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Rahmanpour D, Malek Mahdavi A, Mahmoudi M, Esalatmanesh K, Akhgari A, Hajialilo M, Ghassembaglou A, Farzaneh R, Azizi S, Khabbazi A. Cigarette smoking and risk of adult-onset Still disease: a propensity score matching analysis. Intern Med J 2024; 54:467-472. [PMID: 37496301 DOI: 10.1111/imj.16186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/04/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Environmental factors play an important role in the pathogenesis of rheumatic diseases. Smoking is thought to be a risk factor for autoimmune rheumatic diseases. AIMS The purpose of the present study was to assess the association between smoking and adult-onset Still disease (AOSD) and the effect of smoking on outcomes of this disease. METHODS In this case-control study, patients with AOSD who met the Yamaguchi criteria, were older than 16 years at the disease onset and were in follow-up for at least 12 months were consecutively enrolled in the study. The outcome of AOSD was assessed by acquiring remission on treatment, remission off treatment, time to remission and rate of flare. The smoking status of participants was defined by direct or phone interviews. Individuals who had smoked daily for at least 6 months were defined as a smoker. We performed propensity score matching analyses by using four parameters, including age, sex, educational status and marital status. RESULTS Propensity score matching resulted in 72 patients with AOSD and 216 matched controls. The number of ever smokers in the AOSD and control groups were 11 (15.3%) and 25 (11.6%) respectively. There was no significant increase in the risk of AOSD in multivariate analysis after adjustment for age, sex, marital status and educational level. There were no significant differences in the outcomes of AOSD between ever and never smokers. CONCLUSIONS Smoking probably is not a risk factor for AOSD and did not affect the response to treatment.
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Affiliation(s)
- Dara Rahmanpour
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Aida Malek Mahdavi
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Rahat Breath and Sleep Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Mahmoudi
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kamal Esalatmanesh
- Internal Medicine Department, Kashan University of Medical Sciences, Kashan, Iran
| | - Aisan Akhgari
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrzad Hajialilo
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arezou Ghassembaglou
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rojin Farzaneh
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Azizi
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Khabbazi
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Dinler M, Yaşar Bilge NŞ, Arslan AE, Yıldırım R, Kaşifoğlu T. Neurologic manifestations of Behçet disease: rheumatology experience. Z Rheumatol 2024; 83:200-205. [PMID: 37848717 DOI: 10.1007/s00393-023-01436-0] [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] [Accepted: 09/07/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE Neurologic involvement in Behçet disease (BD) is a rare manifestation. Herein, we aimed to evaluate the clinical features and treatment choices of neuro-Behçet (NB) patients. METHODS There were records of 800 BD patients between 1998 and 2021. Fifty-five of the BD patients had NB and the files of these patients were retrospectively evaluated. Patients were grouped into three subgroups: 22 (40%) had non-parenchymal, 25 (45%) had parenchymal, and 8 (15%) had both parenchymal and non-parenchymal (mixed) involvement. RESULTS Of the 55 patients, 32 were male. Twenty-six of the NB patients were diagnosed with BD simultaneously. The most common complaint was headache (n = 24, 44%). The most affected site was periventricular white matter (n = 21, 38%). All patients had received corticosteroids. Azathioprine (AZA; n = 39, 71%) was the most common immunosuppressive agent after corticosteroids, followed by cyclophosphamide (n = 16, 29%). CONCLUSION Neurologic involvement is a rare complication of BD but is related to increased mortality and morbidity. Neurologic manifestations may be the initial symptom of BD, thus leading to diagnosis. Both neurology and rheumatology specialists should be aware of this rare condition.
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Affiliation(s)
- Mustafa Dinler
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
| | - Nazife Şule Yaşar Bilge
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey.
| | - Ayşe Erçin Arslan
- Department of Internal Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Reşit Yıldırım
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
| | - Timuçin Kaşifoğlu
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
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Merashli M, Bucci T, Delgado-Alves J, Ames PRJ. Relevance of vein wall thickness in Behcet's disease: A systematic review and meta-analysis. Autoimmun Rev 2024; 23:103487. [PMID: 38040099 DOI: 10.1016/j.autrev.2023.103487] [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: 11/10/2023] [Accepted: 11/23/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVES To perform a meta-analysis on articles evaluating the common femoral vein wall thickness (VWT) in Behcet's disease and its possible clinical, laboratory and treatment correlates (BD). METHODS Systematic search of EMBASE and PubMed databases from inception to October 2023; we employed random effect meta-analyses for continuous outcomes. RESULTS The meta-analysis included 9 case-control and 1 cohort study: the VWT was greater in BD (n = 650) than in controls (n = 396) (p < 0.0001) with wide heterogeneity (I2 = 94.4%); a sensitivity analysis that included mean age of BD participants, gender, disease duration and activity, C-reactive protein, smoking status, immune-suppressive and anti-inflammatory medication, revealed that the heterogeneity variance was partly explained by age (p < 0.0001), male gender (p = 0.03), disease duration (p < 0.0001) and smoking (p = 0.06). The VWT was greater in BD with thrombotic/vascular (n = 189) than in non-thrombotic/vascular BD (n = 140) (p = 0.006) with no heterogeneity. CONCLUSION VWT is greater in BD than controls: age, male gender, disease duration and smoking relate to VWT that was greater in BD patients with a history of thrombotic/vascular disease. Prospective studies are required to assess whether VWT may be considered a vascular marker of disease activity.
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Affiliation(s)
- Mira Merashli
- Department of Rheumatology, American University of Beirut, Beirut, Lebanon
| | - Tommaso Bucci
- Department of General and Specialised Surgery, Sapienza University of Rome, Rome, Italy
| | - Jose Delgado-Alves
- Immune Response & Vascular Disease Unit, CEDOC, Nova University Lisbon, Rua Camara Pestana, Lisbon, Portugal
| | - Paul R J Ames
- Immune Response & Vascular Disease Unit, CEDOC, Nova University Lisbon, Rua Camara Pestana, Lisbon, Portugal; Department of Haematology, Dumfries Royal Infirmary, Cargenbridge, Dumfries, UK.
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Moos J, Moos Ł, Brzoza Z. Can smoking have a positive effect on the course of certain diseases? A systematic review. MEDICAL SCIENCE PULSE 2022. [DOI: 10.5604/01.3001.0015.8804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Smoking cigarettes is a process during which many harmful substances are introduced into the lungs and the influence of these substances on the human body is not completely known. There are many diseases caused by smoking. Interestingly, there are also reports of positive consequences of smoking on some disorders. Aim of the study: The purpose of this article is to review the literature in regards to the diseases in which cigarettes might have a paradoxically beneficial effect — both on the onset and their course. We also want to focus on the mechanisms responsible for this impact. Material and Methods: Electronic searching of PubMed was performed. We analyzed articles published in the last 10 years with a particular emphasis on the most recent publications. Combinations of the following words were used: “smoking”, “nicotine”, and “autoimmune”. Publications were selected for reliability and non-bias. Results: A total of 69 articles out of 2979 qualified for the review. Only studies involving humans were included. The positive effect of smoking cigarettes is observed especially in immunological diseases. It is possible that it is mediated by both stimulating and suppressing the immune system. It is assumed that cigarettes can reduce the risk of developing certain diseases. Smoking might also have an impact on the course of different comorbidities in the same patient. Conclusions: There are many different mechanisms through which cigarette smoke and nicotine affect the human body. The harmful impact of these substances on one’s health has been demonstrated and their addictive component disqualifies them as remedies. Analysis of the mechanisms responsible for the beneficial effects of nicotine can lead to the search for new forms of therapy and prevention.
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Affiliation(s)
- Justyna Moos
- Department of Internal Diseases with Division of Diabetology, Hospital of the Ministry of Interior and Administration in Opole, Poland
| | - Łukasz Moos
- Department of Internal Diseases with Division of Allergology, Institute of Medical Sciences, University of Opole, Poland
| | - Zenon Brzoza
- Department of Internal Diseases with Division of Allergology, Institute of Medical Sciences, University of Opole, Poland
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Choi SH, BA, Kim DY. Epidemiologic and Etiological Features of Korean Patients With Behçet's Disease. JOURNAL OF RHEUMATIC DISEASES 2021; 28:183-191. [PMID: 37476362 PMCID: PMC10324907 DOI: 10.4078/jrd.2021.28.4.183] [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: 08/17/2021] [Accepted: 08/25/2021] [Indexed: 07/22/2023]
Abstract
Behçet's disease (BD) is a multisystem disease in which environmental factors provoke an adverse immune response in patients with genetic susceptibility towards BD, subsequently leading to a cascade of dysregulated inflammation throughout the body. It is particularly prevalent in regions spanning the ancient Silk Road, including Korea, where the first known case of BD was reported in 1961. We summarize the history, epidemiology, and clinical presentation of BD in Korea, highlighting the clinical tendencies that are particularly seen in the Korean BD population as compared to European populations. Analysis of epidemiologic trends over the past three decades in Korea shows a decreasing prevalence of complete BD and a higher prevalence of intestinal BD. We also discuss the ever-evolving understanding of the pathogenesis of BD, noting the complex interplay among genetics, environment, and immunology. The HLA-B51 allele is the most significant known genetic risk factor in developing BD. We also discuss more recently studied associations between BD and immune factors such as IL-10, IL-23R-IL-12RB2, IL-1A-IL-1B, CCR1, ERAP1, and the GIMAP cluster, the last of which has been found to have an association with BD specifically in Korea. Environmental factors such as pollution and microbials are often the inciting event in developing BD, as they trigger an imbalanced immune response in genetically susceptible individuals, one that has been often found to exhibit an aberrant Th1/Th17 response. There would be value to further studying the pathogenesis and clinical characteristics of Korean BD.
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Affiliation(s)
- Soo Hyun Choi
- Tulane University School of Medicine, New Orleans, LA, USA
| | - BA
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Do-Young Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Torgutalp M, Eroğlu DŞ, Sezer S, Yayla ME, Karataş G, Özel EM, Dinçer A, Yüksel ML, Gülöksüz E, Yılmaz R, Turgay TM, Kınıklı G, Ateş A. Patients characteristics in Behçet's Syndrome and their associations with major organ involvement: a single-centre experience of 2118 cases. Scand J Rheumatol 2021; 51:50-58. [PMID: 34121600 DOI: 10.1080/03009742.2021.1904622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objectives: To evaluate the demographic and clinical characteristics of patients with Behçet's syndrome (BS), and to define their associations with the presence of major organ involvement (MOI).Method: Medical records of 2118 patients (964 males, 1154 females) were analysed retrospectively. MOI was defined as the presence of at least one of vascular, eye, nervous, or gastrointestinal system involvement. Univariable and multivariable binary and ordinal logistic regression analyses were applied to assess the factors that were potentially associated with MOI.Results: The mean ± sd age at diagnosis was 30.5 ± 9.4 years. Genital ulcer and joint involvement were more common in females (both p < 0.001), while MOI was more frequent in males (p < 0.001). Genital ulcer (p < 0.001) and vascular involvement (p = 0.006) were more common in patients with a younger age at diagnosis, while joint involvement was more common in older patients. A total of 1097 patients (51.8%) had at least one MOI, 322 (15.2%) at least two MOIs, and 48 (2.3%) at least three MOIs. Male gender, smoking history, and absence of genital ulcer were significantly associated with MOI in multivariable binary logistic regression. Multivariable ordinal regression analyses confirmed the association between MOI and male gender and smoking, but not the protective effect of genital ulcers. In both regression analyses, we found no significant effects of age, human leucocyte antigen-B51, skin involvement, or joint involvement on MOI.Conclusion: Male gender and positive smoking history have a significant influence on the presence of MOI in patients with BS.
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Affiliation(s)
- M Torgutalp
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey.,Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité-Universitätsmedizin, Berlin, Germany
| | - D Ş Eroğlu
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - S Sezer
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - M E Yayla
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - G Karataş
- Faculty of Medicine, Department of Internal Medicine, Ankara University, Ankara, Turkey
| | - E M Özel
- Faculty of Medicine, Department of Internal Medicine, Ankara University, Ankara, Turkey
| | - Abk Dinçer
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - M L Yüksel
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - Ega Gülöksüz
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - R Yılmaz
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - T M Turgay
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - G Kınıklı
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
| | - A Ateş
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Turkey
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Abstract
Behcet's syndrome (BS) is a chronic systemic inflammatory vasculitis with a wide range of clinical manifestations including recurrent oral and genital ulcers; cutaneous lesions; and ophthalmic, neurologic, and gastrointestinal involvement. BS has a global distribution but is particularly prevalent in so-called Silk Road populations. Disease onset is usually around the third or fourth decade of life, and the sex ratio is roughly 1:1. Both environmental and genetic factors contribute to the etiology of BS, although the detailed mechanisms remain unclear. At present, there is no laboratory examination with diagnostic value for BS; therefore, a diagnosis is made based on clinical manifestations. The International Study Group diagnostic criteria published in 1990 is the most widely used and recognized, but in order to improve sensitivity, the International Criteria for Behcet's Disease is developed in 2014. Evaluating disease activity in BS is an important basis for treatment selection and monitoring, the simplified Behcet's Disease Current Activity Form (2006 version) is a well-established scoring method. Given that multiple organs are affected in BS, it must be differentiated from other diseases with similar manifestations or that may be induced by drug treatment. The goal of BS treatment is to eradicate triggers and/or aggravating factors, alleviate and control clinical symptoms, prevent and treat any damage to organs, slow disease progression, and improve the patient's quality of life. The clinical management of BS depends on the affected organs and disease severity. In this review, we summarize the current state of knowledge of BS pathogenesis and therapeutic options.
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Affiliation(s)
- Jingjing Chen
- Department of Allergy and Rheumatology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences, Peking Union Medical College, 12 Jiangwangmiao Street, Nanjing, 210042, China
| | - Xu Yao
- Department of Allergy and Rheumatology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences, Peking Union Medical College, 12 Jiangwangmiao Street, Nanjing, 210042, China.
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Signature of Circulating Biomarkers in Recurrent Non-Infectious Anterior Uveitis. Immunomodulatory Effects of DHA-Triglyceride. A Pilot Study. Diagnostics (Basel) 2021; 11:diagnostics11040724. [PMID: 33921773 PMCID: PMC8072877 DOI: 10.3390/diagnostics11040724] [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: 04/11/2021] [Revised: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 12/11/2022] Open
Abstract
The purpose of this study was to identify circulating biomarkers of recurrent non-infectious anterior uveitis (NIAU), and to address the anti-inflammatory effects of triglyceride containing docosahexaenoic acid (DHA-TG). A prospective multicenter study was conducted in 72 participants distributed into: patients diagnosed with recurrent NIAU in the quiescence stage (uveitis group (UG); n = 36) and healthy controls (control group (CG); n = 36). Each group was randomly assigned to the oral supplementation of one pill/day (+) containing DHA-TG (n = 18) or no-pill condition (−) (n = 17) for three consecutive months. Data from demographics, risk factors, comorbidities, eye complications and therapy were recorded. Blood was collected and processed to determine pro-inflammatory biomarkers by bead-base multiplex assay. Statistical processing with multivariate statistical analysis was performed. The mean age was 50, 12 (10, 31) years. The distribution by gender was 45% males and 55% females. The mean number of uveitis episodes was 5 (2). Higher plasma expression of interleukin (IL)-6 was detected in the UG versus the CG (p = 5 × 10−5). Likewise, significantly higher plasma levels were seen for IL-1β, IL-2, INFγ (p = 10−4), and TNFα (p = 2 × 10−4) in the UG versus the CG. Significantly lower values of the above molecules were found in the +DHA-TG than in the -DHA-TG subgroups, after 3 months of follow-up, TNFα (p = 10−7) and IL-6 (p = 3 × 10−6) being those that most significantly changed. Signatures of circulating inflammatory mediators were obtained in the quiescent stage of recurrent NIAU patients. This 3-month follow-up strongly reinforces that a regular oral administration of DHA-TG reduces the inflammatory load and may potentially supply a prophylaxis-adjunctive mediator for patients at risk of uveitis vision loss.
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Jung JH, Han KD, Lee YB, Park YG. Behçet's Disease Is Associated with Multiple Sclerosis and Rheumatoid Arthritis: A Korean Population-Based Study. Dermatology 2021; 238:86-91. [PMID: 33756455 DOI: 10.1159/000514634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 01/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND No epidemiologic study has previously reported on the associations among Behçet's disease (BD) and autoimmune disorders. OBJECTIVES To investigate the association between BD and the autoimmune disorders multiple sclerosis and rheumatoid arthritis. METHODS Medical records of patients newly diagnosed with BD (n = 6,214) in 2012-2017 were analyzed using data entered into a large, nationwide database from 2007 to 2017. An age- and sex-matched control population of individuals without BD was sampled at a ratio of controls:BD cases of 3:1 (n = 18,642). Both cohorts were analyzed for the presence of multiple sclerosis or rheumatoid arthritis within a minimum of 5 years prior to their BD diagnosis. RESULTS Patients with BD had significantly higher odds ratios (ORs) for multiple sclerosis (8.85 [95% CI 2.36-33.17]) and rheumatoid arthritis (4.62 [95% CI 3.35-6.35]) than the control group after adjustment for diabetes mellitus, hypertension, and dyslipidemia. BD patients aged <40 years had a higher proportion of rheumatoid arthritis (OR 23.91, 95% CI 5.50-103.9) than older patients (OR 3.96, 95% CI 2.83-5.54). CONCLUSION Our results suggest that BD is associated with multiple sclerosis and rheumatoid arthritis.
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Affiliation(s)
- Jin Hyung Jung
- Department of Biomedicine and Health Science, Graduate School, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Young Bok Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea,
| | - Yong Gyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Soejima Y, Kirino Y, Takeno M, Kurosawa M, Takeuchi M, Yoshimi R, Sugiyama Y, Ohno S, Asami Y, Sekiguchi A, Igarashi T, Nagaoka S, Ishigatsubo Y, Nakajima H, Mizuki N. Changes in the proportion of clinical clusters contribute to the phenotypic evolution of Behçet's disease in Japan. Arthritis Res Ther 2021; 23:49. [PMID: 33522943 PMCID: PMC7851921 DOI: 10.1186/s13075-020-02406-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/25/2020] [Indexed: 12/13/2022] Open
Abstract
Background We hypothesized that Behçet’s disease (BD) consists of several clinical subtypes with different severity, resulting in heterogeneity of the disease. Here, we conducted a study to identify clinical clusters of BD. Methods A total of 657 patients registered in the Yokohama City University (YCU) regional BD registry between 1990 and 2018, as well as 6754 patients who were initially registered in the Japanese Ministry of Health, Labour and Welfare (MHLW) database between 2003 and 2014, were investigated. The YCU registry data regarding the clinical manifestations of BD, human leukocyte antigen (HLA) status, treatments, and hospitalizations were analyzed first, followed by similar analyses of the MHLW for validation. A hierarchical cluster analysis was independently performed in both patient groups. Results A hierarchical cluster analysis determined five independent clinical clusters in the YCU cohort. Individual counterparts of the YCU clusters were confirmed in the MHLW registry. Recent phenotypical evolutions of BD in Japan, such as increased gastrointestinal (GI) involvement, reduced complete type according to the Japan Criteria, and reduced HLA-B51 positivity were associated with chronologically changing proportions of the clinical clusters. Conclusions In this study, we identified independent clinical clusters among BD patients in Japan and found that the proportion of each cluster varied over time. We propose five independent clusters namely “mucocutaneous”, “mucocutaneous with arthritis”, “neuro”, “GI”, and “eye.”
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Affiliation(s)
- Yutaro Soejima
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Yohei Kirino
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
| | - Mitsuhiro Takeno
- Department of Allergy and Rheumatology, Nippon Medical School, Musashi Kosugi Hospital, 1-396 Kosugi-machi, Nakahara-ku, Kawasaki, Kanagawa, 211-8533, Japan
| | - Michiko Kurosawa
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Masaki Takeuchi
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Ryusuke Yoshimi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Yumiko Sugiyama
- Yokohama City University Medical Center, Center for Rheumatic Diseases, 4-57 Urafunecho, Minami-ku, Yokohama, 232-0024, Japan
| | - Shigeru Ohno
- Yokohama City University Medical Center, Center for Rheumatic Diseases, 4-57 Urafunecho, Minami-ku, Yokohama, 232-0024, Japan
| | - Yukiko Asami
- Yokosuka Center for Rheumatic Diseases, Yokosuka City Hospital, 1-3-2 Nagasaka, Yokosuka, 240-0101, Japan
| | - Akiko Sekiguchi
- Department of Hematology and Rheumatology, Fujisawa City Hospital, 2-6-1 Fujisawa, Fujisawa, 251-8550, Japan
| | - Toshihisa Igarashi
- Department of Rheumatology, Yamato City Hospital, Fukaminishi, Yamato, 242-8602, Japan
| | - Shohei Nagaoka
- Department of Rheumatology, Yokohama Minami Kyosai Hospital, 1-21-1 Mutsuura Higashi, Yokohama, 236-0037, Japan
| | - Yoshiaki Ishigatsubo
- Yokohama City University, Yokohama, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Hideaki Nakajima
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Nobuhisa Mizuki
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
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Gazel U, Ayan G, Solmaz D, Akar S, Aydin SZ. Comment on: The impact of smoking on prevalence of psoriasis and psoriatic arthritis: reply. Rheumatology (Oxford) 2021; 60:e27. [PMID: 32995878 DOI: 10.1093/rheumatology/keaa559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ummugulsum Gazel
- Rheumatology, University of Ottawa Faculty of Medicine.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Gizem Ayan
- Rheumatology, University of Ottawa Faculty of Medicine.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Dilek Solmaz
- Department of Internal Medicine, Division of Rheumatology, Izmir Katip Celebi University, Izmir, Turkey
| | - Servet Akar
- Department of Internal Medicine, Division of Rheumatology, Izmir Katip Celebi University, Izmir, Turkey
| | - Sibel Zehra Aydin
- Rheumatology, University of Ottawa Faculty of Medicine.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
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Cigarette Smoking Is Associated with Increased Risk of Malignant Gliomas: A Nationwide Population-Based Cohort Study. Cancers (Basel) 2020; 12:cancers12051343. [PMID: 32466105 PMCID: PMC7280985 DOI: 10.3390/cancers12051343] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/13/2020] [Accepted: 05/22/2020] [Indexed: 01/23/2023] Open
Abstract
The association between cigarette smoking and the risk of developing malignant glioma (MG) remains unclear. We aimed to evaluate this potential association in a large general population, using a well-established and validated longitudinal nationwide database. Using data from the Korean National Health Insurance System cohort, 9,811,768 people over 20 years old without any cancer history in 2009 were followed until the end of 2017. We documented 6100 MG cases (ICD-10 code C71) during the median follow-up period of 7.31 years. Current smokers had a higher risk of developing MG (HR = 1.22, CI: 1.13–1.32) compared with never-smokers, after adjusting for confounders. This association was stronger for those who smoked ≥ 20 cigarettes daily (HR = 1.50, CI: 1.36–1.64). Furthermore, having 30 or more pack-years of smoking over the course of one’s lifetime was associated with an increased risk of developing MG in a dose-dependent manner, compared with never-smokers (HR = 1.31, CI: 1.16–1.48 for 30–39 pack-years of smoking; HR = 1.36, CI: 1.17–1.59 for 40–49 pack-years of smoking; HR = 1.68; CI: 1.44–1.95 for ≥ 50 pack-years of smoking). These results suggest that cigarette smoking may be associated with developing MG. Further prospective studies could help elucidate this association.
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Lee YB, Lee JH, Lee SY, Yu DS, Han KD, Park YG. Association between vitiligo and smoking: A nationwide population-based study in Korea. Sci Rep 2020; 10:6231. [PMID: 32277157 PMCID: PMC7148336 DOI: 10.1038/s41598-020-63384-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 03/18/2020] [Indexed: 01/23/2023] Open
Abstract
No study has examined the associations between vitiligo and smoking. The purpose of this study was to investigate the incidence of vitiligo according to smoking status. We used clinical data from individuals aged over 20 years who received a health examination in the National Insurance Program between 2009 and 2012 (n = 23,503,807). We excluded individuals with pre-existing vitiligo who had ever been diagnosed with vitiligo before the index year (n = 35,710) or who were diagnosed with vitiligo within a year of the index year (n = 46,476). Newly diagnosed vitiligo was identified using claims data from baseline to date of diagnosis or December 31, 2016 (n = 22,811). The development of vitiligo was compared according to self-reported smoking status by a health examination survey. The hazard ratio of vitiligo in current smokers was 0.69 (95% confidence interval; 0.65-0.72) with a reference of never-smokers after adjustment for age, sex, regular exercise, drinking status, body mass index, diabetes mellitus, hypertension, dyslipidemia, history of stroke, and history of ischemic heart diseases. The decreased risk of vitiligo in current smokers persisted after subgroup analysis of sex and age groups. The results suggested there are suppressive effects of smoking on the development of vitiligo. Further studies are needed to evaluate the mechanism of smoking on the development of vitiligo.
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Affiliation(s)
- Young Bok Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Hyun Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Soo Young Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Soo Yu
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Gyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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