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Associations between biomarkers and skeletal muscle function in individuals with osteoarthritis: a systematic review and meta-analysis. 骨关节炎患者的生物标志物与骨骼肌功能之间的关系:系统回顾与荟萃分析。
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2024-11-05 DOI: 10.1186/s13075-024-03419-1
Stephanie L Smith, Lorna Paul, Martijn P M Steultjens, Rebecca L Jones

Objectives: Skeletal muscle dysfunction is the primary cause of functional limitations in osteoarthritis, associated biomarkers have the potential as targets for early disease identification, diagnosis, and prevention of osteoarthritis disability. This review aimed to identify associations between biomarkers and lower limb skeletal muscle function in individuals with osteoarthritis.

Methods: A systematic literature review and meta-analysis conducted in PubMed, MEDLINE, CINAHL, EMBASE, Scopus, SPORTDiscus and Web of Science databases from inception to 8th August 2023. Two independent reviewers performed the title, abstract, full-text screening, data extraction and methodological quality assessment. A meta-analysis was undertaken based on the available data.

Results: Twenty-four studies with 4101 participants with osteoarthritis were included (females: 78%; age range; 49 to 71 years). One study reported muscle-specific biomarkers (n = 3), whilst six studies reported osteoarthritis-specific markers (n = 5). Overall, 93 biomarkers were reported, predominately characterised as inflammatory (n = 35), metabolic (n = 15), and hormones (n = 10). Muscle strength and vitamin D reported a significant association (Hedge's g: 0.58 (Standard Error (SE): 0.27; P = 0.03), k = 3 studies). Walking speed and high-sensitivity C-reactive protein reported no significant associations (Hedge's g: -0.02 (SE: 0.05; P = 0.73), k = 3 studies).

Conclusion: Associations between biomarkers and lower limb skeletal muscle function in individuals with osteoarthritis was limited, the few studies exploring lower limb muscle measures were mainly secondary outcomes. Furthermore, biomarkers were largely related to overall health, with a lack of muscle specific biomarkers. As such, the mechanistic pathways through which these associations occur are less evident, and difficult to draw clear conclusions on these relationships.

Trial registration: Registered on PROSPERO (CRD42022359405).

目的:骨骼肌功能障碍是骨关节炎患者功能受限的主要原因,相关的生物标志物有可能成为早期疾病识别、诊断和预防骨关节炎残疾的目标。本综述旨在确定骨关节炎患者的生物标志物与下肢骨骼肌功能之间的关联:从开始到 2023 年 8 月 8 日,在 PubMed、MEDLINE、CINAHL、EMBASE、Scopus、SPORTDiscus 和 Web of Science 数据库中进行了系统的文献综述和荟萃分析。两位独立审稿人对论文标题、摘要、全文进行了筛选,并对数据提取和方法学质量进行了评估。根据现有数据进行了荟萃分析:结果:共纳入 24 项研究,4101 名骨关节炎患者参与了研究(女性:78%;年龄范围:49 岁至 71 岁)。一项研究报告了肌肉特异性生物标记物(n = 3),六项研究报告了骨关节炎特异性标记物(n = 5)。总体而言,共报告了 93 种生物标记物,主要分为炎症标记物(35 种)、代谢标记物(15 种)和激素标记物(10 种)。据报告,肌肉力量与维生素 D 有显著关联(Hedge's g:0.58(标准误差 (SE):0.27;P = 0.03),k = 3 项研究)。步行速度与高敏 C 反应蛋白无明显关联(Hedge's g:-0.02 (SE: 0.05; P = 0.73),k = 3 项研究):结论:骨关节炎患者的生物标志物与下肢骨骼肌功能之间的关联有限,少数几项探讨下肢肌肉指标的研究主要是次要结果。此外,生物标志物主要与整体健康有关,缺乏肌肉特异性生物标志物。因此,发生这些关联的机理途径并不明显,也很难就这些关系得出明确的结论:注册于 PROSPERO(CRD42022359405)。
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引用次数: 0
Integrated multi-omics revealed that dysregulated lipid metabolism played an important role in RA patients with metabolic diseases. 综合多组学研究发现,脂质代谢失调在患有代谢性疾病的 RA 患者中起着重要作用。
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2024-11-01 DOI: 10.1186/s13075-024-03423-5
Xiaoting Zhu, Wubin Long, Jing Zhang, Congcong Jian, Jianghua Chen, Jiaxin Huang, Shilin Li, Jie Zhang, Liang Wang, Yan Chen, Jianhong Wu, Tingting Wang, Qinghua Zou, Jing Zhu, Fanxin Zeng

Objectives: Patients with rheumatoid arthritis (RA) commonly experience a high prevalence of multiple metabolic diseases (MD), leading to higher morbidity and premature mortality. Here, we aimed to investigate the pathogenesis of MD in RA patients (RA_MD) through an integrated multi-omics approach.

Methods: Fecal and blood samples were collected from a total of 181 subjects in this study for multi-omics analyses, including 16S rRNA and internally transcribed spacer (ITS) gene sequencing, metabolomics, transcriptomics, proteomics and phosphoproteomics. Spearman's correlation and protein-protein interaction networks were used to assess the multi-omics data correlations. The Least Absolute Shrinkage and Selection Operator (LASSO) machine learning algorithm were used to identify disease-specific biomarkers for RA_MD diagnosis.

Results: Our results found that RA_MD was associated with differential abundance of gut microbiota such as Turicibacter and Neocosmospora, metabolites including decreased unsaturated fatty acid, genes related to linoleic acid metabolism and arachidonic acid metabolism, as well as downregulation of proteins and phosphoproteins involved in cholesterol metabolism. Furthermore, a multi-omics classifier differentiated RA_MD from RA with high accuracy (AUC: 0.958). Compared to gouty arthritis and systemic lupus erythematosus, dysregulation of lipid metabolism showed disease-specificity in RA_MD.

Conclusions: The integration of multi-omics data demonstrates that lipid metabolic pathways play a crucial role in RA_MD, providing the basis and direction for the prevention and early diagnosis of MD, as well as new insights to complement clinical treatment options.

目的:类风湿性关节炎(RA)患者通常患有多种代谢性疾病(MD),导致发病率和死亡率升高。在此,我们旨在通过综合多组学方法研究 RA 患者(RA_MD)的 MD 发病机制:方法:本研究共收集了 181 名受试者的粪便和血液样本进行多组学分析,包括 16S rRNA 和内部转录间隔(ITS)基因测序、代谢组学、转录组学、蛋白质组学和磷酸化蛋白质组学。斯皮尔曼相关性和蛋白质-蛋白质相互作用网络用于评估多组学数据的相关性。使用最小绝对收缩和选择操作器(LASSO)机器学习算法来识别用于诊断RA_MD的疾病特异性生物标记物:我们的结果发现,RA_MD 与肠道微生物群(如 Turicibacter 和 Neocosmospora)的丰度差异、代谢物(包括不饱和脂肪酸的减少)、亚油酸代谢相关基因和花生四烯酸代谢相关基因以及参与胆固醇代谢的蛋白质和磷蛋白的下调有关。此外,多组学分类器还能准确地将 RA_MD 与 RA 区分开来(AUC:0.958)。与痛风性关节炎和系统性红斑狼疮相比,脂质代谢失调在RA_MD中表现出疾病特异性:多组学数据的整合表明,脂质代谢通路在RA_MD中起着至关重要的作用,为MD的预防和早期诊断提供了依据和方向,也为补充临床治疗方案提供了新的见解。
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引用次数: 0
Does regression of skin thickening predict improvement of internal organ involvement and survival in patients with diffuse cutaneous systemic sclerosis? A EUSTAR analysis 皮肤增厚的消退是否预示着弥漫性皮肤系统性硬化症患者内脏受累情况的改善和生存期的延长?EUSTAR 分析
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2024-10-31 DOI: 10.1186/s13075-024-03418-2
Anja Wyss, Suzana Jordan, Nicole Graf, Patricia E. Carreira, Jörg Distler, Marco Matucci Cerinic, Elise Siegert, Jörg Henes, Elisabetta Zanatta, Valeria Riccieri, Marie-Elise Truchetet, Fahrettin Oksel, Mengtao Li, Eugene J. Kucharz, Kilian Eyerich, Francesco Del Galdo, Madelon C. Vonk, Anna-Maria Hoffman Vold, Armando Gabrielli, Oliver Distler
Patients with diffuse cutaneous systemic sclerosis (dcSSc) frequently show spontaneous improvement of skin fibrosis. Our aim was to examine whether an improvement in skin fibrosis predicts lower likelihood of visceral organ progression and better survival. Patients from the European Scleroderma Trials and Research (EUSTAR) cohort with dcSSc, baseline modified Rodnan skin score (mRSS) ≥7, and valid mRSS at 12±3 months follow up were included. Regression/progression of skin fibrosis was defined as a decrease/increase in mRSS >5 points and≥25% from baseline to follow up. The outcomes included progression of lung, renal, cardiac and gastrointestinal manifestations using consensus derived definitions and all-cause death. Regressive, stable and progressive patients were compared by univariate, Kaplan-Meier survival curve and Cox regression analysis. Of 1257 included patients, 883 (70.2%) were stable, 282 (22.4%) regressive, and 92 (7.3%) progressive. Regressive patients, adjusted for baseline mRSS, baseline immunosuppression, baseline FVC, and disease duration, showed a significantly lower probability of FVC decline ≥10% than progressive patients (p=0.00003), lower probability of all-cause mortality during follow up (p=0.035) compared to progressive patients. .Improvement of skin fibrosis was not associated with progression of other organ manifestations. We found that regression of skin fibrosis is associated with a lower probability of lung progression and better survival at follow up. The link between the disease course of skin and lung fibrosis in SSc can help to better stratify patients in clinical practice and enrich for ILD progressive patients in clinical trials. • Diffuse SSc patients with improvement of skin fibrosis had a lower probability of lung function progression and all-cause mortality than skin progressive patients. • This allows better risk stratification of SSc patients in clinical practice. • It could help to improve the design of clinical trials in SSc and better enrichment of ILD progressive patients.
弥漫性皮肤系统性硬化症(dcSSc)患者的皮肤纤维化经常出现自发性改善。我们的目的是研究皮肤纤维化的改善是否预示着内脏器官恶化的可能性降低和生存率提高。研究对象包括欧洲硬皮病试验与研究(EUSTAR)队列中的 dcSSc 患者,这些患者的基线改良罗德南皮肤评分(mRSS)≥7 分,且在 12±3 个月的随访中 mRSS 评分有效。皮肤纤维化的消退/进展定义为从基线到随访期间mRSS下降/上升>5分且≥25%。随访结果包括肺、肾、心脏和胃肠道表现的进展(根据共识得出的定义)以及全因死亡。通过单变量、Kaplan-Meier 生存曲线和 Cox 回归分析,比较了退缩、稳定和进展患者的情况。在纳入的 1257 名患者中,883 人(70.2%)病情稳定,282 人(22.4%)病情退步,92 人(7.3%)病情进展。与进展期患者相比,根据基线 mRSS、基线免疫抑制、基线 FVC 和病程进行调整后,进展期患者的 FVC 下降≥10% 的概率显著低于进展期患者(P=0.00003),随访期间全因死亡的概率也显著低于进展期患者(P=0.035)。.皮肤纤维化的改善与其他器官表现的进展无关。我们发现,皮肤纤维化的消退与较低的肺部进展概率和较好的随访生存率有关。SSc患者皮肤纤维化和肺纤维化病程之间的联系有助于在临床实践中更好地对患者进行分层,并在临床试验中为ILD进展期患者提供丰富的治疗方案。- 皮肤纤维化得到改善的弥漫性 SSc 患者的肺功能进展和全因死亡率均低于皮肤进展期患者。- 这有助于在临床实践中更好地对 SSc 患者进行风险分层。- 这有助于改进SSc临床试验的设计,更好地丰富ILD进展期患者。
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引用次数: 0
Infiltrations of plasma cells in synovium predict inadequate response to Adalimumab in Rheumatoid Arthritis patients. 滑膜中浆细胞的浸润预示着类风湿性关节炎患者对阿达木单抗的反应不足。
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2024-10-31 DOI: 10.1186/s13075-024-03426-2
Jian Bin Li, Peng Cheng Liu, Liming Chen, Rui Wu

Objective: Rheumatoid arthritis (RA) is a clinically heterogeneous and complex autoimmune disease, making the prediction of therapeutic responses a significant challenge. This study aims to assess the role of clinical and synovial biomarkers in predicting poor response to adalimumab treatment in RA patients.

Methods: This single-center prospective study included 56 RA patients who had an inadequate response to methotrexate (MTX). At baseline, comprehensive assessments including complete blood count, liver and kidney function tests, blood glucose levels, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-citrullinated protein antibody (ACPA), as well as counts of swollen and tender joints, Health Assessment Questionnaire (HAQ) score, pain visual analogue scale (VAS) scores, and DAS28-CRP scores were conducted. Synovial biopsies were performed, followed by an efficacy evaluation at 12 weeks of adalimumab treatment. Patients not meeting the ACR20 criteria were classified into the non-responder group, with the remainder categorized as the responder group.

Results: Out of the participants, 24 (42.9%) failed to achieve ACR20 with adalimumab treatment. Non-responders exhibited higher infiltration of plasma cells in the synovium. Multivariate logistic regression analysis identified the presence of plasma cells as an independent risk factor for inadequate response to adalimumab.

Conclusion: Inadequate responses to adalimumab in RA patients were associated with increased plasma cell infiltrations in the synovium. These findings suggest a promising target for tailored therapies in rheumatoid arthritis.

目的:类风湿性关节炎(RA)是一种临床异质性和复杂的自身免疫性疾病,因此预测治疗反应是一项重大挑战。本研究旨在评估临床和滑膜生物标志物在预测RA患者对阿达木单抗治疗不良反应中的作用:这项单中心前瞻性研究纳入了56名对甲氨蝶呤(MTX)反应不佳的RA患者。研究人员在基线时进行了全面评估,包括全血细胞计数、肝肾功能检查、血糖水平、红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、抗瓜氨酸蛋白抗体(ACPA)以及关节肿胀和压痛计数、健康评估问卷(HAQ)评分、疼痛视觉模拟量表(VAS)评分和DAS28-CRP评分。进行滑膜活检后,在阿达木单抗治疗12周时进行疗效评估。不符合 ACR20 标准的患者被归入非应答组,其余患者被归入应答组:结果:参与者中有24人(42.9%)在接受阿达木单抗治疗后未能达到ACR20标准。无应答者的滑膜浆细胞浸润程度较高。多变量逻辑回归分析发现,浆细胞的存在是阿达木单抗治疗反应不充分的独立风险因素:结论:RA患者对阿达木单抗反应不足与滑膜中浆细胞浸润增加有关。这些发现为类风湿性关节炎的定制疗法提供了一个很有前景的靶点。
{"title":"Infiltrations of plasma cells in synovium predict inadequate response to Adalimumab in Rheumatoid Arthritis patients.","authors":"Jian Bin Li, Peng Cheng Liu, Liming Chen, Rui Wu","doi":"10.1186/s13075-024-03426-2","DOIUrl":"10.1186/s13075-024-03426-2","url":null,"abstract":"<p><strong>Objective: </strong>Rheumatoid arthritis (RA) is a clinically heterogeneous and complex autoimmune disease, making the prediction of therapeutic responses a significant challenge. This study aims to assess the role of clinical and synovial biomarkers in predicting poor response to adalimumab treatment in RA patients.</p><p><strong>Methods: </strong>This single-center prospective study included 56 RA patients who had an inadequate response to methotrexate (MTX). At baseline, comprehensive assessments including complete blood count, liver and kidney function tests, blood glucose levels, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-citrullinated protein antibody (ACPA), as well as counts of swollen and tender joints, Health Assessment Questionnaire (HAQ) score, pain visual analogue scale (VAS) scores, and DAS28-CRP scores were conducted. Synovial biopsies were performed, followed by an efficacy evaluation at 12 weeks of adalimumab treatment. Patients not meeting the ACR20 criteria were classified into the non-responder group, with the remainder categorized as the responder group.</p><p><strong>Results: </strong>Out of the participants, 24 (42.9%) failed to achieve ACR20 with adalimumab treatment. Non-responders exhibited higher infiltration of plasma cells in the synovium. Multivariate logistic regression analysis identified the presence of plasma cells as an independent risk factor for inadequate response to adalimumab.</p><p><strong>Conclusion: </strong>Inadequate responses to adalimumab in RA patients were associated with increased plasma cell infiltrations in the synovium. These findings suggest a promising target for tailored therapies in rheumatoid arthritis.</p>","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"26 1","pages":"186"},"PeriodicalIF":4.9,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Circ-CAMTA1 regulated by Ca2+ influx inhibited pyruvate carboxylase activity and modulate T cell function in patients with systemic lupus erythematosus 受 Ca2+ 流入调控的 Circ-CAMTA1 可抑制丙酮酸羧化酶活性并调节系统性红斑狼疮患者的 T 细胞功能
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2024-10-29 DOI: 10.1186/s13075-024-03422-6
Hui-Chun Yu, Hsien-Yu Huang Tseng, Hsien-Bin Huang, Ming-Chi Lu
To investigate the roles of Ca2+ influx-regulated circular RNAs (circRNAs) in T cells from patients with systemic lupus erythematosus (SLE). The expression profile of circRNAs in Jurkat cells, co-cultured with and without ionomycin, was analyzed by next-generation sequencing and validated using real-time polymerase chain reaction. The identified Ca2+ influx-regulated circRNAs were further examined in T cells from 42 patients with SLE and 23 healthy controls. The biological function of specific circRNA was investigated using transfection and RNA pull-down assay. After validation, we confirmed that the expression levels of circ-ERCC4, circ-NFATC2, circ-MYH10, circ-CAMTA1, circ-ASH1L, circ-SOCS7, and circ-ASAP1 were consistently increased in Jurkat cells following Ca2+ influx. The expression levels of circ-CAMTA1, circ-ASH1L, and circ-ASAP1 were significantly lower in T cells from patients with SLE, with even lower levels observed in those with higher disease activity. Interferon (IFN)-α was found to suppress the expression of circ-CAMTA1. Circ-CAMTA1 bound to pyruvate carboxylase and inhibited its biological activity. Overexpression of circ-CAMTA1, but not its linear form, significantly decreased extracellular glucose levels. Furthermore, increased expression of circ-CAMTA1, but not its linear form, decreased miR-181c-5p expression, resulting increased IL-2 secretion. Three Ca2+ influx-regulated circ-RNAs—circ-CAMTA1, circ-ASH1L, and circ-ASAP1 —were significantly reduced in T cells from patients with SLE and associated with disease activity. IFN-α suppressed the expression of circ-CAMTA1, which interacted with pyruvate carboxylase, inhibited its activity, affected glucose metabolism, and increased IL-2 secretion. These findings suggest that circ-CAMTA1 regulated by Ca²⁺ influx modulated T cell function in patients with SLE.
研究系统性红斑狼疮(SLE)患者T细胞中Ca2+流入调控的环状RNA(circRNA)的作用。通过新一代测序分析了与离子霉素共培养和未与离子霉素共培养的 Jurkat 细胞中 circRNAs 的表达谱,并使用实时聚合酶链反应进行了验证。在 42 名系统性红斑狼疮患者和 23 名健康对照者的 T 细胞中进一步检测了已确定的 Ca2+ 流入调控的 circRNA。我们使用转染和 RNA 牵引试验研究了特定 circRNA 的生物功能。经过验证,我们证实在 Ca2+ 流入后,Jurkat 细胞中 circ-ERCC4、circ-NFATC2、circ-MYH10、circ-CAMTA1、circ-ASH1L、circ-SOCS7 和 circ-ASAP1 的表达水平持续上升。在系统性红斑狼疮患者的 T 细胞中,circ-CAMTA1、circ-ASH1L 和 circ-ASAP1 的表达水平明显较低,而在疾病活动度较高的患者中,其表达水平甚至更低。研究发现,干扰素(IFN)-α能抑制circ-CAMTA1的表达。circ-CAMTA1 与丙酮酸羧化酶结合,抑制其生物活性。过量表达 circ-CAMTA1(而非其线性形式)可显著降低细胞外葡萄糖水平。此外,circ-CAMTA1(而非其线性形式)的表达增加会降低 miR-181c-5p 的表达,从而导致 IL-2 分泌增加。在系统性红斑狼疮患者的 T 细胞中,三种受 Ca2+ 流入调节的 circ-RNAs - circ-CAMTA1、circ-ASH1L 和 circ-ASAP1 - 显著减少,并与疾病活动相关。IFN-α 抑制了 circ-CAMTA1 的表达,而 circ-CAMTA1 与丙酮酸羧化酶相互作用,抑制了其活性,影响了葡萄糖代谢,并增加了 IL-2 的分泌。这些研究结果表明,Ca²⁺的流入调节了系统性红斑狼疮患者T细胞的功能。
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引用次数: 0
Increased serum level of IL-6 predicts poor prognosis in anti-MDA5-positive dermatomyositis with rapidly progressive interstitial lung disease 血清 IL-6 水平升高可预测抗 MDA5 阳性皮肌炎伴快速进展性间质性肺病患者的不良预后
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2024-10-28 DOI: 10.1186/s13075-024-03415-5
Yuanyuan Niu, Suling Liu, Qian Qiu, Di Fu, Youjun Xiao, Liuqin Liang, Yang Cui, Shanhui Ye, Hanshi Xu
Anti-melanoma differentiation-associated protein 5 antibody-positive dermatomyositis (anti-MDA5-positvie DM) is a subtype of dermatomyositis with a poor prognosis, characterized by rapidly progressive interstitial lung disease (RP-ILD). The study aims to investigate the significance of serum cytokines profiles and peripheral lymphocytes in predicting prognoses of anti-MDA5-positvie DM with RP-ILD. Furthermore, it seeks to analyze longitudinal data of lymphocytes during hospitalization to identify distinct trajectories and cluster patients accordingly. A total of 168 patients with anti-MDA5-positive DM were enrolled in this retrospective study from two cohorts. Univariate and multivariate Cox regression analyses were conducted to determine the predictors of 6-month all-cause mortality and RP-ILD. Group-based trajectory modeling (GBTM) was employed to model the trajectories of longitudinal peripheral lymphocytes. In the multivariate Cox regression analysis, IL-6 ≥ 13.41pg/mL, lymphocytes < 0.5 × 109 /L, lymphocytes from 0.5 to 1.0 × 109 /L, older age, and elevated LDH were identified as independent predictors of 6-month all-cause mortality. Furthermore, IL-6 ≥ 13.41pg/mL, lymphocytes < 0.5 × 109 /L, and lymphocytes from 0.5 to 1.0 × 109 /L were found to be independent predictors of RP-ILD. Additionally, three trajectory groups of lymphocytes within the first week after admission were established based on GBTM. These groups included: Group 1, with low-level of lymphocytes that declined; Group 2, with medium-level of lymphocytes that slightly rose; and Group 3, with high-level of lymphocytes that rose. Notably, group 1 showed the highest mortality (90.7%) and all experiencing RP-ILD. Increased expression of IL-6 in lung tissues was observed in two cases with RP-ILD compared to two cases without RP-ILD. We also found the increased infiltration of CD4 + and CD8 + T cells, particularly CD8 + T cells, in lung tissues from patients with RP-ILD. Our study demonstrated that increased level of serum IL-6 (≥ 13.41pg/mL) and severe lymphopenia were promising predictors of 6-month all-cause mortality and the occurrence of RP-ILD in anti-MDA5-positive DM patients. Furthermore, tracking distinct trajectories of lymphocytes during hospitalization can be utilized to cluster patients.
抗黑色素瘤分化相关蛋白5抗体阳性皮肌炎(anti-MDA5-positvie DM)是一种预后不良的皮肌炎亚型,以快速进展性间质性肺病(RP-ILD)为特征。本研究旨在探讨血清细胞因子谱和外周淋巴细胞在预测抗MDA5-positvie DM合并RP-ILD预后中的意义。此外,该研究还试图分析住院期间淋巴细胞的纵向数据,以确定不同的轨迹,并据此对患者进行分组。这项回顾性研究共纳入了168名抗MDA5阳性DM患者,他们来自两个队列。研究人员进行了单变量和多变量Cox回归分析,以确定6个月全因死亡率和RP-ILD的预测因素。采用基于组的轨迹模型(GBTM)来模拟纵向外周淋巴细胞的轨迹。在多变量 Cox 回归分析中,IL-6 ≥ 13.41pg/mL、淋巴细胞< 0.5 × 109 /L、淋巴细胞从 0.5 到 1.0 × 109 /L、年龄较大和 LDH 升高被确定为 6 个月全因死亡率的独立预测因素。此外,IL-6 ≥ 13.41pg/mL、淋巴细胞< 0.5 × 109 /L、淋巴细胞从 0.5 到 1.0 × 109 /L也是 RP-ILD 的独立预测因子。此外,还根据 GBTM 确定了入院后第一周内淋巴细胞的三个轨迹组。这些组别包括第一组,低水平淋巴细胞下降;第二组,中等水平淋巴细胞轻微上升;第三组,高水平淋巴细胞上升。值得注意的是,第 1 组死亡率最高(90.7%),所有患者都出现了 RP-ILD。与两例无 RP-ILD 的病例相比,两例有 RP-ILD 的病例肺组织中 IL-6 表达增加。我们还发现,RP-ILD 患者的肺组织中 CD4 + 和 CD8 + T 细胞浸润增加,尤其是 CD8 + T 细胞。我们的研究表明,血清 IL-6 水平升高(≥ 13.41pg/mL)和严重淋巴细胞减少症是抗 MDA5 阳性 DM 患者 6 个月全因死亡率和 RP-ILD 发生率的预测因子。此外,跟踪住院期间淋巴细胞的不同轨迹可用于对患者进行分组。
{"title":"Increased serum level of IL-6 predicts poor prognosis in anti-MDA5-positive dermatomyositis with rapidly progressive interstitial lung disease","authors":"Yuanyuan Niu, Suling Liu, Qian Qiu, Di Fu, Youjun Xiao, Liuqin Liang, Yang Cui, Shanhui Ye, Hanshi Xu","doi":"10.1186/s13075-024-03415-5","DOIUrl":"https://doi.org/10.1186/s13075-024-03415-5","url":null,"abstract":"Anti-melanoma differentiation-associated protein 5 antibody-positive dermatomyositis (anti-MDA5-positvie DM) is a subtype of dermatomyositis with a poor prognosis, characterized by rapidly progressive interstitial lung disease (RP-ILD). The study aims to investigate the significance of serum cytokines profiles and peripheral lymphocytes in predicting prognoses of anti-MDA5-positvie DM with RP-ILD. Furthermore, it seeks to analyze longitudinal data of lymphocytes during hospitalization to identify distinct trajectories and cluster patients accordingly. A total of 168 patients with anti-MDA5-positive DM were enrolled in this retrospective study from two cohorts. Univariate and multivariate Cox regression analyses were conducted to determine the predictors of 6-month all-cause mortality and RP-ILD. Group-based trajectory modeling (GBTM) was employed to model the trajectories of longitudinal peripheral lymphocytes. In the multivariate Cox regression analysis, IL-6 ≥ 13.41pg/mL, lymphocytes < 0.5 × 109 /L, lymphocytes from 0.5 to 1.0 × 109 /L, older age, and elevated LDH were identified as independent predictors of 6-month all-cause mortality. Furthermore, IL-6 ≥ 13.41pg/mL, lymphocytes < 0.5 × 109 /L, and lymphocytes from 0.5 to 1.0 × 109 /L were found to be independent predictors of RP-ILD. Additionally, three trajectory groups of lymphocytes within the first week after admission were established based on GBTM. These groups included: Group 1, with low-level of lymphocytes that declined; Group 2, with medium-level of lymphocytes that slightly rose; and Group 3, with high-level of lymphocytes that rose. Notably, group 1 showed the highest mortality (90.7%) and all experiencing RP-ILD. Increased expression of IL-6 in lung tissues was observed in two cases with RP-ILD compared to two cases without RP-ILD. We also found the increased infiltration of CD4 + and CD8 + T cells, particularly CD8 + T cells, in lung tissues from patients with RP-ILD. Our study demonstrated that increased level of serum IL-6 (≥ 13.41pg/mL) and severe lymphopenia were promising predictors of 6-month all-cause mortality and the occurrence of RP-ILD in anti-MDA5-positive DM patients. Furthermore, tracking distinct trajectories of lymphocytes during hospitalization can be utilized to cluster patients.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"12 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142519705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-term outcome of autologous haematopoietic stem cell transplantation in patients with systemic sclerosis: a comparison with patients treated with rituximab and with traditional immunosuppressive agents 系统性硬化症患者自体造血干细胞移植的长期疗效:与利妥昔单抗和传统免疫抑制剂治疗患者的比较
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2024-10-23 DOI: 10.1186/s13075-024-03408-4
Nicoletta Del Papa, Silvia Cavalli, Andrea Rindone, Francesco Onida, Giorgia Saporiti, Antonina Minniti, Maria Rosa Pellico, Claudia Iannone, Giorgia Trignani, Nicoletta D’Angelo, Manuel Sette, Raffaella Greco, Claudio Vitali, Roberto Caporali
Autologous haematopoietic stem cell transplantation (AHSCT) is more effective than conventional immunosuppressive therapies (CIT) in improving the outcome of patients with rapidly progressive diffuse cutaneous systemic sclerosis (dcSSc). So far, there is still a paucity of data comparing AHSCT with rituximab (RTX). Aim of the study is to retrospectively compare, in patients with dcSSc, the effectiveness of AHSCT with that of RTX and CIT. Thirty-five dcSSc AHSCT-treated patients were compared with 29 and 36 matched cases treated with RTX and CIT, respectively. The patients were followed up for 5 years by assessing selected outcome measures every year. Overall survival, modified Rodnan skin score (mRSS), lung function tests (FVC and DLCO), and the revised EUSTAR Activity Index (REAI) were the outcome measures chosen to evaluate the therapy efficacy. AHSCT was significantly more effective than RTX and CIT in prolonging survival, inducing a rapid reduction of the mRSS and REAI and maintaining the baseline level of lung function tests for a longer time. RTX therapy was also superior to CIT in reducing REAI, mRSS and in saving lung function. AHSCT is more effective than both RTX and CIT in prolonging survival and inducing prolonged remission in patients with rapidly progressive dcSSc.
自体造血干细胞移植(AHSCT)比传统的免疫抑制疗法(CIT)更能有效改善快速进展性弥漫性皮肤系统性硬化症(dcSSc)患者的预后。迄今为止,将 AHSCT 与利妥昔单抗(RTX)进行比较的数据仍然很少。本研究旨在回顾性比较 AHSCT 与 RTX 和 CIT 对 dcSSc 患者的疗效。研究将 35 例接受 AHSCT 治疗的 dcSSc 患者与分别接受 RTX 和 CIT 治疗的 29 例和 36 例匹配病例进行了比较。对患者进行了为期5年的随访,每年对选定的结果指标进行评估。总生存期、改良罗德南皮肤评分(mRSS)、肺功能测试(FVC和DLCO)以及修订后的EUSTAR活动指数(REAI)是评估疗效的结果指标。在延长生存期方面,AHSCT明显比RTX和CIT更有效,它能迅速降低mRSS和REAI,并在更长时间内维持肺功能测试的基线水平。在降低REAI、mRSS和挽救肺功能方面,RTX疗法也优于CIT疗法。与 RTX 和 CIT 相比,AHSCT 在延长快速进展的 dcSSc 患者的生存期和诱导长期缓解方面更为有效。
{"title":"Long-term outcome of autologous haematopoietic stem cell transplantation in patients with systemic sclerosis: a comparison with patients treated with rituximab and with traditional immunosuppressive agents","authors":"Nicoletta Del Papa, Silvia Cavalli, Andrea Rindone, Francesco Onida, Giorgia Saporiti, Antonina Minniti, Maria Rosa Pellico, Claudia Iannone, Giorgia Trignani, Nicoletta D’Angelo, Manuel Sette, Raffaella Greco, Claudio Vitali, Roberto Caporali","doi":"10.1186/s13075-024-03408-4","DOIUrl":"https://doi.org/10.1186/s13075-024-03408-4","url":null,"abstract":"Autologous haematopoietic stem cell transplantation (AHSCT) is more effective than conventional immunosuppressive therapies (CIT) in improving the outcome of patients with rapidly progressive diffuse cutaneous systemic sclerosis (dcSSc). So far, there is still a paucity of data comparing AHSCT with rituximab (RTX). Aim of the study is to retrospectively compare, in patients with dcSSc, the effectiveness of AHSCT with that of RTX and CIT. Thirty-five dcSSc AHSCT-treated patients were compared with 29 and 36 matched cases treated with RTX and CIT, respectively. The patients were followed up for 5 years by assessing selected outcome measures every year. Overall survival, modified Rodnan skin score (mRSS), lung function tests (FVC and DLCO), and the revised EUSTAR Activity Index (REAI) were the outcome measures chosen to evaluate the therapy efficacy. AHSCT was significantly more effective than RTX and CIT in prolonging survival, inducing a rapid reduction of the mRSS and REAI and maintaining the baseline level of lung function tests for a longer time. RTX therapy was also superior to CIT in reducing REAI, mRSS and in saving lung function. AHSCT is more effective than both RTX and CIT in prolonging survival and inducing prolonged remission in patients with rapidly progressive dcSSc.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"62 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
WIF-1 contributes to lupus-induced neuropsychological deficits via the CRYAB/STAT4-SHH axis WIF-1通过CRYAB/STAT4-SHH轴对狼疮诱发的神经心理缺陷做出贡献
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2024-10-23 DOI: 10.1186/s13075-024-03420-8
Liping Tan, Yu Fan, Xinyi Xu, Tianshu Zhang, Xiangyu Cao, Chenghao Zhang, Jun Liang, Yayi Hou, Huan Dou
Neuropsychiatric systemic lupus erythematosus (NPSLE) often manifests as cognitive deterioration, with activated microglia and blood-brain barrier (BBB) disruption implicated in these neurological complications. Wnt-inhibitory factor-1 (WIF-1), a secreted protein, has been detected in the cerebrospinal fluid (CSF) of NPSLE patients. However, the contribution of WIF-1 in contributing to lupus cognitive impairment remains poorly understood. Using MRL/MpJ-Faslpr (MRL/lpr) lupus-prone mice and TLR7 agonist imiquimod (IMQ)-induced lupus mice, recombinant WIF-1 protein (rWIF-1) and adeno-associated virus (AAV) encoding sh-WIF-1 were administered via intracerebroventricular injection. Behavioral tests, histopathological examinations, flow cytometry, and molecular biology techniques were employed to investigate the underlying mechanisms. Microinjection of rWIF-1 exacerbated cognitive deficits and mood abnormalities, increased BBB leakage and neuronal degeneration, and caused aberrant activation of microglia and synaptic pruning in the hippocampus. Conversely, lupus mice injected with AAV-shWIF-1 exhibited significant remission. In vitro, rWIF-1 induced overactivation of microglia with an increased CD86+ pro-inflammatory subpopulation, upregulated phagocytic activity, and excessive synaptic engulfment, contributing to increased BBB permeability. Furthermore, WIF-1 exerted its biological effects through the CRYAB/STAT4 pathway, transcriptionally decreasing SHH production. We also identified that symmetric dimethylarginine (SDMA) could alleviate rWIF-1-induced microglial activation and BBB damage, thereby restoring SHH levels. In conclusion, WIF-1 exacerbates lupus-induced cognitive dysfunction in mice by triggering aberrant microglial activation and BBB disruption through the CRYAB/STAT4-SHH axis, highlighting the potential therapeutic effects of SDMA for the treatment of NPSLE.
神经精神系统性红斑狼疮(NPSLE)通常表现为认知能力下降,活化的小胶质细胞和血脑屏障(BBB)破坏与这些神经系统并发症有关。在 NPSLE 患者的脑脊液(CSF)中检测到了一种分泌蛋白 Wnt 抑制因子-1(WIF-1)。然而,人们对WIF-1在狼疮认知障碍中的作用仍知之甚少。研究人员利用MRL/MpJ-Faslpr(MRL/lpr)狼疮易感小鼠和TLR7激动剂咪喹莫特(IMQ)诱导的狼疮小鼠,通过脑室内注射给药重组WIF-1蛋白(rWIF-1)和编码sh-WIF-1的腺相关病毒(AAV)。实验采用了行为测试、组织病理学检查、流式细胞术和分子生物学技术来研究其潜在机制。rWIF-1的显微注射加剧了认知障碍和情绪异常,增加了BBB渗漏和神经元变性,并导致海马中小胶质细胞的异常激活和突触修剪。相反,注射了AAV-shWIF-1的狼疮小鼠则表现出明显的病情缓解。在体外,rWIF-1诱导小胶质细胞过度活化,CD86+促炎亚群增加,吞噬活性上调,突触吞噬过度,导致BBB通透性增加。此外,WIF-1 还通过 CRYAB/STAT4 通路发挥其生物效应,转录减少 SHH 的产生。我们还发现,对称二甲基精氨酸(SDMA)可缓解 rWIF-1 诱导的小胶质细胞活化和 BBB 损伤,从而恢复 SHH 水平。总之,WIF-1通过CRYAB/STAT4-SHH轴引发异常的小胶质细胞活化和BBB破坏,从而加剧了狼疮诱导的小鼠认知功能障碍,这凸显了SDMA治疗NPSLE的潜在疗效。
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引用次数: 0
Oxysterols contribute to immune cell recruitment in SLE skin lesions 羟基甾醇有助于系统性红斑狼疮皮肤病变中免疫细胞的招募
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2024-10-22 DOI: 10.1186/s13075-024-03414-6
Xiaoyun Chen, Lianlian Ouyang, Sujie Jia, Ming Zhao
Abnormal oxysterol metabolism has been observed in the peripheral blood of SLE patients, but its role in systemic lupus erythematosus (SLE) skin lesions remains unclear. Targeted oxidized lipid metabolomics analysis using liquid chromatography-mass spectrometry (LC-MS) was performed to quantify oxysterols in SLE skin lesions. Immunohistochemical staining and single-cell sequencing data analysis confirmed the upregulation of oxysterol-encoding enzymes CH25H and CYP7B1. The impact on fibroblast-mediated PBMCs chemotaxis was assessed using a transwell chamber. We identified aberrant oxidized cholesterol metabolism in SLE skin lesions, characterized by elevated levels of 7-ketocholesterol, 5α-6α-cholestane-3β,5α,6β-triol, and so on. Fibroblasts were the primary cells expressing oxysterol-encoding genes, with CH25H and CYP7B1 expression upregulated via the IL-1β-mediated p38 MAPK and NFκB pathways. Notably, IL-1β-stimulated fibroblasts demonstrated enhanced PBMCs recruitment, which was attenuated by a GPR183 inhibitor. Our findings reveal a potential mechanism by which fibroblasts contribute to immune cell recruitment in SLE skin lesions by expression of CH25H and CYP7B1. This study underscores the significance of oxysterol metabolism in SLE skin lesion pathogenesis and highlights potential therapeutic targets for SLE skin lesion treatment. • SLE skin lesions show abnormal oxysterol metabolism, with fibroblasts being the main source of increased CH25H and CYP7B1 genes. • IL-1β-mediated p38 MAPK and NFκB pathways implicated in CH25H and CYP7B1 upregulation. • Enhanced PBMCs recruitment by IL-1β-stimulated fibroblasts can be attenuated by a GPR183 inhibitor, offering potential SLE skin lesion treatment.
在系统性红斑狼疮(SLE)患者的外周血中已观察到羟基固醇代谢异常,但其在系统性红斑狼疮(SLE)皮肤病变中的作用仍不清楚。研究人员利用液相色谱-质谱联用技术(LC-MS)进行了靶向氧化脂质代谢组学分析,以量化系统性红斑狼疮皮肤病变中的氧基甾醇。免疫组化染色和单细胞测序数据分析证实了氧固醇编码酶 CH25H 和 CYP7B1 的上调。我们使用转孔室评估了对成纤维细胞介导的 PBMC 趋化性的影响。我们在系统性红斑狼疮皮肤病变中发现了氧化胆固醇代谢异常,其特点是 7-酮胆固醇、5α-6α-胆甾烷-3β,5α,6β-三醇等的水平升高。成纤维细胞是表达氧杂环醇编码基因的主要细胞,CH25H和CYP7B1的表达通过IL-1β介导的p38 MAPK和NFκB途径上调。值得注意的是,IL-1β 刺激的成纤维细胞会增强 PBMCs 的募集,而 GPR183 抑制剂会减弱这种效应。我们的研究结果揭示了成纤维细胞通过表达 CH25H 和 CYP7B1 促进系统性红斑狼疮皮肤病变中免疫细胞募集的潜在机制。这项研究强调了氧甾醇代谢在系统性红斑狼疮皮损发病机制中的重要性,并突出了系统性红斑狼疮皮损治疗的潜在治疗靶点。- 系统性红斑狼疮皮损显示出氧固醇代谢异常,成纤维细胞是CH25H和CYP7B1基因增加的主要来源。- IL-1β 介导的 p38 MAPK 和 NFκB 通路与 CH25H 和 CYP7B1 的上调有关。- GPR183抑制剂可减轻IL-1β刺激成纤维细胞所增强的PBMCs招募,从而为系统性红斑狼疮皮肤病变的治疗提供了可能。
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引用次数: 0
Predictive biomarkers for low-dose IL-2 therapy efficacy in systemic lupus erythematosus: a clinical analysis 系统性红斑狼疮低剂量IL-2疗法疗效的预测性生物标志物:临床分析
IF 4.9 2区 医学 Q1 Medicine Pub Date : 2024-10-22 DOI: 10.1186/s13075-024-03388-5
Ruiling Feng, Xian Xiao, Bo Huang, Kai Zhang, Xia Zhang, Zhanguo Li, Yuan Jia, Jing He
Low-dose IL-2 (Ld-IL2) has shown favorable therapeutic effects in systemic lupus erythematosus (SLE) therapy. However, previous clinical trials reported an SLE Responder Index-4 (SRI-4) response rate of 65.52%-68%, with approximately half failing to achieve the primary endpoint by week 24. Our study aims to determine the real-world use of Ld-IL2 and to identify determinants of its effectiveness in SLE. We pooled data from 342 SLE patients undergoing sequential Ld-IL2 treatment, with 314 persisting for over 3 months were included in effectiveness and prediction analyses. All patients were categorized into responder (n = 136) and non-responder group (n = 178) according to SRI-4. Lupus Low Disease Activity State (LLDAS) was also analyzed to validate our results. Rash, lower complement 3 (C3), and renal involvement including urine protein, urine occult blood and urine casts emerged as prominent predictors of achieving SRI-4. Adjusting for baseline values using the ratio of change to baseline revealed significant differences in CD4 + T cell immune profiles between responders and non-responders. ROC analysis confirmed a satisfactory performance of rash, renal involvement, percentage change of CD4 + T cells, and C3 in predicting SRI-4, yielding an AUC of 0.933. LLDAS analysis showed that hematological involvements and lower CLA + Treg were potent predictive markers in LLDAS attainment. Conversely, renal involvement failed to have significant association in achieving LLDAS. The analysis of background therapy in SLE patients showed that MMF was more likely to reach the SRI-4 response with the combination of Ld-IL2. These findings uncovered the predictors of Ld-IL2 treatment efficacy in SLE patients and provided guidance to physicians for rational utilization.
低剂量 IL-2(Ld-IL2)在系统性红斑狼疮(SLE)治疗中显示出良好的疗效。然而,之前的临床试验报告显示,系统性红斑狼疮应答者指数-4(SRI-4)的应答率为65.52%-68%,其中约有一半患者在第24周时未能达到主要终点。我们的研究旨在确定 Ld-IL2 在现实世界中的使用情况,并找出其对系统性红斑狼疮疗效的决定因素。我们汇总了342名接受Ld-IL2序贯治疗的系统性红斑狼疮患者的数据,其中314名患者的疗效和预测分析持续了3个月以上。根据SRI-4将所有患者分为有反应组(136人)和无反应组(178人)。为了验证我们的结果,还对狼疮低疾病活动状态(LLDAS)进行了分析。皮疹、补体3(C3)降低和肾脏受累(包括尿蛋白、尿潜血和尿铸型)是达到SRI-4的主要预测因素。用变化与基线的比值调整基线值后,发现应答者和非应答者的 CD4 + T 细胞免疫特征存在显著差异。ROC分析证实,皮疹、肾脏受累、CD4 + T细胞百分比变化和C3在预测SRI-4方面的表现令人满意,AUC为0.933。LLDAS 分析表明,血液学受累和较低的 CLA + Treg 是 LLDAS 达标的有力预测指标。相反,肾脏受累与达到LLDAS没有显著关联。对系统性红斑狼疮患者背景疗法的分析表明,MMF与Ld-IL2联用更有可能达到SRI-4反应。这些发现揭示了系统性红斑狼疮患者Ld-IL2疗效的预测因素,为医生合理使用Ld-IL2提供了指导。
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引用次数: 0
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Arthritis Research & Therapy
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