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Pekdiker M, Oğuzman H. The first involved joints and associated factors in patients with rheumatoid arthritis. Arch Rheumatol 2024; 39:274-284. [PMID: 38933716 PMCID: PMC11196237 DOI: 10.46497/archrheumatol.2024.10417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/09/2023] [Indexed: 06/28/2024] Open
Abstract
Objectives This study aimed to investigate the first involved joints and associated factors in Turkish patients with rheumatoid arthritis (RA). Patients and methods This retrospective cross-sectional study included 300 newly diagnosed and disease-modifying antirheumatic drug-naïve RA patients (240 females, 60 males; mean age: 54±1.2 years; range, 18 to 82 years). Baseline demographic, clinical, and laboratory data were evaluated between January 2022 and December 2022. The patients were divided into four groups according to autoantibody profile: antibody-negative patients (Group 1; both RF and anti-CCP were negative in this group of patients), RF-positive patients (Group 2), anti-CCP-positive patients (Group 3), and patients with dual seropositivity with RF and antiCCP (Group 4). The patients were also divided into two groups according to the size of the first affected joint: patients with SJI at diagnosis and patients without SJI involvement at diagnosis. Results Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibody positivity rates were 40.3% and 35.6%, respectively. The mean lag time to diagnosis was 25±36 months. At the disease onset, 20% of patients did not have small joint involvement (SJI). Seronegative patients tended to be female (p=0.001), had longer lag time (p=0.001), and had lower levels of C-reactive protein (p=0.025), white blood count (p=0.005), and neutrophil/lymphocyte ratio (p=0.001) compared to the dual seropositive group. Patients presenting with SJI had a younger age (p=0.002), tended to be female (p=0.001), and had lower RF (p=0.034) and anti-CCP (p=0.031) positivity. Only age (p=0.005) and dual seronegativity (RF and anti-CCP; p=0.035) were the independent predictors of SJI in multivariate analysis. Conclusion The decreasing age and seronegative status were defined as independent risk factors of SJI at the onset of RA. Population-based, prospective studies are needed for earlier diagnosis.
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Affiliation(s)
- Mete Pekdiker
- Department of Internal Medicine and Rheumatology, Hatay Mustafa Kemal University, Hatay, Türkiye
| | - Hamdi Oğuzman
- Department of Clinical Biochemistry, Hatay Mustafa Kemal University, Hatay, Türkiye
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Wang J, Vordenbäumen S, Schneider M, Brinks R. Population-based epidemiological projections of rheumatoid arthritis in Germany until 2040. Scand J Rheumatol 2024; 53:161-172. [PMID: 38358097 DOI: 10.1080/03009742.2024.2312693] [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: 11/13/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVES Our aim was to conduct a population-based projection to estimate the number of rheumatoid arthritis (RA) cases in Germany until 2040. METHOD Data obtained from a report published in 2017 (doi:10.20364/VA-17.08) were used for future prediction analysis. The data were originally collected by the German Central Institute for Statutory Health Insurance. We used the illness-death model to estimate future numbers of RA cases, considering nine possible scenarios based on different incidence and mortality rates. RESULTS In the baseline scenario, the number of women with RA is projected to increase by 417 000 cases and men by 179 000 cases by 2040, compared with 2015. Peak numbers of cases are concentrated in the 70-80-year-old age group, particularly among women. In the most favourable scenario (scenario 2), assuming a decreasing incidence, the total number of RA cases is projected to rise by 284 000 by 2040, reflecting a 38% relative increase from 2015 to 2040. The least favourable scenario (scenario 9), assuming an increasing incidence, projects a significant burden on the healthcare system. The total number of RA cases is expected to rise by 1.16 million by 2040, marking a substantial 158% relative increase from 2015 to 2040. CONCLUSIONS Our research emphasizes a discernible trend: with an ageing society, improving treatment effectiveness, and declining all-cause mortality, we anticipate a rise in the absolute numbers of RA cases in Germany in the coming years. Our models robustly support this viewpoint, underscoring impending challenges for healthcare systems. Addressing these challenges demands multifaceted interventions.
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Affiliation(s)
- J Wang
- Institute of Biometry and Epidemiology, The German Diabetes Center, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - S Vordenbäumen
- Department of Rheumatology, St. Elisabeth-Hospital Meerbusch-Lank, Meerbusch, Germany
- Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany
| | - M Schneider
- Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany
| | - R Brinks
- Chair for Medical Biometry and Epidemiology, University of Witten/Herdecke, Witten, Germany
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Tang Y, Varavko Y, Aringazina R, Menshikova I. Changes in renal function and morphological variations of kidney diseases in rheumatoid arthritis patients. Asian J Urol 2024; 11:304-310. [PMID: 38680581 PMCID: PMC11053339 DOI: 10.1016/j.ajur.2022.06.005] [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: 03/01/2022] [Accepted: 06/28/2022] [Indexed: 11/22/2022] Open
Abstract
Objective Rheumatoid nephropathy is one of the most severe extra-articular manifestations of rheumatoid arthritis (RA) associated with a very unfavorable prognosis. This study aimed to identify changes in renal function and morphological variations of kidney diseases in RA patients. Methods The study enrolled patients (126 patients) between 18 and 55 years of age with a confirmed active RA of more than 12 months. Each patient underwent the following range of laboratory and instrumental research methods: general clinical analysis of blood and urine, performing urinalysis according to Nechiporenko method; determining daily proteinuria; determining the blood content of glucose, urea, creatinine, uric acid, total bilirubin, liver transaminase level, ionogram, lipidogram, and coagulogram; determining the blood content of rheumatoid factor, anti-streptolysin O, and C-reactive protein; and X-ray of the joints of hands and feet. Renal function was examined by estimating glomerular filtration rate, tubular reabsorption index, and renal functional reserve. For studying the morphological changes in the kidneys under ultrasound examination, renal biopsy was performed in 31 patients with RA with urinary syndrome (proteinuria more than 0.3 g per day and hematuria). Results Nephropathy in RA is characterized by impaired renal function and manifested by an increased blood creatinine and a decrease in glomerular filtration rate and renal functional reserve. Among morphological variations of nephropathy at RA, mesangial proliferative glomerulonephritis prevails, accounting for 48.4% of patients. Other disorders include the secondary amyloidosis (29.0% of patients), tubulointerstitial nephritis (16.1%), membranous glomerulonephritis (3.2%), and focal-segmental glomerulosclerosis (3.2%). Conclusion Kidney damage is a common systemic manifestation of RA with a long and active course, a major nephropathy trigger.
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Affiliation(s)
- Yan Tang
- College of Medical Technology, Yongzhou Vocational Technical College, Yongzhou, China
| | - Yuliya Varavko
- Department of Internal Diseases Propaedeutics, Irkutsk State Medical University, Irkutsk, Russian Federation
| | - Raisa Aringazina
- Department of Internal Diseases No. 1, Non-Commercial Joint-Stock Society “West Kazakhstan Marat Ospanov Medical University”, Aktobe, Kazakhstan
| | - Irina Menshikova
- Department of Hospital Therapy No. 1, I. M. Sechenov First Moscow State Medical University of Ministry of Health of Russian Federation (Sechenov University), Moscow, Russian Federation
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Xiao C, Xie S, Ouyang S. FNDC4 reduces inflammation, proliferation, invasion and migration of rheumatoid synovial cells by inhibiting CCL2/ERK signaling. Tissue Cell 2024; 86:102294. [PMID: 38181585 DOI: 10.1016/j.tice.2023.102294] [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: 09/18/2023] [Revised: 12/01/2023] [Accepted: 12/22/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic joint inflammation. Fibronectin type III domain-containing protein 4 (FNDC4) is a secretory factor that can regulate inflammatory diseases. However, the role of FNDC4 in RA has not been reported so far. METHODS The expression of FNDC4 in synovial tissues of RA was analyzed by GEO database (GSE55235 dataset). Then, the expression of FNDC4 in RA fibroblast-like synoviocytes (RA-FLSs) was detected by RT-qPCR and western blot. After constructing FNDC4 overexpression plasmid, cell proliferation and apoptosis were detected. Wound healing and transwell assays were used to detect cell migration and invasion. Then we examined the expression of cytokines related to cell inflammation. Subsequently, the regulatory mechanism of FNDC4 was further discussed. We detected the expression of CCL2 and ERK signaling pathway related proteins downstream of FNDC4. Finally, the mechanism was discussed through the overexpression of FNDC4 and CCL2 and the addition of ERK pathway activator tBHQ. RESULTS GEO database showed that FNDC4 expression decreased in synovial tissues of RA. FNDC4 expression was also decreased in RA-FLSs. Overexpression of FNDC4 inhibited the proliferation, invasion and migration of RA-FLSs whereas promoted the cellapoptosis. Overexpression of FNDC4 inhibited the release of inflammatory factors in RA-FLSs. The regulatory effect of FNDC4 is achieved by inhibiting the CCL2/ERK signaling pathway. CONCLUSION FNDC4 reduces inflammation, proliferation, invasion and migration of RA-FLSs in RA by inhibiting CCL2/ERK signaling.
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Affiliation(s)
- Changjuan Xiao
- Nephrology Department, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha 410000, Hunan, P.R. China.
| | - Shuoshan Xie
- Nephrology Department, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha 410000, Hunan, P.R. China
| | - Shaxi Ouyang
- Nephrology Department, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha 410000, Hunan, P.R. China
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Fujii T, Murata K, Onizawa H, Onishi A, Tanaka M, Murakami K, Nishitani K, Furu M, Watanabe R, Hashimoto M, Ito H, Fujii T, Mimori T, Morinobu A, Matsuda S. Management and treatment outcomes of rheumatoid arthritis in the era of biologic and targeted synthetic therapies: evaluation of 10-year data from the KURAMA cohort. Arthritis Res Ther 2024; 26:16. [PMID: 38195572 PMCID: PMC10775516 DOI: 10.1186/s13075-023-03251-z] [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: 07/27/2023] [Accepted: 12/21/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Advances in rheumatoid arthritis (RA) treatment, highlighted by biological disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs), have altered the paradigm of RA treatment in the last decade. Therefore, real-world clinical evidence is needed to understand how treatment strategies and outcomes have changed. METHODS Using an observational cohort of RA from 2012 to 2021, we collected cross-sectional data of RA patients annually to analyze a trend in RA management. For patients who initiated b/tsDMRDs, we evaluated treatment outcomes between b/tsDMARDs. Mixed-effect models were applied to examine the statistical implications of changes over time in treatment outcomes with a background adjustment. RESULTS We analyzed annual cross-sectional data from 5070 patients and longitudinal data from 1816 patients in whom b/tsDMARDs were initiated between 2012 and 2021. b/tsDMARD use increased, whereas glucocorticoid use decreased from 2012 to 2021. Disease activity and functional disability measures improved over time. The percentage of tsDMARD prescriptions considerably increased. All b/tsDMARDs showed clinical improvements in disease activity and functional disability. Statistically, TNFi showed better short-term improvements in b/tsDMARD-naïve patients, while IL6Ri demonstrated significant long-term benefits. IL6Ri had better retention rates in switched patients. After adjustment for patient characteristics, the annual change of RA disease activity and functional disability fared significantly better from 2012 to 2021. CONCLUSIONS With the development of new RA therapeutics, overall treatment outcomes advanced in the past decade.
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Affiliation(s)
- Takayuki Fujii
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo, Kyoto, 6068507, Japan.
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo, Kyoto, 6068507, Japan.
| | - Koichi Murata
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo, Kyoto, 6068507, Japan
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo, Kyoto, 6068507, Japan
| | - Hideo Onizawa
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo, Kyoto, 6068507, Japan
| | - Akira Onishi
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo, Kyoto, 6068507, Japan
| | - Masao Tanaka
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo, Kyoto, 6068507, Japan
| | - Kosaku Murakami
- Center for Cancer Immunotherapy and Immunobiology, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo, Kyoto, 6068507, Japan
| | - Kohei Nishitani
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo, Kyoto, 6068507, Japan
| | - Moritoshi Furu
- Furu Clinic, 1098 Terasho, Konancho, Koka, Shiga, 5203301, Japan
| | - Ryu Watanabe
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahicho, Abeno, Osaka, 5450051, Japan
| | - Motomu Hashimoto
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahicho, Abeno, Osaka, 5450051, Japan
| | - Hiromu Ito
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo, Kyoto, 6068507, Japan
- Department of Orthopaedic Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kuchiki, Okayama, 7100052, Japan
| | - Takao Fujii
- Department of Rheumatology and Clinical Immunology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 6410012, Japan
| | - Tsuneyo Mimori
- Takeda Clinic for Rheumatic Diseases, 606-3-2, Higashi-Shiokojicho, Sanoh Kyotoekimae Building 1F, Kyoto, 6008216, Japan
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo, Kyoto, 6068507, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo, Kyoto, 6068507, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyo, Kyoto, 6068507, Japan
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Díaz-González F, Hernández-Hernández MV. Rheumatoid arthritis. Med Clin (Barc) 2023; 161:533-542. [PMID: 37567824 DOI: 10.1016/j.medcli.2023.07.014] [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: 04/16/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 08/13/2023]
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory multisystemic disease of unknown etiology and autoimmune nature that predominantly affects peripheral joints in a symmetrical fashion. Although much progress has been made in understanding the pathophysiology of RA, its etiology remains unknown. Tumor necrosis factor (TNF)-α and interleukin (IL)-6 play the important roles in the pathogenesis and maintenance of inflammation in RA. The presence of anti-citrullinated peptide antibodies aids in the diagnosis in patients with undifferentiated polyarthritis and is associated with a more aggressive RA. The natural history of RA causes joint deformity and disability, as well as reduced life expectancy, both due to increased cardiovascular risk, pulmonary involvement, infections, iatrogenesis or tumors. Early diagnosis and the use of targeted drugs to induce early remission have improved the RA prognosis.
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Affiliation(s)
- Federico Díaz-González
- Servicio de Reumatología, Hospital Universitario de Canarias, Tenerife, España; Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, San Cristóbal de La Laguna, Tenerife, España; Instituto Universitario de Tecnologías Biomédicas (ITB), Universidad de La Laguna, San Cristóbal de La Laguna, Tenerife, España.
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Sharpe L, Richmond B, Todd J, Dudeney J, Dear BF, Szabo M, Sesel AL, Forrester M, Menzies RE. A cross-sectional study of existential concerns and fear of progression in people with Rheumatoid Arthritis. J Psychosom Res 2023; 175:111514. [PMID: 37883892 DOI: 10.1016/j.jpsychores.2023.111514] [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: 02/01/2023] [Revised: 09/20/2023] [Accepted: 10/01/2023] [Indexed: 10/28/2023]
Abstract
OBJECTIVES People with rheumatoid arthritis (RA) have higher levels of fear of disease progression (FOP) than cancer survivors. In cancer, FOP is inextricably linked with existential concerns. However, this has not been investigated in people with RA. METHODS We recruited 165 people with RA (96%F) who volunteered for a treatment trial of psychological intervention. Participants completed the Existential Concerns Questionnaire (ECQ) and questionnaires measuring constructs associated with FOP in cancer. We created groups of people with RA, with and without clinically significant levels of FOP (clinical and control groups) and compared their existential concerns. We hypothesized that existential concerns would add to the variance in FOP over and above pain, psychopathology, and disability. RESULTS Nearly two-thirds of people with RA scored in the clinical range for FOP. The clinical group had higher levels of all existential concerns than the control group. When subscales of the ECQ were entered into a multiple regression with FOP as the dependent variable, death anxiety, meaninglessness and guilt domains accounted for significant variance in FOP. Moreover, when added to a regression equation controlling all other variables, existential concerns continued to account for unique variance in FOP (t = 2.712, p = 0.007). CONCLUSION Existential concerns were strongly associated with FOP. While this cross-sectional study cannot determine whether existential concerns underlie FOP in RA, these results show robust relationships that warrant future investigation.
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Affiliation(s)
- Louise Sharpe
- The School of Psychology, Faculty of Science, The University of Sydney, Australia.
| | - Bethany Richmond
- The School of Psychology, Faculty of Science, The University of Sydney, Australia
| | - Jemma Todd
- The School of Psychology, Faculty of Science, The University of Sydney, Australia
| | - Joanne Dudeney
- The eCentreClinic, School of Psychological Sciences, Macquarie University, Australia
| | - Blake F Dear
- The eCentreClinic, School of Psychological Sciences, Macquarie University, Australia
| | - Marianna Szabo
- The School of Psychology, Faculty of Science, The University of Sydney, Australia
| | - Amy-Lee Sesel
- The School of Psychology, Faculty of Science, The University of Sydney, Australia
| | - Madeline Forrester
- The School of Psychology, Faculty of Science, The University of Sydney, Australia
| | - Rachel E Menzies
- The School of Psychology, Faculty of Science, The University of Sydney, Australia
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8
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Marín-Prida J, Rodríguez-Ulloa A, Besada V, Llopiz-Arzuaga A, Batista NV, Hernández-González I, Pavón-Fuentes N, Marciano Vieira ÉL, Falcón-Cama V, Acosta EF, Martínez-Donato G, Cervantes-Llanos M, Lingfeng D, González LJ, Fernández-Massó JR, Guillén-Nieto G, Pentón-Arias E, Amaral FA, Teixeira MM, Pentón-Rol G. The effects of Phycocyanobilin on experimental arthritis involve the reduction in nociception and synovial neutrophil infiltration, inhibition of cytokine production, and modulation of the neuronal proteome. Front Immunol 2023; 14:1227268. [PMID: 37936684 PMCID: PMC10627171 DOI: 10.3389/fimmu.2023.1227268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/02/2023] [Indexed: 11/09/2023] Open
Abstract
Introduction The antinociceptive and pharmacological activities of C-Phycocyanin (C-PC) and Phycocyanobilin (PCB) in the context of inflammatory arthritis remain unexplored so far. In the present study, we aimed to assess the protective actions of these compounds in an experimental mice model that replicates key aspects of human rheumatoid arthritis. Methods Antigen-induced arthritis (AIA) was established by intradermal injection of methylated bovine serum albumin in C57BL/6 mice, and one hour before the antigen challenge, either C-PC (2, 4, or 8 mg/kg) or PCB (0.1 or 1 mg/kg) were administered intraperitoneally. Proteome profiling was also conducted on glutamate-exposed SH-SY5Y neuronal cells to evaluate the PCB impact on this key signaling pathway associated with nociceptive neuronal sensitization. Results and discussion C-PC and PCB notably ameliorated hypernociception, synovial neutrophil infiltration, myeloperoxidase activity, and the periarticular cytokine concentration of IFN-γ, TNF-α, IL-17A, and IL-4 dose-dependently in AIA mice. In addition, 1 mg/kg PCB downregulated the gene expression for T-bet, RORγ, and IFN-γ in the popliteal lymph nodes, accompanied by a significant reduction in the pathological arthritic index of AIA mice. Noteworthy, neuronal proteome analysis revealed that PCB modulated biological processes such as pain, inflammation, and glutamatergic transmission, all of which are involved in arthritic pathology. Conclusions These findings demonstrate the remarkable efficacy of PCB in alleviating the nociception and inflammation in the AIA mice model and shed new light on mechanisms underlying the PCB modulation of the neuronal proteome. This research work opens a new avenue to explore the translational potential of PCB in developing a therapeutic strategy for inflammation and pain in rheumatoid arthritis.
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Affiliation(s)
- Javier Marín-Prida
- Center for Research and Biological Evaluations, Institute of Pharmacy and Food, University of Havana, Havana, Cuba
| | - Arielis Rodríguez-Ulloa
- Division of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Vladimir Besada
- Division of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
- China-Cuba Biotechnology Joint Innovation Center (CCBJIC), Yongzhou Zhong Gu Biotechnology Co. Ltd, Yongzhou, China
| | - Alexey Llopiz-Arzuaga
- Division of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
- Department of Cellular Engineering and Biocatalysis , Institute of Biotechnology, National Autonomous University of Mexico (UNAM), Cuernavaca, Mexico
| | - Nathália Vieira Batista
- Laboratory of Immunopharmacology, Department of Biochemistry and Immunology, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Nancy Pavón-Fuentes
- Immunochemical Department, International Center for Neurological Restoration (CIREN), Havana, Cuba
| | - Érica Leandro Marciano Vieira
- Translational Psychoneuroimmunology Group, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Viviana Falcón-Cama
- Division of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
- Departments of Physiological or Morphological Sciences, Latin American School of Medicine (ELAM), Havana, Cuba
| | - Emilio F. Acosta
- Department of Characterization, Center for Advanced Studies of Cuba, Havana, Cuba
| | - Gillian Martínez-Donato
- Division of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Majel Cervantes-Llanos
- Division of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Dai Lingfeng
- China-Cuba Biotechnology Joint Innovation Center (CCBJIC), Yongzhou Zhong Gu Biotechnology Co. Ltd, Yongzhou, China
| | - Luis J. González
- Division of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | | | - Gerardo Guillén-Nieto
- Division of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
- Departments of Physiological or Morphological Sciences, Latin American School of Medicine (ELAM), Havana, Cuba
| | - Eduardo Pentón-Arias
- Division of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
- Departments of Physiological or Morphological Sciences, Latin American School of Medicine (ELAM), Havana, Cuba
| | - Flávio Almeida Amaral
- Laboratory of Immunopharmacology, Department of Biochemistry and Immunology, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mauro Martins Teixeira
- Laboratory of Immunopharmacology, Department of Biochemistry and Immunology, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Giselle Pentón-Rol
- Division of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
- Departments of Physiological or Morphological Sciences, Latin American School of Medicine (ELAM), Havana, Cuba
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Gu P, Pu B, Liu T, Yue D, Xin Q, Li HS, Yang BL, Ke DZ, Zheng XH, Zeng ZP, Zhang ZQ. Appraising causal risk and protective factors for rheumatoid arthritis. Bone Joint Res 2023; 12:601-614. [PMID: 37732818 PMCID: PMC10512867 DOI: 10.1302/2046-3758.129.bjr-2023-0118.r1] [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] [Indexed: 09/22/2023] Open
Abstract
Aims Mendelian randomization (MR) is considered to overcome the bias of observational studies, but there is no current meta-analysis of MR studies on rheumatoid arthritis (RA). The purpose of this study was to summarize the relationship between potential pathogenic factors and RA risk based on existing MR studies. Methods PubMed, Web of Science, and Embase were searched for MR studies on influencing factors in relation to RA up to October 2022. Meta-analyses of MR studies assessing correlations between various potential pathogenic factors and RA were conducted. Random-effect and fixed-effect models were used to synthesize the odds ratios of various pathogenic factors and RA. The quality of the study was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology using Mendelian Randomization (STROBE-MR) guidelines. Results A total of 517 potentially relevant articles were screened, 35 studies were included in the systematic review, and 19 studies were eligible to be included in the meta-analysis. Pooled estimates of 19 included studies (causality between 15 different risk factors and RA) revealed that obesity, smoking, coffee intake, lower education attainment, and Graves' disease (GD) were related to the increased risk of RA. In contrast, the causality contribution from serum mineral levels (calcium, iron, copper, zinc, magnesium, selenium), alcohol intake, and chronic periodontitis to RA is not significant. Conclusion Obesity, smoking, education attainment, and GD have real causal effects on the occurrence and development of RA. These results may provide insights into the genetic susceptibility and potential biological pathways of RA.
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Affiliation(s)
- Peng Gu
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Bin Pu
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Teng Liu
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dan Yue
- Southwest Medical University, Luzhou, China
| | - Qiao Xin
- Jiangxi University of Chinese Medicine, Nanchang, China
| | - Hai-Shan Li
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Bai-Lin Yang
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dao-Ze Ke
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiao-Hui Zheng
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhan-Peng Zeng
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
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Conley B, Bunzli S, Bullen J, O’Brien P, Persaud J, Gunatillake T, Nikpour M, Grainger R, Barnabe C, Lin I. What are the core recommendations for rheumatoid arthritis care? Systematic review of clinical practice guidelines. Clin Rheumatol 2023; 42:2267-2278. [PMID: 37291382 PMCID: PMC10412487 DOI: 10.1007/s10067-023-06654-0] [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: 02/15/2023] [Revised: 05/10/2023] [Accepted: 05/28/2023] [Indexed: 06/10/2023]
Abstract
Systematic r eview to evaluate the quality of the clinical practice guidelines (CPG) for rheumatoid arthritis (RA) management and to provide a synthesis of high-quality CPG recommendations, highlighting areas of consistency, and inconsistency. Electronic searches of five databases and four online guideline repositories were performed. RA management CPGs were eligible for inclusion if they were written in English and published between January 2015 and February 2022; focused on adults ≥ 18 years of age; met the criteria of a CPG as defined by the Institute of Medicine; and were rated as high quality on the Appraisal of Guidelines for Research and Evaluation II instrument. RA CPGs were excluded if they required additional payment to access; only addressed recommendations for the system/organization of care and did not include interventional management recommendations; and/or included other arthritic conditions. Of 27 CPGs identified, 13 CPGs met eligibility criteria and were included. Non-pharmacological care should include patient education, patient-centered care, shared decision-making, exercise, orthoses, and a multi-disciplinary approach to care. Pharmacological care should include conventional synthetic disease modifying anti-rheumatic drugs (DMARDs), with methotrexate as the first-line choice. If monotherapy conventional synthetic DMARDs fail to achieve a treatment target, this should be followed by combination therapy conventional synthetic DMARDs (leflunomide, sulfasalazine, hydroxychloroquine), biologic DMARDS and targeted synthetic DMARDS. Management should also include monitoring, pre-treatment investigations and vaccinations, and screening for tuberculosis and hepatitis. Surgical care should be recommended if non-surgical care fails. This synthesis offers clear guidance of evidence-based RA care to healthcare providers. TRIAL REGISTRATION: The protocol for this review was registered with Open Science Framework ( https://doi.org/10.17605/OSF.IO/UB3Y7 ).
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Affiliation(s)
- Brooke Conley
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC Australia
| | - Samantha Bunzli
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, QLD Australia
- Physiotherapy Department, Royal Brisbane and Women’s Hospital, Brisbane, QLD Australia
| | | | - Penny O’Brien
- Department of Surgery, The University of Melbourne, St Vincent’s Hospital Melbourne, Melbourne, VIC Australia
| | - Jennifer Persaud
- Arthritis and Osteoporosis Western Australia, Perth, WA Australia
- Physiotherapy Department, Sir Charles Gairdner Hospital, Nedlands, WA Australia
| | - Tilini Gunatillake
- Department of Surgery, The University of Melbourne, St Vincent’s Hospital Melbourne, Melbourne, VIC Australia
| | - Mandana Nikpour
- Departments of Medicine and Rheumatology Melbourne, The University of Melbourne at St. Vincent’s Hospital, Melbourne, VIC Australia
| | - Rebecca Grainger
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
- Te Whatu Ora Health New Zealand – Capital Coast and Hutt Valley, Wellington, New Zealand
| | - Cheryl Barnabe
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Ivan Lin
- Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, WA Australia
- Geraldton Regional Aboriginal Medical Service, Geraldton, WA Australia
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11
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Cui S, Qian J. Future Biomarkers for Infection and Inflammation in Rheumatoid Arthritis. J Inflamm Res 2023; 16:2719-2726. [PMID: 37404716 PMCID: PMC10317533 DOI: 10.2147/jir.s413579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/02/2023] [Indexed: 07/06/2023] Open
Abstract
Rheumatoid arthritis (RA) increases the susceptibility to a variety of infections that are often difficult to diagnose and can be asymptomatic or symptoms are atypical. Usually, this is a great challenge for rheumatologists, because it is difficult to distinguish infection and aseptic inflammation at an early stage. Prompt diagnosis and treatment of bacterial infections in immunosuppressed individuals is critical for clinicians, and early exclusion of infection allows for specific treatment of inflammatory diseases and avoids the unnecessary use of antibiotics. However, for patients with clinically suspected infection, traditional laboratory markers are not specific for bacterial infection and cannot be used to distinguish outbreaks from infections. Therefore, new infection markers that can distinguish infection from underlying disease are urgently needed for clinical practice. Here, we review the novel biomarkers in RA patients with infection. These biomarkers include presepsin, serology and haematology, as well as neutrophils, T cells, and natural killer cells. Meanwhile, we discuss meaningful biomarkers that distinguish infection from inflammation and develop novel biomarkers for clinical applications, allowing clinicians to make better decisions when diagnosing and treating RA.
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Affiliation(s)
- Shuang Cui
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People’s Republic of China
| | - Jie Qian
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People’s Republic of China
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12
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Suwa Y, Nagafuchi Y, Yamada S, Fujio K. The role of dendritic cells and their immunometabolism in rheumatoid arthritis. Front Immunol 2023; 14:1161148. [PMID: 37251399 PMCID: PMC10213288 DOI: 10.3389/fimmu.2023.1161148] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/28/2023] [Indexed: 05/31/2023] Open
Abstract
Dendritic cells (DCs) play crucial roles in the pathogenesis of rheumatoid arthritis (RA), a prototypic autoimmune disease characterized by chronic synovitis and joint destruction. Conventional dendritic cells (cDCs) with professional antigen-presenting functions are enriched in the RA synovium. In the synovium, the cDCs are activated and show both enhanced migratory capacities and T cell activation in comparison with peripheral blood cDCs. Plasmacytoid dendritic cells, another subtype of DCs capable of type I interferon production, are likely to be tolerogenic in RA. Monocyte-derived dendritic cells (moDCs), once called "inflammatory DCs", are localized in the RA synovium, and they induce T-helper 17 cell expansion and enhanced proinflammatory cytokine production. Recent studies revealed that synovial proinflammatory hypoxic environments are linked to metabolic reprogramming. Activation of cDCs in the RA synovium is accompanied by enhanced glycolysis and anabolism. In sharp contrast, promoting catabolism can induce tolerogenic DCs from monocytes. Herein, we review recent studies that address the roles of DCs and their immunometabolic features in RA. Immunometabolism of DCs could be a potential therapeutic target in RA.
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Affiliation(s)
- Yuichi Suwa
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuo Nagafuchi
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Functional Genomics and Immunological Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Saeko Yamada
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keishi Fujio
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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13
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Shan H, Liu W, Li Y, Pang K. The Autoimmune Rheumatic Disease Related Dry Eye and Its Association with Retinopathy. Biomolecules 2023; 13:724. [PMID: 37238594 PMCID: PMC10216215 DOI: 10.3390/biom13050724] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
Dry eye disease is a chronic disease of the ocular surface characterized by abnormal tear film composition, tear film instability, and ocular surface inflammation, affecting 5% to 50% of the population worldwide. Autoimmune rheumatic diseases (ARDs) are systemic disorders with multi-organ involvement, including the eye, and play a significant role in dry eye. To date, most studies have focused on Sjögren's syndrome (one of the ARDs) since it manifests as two of the most common symptoms-dry eyes and a dry mouth-and attracts physicians to explore the relationship between dry eye and ARDs. Many patients complained of dry eye related symptoms before they were diagnosed with ARDs, and ocular surface malaise is a sensitive indicator of the severity of ARDs. In addition, ARD related dry eye is also associated with some retinal diseases directly or indirectly, which are described in this review. This review also summarizes the incidence, epidemiological characteristics, pathogenesis, and accompanying ocular lesions of ARD's related dry eye, emphasizing the potential role of dry eye in recognition and monitoring among ARDs patients.
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Affiliation(s)
| | | | | | - Kunpeng Pang
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan 250012, China
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14
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Morse JL, Afari N, Norman SB, Guma M, Pietrzak RH. Prevalence, characteristics, and health burden of rheumatoid arthritis in the U.S. veteran population. J Psychiatr Res 2023; 159:224-229. [PMID: 36746059 DOI: 10.1016/j.jpsychires.2023.01.039] [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: 08/08/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To examine the prevalence, characteristics, and physical and mental health burden of rheumatoid arthritis (RA) in a nationally representative sample of U.S. military veterans. METHODS Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), which surveyed a contemporary, nationally representative sample of 4,069 U.S. veterans. Veterans with RA (n = 227) were compared to veterans with any other medical condition(s) (n = 3,444) on measures of sociodemographic, military, trauma, medical and psychiatric characteristics. Multivariable analyses were then conducted to examine independent associations between RA and health conditions. RESULTS A total of 5.3% (95% confidence interval = 4.5-6.2%) of primarily male U.S. veterans reported having been diagnosed with RA. Relative to controls, veterans with RA were older, and more likely to be racial/ethnic minorities, unpartnered, lower income, and combat veterans. They also reported greater cumulative trauma burden, more medical conditions (i.e., osteoarthritis, chronic pain, respiratory and cardiovascular conditions), and greater severity of somatic symptoms, and were more likely to screen positive for current insomnia and subthreshold posttraumatic stress disorder (PTSD), and lifetime alcohol use disorder (AUD). In adjusted analyses, RA remained associated with number of medical conditions, more severe somatic symptoms, insomnia, subthreshold PTSD, and AUD. CONCLUSIONS One of 20 U.S. veterans has RA, which is more prevalent among certain sociodemographic subsets, and is associated with elevated physical and mental health burden. Results provide insight into risk correlates of RA and underscore the importance of assessing, monitoring, and treating medical and psychiatric conditions/symptoms that co-occur with RA in this population.
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Affiliation(s)
- Jessica L Morse
- VA San Diego Healthcare System, 3350 La Jolla Village Drive, 116, San Diego, CA, 92161, USA; Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, 0603, La Jolla, CA, 92037, USA.
| | - Niloofar Afari
- VA San Diego Healthcare System, 3350 La Jolla Village Drive, 116, San Diego, CA, 92161, USA; Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, 0603, La Jolla, CA, 92037, USA; VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Drive, 116, San Diego, CA, 92161, USA
| | - Sonya B Norman
- VA San Diego Healthcare System, 3350 La Jolla Village Drive, 116, San Diego, CA, 92161, USA; Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, 0603, La Jolla, CA, 92037, USA; VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Drive, 116, San Diego, CA, 92161, USA; National Center for PTSD, White River Junction, VT, USA
| | - Monica Guma
- VA San Diego Healthcare System, 3350 La Jolla Village Drive, 116, San Diego, CA, 92161, USA; Department of Medicine, School of Medicine, University of California, 9500 Gilman Drive, San Diego, CA, 92037, USA
| | - Robert H Pietrzak
- National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, 06510, USA
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15
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Stimulus-responsive and dual-target DNA nanodrugs for rheumatoid arthritis treatment. Int J Pharm 2023; 632:122543. [PMID: 36572263 DOI: 10.1016/j.ijpharm.2022.122543] [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: 08/28/2022] [Revised: 12/08/2022] [Accepted: 12/21/2022] [Indexed: 12/25/2022]
Abstract
Tumor necrosis factor receptor-1 (TNFR1) and DEK are closely associated with the development of rheumatoid arthritis (RA). Taking advantage of the high adenosine triphosphate (ATP) in RA microenvironment and the interactions of DNA aptamers with their targets, an ATP-responsive DNA nanodrug was constructed that simultaneously targets TNFR1 and DEK for RA therapy. To this end, DEK target aptamer DTA and TNFR1 target aptamer Apt1-67 were equipped with sticky ends to hybridize with ATP aptamer (AptATP) and fabricated DNA nanodrug DAT. Our results showed that DAT was successfully prepared with good stability. In the presence of ATP, DAT was disassembled, resulting in the release of DTA and Apt1-67. In vitro studies demonstrated that DAT was superior to the non-responsive DNA nanodrug TD-3A3T in terms of anti-inflammation activity and ATP was inevitable to maximize the anti-inflammation ability of DAT. The superior efficacy of DAT is attributed to the more potent inhibition of caspase-3 and NETs formation. In vivo results further confirmed the anti-RA efficacy of DAT, whereas the administration routes (intravenous injection and transdermal administration via microneedles) did not cause significant differences. Overall, the present study supplies an intelligent strategy for RA therapy and explores a promising administration route for future clinical medication of RA patients.
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16
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Cai B, Zhou M, Xiao Q, Zou H, Zhu X. L-shaped association between serum 25-hydroxyvitamin D and all-cause mortality of individuals with rheumatoid arthritis. Rheumatology (Oxford) 2023; 62:575-582. [PMID: 35689616 DOI: 10.1093/rheumatology/keac341] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/03/2022] [Accepted: 06/03/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE We aimed to examine the relationship between serum 25-hydroxyvitamin D and all-cause, cause-specific mortality of patients with RA. METHODS This cohort study included 1466 patients with RA from The National Health and Nutrition Examination Survey (NHANES) 2001-14. Mortality status was obtained according to death certificate records from the National Death Index. Cox proportional risk models were used to estimate hazard ratios (HR) and 95% CI for mortality. A generalized additive model, smooth curve fitting and 2-piecewise Cox proportional hazards models were established to address the nonlinearity between serum 25-hydroxyvitamin D and mortality. RESULTS A total of 1466 patients [mean (s.d.) 59.89 (14.14) years old; 58.94% female] were enrolled. The weighted mean level of 25-hydroxyvitamin D was 59.26 (24.99) nmol/l and 38.95% were found with deficient (or severe deficient) vitamin D (<50.00 nmol/l). During 10453 person-years of follow-up, 268 patients were documented for all-cause death, including 52 cardiovascular disease (CVD)deaths and 48 cancer deaths. Compared with patients with serum 25-hydroxyvitamin D <25.00 nmol/l, patients with higher serum 25-hydroxyvitamin D were more likely to have lower rate of all-cause mortality. Nonlinear and L-shaped association between serum 25-hydroxyvitamin D and all-cause mortality was found, and decreased serum 25-hydroxyvitamin D was significantly associated with increased risk of all-cause mortality in patients with serum 25-hydroxyvitamin D <37.30 nmol/l [HR 0.95 (0.92, 0.98); P < 0.01]. CONCLUSION An L-shaped association between serum 25-hydroxyvitamin D and all-cause mortality was found among patients with RA, indicating that serum 25-hydroxyvitamin D should be improved to a certain level for the prevention of premature death.
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Affiliation(s)
- Bin Cai
- Department of Rheumatology, Huashan Hospital, Fudan University.,Department of Rheumatology and Immunology, Renji Hospital, Shanghai Jiaotong University School of Medicine
| | - Mengmeng Zhou
- Department of Rheumatology, Huashan Hospital, Fudan University
| | - Qingqing Xiao
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hejian Zou
- Department of Rheumatology, Huashan Hospital, Fudan University
| | - Xiaoxia Zhu
- Department of Rheumatology, Huashan Hospital, Fudan University
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17
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Hino C, Edigin E, Aihie O, Odion J, Eseaton P, Okpujie V, Onobraigho P, Omoike E, Manadan A, Hojjati M. Longitudinal Trends of Hospitalizations for Giant Cell Arteritis: A 21-Year Longitudinal National Population-Based Study. Cureus 2023; 15:e35038. [PMID: 36942165 PMCID: PMC10023869 DOI: 10.7759/cureus.35038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 02/18/2023] Open
Abstract
Background Long-term longitudinal studies on giant cell arteritis (GCA) hospitalizations are limited. Here we aim to fill gaps in knowledge by analyzing longitudinal trends of GCA hospitalizations over the last two decades in the United States (U.S.). Materials and methods We performed a 21-year longitudinal trend analysis of GCA hospitalizations using data obtained from the National Inpatient Sample (NIS) database between 1998 and 2018. Using the NIS database, we searched for hospitalizations for patients aged ≥ 50 years with a principal diagnosis of GCA using ICD billing codes. The principal diagnosis was the main reason for hospitalization. We used all hospitalizations in patients without GCA aged ≥50 years as the control population. Multivariable logistic and linear regression analysis was utilized to calculate the adjusted p-trend for outcomes of interest. Results The incidence of GCA hospitalization remained stable at about one per 100,000 U.S. persons throughout the study period. There was no statistically significant change in the inpatient mortality for the GCA group during the study period (adjusted p-trend=0.111). In comparison, inpatient mortality reduced from 4.4% to 3.1% from 1998 to 2018 (adjusted p-trend <0.0001) in the control group. The proportion of whites reduced, while the proportion of racial minorities increased over time in both the GCA and control groups. Conclusion The non-GCA control population saw significant reductions in mortality over time, but unfortunately, the GCA group did not see such improvements. More research into additional treatment modalities for inpatient GCA management may help improve mortality.
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Affiliation(s)
- Christopher Hino
- Department of Internal Medicine, Loma Linda University School of Medicine, Loma Linda, USA
| | - Ehizogie Edigin
- Department of Internal Medicine, Loma Linda University School of Medicine, Loma Linda, USA
| | - Osaigbokan Aihie
- School of Medicine, University of Missouri School of Medicine, Columbia, USA
| | - Jesse Odion
- Department of Internal Medicine, University of Benin College of Medicine, Benin City, NGA
| | - Precious Eseaton
- Department of Internal Medicine, University of Benin College of Medicine, Benin City, NGA
| | - Victory Okpujie
- Department of Internal Medicine, University of Benin College of Medicine, Benin City, NGA
| | - Precious Onobraigho
- Department of Internal Medicine, University of Benin College of Medicine, Benin City, NGA
| | - Eugene Omoike
- Department of Internal Medicine, University of Benin College of Medicine, Benin City, NGA
| | - Augustine Manadan
- Department of Rheumatology, Rush University Medical Center, Chicago, USA
| | - Mehrnaz Hojjati
- Department of Internal Medicine, Loma Linda University School of Medicine, Loma Linda, USA
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18
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Triptolide and methotrexate binding competitively to bovine serum albumin: A study of spectroscopic experiments, molecular docking, and molecular dynamic simulation. J Mol Liq 2022. [DOI: 10.1016/j.molliq.2022.120300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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19
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Scott IC, Whittle R, Bailey J, Twohig H, Hider SL, Mallen CD, Muller S, Jordan KP. Rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis epidemiology in England from 2004 to 2020: An observational study using primary care electronic health record data. THE LANCET REGIONAL HEALTH. EUROPE 2022; 23:100519. [PMID: 36246147 PMCID: PMC9557034 DOI: 10.1016/j.lanepe.2022.100519] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Contemporary data on rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritits (SpA) epidemiology in England are lacking. This knowledge is crucial to planning healthcare services. We updated algorithms defining patients with diagnoses of RA, PsA, and axial SpA in primary care and applied them to describe their incidence and prevalence in the Clinical Practice Research Datalink Aurum, an electronic health record (EHR) database covering ∼20% of England. METHODS Algorithms for ascertaining patients with RA, axial SpA, and PsA diagnoses validated in primary care EHR databases using Read codes were updated (to account for the English NHS change to SNOMED CT diagnosis coding) and applied. Updated diagnosis and synthetic disease-modifying anti-rheumatic drug code lists were devised by rheumatologists and general practitioners. Annual incidence/point-prevalence of RA, PsA, and axial SpA diagnoses were calculated from 2004 to 2020 and stratified by age/sex. FINDINGS Point-prevalence of RA/PsA diagnoses increased annually, peaking in 2019 (RA 0·779% [95% confidence interval (CI) 0·773, 0·784]; PsA 0·287% [95% CI 0·284, 0·291]) then falling slightly. Point-prevalence of axial SpA diagnoses increased annually (except in 2018/2019), peaking in 2020 (0·113% [95% CI 0·111, 0·115]). RA diagnosis annual incidence was higher between 2013-2019 (after inclusion in the Quality and Outcomes Framework, range 49·1 [95% CI 47·7, 50·5] to 52·1 [95% CI 50·6, 53·6]/100,000 person-years) than 2004-2012 (range 34·5 [95% CI 33·2, 35·7] to 40·0 [95% CI 38·6, 41·4]/100,000 person-years). Increases in the annual incidence of PsA/axial SpA diagnosis occurred following new classification criteria publication. Annual incidence of RA, PsA and axial SpA diagnoses fell by 40·1%, 67·4%, and 38·1%, respectively between 2019 and 2020, likely reflecting the COVID-19 pandemic's impact on their diagnosis. INTERPRETATION Recorded RA, PsA, and axial SpA diagnoses are increasingly prevalent in England, underlining the importance of organising healthcare services to provide timely, treat-to-target care to optimise the health of >1% of adults in England. FUNDING National Institute for Health and Care Research (NIHR300826).
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Affiliation(s)
- Ian C. Scott
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership NHS Foundation Trust, High Lane, Burslem, Staffordshire, UK
| | - Rebecca Whittle
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - James Bailey
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Helen Twohig
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Samantha L. Hider
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership NHS Foundation Trust, High Lane, Burslem, Staffordshire, UK
| | - Christian D Mallen
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership NHS Foundation Trust, High Lane, Burslem, Staffordshire, UK
| | - Sara Muller
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Kelvin P. Jordan
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
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20
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Finckh A, Gilbert B, Hodkinson B, Bae SC, Thomas R, Deane KD, Alpizar-Rodriguez D, Lauper K. Global epidemiology of rheumatoid arthritis. Nat Rev Rheumatol 2022; 18:591-602. [PMID: 36068354 DOI: 10.1038/s41584-022-00827-y] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2022] [Indexed: 11/09/2022]
Abstract
Rheumatoid arthritis (RA) is a systemic autoimmune disease that predominantly affects the joints. The prevalence of RA varies globally, with generally a higher prevalence in industrialized countries, which may be explained by exposures to environmental risk factors, but also by genetic factors, differing demographics and under-reporting in other parts of the world. Over the past three decades, strong trends of the declining severity of RA probably reflect changes in treatment paradigms and overall better management of the disease. Other trends include increasing RA prevalence. Common risk factors for RA include both modifiable lifestyle-associated variables and non-modifiable features, such as genetics and sex. A better understanding of the natural history of RA, and of the factors that contribute to the development of RA in specific populations, might lead to the introduction of specific prevention strategies for this debilitating disease.
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Affiliation(s)
- Axel Finckh
- Division of Rheumatology, Department of Medicine, Geneva University Hospital (HUG), Geneva, Switzerland.
| | - Benoît Gilbert
- Division of Rheumatology, Department of Medicine, Geneva University Hospital (HUG), Geneva, Switzerland
| | - Bridget Hodkinson
- Division of Rheumatology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Sang-Cheol Bae
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Hanyang University Institute for Rheumatology and Hanyang University Institute of Bioscience and Biotechnology, Seoul, Republic of Korea
| | - Ranjeny Thomas
- The University of Queensland Diamantina Institute, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Kevin D Deane
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Kim Lauper
- Division of Rheumatology, Department of Medicine, Geneva University Hospital (HUG), Geneva, Switzerland.,Centre for Epidemiology versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
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21
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Perez-Roman RJ, Govindarajan V, Levi DJ, Luther E, Levi AD. The declining incidence of cervical spine surgery in patients with rheumatoid arthritis: a single-surgeon series and literature review. J Neurosurg Spine 2022; 37:350-356. [PMID: 35364594 DOI: 10.3171/2022.2.spine226] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 02/09/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE With an increasing number of disease-modifying drugs available to manage rheumatoid arthritis (RA), spine surgeons have anecdotally noted decreased rates of cervical spine surgical procedures in this population. Although these medications have been shown to mitigate RA progression and its systemic effects on joint destruction, there are currently no large-scale studies of RA patients that suggest the use of these disease-modifying drugs has truly coincided with a decline in cervical spine surgery. METHODS Patients with RA who underwent cervical spinal fusion from 1998 to 2021 performed by the senior author were retrospectively reviewed. The cohort was stratified into 3 categories based on procedure level: 1) occipitocervical, 2) atlantoaxial, and 3) subaxial. The number of surgical procedures per year in each subgroup was evaluated to determine treatment trends over time. National (Nationwide) Inpatient Sample (NIS) data on both RA and non-RA patients who underwent cervical fusion were analyzed to assess for surgical trends over time and for differences in likelihood of surgical intervention between RA and non-RA patients over the epoch. RESULTS From 1998 to 2021, the number of overall cervical fusions performed in RA patients significantly declined (-0.13 procedures/year, p = 0.01) in this cohort, despite an overall significant increase in cervical fusions in non-RA patients over the same period. NIS analysis of cervical fusions across all patients similarly demonstrated a significant increase in cervical fusions over the same epoch (19,278 cases/year, p < 0.0001). When normalized for changes in population size, the incidence of new surgical procedures was lower in patients with RA regardless of surgical technique. Anterior cervical fusion was the most common approach used over the epoch in both RA and non-RA patients; correspondingly, RA patients were significantly less likely to undergo anterior cervical fusion (OR 0.655, 95% CI -0.4504 to -0.3972, p < 0.0001). CONCLUSIONS At the authors' institution, there was a clear decline in the number of cervical fusions performed to treat the 3 most common forms of cervical spine pathology in RA patients (basilar impression, atlantoaxial instability, and subaxial cervical deformity). Although national trends suggest an increase in total cervical fusions in both RA and non-RA patients, the incidence of new procedures in patients with RA was significantly lower than in patients without RA, which supports the anecdotal results of spine surgeons nationally.
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22
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van Delft ETAM, Jamal M, den Braanker H, Kuijper TM, Hazes JMW, Lopes Barreto D, Weel-Koenders AEAM. A systematic review on time trend incidence of rheumatoid arthritis in outpatient rheumatology clinics. Front Med (Lausanne) 2022; 9:933884. [PMID: 36091689 PMCID: PMC9448917 DOI: 10.3389/fmed.2022.933884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/01/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives To classify patients with rheumatoid arthritis (RA) in an earlier stage of the disease, the ACR/EULAR classification criteria were updated in 2010. These criteria might have led to an increased incidence of RA in the rheumatology clinic. Since a higher incidence increases the socio-economic burden of RA, it is worthwhile to evaluate whether there is a time effect. Materials and methods A systematic review was conducted using Embase, Medline Ovid, Cochrane Central, and Web of Science from database inception to February 2021. Included were only articles that addressed incidence rates of rheumatoid arthritis from rheumatology outpatient clinics. Results Of the 6,289 publications only 243 publications on RA were found eligible for full-text review. Nine studies were included reporting incidence. The pooled incidence for RA was 11% (95% CI 6-16%) per year. Over time the incidence increased after the introduction of the 2010 ACR/EULAR classification criteria. Overall there was a high intragroup heterogeneity (I 2 = 97.93%, p < 0.001), caused by geographical area, study design and differences in case definitions. Conclusion Although the incidence seems to increase after the introduction of the 2010 ACR/EULAR criteria, no conclusions can be drawn on this time effect due to heterogeneity.
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Affiliation(s)
| | - Maha Jamal
- Department of Rheumatology, Maasstad Hospital, Rotterdam, Netherlands
| | - Hannah den Braanker
- Department of Rheumatology, Maasstad Hospital, Rotterdam, Netherlands
- Department of Rheumatology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - T. M. Kuijper
- Department of Rheumatology, Maasstad Hospital, Rotterdam, Netherlands
| | - J. M. W. Hazes
- Department of Rheumatology, Erasmus Medical Centre, Rotterdam, Netherlands
| | | | - A. E. A. M. Weel-Koenders
- Department of Rheumatology, Maasstad Hospital, Rotterdam, Netherlands
- Department of Rheumatology, Erasmus Medical Centre, Rotterdam, Netherlands
- Health Technology Assessment, Erasmus University, Rotterdam, Netherlands
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23
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Feng Z, Fu L, Wang J, Zhu Y, He X, Zhou L, Zhou X. Efficacy of tripterygium glycosides (TG) in rheumatoid arthritis as a disease-modifying anti-rheumatic drug (DMARD) in combination with conventional DMARDs: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res 2022; 184:106405. [PMID: 36028187 DOI: 10.1016/j.phrs.2022.106405] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To explore efficacy and safety, as well as efficacy mechanisms, main efficacy characteristics, and efficacy influencing factors of TG, in combination with one conventional DMARD, to provide guidance for the clinical application of TG in treating RA. METHODS We searched the databases of PubMed, Embase, Web of Science, Cochrane Library, Ovid, Scopus, Clinicaltrials.gov, CNKI, Wanfang, SinoMed, VIP, Chinese Clinical Trial Registry, KTKP, and J-STAGE to August 12, 2022. All included studies were analyzed with Stata 16.0 software and Review Manager 5.4 software according to the PRISMA Statement. RESULTS Thirty-eight randomized controlled trials (RCTs) were included. Combined TG was superior in 28-joint count Disease Activity Score (DAS28) and American College of Rheumatology 50 response (ACR50) and did not increase adverse events (AEs). Combined TG significantly suppressed interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). And combined TG showed significant advantages in improving tender joint count (TJC), swollen joint count (SJC), pain score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and physician's and patient's global assessments of disease activity. However, the average age of the intervention population, treatment course, the combined DMARDs category, and the risk of bias were important factors influencing the above effects. CONCLUSIONS The combination of TG is superior to conventional DMARD monotherapy in improving RA conditions with a good safety profile. This effect is closely related to the mechanism of TG reducing IL-1, IL-6 and TNF-α. And the combination of TG shows better effect in all aspects such as improving joint signs, symptoms, inflammatory indicators, and overall health. But for those under 45 years of age, with short-term intermittent dosing, in combination with MTX may be more beneficial for TG to show better efficacy.
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Affiliation(s)
- Zhe Feng
- The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Ling Fu
- Department of Diabetes and Cancer Metabolism, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Junqin Wang
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Yamei Zhu
- Department of Rheumatology, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210001, China
| | - Xiaojin He
- The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Lingling Zhou
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Xueping Zhou
- The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210023, China
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24
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Qin Y, Wang Y, Meng F, Feng M, Zhao X, Gao C, Luo J. Identification of biomarkers by machine learning classifiers to assist diagnose rheumatoid arthritis-associated interstitial lung disease. Arthritis Res Ther 2022; 24:115. [PMID: 35590341 PMCID: PMC9118651 DOI: 10.1186/s13075-022-02800-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/06/2022] [Indexed: 12/14/2022] Open
Abstract
Background This study aimed to search for blood biomarkers among the profiles of patients with RA-ILD by using machine learning classifiers and probe correlations between the markers and the characteristics of RA-ILD. Methods A total of 153 RA patients were enrolled, including 75 RA-ILD and 78 RA-non-ILD. Routine laboratory data, the levels of tumor markers and autoantibodies, and clinical manifestations were recorded. Univariate analysis, least absolute shrinkage and selection operator (LASSO), random forest (RF), and partial least square (PLS) were performed, and the receiver operating characteristic (ROC) curves were plotted. Results Univariate analysis showed that, compared to RA-non-ILD, patients with RA-ILD were older (p < 0.001), had higher white blood cell (p = 0.003) and neutrophil counts (p = 0.017), had higher erythrocyte sedimentation rate (p = 0.003) and C-reactive protein (p = 0.003), had higher levels of KL-6 (p < 0.001), D-dimer (p < 0.001), fibrinogen (p < 0.001), fibrinogen degradation products (p < 0.001), lactate dehydrogenase (p < 0.001), hydroxybutyrate dehydrogenase (p < 0.001), carbohydrate antigen (CA) 19–9 (p < 0.001), carcinoembryonic antigen (p = 0.001), and CA242 (p < 0.001), but a significantly lower albumin level (p = 0.003). The areas under the curves (AUCs) of the LASSO, RF, and PLS models attained 0.95 in terms of differentiating patients with RA-ILD from those without. When data from the univariate analysis and the top 10 indicators of the three machine learning models were combined, the most discriminatory markers were age and the KL-6, D-dimer, and CA19-9, with AUCs of 0.814 [95% confidence interval (CI) 0.731–0.880], 0.749 (95% CI 0.660–0.824), 0.749 (95% CI 0.660–0.824), and 0.727 (95% CI 0.637–0.805), respectively. When all four markers were combined, the AUC reached 0.928 (95% CI 0.865–0.968). Notably, neither the KL-6 nor the CA19-9 level correlated with disease activity in RA-ILD group. Conclusions The levels of KL-6, D-dimer, and tumor markers greatly aided RA-ILD identification. Machine learning algorithms combined with traditional biostatistical analysis can diagnose patients with RA-ILD and identify biomarkers potentially associated with the disease. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-022-02800-2.
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Affiliation(s)
- Yan Qin
- Department of Rheumatology, Second Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Yanlin Wang
- Department of Rheumatology, Second Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Fanxing Meng
- The Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Min Feng
- Department of Rheumatology, Second Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Xiangcong Zhao
- Department of Rheumatology, Second Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Chong Gao
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jing Luo
- Department of Rheumatology, Second Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China.
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25
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Larid G, Vix J, Garlantezec R, Loppin E, Gervais E. Increased remission with fewer corticosteroids and more biologics in rheumatoid arthritis at 7-year follow-up in real-life conditions. Sci Rep 2022; 12:2563. [PMID: 35169251 PMCID: PMC8847581 DOI: 10.1038/s41598-022-06584-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/12/2022] [Indexed: 11/09/2022] Open
Abstract
Remission in rheumatoid arthritis (RA) is an important therapeutic target that is not easy to achieve in real-life conditions. Some prognostic factors have been identified but the literature is variable. The objectives of this study were to evaluate the remission rate and the maintenance of remission in patients with RA over 7 years of follow-up in real-life conditions and to identify prognostic factors of long-term remission. Patients with RA seen at the Poitiers University Hospital were identified and clinical and biological data were collected. Data were analysed after 1 year and 7 years. Twice as many patients were in remission at 7 years than at 1 year of follow-up. 48.6% of patients who were not in remission at 1 year obtained remission at 7 years of follow-up. Patients achieving remission were more often receiving coprescription of csDMARDs and bDMARDs. Patients not in remission at 7 years were given more corticosteroids at higher doses. After 7 years of follow-up, low initial disease activity and use of csDMARDs and bDMARDs appeared to be independent positive predictive factors. Once obtained at one year, remission was maintained for 76% of our patients. As a conclusion, modern management of RA, whatever disease duration, leads to remission rates similar to those of early RA after 7 years of follow-up.
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Affiliation(s)
- Guillaume Larid
- Rheumatology Department, University Hospital of Poitiers, CHU de Poitiers, 2 Rue de la Milétrie, 86021, Poitiers, France.,LITEC Laboratory, EA 4331, Poitiers University, Poitiers, France
| | - Justine Vix
- Rheumatology Department, University Hospital of Poitiers, CHU de Poitiers, 2 Rue de la Milétrie, 86021, Poitiers, France
| | | | - Elodie Loppin
- Rheumatology Department, University Hospital of Poitiers, CHU de Poitiers, 2 Rue de la Milétrie, 86021, Poitiers, France
| | - Elisabeth Gervais
- Rheumatology Department, University Hospital of Poitiers, CHU de Poitiers, 2 Rue de la Milétrie, 86021, Poitiers, France. .,LITEC Laboratory, EA 4331, Poitiers University, Poitiers, France.
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26
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Li Y, Yang C, Jia K, Wang J, Wang J, Ming R, Xu T, Su X, Jing Y, Miao Y, Liu C, Lin N. Fengshi Qutong capsule ameliorates bone destruction of experimental rheumatoid arthritis by inhibiting osteoclastogenesis. JOURNAL OF ETHNOPHARMACOLOGY 2022; 282:114602. [PMID: 34492323 DOI: 10.1016/j.jep.2021.114602] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 05/28/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Bone destruction plays a key role in damaging the joint function of rheumatoid arthritis (RA). Fengshi Qutong capsule (FSQTC) consisting of 19 traditional Chinese medicines has been used for treating RA in China for many years. Preliminary studies show that FSQTC has analgesic activity and inhibits synovial angiogenesis of collagen-induced arthritis (CIA), but its role on bone destruction of RA is still unclear. AIM OF THE STUDY To explore the effect of FSQTC on bone destruction of RA and the possible mechanism of osteoclastogenesis in vivo and in vitro. MATERIALS AND METHODS LC-MS system was used to detect the quality control components of FSQTC. The anti-arthritic effect of FSQTC on CIA rats was evaluated by arthritis score, arthritis incidence and histopathology evaluation of inflamed joints. The effect of treatment with FSQTC on bone destruction of joint tissues was determined with X-ray and micro-CT quantification, and on bone resorption marker CTX-I and formation marker osteocalcin in sera were detected by ELISA. Then, osteoclast differentiation and mature were evaluated by TRAP staining, actin ring immunofluorescence and bone resorption assay both in joints and RANKL-induced RAW264.7 cells. In addition, RANKL, OPG, IL-1β and TNFα in sera were evaluated by ELISA. The molecular mechanisms of the inhibitions were elucidated by analyzing the protein and gene expression of osteoclastic markers CTSK, MMP-9 and β3-Integrin, transcriptional factors c-Fos and NFATc1, as well as phosphorylation of ERK1/2, JNK and P38 in joints and in RANKL-induced RAW264.7 cells using western blot and/or qPCR. RESULTS In this study, 12 major quality control components were identified. Our data showed that FSQTC significantly increased bone mineral density, volume fraction, trabecular thickness, and decreased trabecular separation of inflamed joints both at periarticular and extra-articular locations in CIA rats. FSQTC also diminished the level of CTX-I and simultaneously increased osteocalcin in sera of CIA rats. The effects were accompanied by reductions of osteoclast differentiation, bone resorption, and expression of osteoclastic markers (CTSK, MMP-9 and β3-Integrin) in joints. Interestingly, FSQTC treatment could reduce the protein level of RANKL, increase the expression of OPG, and decrease the ratio of RANKL to OPG in inflamed joints and sera of CIA rats. In addition, FSQTC inhibited the levels of pro-inflammatory cytokines implicated in bone resorption, such as IL-1β and TNFα in sera. When RAW264.7 cells were treated with RANKL, FSQTC inhibited the formation of TRAP + multinucleated cells, actin ring and the bone-resorbing activity in dose-dependent manners. Furthermore, FSQTC reduced the RANKL-induced expression of osteoclastic genes and proteins and transcriptional factors (c-Fos and NFATc1), as well as phosphorylation of mitogen-activated protein kinases (MAPKs). CONCLUSION FSQTC may inhibit bone destruction of RA by its anti-osteoclastogenic activity both in vivo and in vitro.
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Affiliation(s)
- Yiqun Li
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Chao Yang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Kexin Jia
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Jinxia Wang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Jingxia Wang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Ruirui Ming
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Tengteng Xu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Xiaohui Su
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Yu Jing
- Tonghua Golden-Horse Pharmaceutical Industry Co.,Ltd, Beijing, 100028, China
| | - Yandong Miao
- Tonghua Golden-Horse Pharmaceutical Industry Co.,Ltd, Beijing, 100028, China
| | - Chunfang Liu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Na Lin
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
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27
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Rheumatoid arthritis and spondyloarthritis prevalence in four European countries - a comparative study. SRP ARK CELOK LEK 2022. [DOI: 10.2298/sarh210530063z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction/Objective. The objective was to compare rheumatoid arthritis (RA), spondyloarthritis (SpA) and subtypes of SpA prevalence in four European countries. Methods. A 33-items detection questionnaire, containing self-reported diagnosis, classification criteria for RA and SpA, personal and family history, was translated using cross-cultural adaptation and validated in France, Turkey, Lithuania and Serbia, where it was used on a population sample. Suspected cases were evaluated and confirmed by a rheumatologist. Prevalence estimates were age- and sex-standardized to European standard population. Results. In total, 33,454 people older than 18 years were screened and 31,454 interviewed: France 14,671, Lithuania 6,558, Serbia 6,213, Turkey 4,012. Standardized RA prevalence varied from 0.29% (95% CI: 0.17?0.40) in France to 0.57% (0.31?0.84) in Turkey; this inequality was mostly caused by differences in women prevalence (from 0.42% in France to 1.02% in Turkey) SpA prevalence was similar in France (0.30%), Serbia (0.35%) and Turkey (0.37%), but in Lithuania it was 0.89%, which could be caused by geographic and genetic differences, as SpA prevalence was higher in North and East Europe, as well as the human leukocyte antigen B27 presence. SpA prevalence was equally presented by gender for France and Serbia. Regarding SpA subtypes, ankylosing spondylitis prevalence varied from 0.07?0.30% (Serbia?Lithuania), PsA 0.10?0.26% (France?Lithuania), reactive arthritis was 0.09?0.18% (Serbia?Lithuania). Previously nondiagnosed SpA cases were found in 6.9% in France, 25.9% in Lithuania and 31.2% in Serbia. Conclusion. East?West decreasing tendency for the female RA prevalence was noted. SpA was higher in North-Eastern Europe than in its Western and Southern part. One quarter of the SpA patients in Lithuania and one third in Serbia were not previously diagnosed. The SpA population prevalence was higher than expected and similar to RA.
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28
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Raunsbæk Knudsen L, Lomborg K, Ndosi M, Hauge EM, de Thurah A. The effectiveness of e-learning in patient education delivered to patients with rheumatoid arthritis: The WebRA study-protocol for a pragmatic randomised controlled trial. BMC Rheumatol 2021; 5:57. [PMID: 34924034 PMCID: PMC8686289 DOI: 10.1186/s41927-021-00226-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 08/24/2021] [Indexed: 12/31/2022] Open
Abstract
Background Patient education is integral to the treatment and care of patients with rheumatoid arthritis. Change is taking place in the organisation of healthcare systems because of a demographic shift towards ageing populations, an increasing use of technology and advancements in digital technologies, allowing for new interventions. This study will aim to evaluate the effectiveness of a newly developed e-learning patient education programme based on self-management that targets patients with rheumatoid arthritis.
Methods A pragmatic multi-centre randomised controlled trial is planned. We intend to recruit approximately 200 patients with a new diagnosis (< 3 months) of rheumatoid arthritis. Participants will be randomised 1:1 to web-based patient education delivered through an e-learning programme at home or standard face-to-face patient education provided at the hospital. The primary outcome is self-efficacy. Secondary outcomes are improved knowledge of rheumatoid arthritis, adherence to medication, health literacy level and quality of life. Outcomes will be measured at baseline and follow-up occurring 1, 3, 6 and 12 months after enrolment. Furthermore, data on healthcare utilisation and utilisation of the e-learning programme will be assessed at the 12-month follow-up. Statistical analysis, including differences between groups, will be evaluated using the chi-square and Kruskal–Wallis tests. Statistical analysis will follow the intention-to-treat principle, and analysis of variance will be used to evaluate the within- and between-groups differences testing the hypothesis of the ‘superiority’ of web-based patient education over standard face-to-face education provided at the hospital. Per protocol analysis will be used to assess the impact of missing data. Enrolment started in February 2021 and will end in June 2022. Discussion The study is expected to contribute to the evidence on the effectiveness of web-based patient education within rheumatic diseases. If the e-learning programme is effective, it will be incorporated into existing services to improve the self-management of patients with rheumatoid arthritis. Further, this mode of providing patient education may impact the organisation of health care for both rheumatic diseases and other chronic diseases by offering different modes of delivering patient education based on the needs and preferences of patients. Trial registration: ClinicalTrials.gov identifier NCT04669340. Registered on November 27, 2020. https://www.clinicaltrials.gov/ct2/show/NCT04669340?term=e-learning&cond=Rheumatoid+Arthritis&draw=2&rank=1. See Additional file 1 for detailed information on the dataset according to the World Health Organization Trial Registration Data Set. Supplementary Information The online version contains supplementary material available at 10.1186/s41927-021-00226-y.
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Affiliation(s)
- Line Raunsbæk Knudsen
- Department of Rheumatology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus, Denmark. .,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Kirsten Lomborg
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mwidimi Ndosi
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK.,University Hospitals Bristol, Bristol, England
| | - Ellen-Margrethe Hauge
- Department of Rheumatology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Annette de Thurah
- Department of Rheumatology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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29
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Soussi BG, Cordtz RL, Kristensen S, Bork CS, Christensen JH, Schmidt EB, Torp-Pedersen C, Prieto-Alhambra D, Dreyer L. Incidence and prevalence of rheumatoid arthritis in Denmark from 1998 to 2018: a nationwide register-based study. Scand J Rheumatol 2021; 51:481-489. [PMID: 34913402 DOI: 10.1080/03009742.2021.1957557] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: To investigate the incidence and prevalence of rheumatoid arthritis (RA) in the adult Danish population.Method: In this nationwide register-based cohort study, patients with incident RA between 1998 and the end of 2018 were identified using Danish administrative registries. The age- and sex-standardized incidence rate (IR), incidence proportion (IP), lifetime risk (LR), and point prevalence (PP) of RA were calculated. RA was defined as a first-time RA diagnosis registered in the Danish National Patient Registry combined with a redeemed prescription of a conventional synthetic disease-modifying anti-rheumatic drug in the following year. In addition, three different case definitions of RA were explored.Results: The overall age- and sex-standardized IR of RA from 1998 to 2018 was 35.5 [95% confidence interval (CI) 35.1-35.9] per 100 000 person-years while the IP was 35.2 (95% CI 34.8-35.5) per 100 000 individuals. The IR was two-fold higher for women than for men. The LR of RA ranged from 2.3% to 3.4% for women and from 1.1% to 1.5% for men, depending on the RA case definition used. The overall PP of RA was 0.6% (95% CI 0.5-0.6%) in 2018: 0.8% (95% CI 0.7-0.8%) for women and 0.3% (95% CI 0.3-0.4%) for men. The prevalence increased about 1.5-fold from 2000 to 2018.Conclusion: The IR and PP were approximately two-fold higher for women than for men. The prevalence of RA in Denmark increased significantly from 2000 to 2018. The RA case definition had more impact on the results than the choice of denominator.
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Affiliation(s)
- B G Soussi
- Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark
| | - R L Cordtz
- Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark
| | - S Kristensen
- Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - C S Bork
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - J H Christensen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Nephrology, Aalborg University Hospital, Aalborg, Denmark
| | - E B Schmidt
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - C Torp-Pedersen
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.,Department of Cardiology, Nordsjælland Hospital, Hillerød, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - D Prieto-Alhambra
- Musculoskeletal Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - L Dreyer
- Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Kim SY, Yoo DM, Kim JH, Kwon MJ, Kim JH, Choi HG. Association between Rheumatoid Arthritis and Meniere's Disease: A Longitudinal Follow-Up Study Using a National Health Screening Cohort. J Clin Med 2021; 10:jcm10235694. [PMID: 34884398 PMCID: PMC8658098 DOI: 10.3390/jcm10235694] [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: 11/03/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 11/23/2022] Open
Abstract
This study aimed to evaluate the impact of pre-existing rheumatoid arthritis (RA) on the occurrence of Meniere’s disease (MD). The 2002–2015 Korean National Health Insurance Service—Health Screening Cohort data were retrospectively analyzed. A total of 3038 participants with RA were matched with 12,152 control participants for demographic factors. The occurrence of MD was evaluated in both the RA and control groups. The hazard ratios (HRs) of RA for participants with MD were calculated using a stratified Cox proportional hazard model. Additionally, subgroup analyses were conducted. The rate of MD was not different between the RA and control groups (1.5% vs. 1.3%, standardized difference = 0.01). The HR was not higher in the RA group than in the MD group (adjusted HR = 1.03, 95% confidence interval = 0.73–1.44, p = 0.885). A higher HR of RA for participants with MD was found in the ≥60-year-old subgroup in the crude model but not in the adjusted model. An association between RA and MD was not found in any of the other subgroups. A previous history of RA was not related to an increased risk of MD.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea;
| | - Dae Myoung Yoo
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Korea;
| | - Ji Hee Kim
- Department of Neurosurgery, Hallym University College of Medicine, Anyang 14068, Korea;
| | - Mi Jung Kwon
- Department of Pathology, Hallym University College of Medicine, Anyang 14068, Korea;
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University College of Medicine, Anyang 14068, Korea;
| | - Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Korea;
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang 14068, Korea
- Correspondence:
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Hulander E, Bärebring L, Turesson Wadell A, Gjertsson I, Calder PC, Winkvist A, Lindqvist HM. Proposed Anti-Inflammatory Diet Reduces Inflammation in Compliant, Weight-Stable Patients with Rheumatoid Arthritis in a Randomized Controlled Crossover Trial. J Nutr 2021; 151:3856-3864. [PMID: 34587253 PMCID: PMC8643575 DOI: 10.1093/jn/nxab313] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 08/17/2021] [Accepted: 08/26/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND It is unclear to what extent adjuvant dietary intervention can influence inflammation in rheumatoid arthritis (RA). OBJECTIVES The objective was to assess the effects of dietary manipulation on inflammation in patients with RA. METHODS In a crossover design, participants [n = 50, 78% females, median BMI (in kg/m2) 27, median age 63 y] were randomly assigned to begin with either a 10-wk portfolio diet of proposed anti-inflammatory foods (i.e., a high intake of fatty fish, whole grains, fruits, nuts, and berries) or a control diet resembling a Western diet with a 4-mo washout in between. This report evaluates the secondary outcome markers of inflammation among participants with stable medication. Analyses were performed using a linear mixed ANCOVA model. RESULTS There were no significant effects on CRP or ESR in the group as a whole. In those with high compliance (n = 29), changes in ESR within the intervention diet period differed significantly compared with changes within the control diet period (mean: -5.490; 95% CI: -10.310, -0.669; P = 0.027). During the intervention diet period, there were lowered serum concentrations of C-X-C motif ligand 1 (CXCL1) (mean: -0.268; 95% CI: -0.452, -0.084;P = 0.006), CXCL5 (mean: -0.278; 95% CI: -0.530, -0.026 P = 0.031), CXCL6 (mean: -0.251; 95% CI: -0.433, -0.069; P = 0.009), and tumor necrosis factor ligand superfamily member 14 (TNFSF14) (mean: -0.139; 95% CI: -0.275, -0.002; P = 0.047) compared with changes within the control diet period. CONCLUSION A proposed anti-inflammatory diet likely reduced systemic inflammation, as indicated by a decreased ESR in those who completed the study with high compliance (n = 29). These findings warrant further studies to validate our results, and to evaluate the clinical relevance of changes in CXCL1, CXCL5, CXCL6, and TNFSF14 in patients with RA.
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Affiliation(s)
- Erik Hulander
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Turesson Wadell
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Inger Gjertsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Philip C Calder
- Faculty of Medicine, University of Southampton and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helen M Lindqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Jones A, Rapisardo S, Zhang L, Mellors T, Withers JB, Gatalica Z, Akmaev VR. Analytical and clinical validation of an RNA sequencing-based assay for quantitative, accurate evaluation of a molecular signature response classifier in rheumatoid arthritis. Expert Rev Mol Diagn 2021; 21:1235-1243. [PMID: 34727834 DOI: 10.1080/14737159.2021.2000394] [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] [Indexed: 01/23/2023]
Abstract
OBJECTIVES This study reports analytical and clinical validation of a molecular signature response classifier (MSRC) that identifies rheumatoid arthritis (RA) patients who are non-responders to tumor necrosis factor-ɑ inhibitors (TNFi). METHODS The MSRC integrates patient-specific data from 19 gene expression features, anti-cyclic citrullinated protein serostatus, sex, body mass index, and patient global assessment into a single score. RESULTS The MSRC results stratified samples (N = 174) according to non-response prediction with a positive predictive value of 87.7% (95% CI: 78-94%), sensitivity of 60.2% (95% CI: 50-69%), and specificity of 77.3% (95% CI: 65-87%). The 25-point scale was subdivided into three thresholds: signal not detected (<10.6), high (≥10.6), and very high (≥18.5). The MSRC relies on sequencing of RNA extracted from blood; this assay displays high gene expression concordance between inter- and intra-assay sample (R2 > 0.977) and minimal variation in cumulative gene assignment diversity, read mapping location, or gene-body coverage. The MSRC accuracy was 95.8% (46/48) for threshold concordance (no signal, high, very high). Intra- and inter-assay precision studies demonstrated high repeatability (92.6%, 25/27) and reproducibility (100%, 35/35). CONCLUSION The MSRC is a robust assay that accurately and reproducibly detects an RA patient's molecular signature of non-response to TNFi therapies.
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Affiliation(s)
- Alex Jones
- Data Science, Scipher Medicine Corporation, Waltham, MA, USA
| | - Sarah Rapisardo
- Laboratory Operations, Scipher Medicine Corporation, Waltham, MA, USA
| | - Lixia Zhang
- Data Science, Scipher Medicine Corporation, Waltham, MA, USA
| | | | | | - Zoran Gatalica
- Laboratory Operations, Scipher Medicine Corporation, Waltham, MA, USA
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Contribution of Dysregulated DNA Methylation to Autoimmunity. Int J Mol Sci 2021; 22:ijms222111892. [PMID: 34769338 PMCID: PMC8584328 DOI: 10.3390/ijms222111892] [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: 10/01/2021] [Revised: 10/22/2021] [Accepted: 10/29/2021] [Indexed: 12/24/2022] Open
Abstract
Epigenetic mechanisms, such as DNA methylation, histone modifications, and non-coding RNAs are known regulators of gene expression and genomic stability in cell growth, development, and differentiation. Because epigenetic mechanisms can regulate several immune system elements, epigenetic alterations have been found in several autoimmune diseases. The purpose of this review is to discuss the epigenetic modifications, mainly DNA methylation, involved in autoimmune diseases in which T cells play a significant role. For example, Rheumatoid Arthritis and Systemic Lupus Erythematosus display differential gene methylation, mostly hypomethylated 5′-C-phosphate-G-3′ (CpG) sites that may associate with disease activity. However, a clear association between DNA methylation, gene expression, and disease pathogenesis must be demonstrated. A better understanding of the impact of epigenetic modifications on the onset of autoimmunity will contribute to the design of novel therapeutic approaches for these diseases.
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Issilbayeva A, Kushugulova A, Meiramova A, Kozhakhmetov S, Akhmetova Z, Nurgaziyev M, Chulenbayeva L, Babenko D, Kunz J, Ainabekova B. Epidemiological Trends of Rheumatoid Arthritis and PADI4, PTPN22, and HLA-DRB9 Genes Distribution in the Kazakhstan Population. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The prevalence of rheumatoid arthritis (RA) is 1% in the global population. The lack of epidemiological studies in developing countries makes it difficult to obtain a complete global epidemiological picture of RA. RA develops due to the interaction of multiple genetic and environmental factors, though the contribution of these factors to the various disease occurrence seen in different populations is unclear.
AIM: The aim of our study was to analyze the dynamics of the general prevalence and incidence of RA among the population of Kazakhstan in 2017–2019 as well as to investigate the three most common single-nucleotide polymorphisms (SNP) of RA in the Kazakhstan population.
METHODS: The analysis of statistical data on Form 12 “On the health of the people and the health care system” was carried out. Prevalence and incidence rates were calculated according to generally accepted rules. Demographic data for the Republic of Kazakhstan were obtained from the official website stat.gov.kz. Our study included 70 RA patients and 113 control subjects. Blood samples were collected and genotyped for peptidylarginine deiminase 4 (PADI4), protein tyrosine phosphatase 22, and human leukocyte antigen (HLA)-DRB9 SNPs by reverse transcription polymerase chain reaction.
RESULTS: The prevalence of RA in Kazakhstan in 2017–2019 was 0.36–0.38%, with an incidence rate of 0.085–0.087%, which can be comparable to data of other countries in Central Asia. The allele and genotypes frequency analyses were carried out between patients and controls. The HLA-DRB9 showed significant association of the G allele odds ratio (OR) 1.96 (95% confidence interval [CI]: 1.252–3.081), p= 0.0025 and G/G genotype OR = 3.67 (95% CI: 1.58–8.54), p = 0.00162 with RA in our sample. Strong association between anti-citrullinated protein antibody (ACPA) profile and PADI4 (OR 12.19 [95% CI: 2.19–67.94], p = 0.00115) was found.
CONCLUSION: There was an increase in RA prevalence with age among females and a higher crude prevalence and incidence of RA in the southern regions of Kazakhstan. HLA-DRB9 prevailed in Kazakhstani patients with RA, PADI4 showed association with ACPA-positive RA. Further studies on larger samples are required to confirm our obtained results.
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35
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Zhou C, Gao S, Yuan X, Shu Z, Li S, Sun X, Xiao J, Liu H. Association between CTLA-4 gene polymorphism and risk of rheumatoid arthritis: a meta-analysis. Aging (Albany NY) 2021; 13:19397-19414. [PMID: 34339393 PMCID: PMC8386564 DOI: 10.18632/aging.203349] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/19/2021] [Indexed: 01/11/2023]
Abstract
Cytotoxic T lymphocyte-associated protein 4 (CTLA-4) gene polymorphisms may be involved in the risk of Rheumatoid arthritis (RA). However, evidence for the association remains controversial. Therefore, we performed a meta-analysis to confirm the relationship between CTLA-4 gene polymorphisms and RA. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the strength of association. Stratified analysis was conducted by ethnicity. In total, 66 case-control studies including 21681 cases and 23457 controls were obtained. For rs3087243 polymorphism, significant association was detected in Asians (A vs. G: OR=0.77, 95%CI=0.65-0.90, P=0.001; AA vs. GG: OR=0.67, 95%CI=0.48-0.94, P=0.02) and Caucasians (A vs. G: OR=0.89, 95%CI=0.86-0.93, P<0.00001; AA vs. GG: OR=0.81, 95%CI=0.75-0.88, P<0.00001). For rs231775 polymorphism, significant association was observed in the overall (G vs. A: OR =1.16, 95%CI=1.08-1.25, P<0.0001; GG vs. AA: OR=1.29, 95%CI=1.12-1.50, P=0.0006), and in Asians (G vs. A: OR=1.27, 95%CI=1.10-1.47, P=0.001; GG vs. AA: OR=1.58, 95%CI=1.24-2.01, P=0.0002), but not in Caucasians. However, there was no association between rs5742909 polymorphism and RA. This meta-analysis confirmed that rs3087243 and rs231775 polymorphism were associated with the risk of RA in both overall population and ethnic-specific analysis, but there was no association between rs5742909 polymorphism and RA risk.
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Affiliation(s)
- Chuankun Zhou
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Shutao Gao
- Department of Spine Surgery, The First Affiliate Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang, China
| | - Xi Yuan
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Zixing Shu
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Song Li
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Xuying Sun
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Jun Xiao
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Hui Liu
- Department of Orthopedics Trauma and Microsurgery, Zhongnan Hospital, Wuhan University, Wuhan 430000, Hubei, China
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Wu R, Long L, Zhou Q, Su J, Su W, Zhu J. Identification of hub genes in rheumatoid arthritis through an integrated bioinformatics approach. J Orthop Surg Res 2021; 16:458. [PMID: 34271942 PMCID: PMC8283956 DOI: 10.1186/s13018-021-02583-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 06/27/2021] [Indexed: 12/22/2022] Open
Abstract
Background Rheumatoid arthritis (RA) is a common chronic autoimmune disease characterized by inflammation of the synovial membrane. However, the etiology and underlying molecular events of RA are unclear. Here, we applied bioinformatics analysis to identify the key genes involved in RA. Methods GSE77298 was downloaded from the Gene Expression Omnibus (GEO) database. We used the R software screen the differentially expressed genes (DEGs). Gene ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes pathway were analyzed by using the DAVID online tool. The STRING database was used to analyze the interaction of differentially encoded proteins. PPI interaction network was divided into subnetworks using MCODE algorithm and was analyzed using Cytoscape. Gene set enrichment analysis (GSEA) was performed to identify relevant biological functions. qRT-PCR analysis was also performed to verify the expression of identified hub DEGs. Results A total of 4062 differentially expressed genes were selected, including 1847 upregulated genes and 2215 downregulated genes. In the biological process, DEGs were mainly concentrated in the fields of muscle filament sliding, muscle contraction, intracellular signal transduction, cardiac muscle contraction, signal transduction, and skeletal muscle tissue development. In the cellular components, DEGs were mainly concentrated in the parts of cytosol, Z disk, membrane, extracellular exosome, mitochondrion, and M band. In molecular functions, DEGs were mainly concentrated in protein binding, structural constituent of muscle, actin binding, and actin filament binding. KEGG pathway analysis shows that DEGs mainly focuses on pathways about lysosome, Wnt/β-catenin signaling pathway, and NF-κB signaling pathway. CXCR3, GNB4, and CXCL16 were identified as the core genes that involved in the progression of RA. By qRT-PCR analysis, we found that CXCR3, GNB4, and CXCL16 were significantly upregulated in RA tissue as compared to healthy controls. Conclusion In conclusion, DEGs and hub genes identified in the present study help us understand the molecular mechanisms underlying the progression of RA, and provide candidate targets for diagnosis and treatment of RA.
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Affiliation(s)
- Rui Wu
- Department of Rheumatology and Immunology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West of First Ring Road, Chengdu, Sichuan, 610072, P.R. China.,Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China
| | - Li Long
- Department of Rheumatology and Immunology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West of First Ring Road, Chengdu, Sichuan, 610072, P.R. China.,Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China
| | - Qiao Zhou
- Department of Rheumatology and Immunology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West of First Ring Road, Chengdu, Sichuan, 610072, P.R. China.,Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China
| | - Jiang Su
- Department of Rheumatology and Immunology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West of First Ring Road, Chengdu, Sichuan, 610072, P.R. China.,Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China
| | - Wei Su
- Department of Rheumatology and Immunology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West of First Ring Road, Chengdu, Sichuan, 610072, P.R. China.,Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China
| | - Jing Zhu
- Department of Rheumatology and Immunology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32 West of First Ring Road, Chengdu, Sichuan, 610072, P.R. China. .,Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China.
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Postlethwaite AE, Tuckey RC, Kim TK, Li W, Bhattacharya SK, Myers LK, Brand DD, Slominski AT. 20 S-Hydroxyvitamin D3, a Secosteroid Produced in Humans, Is Anti-Inflammatory and Inhibits Murine Autoimmune Arthritis. Front Immunol 2021; 12:678487. [PMID: 34276665 PMCID: PMC8278399 DOI: 10.3389/fimmu.2021.678487] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/15/2021] [Indexed: 12/12/2022] Open
Abstract
The ability to use large doses of vitamin D3 (D3) to chronically treat autoimmune diseases such as rheumatoid arthritis (RA) is prohibitive due to its calcemic effect which can damage vital organs. Cytochrome P450scc (CYP11A1) is able to convert D3 into the noncalcemic analog 20S-hydroxyvitamin D3 [20S(OH)D3]. We demonstrate that 20S(OH)D3 markedly suppresses clinical signs of arthritis and joint damage in a mouse model of RA. Furthermore, treatment with 20S(OH)D3 reduces lymphocyte subsets such as CD4+ T cells and CD19+ B cells leading to a significant reduction in inflammatory cytokines. The ratio of T reg cells (CD4+CD25+Foxp3+ T cells) to CD3+CD4+ T cells is increased while there is a decrease in critical complement-fixing anti-CII antibodies. Since pro-inflammatory cytokines and antibodies against type II collagen ordinarily lead to destruction of cartilage and bone, their decline explains why arthritis is attenuated by 20(OH) D3. These results provide a basis for further consideration of 20S(OH)D3 as a potential treatment for RA and other autoimmune disorders.
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Affiliation(s)
- Arnold E. Postlethwaite
- Research Service, Department of Veterans Affairs Medical Center, Memphis, TN, United States
- Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Robert C. Tuckey
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Tae-Kang Kim
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Wei Li
- Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Syamal K. Bhattacharya
- Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Linda K. Myers
- Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - David D. Brand
- Research Service, Department of Veterans Affairs Medical Center, Memphis, TN, United States
- Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Andrzej T. Slominski
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, United States
- Research Service, Department of Veterans Affairs Medical Center, Birmingham, AL, United States
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Lima SC, Gomes da Silva IIF, Nascimento DDQ, de Moura RR, Mesquita MDS, Asano NMJ, Fernandes GV, Valente LM, Rushansky E, Mariano MHQDA, Xavier RM, Chies JAB, Crovella S, Sandrin-Garcia P. CIITA gene polymorphism (rs3087456) in systemic lupus erythematosus and rheumatoid arthritis: A population-based cohort study. Int J Immunogenet 2021; 48:429-434. [PMID: 34180145 DOI: 10.1111/iji.12548] [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: 10/14/2020] [Revised: 05/30/2021] [Accepted: 06/06/2021] [Indexed: 11/30/2022]
Abstract
Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are influenced by genetic variants in immune system HLA genes. The Class II Major Histocompatibility Complex Transactivator (CIITA) is an important co-activator of the HLA transcriptional complex; the single nucleotide variant (SNV) rs3087456 localized in the gene promoter region (-168 A/G) has been reported as able to modify its transcription level. In our study, we assessed CIITA rs3087456 SNV in 1,044 Brazilians from two Brazilian regions (Northeast and South) to verify the association with susceptibility and clinical manifestations of (SLE) and (RA) using TaqMan SNP Genotyping Assays System. We observed a protection for a recessive model (GG x AA+AG) for RA susceptibility and increased risk for erosion development in AG genotype patients. No significant association was observed for SLE susceptibility; however, we observed significant increased risk for Class IV and V nephritis development in G allele and GG genotype patients. In conclusion, we showed the contribution of CIITA rs3087456 to SLE or RA clinical features and RA susceptibility in the studied populations.
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Affiliation(s)
| | | | - Denise de Queiroga Nascimento
- Laboratory of Immunopathology Keizo Asami, Recife, Brazil.,PostGraduate Program in Genetics, Federal University of Pernambuco, Recife, Brazil
| | | | | | | | | | - Lucila Maria Valente
- Division of Nephrology, Clinical Hospital, Federal University of Pernambuco, Recife, Brazil
| | - Eliezer Rushansky
- Division of Clinical Rheumatology, University of Pernambuco, Recife, Brazil
| | | | - Ricardo Machado Xavier
- Rheumatology Sector, Clinical Hospital, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - José Artur Bogo Chies
- Department of Genetics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Sergio Crovella
- Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha, State of Qatar
| | - Paula Sandrin-Garcia
- Laboratory of Immunopathology Keizo Asami, Recife, Brazil.,Department of Genetics, Federal University of Pernambuco, Recife, Brazil
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Marrie RA, Walld R, Bolton JM, Sareen J, Patten SB, Singer A, Lix LM, Hitchon CA, Marriott JJ, El-Gabalawy R, Katz A, Fisk JD, Bernstein CN. Uptake of influenza vaccination among persons with inflammatory bowel disease, multiple sclerosis or rheumatoid arthritis: a population-based matched cohort study. CMAJ Open 2021; 9:E510-E521. [PMID: 33990365 PMCID: PMC8157981 DOI: 10.9778/cmajo.20200105] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Individuals with immune-mediated inflammatory diseases, such as inflammatory bowel disease, multiple sclerosis and rheumatoid arthritis, are at increased risk for influenza and related complications. We examined and compared the uptake of influenza vaccination among people with and without these diseases, as well as the influence of psychiatric comorbidity on vaccine uptake. METHODS Using administrative data from Apr. 1, 1984, to Mar. 31, 2016, we conducted a retrospective matched cohort study in Manitoba, Canada. We matched persons 18 years of age or older who had a diagnosis of inflammatory bowel disease, multiple sclerosis or rheumatoid arthritis (the immune-mediated inflammatory disease cohorts) with persons who did not have these diagnoses (the control cohorts) on age, sex and region. We then identified cohort members with any mood or anxiety disorder (depression, anxiety disorders, bipolar disorder). We identified influenza vaccinations through billing codes. Using binomial regression, we modelled the difference in the proportion of the immune-mediated inflammatory disease and matched cohorts vaccinated annually, with adjustment for sociodemographic characteristics, comorbidity and immune therapy. We tested additive interaction effects between a person's cohort and presence of a mood or anxiety disorder. RESULTS We identified 32 880 individuals with 1 or more immune-mediated inflammatory diseases (10 148 with inflammatory bowel disease, 6158 with multiple sclerosis and 16 975 with rheumatoid arthritis) and a total of 164 152 controls. In fiscal year 2015, 8668 (41.3%, 95% confidence interval [CI] 40.6% to 42.0%) of the 20 982 persons with an immune-mediated inflammatory disease received an influenza vaccination, a rate higher than among controls (35 238 of 104 634; 33.7%, 95% CI 33.4% to 34.0%). After adjustment, participants with an immune-mediated inflammatory disease but no mood or anxiety disorder had 6.44% (95% CI 5.79% to 7.10%) greater uptake of vaccination than participants without such a disease. Among participants without an immune-mediated inflammatory disease, having a mood or anxiety disorder was associated with 4.54% (95% CI 4.20% to 4.89%) greater uptake of vaccination. However, we observed a subadditive interaction between immune-mediated inflammatory disease and psychiatric status (-1.38%, 95% CI -2.26% to -0.50%). INTERPRETATION Uptake of influenza vaccination was consistently low in populations with immune-mediated inflammatory disease, and although psychiatric morbidity is associated with greater vaccine uptake by Manitobans, it negatively interacts with these diseases to reduce uptake. Changes in care delivery are needed to mitigate this gap in care.
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Affiliation(s)
- Ruth Ann Marrie
- Department of Internal Medicine (Marrie, Hitchon, Marriott, Bernstein), Department of Community Health Sciences (Marrie, Lix, Katz), Manitoba Centre for Health Policy (Walld, Katz), Department of Psychiatry (Bolton, Sareen), Department of Family Medicine (Singer, Katz), Department of Clinical Health Psychology (El-Gabalawy) and Department of Anesthesiology and Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Patten), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Departments of Psychiatry (Fisk), of Psychology and Neuroscience (Fisk) and of Medicine (Fisk), Dalhousie University, Halifax, NS
| | - Randy Walld
- Department of Internal Medicine (Marrie, Hitchon, Marriott, Bernstein), Department of Community Health Sciences (Marrie, Lix, Katz), Manitoba Centre for Health Policy (Walld, Katz), Department of Psychiatry (Bolton, Sareen), Department of Family Medicine (Singer, Katz), Department of Clinical Health Psychology (El-Gabalawy) and Department of Anesthesiology and Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Patten), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Departments of Psychiatry (Fisk), of Psychology and Neuroscience (Fisk) and of Medicine (Fisk), Dalhousie University, Halifax, NS
| | - James M Bolton
- Department of Internal Medicine (Marrie, Hitchon, Marriott, Bernstein), Department of Community Health Sciences (Marrie, Lix, Katz), Manitoba Centre for Health Policy (Walld, Katz), Department of Psychiatry (Bolton, Sareen), Department of Family Medicine (Singer, Katz), Department of Clinical Health Psychology (El-Gabalawy) and Department of Anesthesiology and Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Patten), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Departments of Psychiatry (Fisk), of Psychology and Neuroscience (Fisk) and of Medicine (Fisk), Dalhousie University, Halifax, NS
| | - Jitender Sareen
- Department of Internal Medicine (Marrie, Hitchon, Marriott, Bernstein), Department of Community Health Sciences (Marrie, Lix, Katz), Manitoba Centre for Health Policy (Walld, Katz), Department of Psychiatry (Bolton, Sareen), Department of Family Medicine (Singer, Katz), Department of Clinical Health Psychology (El-Gabalawy) and Department of Anesthesiology and Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Patten), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Departments of Psychiatry (Fisk), of Psychology and Neuroscience (Fisk) and of Medicine (Fisk), Dalhousie University, Halifax, NS
| | - Scott B Patten
- Department of Internal Medicine (Marrie, Hitchon, Marriott, Bernstein), Department of Community Health Sciences (Marrie, Lix, Katz), Manitoba Centre for Health Policy (Walld, Katz), Department of Psychiatry (Bolton, Sareen), Department of Family Medicine (Singer, Katz), Department of Clinical Health Psychology (El-Gabalawy) and Department of Anesthesiology and Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Patten), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Departments of Psychiatry (Fisk), of Psychology and Neuroscience (Fisk) and of Medicine (Fisk), Dalhousie University, Halifax, NS
| | - Alexander Singer
- Department of Internal Medicine (Marrie, Hitchon, Marriott, Bernstein), Department of Community Health Sciences (Marrie, Lix, Katz), Manitoba Centre for Health Policy (Walld, Katz), Department of Psychiatry (Bolton, Sareen), Department of Family Medicine (Singer, Katz), Department of Clinical Health Psychology (El-Gabalawy) and Department of Anesthesiology and Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Patten), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Departments of Psychiatry (Fisk), of Psychology and Neuroscience (Fisk) and of Medicine (Fisk), Dalhousie University, Halifax, NS
| | - Lisa M Lix
- Department of Internal Medicine (Marrie, Hitchon, Marriott, Bernstein), Department of Community Health Sciences (Marrie, Lix, Katz), Manitoba Centre for Health Policy (Walld, Katz), Department of Psychiatry (Bolton, Sareen), Department of Family Medicine (Singer, Katz), Department of Clinical Health Psychology (El-Gabalawy) and Department of Anesthesiology and Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Patten), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Departments of Psychiatry (Fisk), of Psychology and Neuroscience (Fisk) and of Medicine (Fisk), Dalhousie University, Halifax, NS
| | - Carol A Hitchon
- Department of Internal Medicine (Marrie, Hitchon, Marriott, Bernstein), Department of Community Health Sciences (Marrie, Lix, Katz), Manitoba Centre for Health Policy (Walld, Katz), Department of Psychiatry (Bolton, Sareen), Department of Family Medicine (Singer, Katz), Department of Clinical Health Psychology (El-Gabalawy) and Department of Anesthesiology and Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Patten), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Departments of Psychiatry (Fisk), of Psychology and Neuroscience (Fisk) and of Medicine (Fisk), Dalhousie University, Halifax, NS
| | - James J Marriott
- Department of Internal Medicine (Marrie, Hitchon, Marriott, Bernstein), Department of Community Health Sciences (Marrie, Lix, Katz), Manitoba Centre for Health Policy (Walld, Katz), Department of Psychiatry (Bolton, Sareen), Department of Family Medicine (Singer, Katz), Department of Clinical Health Psychology (El-Gabalawy) and Department of Anesthesiology and Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Patten), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Departments of Psychiatry (Fisk), of Psychology and Neuroscience (Fisk) and of Medicine (Fisk), Dalhousie University, Halifax, NS
| | - Renée El-Gabalawy
- Department of Internal Medicine (Marrie, Hitchon, Marriott, Bernstein), Department of Community Health Sciences (Marrie, Lix, Katz), Manitoba Centre for Health Policy (Walld, Katz), Department of Psychiatry (Bolton, Sareen), Department of Family Medicine (Singer, Katz), Department of Clinical Health Psychology (El-Gabalawy) and Department of Anesthesiology and Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Patten), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Departments of Psychiatry (Fisk), of Psychology and Neuroscience (Fisk) and of Medicine (Fisk), Dalhousie University, Halifax, NS
| | - Alan Katz
- Department of Internal Medicine (Marrie, Hitchon, Marriott, Bernstein), Department of Community Health Sciences (Marrie, Lix, Katz), Manitoba Centre for Health Policy (Walld, Katz), Department of Psychiatry (Bolton, Sareen), Department of Family Medicine (Singer, Katz), Department of Clinical Health Psychology (El-Gabalawy) and Department of Anesthesiology and Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Patten), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Departments of Psychiatry (Fisk), of Psychology and Neuroscience (Fisk) and of Medicine (Fisk), Dalhousie University, Halifax, NS
| | - John D Fisk
- Department of Internal Medicine (Marrie, Hitchon, Marriott, Bernstein), Department of Community Health Sciences (Marrie, Lix, Katz), Manitoba Centre for Health Policy (Walld, Katz), Department of Psychiatry (Bolton, Sareen), Department of Family Medicine (Singer, Katz), Department of Clinical Health Psychology (El-Gabalawy) and Department of Anesthesiology and Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Patten), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Departments of Psychiatry (Fisk), of Psychology and Neuroscience (Fisk) and of Medicine (Fisk), Dalhousie University, Halifax, NS
| | - Charles N Bernstein
- Department of Internal Medicine (Marrie, Hitchon, Marriott, Bernstein), Department of Community Health Sciences (Marrie, Lix, Katz), Manitoba Centre for Health Policy (Walld, Katz), Department of Psychiatry (Bolton, Sareen), Department of Family Medicine (Singer, Katz), Department of Clinical Health Psychology (El-Gabalawy) and Department of Anesthesiology and Perioperative and Pain Medicine (El-Gabalawy), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Patten), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Departments of Psychiatry (Fisk), of Psychology and Neuroscience (Fisk) and of Medicine (Fisk), Dalhousie University, Halifax, NS
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Long non-coding RNA GAS5 suppresses rheumatoid arthritis progression via miR-128-3p/HDAC4 axis. Mol Cell Biochem 2021; 476:2491-2501. [PMID: 33611674 DOI: 10.1007/s11010-021-04098-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 02/04/2021] [Indexed: 12/13/2022]
Abstract
Rheumatoid arthritis (RA) is a highly relevant public health problem. RA fibroblast-like synoviocytes (RAFLSs) play an important role in RA progression. Long non-coding RNA growth arrest-specific transcript 5 (GAS5) could improve RA by inducing RAFLSs apoptosis. However, the mechanism of GAS5 in RA remains unclear. RT-qPCR detected the expressions of GAS5, microRNA-128-3p (miR-128-3p), and histone deacetylase 4 (HDAC4) in RA synovial tissues and RAFLSs. Proliferation, apoptosis, migration, and invasion were measured by Cell Counting Kit-8 assay (CCK-8), flow cytometry, and transwell assays, severally. The protein levels of B-cell lymphoma-2 (Bcl-2), C-caspase 3, Bcl-2 related X protein (Bax), Tumor Necrosis factor-α (TNF-α), Interleukin 6 (IL-6), Interleukin 17 (IL-17), HDAC4, phosphorylation-protein kinase B (p-AKT), AKT, a phosphorylation-mechanistic target of rapamycin (p-mTOR), and mTOR were assessed by western blot assay. The interaction between miR-128-3p and GAS5 or HDAC4 was predicted by ENCORI or TargetScan Human and verified by the dual-luciferase reporter, RNA Immunoprecipitation (RIP), and RNA pull-down assays. GAS5 and HDAC4 were downregulated, and miR-128-3p was upregulated in RA synovial tissues and RAFLSs. Function analysis indicated that GAS5 curbed proliferation, migration, invasion, inflammation, and facilitated apoptosis of RAFLSs. Rescue assay confirmed that miR-128-3p overexpression or HDAC4 knockdown weakened the inhibitory effect of GAS5 or anti-miR-128-3p on RA development. GAS5 acted as a miR-128-3p sponge to upregulate HDAC4 expression. Besides, GAS5/miR-128-3p/HDAC4 axis regulated RA progression partially through the AKT/mTOR pathway. Our studies disclosed that GAS5 restrained inflammation in synovial tissue partly through regulating HDAC4 via miR-128-3p, suggesting a potential lncRNA-targeted therapy for RA treatment.
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Cao S, Shi H, Sun G, Chen Y, Hou G, Wang D, Shi B. Serum IL-37 Level Is Associated with Rheumatoid Arthritis and Disease Activity: A Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6653439. [PMID: 33628802 PMCID: PMC7884130 DOI: 10.1155/2021/6653439] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/07/2021] [Accepted: 01/20/2021] [Indexed: 12/29/2022]
Abstract
Interleukin-37 (IL-37) inhibits the pathogenesis of rheumatoid arthritis (RA) via downregulating proinflammatory cytokines. Accordingly, we performed an analysis to accurately assess the relationship between serum IL-37 cytokine levels and disease activity of RA. Subgroup analysis and sensitivity analysis were applied to explore the sources of heterogeneity. Correlation coefficient (r) was utilized to evaluate the relationship between IL-37 and disease activity of RA patients. Ten studies were included into the research. Functional analysis revealed elevated serum IL-37 concentrations in RA patients (SMD = 1.61, P < 0.00001). The relationship between serum IL-37 levels and disease activity was statistically significant (C-reactive protein: r = 1.47, P = 0.0002; erythrocyte sedimentation rate: r = 1.55, P < 0.00001; rheumatoid factor: r = 1.40, P = 0.004; tumor necrosis factor⁃α: r = 1.64, P = 0.0003; Disease Activity Score for 28 joints: r = 1.63, P < 0.00001; tender joint count: r = 1.48, P < 0.00001; and swollen joint count: r = 1.52, P = 0.0003), but anti-CCP was not significant (anti-CCP: r = 0.98, P = 0.72). In summary, these data are suggesting that the elevated serum level of IL-37 in RA is positively correlated with the disease activity of RA, suggesting a role for IL-37in the pathogenesis of RA.
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Affiliation(s)
- Shengnan Cao
- School of Acupuncture-Tuina, Shandong University of Traditional Chinese Medicine, Jinan 250062, China
- Bone Biomechanics Engineering Laboratory of Shandong Province, Neck-Shoulder and Lumbocrural Pain Hospital of Shandong First Medical University, Jinan 250062, China
| | - Haojun Shi
- Second Clinical Medical College, Henan University of Chinese Medicine, Henan 450016, China
| | - Guodong Sun
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Shandong First Medical University, Jinan 250062, China
| | - Yuanzhen Chen
- Bone Biomechanics Engineering Laboratory of Shandong Province, Neck-Shoulder and Lumbocrural Pain Hospital of Shandong First Medical University, Jinan 250062, China
| | - Guangjian Hou
- Bone Biomechanics Engineering Laboratory of Shandong Province, Neck-Shoulder and Lumbocrural Pain Hospital of Shandong First Medical University, Jinan 250062, China
| | - Dandan Wang
- Bone Biomechanics Engineering Laboratory of Shandong Province, Neck-Shoulder and Lumbocrural Pain Hospital of Shandong First Medical University, Jinan 250062, China
| | - Bin Shi
- School of Acupuncture-Tuina, Shandong University of Traditional Chinese Medicine, Jinan 250062, China
- Bone Biomechanics Engineering Laboratory of Shandong Province, Neck-Shoulder and Lumbocrural Pain Hospital of Shandong First Medical University, Jinan 250062, China
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Zhao C, Wang Q, Wang M, Tao X, Liu S, Qi Z, Lanxi X, Liu D, He X, Tian X, Zeng X, Jiang Y, Yang M. Ultra-microangiography in evaluating the disease activity of rheumatoid arthritis and enhancing the efficacy of ultrasonography: A preliminary study. Eur J Radiol 2021; 137:109567. [PMID: 33556758 DOI: 10.1016/j.ejrad.2021.109567] [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: 06/12/2020] [Revised: 12/12/2020] [Accepted: 01/19/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Ultra-microangiography (UMA) is a novel Doppler technique that has high sensitivity for low-velocity blood flows. In this study, a distinctive imaging feature, penetrating blood vessels on the surface of eroded bones within the inflamed joints, was observed on UMA. We aimed to investigate the feasibility of UMA in assessing disease activity and identify the clinical value of the UMA feature for evaluating rheumatoid arthritis (RA). METHODS AND MATERIALS Power-Doppler ultrasound (PDUS) and UMA were performed on small joints of RA patients. The semiquantitative scores of PDUS and UMA of the joints were assessed and compared. The UMA imaging feature of penetrating vessels on the surface of eroded bones was evaluated, and the patients were divided into three groups based on imaging features. (Group 1: no inflammatory signs; Group 2: inflammatory US features but no UMA features; and Group 3: detected UMA features). The correlations between the groups and clinical parameters were assessed. RESULTS A total of 52 patients with RA were recruited, with 364 joints (MCP, PIP, MTP and wrist) scanned. Synovial blood vessel signals were detected for 68 by PDUS and for 93 by UMA (display rate of blood vessel signals: 18.68 % VS 25.55 %). UMA presented better display capability of blood vessels within the inflamed regions than that of PDUS in overall. Significant differences were detected in clinical scores (P < 0.0001 for DAS28 [ESR], DAS28 [CRP], SDAI, CDAI, CRP P = 0.0303, SJC P = 0.0059, and TJC P = 0.0423) between Group 2 and 3. Significant correlations between the groups and clinical parameters were also observed (DAS28 [ESR] ρ=0.750; DAS28 [CRP] ρ=0.762; SDAI ρ=0.778; CDAI ρ=0.773; CRP ρ= 0.524; SJC ρ=0.742; TJC ρ=0.693, P < 0.0001), indicating that the UMA feature was related to high disease activity. CONCLUSIONS UMA can help enhance the detection rate of micro-vascularization. The UMA feature of the penetrating vessels on the surface of eroded bones is likely to be associated with severe disease activity.
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Affiliation(s)
- Chenyang Zhao
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Qian Wang
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID) and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, China
| | - Ming Wang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Xixi Tao
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Sirui Liu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Zhenhong Qi
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Xiang Lanxi
- Shenzhen Mindray Bio-Medical Electronics Co., Ltd., Shenzhen, China
| | - Donald Liu
- Mindray Innovation Center, San Jose, CA, USA
| | - Xujin He
- Shenzhen Mindray Bio-Medical Electronics Co., Ltd., Shenzhen, China
| | - Xinping Tian
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID) and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, China
| | - Xiaofeng Zeng
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID) and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, China
| | - Yuxin Jiang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China.
| | - Meng Yang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China.
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Conforti A, Di Cola I, Pavlych V, Ruscitti P, Berardicurti O, Ursini F, Giacomelli R, Cipriani P. Beyond the joints, the extra-articular manifestations in rheumatoid arthritis. Autoimmun Rev 2020; 20:102735. [PMID: 33346115 DOI: 10.1016/j.autrev.2020.102735] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 10/18/2020] [Indexed: 12/24/2022]
Abstract
Rheumatoid arthritis (RA) is an inflammatory disease typically affecting the joints, but the systemic inflammatory process may involve other tissues and organs. Many extra-articular manifestations are recognized, which are related to worse long outcomes. Rheumatoid nodules are the most common extra-articular feature, found in about 30% of patients. Secondary Sjögren's syndrome and pulmonary manifestations are observed in almost 10% of patients, also in the early disease. Active RA with high disease activity has been associated with an increased risk of such features. Male gender, smoking habit, severe joint disease, worse function, high pro-inflammatory markers levels, high titer of rheumatoid factor, and HLA-related shared epitope have been reported as clinical predictors of occurrence of these rheumatoid complications. In addition, there is a little evidence deriving from randomized controlled trials in this field, thus the therapeutic strategy is mainly empiric and based on small case series and retrospective studies. However, considering that these extra-articular manifestations are usually related to the more active and severe RA, an aggressive therapeutic strategy is usually employed in view of the poor outcomes of these patients. The extra-articular features of RA remain, despite the improvement of joint damage, a major diagnostic and therapeutic challenge, since these are associated with a poor prognosis and need to be early recognized and promptly managed.
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Affiliation(s)
- Alessandro Conforti
- Rheumatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ilenia Di Cola
- Rheumatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Viktoriya Pavlych
- Rheumatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Piero Ruscitti
- Rheumatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Onorina Berardicurti
- Rheumatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Francesco Ursini
- IRRCS Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Roberto Giacomelli
- Rheumatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Paola Cipriani
- Rheumatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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Chiu YM, Lu YP, Lan JL, Chen DY, Wang JD. Lifetime Risks, Life Expectancy, and Health Care Expenditures for Rheumatoid Arthritis: A Nationwide Cohort Followed Up From 2003 to 2016. Arthritis Rheumatol 2020; 73:750-758. [PMID: 33295139 PMCID: PMC8247851 DOI: 10.1002/art.41597] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 11/17/2020] [Indexed: 11/10/2022]
Abstract
Objective This study was undertaken to estimate the cumulative incidence rate of rheumatoid arthritis (RA) in the Taiwanese population ages 16–84 years, and life expectancy, loss of life expectancy, and lifetime health care expenditures for incident RA in Taiwan after 2003, when biologics began to be prescribed. Methods We obtained all claims data for the period 1999 to 2016 from the National Health Insurance program of Taiwan, and validated the data against the Catastrophic Illness Registry to establish the study cohort. We estimated the survival function for RA and extrapolated to lifetime using a rolling‐over algorithm. For every RA case, we simulated sex‐, age‐, and calendar year–matched referents from vital statistics and estimated their life expectancy. The difference between the life expectancy of the referent and the life expectancy of the RA patient was the loss of life expectancy for the RA patient. Average monthly health care expenditures were multiplied by the corresponding survival rates and summed up throughout the lifetime to calculate the lifetime health care expenditures. Results A total of 29,352 new RA cases were identified during 2003–2016. There was a decreasing trend in cumulative incidence rate in those ages 16–84 for both sexes. Mean life expectancy after diagnosis of RA was 26.3 years, and mean lifetime cost was $72,953. RA patients had a mean loss of life expectancy of 4.97 years. Women with RA survived 1–2 years longer than men with RA of the same age, which resulted in higher lifetime expenditures for the former. Since the life expectancy for women in Taiwan was 6–7 years higher than that for men, the loss of life expectancy for women with RA was higher than that for men with RA. Annual health care expenditures were similar for both sexes. Conclusion Our findings indicate that since biologics became available, RA patients have lived longer and had higher lifetime expenditures, which should be monitored and evaluated for cost‐effectiveness.
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Affiliation(s)
- Ying-Ming Chiu
- China Medical University and China Medical University Hospital, Taichung, Taiwan
| | - Yi-Peng Lu
- National Cheng Kung University, Tainan, Taiwan
| | - Joung-Liang Lan
- China Medical University and China Medical University Hospital, Taichung, Taiwan
| | - Der-Yuan Chen
- China Medical University and China Medical University Hospital, Taichung, Taiwan
| | - Jung-Der Wang
- National Cheng Kung University and National Cheng Kung University Hospital, Tainan, Taiwan
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Abstract
Rheumatoid arthritis (RA) prevalence is believed to be around 1% worldwide, although it varies considerably among different populations. The aim of EPISER2016 study was to estimate the prevalence of RA in the general adult population in Spain. We designed a population-based cross-sectional study. A national survey was conducted between November 2016 and October 2017 involving a probabilistic sample from the general population aged 20 years or older. Subjects were randomly selected for phone screening using a computer-assisted telephone interviewer system. Positive RA screening results were evaluated by a rheumatologist. Cases fulfilled the 1987 ACR and/or the 2010 ACR/EULAR criteria; previous diagnosis established by a rheumatologist and clearly identified in medical records were also accepted regardless of the criteria used. Prevalence estimates with 95% CI were calculated taking into account the design of the sample (weighting based on age, sex, and geographic origin using as a reference the distribution of the population in Spain). 4916 subjects participated in the study and 39 RA cases were confirmed. RA estimated prevalence was 0.82% (95% CI 0.59–1.15). Mean age of RA cases was 60.48 (14.85) years, they were more frequently women (61.5%), from urban areas (74.4%), non-smokers (43.6%), and with a high body mass index (53.8% with overweight). Extrapolating to the population in Spain (approximately 37 million are ≥ 20 years old), it was estimated that there were between 220,000 and 430,000 people aged 20 years or older with RA. No undiagnosed cases were detected, which could be related to the establishment of early arthritis clinics around the country, increasing the rates of diagnosis during early phases of RA.
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Majjad A, Ghassem MA, Toufik H, Sadni S, Debbarh Z, Djossou JH, El Ouardi N, Taoubane L, Abouqal R, Achemlal L, El Maghraoui A. Relationship between vertebral fracture prevalence and abdominal aortic calcification in women with rheumatoid arthritis. Bone 2020; 141:115599. [PMID: 32822872 DOI: 10.1016/j.bone.2020.115599] [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: 04/25/2020] [Revised: 07/21/2020] [Accepted: 08/13/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Vertebral fracture assessment (VFA)-detected abdominal aortic calcification (AAC) has been validated as an indicator of increased risk of vertebral fractures (VFs) in other populations but this relationship in rheumatoid arthritis (RA) is unclear. We assess the prevalence of AAC on VFA scans and its potential relationship with prevalent VFs in a cohort of RA women. METHODS We enrolled 250 women with RA. VFA images, and scans of the lumbar spine and proximal femur were obtained using dual-energy x-ray absorptiometry. The presence/severity of VFs and AAC were carried out using validated approaches. RESULTS AAC was detected in 95 of 250 (38%) eligible subjects and 83 (33.2%) had at least one VF. Significantly subjects with VFs had a higher AAC score (3.4 ± 3.8 versus 0.7 ± 1.4; p˂0.001) and higher prevalence of AAC than those without VFs (65% versus 26%; P˂0.001). The group with VFs tended to be older, had more menopausal women, and lower lumbar spine and total hip BMD than those without VF. They also had a long-standing disease and high DAS 28-CRP, a great steroid cumulative dose, and a high prevalence of rheumatoid factor (RF). In multivariate analyses, a significant association was noted between prevalent VFs and age of patients, RA disease activity, presence of densitometric osteoporosis, RF, and VFA-detected AAC, whereas there was no significant association with steroid cumulative dose and disease duration. CONCLUSION VFA is a convenient tool for the diagnosis of VFs and AAC. In this cohort, VFA-detected AAC was independently associated with prevalent VFs.
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Affiliation(s)
- Abderrahim Majjad
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco.
| | - Mohamed A Ghassem
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | - Hamza Toufik
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | - Siham Sadni
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | - Zineb Debbarh
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | - Julien H Djossou
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | - Najlae El Ouardi
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | - Laila Taoubane
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | - Redouane Abouqal
- Laboratory of Biostatistics, Clinical Research and Epidemiology, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Lahcen Achemlal
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
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Mednieks J, Naumovs V, Skilters J. Ideational Fluency in Patients with Rheumatoid Arthritis. Curr Rheumatol Rev 2020; 17:205-212. [PMID: 33213351 DOI: 10.2174/1573397116666201119145640] [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: 04/16/2020] [Revised: 08/26/2020] [Accepted: 09/16/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Neuropsychiatric symptoms have been well documented in several systemic inflammatory conditions, for example, systemic lupus erythematosus (SLE). Increased prevalence of cognitive decline and psychiatric issues has been reported in patients with rheumatoid arthritis (RA). However, there is limited evidence of which exact cognitive domains are affected and to what degree. AIM To test the performance of cognition in the domain of ideational fluency (Thing Categories Test in particular) in patients with RA and compare the results with the general population and to the results with cognitive and depression screening scores in both groups. METHODS Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7) assessment, Montreal Cognitive Assessment (MoCA), and Thing Categories Test (TCT) were used to evaluate patients with RA, as well as the control group. RESULTS Twenty patients with RA and 20 controls were tested, with 7 and 4 men, and 13 and 16 women in the study and control group, respectively. Average scores in TCT at three minutes were 7.50 (IQR6.0-10.0) and 6.0 (IQR3.0-8.0) for category "blue"; 17.50 (IQR15.0-19.0) and 16.0 (10.0-18.0) for category "round" in the control and study group, respectively. A statistically significant difference was established between the study and the control group in TCT for the category "blue" (p<0.025). The average score for GAD7 was 2.0 (IQR 0.0-5.75) and 3.0 (IQR0.50-6.00) in the control and study group, respectively. The average score for PHQ-9 was 2.0 (IQR0.25-4.75) and 4.0 (IQR2.00-5.50) in the control and study group, respectively. Finally, the average score for the MoCA scale was 27.0 (IQR25.25-28.00) and 26.0 (IQR23.50-28.00) in the control and study group, respectively. CONCLUSION Preliminary evidence suggests that RA at least partially affects the cognitive domain of ideational fluency. However, further research with larger experimental groups is needed to provide more conclusive evidence.
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Affiliation(s)
- Janis Mednieks
- Department of Neurology and Neurosurgery, Riga Stradins University, Riga, Latvia
| | | | - Jurgis Skilters
- Department of Neurology and Neurosurgery, Riga Stradins University, Riga, Latvia
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Almutairi K, Nossent J, Preen D, Keen H, Inderjeeth C. The global prevalence of rheumatoid arthritis: a meta-analysis based on a systematic review. Rheumatol Int 2020; 41:863-877. [PMID: 33175207 DOI: 10.1007/s00296-020-04731-0] [Citation(s) in RCA: 254] [Impact Index Per Article: 63.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/12/2020] [Indexed: 12/26/2022]
Abstract
The objective is to determine the global population prevalence of rheumatoid arthritis (RA) based on population-based studies and assess factors that influence RA prevalence estimates. Four electronic databases were searched (ProQuest Central, MEDLINE, Web of Science, and EMBASE) for peer-reviewed English publications that report prevalence estimates of RA from 1980 and 2019. We included case-control studies, cross-sectional studies, and prospective or retrospective cohort studies in our search strategy. A random-effect meta-analysis model was used to produce the pooled prevalence estimates. The potential between-study heterogeneity was identified using sensitivity analysis, sub-group and meta-regression analyses. A total of 67 studies were included in the meta-analysis, containing 742,246 RA patients and 211,592,925 healthy controls in the study period. The global RA prevalence estimate was 0.46% (95% confidence interval [CI] 0.39-0.54; I2 = 99.9%) with a 95% prediction interval (0.06-1.27). The RA point-prevalence was 0.45% (95% CI 0.38-0.53%) between 1986 and 2014, while the pooled period-prevalence was 0.46% (95% CI 0.36% and 0.57%) from 1955 to 2015. The highest RA pooled prevalence (0.69%; 95% CI 0.47-0.95) was derived from linked data source studies. Based on meta-regression, the factors that explain the studies' heterogeneity of RA prevalence, including geographical location, the risk bias assessment of studies and sample size. The global prevalence of RA between 1980 and 2019 was 460 per 100,000 population, with variations due to geographical location and study methodology. Linked data are the preferred method to estimate RA population prevalence as they provide the best case ascertainment.
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Affiliation(s)
- Khalid Almutairi
- School of Medicine, The University of Western Australia, Perth, Australia.
- King Fahd Specialist Hospital, Burydah, Saudi Arabia.
| | - Johannes Nossent
- School of Medicine, The University of Western Australia, Perth, Australia
- Sir Charles Gairdner and Osborne Park Health Care Group, Perth, Australia
| | - David Preen
- School of Population and Global Health, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia
| | - Helen Keen
- School of Medicine, The University of Western Australia, Perth, Australia
- Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Charles Inderjeeth
- School of Medicine, The University of Western Australia, Perth, Australia
- Sir Charles Gairdner and Osborne Park Health Care Group, Perth, Australia
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Tatangelo MR, Tomlinson G, Keystone E, Paterson JM, Bansback N, Bombardier C. Comorbidities Before and After the Diagnosis of Rheumatoid Arthritis: A Matched Longitudinal Study. ACR Open Rheumatol 2020; 2:648-656. [PMID: 33104286 PMCID: PMC7672304 DOI: 10.1002/acr2.11182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 08/31/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To determine the contribution of rheumatoid arthritis (RA) to conditions and medical events. A secondary objective is to quantify this association before and after the introduction of biologic medications. METHODS All data were collected as health administrative data in Ontario, Canada. Patients with RA (n = 136 678) matched 1:1 to a pool of possible controls without RA from 1995 to 2016. The study was a retrospective longitudinal observational administrative data-based cohort study with cases (RA) and controls (two non-RA comparator groups). The main exposure was new-onset RA identified by a validated diagnosis algorithm. The secondary exposure was the calendar year, which provided a natural experiment to compare years in which biologics were unavailable (pre-2001) to increasing utilization over time. The main outcomes were counts of 27 Johns Hopkins Expanded Diagnostic Cluster Comorbid Conditions. Outcomes were reported as counts and percentage differences between cases and matched controls. RESULTS Patients experienced increases in conditions and medical events up to 5 years before RA disease incidence-4.9 conditions per patient-year compared with 4.6 conditions per patient-year in matched controls. Comorbidities increased to 8.7 conditions per patient-year in the year of RA incidence but were lower in the years after diagnosis-6.9 conditions per patient-year at 5 years postdiagnosis. CONCLUSION This study reframes the clinical manifestations of RA with detailed data on the marginal contribution of RA to conditions and medical events. These results show that a large portion of disease burden is due to the indirect effects of RA.
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Affiliation(s)
- Mark R. Tatangelo
- University of Toronto and the Toronto General Research InstituteTorontoOntarioCanada
| | - George Tomlinson
- University of Toronto and the Toronto General Research InstituteTorontoOntarioCanada
| | - Edward Keystone
- University of Toronto, Toronto, Ontario, Canada and Mount Sinai HospitalTorontoOntarioCanada
| | - J. Michael Paterson
- University of Toronto, Toronto, Ontario, Canada and ICESTorontoOntarioCanada
| | - Nick Bansback
- School of Population and Public HealthUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Claire Bombardier
- University of Toronto and the Toronto General Research InstituteTorontoOntarioCanada
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Nakajima A, Sakai R, Inoue E, Harigai M. Prevalence of patients with rheumatoid arthritis and age-stratified trends in clinical characteristics and treatment, based on the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Int J Rheum Dis 2020; 23:1676-1684. [PMID: 33016574 DOI: 10.1111/1756-185x.13974] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/18/2020] [Accepted: 09/03/2020] [Indexed: 01/06/2023]
Abstract
AIM To estimate the prevalence and age-stratified treatment trends and clinical characteristics of rheumatoid arthritis (RA) in Japan. METHOD Using 7 RA definitions, the prevalence of RA in those aged ≥16 years was estimated using the National Database of Health Insurance Claims and Specific Health Checkups of Japan in the fiscal year 2017. We analyzed age-stratified trends in characteristics and treatments. RESULTS Of 1 116 122 patients aged ≥16 years with at least 1 RA-related International Classification of Diseases-10 code, 825.7 thousand patients (women, 76.3%) were assessed as having RA with an estimated prevalence of 0.65%. The highest age-stratified prevalence was 1.63% in patients aged 70-79 years. Overall, 60.8% and 7.0% of patients with RA were aged ≥65 years and ≥85 years, respectively. Methotrexate use was most frequent in patients aged 50-59 years (73.0%) and least frequent in patients aged ≥85 years (38.2%). Biologic disease-modifying antirheumatic drugs use was 50.9% in patients aged 16-19 years and decreased to 13.7% in those aged ≥85 years. Preference for the use of tumor necrosis factor inhibitors versus abatacept decreased from 24.0:1 to 1.7:1 in patients aged 16-19 years and ≥85 years, respectively. The prevalence of cardiovascular disease was 3.5% in patients aged 60-69 years and 12.1% in those aged ≥85 years. Overall RA-related orthopedic surgeries were most prevalent in patients aged 70-79 years. CONCLUSION The estimated prevalence of patients with RA in Japan was 0.65%. Age-stratified treatment trends and clinical characteristics have been described in a super-aged society for the first time.
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Affiliation(s)
- Ayako Nakajima
- Center for Rheumatic Diseases, Mie University Hospital, Tsu, Japan.,Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Ryoko Sakai
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Division of Multidisciplinary Management of Rheumatic Diseases, Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Eisuke Inoue
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Research Administration Center, Showa University, Tokyo, Japan
| | - Masayoshi Harigai
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
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