030","DOIUrl":"https://doi.org/10.2478/rir-2023-0030","url":null,"abstract":"<p><strong>Objective: </strong>Recently, the role of long non-coding RNA (lncRNA) in rheumatic immune diseases has attracted widespread attention. However, knowledge of lncRNA in connective tissue disease-associated interstitial lung disease (CTD-ILD) is limited. This study explored the expression profile and possible mechanisms of lncRNA and mRNA in peripheral blood mononuclear cells (PBMCs) of CTD-ILD patients, especially systemic sclerosis (SSc)-ILD and rheumatoid arthritis (RA)-ILD.</p><p><strong>Methods: </strong>LncRNA microarray analysis identified 240 diferentially expressed lncRNAs and 218 diferentially expressed mRNA in the CTD-ILD group and the connective tissue disease without associated interstitial lung disease (CTD-NILD) group. The bioinformatics analysis of diferential genes has identified several important biological processes and signal pathways, including nuclear factor kappa B (NF-kappa B) signaling pathway, interleukin 17 (IL-17) signaling pathway, B cell receptor signaling pathway. Relative expression levels of five diferentially expressed lncRNAs and one mRNA in 120 SSc and RA patients with or without ILD were detected by quantitative reverse-transcription (PCR).</p><p><strong>Results: </strong>The <i>ENST00000604692</i> expression level was significantly higher in the ILD than the without interstitial lung disease (NILD) group; <i>T311354</i> and arginase-1 were significantly higher in SSc than RA group.</p><p><strong>Conclusion: </strong>These data suggest that the specific profile of lncRNA in PBMCs of CTD-ILD patients and the potential signal pathways related to the pathogenesis of CTD-ILD, which may provide newfound insights for the diagnosis and treatment of CTD-ILD patients.</p>","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"4 4","pages":"204-215"},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}