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Keshvani C, Laylani N, Davila-Siliezar P, Kopel J, Lee AG. Neuro-ophthalmic challenges and multi-morbidity in vasculitis among the older adults. Expert Rev Clin Immunol 2024; 20:781-791. [PMID: 38572928 DOI: 10.1080/1744666x.2024.2339893] [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: 02/10/2023] [Accepted: 04/03/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Vasculitides are a heterogeneous group of disorders producing inflammation of blood vessels (e.g. arteries or veins). All major vasculitides potentially have ophthalmological symptoms and signs including visual loss. Co-morbidity, multimorbidity, polypharmacy, and geriatric syndromes all play important roles in patient outcomes for these rheumatic conditions in the elderly. This monograph reviews the NCBI PubMed database (Feb 2023) literature on the neuro-ophthalmic and geriatric considerations in vasculitis. AREAS COVERED Cogan Syndrome, Granulomatosis with Polyangiitis, Giant Cell Arteritis, Polyarteritis Nodosa, Takayasu Arteritis, Vasculitis epidemiology, and neuro-ophthalmological symptoms. EXPERT OPINION Geriatric patient care for vasculitis with neuro-ophthalmological manifestations can be complicated by the interplay of multiple co-morbidities, polypharmacy, and specific geriatric syndromes. The valuation and treatment of vasculitis and the complications associated with the disease can negatively impact patient care. Advances in noninvasive imaging and updates in diagnostic criteria have enabled increased identification of patients at earlier stages with less severe disease burden. Novel therapeutic agents can be glucocorticoid sparing and might reduce the adverse effects of chronic steroid use. Holistic care models like the 5 M geriatric care model (mind, mobility, medications, multicomplexity, and matters most) allow patients' needs to be in the forefront with biopsychosocial aspects of a patient being addressed.
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Affiliation(s)
- Caezaan Keshvani
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Noor Laylani
- Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA
| | | | - Jonathan Kopel
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Andrew G Lee
- Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA
- Department of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- Department of Ophthalmology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Tortosa-Carreres J, Lloret-Sos C, Sahuquillo-Arce JM, Suárez-Urquiza P, Prat-Fornells J, Molina-Moreno JM, Alba-Redondo A, Martínez-Triguero ML, Aguado-Codina C, Laiz-Marro B, López-Hontangas JL. Evaluating the diagnostic performance of Liaison® chemiluminescence assay as screening tool for detection of acute Epstein-Barr infection: A comparative study. Diagn Microbiol Infect Dis 2024; 108:116167. [PMID: 38176302 DOI: 10.1016/j.diagmicrobio.2023.116167] [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: 09/08/2023] [Revised: 12/15/2023] [Accepted: 12/23/2023] [Indexed: 01/06/2024]
Abstract
The present investigation assessed the Liaison® diagnostic performance in detecting Epstein-Barr (EBV) IgM-VCA in a large patient cohort, considering age and symptomatology. VIDAS® were employed as a benchmark for acute EBV infection. The study also probed other coexisting conditions and potential cross-reactivity for error sources. A total of 1311 samples were analyzed, with notable associations found only among paediatric (kappa=0.75) and young adult (kappa=0.58) populations with compatible symptoms. ROC analysis revealed varying optimal cutoff values based on age and symptom categorizations. Logistic regression models identified age and patients from Oncology or Infectious Disease as significant factors for false positives. Potential interferences emerged with RF, ANCA, cytomegalovirus-IgM and VHS-IgM. Notably, Liaison® couldn´t distinguish EBV patients from Oncology, Haemathology or Internal Medicine. This study provides valuable insights, such as implementing ageand symptom-specific thresholds or reviewing test requests, for optimizing EBV serology in microbiology laboratories, leading to faster and more reliable responses.
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Affiliation(s)
- Jordi Tortosa-Carreres
- Laboratory Department, Hospital Univeritari i Politècnic la Fe. Av Fernando Abril Martorell 106; 46026 València, Spain.
| | - Carmen Lloret-Sos
- Microbiology Department, Hospital Univeritari i Politècnic la Fe. Av Fernando Abril Martorell 106; 46026 València, Spain.
| | - Jose Miguel Sahuquillo-Arce
- Microbiology Department, Hospital Univeritari i Politècnic la Fe. Av Fernando Abril Martorell 106; 46026 València, Spain.
| | - Pedro Suárez-Urquiza
- Microbiology Department, Hospital Univeritari i Politècnic la Fe. Av Fernando Abril Martorell 106; 46026 València, Spain.
| | - Josep Prat-Fornells
- Microbiology Department, Hospital Univeritari i Politècnic la Fe. Av Fernando Abril Martorell 106; 46026 València, Spain.
| | - Jose Miguel Molina-Moreno
- Microbiology Department, Hospital Univeritari i Politècnic la Fe. Av Fernando Abril Martorell 106; 46026 València, Spain.
| | - Amparo Alba-Redondo
- Laboratory Department, Hospital Univeritari i Politècnic la Fe. Av Fernando Abril Martorell 106; 46026 València, Spain.
| | - Maria Luisa Martínez-Triguero
- Laboratory Department, Hospital Univeritari i Politècnic la Fe. Av Fernando Abril Martorell 106; 46026 València, Spain.
| | - Cristina Aguado-Codina
- Laboratory Department, Hospital Univeritari i Politècnic la Fe. Av Fernando Abril Martorell 106; 46026 València, Spain.
| | - Begoña Laiz-Marro
- Laboratory Department, Hospital Univeritari i Politècnic la Fe. Av Fernando Abril Martorell 106; 46026 València, Spain.
| | - Jose Luis López-Hontangas
- Microbiology Department, Hospital Univeritari i Politècnic la Fe. Av Fernando Abril Martorell 106; 46026 València, Spain.
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Hadrich F, Chamkha M, Sayadi S. Protective effect of olive leaves phenolic compounds against neurodegenerative disorders: Promising alternative for Alzheimer and Parkinson diseases modulation. Food Chem Toxicol 2021; 159:112752. [PMID: 34871668 DOI: 10.1016/j.fct.2021.112752] [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: 08/02/2021] [Revised: 11/24/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023]
Abstract
The main objective of this work was to review literature on compounds extracted from olive tree leaves, such as simple phenols (hydroxytyrosol) and flavonoids (Apigenin, apigenin-7-O-glucoside, luteolin.) and their diverse pharmacological activities as antioxidant, antimicrobial, anti-viral, anti-obesity, anti-inflammatory and neuroprotective properties. In addition, the study discussed the key mechanisms underlying their neuroprotective effects. This study adopted an approach of collecting data through the databases provided by ScienceDirect, SCOPUS, MEDLINE, PubMed and Google Scholar. This review revealed that there was an agreement on the great impact of olive tree leaves phenolic compounds on many metabolic syndromes as well as on the most prevalent neurodegenerative diseases such as Alzheimer and Parkinson. These findings would be of great importance for the use of olive tree leaves extracts as a food supplement and/or a source of drugs for many diseases. In addition, this review would of great help to beginning researchers in the field since it would offer them a general overview of the studies undertaken in the last two decades on the topic.
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Affiliation(s)
- Fatma Hadrich
- Environmental Bioprocesses Laboratory, Center of Biotechnology of Sfax, P.O. Box 1177, 3038, Sfax, Tunisia.
| | - Mohamed Chamkha
- Environmental Bioprocesses Laboratory, Center of Biotechnology of Sfax, P.O. Box 1177, 3038, Sfax, Tunisia
| | - Sami Sayadi
- Biotechnology Program, Center of Sustainable Development, College of Arts and Sciences, Qatar University, Doha, 2713, Qatar.
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Berti A, Specks U. The Survival of Patients With Alveolar Hemorrhage Secondary to Antineutrophil Cytoplasmic Antibody-associated Vasculitis. J Rheumatol 2021; 48:314-317. [PMID: 34237000 DOI: 10.3899/jrheum.201297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Alvise Berti
- A. Berti, MD, Rheumatology Department, Santa Chiara Hospital and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy, and Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA;
| | - Ulrich Specks
- U. Specks, MD, Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
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Monti S, Craven A, Klersy C, Montecucco C, Caporali R, Watts R, Merkel PA, Luqmani R. Association between age at disease onset of anti-neutrophil cytoplasmic antibody-associated vasculitis and clinical presentation and short-term outcomes. Rheumatology (Oxford) 2021; 60:617-628. [PMID: 32447389 DOI: 10.1093/rheumatology/keaa215] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 03/17/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES ANCA-associated vasculitis (AAV) can affect all age groups. We aimed to show that differences in disease presentation and 6 month outcome between younger- and older-onset patients are still incompletely understood. METHODS We included patients enrolled in the Diagnostic and Classification Criteria for Primary Systemic Vasculitis (DCVAS) study between October 2010 and January 2017 with a diagnosis of AAV. We divided the population according to age at diagnosis: <65 years or ≥65 years. We adjusted associations for the type of AAV and the type of ANCA (anti-MPO, anti-PR3 or negative). RESULTS A total of 1338 patients with AAV were included: 66% had disease onset at <65 years of age [female 50%; mean age 48.4 years (s.d. 12.6)] and 34% had disease onset at ≥65 years [female 54%; mean age 73.6 years (s.d. 6)]. ANCA (MPO) positivity was more frequent in the older group (48% vs 27%; P = 0.001). Younger patients had higher rates of musculoskeletal, cutaneous and ENT manifestations compared with older patients. Systemic, neurologic,cardiovascular involvement and worsening renal function were more frequent in the older-onset group. Damage accrual, measured with the Vasculitis Damage Index (VDI), was significantly higher in older patients, 12% of whom had a 6 month VDI ≥5, compared with 7% of younger patients (P = 0.01). Older age was an independent risk factor for early death within 6 months from diagnosis [hazard ratio 2.06 (95% CI 1.07, 3.97); P = 0.03]. CONCLUSION Within 6 months of diagnosis of AAV, patients >65 years of age display a different pattern of organ involvement and an increased risk of significant damage and mortality compared with younger patients.
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Affiliation(s)
- Sara Monti
- Rheumatology, Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy
- Experimental Medicine, University of Pavia, Pavia, Italy
| | - Anthea Craven
- NDORMS, Rheumatology Department, University of Oxford, Oxford, UK
| | - Catherine Klersy
- Biometry and Clinical Epidemiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | | | - Roberto Caporali
- Rheumatology, Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy
| | - Richard Watts
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Peter A Merkel
- Division of Rheumatology and Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Raashid Luqmani
- NDORMS, Rheumatology Department, University of Oxford, Oxford, UK
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Quartuccio L, Isola M, Bruno D, Treppo E, Gigante L, Angelotti F, Capecchi R, Vitiello G, Cavallaro E, Tavoni A, Bosello SL, Cammelli D, De Vita S, Gremese E. Treatment strategy introducing immunosuppressive drugs with glucocorticoids ab initio or very early in giant cell arteritis: A multicenter retrospective controlled study. J Transl Autoimmun 2020; 3:100072. [PMID: 33305250 PMCID: PMC7718148 DOI: 10.1016/j.jtauto.2020.100072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/11/2020] [Accepted: 11/16/2020] [Indexed: 11/26/2022] Open
Abstract
Objective Glucocorticoids (GC) are associated with side effects in giant cell arteritis (GCA). Immunosuppressive therapies (ITs) have given conflicting results in GCA, regarding GC sparing effect. Primary endpoint is to evaluate whether very early introduction of ITs in GCA minimize the rate of GC-induced adverse events, in terms of infections, new onset systemic arterial hypertension, GC-induced diabetes and osteoporotic fractures. Methods A multicenter retrospective case-control study included 165 patients. One group included 114 patients who were treated with at least one IT given at diagnosis or within 3 months from the start of GC. A second group included 51 GCA who received only GC or an IT more than 3 months later. Results The most frequently used ITs were: methotrexate (138 patients), cyclophosphamide (48 patients) and tocilizumab (27 patients). No difference was observed as concerns the follow-up time between groups [48.5 (IQR 26-72) vs 40 (IQR 24-69), p = 0.3)]. The first group showed a significantly lower incidence of steroid-induced diabetes (8/114, 7% vs 12/51, 23.5%; p = 0.003) and no differences for the rate of infections (p = 0.64). The group was also exposed to lower doses of GC at first (p < 0.0001) and third (p < 0.0001, rank-sum test) month. Forty-four patients in the first group (38.6%) compared with 34 in the second one (66.7%) experienced at least one relapse (p = 0.001). Conclusion Very early introduction of IT in GCA lowered the incidence of steroid-induced diabetes, possibly due to the lower doses of GC in the first three months. Relapse rate was even lower.
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Affiliation(s)
- Luca Quartuccio
- Department of Medicine, Rheumatology Clinic, Udine Academic Hospital "Santa Maria Della Misericordia", Udine, Italy
| | - Miriam Isola
- Department of Medicine, Institute of Statistics, University of Udine, Udine, Italy
| | - Dario Bruno
- Rheumatology Unit, Catholic University of the Sacred Heart, Rome, Italy
| | - Elena Treppo
- Department of Medicine, Rheumatology Clinic, Udine Academic Hospital "Santa Maria Della Misericordia", Udine, Italy
| | - Laura Gigante
- Rheumatology Unit, Catholic University of the Sacred Heart, Rome, Italy
| | | | | | | | - Elena Cavallaro
- Department of Medicine, Rheumatology Clinic, Udine Academic Hospital "Santa Maria Della Misericordia", Udine, Italy
| | - Antonio Tavoni
- Department of Internal Medicine, Clinic of Immunology, Pisa, Italy
| | - Silvia Laura Bosello
- Division of Rheumatology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | | | - Salvatore De Vita
- Department of Medicine, Rheumatology Clinic, Udine Academic Hospital "Santa Maria Della Misericordia", Udine, Italy
| | - Elisa Gremese
- Rheumatology Unit, Catholic University of the Sacred Heart, Rome, Italy.,Division of Rheumatology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
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Berti A, Bond M, Volpe A, Felicetti M, Bortolotti R, Paolazzi G. Practical approach to vasculitides in adults: an overview of clinical conditions that can mimic vasculitides closely. ACTA ACUST UNITED AC 2020. [DOI: 10.4081/br.2020.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Primary systemic vasculitides are rare diseases affecting blood vessel walls. The type and patterns of distribution of the organs affected usually reflect the size of the vessels predominantly involved, and the patterns of clinical manifestations are generally useful to reach a specific diagnosis. However, presenting symptoms may lack adequate specificity for a prompt diagnosis, leading to a diagnostic (and therapeutic) delay, often causing irreversible damage to the affected organs. Due to their rarity and variable clinical presentation, the diagnosis of primary vasculitides could be challenging for physicians. Vasculitis mimickers, i.e. the clinical conditions that could be likely mistaken for vasculitides, need to be carefully ruled out, especially before starting the immunosuppressive therapy. We present here a practical approach to the diagnosis of primary systemic vasculitides involving large, medium and small size vessels, and reviewed most of the conditions that could mimic primary systemic vasculitides.
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de Pablos RM, Espinosa-Oliva AM, Hornedo-Ortega R, Cano M, Arguelles S. Hydroxytyrosol protects from aging process via AMPK and autophagy; a review of its effects on cancer, metabolic syndrome, osteoporosis, immune-mediated and neurodegenerative diseases. Pharmacol Res 2019; 143:58-72. [DOI: 10.1016/j.phrs.2019.03.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/04/2019] [Accepted: 03/06/2019] [Indexed: 12/31/2022]
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