Autoimmunity in 2017

Prevalence of autoimmune conditions in pregnant women in a tertiary maternity hospital: A cross-sectional survey and maternity database review

Background

Autoimmune conditions are associated with adverse pregnancy and offspring outcomes; however, the prevalence in pregnant women is not well understood. Estimates based on administrative data alone may underestimate prevalence.

Methods

A cross-sectional survey of women attending a tertiary referral hospital for antenatal care in December 2018-February 2019 and review of the hospital's maternity database of women giving birth from October 2017-June 2018 to estimate autoimmune disease prevalence.

Results

A total of 400 women completed surveys (78% response rate) and 41 (10.3%) reported an autoimmune disease, most commonly Hashimoto's thyroiditis (2.8%) and psoriasis (2.5%). From the maternity database, 112 of 2756 women giving birth (4.1%) had a recorded autoimmune disease, most commonly Hashimoto's thyroiditis (1.3%) followed by coeliac disease, Graves' disease, and immune thrombocytopenic purpura (all 0.4%).

Conclusion

Autoimmune disease prevalence in pregnant women is higher when self-reported and may be more common than previously reported using administrative data.

Decipher manifestations and Treg /Th17 imbalance in multi-staging rheumatoid arthritis and correlation with TSDR/RORC methylation

T regulatory (Treg)/T-helper (Th) 17 imbalance has been shown to integrate with epigenetics to result in the development of autoimmune diseases. We aim to investigate the influence of disease staging on Treg/Th17 cells and whether the aberrant DNA methylation is implicated in the development of rheumatoid arthritis (RA). By recruiting 65 patients with multi-staging RA and 20 healthy controls (HC), we found that patients with active RA exhibited relative lymphopenia and higher WBC, neutrophils, and PLT. Circulating Treg/Th17 in patients with early active RA was significantly decreased. The expression of IL-6 and IL-17A was significantly increased in early active RA, whereas that of IL-10 and TGF-β was on the contrary. Furthermore, the frequency of Treg cells and Treg/Th17 were negatively correlated with DAS28, and the frequency of Th17 cells was on the contrary. Levels of DNA methylation related enzymes had significant difference between early active RA and HC. Relative hypermethylation was observed at the gene level for Treg-specific demethylated region (TSDR) and hypomethylation for retinoic acid-related orphan receptor (ROR)-C in early active RA. Thus, manifestations of RA and Treg/Th17 imbalance vary with disease staging, and the aberrant DNA methylation pattern may contribute to RA disease pathogenesis. Our results highlight the importance of disease staging in clinical research.

Update on Autoimmune Diseases Pathogenesis

BACKGROUND

Autoimmune diseases result from the interplay of cellular effectors like T and B cells, regulatory cells in addition to molecular factors like cytokines and regulatory molecules.

METHODS

Different electronic databases were searched in a non-systematic way to find out the literature of interest.

RESULTS

Pathogenesis of autoimmune diseases involves typical factors such as genetic background including HLA and non HLA system genes, environmental factors such as infectious agents and inflammatory cells mainly T and B lymphocytes abnormally activated leading to immune dysfunction. Other recently reported less typical factors such as micro-RNAs, circular RNAs, myeloperoxidase, vimentine and microbiome dysbiosis seem to be potential target therapies.

CONCLUSION

We aimed in this manuscript to review common factors in the pathogenesis of autoimmune diseases.

Red Grape Polyphenol Oral Administration Improves Immune Response in Women Affected by Nickel-Mediated Allergic Contact Dermatitis

BACKGROUND

Our previous findings demonstrated that in vitro supplementation of polyphenols, extracted from seeds of red grape (Nero di Troia cultivar), to peripheral lymphomonocytes from patients affected by allergic contact dermatitis (ACD) to nickel (Ni) could reduce the release of proinflammatory cytokines and nitric oxide (NO), while increasing the levels of interleukin (IL)-10, an anti-inflammatory cytokine.

OBJECTIVE

To assess whether an intervention with oral administration of polyphenols leads to a reduction of peripheral biomarkers in ACD patients.

METHODS

At T0, 25 patients affected by ACD to Ni were orally administered with 300 mg polyphenols prodie extracted from seeds of red grape (Nero di Troia cultivar) (NATUR-OX®) for 3 months (T1). The other 25 patients affected by ACD to Ni received placebo only for the same period of time. Serum biomarkers were analyzed at T0 and T1. In both groups, seven dropouts were recorded.

RESULTS

At T1 in comparison to T0, in treated patients, values of interferon-γ, IL-4, IL-17, pentraxin 3 and NO decreased, while IL-10 levels increased when compared with T0 values. Conversely, in placebo- treated patients, no modifications of biomarkers were evaluated at T1.

CONCLUSION

Present laboratory data rely on the anti-oxidant, anti-inflammatory and anti-allergic properties of polyphenols.

Sex and autoimmunity: proposed mechanisms of disease onset and severity

INTRODUCTION

Chronic autoimmune diseases affect 5-10% of the population worldwide and are largely predominant in women. Sex hormone changes have been widely investigated based on changes in the clinical phenotypes observed during pregnancy and menopause. It is known that females with autoimmune diseases manifest a higher rate of circulating leukocytes with a single X chromosome, and there have been several reports on the role of X chromosome gene dosage through inactivation or duplication in autoimmunity. However, it is also important not to overlook men with autoimmune diseases, who might manifest a more frequent loss of the Y chromosome in circulating leukocytes. Areas covered: In the present review, we will discuss the current evidence supporting the mechanisms of female predominance in rheumatic diseases, by discussing the role of reproductive history, sex hormones and abnormalities related to them, clinical differences between male and female patients, and epigenetic changes that have been evaluated through twin studies on genetic and environmental changes in rheumatic patients. Expert opinion: The influence of sex hormones and chromosomes on the function of the innate and adaptive immune systems needs to be clarified, to better understand the risk of autoimmune diseases, early diagnostic tools, and therapeutic response.