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Haridoss M, Bagepally BS, Venkataraman K, Purushothaman SR. Health-related quality of life and its association with disease activity/functional status in rheumatoid arthritis: A cross-sectional study from South India. J Eval Clin Pract 2025; 31:e14127. [PMID: 39138854 DOI: 10.1111/jep.14127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 07/23/2024] [Accepted: 07/30/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is an autoimmune disease with chronic pain that gradually becomes incapacitating and negatively influences the health-related quality of life (HRQoL). This study estimates HRQoL in RA using the EuroQol five dimensions (EQ-5D) tool and its association with functional status and disease activity. METHODS RA patients (n = 320) aged above 18 years, visiting outpatient clinic at a tertiary care multispecialty hospital in south India were the study participants. Sociodemographic, clinical, and laboratory data were collected from them. EQ-5D-5L questionnaire and the EQ Global Health Visual Analogue Scale (EQ-VAS) were used to measure HRQoL. Disease activity was measured using Disease Activity Score-28 (DAS-28), and the Health Assessment Questionnaire (HAQ) was used to assess functional status. Pearson's correlation and multiple linear regression were used to measure association, and statistical significance was considered at p < 0.05. RESULTS The EQ-5D utility score was 0.54 ± 0.36, pain and anxiety were the most affected domains, and the mean EQ-VAS was 63.05 ± 18.54%. A moderate to high disease activity was present in 85% (DAS-28 > 3.2), and a severe functional disability in 32.8% (HAQ > 1.5) of study participants. The mean EQ-5D scores for RA patients were 0.78 (0.65-0.90) for no disease activity, 0.73 (0.65-0.80) for mild, 0.53 (0.32-0.74) for moderate and 0.47 (0.32-0.62) for high disease activity. In multiple linear regression analysis, HAQ and age independently predicted EQ-5D. CONCLUSION RA significantly impacts HRQoL, and interventions focussing on pain and anxiety management are essential. The study's EQ-5D values could help estimate Quality Adjusted Life Years (QALY) while conducting economic evaluation studies in RA within an Indian context.
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Affiliation(s)
- Madhumitha Haridoss
- Health Technology Assessment Resource Centre, Division of Health Systems Research, ICMR-National Institute of Epidemiology, Chennai, India
- Division of Medical Research, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Kattankulathur, Chennai, India
| | - Bhavani Shankara Bagepally
- Health Technology Assessment Resource Centre, Division of Health Systems Research, ICMR-National Institute of Epidemiology, Chennai, India
- Faculty of Medical Research, Academy of Scientific and Innovative Research (AcSIR) (An Institution of National Importance Established by an Act of Parliament), Ghaziabad, India
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Wu W, Hu X, Yan L, Li Z, Li B, Chen X, Lin Z, Zeng H, Li C, Mo Y, Wu Y, Wang Q. Development and Validation of a Cost-Effective Machine Learning Model for Screening Potential Rheumatoid Arthritis in Primary Healthcare Clinics. J Inflamm Res 2025; 18:1511-1522. [PMID: 39925929 PMCID: PMC11804240 DOI: 10.2147/jir.s487595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Accepted: 01/09/2025] [Indexed: 02/11/2025] Open
Abstract
Objective In primary healthcare, diagnosing rheumatoid arthritis (RA) is challenging due to a general lack of in-depth knowledge of RA by general practitioners (GPs) and the lack of effective tools, leading to high rates of missed diagnosis. This study focuses on a screening model for primary healthcare, aiming to improve early RA screening accuracy and efficiency at a relatively lower cost, reducing delays in GPs' recognition of RA. Methods We randomly selected 2106 participants from the RA group or combined control group (comprising healthy individuals and patients with non-RA rheumatic diseases) at Peking University Shenzhen Hospital as the developing cohort. Guided by experienced rheumatologists, we built a comprehensive database with 26 clinical features. Using 10 classical machine learning algorithms, we developed screening models. Evaluation metrics determined the best model. Employing multivariatelogistic regression results and the best-performing model to identify the least costly features, ensuring applicability in primary healthcare clinics. Subsequently, we retrained and validated our proposed model based on two primary healthcare validation cohorts. Results In experiments, the algorithms achieved over 88% accuracy on training and test sets. Random Forest (RF) excelled with 96.20% (95% CI 95.39% to 97.02%) accuracy, 96.22% (95% CI 95.40% to 97.03%) specificity, 96.18% (95% CI 95.37% to 97.00%) sensitivity, and 96.20% (95% CI 95.39% to 97.02%) Areas Under Curves (AUC). A meticulous feature selection identified 11 key features for RA screening. In an external test on two primary healthcare datasets with these features, RF demonstrated an accuracy of 88.435% (95% CI 85.55% to 91.32%), sensitivity of 98.55% (95% CI 97.47% to 99.63%), specificity of 85.56% (95% CI 82.39% to 88.73%), and an AUC of 92.055% (95% CI 89.62% to 94.49%). Conclusion The screening model excels in automating prompt identification of RA in primary healthcare, improving the early detection of RA, and reducing delays and associated costs. Our findings contribute positively and are poised to elevate prospective RA management, fostering improvements in healthcare sector responsiveness and resource efficiency.
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Affiliation(s)
- Wenqi Wu
- Department of Rheumatology and Immunology, Peking University Shenzhen Hospital, Shenzhen, People’s Republic of China
- Shenzhen Key Laboratory of Inflammatory and Immunology Diseases, Shenzhen, People’s Republic of China
| | - Xiaohao Hu
- Department of Rheumatology and Immunology, Peking University Shenzhen Hospital, Shenzhen, People’s Republic of China
- Shenzhen Key Laboratory of Inflammatory and Immunology Diseases, Shenzhen, People’s Republic of China
| | - Linyang Yan
- Department of Ultrasound, Institute of Ultrasonic Medicine, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, People’s Republic of China
| | - Zhiyin Li
- Department of Information Systems, City University of Hong Kong, Hong Kong, People’s Republic of China
| | - Bo Li
- Department of Rheumatology and Immunology, People’s Hospital of Longhua District, Shenzhen, People’s Republic of China
| | - Xinpeng Chen
- Department of Rheumatology and Immunology, Shenzhen Futian Hospital for Rheumatic Diseases, Shenzhen, People’s Republic of China
| | - Zexun Lin
- Shenzhen Nanshan Medical Group HQ Taohuayuan Community Health Service Center, Shenzhen, People’s Republic of China
| | - Huiqiong Zeng
- Traditional Chinese Medicine Department of Rheumatism, Women & Children Health Institute, Shenzhen, People’s Republic of China
| | - Chun Li
- Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, People’s Republic of China
| | - Yingqian Mo
- Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Yalin Wu
- Department of Ultrasound, Institute of Ultrasonic Medicine, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, People’s Republic of China
| | - Qingwen Wang
- Department of Rheumatology and Immunology, Peking University Shenzhen Hospital, Shenzhen, People’s Republic of China
- Shenzhen Key Laboratory of Inflammatory and Immunology Diseases, Shenzhen, People’s Republic of China
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Liao Q, Zhong Y, Cheng Y, Li X. Clinical characteristics and risk factors of cardiovascular disease in systemic lupus erythematosus patients. Heart Vessels 2024:10.1007/s00380-024-02508-0. [PMID: 39719523 DOI: 10.1007/s00380-024-02508-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Accepted: 12/04/2024] [Indexed: 12/26/2024]
Abstract
To analyze the clinical characteristics of cardiovascular disease in systemic lupus erythematosus (SLE) patients and identify risk factors for predicting the occurrence of cardiovascular disease in SLE patients. Clinical data of 110 SLE patients were randomly selected from the Tongde Hospital of Zhejiang Province clinical medical record database, including 50 patients with cardiovascular disease and 60 patients without. Clinical data, blood biochemistry indicators, antibody detection results, and complement levels were collected. The receiver operating characteristic (ROC) curve was used to analyze the efficacy of these differential indicators in predicting the occurrence of cardiovascular disease in SLE patients. Univariate logistic regression analysis and multivariate logistic regression analysis showed that anti-ribosomal P protein, RNP/sm, IgG, IgM, serum creatinine, uric acid, and lipoprotein a were independent risk factors for cardiovascular disease in SLE patients (P < 0.05). The area under the curve (AUC) for predicting cardiovascular disease in SLE patients using IgG was 0.67, with low sensitivity of 44% and high specificity of 88.48%. The AUC for predicting cardiovascular disease in SLE patients using IgM was 0.67, with sensitivity of 76% and specificity of 55.17%. The AUC for predicting cardiovascular disease in SLE patients using serum creatinine was 0.73, with sensitivity of 68% and specificity of 78.33%. The AUC for predicting cardiovascular disease in SLE patients using uric acid was 0.69, with sensitivity of 52% and specificity of 81.67%. The AUC for predicting cardiovascular disease in SLE patients using lipoprotein a was 0.96, with high sensitivity of 96% and specificity of 91.67%. Levels of anti-ribosomal P protein, RNP/sm, IgG, IgM, serum creatinine, uric acid, and lipoprotein A are significantly altered in SLE patients with cardiovascular disease. These indicators can be used to predict the risk of cardiovascular disease in SLE patients.
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Affiliation(s)
- Qiumei Liao
- Department of Nephrology and Rheumatology, Tongde Hospital of Zhejiang Province, No.234 Gucui Road, Xihu District, Hangzhou, 310012, Zhejiang, China
| | - Yeping Zhong
- Department of Geriatric, Tongde Hospital of Zhejiang Province, Hangzhou, 318050, Zhejiang, China
| | - Yalin Cheng
- Department of Geriatric, Tongde Hospital of Zhejiang Province, Hangzhou, 318050, Zhejiang, China
| | - Xiuxiu Li
- Department of Nephrology and Rheumatology, Tongde Hospital of Zhejiang Province, No.234 Gucui Road, Xihu District, Hangzhou, 310012, Zhejiang, China.
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Etchegaray-Morales I, Mendoza-Pinto C, Arellano-Avendaño FJ, Ibañez-Ovando S, Munguía-Realpozo P, Orbe-Sosa JG, Ramírez-Lara E, García-Carrasco M. Epidemiology of systemic lupus erythematosus in Latin America. REUMATOLOGIA CLINICA 2024; 20:560-566. [PMID: 39523135 DOI: 10.1016/j.reumae.2024.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 09/18/2024] [Indexed: 11/16/2024]
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects several organs, causing significant morbidity and increased mortality. It's more frequent in young, fertile women and can appear in all ethnic groups. The worldwide prevalence report indicates that there are at least 5 million patients with SLE. Although this disease can be found in every geographic region, certain races are more affected, such as Afro-American, Hispanic, and Asian populations. Furthermore, most of the epidemiologic information comes from Europe or the USA. In Latin America, only a few countries have reported data, like Argentina, Colombia, or Mexico, and even in these countries, the numbers vary.
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Affiliation(s)
- Ivet Etchegaray-Morales
- Departamento de Reumatología, Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Claudia Mendoza-Pinto
- Departamento de Reumatología, Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico; Unidad de Investigación de Enfermedades Autoinmunes Sistémicas, CIBIOR-Hospital de Especialidades UMAE, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | | | - Sandra Ibañez-Ovando
- Unidad de Investigación de Enfermedades Autoinmunes Sistémicas, CIBIOR-Hospital de Especialidades UMAE, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Pamela Munguía-Realpozo
- Departamento de Reumatología, Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico; Unidad de Investigación de Enfermedades Autoinmunes Sistémicas, CIBIOR-Hospital de Especialidades UMAE, Instituto Mexicano del Seguro Social, Puebla, Mexico.
| | - Jacsiry Guadalupe Orbe-Sosa
- Departamento de Reumatología, Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Edith Ramírez-Lara
- Unidad de Investigación de Enfermedades Autoinmunes Sistémicas, CIBIOR-Hospital de Especialidades UMAE, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Mario García-Carrasco
- Departamento de Reumatología, Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
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Zhang Z, Ye Z, He S, Tang L, Xie C, Yin S, Chi S, Yang J, Yu Q, Yang M, Zhao X, He Y, Hu J, Wang W, Tung A. Belimumab safety in adult and paediatric Chinese patients with systemic lupus erythematosus: A Phase 4, multicentre, observational study. Lupus 2024; 33:1562-1572. [PMID: 39517123 PMCID: PMC11840992 DOI: 10.1177/09612033241299175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 10/15/2024] [Indexed: 11/16/2024]
Abstract
OBJECTIVE Although belimumab has been widely used in patients with systemic lupus erythematosus (SLE) globally, real-world safety data among Chinese patients are limited, particularly for children. This study assessed the safety and tolerability of belimumab in adult and paediatric patients with SLE in China in real-world clinical practice. METHODS This Phase 4, multicentre, prospective, observational study enrolled patients prescribed intravenous belimumab by their physicians in tertiary hospitals, independent of a clinical study, during routine clinical visits between May 2021 and May 2022. Patients could have been receiving belimumab prior to enrolment. The primary objective was to describe the incidence of adverse events (AEs), serious AEs (SAEs), adverse drug reactions (ADRs) and AEs of special interest (AESIs) over the 24-week follow-up period. Data were collected at enrolment and approximately 4, 12 and 24 weeks post-enrolment, during routine clinical visits. AEs, ADRs and SAEs were collected as independent events. The safety population comprised patients who received ≥1 dose of belimumab and completed ≥1 follow-up visit. RESULTS Overall, 417 patients were included in the analysis (safety population); 89.2% were female and mean (standard deviation) age was 35.5 (11.9) years. AEs were reported in 158 patients (37.9%) and were mostly mild (79.1%). The most common AEs were upper respiratory tract infections (n = 19, 4.6%) and hypokalaemia (n = 18, 4.3%; all mild). Among 22 patients (5.3%) with SAEs, four patients (1.0%) had drug-related SAEs (pneumonia, respiratory tract infection, gingivitis and decreased white blood cell and neutrophil count). ADRs were experienced by 25 patients (6.0%), most commonly urinary tract infections (n = 5, 1.2%). There were no fatal SAEs. AESIs occurred in 14 patients (3.4%), including infections of interest (n = 5, 1.2% all herpes zoster), serious selected psychiatric events (n = 3, 0.7%) and infusion-related systemic and anaphylactic reactions (n = 7, 1.7%). Of 14 paediatric patients enrolled, six experienced AEs, zero ADRs, two SAEs and one AESI. CONCLUSION Belimumab was generally well tolerated in adult and paediatric patients with SLE in this real-world setting in China, with no new safety signals identified. Future assessment of long-term belimumab safety in China beyond 24 weeks will extend this current body of evidence.
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Affiliation(s)
- Zhuoli Zhang
- Department of Rheumatology and Clinical Immunology, Peking University First Hospital, Beijing, China
| | - Zhizhong Ye
- Department of Rheumatology, Shenzhen Futian District Rheumatology College Hospital, Shenzhen, China
| | - Shanzhi He
- Department of Rheumatology, Zhongshan City People Hospital, Guangdong Province, China
| | - Lin Tang
- Department of Rheumatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chuanmei Xie
- Department of Rheumatology, Affiliated Hospital of North Sichuan Medical College, Nanchong City, China
| | - Songlou Yin
- Department of Rheumatology, The Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou, China
| | - Shuhong Chi
- Department of Rheumatology, Ningxia Medical University General Hospital, Yinchuan, China
| | - Jing Yang
- Department of Rheumatology, Mianyang Central Hospital, Sichuan, China
| | - Qinghong Yu
- Department of Rheumatology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Min Yang
- Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xuefeng Zhao
- China Clinical Development, GSK, Shanghai, China
| | - Yifan He
- Biostatistics, China Clinical Development, GSK, Shanghai, China
| | - Jingwen Hu
- China Clinical Development, GSK, Shanghai, China
| | - Weibo Wang
- China Clinical Development, GSK, Shanghai, China
| | - Annie Tung
- Pharmacovigilance, Medical Department, GSK, Shanghai, China
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Zhao L, Zheng K, Wan X, Xiao Q, Yuan L, Wu C, Bao J. Chinese traditional medicine DZGP beneficially affects gut microbiome, serum metabolites and recovery from rheumatoid arthritis through mediating NF-κB signaling pathway. Heliyon 2024; 10:e33706. [PMID: 39071566 PMCID: PMC11283109 DOI: 10.1016/j.heliyon.2024.e33706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 06/22/2024] [Accepted: 06/25/2024] [Indexed: 07/30/2024] Open
Abstract
Rheumatoid arthritis (RA) is globally treated with several commercially available anti-inflammatory and analgesic drugs, which pose adverse side effects in many cases. Due to increasing population affected by autoimmune disorder of joints inflammation, it is crucial to use natural therapies, which are less toxic at metabolic level and promote gut health. In this study, we investigated the potential role of a locally developed traditional Chinese medicine (TCM), namely Duzheng tablet (DZGP) in controlling the RA. For this purpose, we introduced RA in male mice and divided them into 5 different groups. High throughput transcriptome analysis of synovial cells after DZGP treatment in arthritic mice revealed a significant alteration of gene expression. The correlation analysis of transcriptome with metabolites revealed that DZGP specifically targeted the B cells mediated immunity pathways. Treatment with DZGP inhibited the cytokines production, while reducing the production of inflammatory TNF-α, which led to the alleviation of inflammatory response in arthritic mice. Additionally, we applied integrated approach using 16S rDNA sequencing to understand the microbial population in relation to metabolites accumulation. The results showed that DZGP promoted the healthy gut microbiota by maintaining the ratio of Firmicutes and Bacteroidota and introduction of two additional phyla namely, Verrucomicrobiota and Cyanobacteria. Therefore, it is concluded that DZGP offers an advantage over commercial drug by changing the metabolic profile, gut microbiota while exhibiting lower cellular toxicity.
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Affiliation(s)
- Liming Zhao
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, 610065, Sichuan, China
- Hubei Key Laboratory of Biological Resources Protection and Utilization, Hubei Minzu University, 445000, Enshi, China
| | - Kai Zheng
- Forest Seedlings and Wildlife Protection Management Station of Enshi Tujia and Miao Autonomous Prefecture, 445000, Enshi, China
| | - Xiaolin Wan
- College of Forestry and Horticulture, Hubei Minzu University, 445000, Enshi, China
| | - Qiang Xiao
- Hubei Key Laboratory of Biological Resources Protection and Utilization, Hubei Minzu University, 445000, Enshi, China
| | - Lin Yuan
- Hubei Provincial Key Laboratory of Occurrence and Intervention of Rheumatic Diseases, Hubei Minzu University, 445000, Enshi, China
| | - Chuanfang Wu
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, 610065, Sichuan, China
| | - Jinku Bao
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, 610065, Sichuan, China
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Chen Y, Zhong J, Liu X, Liu Y, Zhou B, Ruan G, Zhao L, Shi X, Zhang L. Cytomegalovirus antigen-specific multi-cytokine immune responses in patients with rheumatic diseases under different cytomegalovirus infection status: A case-control study. Clin Chim Acta 2024; 561:119828. [PMID: 38909979 DOI: 10.1016/j.cca.2024.119828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/13/2024] [Accepted: 06/20/2024] [Indexed: 06/25/2024]
Abstract
OBJECTIVE To explore Cytomegalovirus (CMV) antigen-specific multi-cytokine immune responses in patients with rheumatic disease (RD) under different CMV infection status. METHODS A total of 60 RD patients in our center from March 2023 to August 2023 were enrolled. The patients were divided into latent CMV infection and active CMV infection, the latter was classified as subclinical CMV infection or CMV disease based on presence or absence of symptoms related to CMV. Whole blood was collected and stimulated with QuantiFERON-CMV antigen. The levels of IFN-γ, TNF-α, IL-2, IL-4, IL-6, IL-10, IL-17 and CXCL-2 in supernatant were measured by Luminex Assays. The receiver operating characteristic curve was used to evaluate the diagnostic accuracy of cytokine for distinguishing different CMV infection status. RESULTS The proportion of patients with severe lymphopenia was lowest in the latent CMV infection group, while there were no significant differences in medication usage in different CMV infection status. After stimulation with QF-CMV antigens, the levels of IFN-γ, TNF-α and IL-2 in the CMV disease group were significantly lower than those in the latent CMV infection group. CMV antigen-specific IFN-γ, TNF-α levels and severe lymphopenia together provided the best discriminatory performance for distinguishing between latent and either active CMV infection patients (AUC = 0.854) or CMV disease patients (AUC = 0.935). CONCLUSION Noninvasive peripheral blood biomarkers (the combination of CMV antigen-specific IFN-γ, TNF-α levels and severe lymphopenia) may have the potential to diferentiate different status of CMV infection in RD population.
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Affiliation(s)
- Yan Chen
- Division of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingjing Zhong
- Division of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoqing Liu
- Division of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Clinical Epidemiology Unit, Peking Union Medical College, International Clinical Epidemiology Network, Beijing, China
| | - Ye Liu
- Division of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Baotong Zhou
- Division of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guiren Ruan
- Division of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lidan Zhao
- Department of Rheumatology and Clinical Immunology, Clinical Immunology Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaochun Shi
- Division of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Lifan Zhang
- Division of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Clinical Epidemiology Unit, Peking Union Medical College, International Clinical Epidemiology Network, Beijing, China.
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Ma Y, Wei C, Yi Z, Song Z, Cheng Y, Zeng L, Zhao R, Mu R. Do rheumatic diseases, long-term glucocorticoids, and immunosuppressant treatment, and vaccination impact the COVID-19 severity? Insight from a retrospective cohort study. Int J Rheum Dis 2024; 27:e15251. [PMID: 38982615 DOI: 10.1111/1756-185x.15251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/06/2024] [Accepted: 06/21/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVES The impact of rheumatic diseases, long-term medication, and vaccination on COVID-19 severity remain insufficiently understood, hindering effective patient management. This study aims to investigate factors influencing COVID-19 severity in Chinese rheumatic patients and to provide real-world evidence for patient care. METHODS We conducted a retrospective observational study consisting of two cohorts, followed by a nested case-control analysis. The outpatient cohort included non-severe COVID-19 patients, while the inpatient cohort included consecutive severe COVID-19 inpatients. Additionally, rheumatic patients from both cohorts were included for the nested case-control study. Clinical information was obtained from electronic medical records and surveys. RESULTS A total of 749 outpatients and 167 inpatients were enrolled. In the outpatient cohort, rheumatic diseases were identified as a risk factor for the severity of dyspnea (No rheumatic disease: OR = 0.577, 95% CI = 0.396-0.841, p = .004), but not for mortality, length of hospitalization, or hospitalization costs in the inpatient cohort. Long-term glucocorticoids use was identified as an independent risk factor for severity of dyspnea in rheumatic patients (OR = 1.814, 95% CI = 1.235-2.663, p = .002), while vaccination and immunosuppressant treatment showed no association. Vaccination was identified as a protective factor against hospitalization due to COVID-19 in patients with rheumatic diseases (OR = 0.031, 95% CI = 0.007-0.136, p < .001), whereas long-term glucocorticoids and immunosuppressant treatment showed no association. CONCLUSIONS Rheumatic diseases and long-term glucocorticoids use are significant risk factors for COVID-19 severity in the Chinese population, whereas emphasizing the protective effects of vaccines against COVID-19 severity is crucial. Additionally, the investigation provides preliminary support for the concept that long-term immunosuppressant therapy does not necessarily require additional prescription adjustments.
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Affiliation(s)
- Yi Ma
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
| | - Chang Wei
- Department of Rheumatology and Immunology, Center for Rare Disease, Peking University Third Hospital, Beijing, China
| | - Zixi Yi
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Zaiwei Song
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
| | - Yinchu Cheng
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
| | - Lin Zeng
- Research Centre of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Rongsheng Zhao
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
| | - Rong Mu
- Department of Rheumatology and Immunology, Center for Rare Disease, Peking University Third Hospital, Beijing, China
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Huang Y, Ni S. Aggregatibacter Actinomycetemcomitans With Periodontitis and Rheumatoid Arthritis. Int Dent J 2024; 74:58-65. [PMID: 37517936 PMCID: PMC10829364 DOI: 10.1016/j.identj.2023.06.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 08/01/2023] Open
Abstract
OBJECTIVE The aim of this work was to explore the association between Aggregatibacter actinomycetemcomitans (A actinomycetemcomitans) infection and disease activity amongst those with rheumatoid arthritis (RA) with or without periodontitis (PD) in a Chinese population. METHODS A case-control study was conducted from November 2017 to March 2019. The correlation coefficients between A actinomycetemcomitans positivity and RA-related examination indicators as well as periodontal examination parameters were calculated by using the Spearman correlation analysis. RESULTS A total of 115 patients with RA were recruited: 67 patients with RA only and 48 with RA + PD. The percentage of A actinomycetemcomitans positivity was significantly higher in the RA + PD group compared with the RA-only group (P = .007 for positive percentage; P = .020 for percentage of A actinomycetemcomitans positivity in the total oral microbiome). Furthermore, RA-related measures such as Disease Activity Score 28, rheumatoid factor, anticyclic citrullinated peptide, and anticitrullinated protein antibodies were all positively correlated with the percentage of A actinomycetemcomitans positivity (P range: .002∼.041). In addition, significant correlations were observed amongst A actinomycetemcomitans positivity and probing pocket depth (P = .027) and gingival index (P = .043), whereas null correlations were found amongst the percentage of A actinomycetemcomitans positivity and plaque index (P = .344), clinical attachment loss (P = .217), and bleeding on probing (P = .710). CONCLUSIONS A actinomycetemcomitans infection may be related to the development of PD amongst patients with RA.
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Affiliation(s)
- Yizhi Huang
- Department of Stomatology, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 29 Xinglong Alley, Changzhou 213003, PR China
| | - Su Ni
- Department of Orthopedics, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, 29 Xinglong Alley, Changzhou 213003, PR China.
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Hung HM, Chen MF, Lee HF, Wang HL. Exploration of Inflammatory Biomarkers and Psychological Cardiovascular Disease Risk Factors Among Community Dwelling Adults: A Gender Comparison Study. Biol Res Nurs 2024; 26:139-149. [PMID: 37603875 DOI: 10.1177/10998004231197845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
Patients with rheumatic disease (RD) are at high risk for cardiovascular disease (CVD), which is the leading non-communicable chronic disease cause of death worldwide. Inflammatory biomarkers and psychological health status are reliable predictors of CVD in patients with RD. The primary aim of this study was to compare the inflammatory biomarkers and psychological CVD risk factors (CRFs) between a group of community-dwelling adults with RD and CRFs and a group of their peers with CRFs only. The secondary aim of this study was to analyze and compare the collected data by gender in the RD group. Data were collected and analyzed from 355 participants, with the 135 participants with physician-diagnosed RD assigned to the RD group and the remainder (n = 220) assigned to the comparison group. The measures used included a demographic datasheet, medical information, serum homocysteine (Hcy) levels, high sensitive C-reactive protein (hs-CRP) levels, and depression and global sleep-quality scale scores. The RD group had higher ratios of hypertension and depression diagnoses than the comparison group. The gender analysis of the RD group found significantly more-severe sleep disturbances in women than men and a significantly higher mean value of Hcy in men than women. The women in the RD group were significantly older, less educated, and less employed than their male counterparts and thus may be presumed to at higher risk of health illiteracy. Gender-tailored interventions to modify the risk factors of CVD identified in this study for patients with RD are recommended.
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Affiliation(s)
- Hsuan-Man Hung
- Department of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Ming-Fu Chen
- Department of Rheumatology, St Joseph Hospital, Kaohsiung, Taiwan
| | - Huan-Fang Lee
- Department of Nursing, National Cheng Kung University, Tainan, Taiwan
| | - Hui-Ling Wang
- Department of Nursing, Fooyin University, Kaohsiung, Taiwan
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11
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Xu S, Zhang Q, Zhou J. The mediating role of psychological resilience on the negative effect of pain in patients with rheumatoid arthritis: A cross-sectional study. PLoS One 2023; 18:e0295255. [PMID: 38039302 PMCID: PMC10691686 DOI: 10.1371/journal.pone.0295255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 11/18/2023] [Indexed: 12/03/2023] Open
Abstract
The objective of this study was to investigate the direct effects of pain-induced depression and anxiety, as well as the mediating role of psychological resilience, on the psychological distress associated with rheumatoid arthritis. The method involved a sample of 196 patients with rheumatoid arthritis and applied the Hospital Anxiety and Depression Scale, Connor-Davidson Resilience Scale, and visual analog scale for pain. Bivariate and path analyses were performed, and a multiple mediational model was utilized. Results showed that all correlations among study variables were significant (p < 0.01). A partial mediation effect of psychological resilience was observed, and direct effects among the variables (pain, psychological resilience, anxiety, and depression) were statistically significant, including the direct effect of psychological resilience on depression and anxiety. The indirect effects of pain through psychological resilience on depression and anxiety were also significant. Thus, the results suggest that psychological resilience partially mediates the effects of pain-induced anxiety and depression in patients with rheumatoid arthritis.
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Affiliation(s)
- Shuang Xu
- Department of Psychology, College of Humanities and Management, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Qiongyu Zhang
- Department of Rheumatology and Immunology, Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Jiayan Zhou
- Department of Rheumatology and Immunology, Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China
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Bekaryssova D, Mruthyunjaya Vijaya P, Ahmed S, Sondur S, Zimba O. Revisiting articular syndrome in the peri-pandemic COVID-19 era. Rheumatol Int 2023; 43:2157-2166. [PMID: 37747562 DOI: 10.1007/s00296-023-05459-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/03/2023] [Indexed: 09/26/2023]
Abstract
Articular syndrome is often the presentation of a person's various rheumatic or related diseases. It includes both arthralgia and arthritis, with objective signs of joint inflammation defining the latter. This syndromic approach to joint pain enables a scientific method for early diagnosis of common rheumatic conditions without compromising the recognition of uncommon conditions. This review explores common rheumatic conditions associated with articular syndrome, including osteoarthritis, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE). It supports the early differentiation of uncommon but emerging entities such as reactive arthritis (ReA). The aim of the review is to comprehensively overview various forms of articular syndrome to update rheumatologists' and allied health specialists' knowledge. Epidemiology, clinical presentations, diagnostic approaches, and therapeutic strategies are discussed in the context of articular syndrome. The challenges emerging in the peri-pandemic COVID-19 era are highlighted. The improved understanding of the spectrum of clinical conditions and disease states presenting with articular syndrome may facilitate early diagnosis, optimal management, and enhanced patient outcomes within the realm of rheumatology.
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Affiliation(s)
- Dana Bekaryssova
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan.
| | - Prakashini Mruthyunjaya Vijaya
- Department of Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, India
| | - Sakir Ahmed
- Department of Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, India
| | - Suhas Sondur
- Department of Orthopedics, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, India
| | - Olena Zimba
- Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Kraków, Poland
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
- Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
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13
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Huang SX, Li HG, Liang HJ, Wang DM, Peng JH, Shen FC, Li WP, Lin L, Xiao ZY, Hou ZD. Comparison of clinical characteristics between adult-onset and juvenile-onset non-radiographic axial spondyloarthritis in Chinese patients: results from the COCAS cohort. Eur J Med Res 2023; 28:388. [PMID: 37770993 PMCID: PMC10537580 DOI: 10.1186/s40001-023-01387-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease predominantly affecting the axial skeleton. We aimed to describe the clinical characteristics of patients with non-radiographic axSpA (nr-axSpA) in China and compare the differences between adult- and juvenile-onset cases. METHODS A cross-sectional study was conducted using data from 776 patients with nr-axSpA in the Clinical Characteristic and Outcome in Chinese Axial Spondyloarthritis (COCAS) study cohort. Patients were divided into two groups including the adult-onset group (n = 662) and the juvenile-onset group (n = 114) according to age at disease onset. Baseline demographics and clinical characteristics were compared between patients with adult-onset and juvenile-onset nr-axSpA. RESULTS Overall, the male-to-female ratio was 1.26:1, the prevalence of HLA-B27 positivity was 72.2%, and the median age at disease onset of nr-axSpA was 22 years. Nearly 75% of nr-axSpA patients had peripheral arthritis in the disease course, and the prevalence of extra-articular manifestations was 10.4%. The juvenile-onset group contained a higher proportion of men (66.7% vs. 53.9%, P = 0.011) and a longer baseline disease duration (4.0 [4.0] vs. 1.6 [3.5], P < 0.001) than the adult-onset group. A family history of spondyloarthritis was more frequent in the juvenile-onset group than in the adult-onset group (23.7% vs. 15.4%, P = 0.028), but no significant difference in the prevalence of HLA-B27 positivity was observed between the two groups (P = 0.537). Regarding initial symptoms, peripheral arthritis occurred more often in patients with juvenile-onset nr-axSpA, whereas patients with adult-onset nr-axSpA presented more frequently with axial involvement. The prevalence of inflammatory back pain (IBP) was higher in the adult-onset group than in the juvenile-onset group (85.0% vs. 75.4%, P = 0.010), whereas the juvenile-onset group showed a higher prevalence of peripheral arthritis and enthesitis than the adult-onset group (67.5% vs. 48.5%, P < 0.001; 35.1% vs. 23.3%, P = 0.007, respectively). CONCLUSIONS Compared with adult-onset nr-axSpA, juvenile-onset nr-axSpA was more common in men and those with a family history of spondyloarthritis. Juvenile-onset nr-axSpA presents with a "peripheral predominant" mode at disease onset and a higher frequency of peripheral arthritis and enthesitis during the disease course.
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Affiliation(s)
- Shu-Xin Huang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Hao-Guang Li
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Department of Rheumatology and Immunology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Hong-Jin Liang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Dan-Min Wang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Jian-Hua Peng
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Feng-Cai Shen
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Wei-Ping Li
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Ling Lin
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Department of Rheumatology, Shantou University Medical College, Shantou, 515041, China
| | - Zheng-Yu Xiao
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Zhi-Duo Hou
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China.
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China.
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Huang H, Li P, Zhang D, Zhang MX, Yu K. Acute flare of systemic lupus erythematosus with extensive gastrointestinal involvement: A case report and review of literature. World J Gastrointest Surg 2023; 15:2074-2082. [PMID: 37901723 PMCID: PMC10600777 DOI: 10.4240/wjgs.v15.i9.2074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/09/2023] [Accepted: 07/28/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Lupus mesenteric vasculitis (LMV) is a serious condition that may occur as an acute manifestation of gastrointestinal (GI) involvement and is not easily diagnosed by physicians. Delayed diagnosis and treatment of LMV may lead to rapid disease progression and can be life threatening. CASE SUMMARY A previously healthy 27-year-old woman presented with abdominal pain following a history of fatigue and consumption of cold water. Laboratory investigations, physical examinations, and enhanced abdominal computed tomography (CT) suggested systemic lupus erythematosus complicated by LMV. She received treatments, such as GI decompression, somatostatin, glucocorticoids, and immunosuppressants, and was evaluated using color ultrasonography. Twenty days later, the patient reported no stomach discomfort and was able to consume semi-liquid food. Laboratory investigations showed that inflammatory factors decreased to normal levels and complement levels increased slightly. One year after discharged, she recovered with methylprednisolone being tapered to 4 mg per day, mycophenolate mofetil to 0.75 g bid, and hydroxychloroquine to 0.2 g bid; however, only C3 complement level was slightly below the normal level. CONCLUSION Early diagnosis of LMV is essential for successful treatment; this depends on a combination of clinical manifestations, laboratory investigations, and imaging findings. Enhanced CT is preferred, but ultrasonography can be used for prompt screening and follow-up.
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Affiliation(s)
- Hua Huang
- Department of Rheumatology and Immunology, General Hospital of Northern Theater Command, Shenyang 110000, Liaoning Province, China
| | - Ping Li
- Department of Rheumatology and Immunology, General Hospital of Northern Theater Command, Shenyang 110000, Liaoning Province, China
| | - Dan Zhang
- Department of Nutrition, General Hospital of Northern Theater Command, Shenyang 110000, Liaoning Province, China
| | - Ming-Xuan Zhang
- Department of Rheumatology and Immunology, General Hospital of Northern Theater Command, Shenyang 110000, Liaoning Province, China
| | - Kai Yu
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110000, Liaoning Province, China
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Lu C, Yang F, Liu H, Dou L, Wang Y, Li H, Duan X, Wu L, Wang Y, Zhang X, Xu J, Su J, Xu D, Zhao J, Wu Q, Li M, Leng X, Zeng X. Chinese Registry of Psoriatic Arthritis (CREPAR): I. Clinical characteristics of Chinese patients with psoriatic arthritis. Int J Rheum Dis 2023; 26:1737-1744. [PMID: 37424174 DOI: 10.1111/1756-185x.14805] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/17/2022] [Accepted: 06/17/2023] [Indexed: 07/11/2023]
Abstract
AIM To describe the clinical characteristics of Chinese patients with psoriatic arthritis (PsA) using the data recorded in the Chinese Registry of Psoriatic Arthritis (CREPAR). METHODS This is a cross-sectional study based on the CREPAR registry, which is a prospective registry founded in December 2018. Data regarding clinical characteristics and treatment of patients were collected during every visit. Data recorded at enrollment were extracted, analyzed, and compared with data in other registries or cohorts. RESULTS A total of 1074 patients were registered from December 2018 to June 2021. Of these, 929 (86.5%) patients had a history of peripheral arthritis, and 844 patients (78.6%) had peripheral arthritis at enrollment, of which polyarthritis is the most common subtype. Axial involvement was present in 39.9% of patients, and 50 (4.7%) patients had axial involvement only. More than half of the patients (55.4%) had at least two musculoskeletal presentations at enrollment. The prevalence of low disease activity and remission according to DAPSA were 26.4% and 6.8%, respectively. Conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and biological DMARDs were used in 64.9% and 29.1% of patients, respectively. Among patients with different musculoskeletal presentations, patients with dactylitis had the highest proportion of nonsteroidal anti-inflammatory and csDMARD use. The proportion of patients receiving bDMARDs was highest in axial PsA. CONCLUSION The CREPAR registry has provided information on Chinese patients with PsA. Compared with data in other registries or cohorts, the disease activity of patients in CREPAR was higher, and the proportion of bDMARD use was lower.
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Affiliation(s)
- Chaofan Lu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Fan Yang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Huilan Liu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Lei Dou
- Department of Rheumatology and Immunology, The Second People's Hospital of Wuhu, Wuhu, China
| | - Yanhong Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hongbin Li
- The Division of Rheumatology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Xinwang Duan
- Department of Rheumatology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lijun Wu
- Department of Rheumatology and Immunology, The People's Hospital of the Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Yongfu Wang
- Department of Rheumatology, First Affiliated Hospital of Baotou Medical College, Baotou, China
| | - Xiuying Zhang
- Department of Rheumatology, ZiBo Central Hospital, Zibo, China
| | - Jian Xu
- Department of Rheumatology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jinmei Su
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Dong Xu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Jiuliang Zhao
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Qingjun Wu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Mengtao Li
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Xiaomei Leng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Xiaofeng Zeng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
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16
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Gui L, Gu J. The study of the effect of HLA-B27 on THP-1 monocytic cells survival and its mechanism. Int J Rheum Dis 2023. [PMID: 37424166 DOI: 10.1111/1756-185x.14758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/11/2023] [Accepted: 05/17/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVE Previous studies have shown that human leukocyte antigen (HLA)-B27 induces the accumulation of unfolded proteins in the endoplasmic reticulum (ER) to cause ER stress, resulting in the unfold protein response (UPR), apoptosis and autophagy. However, it is still unknown whether it affects the survival of monocytes. In this study, we attempted to examine the effect of HLA-B27 gene knockout on the proliferation and apoptosis of THP-1 monocytic cell line and its potential mechanism. METHODS HLA-B27 gene knockout THP-1 cell line was constructed by lentivirus infection, and knockout efficiency was detected by immunofluorescence, quantitative reverse transcription - polymerase chain reaction (qRT-PCR) and western blot. Cell Counting Kit-8 (CCK-8) method and Annexin-V/PI double staining were used to detect the proliferation and apoptosis of the constructed THP-1 cell line, respectively. qRT-PCR was used to detect the effect of HLA-B27 inhibition on the expressions of ER molecular chaperone binding immunoglobulin protein (BiP) and genes about the UPR pathway. The proliferation rate of human BiP protein-stimulated THP-1 cells was detected by CCK-8 method. RESULTS HLA-B27 gene knockout THP-1 cells were successfully constructed by lentivirus infection. Knockout of HLA-B27 effectively promoted the proliferation of THP-1 cells and inhibited the apoptosis induced by cisplatin. qRT-PCR showed that BiP was synchronously increased, while activation of UPR pathway was inhibited. Stimulation with human BiP promoted the proliferation of THP-1 cells in a concentration-dependent manner. CONCLUSIONS HLA-B27 inhibition can promote the proliferation and inhibit the apoptosis of THP-1 cells. The inhibition function may be achieved through promotion of BiP and inhibition of UPR pathway activation.
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Affiliation(s)
- Lian Gui
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jieruo Gu
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Zhang T, Xie Q, Wang L, Wang Y, Yan Z, Li Z, Teng Y, Xu Z, Chen Y, Pan F, Tao J, Cai J, Liang C, Pan H, Su H, Cheng J, Hu W, Zou Y. Impact of climate factors and climate-gene interaction on systemic lupus erythematosus patients' response to glucocorticoids therapy. J Clin Lab Anal 2023; 37:e24945. [PMID: 37488812 PMCID: PMC10492452 DOI: 10.1002/jcla.24945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 06/08/2023] [Accepted: 07/11/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Glucocorticoids (GCs) were the essential drugs for systemic lupus erythematosus (SLE). However, different patients differ substantially in their response to GCs treatment. Our current study aims at investigating whether climate variability and climate-gene interaction influence SLE patients' response to the therapy of GCs. METHODS In total, 778 SLE patients received therapy of GCs for a study of 12-week follow-up. The efficacy of GCs treatment was evaluated using the Systemic Lupus Erythematosus Disease Activity Index. The climatic data were provided by China Meteorological Data Service Center. Additive and multiplicative interactions were examined. RESULTS Compared with patients with autumn onset, the efficacy of GCs in patients with winter onset is relatively poor (ORadj = 1.805, 95%CIadj : 1.181-3.014, padj = 0.020). High mean relative humidity during treatment decreased the efficacy of GCs (ORadj = 1.033, 95%CIadj : 1.008-1.058, padj = 0.011), especially in female (ORadj = 1.039, 95%CIadj : 1.012-1.067, padj = 0.004). There was a significant interaction between sunshine during treatment and TRAP1 gene rs12597773 on GCs efficacy (Recessive model: AP = 0.770). No evidence of significant interaction was found between climate factors and the GR gene polymorphism on the improved GCs efficacy in the additive model. Multiplicative interaction was found between humidity in the month prior to treatment and GR gene rs4912905 on GCs efficacy (Dominant model: OR = 0.470, 95%CI: 0.244-0.905, p = 0.024). CONCLUSIONS Our findings suggest that climate variability influences SLE patients' response to the therapy of GCs. Interactions between climate and TRAP1/GR gene polymorphisms were related to GCs efficacy. The results guide the individualized treatment of SLE patients.
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Affiliation(s)
- Tingyu Zhang
- Department of Epidemiology and Biostatistics, School of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- The Key Laboratory of Anhui Medical Autoimmune DiseasesHefeiAnhuiChina
| | - Qiaomei Xie
- Department of Epidemiology and Biostatistics, School of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- The Key Laboratory of Anhui Medical Autoimmune DiseasesHefeiAnhuiChina
| | - Linlin Wang
- Department of Epidemiology and Biostatistics, School of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- The Key Laboratory of Anhui Medical Autoimmune DiseasesHefeiAnhuiChina
| | - Yuhua Wang
- Department of Epidemiology and Biostatistics, School of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- The Key Laboratory of Anhui Medical Autoimmune DiseasesHefeiAnhuiChina
| | - Ziye Yan
- Department of Epidemiology and Biostatistics, School of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- The Key Laboratory of Anhui Medical Autoimmune DiseasesHefeiAnhuiChina
| | - Zhen Li
- Department of Epidemiology and Biostatistics, School of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- The Key Laboratory of Anhui Medical Autoimmune DiseasesHefeiAnhuiChina
| | - Ying Teng
- Department of Epidemiology and Biostatistics, School of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- The Key Laboratory of Anhui Medical Autoimmune DiseasesHefeiAnhuiChina
| | - Zhiwei Xu
- School of Public Health, Faculty of MedicineUniversity of QueenslandHerstonQueenslandAustralia
| | - Yangfan Chen
- Department of Rheumatology and ImmunologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- The Key Laboratory of Anhui Medical Autoimmune DiseasesHefeiAnhuiChina
| | - Jinhui Tao
- Department of Rheumatology and ImmunologyThe First Affiliated Hospital of University of Science and Technology of ChinaHefeiAnhuiChina
| | - Jing Cai
- Department of Rheumatology and ImmunologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Chunmei Liang
- Department of Laboratory Medicine, School of Public HealthAnhui Medical UniversityHefeiAnhuiChina
| | - Haifeng Pan
- Department of Epidemiology and Biostatistics, School of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- The Key Laboratory of Anhui Medical Autoimmune DiseasesHefeiAnhuiChina
| | - Hong Su
- Department of Epidemiology and Biostatistics, School of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- The Key Laboratory of Anhui Medical Autoimmune DiseasesHefeiAnhuiChina
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- The Key Laboratory of Anhui Medical Autoimmune DiseasesHefeiAnhuiChina
| | - Wenbiao Hu
- School of Public Health and Social WorkQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Yanfeng Zou
- Department of Epidemiology and Biostatistics, School of Public HealthAnhui Medical UniversityHefeiAnhuiChina
- The Key Laboratory of Anhui Medical Autoimmune DiseasesHefeiAnhuiChina
- Key Laboratory of Dermatology (Anhui Medical University)Ministry of EducationHefeiAnhuiChina
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Li X, Wang HX, Yin X, Li X, Li H, Zhang X, Wang Z, Qiu YR. Screening epitope peptides based on a phage-displayed random peptide and peptide microarrays to contribute to improving the diagnostic efficiency of systemic lupus erythematosus. Immunol Lett 2023:S0165-2478(23)00085-8. [PMID: 37247788 DOI: 10.1016/j.imlet.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is one of the most common autoimmune diseases in China. At present, there are hundreds of autoantibodies in SLE patients; however, only a dozen of the autoantibodies can be routinely detected, and the available diagnostic antibodies are not sufficient for diagnosis or differential diagnosis of SLE patients with atypical clinical manifestations or other autoimmune diseases. Therefore, it is necessary to find new diagnostic markers to improve the diagnostic effect of SLE. METHODS The displayed random peptide library and peptide microarray were combined to identify SLE-related epitope peptides. A case-control design was used. The IgG antibodies in the sera from SLE patients, healthy controls, and other autoimmune disease controls underwent a reaction with the phage-display random peptide library, respectively. Selected epitope peptides were used to construct a peptide chip. A total of 644 serum samples (including 296 SLE patients, 168 disease controls, and 180 healthy controls) were used for further screening and verification. Peptides with an area under the curve (AUC) > 0.650 were further verified by ELISA. Finally, 500 serum samples (including 200 SLE patients, 150 disease controls, and 150 healthy controls) were used to verify and evaluate the diagnostic and differential diagnostic efficacy of the selected peptides. RESULTS After the previous screening, five epitope peptides (SLE_P19, SLE_P20, SLE_P27, SLE_P28, and SLE_P29) may have potential as SLE diagnostic markers. Additionally, SLE_P27 was superior to the other four peptides in the diagnosis and differential diagnosis of SLE and rheumatoid arthritis (RA). The AUC of SLE_P27 was 0.938, the sensitivity was 76.00%, the specificity was 92.70%, the positive likelihood ratio was 10.411, the negative likelihood ratio was 0.259, and the accuracy was 84.40%. The diagnostic efficacy of SLE can be increased by combining the five selected peptides with the anti-double stranded DNA antibody (anti-dsDNA)and anti-Smith antibodies (anti-Sm). CONCLUSIONS In this study, we identified five peptides that may serve as potential biomarkers for SLE diagnosis using the strategy of combining the displayed random peptide library with the peptide microarray. The combination of selected peptides and existing autoantibodies can significantly improve the diagnostic efficiency. These specific peptides are expected to be new diagnostic markers for SLE.
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Affiliation(s)
- Xin Li
- Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hong-Xia Wang
- Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaofeng Yin
- Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xueheng Li
- Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Haixia Li
- Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaohe Zhang
- Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zheng Wang
- Department of Clinical Laboratory, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yu-Rong Qiu
- Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangzhou Huayin Medical laboratory center. LTD, Guangzhou, China.
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19
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Zhu W, Ayoub S, Morand E, Tillett W, Antony A. The evolving demographics of participants in psoriatic arthritis phase III randomised controlled trials of b/tsDMARDs: A systematic review. Semin Arthritis Rheum 2023; 60:152175. [PMID: 36803867 DOI: 10.1016/j.semarthrit.2023.152175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/21/2023] [Accepted: 02/06/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVES To characterize the evolving demographics of participants recruited to phase III randomised controlled trials (RCTs) of biologic/targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) in peripheral psoriatic arthritis (PsA). METHODS We conducted a systematic review of EMBASE, MEDLINE, and the Cochrane Database of Clinical Trials (CENTRAL) to identify all placebo-controlled phase III RCTs of b/tsDMARDs in peripheral PsA published up to 1 June 2022. Data extracted included inclusion criteria, date of initiation, countries in which studies were conducted, age, sex, race, disease duration, swollen joint count, tender joint count, Health Assessment Questionnaire - Disability Index, Psoriasis Area and Severity Index, and radiographic damage scores. Trends over time were evaluated using descriptive statistics. RESULTS 34 eligible RCTs from 33 reports were included. The proportion of female participants increased over time with females representing 29.0-43.7% of participants in studies initiated in 2000-2004 which increased to 46.0-58.8% in 2015-2019. While the number of countries included in RCTs increased significantly from 1-8 countries (2000-2004) to 2-46 (2015-2019), the proportion of white participants changed marginally from 90.0-98.0% (2000-2004) to 80.9-97.3% (2015-2019). The SJC and TJC decreased from 13.9 to 24.6 respectively (2000-2004), to 7.0-13.9 and 12.9-24.9 (2015-2019). Baseline CRP and HAQ-DI remained stable. CONCLUSION Despite the expansion of countries from which PsA RCT participants were recruited from, non-white participants continue to be under-represented. Improving diversity in patient representation is imperative to further our understanding of PsA phenotypes, proteogenomics, socioeconomic determinants, and treatment effects, to advance the care of all patients with psoriatic disease.
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Affiliation(s)
- Wendy Zhu
- Department of Rheumatology, Monash Health, 246 Clayton Road, Clayton, VIC 3168, Australia.
| | - Sally Ayoub
- Department of Rheumatology, Monash Health, 246 Clayton Road, Clayton, VIC 3168, Australia; School of Clinical Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3168, Australia
| | - Eric Morand
- Department of Rheumatology, Monash Health, 246 Clayton Road, Clayton, VIC 3168, Australia; School of Clinical Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3168, Australia
| | - William Tillett
- Department of Rheumatology, Royal United Hospital, Bath, United Kingdom; Department of Pharmacology, University of Bath, Bath, United Kingdom
| | - Anna Antony
- Department of Rheumatology, Monash Health, 246 Clayton Road, Clayton, VIC 3168, Australia; School of Clinical Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3168, Australia
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20
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Duan R. An Empirical Study on the Landscape of Mining and Mineral Processing (MMP) With Big Data. INTERNATIONAL JOURNAL OF INFORMATION TECHNOLOGIES AND SYSTEMS APPROACH 2023. [DOI: 10.4018/ijitsa.318041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Over the last two decades, mining and mineral processing (MMP) has changed dramatically. Little is known about the bibliometric analysis of MMP. To this end, this study used the big data analysis to investigate the quantity and quality of scientific outputs in MMP over the past 21-year timespan. This study used IBM SPSS Statistics 25.0 and VOSviewer software to research on the 20 journals from Science Citation Index Expanded (SCI-Expanded) of Web of Science Core Collection (WOSCC). VOSviewer software was used to identify the visualization contributions of scientific outputs over 21-year timespan. Totally, the big data analysis shows people of China have the highest cumulative IFs, but their mean IFs are relatively low and are ranked in fourth place. Visually, people of Chin ranked the first in total link strength (2967), but not in links (86), which is the third place among Top15 countries. From the perspective of quality, it cannot rank the first. Thus, people of China should put more effort into improving the quality of scientific outputs.
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Affiliation(s)
- Ruiyun Duan
- Journal Center, China University of Mining and Technology, Xuzhou, China
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21
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Wang CR, Tsai HW. Seronegative spondyloarthropathy-associated inflammatory bowel disease. World J Gastroenterol 2023; 29:450-468. [PMID: 36688014 PMCID: PMC9850936 DOI: 10.3748/wjg.v29.i3.450] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/18/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Seronegative spondyloarthropathy (SpA) usually starts in the third decade of life with negative rheumatoid factor, human leukocyte antigen-B27 genetic marker and clinical features of spinal and peripheral arthritis, dactylitis, enthesitis and extra-articular manifestations (EAMs). Cases can be classified as ankylosing spondylitis, psoriatic arthritis, reactive arthritis, enteropathic arthritis, or juvenile-onset spondyloarthritis. Joint and gut inflammation is intricately linked in SpA and inflammatory bowel disease (IBD), with shared genetic and immunopathogenic mechanisms. IBD is a common EAM in SpA patients, while extraintestinal manifestations in IBD patients mostly affect the joints. Although individual protocols are available for the management of each disease, the standard therapeutic guidelines of SpA-associated IBD patients remain to be established. Nonsteroidal anti-inflammatory drugs are recommended as initial therapy of peripheral and axial SpA, whereas their use is controversial in IBD due to associated disease flares. Conventional disease-modifying anti-rheumatic drugs are beneficial for peripheral arthritis but ineffective for axial SpA or IBD therapy. Anti-tumor necrosis factor monoclonal antibodies are effective medications with indicated use in SpA and IBD, and a drug of choice for treating SpA-associated IBD. Janus kinase inhibitors, approved for treating SpA and ulcerative colitis, are promising therapeutics in SpA coexistent with ulcerative colitis. A tight collaboration between gastroenterologists and rheumatologists with mutual referral from early accurate diagnosis to appropriately prompt therapy is required in this complex clinical scenario.
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Affiliation(s)
- Chrong-Reen Wang
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 70403, Taiwan
| | - Hung-Wen Tsai
- Department of Pathology, National Cheng Kung University Hospital, Tainan 70403, Taiwan
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22
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Sun X, Zhou C, Chen L, Huang S, Ye Z, Yi M, Liao S, Li H, Jiang J, Chen J, Chen W, Chen T, Guo H, Zhang S, Zhu J, Liang T, Zhan X, Liu C. Epidemiological characteristics of ankylosing spondylitis in Guangxi Province of China from 2014 to 2021. Arch Med Sci 2023; 19:1049-1058. [PMID: 37560717 PMCID: PMC10408009 DOI: 10.5114/aoms/159343] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/16/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION To explore the epidemiological characteristics of ankylosing spondylitis (AS) in Guangxi Province of China through a large sample survey of more than 50 million aboriginal aboriginal population. MATERIAL AND METHODS A systematic search was conducted using the International Classification of Diseases 10 (ICD-10) codes M45.x00(AS), M45.x03+(AS with iridocyclitis), and M40.101(AS with kyphosis) to search the database in the National Health Statistics Network Direct Reporting System (NHSNDRS). 14004 patients were eventually included in the study. The parameters analyzed included the number of patients, gender, marriage, blood type, occupation, age at diagnosis, and location of household registration data each year, and statistical analysis was performed. RESULTS AS incidence rates increased from 1.30 (95% CI: 1.20-1.40) per 100,000 person-years in 2014 to 5.71 (95% CI: 5.50-5.92) in 2020 in Guangxi Province, and decreased slightly in 2021. Males have a higher incidence than females; the ratio was 5.61 : 1. The mean age of diagnosis in male patients was 45.4 (95% CI: 45.1-45.7) years, in females 47.6 (95% CI: 46.8-48.4) years. The most frequent blood type was O, and the most frequent occupation was farmer. The AS incidence rate was disparate in different cities. Liuzhou city had the highest eight-year average AS incidence rates from 2014 to 2021, and Chongzuo city had the lowest (p < 0.05). There was no significant difference in the incidence between different ethnic groups (p > 0.05). CONCLUSIONS The AS person-years incidence rate was increasing in Guangxi province of China from 2014 to 2020, which had obvious gender and regional differences, showing the characteristics of local area aggregation.
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Affiliation(s)
- Xuhua Sun
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Chenxing Zhou
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Liyi Chen
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Shengsheng Huang
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Zhen Ye
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Ming Yi
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Shian Liao
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Hao Li
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jie Jiang
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jiarui Chen
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Wuhua Chen
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Tianyou Chen
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Hao Guo
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Shiqing Zhang
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jichong Zhu
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Tuo Liang
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xinli Zhan
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Chong Liu
- Department of Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Huang X, Wang X, Yu D. Development and validation of a nomogram for renal involvement in primary Sjögren syndrome patients: A retrospective analysis. Mod Rheumatol 2023; 33:169-174. [PMID: 34888691 DOI: 10.1093/mr/roab123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/20/2021] [Accepted: 11/30/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To establish and validate a nomogram for individualized prediction of renal involvement in pSS patients. METHODS A total of 1293 patients with pSS from the First Affiliated Hospital of Wenzhou Medical University between January 2008 and January 2020 were recruited and analyzed retrospectively. The patients were randomly divided into development set (70%, n = 910) and validation set (30%, n = 383). The univariable and multivariate logistic regression were performed to analyze the risk factors of renal involvement in pSS. Based on the regression β coefficients derived from multivariate logistic analysis, an individualized nomogram prediction model was developed and subsequently evaluated by AUC and calibration plot. RESULTS Multivariate logistic analysis showed that hypertension, anemia, albumin, uric acid, anti-Ro52, hematuria, and ChisholmMason grade were independent risk factors of renal involvement in pSS. The AUC were 0.797 and 0.750, respectively, in development set and validation set. The calibration plot showed nomogram had a strong concordance performance between the prediction probability and the actual probability. CONCLUSION The individualized nomogram for pSS patients those who had renal involvement could be used by clinicians to predict the risk of pSS patients developing into renal involvement and improve early screening and intervention.
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Affiliation(s)
- Xinshi Huang
- Department of Ultrasound, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaobing Wang
- Rheumatology Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dinglai Yu
- Departments of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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24
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Combined anterior and posterior approach in treatment of ankylosing spondylitis-associated cervical fractures: a systematic review and meta-analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:27-37. [PMID: 36400905 DOI: 10.1007/s00586-022-07435-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 10/19/2022] [Accepted: 10/24/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Cervical fractures with ankylosing spondylitis (CAS) are a specific type of spinal fracture with poor stability, low healing rate, and high disability rate. Its treatment is mainly surgical, predominantly through the anterior approach, posterior approach, and the anterior-posterior approach. Although many clinical studies have been conducted on various surgical approaches, controversy still exists concerning the choice of these surgical approaches by surgeons. The authors present here a systematic evaluation and meta-analysis exploring the utility of the anterior-posterior approach versus the anterior approach and the posterior approach. METHODS After a comprehensive literature search of PubMed, Cochrane, Web of Science, and Embase databases, 12 clinical studies were included in the final qualitative analysis and 8 in the final quantitative analysis. Of these studies, 11 conducted a comparison between the anterior-posterior approach and the anterior approach and posterior approaches, while one examined only the anterior-posterior approach. Where appropriate, statistical advantage ratios and 95% confidence intervals were calculated. RESULTS The present meta-analysis of postoperative neurological improvement showed no statistical difference in the overall neurological improvement rate between the anterior-posterior approach and anterior approach (OR 1.70, 95% CI 0.61 to 4.75; p = 0.31). However, the mean change in postoperative neurological function was lower in patients who received the anterior approach than in those who received the anterior-posterior approach (MD 0.17, 95% CI -0.02 to 0.36; p = 0.08). There was an identical trend between the anterior-posterior approach and posterior approach, with no statistically significant difference in the overall rate of neurological improvement (OR 1.37, 95% CI 0.70 to 2.56; p = 0.38). Nevertheless, the mean change in neurological function was smaller in patients receiving the anterior-posterior approach compared with the posterior approach, but there was no statistically significant difference between the two (MD 0.17, 95% CI -0.02 to 0.36; p = 0.08). CONCLUSIONS The results of this review and meta-analysis suggest that the benefits of the anterior-posterior approach are different from those of the anterior and posterior approaches in the treatment of ankylosing spondylitis-related cervical fractures. In a word, there is no significant difference between the cervical surgical approach and the neurological functional improvement. Therefore, surgeons should pay more attention to the type of cervical fracture, the displacement degree of cervical fracture, the spinal cord injury, the balance of cervical spine and other aspects to comprehensively consider the selection of appropriate surgical methods.
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Huang Y, Jin X, Liu J, Wu W, Wang H. Systems pharmacology approach to investigate the mechanism of Artemisia argyi in treating rheumatic diseases. Sci Rep 2022; 12:18786. [PMID: 36335258 PMCID: PMC9637220 DOI: 10.1038/s41598-022-23635-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
Abstract
Artemisia argyi (AA) has been proven to be effective in the adjuvant treatment of rheumatism (RA), but the mechanism of its action in RA is not clear. This study aims to clarify the molecular mechanism of AA as a potential therapy for RA by using network pharmacology. The TCM systems pharmacology (TCMSP) was used to screen the active components of AA, and identification of the potential target genes of active compounds and rheumatism was performed with PharmMapper and GeneCards, respectively. Construction of complex target networks and protein-protein interaction networks was based on the Cytoscape software. The biological functions and pathway analysis of targets and effective targets were analyzed using DAVID. Our study demonstrated that 105 target genes were associated with these active compounds and RA. ALB, AKT1, and MAPK1 were the first three hub genes, and the metabolic and signaling pathways related to these hub genes were remarkably abundant. Results showed that AA might play a role in RA by affecting multiple targets and multiple ways, reflecting that TCM was characterized by multicomponents and multitargets. AA has the potential to be a promising new candidate for the treatment of RA and has value for further research and development.
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Affiliation(s)
- Yuanzhi Huang
- grid.443405.20000 0001 1893 9268Hubei Key Laboratory of Economic Forest Germplasm Improvement and Resources Comprehensive Utilization, Hubei Collaborative Innovation Center for the Characteristic Resources Exploitation of Dabie Mountains, Huanggang Normal University, Huangzhou, 438000 China
| | - Xupeng Jin
- grid.443405.20000 0001 1893 9268Hubei Key Laboratory of Economic Forest Germplasm Improvement and Resources Comprehensive Utilization, Hubei Collaborative Innovation Center for the Characteristic Resources Exploitation of Dabie Mountains, Huanggang Normal University, Huangzhou, 438000 China
| | - Jiayi Liu
- grid.443405.20000 0001 1893 9268Hubei Key Laboratory of Economic Forest Germplasm Improvement and Resources Comprehensive Utilization, Hubei Collaborative Innovation Center for the Characteristic Resources Exploitation of Dabie Mountains, Huanggang Normal University, Huangzhou, 438000 China
| | - Wei Wu
- grid.443405.20000 0001 1893 9268Hubei Key Laboratory of Economic Forest Germplasm Improvement and Resources Comprehensive Utilization, Hubei Collaborative Innovation Center for the Characteristic Resources Exploitation of Dabie Mountains, Huanggang Normal University, Huangzhou, 438000 China
| | - Huiping Wang
- grid.464460.4Hanchuan Maternal and Child Health Hospital of Hubei Province, Hanchuan, 431600 Hubei China
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Jakobsson PJ, Robertson L, Welzel J, Zhang M, Zhihua Y, Kaixin G, Runyue H, Zehuai W, Korotkova M, Göransson U. Where traditional Chinese medicine meets Western medicine in the prevention of rheumatoid arthritis. J Intern Med 2022; 292:745-763. [PMID: 35854675 PMCID: PMC9796271 DOI: 10.1111/joim.13537] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Chinese medicine has a long tradition of use against rheumatoid arthritis (RA). The formulations are based on combinations of typically 5-10 plants, which are usually boiled and administered as a decoction or tea. There are few clinical trials performed so the clinical evidence is sparse. One fundamental of traditional medicine is to prevent disease. RA is an autoimmune, inflammatory and chronic disease that primarily affects the joints of 0.5%-1% of the population. In two out of three of the cases, the patients are characterised by the presence of autoantibodies such as the rheumatoid factor and the more disease-specific autoantibody against citrullinated proteins, so-called 'ACPA' (anticitrullinated protein/peptide antibodies). ACPA positivity is also strongly associated with specific variations in the HLA-DRB1 gene, the shared epitope alleles. Together with smoking, these factors account for the major risks of developing RA. In this review, we will summarise the background using certain plant-based formulations based on Chinese traditional medicine for the treatment and prevention of RA and the strategy we have taken to explore the mechanisms of action. We also summarise the major pathophysiological pathways related to RA and how these could be analysed. Finally, we summarise our ideas on how a clinical trial using Chinese herbal medicine to prevent RA could be conducted.
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Affiliation(s)
- Per-Johan Jakobsson
- Division of Rheumatology, Department of Medicine Solna & Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Luke Robertson
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Janika Welzel
- Division of Rheumatology, Department of Medicine Solna & Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Mingshu Zhang
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Yang Zhihua
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Gao Kaixin
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Huang Runyue
- Section of Rheumatology and Immunology Research, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Wen Zehuai
- Key Unit of Methodology in Clinical Research, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Marina Korotkova
- Division of Rheumatology, Department of Medicine Solna & Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Ulf Göransson
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
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Zhong LLD, Wang R, Lam WC, Zhu Q, Du P, Cao PH, Jiang T, Zhang YY, Shen J, Su X, Xue L, Mao J, Fang YF, Gao ML, Hu CR, Peng JY, Gu Y, Wei Q, Huang R, Lyu A, Liu H, He D. The combination of Chinese and Western Medicine in the management of rheumatoid arthritis: A real-world cohort study across China. Front Pharmacol 2022; 13:933519. [PMID: 36278204 PMCID: PMC9582451 DOI: 10.3389/fphar.2022.933519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 09/21/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate the efficacy of Integrative medicine (IM), compare with Western medicine (WM), in the treatment of rheumatoid arthritis (RA) in a cohort study.Methods: This is a cohort study with recruitment of RA patients from 10 hospitals in China. The primary outcome was change in disease activity score 28 (DAS28) during 4 follow-up visits. Generalized estimating equation (GEE) models that controlled for variables were used to investigate a time trend and assess group differences in the primary outcome and secondary outcomes after propensity score matching (PSM).Results: A total of 3195 patients with RA received IM (n = 1379, 43.2%) or WM (n = 1816, 56.8%). Following 1:1 propensity score matching, 1,331 eligible patients prescribed IM were compared to 1,331 matched patients prescribed WM. The GEE analysis with PSM showed that the IM was more beneficial to significantly decrease the levels of VAS, PGA and PhGA (VAS: odds ratio (OR), 0.76; 95% CI, 0.63–0.92; p = 0.004; PGA: OR, 0.76; 95% CI, 0.64–0.92; p = 0.007; and PhGA: OR, 0.77; 95% CI, 0.64, 0.93; p = 0.004), and reduce DAS28 (OR, 0.84; 95% CI, 0.73–0.98; p = 0.030) in the per-protocol population.Conclusion: This study suggests that compare to WM, IM has advantages in improving RA-related outcomes. However, the statistical significance might not reveal significant clinical difference. Further studies should be focused on specific treatment strategies and/or disease stages.
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Affiliation(s)
- Linda LD. Zhong
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
- Department of Rheumatology, Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Hong Kong, China
- *Correspondence: Linda LD. Zhong, ; Linda LD. Zhong, ; Hongxia Liu, ; Dongyi He,
| | - Rongsheng Wang
- Department of Medicine, ShangHai GuangHua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
- Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Wai Ching Lam
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Qi Zhu
- Department of Medicine, ShangHai GuangHua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
- Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Peipei Du
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Pei Hua Cao
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Ting Jiang
- Department of Medicine, ShangHai GuangHua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
- Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Yuan Yuan Zhang
- Department of Medicine, ShangHai GuangHua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
- Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Jie Shen
- Department of Medicine, ShangHai GuangHua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
- Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Xiao Su
- Department of Rheumatology and Immunology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Luan Xue
- Department of Rheumatology and Immunology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jianchun Mao
- Department of Rheumatology, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yong Fei Fang
- Department of Rheumatology, Southwest Hospital, Chongqing, China
| | - Ming Li Gao
- Department of Rheumatology, Liaoning Hospital of Traditional Chinese Medicine, Liaoning, China
| | - Chun Rong Hu
- Department of Rheumatology, The Ninth People’s Hospital of Chongqing, Chongqing, China
| | - Jiang Yun Peng
- Department of Rheumatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, Yunnan, China
| | - Ying Gu
- Department of Rheumatology, Mianyang Hospital of Traditional Chinese Medicine, Sichuan, China
| | - Qianghua Wei
- Department of Rheumatology, Shanghai General Hospital, Shanghai, China
| | - Runyue Huang
- Department of Rheumatology, Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Hong Kong, China
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
- State Key Laboratory of Dampness Syndrome of Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangzhou, China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, China
| | - Aiping Lyu
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
- Department of Rheumatology, Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Hong Kong, China
| | - Hongxia Liu
- Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Linda LD. Zhong, ; Linda LD. Zhong, ; Hongxia Liu, ; Dongyi He,
| | - Dongyi He
- Department of Medicine, ShangHai GuangHua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
- Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Linda LD. Zhong, ; Linda LD. Zhong, ; Hongxia Liu, ; Dongyi He,
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Li W, Bi S, Liang Y, Zhu H. Construction of Rheumatoid Arthritis Risk Prediction and Medical Image Applications from Rheumatoid Factor Levels. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8617467. [PMID: 36238489 PMCID: PMC9553335 DOI: 10.1155/2022/8617467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 11/24/2022]
Abstract
Objective To study the value of rheumatoid factor (RF) levels in the risk assessment of rheumatoid arthritis (RA) and combined hypertension and diabetes mellitus (DM) and construct RA risk prediction and medical image applications from rheumatoid factor levels. Methods A total of 249 RA patients who were treated in the First People's Hospital of Yunnan Province, and another 149 non-RA people were selected as the controls. The clinical data and the detection results of serum circulating RF_IgA, RF_IgG, and RF_IgM were collected. The receiver operating curve (ROC) and logistic regression were used to analyze the value of RF levels in the risk assessment of RA and combined hypertension and DM. Results After adjusting for age, BMI, smoking, drinking, hypertension, and diabetes, logistic regression analysis showed that RF_IgA positive, RF_IgG positive, and RF_IgM positive were all independent risk factors for RA (P < 0.05). The area under the curve (AUC) of circulating RF_IgA, RF_IgG, and RF_IgM levels in predicting RA was 0.79 (95% CI: 0.74-0.83, P < 0.001), 0.73 (95% CI: 0.68-0.78, P < 0.001), and 0.87 (95% CI: 0.84-0.91, P < 0.001), respectively. The AUC for predicting RA was 0.88 (95% CI: 0.85-0.92, P < 0.001) when combined detection of circulating RF_IgA, RF_IgG, and RF_IgM levels in peripheral blood. After adjusting for age and sex, logistic regression analysis showed that RF_IgA positive, RF_IgG positive, and RF_IgM positive were not independent risk factors for DM in RA patients (P > 0.05). Conclusion The levels of serum circulating RF_IgA, RF_IgG, and RF_IgM are valuable indicators for predicting the risk of RA, but not for the risk of RA complicated with hypertension and DM.
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Affiliation(s)
- Wenrun Li
- Department of Medical Laboratory, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Sheng Bi
- Department of Medical Laboratory, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Yu Liang
- Department of Medical Laboratory, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Hongyan Zhu
- Department of Medical Laboratory, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
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Dai Q, Xia X, He C, Huang Y, Chen Y, Wu Y, Chen Y, Hou Q, Shu Y, Zhang W, Xu H, Yin G, Xie Q. Association of anti-TNF-α treatment with gut microbiota of patients with ankylosing spondylitis. Pharmacogenet Genomics 2022; 32:247-256. [PMID: 35852868 PMCID: PMC9351697 DOI: 10.1097/fpc.0000000000000468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/27/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Gut dysbiosis contributes to multiple autoimmune diseases, including ankylosing spondylitis, which is commonly treated with tumor necrosis factor (TNF)-α inhibitors (TNFis). Because host TNF-α levels are considered to interact with gut microbiota, we aimed to systematically investigate the microbiota profile of ankylosing spondylitis patients with anti-TNF-α-based treatment and identify potential key bacteria. METHODS Fecal samples were collected from 11 healthy controls and 24 ankylosing spondylitis patients before/after anti-TNF-α treatment, the microbiota profiles of which were evaluated by 16S ribosomal DNA amplicon sequencing and subsequent bioinformatic analysis. RESULTS Significantly different microbial compositions were observed in samples from ankylosing spondylitis patients compared with healthy controls, characterized by a lower abundance of short-chain fatty acid (SCFA)-producing bacteria. All patients exhibited a positive response after anti-TNF-α treatment, accompanied by a trend of restoration in the microbiota compositions and functional profile of ankylosing spondylitis patients to healthy controls. In particular, the abundance of SCFA-producing bacteria (e.g. Megamonsa and Lachnoclostridium ) was not only significantly lower in ankylosing spondylitis patients than in healthy controls and restored after anti-TNF-α treatment but also negatively correlated with disease severity (e.g. cor = -0.52, P = 8 × 10 -5 for Megamonsa ). In contrast, Bacilli and Haemophilus may contribute to ankylosing spondylitis onset and severity. CONCLUSIONS Microbiota dysbiosis in ankylosing spondylitis patients can be restored after anti-TNF-α treatment, possibly by impacting SCFA-producing bacteria.
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Affiliation(s)
- Qinghong Dai
- Department of Laboratory Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
- Department of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, Xiangya Hospital, Central South University, Changsha, China
| | - Xuyang Xia
- Department of Laboratory Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Chenjia He
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Yupeng Huang
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Yidan Chen
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Yang Wu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Yuehong Chen
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Qianqian Hou
- Department of Laboratory Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Yang Shu
- Department of Laboratory Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Zhang
- Department of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, Xiangya Hospital, Central South University, Changsha, China
| | - Heng Xu
- Department of Laboratory Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Geng Yin
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Qibing Xie
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
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Jiang J, Yang W, Wu Y, Peng W, Zhang W, Pan P, Hu C, Li Y, Li Y. Metagenomic next-generation sequencing for identifying pathogens in patients with rheumatic diseases and diffuse pulmonary lesions: A retrospective diagnostic study. Front Cell Infect Microbiol 2022; 12:963611. [PMID: 36118036 PMCID: PMC9471190 DOI: 10.3389/fcimb.2022.963611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveLung involvement is a major cause of morbidity and mortality in patients with rheumatic diseases. This study aimed to assess the application value of metagenomic next-generation sequencing (mNGS) for identifying pathogens in patients with rheumatic diseases and diffuse pulmonary lesions.MethodsThis retrospective study included patients who were diagnosed with rheumatic diseases and presenting diffuse pulmonary lesions on chest radiography in Xiangya Hospital from July 2018 to May 2022. Clinical characteristics were summarized, including demographics, symptoms, comorbidities, radiological and laboratory findings, and clinical outcomes. Pulmonary infection features of these patients were analyzed. Furthermore, diagnostic performance of mNGS and conventional methods (including smear microscopy, culture, polymerase chain reaction assay, and serum immunological test) in identifying pulmonary infections and causative pathogens were compared.ResultsA total of 98 patients were included, with a median age of 58.0 years old and a female proportion of 59.2%. Of these patients, 71.4% showed the evidence of pulmonary infections. Combining the results of mNGS and conventional methods, 129 infection events were detected, including 45 bacterial, 40 fungal and 44 viral infection events. Pulmonary mixed infections were observed in 38.8% of patients. The detection rates of mNGS for any pathogen (71.4% vs 40.8%, P < 0.001) and mixed pathogens (40.8% vs 12.2%, P < 0.001) were higher than that of conventional methods. Moreover, mNGS had a significantly higher sensitivity (97.1% vs. 57.1%, P < 0.001) than conventional methods in identifying pulmonary infections, while its specificity (92.9% vs. 96.4%, P = 0.553) were comparable to conventional methods. Antimicrobial and antirheumatic treatments were markedly modified based on mNGS results in patients with rheumatic diseases and diffuse pulmonary lesions.ConclusionsFor patients diagnosed with rheumatic diseases and presenting diffuse pulmonary lesions, mNGS is a powerful complement to conventional methods in pathogen identification due to its high efficiency and broad spectrum. Early application of mNGS can provide guidance for precision treatment, and may reduce mortality and avoid antibiotic abuse.
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Affiliation(s)
- Juan Jiang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Wei Yang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Yanhao Wu
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Wenzhong Peng
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Wenjuan Zhang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Pinhua Pan
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Chengping Hu
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Yisha Li
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
- Department of Rheumatology and Immunology, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Yuanyuan Li, ; Yisha Li,
| | - Yuanyuan Li
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
- *Correspondence: Yuanyuan Li, ; Yisha Li,
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Zhang S, Peng L, Li Q, Zhao J, Xu D, Zhao J, Wang Q, Li M, Zhang W, Tian X, Su J, Zeng X. Spectrum of Spondyloarthritis Among Chinese Populations. Curr Rheumatol Rep 2022; 24:247-258. [PMID: 35829981 PMCID: PMC9307523 DOI: 10.1007/s11926-022-01079-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW This review aims to emphasize interesting and important new findings with a focus on the spectrum of spondyloarthritis (SpA) in China. RECENT FINDINGS Over the past decade, significant advances have been made in the investigation of SpA epidemiology, the exploration of genetic and environmental risk factors, the identification of clinical features, and the updating of treatment protocols in the Chinese population. The prevalence of ankylosing spondylitis (AS) in China is 0.20-0.42%, and the prevalence of HLA-B27 in AS patients is 88.8-89.4%. HLA-B*2704 is the most common subtype in Chinese AS patients, followed by HLA-B*2705. HLA-A*01, more precisely HLA-A*01:01, may be associated with psoriatic arthritis (PsA). Tumor necrosis factor inhibitors and IL-17A inhibitors have been shown to be effective and safe for AS patients in China. Juvenile-onset AS is relatively rare, accounting for only 9.1% of the AS population. The prevalence of arthritis related to inflammatory bowel disease is 6.9 to 7.2%. A Chinese study showed that the most frequently prescribed medication was methotrexate (66.4%). Biological agents were prescribed in only16.4% of patients with PsA. This review summarizes the latest research in the epidemiology, pathogenesis, clinical manifestations, and management of SpA among Chinese populations. Multiple HLA associations with SpA have also been described, and it is hoped that discoveries of such ethnic-specific risk factor(s) and understanding of their pathological mechanisms may potentially lead to newer targeted therapies for the Chinese populations worldwide.
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Affiliation(s)
- Shangzhu Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Linyi Peng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Qingyang Li
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Jinwei Zhao
- National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, 300191, Tianjin, China
| | - Dong Xu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Jiuliang Zhao
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Qian Wang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Mengtao Li
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Wen Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Xinping Tian
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China
| | - Jinmei Su
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China.
| | - Xiaofeng Zeng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH); Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education,, No.1 Shuaifuyuan, Dongcheng district, 100730, Beijing, China.
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Long L, Tian J, Xie X, Li F, Xu S. Role of air pollution in systemic lupus erythematosus. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2022; 47:967-972. [PMID: 36039595 PMCID: PMC10930282 DOI: 10.11817/j.issn.1672-7347.2022.210335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Indexed: 06/15/2023]
Abstract
Systemic lupus erythematosus (SLE) is a complex autoimmune disease that can affect almost every organ in the human body. The etiology and pathogenesis are unclear. Recent studies have shown that pathogenesis and development of SLE result from the interaction between various internal and external factors. Current studies suggest that air pollution may increase the risk of SLE through multiple mechanisms such as inducing immune disorders, causing epigenetic changes, and inducing oxidative stress. Air pollution has a certain relationship with pulmonary interstitial lesions, lupus nephritis, decreased reproductive function and other system damages in SLE patients, and it is related to the occurrence and clinical outcomes of SLE. Air pollution has a potential role in the occurrence and development of SLE, providing a brand-new view on the early prevention and control of SLE.
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Affiliation(s)
- Liuxin Long
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha 410011.
- Department of Rheumatology and Immunology, Second Xiangya Hospital, Central South University, Changsha 410011, China.
| | - Jing Tian
- Department of Rheumatology and Immunology, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Xi Xie
- Department of Rheumatology and Immunology, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Fen Li
- Department of Rheumatology and Immunology, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Suqing Xu
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha 410011.
- Department of Rheumatology and Immunology, Second Xiangya Hospital, Central South University, Changsha 410011, China.
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Han Y, Sheng Q, Fang Y. Exploring the Spatial Distribution of Rheumatic Diseases and Its Correlation With Temperature and Humidity Among Middle-Aged and Elderly Adults in China. Int J Public Health 2022; 67:1604782. [PMID: 35936998 PMCID: PMC9351402 DOI: 10.3389/ijph.2022.1604782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: This study aimed to analyze the prevalence of rheumatic diseases and its correlation with temperature and humidity among middle-aged and elderly adults in China from a spatial perspective.Methods: Data on rheumatic diseases among middle-aged and elderly adults were sourced from the 2018 China Health and Retirement Longitudinal Study (CHARLS). Moran’s I was applied to explore the spatial autocorrelation of rheumatic diseases. Spatial lag model (SLM) was established to probe the correlation between rheumatic diseases and temperature and humidity.Results: The age-standardized prevalence of rheumatic diseases was 33.2% for middle-aged and elderly adults in China, varying from 12.0% to 51.4% depending on regions. The Global Moran’s I was 0.506 (p = 0.001). Average temperature had negative correlation while average relative humidity had positive correlation with age-standardized prevalence of rheumatic diseases in the SLM.Conclusion: The age-standardized prevalence of rheumatic diseases of middle-aged and elderly adults showed spatial autocorrelation in China. We recommend taking measures to prevent rheumatic diseases for the middle-aged and elderly adults, especially for those living in cold and humid regions.
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Li QH, Zou YW, Lian SY, Liang JJ, Bi YF, Deng C, Mo YQ, Yang KM, Dai L. Sugar-Sweeten Beverage Consumption Is Associated With More Obesity and Higher Serum Uric Acid in Chinese Male Gout Patients With Early Onset. Front Nutr 2022; 9:916811. [PMID: 35903455 PMCID: PMC9318574 DOI: 10.3389/fnut.2022.916811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundEarly onset gout has received increasing interest from researchers. Previous studies have reported that serum urate (sUA) levels and prevalence of obesity are higher in early onset gout patients than in later-onset gout patients. We explored the dietary habits of early onset and later-onset gout patients and their association with clinical features.Materials and MethodsGout patients completed a 10-item food frequency questionnaire. Early onset gout patients were defined as gout onset before the age of 40, and onset after age 40 was classified as later-onset. Associations between dietary factors, obesity, and sUA level of ≥600 μmol/L were assessed using logistic regression.ResultsAmong the 655 gout patients, 94.6% were males, and 59.1% presented with early onset gout. All early onset patients were males. sUA level was significantly higher in the early onset group than in the later-onset group (550.7 vs. 513.4 μmol/L). The proportion of patients with a sUA level of ≥ 600 μmol/L (40.3 vs. 26.2%) and obesity (27.6 vs. 10.7%) was higher in the early onset group than in the later-onset group (all p < 0.05). The early onset group consumed more red meat (101–200 g/day: 43.6 vs. 26.0%), sugar-sweetened beverages (>4 times/week: 27.9 vs. 7.7%), and milk and milk products (1–2 times/week: 28.5 vs. 16.6%), but less alcohol (>84 g/day: 8.5 vs. 21.5%) and tea (>4 times/week: 35.7 vs. 52.4%; all p < 0.05). Sugar-sweetened beverage intake was positively correlated with sUA level of ≥600 μmol/L (compared with <once/week [reference], >4 times/week: adjusted odds ratio = 2.2, 95% confidence interval: 1.4, 3.7) and obesity (compared with <once/week [reference], >4 times/week: adjusted odds ratio = 2.2, 95% confidence interval: 1.2, 3.7). These correlations remained significant for early onset gout patients.ConclusionSugar-sweetened beverage intake replaced alcohol as the main dietary risk factor for gout in early onset patients, and this change was associated with a greater prevalence of obesity and higher sUA level. Clinicians should provide specific dietary education for different generations of gout patients. The epidemic of sugar-sweetened beverage consumption should be considered for the development of public health policies for the prevention of gout.
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Affiliation(s)
- Qian-Hua Li
- Department of Rheumatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yao-Wei Zou
- Department of Rheumatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shu-Yan Lian
- Department of Rheumatology, Shenshan Medical Center, Memorial Hospital of Sun Yat-sen University, Shanwei, China
| | - Jin-Jian Liang
- Department of Rheumatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yu-Fei Bi
- Department of Rheumatology, Qilu Hospital, Shandong University, Qingdao, China
| | - Chao Deng
- Department of Rheumatology, Shenzhen Third People’s Hospital, The Second Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
| | - Ying-Qian Mo
- Department of Rheumatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Kui-Min Yang
- Department of Rheumatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lie Dai
- Department of Rheumatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Lie Dai, ; orcid.org/0000-0001-6596-8889
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Chen J, Zhang P, Chen H, Wang X, He X, Zhong J, Zheng H, Li X, Jakovlić I, Zhang Y, Chen Y, Shen B, Deng C, Wu Y. Whole-genome sequencing identifies rare missense variants of WNT16 and ERVW-1 causing the systemic lupus erythematosus. Genomics 2022; 114:110332. [PMID: 35283196 DOI: 10.1016/j.ygeno.2022.110332] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 01/27/2022] [Accepted: 03/06/2022] [Indexed: 01/14/2023]
Abstract
Systemic lupus erythematosus (SLE, OMIM 152700) is a rare autoimmune disease with high heritability that affects ~0.1% of the population. Previous studies have revealed several common variants with small effects in European and East Asian SLE patients. However, there is still no rare variant study on Chinese SLE patients using the whole-genome sequencing technology (WGS). Here, we designed a family based WGS study to identify novel rare variants with large effects. Based on large-scale allele frequency data from the gnomAD database, we identified rare protein-coding gene variants with disruptive and sequence-altering impacts in SLE patients. We found that the burden of rare variants was significantly higher than that of common variants in patients, suggesting a larger effect of rare variants on the SLE pathogenesis. We identified the pathogenic risk of rare missense variants with significant odds ratios (p < 0.05) in two genes, including WNT16 (NC_000007.14:g.121329757G > C, NP_057171.2:p.(Ala86Pro) and 7 g.121329760G > C, NP_057171.2:p.(Ala87Pro)), which explains five out of seven patients covering all three families but are absent from all controls, and ERVW-1 (NC_000007.14:g.92469882A > G, NP_001124397.1:p.(Leu167Pro), rs74545114; NC_000007.14:g.92469907G > A, NP_001124397.1:p.(Arg159Cys), rs201142302; NC_000007.14:g.92469919G > A, NP_001124397.1:p.(His155Tyr), rs199552228), which explains the other two patients. None of these variants were identified in any of the controls. These associations are supported by known gene expression studies in SLE patients based on literature review. We further tested the wild and mutant types using the luciferase assays and qPCR in cells. We found that WNT16 can activate the canonical Wnt/β-catenin pathway while the mutant cannot. Additionally, the wild ERVW-1 expression can be significantly up-regulated by cAMP while the mutant cannot. Our study provides the first direct genetic and in vitro evidence for the pathogenic risk of mutant WNT16 and ERVW-1, which may facilitate the design of precision therapy for SLE.
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Affiliation(s)
- Jianhai Chen
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China; Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ping Zhang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Haidi Chen
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xin Wang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xuefei He
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jie Zhong
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China
| | - HuaPing Zheng
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiaoyu Li
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China
| | | | - Yong Zhang
- Key Laboratory of Transplant Engineering and Immunology, Ministry of Health, Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Younan Chen
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Bairong Shen
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Cheng Deng
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yongkang Wu
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
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Tian J, Zhou H, Liu J, Xiong F, Yi P, Cao P, Fang D, Zhang B, Lu Q. The Systemic Lupus Erythematosus Interventional Trials in Mainland China: A Continuous Challenge. Front Immunol 2022; 13:848478. [PMID: 35479089 PMCID: PMC9035534 DOI: 10.3389/fimmu.2022.848478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/21/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives More than a quarter of single-country systemic lupus erythematosus (SLE) interventional randomized clinical trials (RCTs) were conducted in China. To help develop management guidelines and set benchmarks for future SLE research, a systematic review of current trials is needed. Methods We searched systematically three databases and four registries to summarize the interventional RCTs in mainland China and identify factors associated with participant loss. The internal validity of trials was assessed using the Cochrane risk-of-bias tool for assessing risk of bias. The odds ratio (OR) was defined as the ratio of the odds of less than 10% loss to follow-up in the presence or absence of different factors. Results A total of 188 trials met our inclusion criteria, and 15·5% of trials conducted in mainland China ranked low risk of bias. Participant loss was significantly higher among trials that had a defined primary outcome or were registered {primary outcome identification (0·02 [0·00-0·23]) and registration (0·14 [0·03-0·69])}. Trials examining traditional Chinese medicine (TCM) pharmacological treatments had an 8·16-fold (8·16 [1·28-51·98]) higher probability of having low participant loss than trials examining non-TCM pharmacological treatment trials, and trials that did not report masking status had a 15·95-fold (15·95 [2·45-103·88]) higher probability of having low participant loss than open-label trials. In addition, published articles in Chinese also had higher probability of having low participant loss (5·39 [1·10-26·37]). Conclusion SLE trials conducted in mainland China were of relatively poor quality. This situation, including nonrigorous design, lack of registration, and absence of compliance reporting, needs to be ameliorated. To maintain the fundamental repeatability and comparability of mainland China SLE RCTs, transparency of the clinical trial process and complete reporting of the trial data are crucial and urgently needed.
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Affiliation(s)
- Jingru Tian
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and Sexually Transmitted Infections, Nanjing, China
| | - Hang Zhou
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Juan Liu
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Feng Xiong
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ping Yi
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Pengpeng Cao
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Dorthy Fang
- Department of Molecular, Cellular, and Developmental Biology, Yale University, New Haven, CT, United States
| | - Bo Zhang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Qianjin Lu
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and Sexually Transmitted Infections, Nanjing, China
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Reliability and validity analysis of the Chinese version of Evaluation of Ankylosing Spondylitis Quality of Life (EASi-QoL). Clin Rheumatol 2022; 41:2393-2401. [PMID: 35359254 DOI: 10.1007/s10067-022-06153-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/19/2022] [Accepted: 03/25/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE We aimed to convert the English version of the Evaluation of Ankylosing Spondylitis Quality of life (EASi-QoL) into a Chinese version, and to test the reliability and validity of the Chinese version of EASi-QoL. METHODS The EASi-QoL was translated into Chinese. A total of 127 patients with ankylosing spondylitis (AS) were evaluated using the Chinese version of EASi-QoL to test its validity and reliability. Internal and test-retest reliability was assessed. In addition, correlation and exploratory factor analyses evaluating the structural, convergent, and criterion-related validities of this measure were performed. RESULTS The total Cronbach's α coefficient of the Chinese version of EASi-QoL was 0.911. The Kaiser-Meyer-Olkin value of the scale in this study was 0.917, and the Bartlett's test value was 2403.499. The convergent validity of the related domains was analyzed using confirmatory factor analysis; and the average variance extracted values corresponding to the four dimensions were all > 0.5, and the composite reliability values were all > 0.7. Discriminative validity analysis showed that the correlation between the four domains of EASi-QoL and their related domains of the depression/anxiety screening scale and the Medical Outcomes study Short-Form 36 were moderate to high. CONCLUSION The Chinese version of EASi-QoL has high reliability and validity, and can reflect the impact of AS on the quality of life. Key Points • The Chinese version of EASi-QoL can accurately measure the impact of AS on the quality of life from the perspective of a patient. It is applicable to the evaluation of AS patients in China • The Chinese version of EASi-QoL is a scale with good reliability and validity.
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Li Y, Qi W, Shi Y. miR‑150‑5p inhibits osteogenic differentiation of fibroblasts in ankylosing spondylitis by targeting VDR. Exp Ther Med 2022; 23:283. [PMID: 35317439 PMCID: PMC8908459 DOI: 10.3892/etm.2022.11213] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 12/16/2021] [Indexed: 11/05/2022] Open
Abstract
Dysregulated microRNAs (miRNAs or miRs) serve potential roles in inflammatory systemic disease, including ankylosing spondylitis (AS). The aim of the present study was to investigate the potential function of miR-150-5p in osteogenic differentiation of AS fibroblasts and its underlying mechanism. The expression of miR-150-5p and vitamin D receptor (VDR) in AS joint capsules and fibroblasts was detected by reverse transcription-quantitative (RT-q)PCR and western blotting. Following overexpression of miR-150-5p, the alteration in osteogenic gene expression was detected by RT-qPCR, western blotting and alkaline phosphatase activity assay, as well as alizarin red staining. The association between miR-150-5p and VDR was confirmed by luciferase assay and rescue experiments were performed. Patients with AS exhibited decreased expression of miR-150-5p in joint capsules. Treatment with bone morphogenic protein 2 (BMP-2) and transforming growth factor-β1 (TGF-β1) led to downregulation of miR-150-5p in AS fibroblasts. Enforced expression of miR-150-5p attenuated osteogenic differentiation of AS fibroblasts. These results demonstrated that miR-150-5p inhibited osteogenic differentiation of AS fibroblasts by targeting VDR. miR-150-5p overexpression decreased osteogenic transformation of fibroblasts by decreasing VDR expression in AS.
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Affiliation(s)
- Yuan Li
- Department of Rheumatology and Immunology, Tianjin First Central Hospital, Tianjin 300192, P.R. China
| | - Wufang Qi
- Department of Rheumatology and Immunology, Tianjin First Central Hospital, Tianjin 300192, P.R. China
| | - Yuquan Shi
- Department of Rheumatology and Immunology, Tianjin First Central Hospital, Tianjin 300192, P.R. China
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Ji LN, Wu S, Fu DQ, Fang SJ, Xie GQ, Fan YS, Bao J. Jieduquyuziyin Prescription alleviates hepatic gluconeogenesis via PI3K/Akt/PGC-1α pathway in glucocorticoid-induced MRL/lpr mice. JOURNAL OF ETHNOPHARMACOLOGY 2022; 284:114815. [PMID: 34763039 DOI: 10.1016/j.jep.2021.114815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/25/2021] [Accepted: 11/04/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Jieduquyuziyin prescription (JP) is a traditional Chinese medicine (TCM) formula. According to both TCM theory and more than a decade of clinical practice, JP has been testified to be effective for systemic lupus erythematosus (SLE) treatment as an approved hospital prescription in China. AIM OF THE STUDY To determine the effect of JP on the treatment of SLE by glucocorticoid (GC) and to further examine the molecular mechanisms. MATERIALS AND METHODS We conducted in vivo experiments to estimate the effect of JP on hepatic gluconeogenesis in MRL/lpr mice treated with GC. Additionally, isoproterenol (ISO) induced hepatic gluconeogenesis model and GC-treated MRL/lpr mouse hepatocytes were carried out in vitro experiments to verify the effect of JP on gluconeogenesis. RESULTS The results showed that JP combined with GC could effectively alleviate the lupus symptoms in MRL/lpr mice and improve the pathological changes of the kidney and liver. And the combination of JP reduced the side effects caused by GC, which was related to the inhibition of GC-induced hepatic gluconeogenesis in MRL/lpr mice. Specifically, JP up-regulated the expression of glucocorticoid receptor (GR) α, phosphoinositide-3-kinase (PI3K) and Akt restrained by GC to reduce the production of forkhead box O1 (FoxO1), peroxisome proliferator-activated receptor-gamma coactivator-1α (PGC-1α), and the gluconeogenic genes phosphoenolpyruvate carboxykinase (PEPCK) and glucose-6-phosphatase (G6Pase). In vivo, the use of JP either alone or with GC could reduce spleen enlargement, high levels of serum antibodies, aggravated urine protein and renal pathological damage in MRL/lpr mice. Furthermore, the glucose content was reduced in the liver of MRL/lpr mice treated with JP, and the liver damage and steatosis were also alleviated. In vitro, the expressions of PI3K and Akt increased and the expressions of FoxO1, PGC-1α, PEPCK and G6Pase decreased after JP treatment in ISO-treated hepatocytes. Compared with MRL/MP mice, we found that JP could significantly inhibit the expression of gluconeogenesis in the hepatocytes of MRL/lpr mice induced by GC to a greater extent. CONCLUSIONS The therapeutic effect of JP on GC-induced is likely related to hepatic gluconeogenesis, which provides a new perspective to reveal the positive role of JP in SLE.
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Affiliation(s)
- Li-Na Ji
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Shan Wu
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Dan-Qing Fu
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Si-Jia Fang
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Guan-Qun Xie
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Yong-Sheng Fan
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Jie Bao
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China.
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Xu X, Balmer L, Chen Z, Mahara G, Lin L. The role of IgG N-galactosylation in Spondyloarthritis. TRANSLATIONAL METABOLIC SYNDROME RESEARCH 2022. [DOI: 10.1016/j.tmsr.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Bang AA, Bhojraj SY, Deshmukh M, Joshi VR, Yermal T, Kalkotwar S, Bang AT. Epidemiology of pain in back and extremities in rural population: A community-based estimation of age- and sex-specific prevalence, distribution, duration and intensity of pain, number of painful sites and seasonality of pain during twelve months in rural Gadchiroli, India. J Glob Health 2021; 11:12002. [PMID: 34917344 PMCID: PMC8647780 DOI: 10.7189/jogh.11.12002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Population-based estimates of the burden of pain in back and extremities (PBE) by sex, age, intensity, seasonality and site are lacking from rural India. METHODS Two villages were randomly selected from a cluster of 39 villages in Gadchiroli district in India. All residents'≥20 years of age were surveyed in January 2010 by trained surveyors by making household visits. Information on PBE in the 12 months prior to survey was obtained using a structured, pretested questionnaire. RESULTS The 12-month period prevalence of PBE was 75% (95% confidence interval CI = 72.54-77.73) in men and 91% (95% CI = 88.66-92.13) in women. The prevalence of PBE in the participants >50 years was 94% while that in the age group 20 to 50 years was 79% (P < 0.05). The site with the highest prevalence of pain was low back (women 80%, men 59%). The mean number of painful sites per person was 5.42 (95% CI = 5.17-5.67) in women, 3.68 (95% CI = 3.45-3.90) in men, 3.89 (95% CI = 3.71-4.07) in participants aged 20 to 50 years and 6.48 (95% CI = 6.11-6.85) in those >50 years. Among participants across the age and sex groups, the prevalence of mild pain was higher than severe pain at all the anatomical sites. Among various seasons, the highest prevalence of pain was in the rainy season (14%). CONCLUSION The prevalence and the number of painful sites were higher among women and in those >50 years of age. The public health interventions for PBE need to focus on these two high risk groups.
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Affiliation(s)
- Anand A Bang
- Society for Education, Action and Research in Community Health (SEARCH), Gadchiroli, Maharashtra, India
| | | | - Mahesh Deshmukh
- Society for Education, Action and Research in Community Health (SEARCH), Gadchiroli, Maharashtra, India
| | - Vinay R Joshi
- Hinduja Hospital and Research Center, Mumbai, Maharashtra, India
| | - Tushar Yermal
- Naraindas Morbai Budhrani Trust, Mumbai, Maharashtra, India
| | | | - Abhay T Bang
- Society for Education, Action and Research in Community Health (SEARCH), Gadchiroli, Maharashtra, India
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Liu X, Zhang L, Zhang F, Zeng X, Zhao Y, Wang Q, Liu S, Zuo X, Zhang Z, Wu H, Chen S, Li H, Zhu P, Wu L, Qi W, Liu Y, Zhang M, Liu H, Xu D, Zheng W, Zhang Y, Shi X, Han L, Zhou Y, Zhao Y, Wang W, Li T, Tie N, Zhang K, Luo C, Gong B, Zhao Y, Lv C, Song L, Wu Q, Fei Y, Zhang L, Luo H, Sun J, Xue J, Gu L, Wang J, Han Q, Yimaity K, Zhou J, Zhao L, Bian S, Qi W, Li Y, Zhu Y, Han H, Liao S, Liu G. Prevalence and Risk Factors of Active Tuberculosis in Patients with Rheumatic Diseases: A Multi-center, Cross-Sectional Study in China. Emerg Microbes Infect 2021; 10:2303-2312. [PMID: 34753408 PMCID: PMC8654396 DOI: 10.1080/22221751.2021.2004864] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Evidence of active tuberculosis (ATB) in patients with rheumatic diseases are research priorities but limited data from China have been reported. Research targeting patients not taking anti-TNF biologics are especially insufficient. We aimed to investigate the prevalence and risk factors of ATB in this at-risk population. We conducted a tertiary hospital-based, multi-center, cross-sectional study by using stratified multi-stage cluster sampling strategy to screen ATB in patients with rheumatic diseases. We estimated the prevalence of ATB in patients with rheumatic diseases and identified risk factors among those who were not taking anti-TNF biologic. A total of 13,550 patients with rheumatic diseases were enrolled, and the result showed the standardized prevalence of ATB according to the composition ratio of various types of rheumatic disease was 882/100000 (95% confidence interval (CI): 706-1057). Multivariable logistic regression analysis in patients not taking anti-TNF biologics showed that the independent risk factors of ATB were having systemic lupus erythematosus (SLE) (OR=2.722, 95% CI: 1.437-5.159, p=0.002), having Behcet's disease (BD) (OR= 5.261, 95% CI: 2.071-13.365, p<0.001), taking azathioprine(AZA) within the past two years (OR=2.095, 95% CI: 0.986-4.450, p=0.054), exposing to glucocorticoids ≥30mg/d for more than four weeks within the past two years (OR=2.031, 95% CI: 1.247-3.309, p=0.004) and having evidences of previous TB (OR= 6.185, 95% CI: 3.487-10.969, p<0.001). The prevalence of ATB was higher in patients with rheumatic diseases compared to the general population. Patients with SLE or BD, prolonged exposure to moderate to high dose of glucocorticoids and previous TB were independent risk factors for ATB.
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Affiliation(s)
- Xiaoqing Liu
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,Centre for Tuberculosis Research, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,Clinical Epidemiology Unit, International Epidemiology Network, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Lifan Zhang
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,Centre for Tuberculosis Research, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,Clinical Epidemiology Unit, International Epidemiology Network, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Fengchun Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Xiaofeng Zeng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Yan Zhao
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Qian Wang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Shengyun Liu
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoxia Zuo
- Department of Reumatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhiyi Zhang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Huaxiang Wu
- Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Sheng Chen
- Department of Rheumatology, Renji Hospital, Medical College of Shanghai Jiaotong University, Shanghai, China
| | - Hongbin Li
- Department of Rheumatology and Immunology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Ping Zhu
- Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Lijun Wu
- Department of Rheumatology, People Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China
| | - Wencheng Qi
- Department of Rheumatology, Tianjin First Central Hospital, Tianjin, China
| | - Yi Liu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Miaojia Zhang
- Department of Rheumatology, The first affiliated hospital of Nanjing Medical University, Nanjing, China
| | - Huaxiang Liu
- Department of Rheumatology, Qilu Hospital of Shandong University, Ji'nan, China
| | - Dong Xu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Wenjie Zheng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Yueqiu Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Xiaochun Shi
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Lishuai Han
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yaou Zhou
- Department of Reumatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yanping Zhao
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wenwen Wang
- Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Ting Li
- Department of Rheumatology, Renji Hospital, Medical College of Shanghai Jiaotong University, Shanghai, China
| | - Ning Tie
- Department of Rheumatology and Immunology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Kui Zhang
- Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Cainan Luo
- Department of Rheumatology, People Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China
| | - Boqi Gong
- Department of Rheumatology, Tianjin First Central Hospital, Tianjin, China
| | - Yi Zhao
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Chengyin Lv
- Department of Rheumatology, The first affiliated hospital of Nanjing Medical University, Nanjing, China
| | - Lijun Song
- Department of Rheumatology, Qilu Hospital of Shandong University, Ji'nan, China
| | - Qingjun Wu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Yunyun Fei
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Lei Zhang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Luo
- Department of Reumatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiaying Sun
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jing Xue
- Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Liyang Gu
- Department of Rheumatology, Renji Hospital, Medical College of Shanghai Jiaotong University, Shanghai, China
| | - Jing Wang
- Department of Rheumatology and Immunology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Qing Han
- Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Kuerbanjiang Yimaity
- Department of Rheumatology, People Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China
| | - Jiaxin Zhou
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Lidan Zhao
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Sainan Bian
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Wufang Qi
- Department of Rheumatology, Tianjin First Central Hospital, Tianjin, China
| | - Yanhong Li
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Yujing Zhu
- Department of Rheumatology, The first affiliated hospital of Nanjing Medical University, Nanjing, China
| | - Huijun Han
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Susu Liao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Gaifen Liu
- China National Clinical Research Center for Neurological Diseases, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Song Z, Deng X, Xie W, Li B, Zhang Z. Clinical Characteristics of Psoriatic Arthritis in Chinese Patients: A Cross-Sectional Study. Rheumatol Ther 2021; 8:1845-1857. [PMID: 34665456 PMCID: PMC8572294 DOI: 10.1007/s40744-021-00384-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/05/2021] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION The clinical features of psoriatic arthritis (PsA) varied in different studies from different countries, nevertheless rarely reported from China. We aimed to show the portraits of Chinese PsA patients. METHODS Demographics as well as clinical and laboratory data at the first visit of a PsA cohort were collected. Joints and entheses were further assessed by imaging techniques. The correlation between psoriasis severity index (PASI) and disease activity in PsA (DAPSA) was analyzed. The metabolic comorbidities were also explored among patients with different disease activity. RESULTS Three hundred patients with definite PsA were enrolled in this study; 159 (53.0%) of them were male. Their median age was 39 (31, 51) years with disease duration of 3 (0.6, 7) years; 15.6% patients were HLA-B27-positive, and 37.8% patients reported a family history of psoriasis or PsA. Among 300 patients, psoriasis presented earlier than arthritis in most of them (214, 74.0%), while 48 (16.6%) patients presented with arthritis before psoriasis. Articular involvement was found in 293 (97.7%) patients. Polyarticular type was most common, with proximal interphalangeal as most frequently involved joints. Axial joint involvement was found in 45 (15.4%) patients. Dactylitis was observed in 94 (31.3%) patients, most often at the second, third, and fourth toes. Enthesitis was found in 18 (6.0%) patients by physical examination, however in 129/227 (56.8%) patients by ultrasound. The DAPSA score was correlated with PASI (r = 0.22, p = 0.021). A variety of comorbidities were more often observed in patients with moderate/high disease activity comparing with those in remission/low-disease activity, especially type 2 diabetes with statistically significant difference (19.1 vs. 4.1%, p = 0.023). However, further logistic regression analysis showed diabetes was not independently associated with moderate/high disease activity. The most frequently prescribed medication was methotrexate (101, 66.4%). Biological agents were applied in 25 (16.4%) patients. CONCLUSIONS Polyarticular involvement was most common in Chinese PsA patients. Ultrasound dramatically increased the identification of peripheral enthesitis. Active PsA patients were more likely to have comorbidities.
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Affiliation(s)
- Zhibo Song
- Department of Rheumatology and Clinical Immunology, Peking University First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing, 100034, People's Republic of China
| | - Xuerong Deng
- Department of Rheumatology and Clinical Immunology, Peking University First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing, 100034, People's Republic of China
| | - Wenhui Xie
- Department of Rheumatology and Clinical Immunology, Peking University First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing, 100034, People's Republic of China
| | - Borui Li
- Department of Rheumatology and Clinical Immunology, Peking University First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing, 100034, People's Republic of China
| | - Zhuoli Zhang
- Department of Rheumatology and Clinical Immunology, Peking University First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing, 100034, People's Republic of China.
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Zainal AA, Faisal IM, Ahmad AA. Biomarkers of iron status in allopurinol-treated renal stone patients. PHARMACIA 2021. [DOI: 10.3897/pharmacia.68.e70275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Limited evidence exists on the effect of xanthine oxidase inhibitors in nephrolithiasis patients on iron status markers, beyond their effects on urate. The aim of this study was to investigate whether allopurinol therapy was associated with a significant impact on parameters related to iron status, in patients with renal stones. Allopurinol treatment was associated with a nonsignificant decline in serum uric acid. There were no significant differences in serum levels of transferrin and ferritin after treatment with allopurinol compared to pre-treatment levels. A non-significant fall in serum levels of haptoglobin was registered. The drug was associated with a significant rise in serum iron levels. Serum uric acid and iron did not show a significant correlation with any parameter in the study. Allopurinol exerted an overall non-significant effect on iron metabolism in nephrolithiasis patients, save for serum iron, this entails lack of untoward effects in populations with-iron related conditions.
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Li Z, Wu X, Leo PJ, De Guzman E, Akkoc N, Breban M, Macfarlane GJ, Mahmoudi M, Marzo-Ortega H, Anderson LK, Wheeler L, Chou CT, Harrison AA, Stebbings S, Jones GT, Bang SY, Wang G, Jamshidi A, Farhadi E, Song J, Lin L, Li M, Wei JCC, Martin NG, Wright MJ, Lee M, Wang Y, Zhan J, Zhang JS, Wang X, Jin ZB, Weisman MH, Gensler LS, Ward MM, Rahbar MH, Diekman L, Kim TH, Reveille JD, Wordsworth BP, Xu H, Brown MA. Polygenic Risk Scores have high diagnostic capacity in ankylosing spondylitis. Ann Rheum Dis 2021; 80:1168-1174. [PMID: 34161253 PMCID: PMC8364478 DOI: 10.1136/annrheumdis-2020-219446] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE We sought to test the hypothesis that Polygenic Risk Scores (PRSs) have strong capacity to discriminate cases of ankylosing spondylitis (AS) from healthy controls and individuals in the community with chronic back pain. METHODS PRSs were developed and validated in individuals of European and East Asian ethnicity, using data from genome-wide association studies in 15 585 AS cases and 20 452 controls. The discriminatory values of PRSs in these populations were compared with other widely used diagnostic tests, including C-reactive protein (CRP), HLA-B27 and sacroiliac MRI. RESULTS In people of European descent, PRS had high discriminatory capacity with area under the curve (AUC) in receiver operator characteristic analysis of 0.924. This was significantly better than for HLA-B27 testing alone (AUC=0.869), MRI (AUC=0.885) or C-reactive protein (AUC=0.700). PRS developed and validated in individuals of East Asian descent performed similarly (AUC=0.948). Assuming a prior probability of AS of 10% such as in patients with chronic back pain under 45 years of age, compared with HLA-B27 testing alone, PRS provides higher positive values for 35% of patients and negative predictive values for 67.5% of patients. For PRS, in people of European descent, the maximum positive predictive value was 78.2% and negative predictive value was 100%, whereas for HLA-B27, these values were 51.9% and 97.9%, respectively. CONCLUSIONS PRS have higher discriminatory capacity for AS than CRP, sacroiliac MRI or HLA-B27 status alone. For optimal performance, PRS should be developed for use in the specific ethnic groups to which they are to be applied.
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Affiliation(s)
- Zhixiu Li
- Queensland University of Technology, Centre for Genomics and Personalised Health, School of Biomedical Sciences, Faculty of Health, Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Xin Wu
- Department of Rheumatology and Immunology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, Shanghai, China
| | - Paul J Leo
- Queensland University of Technology, Centre for Genomics and Personalised Health, School of Biomedical Sciences, Faculty of Health, Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Erika De Guzman
- Australian Translational Genomics Centre, Queensland University of Technology (QUT), Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Nurullah Akkoc
- Department of Internal Medicine, Division of Rheumatology, School of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Maxime Breban
- UMR 1173, Inserm, University of Versailles Saint-Quentin, Montigny-le-Bretonneux, France
- Service de Rhumatologie, Hôpital Ambroise Paré, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France
- Laboratoire d'Excellence Inflamex, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Gary J Macfarlane
- Epidemiology Group, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill, Aberdeen, UK
- Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Foresterhill, Aberdeen, UK
| | - Mahdi Mahmoudi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran (the Islamic Republic of)
| | - Helena Marzo-Ortega
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Lisa K Anderson
- Australian Translational Genomics Centre, Queensland University of Technology (QUT), Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Lawrie Wheeler
- Australian Translational Genomics Centre, Queensland University of Technology (QUT), Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Chung-Tei Chou
- Division of Allergy, Immunology, Rheumatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Andrew A Harrison
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Simon Stebbings
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Gareth T Jones
- Epidemiology Group, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill, Aberdeen, UK
- Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Foresterhill, Aberdeen, UK
| | - So-Young Bang
- Hanyang University Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea (the Republic of)
| | - Geng Wang
- University of Queensland Diamantina Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Ahmadreza Jamshidi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran (the Islamic Republic of)
| | - Elham Farhadi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran (the Islamic Republic of)
| | - Jing Song
- Department of Rheumatology and Immunology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, Shanghai, China
| | - Li Lin
- Department of Rheumatology and Immunology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, Shanghai, China
| | - Mengmeng Li
- Department of Rheumatology and Immunology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, Shanghai, China
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Nicholas G Martin
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Margaret J Wright
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - MinJae Lee
- Population & Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Yuqin Wang
- State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jian Zhan
- Institute for Glycomics, Griffith University, Nathan, Queensland, Australia
| | - Jin-San Zhang
- Center for Precision Medicine, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Institute of Life Sciences, Wenzhou University, Wenzhou, Zhejiang, China
| | - Xiaobing Wang
- Rheumatology Department, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zi-Bing Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing, Beijing, China
| | - Michael H Weisman
- Department of Medicine/Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Lianne S Gensler
- Division of Medicine/Rheumatology, University of California San Francisco, San Francisco, California, USA
| | - Michael M Ward
- Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Mohammad Hossein Rahbar
- Internal Medicine, The University of Texas Health Science Center at Houston John P and Katherine G McGovern Medical School, Houston, Texas, USA
| | - Laura Diekman
- Department of Internal Medicine, Division of Rheumatology, McGovern Medical School at The University of Texas Health Science Center, Houston, Texas, USA
| | - Tae-Hwan Kim
- Hanyang University Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea (the Republic of)
| | - John D Reveille
- Department of Internal Medicine, Division of Rheumatology, McGovern Medical School at The University of Texas Health Science Center, Houston, Texas, USA
| | - Bryan Paul Wordsworth
- NIHR Oxford Musculoskeletal Biomedical Research Unit, Botnar Research Centre, University of Oxford, Oxford, Oxfordshire, UK
| | - Huji Xu
- Department of Rheumatology and Immunology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, Shanghai, China
- School of Clinical Medicine, Tsinghua University, Beijing, Beijing, China
- Peking-Tsinghua Center for Life Sciences, Tsinghua University, Beijing, China
| | - Matthew A Brown
- Center for Precision Medicine, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- NIHR Biomedical Research Centre at Guy's and Saint Thomas' NHS Foundation Trust and King's College London, London, UK
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Emorinken A, Dic-Ijiewere MO, Erameh CO, Ugheoke AJ, Agbebaku FO, Agbadaola OR. Fibromyalgia in HIV-positive patients in Nigeria: A cross-sectional prospective study. Int J Rheum Dis 2021; 24:1273-1281. [PMID: 34323376 DOI: 10.1111/1756-185x.14195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/14/2021] [Accepted: 07/19/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Fibromyalgia is a chronic pain syndrome of unknown etiology characterized by chronic widespread musculoskeletal pain and tenderness. It affects the quality of life of patients and has been associated with the human immunodeficiency virus (HIV). The study aimed to determine the prevalence of fibromyalgia in HIV-positive patients and assess the effect of fibromyalgia on their functional status. METHODOLOGY This was a cross-sectional study comprising 160 treatment-naive HIV-positive patients and 160 age- and sex-matched HIV-negative controls. The diagnosis of fibromyalgia was based on the 2011 modification of the 2010 American College of Rheumatology diagnostic criteria by assessing the widespread pain index and symptom severity score. The severity of fibromyalgia was assessed with the revised fibromyalgia impact questionnaire. RESULTS The prevalence of fibromyalgia in HIV-positive individuals was found to be 10.6%, which was significantly higher compared with controls (3.1%; P = .008). There was no significant association between fibromyalgia and age, gender, or occupation. There was a significant relationship between CD4 count levels (P < .001), WHO clinical stage (P < .001), and fibromyalgia. A statistically significant higher score on the Revised FM Impact Questionnaire was found in HIV-positive individuals with fibromyalgia (P < .001). CONCLUSION The study found that HIV-positive patients had a significantly higher incidence of fibromyalgia than controls and this was related to active indices of HIV disease. Fibromyalgia had a greater clinical impact on HIV patients than in controls. As a result, fibromyalgia should be identified and treated in people living with HIV.
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Affiliation(s)
- Airenakho Emorinken
- Department of Internal Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | | | - Cyril Oshomah Erameh
- Department of Internal Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | - Asuwemhe Johnson Ugheoke
- Department of Internal Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria.,Department of Medicine, Ambrose Alli University, Ekpoma, Nigeria
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Cytokine Profiling in Chinese SLE Patients: Correlations with Renal Dysfunction. J Immunol Res 2021; 2020:8146502. [PMID: 33134397 PMCID: PMC7568803 DOI: 10.1155/2020/8146502] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 12/19/2022] Open
Abstract
Background Systemic lupus erythematosus (SLE) is a chronic, systemic autoimmune disease that commonly causes kidney damage. Therefore, we measured plasma levels of cytokines that may be related to renal dysfunction in SLE patients. Methods To explore the differences between SLE patients with renal dysfunction and healthy volunteers, the levels of cytokines in plasma were screened using a human cytokine antibody array. Then, we chose fourteen of the elevated cytokines for verification with an expanded sample size by a human magnetic Luminex assay. Plasma samples were isolated from SLE patients (n = 72) and healthy volunteers (n = 8). Results Cytokine antibody array data showed elevated plasma cytokines in SLE patients with renal dysfunction compared with healthy volunteers. By using the human magnetic Luminex assay, we found that plasma levels of CHI3L1, GDF-15, IGFBP-2, MIF, ST2, TFF3, and uPAR were significantly higher in SLE patients than in healthy volunteers. Plasma levels of CXCL4 were significantly lower in the active group than in the inactive group, and plasma levels of CHI3L1, IGFBP-2, MIF, and MPO were significantly higher in the active group than in the inactive group. We also analyzed the correlation between plasma cytokine levels and the SLEDAI-2K, and our results showed that the plasma levels of the fourteen selected cytokines were weakly correlated or not correlated with the SLEDAI-2K. We further analyzed the correlation between cytokines and renal dysfunction. Plasma levels of GDF-15 and TFF3 were highly positively correlated with serum creatinine levels and 24-hour urine protein levels. Conclusion Our data suggest that plasma levels of GDF-15 and TFF3 are potential renal dysfunction markers in SLE patients, but plasma levels of these cytokines are not correlated with the SLEDAI-2K. Further study is warranted to determine how these cytokines regulate inflammatory responses and renal dysfunction in SLE.
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Sun J, Dai S, Zhang L, Feng Y, Yu X, Zhang Z. Investigating the safety and compliance of using csDMARDs in rheumatoid arthritis treatment through face-to-face interviews: a cross-sectional study in China. Clin Rheumatol 2021; 40:1789-1798. [PMID: 33058034 PMCID: PMC8102276 DOI: 10.1007/s10067-020-05458-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 09/06/2020] [Accepted: 10/08/2020] [Indexed: 02/07/2023]
Abstract
Rheumatoid arthritis (RA) significantly impacts the health of Chinese patients. Conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) are used as the standard treatment for patients with RA. However, Chinese patients with RA have reported poor compliance with csDMARDs. This study aims to better understand the safety and compliance of using csDMARDs in RA treatment. Face-to-face interviews were conducted by questionnaires on safety and compliance of csDMARDs in 400 patients with RA and 100 rheumatologists from 13 cities in China. Rheumatologists were from Tier 3 Class A hospitals with independent rheumatology departments, who admitted more than 30 patients with RA per week. All patients were diagnosed for > 3 months before the survey and had been treated with csDMARDs for > 3 months. The incidence of adverse events (AEs) that attributed to csDMARDs estimated by rheumatologists was lower than that reported by patients for all four prescribed csDMARDs. Also, types of common AEs in rheumatologist's perception differed from those in the patient's report. Only 86% (116/135) of patients claimed they notified their rheumatologist about AEs, and 40.8% (150/368) of patients did not strictly adhere to their prescribed treatment. Reasons why patients were not compliant with their treatment, other than AEs, included symptoms being less severe, travel, and busy working life/business trips. This study revealed gaps in perceptions of csDMARDs-related AEs and medication adherence between rheumatologists and patients. These findings suggested adequate doctor-patient communications, and considerations of multiple real-world situations may improve adherence in the treatment of RA patients. Key Points • This study identified gaps in rheumatologists' perception of the prevalence and type of AEs experienced by their patients, which could potentially help them improve their patients' compliance with treatment.
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Affiliation(s)
- Jiaying Sun
- Department of Rheumatology and Immunology, First Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang, China
| | - Siming Dai
- Department of Rheumatology and Immunology, First Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang, China
| | - Ling Zhang
- Shanghai Roche Pharmaceuticals Ltd., Shanghai, 201203, China
| | - Yajing Feng
- Shanghai Roche Pharmaceuticals Ltd., Shanghai, 201203, China
| | - Xin Yu
- Shanghai Roche Pharmaceuticals Ltd., Shanghai, 201203, China
| | - Zhiyi Zhang
- Department of Rheumatology and Immunology, First Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang, China.
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Wang L, Yu Y, Zhang S, Zhang W, Li C. Coexistence of Sjögren syndrome in patients with synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome: A retrospective observational study. Medicine (Baltimore) 2021; 100:e23940. [PMID: 33761629 PMCID: PMC9281907 DOI: 10.1097/md.0000000000023940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 12/01/2020] [Indexed: 01/05/2023] Open
Abstract
To identify the prevalence and clinical characteristics of Sjögren syndrome (SS) in a Chinese single-center cohort of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome.Patients diagnosed with SS were screened out from a cohort of 164 cases of SAHPO syndrome. Information regarding the patients' gender, age at onset, clinical features, laboratory tests, bone scintigraphy, and treatment was reviewed.Five patients were screened out. The prevalence of SS in SAPHO patients was 3.05% The mean onset age of SS was 48.0 ± 12.0 years old and no apparent time order in the occurrence of SAPHO and SS was observed. Compared with the general SAPHO cohort, the 5 SS patients exhibited no significant difference in the SAPHO related clinical features or inflammatory markers, except for a higher prevalence of peripheral joints and bones involvement in bone scintigraphy. Objective evidence of dryness and positive salivary gland biopsy were found in all the patients. However, the positive rates of SSA and SSB antibody were only 20%. Anti-inflammatory treatment for SS was recorded in 3 patients (ESSDAI score: 3 in 2 patients; 12 in 1 patient) with extra-glandular manifestations, severe complications or poor response to the basic treatment.The prevalence of SS is higher in the SAPHO cohort than in the general Chinese population. Objective tests or biopsy might be more indicative than the antibody detection for SS diagnosis. Anti-inflammatory treatment should be prescribed in consideration of both the severity of SS and the demand for disease activity control of SAPHO.
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Affiliation(s)
| | | | - Shuo Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital
| | - Wen Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital
| | - Chen Li
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Zhang H, Wu M, Sun J, Zhu X, Li C, Ding Y, Zhang X, Chai K, Li X. Pharmacokinetics, safety, and immunogenicity of HLX03, an adalimumab biosimilar, compared with reference biologic in healthy Chinese male volunteers: Results of a randomized, double-blind, parallel-controlled, phase 1 study. Pharmacol Res Perspect 2021; 9:e00733. [PMID: 33682358 PMCID: PMC7937819 DOI: 10.1002/prp2.733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/27/2021] [Accepted: 01/27/2021] [Indexed: 01/17/2023] Open
Abstract
The primary objective of this randomized, double‐blind, parallel‐controlled study (from December 2016 to October 2018) was to evaluate pharmacokinetic (PK) equivalence of adalimumab biosimilar HLX03 and reference adalimumab in healthy volunteers, and to assess safety, and immunogenicity of HLX03. The primary PK endpoints were maximum observed plasma concentration (Cmax) and area under the concentration curve from time zero to the last quantifiable concentration (AUC0–t). Equivalence was determined if the 90% confidence interval (CI) of geometric least square mean ratio between the two treatment groups were within the predefined range of 80%–125%. Safety and immunogenicity were monitored during the study. Healthy Chinese males (N = 220) were randomized 1:1 to receive a single subcutaneous 40 mg dose of HLX03 or China (CN)‐sourced adalimumab. The ratios of the geometric mean of Cmax and AUC0–t were 102.2% and 105.7%, respectively, with corresponding 90% CIs falling in the predefined margins, which demonstrated PK equivalence between HLX03 and CN‐adalimumab. The incidence of treatment‐emergent adverse events (TEAEs) was similar in the two groups (73.8% and 66.0% in the HLX03 and CN‐adalimumab groups, respectively). Grade 3–4 TEAEs were reported in 7.5% and 5.7% of participants, respectively. The incidences of participants with antidrug antibodies (HLX03: 96.2%; CN‐adalimumab: 93.4%) or neutralizing antibodies (HLX03: 40.6%, CN‐adalimumab: 41.4%) were comparable between groups. This study demonstrated PK bioequivalence between HLX03 and CN‐adalimumab, with similar safety and immunogenicity profiles. These data support further clinical development of HLX03 as an adalimumab biosimilar.
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Affiliation(s)
- Hong Zhang
- Phase 1 Clinical Research Center, the First Hospital of Jilin University, Changchun, China
| | - Min Wu
- Phase 1 Clinical Research Center, the First Hospital of Jilin University, Changchun, China
| | - Jixuan Sun
- Phase 1 Clinical Research Center, the First Hospital of Jilin University, Changchun, China
| | - Xiaoxue Zhu
- Phase 1 Clinical Research Center, the First Hospital of Jilin University, Changchun, China
| | - Cuiyun Li
- Phase 1 Clinical Research Center, the First Hospital of Jilin University, Changchun, China
| | - Yanhua Ding
- Phase 1 Clinical Research Center, the First Hospital of Jilin University, Changchun, China
| | | | | | - Xiaojiao Li
- Phase 1 Clinical Research Center, the First Hospital of Jilin University, Changchun, China
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