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Mena-Vázquez N, Redondo-Rodriguez R, Cabezudo-García P, Garcia-Studer A, Ortiz-Márquez F, Borregón-Garrido P, Martín-Valverde M, Ureña-Garnica I, Manrique-Arija S, Cano-García L, Fernández-Nebro A. Interstitial Lung Disease Is Associated with Sleep Disorders in Rheumatoid Arthritis Patients. Clocks Sleep 2023; 5:755-769. [PMID: 38131748 PMCID: PMC10742867 DOI: 10.3390/clockssleep5040049] [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: 10/08/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To evaluate sleep disorders and associated factors in patients with rheumatoid-arthritis-associated interstitial lung disease (RA-ILD). METHODS We performed an observational study of 35 patients with RA-ILD (cases) and 35 age- and sex-matched RA patients without ILD (controls). We evaluated sleep disorders (Oviedo Sleep Questionnaire), positive psychological factors (resilience using the Wagnild and Young Resilience Scale, emotional intelligence using the 24-item Trait Meta-Mood Scale), anxiety and depression (Hospital Anxiety and Depression Scale), quality of life (36-item short-form survey), and fatigue (Functional Assessment of Chronic Illness Therapy Questionnaire). Other variables studied included the Charlson Comorbidity Index (CCI) and RA activity according to the DAS28-ESR. RESULTS Compared to the controls, the cases were characterized by poorer sleep quality with a higher prevalence of insomnia (42% vs. 20%; p = 0.039), greater severity of insomnia (p = 0.001), and lower sleep satisfaction (p = 0.033). They also had poorer resilience and emotional recovery and more severe anxiety and depression. A diagnosis of ILD was the only factor independently associated with the three dimensions of sleep quality. The predictors of poorer sleep satisfaction in patients with RA-ILD were age (β = -0.379), DAS28-ESR (β = -0.331), and usual interstitial pneumonia pattern (β = -0.438). The predictors of insomnia were DAS28-ESR (β = 0.294), resilience (β = -0.352), and CCI (β = 0.377). CONCLUSIONS RA-ILD is associated with significant sleep disorders. RA-ILD seems to be an independent risk factor for sleep alterations, with a greater impact on insomnia. Age, disease activity, and comorbidity also play a role in sleep disorders in patients with RA-ILD.
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Affiliation(s)
- Natalia Mena-Vázquez
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Rocío Redondo-Rodriguez
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- Departamento de Medicina y Dermatología, Universidad de Málaga, 29010 Malaga, Spain;
| | - Pablo Cabezudo-García
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- UGC Neurociencia, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Aimara Garcia-Studer
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- Departamento de Medicina y Dermatología, Universidad de Málaga, 29010 Malaga, Spain;
| | - Fernando Ortiz-Márquez
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- Departamento de Medicina y Dermatología, Universidad de Málaga, 29010 Malaga, Spain;
| | - Paula Borregón-Garrido
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
| | | | - Inmaculada Ureña-Garnica
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Sara Manrique-Arija
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- Departamento de Medicina y Dermatología, Universidad de Málaga, 29010 Malaga, Spain;
| | - Laura Cano-García
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Antonio Fernández-Nebro
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- UGC Neurociencia, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
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Frede N, Rieger E, Lorenzetti R, Venhoff AC, Kanne AM, Finzel S, Jandova I, Glaser C, Thiel J, Voll RE, Venhoff N. Sleep behaviour differs in women and men with psoriatic arthritis and axial spondyloarthritis with impact on quality of life and depressive symptoms. RMD Open 2023; 9:rmdopen-2022-002912. [PMID: 37208029 DOI: 10.1136/rmdopen-2022-002912] [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: 12/02/2022] [Accepted: 05/03/2023] [Indexed: 05/21/2023] Open
Abstract
OBJECTIVES Axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) may have a profound impact on sleep and health-related quality of life. The aim of this study was to assess sleep quality and quality of life and determine associated factors in patients treated with spondyloarthritides (SpA). METHODS Cross-sectional questionnaire-based assessment of sleep behaviour, quality of life, functional impairment and depression (Regensburg Insomnia Scale, WHO Quality of Life questionnaire, Funktionsfragebogen Hannover questionnaire, Beck Depression Inventory II, Patient health questionnaire 9) and retrospective medical chart analysis of a monocentric cohort of 330 patients with SpA (n=168 PsA and n=162 axSpA). RESULTS 46.6% of patients with SpA demonstrated abnormal sleep behaviour. Linear regression models showed HLA-B27 positivity, Bath Ankylosing Spondylitis Disease Activity Index, depressive symptoms, functional capacity and disease duration to be predictive of insomnia symptoms in axSpA, respectively, depressive symptoms, female sex and Disease Activity Score 28 in patients with PsA. Patients with unrestful sleep had a significantly reduced health-related quality of life (p<0.001) as well as significantly more depressive symptoms (p<0.001). Satisfaction with health was rated significantly lower (p<0.001), indicating poor sleep as a burden on general well-being.In particular, female patients had a significantly worse sleep quality with a prolonged sleep latency (p=0.009), increased sleep disturbances (p=0.014) and unrestful sleep (p<0.001) as well as a reduced physical and mental health-related quality of life (p=0.015, p<0.001) and more depressive symptoms (p=0.015). CONCLUSION Despite treatment, many patients with SpA demonstrate abnormal sleep behaviour with symptoms of insomnia and a reduced quality of life with significant differences between male and female patients. An interdisciplinary and holistic approach may be needed to address unmet needs.
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Affiliation(s)
- Natalie Frede
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Eva Rieger
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Raquel Lorenzetti
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Ana C Venhoff
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Anna-Maria Kanne
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Stephanie Finzel
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Ilona Jandova
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Cornelia Glaser
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Jens Thiel
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
- Division of Rheumatology and Clinical Immunology, Medical University Graz, Graz, Austria
| | - Reinhard E Voll
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Nils Venhoff
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
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Nursing interventions for patients with rheumatic and musculoskeletal diseases on biological therapies: a systematic literature review. Clin Rheumatol 2023; 42:1521-1535. [PMID: 36801986 DOI: 10.1007/s10067-023-06520-z] [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: 08/09/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 02/21/2023]
Abstract
Investigating unmet needs and identifying the necessary interventions for patients affected by rheumatic and musculoskeletal diseases (RMDs) may help significantly to ensure the continuity and quality of the chronic care pathway. To this aim, the contribution of rheumatology nurses requires further evidence. The aim of our systematic literature review (SLR) was to identify the nursing interventions directed towards patients with RMDs undergoing biological therapy. To retrieve data, a search was carried out in the MEDLINE database, the Cumulative Index to Nursing and Allied Health Literature (CINAHL database), the APA PsycINFO database and the Excerpta Medica Database (EMBASE) from 1990 to 2022. The systematic review was carried out in accordance with the relevant PRISMA guidelines. Inclusion criteria were as follows: (I) adult patients with RMDs, (II) undergoing therapy with Biological Disease-Modifying Anti-Rheumatic Drugs (bDMARDs), (III) original and quantitative research papers in English with available abstract, (IV) specific to nursing interventions and/or outcomes. Two independent reviewers screened the identified records for eligibility according to their title and abstract, full texts were subsequently assessed and, finally, data was extracted. Critical Appraisal Skills Programme (CASP) tools were used to evaluate the quality of the studies included. Among the 2348 records retrieved, 13 articles met the inclusion criteria. These consisted of six randomised controlled trials (RCTs), one pilot study and six observational studies on RMDs. In a total population of 2004 patients, 43% (862/2004) of the cases concerned rheumatoid arthritis (RA) and 56% (1122/2004) of the cases concerned spondyloarthritis (SpA). Three major nursing interventions were identified, namely education, patient-centred care and data collection/nurse monitoring, which were correlated with high satisfaction rates regarding care, increased self-care capacity and treatment adherence among patients. All interventions followed a protocol defined in collaboration with rheumatologists. The large degree of heterogeneity in the interventions did not allow the performance of a meta-analysis. Rheumatology nurses are part of a multidisciplinary team caring for patients with RMDs. Following an accurate initial nursing evaluation, rheumatology nurses can plan and standardise their interventions focusing primarily on patient education and personalised care based on actual needs, such as psychological well-being and disease control. However, the training for rheumatology nurses should define and standardise, as much as possible, the competencies required for the detection of disease parameters. Key Points • This SLR provides an overview of nursing interventions for patients with RMDs. • This SLR considers the specific population of patients on biological therapies. • Training for rheumatology nurses should standardise, as much as possible, the knowledge and methods required for detecting disease parameters. • This SLR highlights the various competencies of rheumatology nurses.
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Aykurt Karlıbel I, Kasapoğlu Aksoy M. The relationship between central sensitization and disease activity, quality of life, and sleep quality among patients with axial spondyloarthritis. Ir J Med Sci 2023; 192:481-489. [PMID: 35226249 DOI: 10.1007/s11845-022-02957-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/18/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Central sensitization (CS) has been held responsible in previous studies for persistent pain and persistently high disease activity in axial spondyloarthritis (axSpA). Sleep disturbance is also regarded as an important problem for patients with axSpA. AIMS This study determines the CS levels of patients with axSpA compared to healthy controls (HC) and investigates its relationship with disease activity, quality of life (QoL), and sleep quality. METHODS Eighty-two patients with axSpA (group 1: mean age 38.83 ± 10.11 (76.8%male)) and 40 healthy volunteers (group2: mean age 38.58 ± 7.48 (77.5%male)) were included in this cross-sectional observational study. Evaluation parameters were visual analog scale (VAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), Short Form-36 (SF-36), Central Sensitization Inventory (CSI), and Pittsburgh Sleep Quality Index (PSQI). Also, participants were divided into subgroups as CSI < 40 and CSI ≥ 40. Groups were compared to themselves. A correlation between the patients' CSI scores and other evaluation parameters was examined. RESULTS CS rates were 45.1% and 7.5% for axSpA and HC, respectively (p < 0,001). The frequency of severe forms of CS was higher in patients with axSpA than in the healthy controls (p < 0.05). AxSpA patients with CS exhibited significantly higher pain, MASES, BASDAI, ASDAS-CRP, and PSQI scores than axSpA patients without CS (p < 0.05). A close relationship between CS severity and the female gender, pain, disease activity, sleep quality, and QoL was found among axSpA patients. CONCLUSIONS Clinical CS is common among axSpA patients. CS adversely affects disease activity, pain, sleep quality, and QoL of axSpA patients. CS should be considered when planning axSpA treatment.
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Affiliation(s)
- Ilknur Aykurt Karlıbel
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital, 16800, Yildirim, Bursa, Turkey.
| | - Meliha Kasapoğlu Aksoy
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital, 16800, Yildirim, Bursa, Turkey
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Mena-Vázquez N, Ortiz-Márquez F, Cabezudo-García P, Padilla-Leiva C, Diaz-Cordovés Rego G, Muñoz-Becerra L, Ramírez-García T, Lisbona-Montañez JM, Manrique-Arija S, Mucientes A, Núñez-Cuadros E, Galindo Zavala R, Serrano-Castro PJ, Fernández-Nebro A. Longitudinal Study of Cognitive Functioning in Adults with Juvenile Idiopathic Arthritis. Biomedicines 2022; 10:biomedicines10071729. [PMID: 35885032 PMCID: PMC9312867 DOI: 10.3390/biomedicines10071729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: To prospectively evaluate possible decline of cognitive functions in adult patients with juvenile idiopathic arthritis (JIA) and identify associated factors. Patients and methods: We performed a 24-month prospective observational study of adults (≥16 years) with JIA. The primary outcome measure was decline in cognitive function defined as a worsening of ≥2 points on the scales of the subsets administered to evaluate the different cognitive areas using the Wechsler Adult Intelligence Scale (WAIS) after 24 months: attention/concentration (digit span); verbal function (vocabulary); visual-spatial organization (block design); working memory (letter-number sequencing); and problem solving (similarities). Other variables included average inflammatory activity using C-reactive protein and composite activity indexes, comorbidity, and treatment. Logistic regression was performed to identify factors associated with cognitive decline. Results: The study population comprised 52 patients with JIA. Of these, 15 (28.8%) had cognitive decline at V24. The most affected functions were working memory (17.3%), attention/concentration (9.6%), verbal function (7.7%), visual-spatial organization (7.7%), and problem solving (3.8%). There were no significant differences in the median direct or scale scores for the cognitive functions evaluated between V0 and V24 for the whole sample. The factors associated with cognitive decline in patients with JIA were average C-reactive protein (OR [95% CI], 1.377 [1.060–1.921]; p = 0.039), depression (OR [95% CI], 3.691 [1.294–10.534]; p = 0.015), and treatment with biologics (OR [95% CI], 0.188 [0.039–0.998]; p = 0.046). Conclusion: Cognitive decline was detected in almost one third of adults with JIA after 24 months of follow-up. Systemic inflammatory activity in JIA patients was related to cognitive decline. Patients treated with biologics had a lower risk of decline in cognitive functions.
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Affiliation(s)
- Natalia Mena-Vázquez
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Fernando Ortiz-Márquez
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Pablo Cabezudo-García
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Servicio de Neurología, Unidad de Gestion Clinica de Neurociencias, Hospital Regional Universitario de Malaga (HRUM), 29010 Malaga, Spain
- Correspondence: ; Tel.: +34-951291135
| | | | - Gisela Diaz-Cordovés Rego
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Luis Muñoz-Becerra
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Servicio de Neurología, Unidad de Gestion Clinica de Neurociencias, Hospital Regional Universitario de Malaga (HRUM), 29010 Malaga, Spain
| | - Teresa Ramírez-García
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Servicio de Neurología, Unidad de Gestion Clinica de Neurociencias, Hospital Regional Universitario de Malaga (HRUM), 29010 Malaga, Spain
| | - Jose Manuel Lisbona-Montañez
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- Departamento de Medicina, Universidad de Málaga, 29016 Malaga, Spain;
| | - Sara Manrique-Arija
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- Departamento de Medicina, Universidad de Málaga, 29016 Malaga, Spain;
| | - Arkaitz Mucientes
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Esmeralda Núñez-Cuadros
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Pediatría, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Rocío Galindo Zavala
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Pediatría, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Pedro Jesús Serrano-Castro
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Servicio de Neurología, Unidad de Gestion Clinica de Neurociencias, Hospital Regional Universitario de Malaga (HRUM), 29010 Malaga, Spain
- Departamento de Medicina, Universidad de Málaga, 29016 Malaga, Spain;
| | - Antonio Fernández-Nebro
- Instituto de Investigación Biomedica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (N.M.-V.); (F.O.-M.); (G.D.-C.R.); (L.M.-B.); (T.R.-G.); (J.M.L.-M.); (S.M.-A.); (A.M.); (E.N.-C.); (R.G.Z.); (P.J.S.-C.); (A.F.-N.)
- Unidad de Gestion Clinica de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- Departamento de Medicina, Universidad de Málaga, 29016 Malaga, Spain;
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Stenger S, Grasshoff H, Hundt JE, Lange T. Potential effects of shift work on skin autoimmune diseases. Front Immunol 2022; 13:1000951. [PMID: 36865523 PMCID: PMC9972893 DOI: 10.3389/fimmu.2022.1000951] [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: 07/22/2022] [Accepted: 11/29/2022] [Indexed: 02/16/2023] Open
Abstract
Shift work is associated with systemic chronic inflammation, impaired host and tumor defense and dysregulated immune responses to harmless antigens such as allergens or auto-antigens. Thus, shift workers are at higher risk to develop a systemic autoimmune disease and circadian disruption with sleep impairment seem to be the key underlying mechanisms. Presumably, disturbances of the sleep-wake cycle also drive skin-specific autoimmune diseases, but epidemiological and experimental evidence so far is scarce. This review summarizes the effects of shift work, circadian misalignment, poor sleep, and the effect of potential hormonal mediators such as stress mediators or melatonin on skin barrier functions and on innate and adaptive skin immunity. Human studies as well as animal models were considered. We will also address advantages and potential pitfalls in animal models of shift work, and possible confounders that could drive skin autoimmune diseases in shift workers such as adverse lifestyle habits and psychosocial influences. Finally, we will outline feasible countermeasures that may reduce the risk of systemic and skin autoimmunity in shift workers, as well as treatment options and highlight outstanding questions that should be addressed in future studies.
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Affiliation(s)
- Sarah Stenger
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Hanna Grasshoff
- Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
| | - Jennifer Elisabeth Hundt
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany
| | - Tanja Lange
- Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany.,Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany.,Center of Brain, Behavior and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
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Ability to Participate in Social Activities of Rheumatoid Arthritis Patients Compared with Other Rheumatic Diseases: A Cross-Sectional Observational Study. Diagnostics (Basel) 2021; 11:diagnostics11122258. [PMID: 34943495 PMCID: PMC8700244 DOI: 10.3390/diagnostics11122258] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To compare the ability to participate in social activities among rheumatoid arthritis patients with other rheumatic disease patients and identify potentially implicated factors. PATIENTS AND METHODS Between June and November 2019, we consecutively selected patients aged ≥18 years with RA (defined according to ACR/EULAR 2010), SpA (ASAS/EULAR 2010), and SLE (ACR 1997). MAIN OUTCOME MEASURES Ability to participate in social roles and activities evaluated using the PROMIS score v2.0 short-form 8a (PROMIS-APS). SECONDARY OUTCOMES Participation in social activities according to a series of variables (mobility, depression, satisfaction with social relationships, social isolation, company, emotional support, instrumental support, and support via information). We evaluated the association between the ability to participate in social activities and associated variables using multivariable linear regression analysis. RESULTS The study population comprised 50 patients with RA (33.1%), 51 patients (33.8%) with SpA, and 50 patients (33.1%) with SLE. The mean PROMIS-APS scores were similar in the three groups. The multivariable analysis for the whole sample showed that the ability to participate in social activities was inversely associated with depression and directly with social satisfaction, mobility, company, and age. The stratified analysis revealed an inverse association between inflammatory activity and ability to participate in social activities in patients with RA and SpA, but not in those with SLE. CONCLUSION All patients with RA, SpA, and SLE had a similar ability to participate in social activities. This was associated with other psychosocial factors (social satisfaction, mobility, company, depression) and clinical factors (age and inflammatory activity).
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