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Moinzadeh P, Hunzelmann N, Krieg T, Blank N, Gerhard F, Genth E, Graefenstein K, Koetter I, Kreuter A, Melchers I, Pfeiffer C, Müller-Ladner U, Riemekasten G, Sardy M, Seitz C, Sunderkoetter C, Wozel G. SAT0191 Disease Progression in SSC-Overlap Syndromes is Significantly Different from Limited and Diffuse Cutaneous SSC. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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102
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Koumakis E, Wipff J, Matucci-Cerinic M, Riemekasten G, Airo P, Cusi D, Wichmann H, Müller-Ladner U, Vlachoyiannopoulos P, Chiocchia G, Allanore Y. THU0012 TGFβ receptor polymorphisms in systemic sclerosis related pulmonary arterial hypertension: Results from a multicenter eustar study of european caucasian patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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103
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Rose A, von Spee-Mayer C, Humrich J, Riemekasten G. AB0120 Il-2 therapy results in intrarenal foxp3+ regulatory t cells expansion and decreased number of infiltrating cd4+ t cells in nzb/w mice. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Koumakis E, Bouaziz M, Dieudé P, Riemekasten G, Airo P, Matucci-Cerinic M, Allanore Y. THU0014 A Regulatory Variant in CCR6 is Associated with Anti-Topoisomerase Positive Systemic Sclerosis Susceptibility. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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105
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Cash H, Noack C, Fuller T, Riemekasten G. THU0364 Longterm follow-up for patients MIT retroperitnoeal fibrosis after medical and surgical treatment. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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106
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Guenther J, Kill A, Becker MO, Siegert E, Radic M, Riemekasten G. AB0143 Angiotensin receptor type 1 and endothelin receptor type a on immune cells mediate migration and the expression of il-8 and ccl18 when stimulated by autoantibodies from systemic sclerosis patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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107
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Humrich J, Undeutsch R, Weigert O, Reiser J, Seriot L, Riemekasten G. AB0204 Targeting of steady state DC via DEC205 and 33D1 expands regulatory T cells but does not restore tolerance in murine lupus. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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108
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Kill A, Günther J, Becker MO, Dragun D, Burmester GR, Riemekasten G. OP0224 Anti-AT1R and Anti-ETAR Autoantibodies from Patients with SSC and their Agonistic Effects. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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109
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von Spee C, Wassermann N, Humrich J, Riemekasten G. SAT0160 IL-2 deprivation of FOXP3+ TREG in systemic lupus erythematosus. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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110
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Humrich J, Kloke L, Rose A, von Spee C, Klaus A, Undeutsch R, Riemekasten G. SAT0165 Low-dose IL-2 therapy selectively expands regulatory T cells and suppresses murine lupus. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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111
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Becker C, Huscher D, Becker M, Hunzelmann N, Riemekasten G. THU0244 Additive value of scleroderma health assessment questionnaire (SHAQ) scores over haq disability index values for measuring disability and quality of life in patients with systemic sclerosis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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112
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von Spee-Mayer C, Wassermann N, Rose A, Alexander T, Klocke J, Humrich JY, Riemekasten G. AB0122 Regulatory t cell abnormalities and il-2 deficiency in patients with systemic lupus erythematosus. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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113
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Riemekasten G. SP0202 Functional autoantibodies against vascular receptors in systemic sclerosis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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114
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Johnson S, Naden R, Fransen J, van den Hoogen F, Pope J, Baron M, Matucci-Cerinic M, Tyndall A, Distler O, Denton C, Gabrielli A, van Laar J, Mayes M, Steen V, Seibold J, Clements P, Medsger T, Carreira P, Riemekasten G, Khanna D. AB0840 Scleroderma classification criteria: Disease-specific methods for valid case comparisons. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rose A, Humrich JY, Riemekasten G. A3.12 Intrarenal Foxp3+ Regulatory T Cells Expansion and Decreased Number of Infiltrating CD4+ T Cells in Murine Lupus by IL-2 Therapy. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-203216.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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116
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Spee CV, Wassermann N, Humrich JY, Riemekasten G. A9.14 Regulatory T Cell Abnormalities in Patients with SLE Suggest an IL-2-Based Immunotherapy. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-203223.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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117
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Günther J, Kill A, Becker MO, Riemekasten G. A10.27 Systemic Sclerosis – Role of Agonistic Autoantibodies Directed Against the Angiotensin Receptor Type 1 and the Endothelin Receptor Type A on Immune Cells in Disease Pathogenesis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-203224.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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118
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Riemekasten G, Gundelach B. [Mentor program: feedback of participating students : response to the German Society for Rheumatology congress in Bochum]. Z Rheumatol 2013; 72:89-90. [PMID: 23392603 DOI: 10.1007/s00393-013-1143-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- G Riemekasten
- Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Charité Universitätsmedizin Berlin - Campus Mitte, Charitéplatz 1, 10117, Berlin.
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Becker MO, Schohe A, Weinert K, Huscher D, Schneider U, Burmester GR, Riemekasten G. Responders to cyclophosphamide: results of a single-centre analysis among systemic sclerosis patients. Ann Rheum Dis 2012; 71:2061-2. [PMID: 22689320 DOI: 10.1136/annrheumdis-2011-200389] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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120
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McKinney C, Broen JCA, Vonk MC, Beretta L, Hesselstrand R, Hunzelmann N, Riemekasten G, Scorza R, Simeon CP, Fonollosa V, Carreira PE, Ortego-Centeno N, Gonzalez-Gay MA, Airo P, Coenen M, Martin J, Radstake TRDJ, Merriman TR. Evidence that deletion at FCGR3B is a risk factor for systemic sclerosis. Genes Immun 2012; 13:458-60. [PMID: 22551723 DOI: 10.1038/gene.2012.15] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is increasing evidence that gene copy number (CN) variation influences clinical phenotype. The low-affinity Fc receptor 3B (FCGR3B) located in the FCGR gene cluster is a CN polymorphic gene involved in the recruitment of polymorphonuclear neutrophils to sites of inflammation and their activation. Given the genetic overlap between systemic lupus erythematosus and systemic sclerosis (SSc) and the strong evidence for FCGR3B CN in the pathology of SLE, we hypothesised that FCGR3B gene dosage influences susceptibility to SSc. We obtained FCGR3B deletion status in 777 European Caucasian cases and 1000 controls. There was an inverse relationship between FCGR3B CN and disease susceptibility. CN of ≤ 1 was a significant risk factor for SSc (OR=1.55 (1.13-2.14), P=0.007) relative to CN ≥ 2. Although requiring replication, these results suggest that impaired immune complex clearance arising from FCGR3B deficiency contributes to the pathology of SSc, and FCGR3B CN variation is a common risk factor for systemic autoimmunity.
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Affiliation(s)
- C McKinney
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
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Spethmann S, Dreger H, Schattke S, Riemekasten G, Borges AC, Baumann G, Knebel F. Two-dimensional speckle tracking of the left ventricle in patients with systemic sclerosis for an early detection of myocardial involvement. Eur Heart J Cardiovasc Imaging 2012; 13:863-70. [DOI: 10.1093/ehjci/jes047] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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122
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Rose A, Undeutsch R, Kloke L, Riemekasten G, Humrich JY. IL-2 therapy expands intrarenal FOXP3+ regulatory T cells and decreases the number of infiltrating CD4+T cell in murine lupus nephritis. Ann Rheum Dis 2012. [DOI: 10.1136/annrheumdis-2011-201239.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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123
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Broen JCA, Bossini-Castillo L, van Bon L, Vonk MC, Knaapen H, Beretta L, Rueda B, Hesselstrand R, Herrick A, Worthington J, Hunzelman N, Denton CP, Fonseca C, Riemekasten G, Kiener HP, Scorza R, Simeón CP, Ortego-Centeno N, Gonzalez-Gay MA, Airò P, Coenen MJH, Martín J, Radstake TRDJ. A rare polymorphism in the gene for Toll-like receptor 2 is associated with systemic sclerosis phenotype and increases the production of inflammatory mediators. ACTA ACUST UNITED AC 2012; 64:264-71. [PMID: 21905008 DOI: 10.1002/art.33325] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To investigate whether polymorphisms in Toll-like receptor (TLR) genes, previously reported to be associated with immune-mediated diseases, are involved in systemic sclerosis (SSc). METHODS We genotyped 14 polymorphisms in the genes for TLRs 2, 4, 7, 8, and 9 in a discovery cohort comprising 452 SSc patients and 537 controls and a replication cohort consisting of 1,170 SSc patients and 925 controls. In addition, we analyzed 15-year followup data on 964 patients to assess the potential association of TLR variants with the development of disease complications. We analyzed the functional impact of the associated polymorphism on monocyte-derived dendritic cells. RESULTS In the discovery cohort, we observed that a rare functional polymorphism in TLR2 (Pro631His) was associated with antitopoisomerase (antitopo) positivity (odds ratio 2.24 [95% confidence interval 1.24-4.04], P=0.003). This observation was validated in the replication cohort (odds ratio 2.73 [95% confidence interval 1.85-4.04], P=0.0001). In addition, in the replication cohort the TLR2 variant was associated with the diffuse subtype of the disease (P=0.02) and with the development of pulmonary arterial hypertension (PAH) (Cox proportional hazards ratio 5.61 [95% confidence interval 1.53-20.58], P=0.003 by log rank test). Functional analysis revealed that monocyte-derived dendritic cells carrying the Pro63His variant produced increased levels of inflammatory mediators (tumor necrosis factor α and interleukin-6) upon TLR-2-mediated stimulation (both P<0.0001). CONCLUSION Among patients with SSc, the rare TLR2 Pro631His variant is robustly associated with antitopoisomerase positivity, the diffuse form of the disease, and the development of PAH. In addition, this variant influences TLR-2-mediated cell responses. Further research is needed to elucidate the precise role of TLR-2 in the pathogenesis of SSc.
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Affiliation(s)
- J C A Broen
- Department of Rheumatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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Andrade D, Seguro L, Ribeiro A, Moraes J, Saad C, Aikawa N, Calich A, Viana V, Pasoto S, Levy-Neto M, Laurindo I, Timenestsky M, Precioso A, Bonfa E, Sampaio-Barros P, Wang JC, Assassi S, Guo G, Tu WZ, Tan FK, Mayes MD, Reveille JD, Wu WY, Zou HJ, Zhao YQ, Chu HY, Liu J, Zhou XD, Dieude P, Bouaziz M, Riemekasten G, Airo P, Muller M, Cusi D, Chiocchia G, Boileau C, Allanore Y, Carmona F, Gutala R, Simeon CP, Carreira P, Ortego Centeno N, Vicente Rabaneda E, Garcia Hernandez FJ, Garcia De La Pena P, Fernandez Castro M, Martinez Estupinan L, Egurbide MV, Tsao BP, Gourh P, Agarwal SK, Assassi S, Mayes MD, Arnett FC, Tan FK, Martin J. S.12.1 Is H1N1 influenza vaccine safe and effective in patients with SSc? Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/ker486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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125
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Dieudé P, Bouaziz M, Guedj M, Riemekasten G, Airò P, Müller M, Cusi D, Matucci-Cerinic M, Melchers I, Koenig W, Salvi E, Wichmann HE, Cuomo G, Hachulla E, Diot E, Hunzelmann N, Caramaschi P, Mouthon L, Riccieri V, Distler J, Tarner I, Avouac J, Meyer O, Kahan A, Chiocchia G, Boileau C, Allanore Y. Evidence of the contribution of the X chromosome to systemic sclerosis susceptibility: association with the functional IRAK1 196Phe/532Ser haplotype. ACTA ACUST UNITED AC 2012; 63:3979-87. [PMID: 21898345 DOI: 10.1002/art.30640] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Several autoimmune disorders, including systemic sclerosis (SSc), are characterized by a strong sex bias. To date, it is not known whether genes on the sex chromosomes influence SSc susceptibility. Recently, an IRAK1 haplotype that contains the 196Phe functional variant (rs1059702), located on Xq28, was found to confer susceptibility to systemic lupus erythematosus (SLE). This study was undertaken to test for an association between SSc and the IRAK1 SLE risk haplotype. METHODS We tested for an association with the IRAK1 SLE risk haplotype in a discovery set of 849 SSc patients and 625 controls. IRAK1 rs1059702 was further genotyped in a replication set, which included Caucasian women from Italy (493 SSc patients and 509 controls) and Germany (466 SSc patients and 1,083 controls). RESULTS An association between the IRAK1 haplotype and SSc was detected in the discovery set. In both the discovery and replication sets, the rs1059702 TT genotype was found to be associated with specific SSc subsets, highlighting a potential contribution to disease severity. A meta-analysis provided evidence of an association of both the T allele and TT genotype with the overall disease, with an odds ratio (OR) of 1.20 and 95% confidence interval (95% CI) of 1.06-1.35 for the T allele (P = 0.003) and an OR of 1.49 and 95% CI of 1.06-2.10 for the TT genotype (P = 0.023). However, the most notable associations were observed with the diffuse cutaneous, anti-topoisomerase I antibody positive, and SSc-related fibrosing alveolitis subsets (OR 2.35 [95% CI 1.51-3.66], P = 1.56 × 10(-4), OR 2.84 [95% CI 1.87-4.32], P = 1.07 × 10(-6), and OR 2.09 [95% CI 1.35-3.24], P = 9.05 × 10(-4), respectively). CONCLUSION Our study provides the first evidence of an association between IRAK1 and SSc, demonstrating that a sex chromosome gene directly influences SSc susceptibility and its phenotypic heterogeneity.
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Affiliation(s)
- P Dieudé
- Paris Diderot University, AP-HP, INSERM U699, Paris, France.
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Riemekasten G. Geschlechtsspezifische Aspekte bei der systemischen Sklerose. AKTUEL RHEUMATOL 2011. [DOI: 10.1055/s-0031-1287801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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127
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Cash H, Noack C, Fuller T, Riemekasten G. UP-01.112 Short-Term Success Rates of Ureteral Desobstruction in Patients with Primary Retroperitoneal Fibrosis Undergoing Medical or Surgical Treatment. Urology 2011. [DOI: 10.1016/j.urology.2011.07.664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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128
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Enghard P, Grussie E, Rieder C, Burmester GR, Riemekasten G. Subset size, activation threshold and distribution of autoreactive MZ and FO B cells do not differ in a sex-specific manner in the NZB/W F1 murine lupus model: an experimental mouse study. Lupus 2011; 20:1240-9. [PMID: 21844114 DOI: 10.1177/0961203311409611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Systemic lupus erythematosus (SLE) shows a strong sex bias, preferentially affecting females, and B cells are thought to play a pivotal role in its pathogenesis. Here, we compared the splenic B-cell compartments, their autoreactivity and activation threshold of female and male NZB/W F1, a murine lupus model reflecting the sex bias observed in patients with SLE. METHODS Autoantibody levels and the amount of autoantibody secreting cells were determined using ELISA and ELISPOT. Flow cytometry and immunofluorescence were applied to analyse the composition of the splenic B-cell pool. Purified follicular (FO) and marginal zone (MZ) B cells were stimulated and the frequency of autoreactive cells was determined. Finally, the proliferative response of FO and MZ B cells upon stimulation was assessed using CFSE dilution and [(3)H]-Thymidin incorporation. RESULTS Higher autoantibody titres were detected in female NZB/W F1 mice, which were mainly produced in the spleen. Analysing the composition of the splenic B-cell subsets, no differences were found prior to disease development. Autoreactive dsDNA-specific B cells were mostly found in the MZ compartment, while SmD1((83-119))-reactive cells were more evenly distributed. Equal frequencies of autoreactive B cells were found in female and malemice, and no difference in the response to polyclonal stimuli of the cells of both sexes was detected. CONCLUSIONS No differences in the composition or functionality of splenic B cells were observed that account for the different disease course in both sexes.
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Affiliation(s)
- P Enghard
- Nephrology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.
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129
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Fransen J, Popa-Diaconu D, Hesselstrand R, Carreira P, Valentini G, Beretta L, Airo P, Inanc M, Ullman S, Balbir-Gurman A, Sierakowski S, Allanore Y, Czirjak L, Riccieri V, Giacomelli R, Gabrielli A, Riemekasten G, Matucci-Cerinic M, Farge D, Hunzelmann N, Van den Hoogen FHJ, Vonk MC. Clinical prediction of 5-year survival in systemic sclerosis: validation of a simple prognostic model in EUSTAR centres. Ann Rheum Dis 2011; 70:1788-92. [PMID: 21784727 DOI: 10.1136/ard.2010.144360] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Systemic sclerosis (SSc) is associated with a significant reduction in life expectancy. A simple prognostic model to predict 5-year survival in SSc was developed in 1999 in 280 patients, but it has not been validated in other patients. The predictions of a prognostic model are usually less accurate in other patients, especially from other centres or countries. A study was undertaken to validate the prognostic model to predict 5-year survival in SSc in other centres throughout Europe. METHODS A European multicentre cohort of patients with SSc diagnosed before 2002 was established. Patients with SSc according to the preliminary American College of Rheumatology classification criteria were eligible for the study when they were followed for at least 5 years or shorter if they died. The primary outcome was 5-year survival after diagnosis of SSc. The predefined prognostic model uses the following baseline variables: age, gender, presence of urine protein, erythrocyte sedimentation rate (ESR) and carbon monoxide diffusing capacity (DLCO). RESULTS Data were available for 1049 patients, 119 (11%) of whom died within 5 years after diagnosis. Of the patients, 85% were female, the mean (SD) age at diagnosis was 50 (14) years and 30% were classified as having diffuse cutaneous SSc. The prognostic model with age (OR 1.03), male gender (OR 1.93), urine protein (OR 2.29), elevated ESR (1.89) and low DLCO (OR 1.94) had an area under the receiver operating characteristic curve of 0.78. Death occurred in 12 (2.2%) of 509 patients with no risk factors, 45 (13%) of 349 patients with one risk factor, 55 (33%) of 168 patients with two risk factors and 7 (30%) of 23 patients with three risk factors. CONCLUSION A simple prognostic model using three disease factors to predict 5-year survival at diagnosis in SSc showed reasonable performance upon validation in a European multicentre study.
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Affiliation(s)
- J Fransen
- Correspondence to J Fransen, Department of Rheumatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
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Carmona FD, Simeon CP, Beretta L, Carreira P, Vonk MC, Rios-Fernandez R, Espinosa G, Navarrete N, Vicente-Rabaneda E, Rodriguez-Rodriguez L, Tolosa C, Garcia-Hernandez FJ, Castellvi I, Egurbide MV, Fonollosa V, Gonzalez-Gay MA, Rodriguez-Carballeira M, Diaz-Gonzalez F, Saez-Comet L, Hesselstrand R, Riemekasten G, Witte T, Voskuyl AE, Schuerwegh AJ, Madhok R, Shiels P, Fonseca C, Denton C, Nordin A, Palm O, Hoffmann-Vold AM, Airo P, Scorza R, Lunardi C, van Laar JM, Hunzelmann N, Kreuter A, Herrick A, Worthington J, Koeleman BPC, Radstake TRDJ, Martin J. Association of a non-synonymous functional variant of the ITGAM gene with systemic sclerosis. Ann Rheum Dis 2011; 70:2050-2. [DOI: 10.1136/ard.2010.148874] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Dieudé P, Guedj M, Truchetet ME, Wipff J, Revillod L, Riemekasten G, Matucci-Cerinic M, Melchers I, Hachulla E, Airo P, Diot E, Hunzelmann N, Mouthon L, Cabane J, Cracowski JL, Riccieri V, Distler J, Amoura Z, Valentini G, Camaraschi P, Tarner I, Frances C, Carpentier P, Brembilla NC, Meyer O, Kahan A, Chizzolini C, Boileau C, Allanore Y. Association of the CD226 Ser307 variant with systemic sclerosis: Evidence of a contribution of costimulation pathways in systemic sclerosis pathogenesis. ACTA ACUST UNITED AC 2011; 63:1097-105. [DOI: 10.1002/art.30204] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Opitz C, Klein-Weigel PF, Riemekasten G. Systemic sclerosis - a systematic overview: part 2 - immunosuppression, treatment of SSc-associated vasculopathy, and treatment of pulmonary arterial hypertension. VASA 2011; 40:20-30. [PMID: 21283970 DOI: 10.1024/0301-1526/a000066] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Here we give an overview over treatment recommendations propagated by the European League Against Rheumatism (EULAR), EULAR Scleroderma Trials and Research Group, the German Network for Systemic Sclerosis, the European Respiratory Society, and the International Society of Heart and Lung Transplantation. As response to immunosuppressant (IS) therapy is usually weaker in systematic sclerosis (SSc) compared to other connective tissue disorders IS should be considered with caution. To prevent scleroderma renal crisis steroid doses should not exceed 15 mg/d. The definitive role of a number of new immunosuppressant drugs and the effects of autologous stem cell transplantation in systemic clerosis (SSc) have to be elucidated. Prostanoids, especially iloprost, are widely used as intravenous formulas for the treatment of severe Raynaud's phenomenon (RP) and digital ulcers (DU). Calcium antagonists are of limited therapeutic value. Bosentan, an oral endothelin receptor antagonists (ETRA), was shown to prevent new DU, but failed to heal existing DU, while the oral phopshodiesterase inhibitor (PDI) Sildenafil reduces the occurrence of RP and might be effective in ulcer healing. Combination therapies of PDI with ETRA are currently evaluated. Therapy of pulmonary arterial hypertension (PAH) is usually started as oral monotherapy, frequently using an ETRA. When this first-line therapy is not tolerated ETRA is substituted by PDI. If treatment goals are not reached with monotherapy combinationtherapy is started, for example by adding a PDI to an existing ETRA. In general, treatment of PAH in patients with connective tissue disease follows the same algorithms as in idiopathic PAH.
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Affiliation(s)
- C Opitz
- Klinik für Innere Medizin, Schwerpunkt Kardiologie, DRK Kliniken Berlin, Germany.
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Klein-Weigel P, Opitz C, Riemekasten G. Systemic sclerosis - a systematic overview: part 1 - disease characteristics and classification, pathophysiologic concepts, and recommendations for diagnosis and surveillance. VASA 2011; 40:6-19. [PMID: 21283969 DOI: 10.1024/0301-1526/a000065] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Due to its high association with Raynaud's phenomenon systemic sclerosis (SSc) is probably the most common connective tissue disease seen by vascular specialists. In part 1 of our systematic overview we summarize classification concepts of scleroderma disorders, the epidemiologic and genetic burden, the complex pathophysiologic background, and the clinical features and the stage-dependent capillary microscopic features of SSc. Furthermore, we address the diagnostic recommendations propagated by the German Network for Systemic Sclerosis and the Task Force for Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology, the European Respiratory Society, and the International Society of Heart and Lung Transplantation.
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Affiliation(s)
- P Klein-Weigel
- Klinik für Innere Medizin, Schwerpunkt Angiologie und kardiovaskuläre Frührehabilitation, DRK Kliniken Berlin, Germany.
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Broen JCA, Dieude P, Vonk MC, Beretta L, Rueda B, Herrick A, Worthington J, Hunzelmann N, Riemekasten G, Kiener H, Scorza R, Simeon CP, Fonollosa V, Carreira P, Ortego-Centeno N, Gonzalez-Gay MA, Airo' P, Coenen MJH, Aliprantis A, Martin J, Allanore Y, Radstake TRDJ. Polymorphisms in the interleukin 4, interleukin 13 and corresponding receptor genes are not associated with systemic sclerosis and do not influence gene expression. Ann Rheum Dis 2011. [DOI: 10.1136/ard.2010.148965.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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135
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Broen JCA, Gourh P, Vonk MC, Beretta L, Niederer F, Rueda B, Geurts-van Bon L, Brouwer C, Hesselstrand R, Herrick A, Worthington J, Hunzelman N, Fonseca DC, Riemekasten G, Kiener H, Scorza R, Simeon CP, Fonollosa V, Carreira P, Ortego-Centeno N, Gonzalez-Gay MA, Airo' P, Coenen MJH, Mayes M, Kyburz D, Arnett FC, Martin J, Radstake TRDJ. Variants of PBEF predispose to systemic sclerosis and pulmonary arterial hypertension development. Ann Rheum Dis 2011. [DOI: 10.1136/ard.2010.148965.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Gunther J, Kill A, Becker M, Riemekasten G. Systemic sclerosis - agonistic auto-antibodies directed against the angiotensin receptor type 1 and the endothelin receptor type A and their effects on immune cells. Ann Rheum Dis 2011. [DOI: 10.1136/ard.2010.149104.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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138
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Dieudé P, Guedj M, Wipff J, Ruiz B, Riemekasten G, Airo P, Melchers I, Hachulla E, Cerinic MM, Diot E, Hunzelmann N, Caramaschi P, Sibilia J, Tiev K, Mouthon L, Riccieri V, Cracowski JL, Carpentier PH, Distler J, Amoura Z, Tarner I, Avouac J, Meyer O, Kahan A, Boileau C, Allanore Y. NLRP1 influences the systemic sclerosis phenotype: a new clue for the contribution of innate immunity in systemic sclerosis-related fibrosing alveolitis pathogenesis. Ann Rheum Dis 2010; 70:668-74. [PMID: 21149496 DOI: 10.1136/ard.2010.131243] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Recent evidence has highlighted a potential role of interleukin 1β (IL-1β) in systemic sclerosis (SSc). NLRP1 provides a scaffold for the assembly of the inflammasome that promotes the processing and maturation of pro-IL-1β. In addition, NLRP1 variants were found to confer susceptibility to autoimmune disorders. OBJECTIVE /st> To study a possible association of the NLRP1 rs6502867, rs2670660 and rs8182352, rs12150220 and rs4790797 with SSc in the European Caucasian population. METHODS NLRP1 single nucleotide polymorphisms were genotyped in 3227 individuals comprising a discovery set (870 SSc patients and 962 controls) and a replication set including individuals from Germany (532 SSc patients and 324 controls) and Italy (527 SSc patients and 301 controls), all individuals being of European Caucasian origin. RESULTS Conditional analyses revealed a significant association for the NLRP1 rs8182352 variant with both anti-topoisomerase-positive and SSc-related fibrosing alveolitis (FA) subsets under an additive model: p=0.0042, OR 1.23 (95% CI 1.07 to 1.41) and p=0.0065 OR 1.19 (95% CI 1.05 to 1.36), respectively. Logistic regression analysis showed an additive effect of IRF5 rs2004640, STAT4 rs7574865 and NLRP1 rs8182352 risk alleles on SSc-related FA. CONCLUSIONS Our results establish NLRP1 as a new genetic susceptibility factor for SSc-related pulmonary fibrosis and anti-topoisomerase-positive SSc phenotypes. This provides new insights into the pathogenesis of SSc, underlining the potential role of innate immunity in particular in the FA-positive SSc subphenotype, which represents a severe subset of the disease.
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Affiliation(s)
- P Dieudé
- Service de Rhumatologie, Paris Diderot University, INSERM U699, Hôpital Bichat Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France.
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Diaz-Gallo LM, Gourh P, Broen J, Simeon C, Fonollosa V, Ortego-Centeno N, Agarwal S, Vonk MC, Coenen M, Riemekasten G, Hunzelmann N, Hesselstrand R, Tan FK, Reveille JD, Assassi S, García-Hernandez FJ, Carreira P, Camps MT, Fernandez-Nebro A, de la Peña PG, Nearney T, Hilda D, González-Gay MA, Airo P, Beretta L, Scorza R, Herrick A, Worthington J, Pros A, Gómez-Gracia I, Trapiella L, Espinosa G, Castellvi I, Witte T, de Keyser F, Vanthuyne M, Mayes MD, Radstake TRDJ, Arnett FC, Martin J, Rueda B. Analysis of the influence of PTPN22 gene polymorphisms in systemic sclerosis. Ann Rheum Dis 2010; 70:454-62. [PMID: 21131644 DOI: 10.1136/ard.2010.130138] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Two functional single nucleotide polymorphisms (SNP) in the PTPN22 gene (rs24746601 and rs33996649) have been associated with autoimmunity. The aim of this study was to investigate the role of the R263Q SNP for the first time and to re-evaluate the role of the R620W SNP in the genetic predisposition to systemic sclerosis (SSc) susceptibility and clinical phenotypes. METHODS 3422 SSc patients (2020 with limited cutaneous SSc and 1208 with diffuse cutaneous SSc) and 3638 healthy controls of Caucasian ancestry from an initial case--control set of Spain and seven additional independent replication cohorts were included in our study. Both rs33996649 and rs2476601 PTPN22 polymorphisms were genotyped by TaqMan allelic discrimination assay. A meta-analysis was performed to test the overall effect of these PTPN22 polymorphisms in SSc. RESULTS The meta-analysis revealed evidence of association of the rs2476601 T allele with SSc susceptibility (p(FDRcorrected)=0.03 pooled, OR 1.15, 95% CI 1.03 to 1.28). In addition, the rs2476601 T allele was significantly associated with anticentromere-positive status (p(FDRcorrected)=0.02 pooled, OR 1.22, 95% CI 1.05 to 1.42). Although the rs33996649 A allele was significantly associated with SSc in the Spanish population (p(FDRcorrected)=0.04, OR 0.58, 95% CI 0.36 to 0.92), this association was not confirmed in the meta-analysis (p=0.36 pooled, OR 0.89, 95% CI 0.72 to 1.1). CONCLUSION The study suggests that the PTPN22 R620W polymorphism influences SSc genetic susceptibility but the novel R263Q genetic variant does not. These data strengthen evidence that the R620W mutation is a common risk factor in autoimmune diseases.
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Affiliation(s)
- L M Diaz-Gallo
- Referral Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan. [corrected]
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Broen JCA, Dieude P, Vonk MC, Beretta L, Rueda B, Herrick A, Worthington J, Hunzelmann N, Riemekasten G, Kiener H, Scorza R, Simeon CP, Fonollosa V, Carreira P, Ortego-Centeno N, Gonzalez-Gay MA, Airò P, Coenen MJH, Aliprantis A, Martin J, Allanore Y, Radstake TRDJ. Polymorphisms in the interleukin 4, interleukin 13 and corresponding receptor genes are not associated with Systemic Sclerosis and do not influence gene expression. J Transl Med 2010. [PMCID: PMC3007792 DOI: 10.1186/1479-5876-8-s1-p47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Bossini-Castillo L, Broen JCA, Simeon CP, Beretta L, Vonk MC, Ortego-Centeno N, Espinosa G, Carreira P, Camps MT, Navarrete N, González-Escribano MF, Vicente-Rabaneda E, Rodríguez L, Tolosa C, Román-Ivorra JA, Gómez-Gracia I, García-Hernández FJ, Castellví I, Gallego M, Fernández-Nebro A, Egurbide MV, Follonosa V, García de la Peña P, Pros A, González-Gay MA, Hesselstrand R, Riemekasten G, Witte T, Coenen MJH, Koeleman BP, Houssiau F, Smith V, De Keyser F, Westhovens R, De Langhe E, Voskuyl AE, Schuerwegh AJ, Chee MM, Madhok R, Shiels P, Fonseca C, Denton C, Claes K, Padykov L, Nordin A, Palm Ø, Lie BA, Airó P, Scorza R, van Laar JM, Hunzelmann N, Kreuter A, Herrick A, Worthington J, Radstake TRDJ, Martín J, Rueda B. A replication study confirms the association of TNFSF4 (OX40L) polymorphisms with Systemic Sclerosis in a large European cohort. J Transl Med 2010. [PMCID: PMC3007795 DOI: 10.1186/1479-5876-8-s1-p5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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142
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Becker MO, Brückner C, Scherer HU, Wassermann N, Humrich JY, Hanitsch LG, Schneider U, Kawald A, Hanke K, Burmester GR, Riemekasten G. The monoclonal anti-CD25 antibody basiliximab for the treatment of progressive systemic sclerosis: an open-label study. Ann Rheum Dis 2010; 70:1340-1. [PMID: 21068100 DOI: 10.1136/ard.2010.137935] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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143
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Gorlova O, Martin JM, Rueda B, Koeleman BPC, Ying J, Teruel M, Diaz-Gallo LM, Broen JC, Vonk MC, Simeon CP, Alizadeh BZ, Coenen MJH, Voskuyl AE, Schuerwegh AJ, van Riel PLCM, Vanthuyne M, van ‘t Slot R, Italiaander A, Ophoff RA, Hunzelmann N, Fonollosa V, Ortego-Centeno N, González-Gay MA, García-Hernández FJ, González-Escribano MF, Airo P, van Laar J, Worthington J, Hesselstrand R, Smith V, De Keyser F, Houssiau F, Chee MM, Madhok R, Shiels P, Westhovens R, Kreuter A, de Baere E, Witte T, Padyukov L, Nordin A, Scorza R, Lunardi C, Lie BA, Hoffmann-Vold AM, García de la Peña P, Carreira P, Varga J, Hinchcliff M, Lee AT, Gourh P, Amos CI, Riemekasten G, Herrick A, Beretta L, Fonseca C, Denton CP, Gregersen PK, Agarwal S, Assassi S, Tan FK, Arnett FC, Radstake TRDJ, Mayes MD, Martin J. Identification of novel genetic markers associated with the clinical phenotypes of systemic sclerosis through a genome wide association strategy. Lab Invest 2010. [PMCID: PMC3007743 DOI: 10.1186/1479-5876-8-s1-o1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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144
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Broen JCA, Gourh P, Vonk MC, Beretta L, Niederer F, Rueda B, Geurts-van Bon L, Brouwer C, Hesselstrand R, Herrick A, Worthington J, Hunzelman N, Denton C, Fonseca C, Riemekasten G, Kiener H, Scorza R, Simeon CP, Fonollosa V, Carreira P, Ortego-Centeno N, Gonzalez-Gay MA, Airò P, Coenen MJH, Mayes M, Kyburz D, Arnett FC, Martin J, Radstake TRDJ. Variants of PBEF predispose to systemic sclerosis and pulmonary arterial hypertension development. Lab Invest 2010. [PMCID: PMC3007791 DOI: 10.1186/1479-5876-8-s1-p46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Ghofrani H, Distler O, Gerhardt F, Gorenflo M, Grünig E, Haefeli W, Held M, Hoeper M, Kähler CM, Kaemmerer H, Klose H, Köllner V, Kopp B, Mebus S, Meyer A, Miera O, Pittrow D, Riemekasten G, Rosenkranz S, Schranz D, Voswinckel R, Olschewski H. Therapie der pulmonal arteriellen Hypertonie (PAH). Dtsch Med Wochenschr 2010; 135 Suppl 3:S87-101. [DOI: 10.1055/s-0030-1263316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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146
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Grünig E, Barner A, Bell M, Claussen M, Dandel M, Dumitrescu D, Gorenflo M, Holt S, Kovacs G, Ley S, Meyer JF, Pabst S, Riemekasten G, Saur J, Schwaiblmair M, Seck C, Sinn L, Sorichter S, Winkler J, Leuchte HH. [Non-invasive diagnosis of pulmonary hypertension: ESC/ERS Guidelines with commentary of the Cologne Consensus Conference 2010]. Dtsch Med Wochenschr 2010; 135 Suppl 3:S67-77. [PMID: 20862623 DOI: 10.1055/s-0030-1263314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The 2009 European Guidelines on Diagnosis and Treatment of Pulmonary Hypertension have been adopted for Germany. The guidelines contain detailed recommendations for the diagnosis of pulmonary hypertension. However, the practical implementation of the European Guidelines in Germany requires the consideration of several country-specific issues and already existing novel data. This requires a detailed commentary to the guidelines, and in some aspects an update y appears necessary. In June 2010, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany. This conference aimed to solve practical and controversial issues surrounding the implementation of the European Guidelines in Germany. To this end, a number of working groups was initiated, one of which was specifically dedicated to non-invasive diagnosis of PH. This commentary summarizes the results and recommendations of the working group on treatment of PAH.
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Affiliation(s)
- E Grünig
- Zentrum für pulmonale Hypertonie, Thoraxklinik am Universitätsklinikum Heidelberg, Heidelberg.
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Seibold JR, Denton CP, Furst DE, Guillevin L, Rubin LJ, Wells A, Matucci Cerinic M, Riemekasten G, Emery P, Chadha-Boreham H, Charef P, Roux S, Black CM. Randomized, prospective, placebo-controlled trial of bosentan in interstitial lung disease secondary to systemic sclerosis. ACTA ACUST UNITED AC 2010; 62:2101-8. [PMID: 20506355 DOI: 10.1002/art.27466] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Endothelin is implicated as a participatory pathway in systemic sclerosis (SSc). We tested this hypothesis in a 12-month trial of bosentan, a nonselective endothelin receptor antagonist, as a therapy for SSc-related interstitial lung disease (ILD). METHOD Patients with SSc and significant ILD were recruited to this prospective, double-blind, randomized, placebo-controlled, parallel group study. The inclusion criteria were designed to select a cohort enriched for patients with active and progressive disease. Exclusion factors included significant pulmonary hypertension. Patients with a diffusing capacity for carbon monoxide of <80% predicted and a 6-minute walk distance of 150-500 meters or a 6-minute walk distance of > or = 500 meters with a decrease in oxygen saturation received bosentan or placebo. The primary efficacy end point was a change in the 6-minute walk distance from baseline up to month 12. Secondary end points included time to death or worsening results of pulmonary function tests (PFTs). The safety and tolerability of bosentan were also assessed. RESULTS Among the 163 patients, 77 were randomized to receive bosentan, and 86 were randomized to receive placebo. No significant difference between treatment groups was observed for change in the 6-minute walk distance up to month 12. No deaths occurred in this study group. Forced vital capacity and diffusing capacity for carbon monoxide remained stable in the majority of patients in both groups. Significant worsening of PFT results occurred in 25.6% of patients receiving placebo and 22.5% of those receiving bosentan (P not significant). CONCLUSION No improvement in exercise capacity was observed in the bosentan-treated group compared with the placebo group, and no significant treatment effect was observed for the other end points. Although many outcome variables were stable, bosentan did not reduce the frequency of clinically important worsening. These data do not support the use of endothelin receptor antagonists as therapy for ILD secondary to SSc.
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Affiliation(s)
- J R Seibold
- Division of Rheumatology, University of Connecticut, Farmington, CT 06034, USA.
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Lorenzen JM, Kramer R, Meier M, Werfel T, Wichmann K, Hoeper MM, Riemekasten G, Becker MO, Haller H, Witte T. Osteopontin in the development of systemic sclerosis--relation to disease activity and organ manifestation. Rheumatology (Oxford) 2010; 49:1989-91. [DOI: 10.1093/rheumatology/keq223] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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149
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Avouac J, Walker U, Tyndall A, Kahan A, Matucci-Cerinic M, Allanore Y, Miniati I, Muller A, Iannone F, Distler O, Becvar R, Sierakowsky S, Kowal-Bielecka O, Coelho P, Cabane J, Cutolo M, Shoenfeld Y, Valentini G, Rovensky J, Riemekasten G, Vlachoyiannopoulos P, Caporali R, Jiri S, Inanc M, Zimmermann Gorska I, Carreira P, Novak S, Czirjak L, Oliveira Ramos F, Jendro M, Chizzolini C, Kucharz EJ, Richter J, Cozzi F, Rozman B, Mallia CM, Gabrielli A, Farge D, Kiener HP, Schöffel D, Airo P, Wollheim F, Martinovic D, Trotta F, Jablonska S, Reich K, Bombardieri S, Siakka P, Pellerito R, Bambara LM, Morovic-Vergles J, Denton C, Hinrichs R, Van den Hoogen F, Damjanov N, Kötter I, Ortiz V, Heitmann S, Krasowska D, Seidel M, Hasler P, Van Laar JM, Kaltwasser JP, Foeldvari I, Juan Mas A, Bajocchi G, Wislowska M, Pereira Da Silva JA, Jacobsen S, Worm M, Graniger W, Kuhn A, Stankovic A, Cossutta R, Majdan M, Damjanovska Rajcevska L, Tikly M, Nasonov EL, Steinbrink K, Herrick A, Müller-Ladner U, Dinc A, Scorza R, Sondergaard K, Indiveri F, Nielsen H, Szekanecz Z, Silver RM, Antivalle M, Espinosa IB, García de la Pena Lefebvre P, Midtvedt O, Launay D, Valesini F, Tuvik P, Ionescu RM, Del Papa N, Pinto S, Wigley F, Mihai C, Sinziana Capranu M, Sunderkötter C, Jun JB, Alhasani S, Distler JH, Ton E, Soukup T, Seibold J, Zeni S, Nash P, Mouthon L, De Keyser F, Duruöz MT, Cantatore FP, Strauss G, von Mülhen CA, Pozzi MR, Eyerich K, Szechinski J, Keiserman M, Houssiau FA, Román-Ivorra JA, Krummel-Lorenz B, Aringer M, Westhovens R, Bellisai F, Mayer M, Stoeckl F, Uprus M, Volpe A, Buslau M, Yavuz S, Granel B, Valderílio Feijó A, Del Galdo F, Popa S, Zenone T, Ricardo Machado X, Pileckyte M, Stebbings S, Mathieu A, Tulli A, Tourinho T, Souza R, Acayaba de Toledo R, Stamp L, Solanki K, Veale D, Francisco Marques Neto J, Bagnato GF, Loyo E, Toloza S, Li M, Ahmed Abdel Atty Mohamed W, Cobankara V, Olas J, Salsano F, Oksel F, Tanaseanu CM, Foti R, Ancuta C, Vonk M, Caramashi P, Beretta L, Balbir A, Chiàla A, Pasalic Simic K, Ghio M, Stamenkovic B, Rednic S, Host N, Pellerito R, Hachulla E, Furst DE. Characteristics of joint involvement and relationships with systemic inflammation in systemic sclerosis: results from the EULAR Scleroderma Trial and Research Group (EUSTAR) database. J Rheumatol 2010. [PMID: 20551097 DOI: 10.3899/jrheum.091165.] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine the prevalence of and independent factors associated with joint involvement in a large population of patients with systemic sclerosis (SSc). METHODS This study was cross-sectional, based on data collected on patients included in the European League Against Rheumatism (EULAR) Scleroderma Trials and Research (EUSTAR) registry. We queried this database to extract data regarding global evaluation of patients with SSc and the presence of any clinical articular involvement: synovitis (tender and swollen joints), tendon friction rubs (rubbing sensation detected as the tendon was moved), and joint contracture (stiffness of the joints that decreased their range of motion). Overall joint involvement was defined by the occurrence of synovitis and/or joint contracture and/or tendon friction rubs. RESULTS We recruited 7286 patients with SSc; their mean age was 56 +/- 14 years, disease duration 10 +/- 9 years, and 4210 (58%) had a limited cutaneous disease subset. Frequencies of synovitis, tendon friction rubs, and joint contractures were 16%, 11%, and 31%, respectively. Synovitis, tendon friction rubs, and joint contracture were more prevalent in patients with the diffuse cutaneous subset and were associated together and with severe vascular, muscular, renal, and interstitial lung involvement. Moreover, synovitis had the highest strength of association with elevated acute-phase reactants taken as the dependent variable. CONCLUSION Our results highlight the striking level of articular involvement in SSc, as evaluated by systematic examination in a large cohort of patients with SSc. Our data also show that synovitis, joint contracture, and tendon friction rubs are associated with a more severe disease and with systemic inflammation.
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Affiliation(s)
- Jerome Avouac
- Service de Rhumatologie A, Hôpital Cochin, Université Paris Descartes, 75014 Paris, France
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Tyndall AJ, Bannert B, Vonk M, Airo P, Cozzi F, Carreira PE, Bancel DF, Allanore Y, Muller-Ladner U, Distler O, Iannone F, Pellerito R, Pileckyte M, Miniati I, Ananieva L, Gurman AB, Damjanov N, Mueller A, Valentini G, Riemekasten G, Tikly M, Hummers L, Henriques MJ, Caramaschi P, Scheja A, Rozman B, Ton E, Kumanovics G, Coleiro B, Feierl E, Szucs G, Von Muhlen CA, Riccieri V, Novak S, Chizzolini C, Kotulska A, Denton C, Coelho PC, Kotter I, Simsek I, de la Pena Lefebvre PG, Hachulla E, Seibold JR, Rednic S, Stork J, Morovic-Vergles J, Walker UA. Causes and risk factors for death in systemic sclerosis: a study from the EULAR Scleroderma Trials and Research (EUSTAR) database. Ann Rheum Dis 2010; 69:1809-15. [DOI: 10.1136/ard.2009.114264] [Citation(s) in RCA: 795] [Impact Index Per Article: 56.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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