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Bertani L, D’Alessandro C, Fornili M, Coppini F, Zanzi F, Carmisciano L, Geri F, Svizzero GB, Rosi EM, De Bernardi A, Ceccarelli L, Mumolo MG, Baglietto L, Bellini M, De Bortoli N, Costa F. Response to Ustekinumab Therapy Is Associated with an Improvement of Nutritional Status in Patients with Crohn's Disease. J Clin Med 2023; 12:6118. [PMID: 37834762 PMCID: PMC10573723 DOI: 10.3390/jcm12196118] [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: 08/15/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023] Open
Abstract
The presence of sarcopenia has been associated with the worst outcome of Crohn's disease (CD). At present, no studies have evaluated the impact of ustekinumab (UST) in terms of its effects on body composition. The aim of this prospective study was to evaluate whether UST treatment could modify the parameters of body composition as assessed by bioelectrical impedance assay (BIA) in patients with CD. We prospectively enrolled consecutive patients with CD treated with UST, evaluating the therapeutic outcome at week 48 in terms of clinical remission and mucosal healing. BIA was performed at baseline and at week 48, assessing body cellular mass, total body water, phase angle, and body mass index. Out of 44 patients enrolled, 26 (59%) were in clinical remission and 22 (50%) achieved mucosal healing at the end of follow up. No significant differences were observed at baseline in all the BIA parameters between responders and non-responders. Phase angle increased over time in responders, while this was not observed in non-responders (test for the interaction between time and outcome, p-value = 0.009 and 0.007 for clinical remission and mucosal healing, respectively). The same differential increase was observed for body cellular mass (test for the interaction between time and outcome, p-value = 0.03 and 0.05 for clinical remission and mucosal healing, respectively). Total body water and BMI increased homogenously over time regardless of the outcomes (tests for the association with time, p-values of 0.01). To conclude, responsiveness to UST therapy seems to be associated with body composition modifications in patients with CD. In particular, the increase in phase angle in responders suggests that a significant improvement of nutritional status occurred in these patients.
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Affiliation(s)
- Lorenzo Bertani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy; (C.D.); (F.C.); (F.Z.); (F.G.); (E.M.R.); (A.D.B.); (M.B.); (N.D.B.)
- Tuscany North West ASL, Department of General Surgery and Gastroenterology, Pontedera Hospital, Via Roma, 147, 56025 Pontedera, Italy
| | - Claudia D’Alessandro
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy; (C.D.); (F.C.); (F.Z.); (F.G.); (E.M.R.); (A.D.B.); (M.B.); (N.D.B.)
| | - Marco Fornili
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100 Pisa, Italy; (M.F.); (L.C.); (L.B.)
| | - Francesca Coppini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy; (C.D.); (F.C.); (F.Z.); (F.G.); (E.M.R.); (A.D.B.); (M.B.); (N.D.B.)
| | - Federico Zanzi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy; (C.D.); (F.C.); (F.Z.); (F.G.); (E.M.R.); (A.D.B.); (M.B.); (N.D.B.)
| | - Luca Carmisciano
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100 Pisa, Italy; (M.F.); (L.C.); (L.B.)
| | - Francesca Geri
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy; (C.D.); (F.C.); (F.Z.); (F.G.); (E.M.R.); (A.D.B.); (M.B.); (N.D.B.)
| | - Giovanni Baiano Svizzero
- Department of General Surgery and Gastroenterology, IBD Unit, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy; (G.B.S.); (L.C.); (M.G.M.); (F.C.)
| | - Emma Maria Rosi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy; (C.D.); (F.C.); (F.Z.); (F.G.); (E.M.R.); (A.D.B.); (M.B.); (N.D.B.)
| | - Alice De Bernardi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy; (C.D.); (F.C.); (F.Z.); (F.G.); (E.M.R.); (A.D.B.); (M.B.); (N.D.B.)
| | - Linda Ceccarelli
- Department of General Surgery and Gastroenterology, IBD Unit, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy; (G.B.S.); (L.C.); (M.G.M.); (F.C.)
| | - Maria Gloria Mumolo
- Department of General Surgery and Gastroenterology, IBD Unit, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy; (G.B.S.); (L.C.); (M.G.M.); (F.C.)
| | - Laura Baglietto
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100 Pisa, Italy; (M.F.); (L.C.); (L.B.)
| | - Massimo Bellini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy; (C.D.); (F.C.); (F.Z.); (F.G.); (E.M.R.); (A.D.B.); (M.B.); (N.D.B.)
| | - Nicola De Bortoli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy; (C.D.); (F.C.); (F.Z.); (F.G.); (E.M.R.); (A.D.B.); (M.B.); (N.D.B.)
| | - Francesco Costa
- Department of General Surgery and Gastroenterology, IBD Unit, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy; (G.B.S.); (L.C.); (M.G.M.); (F.C.)
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Polak-Szczybyło E, Stępień AE, Zielińska M, Dąbrowski M. Hashimoto Thyroiditis, but Not Hypothyroidism Due to Other Causes, Is Associated with Lower Phase Angle Score in Adult Women: A Pilot Cross-Sectional Study. J Clin Med 2022; 12:jcm12010056. [PMID: 36614854 PMCID: PMC9821760 DOI: 10.3390/jcm12010056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/18/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE In recent years, Hashimoto's thyroiditis (HT) has become one of the commonest autoimmune diseases. Its clinical symptoms include systemic manifestations related mainly, but not solely, to thyroid hormone deficiency. The bioimpedance phase angle (PhA) is a reliable indicator of nutritional as well as cellular health status. PhA is decreased not only in malnutrition, but also in many inflammatory diseases. The aim of this study was to assess the relationship between HT and PhA score. METHODS In this cross-sectional study, we compared the anthropometric, laboratory and body composition parameters of 49 women with HT and 98 propensity-score-matched women without thyroid disease. RESULTS Females with HT had significantly lower PhA scores (5.78 ± 0.43) compared to women without a thyroid disorder (5.98 ± 0.49, p = 0.017). Regarding TSH levels, although they were within the normal range in all study participants, in women with HT, they were slightly but significantly higher. Women with HT treated with L-thyroxin had significantly higher PhA compared to their non-treated counterparts. No differences between women with non-HT hypothyroidism and the control group were found. CONCLUSIONS Decreased PhA scores in patients with HT may indicate that the inflammatory process in this autoimmune disease has an influence on cellular health and on the function of the entire body. Such an association was not found in women with non-HT hypothyroidism.
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Affiliation(s)
- Ewelina Polak-Szczybyło
- Department of Dietetics, Institute of Health Sciences, University of Rzeszow, College of Medical Sciences, 35-959 Rzeszów, Poland
| | - Agnieszka Ewa Stępień
- Department of Dietetics, Institute of Health Sciences, University of Rzeszow, College of Medical Sciences, 35-959 Rzeszów, Poland
- Correspondence:
| | - Magdalena Zielińska
- Department of Dietetics, Institute of Health Sciences, University of Rzeszow, College of Medical Sciences, 35-959 Rzeszów, Poland
| | - Mariusz Dąbrowski
- Institute of Medical Sciences, University of Rzeszow, College of Medical Sciences, 35-959 Rzeszów, Poland
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Koç Yıldırım S, Demirel Öğüt N, Erbağcı E, Hapa A. A real life experience with ustekinumab: The effectiveness of 45 mg on patients greater than 80 kilograms but lower than 100 kilograms. Dermatol Ther 2022; 35:e15494. [PMID: 35384189 DOI: 10.1111/dth.15494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/12/2022] [Accepted: 04/01/2022] [Indexed: 11/30/2022]
Abstract
Ustekinumab is a fully human monoclonal antibody has been demonstrated efficacious and safe in clinical trials. However, there are few real-life data evaluating the efficacy of ustekinumab. The aim of this retrospective follow up study was showing the efficacy in 58 adult patients with moderate to severe psoriasis treated at least 24 weeks with ustekinumab. The efficacy was evaluated as PASI75, PASI90 and PASI100 response rates at week 4, 12, 24 and 36 in patient groups according to the treatment dose, weight, biologic treatment naivety and obesity. PASI75, PASI90 and PASI100 response rates were 79.3%, 62.1% and 8.6% respectively, at week 12 and, 92.5%, 71.7% and 9.4%, respectively, at week 36. PASI75, PASI90 and PASI100 responses were generally higher in naive patients to the biologic therapy. Also, the responses were generally higher in non-obese patients at 4 and 12 weeks. According to the weight categories, PASI100 response rates were higher in the 81-99 kg group at week 12. In conclusion, ustekinumab is an effective and safe treatment option for moderate to severe psoriasis patients. It seems to be more effective in biologic treatment naive patients and non-obese patients. A 45 mg dose of ustekinumab seems to be effective in patients weighing 99 kg or less. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Sema Koç Yıldırım
- Department of Dermatology and Venereology, Uşak University Training and Research Hospital, Uşak, Turkey
| | - Neslihan Demirel Öğüt
- Department of Dermatology and Venereology, Uşak University Training and Research Hospital, Uşak, Turkey
| | - Ece Erbağcı
- Department of Dermatology and Venereology, Uşak University Training and Research Hospital, Uşak, Turkey
| | - Aslı Hapa
- Department of Dermatology and Venereology, Buca Seyfi Demirsoy Training and Research Hospital, İzmir, Turkey
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Can Biological Drugs Diminish the Risk of Sarcopenia in Psoriatic Patients? Life (Basel) 2022; 12:life12030435. [PMID: 35330186 PMCID: PMC8952562 DOI: 10.3390/life12030435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 11/28/2022] Open
Abstract
Sarcopenia and psoriasis are different inflammatory diseases that share common comorbidities (e.g., cardiovascular diseases, metabolic syndrome, obesity, autoimmune diseases, depression). Psoriasis is a dermatosis involving the skin, joints, and nails. Its estimated prevalence is 2–4%, and the possibility of progression to psoriatic arthritis reaches 6–42%. Sarcopenia is defined as reduced muscle strength, muscle quantity, and physical performance due to non-ageing related causes. It affects up to 10% of the general population. We conducted a review of the literature to provide up-to-date information about the risk of sarcopenia in psoriasis and to identify risk factors that increase this risk. The search of the literature allowed us to include 51 publications, but only five cross-sectional studies provided quantitative results on the rates of sarcopenia in psoriasis. The prevalence of sarcopenia in psoriasis varied from 9.1% to 61.7%. This wide range was caused by different definitions of sarcopenia and different cut-off values across studies. Prognostic factors include lean mass and fat mass. Further research based on the European Working Group on Sarcopenia in Older People guidelines is required. Such studies should include not only muscle mass and strength but also other factors that may influence the occurrence of sarcopenia and inflammatory markers.
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Qu H, Zhao Y. Advances in tissue state recognition in spinal surgery: a review. Front Med 2021; 15:575-584. [PMID: 33990898 DOI: 10.1007/s11684-020-0816-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 07/27/2020] [Indexed: 12/27/2022]
Abstract
Spinal disease is an important cause of cervical discomfort, low back pain, radiating pain in the limbs, and neurogenic intermittent claudication, and its incidence is increasing annually. From the etiological viewpoint, these symptoms are directly caused by the compression of the spinal cord, nerve roots, and blood vessels and are most effectively treated with surgery. Spinal surgeries are primarily performed using two different techniques: spinal canal decompression and internal fixation. In the past, tactile sensation was the primary method used by surgeons to understand the state of the tissue within the operating area. However, this method has several disadvantages because of its subjectivity. Therefore, it has become the focus of spinal surgery research so as to strengthen the objectivity of tissue state recognition, improve the accuracy of safe area location, and avoid surgical injury to tissues. Aside from traditional imaging methods, surgical sensing techniques based on force, bioelectrical impedance, and other methods have been gradually developed and tested in the clinical setting. This article reviews the progress of different tissue state recognition methods in spinal surgery and summarizes their advantages and disadvantages.
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Affiliation(s)
- Hao Qu
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Yu Zhao
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
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Paccou J, Bavière W, Sornay-Rendu E, Szulc P, Ramdane N, Cortet B, Chapurlat R, Flipo RM. Body composition in patients with psoriatic arthritis and changes during interleukin 12/23 inhibition. Arthritis Care Res (Hoboken) 2021; 74:1608-1613. [PMID: 33973385 DOI: 10.1002/acr.24623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/11/2021] [Accepted: 04/13/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Little is known about body composition in patients with PsA. We compared body composition parameters in PsA patients and healthy controls, and then investigated the effects of ustekinumab (UST) on body composition in patients with PsA. METHODS At baseline, 30 PsA patients were compared cross-sectionnally with 60 non-PsA healthy controls matched for age, sex, menopausal status and body mass index. Thirty active PsA patients treated with UST were included in a 6-month open follow-up study. Body composition parameters were measured at baseline and 6 months of treatment. RESULTS Body composition parameters were different in PsA patients compared to healthy controls: in PsA patients, total and appendicular lean mass were lower (p=0.013 and p=0.010 respectively), whereas total fat mass was higher (p<0.001). In 30% of the PsA patients, skeletal muscle mass was below the cut-off for low muscle quantity (men 7.26 kg/m2, women 5.5 kg/m2), whereas no such change was observed in the control group. After 6 months of treatment with UST, there was no significant change in BMI in 18 of the PsA patients. Total lean mass decreased slightly (p=0.046), whereas fat mass tended to increase, but not significantly. No significant changes in appendicular lean mass and skeletal muscle mass index were observed. CONCLUSION In this study, we found that PsA patients had higher fat mass and lower lean mass than healthy controls. At 6-months of treatment, total lean mass decreased slightly, whereas fat mass tended to increase, but not significantly.
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Affiliation(s)
- Julien Paccou
- Univ. Lille, CHU Lille, MABlab ULR 4490, Department of Rheumatology, 59000, Lille, France
| | - Wallis Bavière
- Univ. Lille, CHU Lille, Department of Rheumatology, 59000, Lille, France
| | | | - Pawel Szulc
- INSERM UMR 1033, Université de Lyon, Hôpital E Herriot, Lyon, France
| | - Nassima Ramdane
- Univ. Lille, CHU Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, F-59000, Lille, France
| | - Bernard Cortet
- Univ. Lille, CHU Lille, MABlab ULR 4490, Department of Rheumatology, 59000, Lille, France
| | - Roland Chapurlat
- INSERM UMR 1033, Université de Lyon, Hôpital E Herriot, Lyon, France
| | - René-Marc Flipo
- Univ. Lille, CHU Lille, Department of Rheumatology, 59000, Lille, France
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Assan F, Tubach F, Arlegui H, Viguier M, Beylot-Barry M, Dupuy A, Beneton N, Joly P, Jullien D, Mahé E, Paul C, Richard MA, Bachelez H, Giboin C, Chosidow O, Sbidian E. First-Line Biologic Therapy and Obesity in Moderate-to-Severe Psoriasis: Results from the Prospective Multicenter Cohort Psobioteq. Dermatology 2021; 237:338-346. [PMID: 33535213 DOI: 10.1159/000513398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/26/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Obesity is associated with an increased risk of psoriasis. OBJECTIVE In this study, we examined whether body mass index (BMI) is taken into account when choosing first-line biologic therapy for psoriasis. METHODS In this cohort study, we compared obese (BMI ≥30 kg/m2) and non-obese patients for the first-line biologic therapy prescribed, its survival, reasons for discontinuation, therapy optimization, co-prescription of methotrexate and factors associated with long drug survival. RESULTS A total of 931 patients were included: 594 (64%) were male, median age was 46 years (interquartile range 36-56). The most-prescribed biologic agents as first-line treatment were adalimumab (ADA; 42.7%), ustekinumab (UST; 29.9%) and etanercept (ETA; 22.9%); only frequency of infliximab (IFX) prescription differed between groups. Drug survival was significantly shorter for obese than non-obese patients (p < 2.10-4) and was worse for obese than non-obese patients for UST (p = 0.009) and ETA (p = 0.02), with no difference for ADA (p = 0.11). The main reason for discontinuation was primary inefficacy (62%), which was more frequent in obese than non-obese patients. The cumulative incidence of optimization did not significantly differ between the groups, except for ADA (SHR 1.91, 95% CI [1.23-2.96], p = 0.005). On multivariate analysis, risk of discontinuation was associated with only ETA as first-line biologic therapy (HR 1.51, 95% CI 1.04-2.19). CONCLUSION This study highlighted the lack of difference in prescription of first-line biologic treatment, except for IFX, between obese and non-obese patients presenting moderate-to-severe psoriasis. Drug survival in obese patients is shorter, mainly because of inefficacy, than in non-obese patients. This highlights the need for targeted pharmacological studies in obese individuals to find optimal administration schemes.
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Affiliation(s)
- Florence Assan
- Department of Dermatology, Hôpital Henri Mondor, Créteil, France
| | - Florence Tubach
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.,AP-HP, Sorbonne Université, Hôpital Pitié Salpêtrière, Centre de Pharmacoépidémiologie (Cephepi), Paris, France
| | - Hugo Arlegui
- AP-HP, Sorbonne Université, Hôpital Pitié Salpêtrière, Centre de Pharmacoépidémiologie (Cephepi), Paris, France
| | - Manuelle Viguier
- Department of Dermatology-Venereology, Hôpital Robert Debré, Reims, France
| | - Marie Beylot-Barry
- Department of Dermatology, Hôpital Saint-André, INSERM U1053, Oncogenesis of Cutaneous Lymphoma, Bordeaux, France
| | - Alain Dupuy
- Department of Dermatology, University of Rennes, CHU Rennes, Rennes, France.,REPERES Pharmaco-Epidemiology and Health Services Research, University Rennes and French School of Public Health, Rennes, France
| | | | - Pascal Joly
- Department of Dermatology, Rouen University Hospital, INSERM U1234, Normandy University Rouen, Rouen, France
| | - Denis Jullien
- Department of Dermatology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Emmanuel Mahé
- Department of Dermatology, Hôpital Victor Dupouy, Argenteuil, France
| | - Carle Paul
- Department of Dermatology, Toulouse University Hospital (CHU), Paul Sabatier University, Toulouse, France
| | | | - Hervé Bachelez
- Department of Dermatology, AP-HP Hôpital Saint-Louis, Sorbonne Paris Cité Université Paris Diderot, Paris, France.,INSERM UMR1163, Institut Imagine, Paris, France
| | - Caroline Giboin
- AP-HP, Sorbonne Université, Hôpital Pitié Salpêtrière, Centre de Pharmacoépidémiologie (Cephepi), Paris, France
| | - Olivier Chosidow
- Department of Dermatology, Hôpital Henri Mondor, Créteil, France.,Hôpital Henri Mondor, Clinical Investigation Centre, Créteil, France.,Université Paris Est Créteil (UPEC), Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), Créteil, France
| | - Emilie Sbidian
- Department of Dermatology, Hôpital Henri Mondor, Créteil, France, .,Hôpital Henri Mondor, Clinical Investigation Centre, Créteil, France, .,Université Paris Est Créteil (UPEC), Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), Créteil, France,
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Ghashang SK, Raha S, Hamdan I, Gutenbrunner C, Nugraha B. A prospective controlled study on Ramadan fasting in the healthy young males in summer in Germany: effect on cytokines. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2020; 18:425-431. [PMID: 34187127 DOI: 10.1515/jcim-2019-0209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 08/18/2020] [Indexed: 12/21/2022]
Abstract
SHORT COMMUNICATION During the Ramadan fasting (RF) month, participants restrict some activities during day time, particularly consumption of food and beverages. In Germany, Muslims fast about 18-19 h a day when Ramadan falls in the summer. This longer period of restriction could lead to the changes of the body physiology, anthropometric parameters and biological mediators. OBJECTIVES This study aimed to determine the effect of Ramadan fasting on cytokines (Interleukin (IL)-1β. IL-6, IL-8, IL-10, IL-12, tumor necrosis factor (TNF)-α) during RF in Germany. Correlations of cytokines with anthropometric parameters were also determined. METHODS Fifty healthy adult males were recruited and divided into two equal groups: fasting group (FG) and non-fasting group (NFG). FG was evaluated at T1: one week before, T2: mid-, T3: last days of, and T4: one week after Ramadan. The NFG were evaluated only at T1 and T3. RESULTS In FG significant alterations of IL-1β was observed. Insignificant differences were found between the FG and NFG at T1 and T3 concerning the measured cytokines. Circulating IL-1β increased significantly from T2 to T4 and from T3 to T4. At T3, TNF-α was correlated significantly with anthropometric parameters such as the body weight, the skeletal muscle mass and the fat free mass, whilst IL-12 was correlated significantly with the skeletal muscle mass, the fat free mass and the body water mass at T4. CONCLUSIONS Significant Alterations of IL-1β during RF in FG were observed. Anthropometric parameters correlate with TNF-α and IL-12 levels during at T3 and T4, respectively.
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Affiliation(s)
| | - Solaiman Raha
- Department Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany
| | - Imad Hamdan
- Department Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany
| | - Christoph Gutenbrunner
- Department Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany
| | - Boya Nugraha
- Department Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany
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Blake T, Gullick NJ, Hutchinson CE, Barber TM. Psoriatic disease and body composition: A systematic review and narrative synthesis. PLoS One 2020; 15:e0237598. [PMID: 32790787 PMCID: PMC7425946 DOI: 10.1371/journal.pone.0237598] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/29/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Obesity is a leading comorbidity in psoriatic disease, including both psoriasis (PsO) and psoriatic arthritis (PsA), and is associated with adverse metabolic and cardiovascular (CV) outcomes. Anthropometric parameters, such as weight, body mass index (BMI) and waist-to-hip ratio, have been extensively reported in psoriatic disease. However, the associations of body composition and fat distribution with psoriasis have not yet been fully defined. OBJECTIVES To identify whether patients with psoriatic disease, including psoriatic arthritis, have altered body composition compared with the general population, and to review existing modalities for the assessment of body composition. METHODS Electronic searches of the literature were conducted in PubMed, Medline (Ovid®), Embase (Ovid®), Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar. Titles and abstracts were reviewed by two authors independently against a set of prespecified inclusion/exclusion criteria. The research question was answered with a systematic literature review and results were summarized narratively. RESULTS Twenty-five full text articles met the inclusion criteria and were included in the final narrative analysis. The studies were of heterogeneous design and used a range of objective measures to assess body composition, including simple anthropometric measures, bioimpedance analysis (BIA), dual energy X-ray absorptiometry (DXA) and computed tomography (CT). Few studies met all the quality assessment criteria. Clinical heterogeneity prevented meta-analysis. CONCLUSIONS Patients with psoriatic disease reveal defined body composition changes that are independent of obesity and the customary metabolic syndrome, including higher overall body fat, visceral fat and sarcopenia. These findings emphasize that patients with psoriatic disease should be screened for abnormal adipose effects beyond their weight and body mass index (BMI). Our findings show that the last decade has seen an exciting expansion of research interest in the development and validation of new modalities for the assessment of body composition. There is no consensus on the optimal assessment method of body composition for this diverse group; hence there is a need for validation of existing modalities and standardization of assessment tools.
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Affiliation(s)
- Tim Blake
- Rheumatology Department, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Nicola J. Gullick
- Rheumatology Department, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - Charles E. Hutchinson
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Department of Imaging, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - Thomas M. Barber
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
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Toussirot E. The Interrelations between Biological and Targeted Synthetic Agents Used in Inflammatory Joint Diseases, and Obesity or Body Composition. Metabolites 2020; 10:E107. [PMID: 32183053 PMCID: PMC7175105 DOI: 10.3390/metabo10030107] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/08/2020] [Accepted: 03/10/2020] [Indexed: 12/16/2022] Open
Abstract
Obesity is a comorbidity that plays a role in the development and severity of inflammatory joint diseases, including rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis. The relationships between obesity and adipose tissue and the treatments given for inflammatory joint diseases are bidirectional. In fact, biological agents (bDMARDs) and targeted synthetic agents (tsDMARDs) may influence body weight and body composition of treated patients, while obesity in turn may influence clinical response to these agents. Obesity is a prevalent comorbidity mainly affecting patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) with specific phenotypes. Tumour necrosis factor alpha (TNFα) inhibitors have been associated with changes in body composition by improving lean mass, but also by significantly increasing fat mass, which localized toward the abdominal/visceral region. The IL-6 inhibitor tocilizumab is associated with an increase in lean mass without change in fat mass. The clinical response to TNFα inhibitors is attenuated by obesity, an effect that is less pronounced with IL-6 inhibitors and the B-cell depletion agent rituximab. Conversely, body weight has no influence on the response to the costimulation inhibitor abatacept. These effects may be of help to the physician in personalized medicine, and may guide the therapeutic choice in obese/overweight patients.
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Affiliation(s)
- Eric Toussirot
- INSERM CIC-1431, CHU de Besançon, Centre d’Investigation Clinique Biothérapie, Pôle Recherche, 25000 Besançon, France; ; Tel.: +33-3-81-21-89-97
- Fédération Hospitalo-Universitaire INCREASE, CHU de Besançon, 25000 Besançon, France
- CHU de Besançon, Rhumatologie, Pôle PACTE (Pathologies Aiguës Chroniques Transplantation Éducation), 25000 Besançon, France
- Département Universitaire de Thérapeutique, Université de Bourgogne Franche-Comté, UFR des Sciences Médicales et Pharmaceutiques de Besançon, CS 71806, 25030 Besançon Cedex, France
- INSERM UMR1098, Relations Hôte Greffon Tumeurs, ingénierie cellulaire et génique, Université de Bourgogne Franche-Comté, 25000 Besançon, France
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D’Adamio S, Silvaggio D, Lombardo P, Bianchi L, Talamonti M, Galluzzo M. The safety of anti-interleukins monoclonal antibodies for the treatment of psoriasis. Expert Opin Drug Saf 2019; 18:1031-1041. [DOI: 10.1080/14740338.2019.1663168] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- S. D’Adamio
- Dermatology Unit, University of Rome “Tor Vergata”, Rome, Italy
| | - D. Silvaggio
- Dermatology Unit, University of Rome “Tor Vergata”, Rome, Italy
| | - P. Lombardo
- Dermatology Unit, University of Rome “Tor Vergata”, Rome, Italy
| | - L. Bianchi
- Dermatology Unit, University of Rome “Tor Vergata”, Rome, Italy
| | - M. Talamonti
- Dermatology Unit, University of Rome “Tor Vergata”, Rome, Italy
| | - M. Galluzzo
- Dermatology Unit, University of Rome “Tor Vergata”, Rome, Italy
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12
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Dalamaga M, Papadavid E. Can we better strategize our choice of pharmacotherapy for patients with co-morbid psoriasis and obesity? Expert Opin Pharmacother 2019; 20:1303-1308. [PMID: 31002541 DOI: 10.1080/14656566.2019.1603294] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Maria Dalamaga
- a Department of Biological Chemistry , Medical School, National and Kapodistrian University of Athens , Athens , Greece.,b 2nd Department of Dermatology and Venereal Diseases , Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Evangelia Papadavid
- b 2nd Department of Dermatology and Venereal Diseases , Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece
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