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Jin Q, Ren F, Song P. Innovate therapeutic targets for autoimmune diseases: insights from proteome-wide mendelian randomization and Bayesian colocalization. Autoimmunity 2024; 57:2330392. [PMID: 38515381 DOI: 10.1080/08916934.2024.2330392] [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: 11/23/2023] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Despite growing knowledge regarding the pathogenesis of autoimmune diseases (ADs) onset, the current treatment remains unsatisfactory. This study aimed to identify innovative therapeutic targets for ADs through various analytical approaches. RESEARCH DESIGN AND METHODS Utilizing Mendelian randomization, Bayesian co-localization, phenotype scanning, and protein-protein interaction network, we explored potential therapeutic targets for 14 ADs and externally validated our preliminary findings. RESULTS This study identified 12 circulating proteins as potential therapeutic targets for six ADs. Specifically, IL12B was judged to be a risk factor for ankylosing spondylitis (p = 1.61E - 07). TYMP (p = 6.28E - 06) was identified as a protective factor for ulcerative colitis. For Crohn's disease, ERAP2 (p = 4.47E - 14), HP (p = 2.08E - 05), and RSPO3 (p = 6.52E - 07), were identified as facilitators, whereas FLRT3 (p = 3.42E - 07) had a protective effect. In rheumatoid arthritis, SWAP70 (p = 3.26E - 10), SIGLEC6 (p = 2.47E - 05), ISG15 (p = 3.69E - 05), and FCRL3 (p = 1.10E - 10) were identified as risk factors. B4GALT1 (p = 6.59E - 05) was associated with a lower risk of Type 1 diabetes (T1D). Interestingly, CTSH was identified as a protective factor for narcolepsy (p = 1.58E - 09) but a risk factor for T1D (p = 7.36E - 11), respectively. External validation supported the associations of eight of these proteins with three ADs. CONCLUSIONS Our integrated study identified 12 potential therapeutic targets for ADs and provided novel insights into future drug development for ADs.
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Affiliation(s)
- Qiubai Jin
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Feihong Ren
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate school, Beijing University of Chinese Medicine, Beijing, China
| | - Ping Song
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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2
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Frisch E, Dussouillez C, McCartin C, Blumberger J, Humbert C, Lebeau L, Frisch B, Heurtault B, Kichler A, Fournel S. Reduction of Pro-Inflammatory Markers in RAW264.7 Macrophages by Polyethylenimines. Macromol Biosci 2024; 24:e2300492. [PMID: 38414380 DOI: 10.1002/mabi.202300492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/31/2024] [Indexed: 02/29/2024]
Abstract
The physiological problem of chronic inflammation and its associated pathologies attract ongoing attention with regard to methods for their control. Current systemic pharmacological treatments present problematic side effects. Thus, the possibility of new anti-inflammatory compounds with differing mechanisms of action or biophysical properties is enticing. Cationic polymers, with their ability to act as carriers for other molecules or to form bio-compatible materials, present one such possibility. Although not well described, several polycations such as chitosan and polyarginine, have displayed anti-inflammatory properties. The present work shows the ubiquitous laboratory transfection reagent, polyethylenimine (PEI) and more specifically low molecular weight branched PEI (B-PEI) as also possessing such properties. Using a RAW264.7 murine cell line macrophage as an inflammation model, it is found the B-PEI 700 Da as being capable of reducing the production of several pro-inflammatory molecules induced by the endotoxin lipopolysaccharide. Although further studies are required for elucidation of its mechanisms, the revelation that such a common lab reagent may present these effects has wide-ranging implications, as well as an abundance of possibilities.
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Affiliation(s)
- Emilie Frisch
- 3Bio Team, CAMB UMR7199, Faculté de Pharmacie, CNRS-Université de Strasbourg, 74 route du Rhin, Illkirch Cedex, F-67401, France
- Inserm UMR_S 1121, EMR 7003 CNRS, Biomaterials and Bioengineering, Centre de Recherche en Biomédecine de Strasbourg, Université de Strasbourg, 1 rue Eugène Boeckel, Strasbourg, F-67000, France
| | - Candice Dussouillez
- 3Bio Team, CAMB UMR7199, Faculté de Pharmacie, CNRS-Université de Strasbourg, 74 route du Rhin, Illkirch Cedex, F-67401, France
- Inserm UMR_S 1121, EMR 7003 CNRS, Biomaterials and Bioengineering, Centre de Recherche en Biomédecine de Strasbourg, Université de Strasbourg, 1 rue Eugène Boeckel, Strasbourg, F-67000, France
| | - Conor McCartin
- 3Bio Team, CAMB UMR7199, Faculté de Pharmacie, CNRS-Université de Strasbourg, 74 route du Rhin, Illkirch Cedex, F-67401, France
| | - Juliette Blumberger
- 3Bio Team, CAMB UMR7199, Faculté de Pharmacie, CNRS-Université de Strasbourg, 74 route du Rhin, Illkirch Cedex, F-67401, France
| | - Chana Humbert
- 3Bio Team, CAMB UMR7199, Faculté de Pharmacie, CNRS-Université de Strasbourg, 74 route du Rhin, Illkirch Cedex, F-67401, France
| | - Luc Lebeau
- V-SAT Team, Laboratoire de Conception et Application de Molécules Bioactives, UMR 7199, Faculté de Pharmacie, CNRS-Université de Strasbourg, Illkirch, F-67401, France
| | - Benoît Frisch
- 3Bio Team, CAMB UMR7199, Faculté de Pharmacie, CNRS-Université de Strasbourg, 74 route du Rhin, Illkirch Cedex, F-67401, France
- Inserm UMR_S 1121, EMR 7003 CNRS, Biomaterials and Bioengineering, Centre de Recherche en Biomédecine de Strasbourg, Université de Strasbourg, 1 rue Eugène Boeckel, Strasbourg, F-67000, France
| | - Béatrice Heurtault
- 3Bio Team, CAMB UMR7199, Faculté de Pharmacie, CNRS-Université de Strasbourg, 74 route du Rhin, Illkirch Cedex, F-67401, France
- Inserm UMR_S 1121, EMR 7003 CNRS, Biomaterials and Bioengineering, Centre de Recherche en Biomédecine de Strasbourg, Université de Strasbourg, 1 rue Eugène Boeckel, Strasbourg, F-67000, France
| | - Antoine Kichler
- 3Bio Team, CAMB UMR7199, Faculté de Pharmacie, CNRS-Université de Strasbourg, 74 route du Rhin, Illkirch Cedex, F-67401, France
- Inserm UMR_S 1121, EMR 7003 CNRS, Biomaterials and Bioengineering, Centre de Recherche en Biomédecine de Strasbourg, Université de Strasbourg, 1 rue Eugène Boeckel, Strasbourg, F-67000, France
| | - Sylvie Fournel
- 3Bio Team, CAMB UMR7199, Faculté de Pharmacie, CNRS-Université de Strasbourg, 74 route du Rhin, Illkirch Cedex, F-67401, France
- Inserm UMR_S 1121, EMR 7003 CNRS, Biomaterials and Bioengineering, Centre de Recherche en Biomédecine de Strasbourg, Université de Strasbourg, 1 rue Eugène Boeckel, Strasbourg, F-67000, France
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3
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Joubert M, Desbois AC, Domont F, Ghembaza A, Lejoncour A, Mirouse A, Maalouf G, Leclercq M, Touhami S, Cacoub P, Bodaghi B, Saadoun D. Behçet's disease uveitis. Rev Med Interne 2023; 44:546-554. [PMID: 37414674 DOI: 10.1016/j.revmed.2023.06.004] [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: 05/09/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023]
Abstract
Uveitis in Behçet's disease (BD) is frequent (40% of cases) and is a major cause of morbidity. The age of onset of uveitis is between 20 and 30 years. Ocular involvement includes anterior, posterior or panuveitis. It is non-granulomatous. Uveitis may be the first sign of the disease in 20% of cases or it may appear 2 or 3 years after the first symptoms. Panuveitis is the most common presentation and is more commonly found in men. Bilateralisation usually occurs on average 2 years after the first symptoms. The estimated risk of blindness at 5 years is 10-15%. BD uveitis has several ophthalmological features that distinguish it from other uveitis. The main goals in the management of patients are the rapid resolution of intraocular inflammation, prevention of recurrent attacks, achievement of complete remission, and preservation of vision. Biologic therapies have changed the management of intraocular inflammation. The aim of this review is to provide an update previous article by our team on pathogenesis, diagnostic approaches, identification of factors associated with relapse and the therapeutic strategy of BD uveitis.
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Affiliation(s)
- M Joubert
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - A-C Desbois
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - F Domont
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Ghembaza
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Lejoncour
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Mirouse
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - G Maalouf
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - M Leclercq
- Internal Medicine Department, CHU de Rouen, 76000 Rouen, France
| | - S Touhami
- Department of Ophtalmology, Sorbonne universités, Pitié-Salpêtrière University Hospital, Paris, France
| | - P Cacoub
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - B Bodaghi
- Department of Ophtalmology, Sorbonne universités, Pitié-Salpêtrière University Hospital, Paris, France
| | - D Saadoun
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France.
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4
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Joubert M, Desbois AC, Domont F, Ghembaza A, Le Joncour A, Mirouse A, Maalouf G, Leclercq M, Touhami S, Cacoub P, Bodaghi B, Saadoun D. Behçet's Disease Uveitis. J Clin Med 2023; 12:jcm12113648. [PMID: 37297843 DOI: 10.3390/jcm12113648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/26/2023] [Accepted: 05/20/2023] [Indexed: 06/12/2023] Open
Abstract
Uveitis in Behçet's disease (BD) is frequent (40% of cases) and is a major cause of morbidity. The age of onset of uveitis is between 20 and 30 years. Ocular involvement includes anterior, posterior, or panuveitis. Uveitis may be the first sign of the disease in 20% of cases or it may appear 2 or 3 years after the first symptoms. Panuveitis is the most common presentation and is more commonly found in men. Bilateralization usually occurs on average 2 years after the first symptoms. The estimated risk of blindness at 5 years is 10-15%. BD uveitis has several ophthalmological features that distinguish it from other uveitis. The main goals in the management of patients are the rapid resolution of intraocular inflammation, the prevention of recurrent attacks, the achievement of complete remission, and the preservation of vision. Biologic therapies have changed the management of intraocular inflammation. The aim of this review is to provide an update to a previous article by our team on pathogenesis, diagnostic approaches, and the therapeutic strategy of BD uveitis.
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Affiliation(s)
- Morgane Joubert
- AP-HP. Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose Inflammatoire, F-75013 Paris, France
| | - Anne-Claire Desbois
- AP-HP. Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose Inflammatoire, F-75013 Paris, France
| | - Fanny Domont
- AP-HP. Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose Inflammatoire, F-75013 Paris, France
| | - Amine Ghembaza
- AP-HP. Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose Inflammatoire, F-75013 Paris, France
| | - Alexandre Le Joncour
- AP-HP. Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose Inflammatoire, F-75013 Paris, France
| | - Adrien Mirouse
- AP-HP. Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose Inflammatoire, F-75013 Paris, France
| | - Georgina Maalouf
- AP-HP. Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose Inflammatoire, F-75013 Paris, France
| | | | - Sarah Touhami
- Department of Ophthalmology, Pitié-Salpêtrière University Hospital, Sorbonne Universités, F-75013 Paris, France
| | - Patrice Cacoub
- AP-HP. Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose Inflammatoire, F-75013 Paris, France
| | - Bahram Bodaghi
- Department of Ophthalmology, Pitié-Salpêtrière University Hospital, Sorbonne Universités, F-75013 Paris, France
| | - David Saadoun
- AP-HP. Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l'Amylose Inflammatoire, F-75013 Paris, France
- Institut National de la Santé Et de la Recherche Médicale (INSERM), Unité Médical de Recherche (UMR)S 59, F-75013 Paris, France
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5
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Plocica J, Guo F, Das JK, Kobayashi KS, Ficht TA, Alaniz RC, Song J, de Figueiredo P. Engineering live attenuated vaccines: Old dogs learning new tricks. J Transl Autoimmun 2023; 6:100198. [PMID: 37090898 PMCID: PMC10113845 DOI: 10.1016/j.jtauto.2023.100198] [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: 02/17/2023] [Revised: 03/24/2023] [Accepted: 03/26/2023] [Indexed: 03/29/2023] Open
Abstract
Autoimmune diseases such as rheumatoid arthritis and type 1 diabetes are increasingly common global problems. Concerns about increases in the prevalence of such diseases and the limited efficacy of conventional treatment regimens necessitates new therapies to address these challenges. Autoimmune disease severity and dysbiosis are interconnected. Although probiotics have been established as a therapy to rebalance the microbiome and suppress autoimmune symptoms, these microbes tend to lack a number of advantageous qualities found in non-commensal bacteria. Through attenuation and genetic manipulation, these non-commensal bacteria have been engineered into recombinant forms that offer malleable platforms capable of addressing the immune imbalances found in RA and T1D. Such bacteria have been engineered to express valuable gene products known to suppress autoimmunity such as anti-inflammatory cytokines, autoantigens, and enzymes synthesizing microbial metabolites. This review will highlight current and emerging trends in the field and discuss how they may be used to prevent and control autoimmune diseases.
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Affiliation(s)
- Julia Plocica
- Department of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan, TX, 77807, USA
| | - Fengguang Guo
- Department of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan, TX, 77807, USA
| | - Jugal Kishore Das
- Department of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan, TX, 77807, USA
| | - Koichi S. Kobayashi
- Department of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan, TX, 77807, USA
- Department of Immunology, Graduate School of Medicine, Hokkaido University Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
- Institute of Vaccine Research and Development, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Thomas A. Ficht
- Department of Veterinary Pathobiology, Texas A&M University, College Station, TX, 77845, USA
| | - Robert C. Alaniz
- Department of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan, TX, 77807, USA
| | - Jianxun Song
- Department of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan, TX, 77807, USA
| | - Paul de Figueiredo
- Department of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan, TX, 77807, USA
- Department of Veterinary Pathobiology, Texas A&M University, College Station, TX, 77845, USA
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6
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Scarneo SA, Smith AP, Favret J, O’Connell R, Pickeral J, Yang KW, Ferrari G, Loiselle DR, Hughes PF, Kulkarni MM, Gargesha M, Scott B, Roy D, Haynes BF, Kwiek JJ, Haystead TAJ. Expression of membrane Hsp90 is a molecular signature of T cell activation. Sci Rep 2022; 12:18091. [PMID: 36302951 PMCID: PMC9613876 DOI: 10.1038/s41598-022-22788-8] [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: 06/10/2022] [Accepted: 10/19/2022] [Indexed: 12/30/2022] Open
Abstract
Heat shock protein 90 (Hsp90) maintains cellular proteostasis during stress and has been under investigation as a therapeutic target in cancer for over two decades. We and others have identified a membrane expressed form of Hsp90 (mHsp90) that previously appeared to be restricted to rapidly proliferating cells exhibiting a metastatic phenotype. Here, we used HS-131, a fluor-tethered mHsp90 inhibitor, to quantify the effect of T cell activation on the expression of mHsp90 in human and mouse T cells. In cell-based assays, stimulation of human T cells induced a 20-fold increase in mHsp90 expression at the plasma membrane, suggesting trafficking of mHsp90 is regulated by TCR and inflammatory mediated signaling. Following injection of HS-131 in mouse models of human rheumatoid arthritis and inflammatory bowel disease, we detected localization of the probe at sites of active disease, consistent with immune cell invasion. Moreover, despite rapid hepatobiliary clearance, HS-131 demonstrated efficacy in reducing the mean clinical score in the CIA arthritis model. Our results suggest mHsp90 expression on T cells is a molecular marker of T cell activation and potentially a therapeutic target for chronic diseases such as rheumatoid arthritis.
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Affiliation(s)
- Scott A. Scarneo
- grid.26009.3d0000 0004 1936 7961Department of Pharmacology and Cancer Biology, Duke University School of Medicine, 308 Research Drive, Durham, NC 27710 USA
| | - Aaron P. Smith
- grid.26009.3d0000 0004 1936 7961Department of Pharmacology and Cancer Biology, Duke University School of Medicine, 308 Research Drive, Durham, NC 27710 USA
| | | | | | - Joy Pickeral
- grid.26009.3d0000 0004 1936 7961Department of Surgery, Duke University School of Medicine, Durham, NC 27710 USA
| | - Kelly W. Yang
- grid.26009.3d0000 0004 1936 7961Department of Pharmacology and Cancer Biology, Duke University School of Medicine, 308 Research Drive, Durham, NC 27710 USA
| | - Guido Ferrari
- grid.26009.3d0000 0004 1936 7961Department of Surgery, Duke University School of Medicine, Durham, NC 27710 USA
| | - David R. Loiselle
- grid.26009.3d0000 0004 1936 7961Department of Pharmacology and Cancer Biology, Duke University School of Medicine, 308 Research Drive, Durham, NC 27710 USA
| | - Philip F. Hughes
- grid.26009.3d0000 0004 1936 7961Department of Pharmacology and Cancer Biology, Duke University School of Medicine, 308 Research Drive, Durham, NC 27710 USA
| | - Manjusha M. Kulkarni
- grid.261331.40000 0001 2285 7943Department of Microbiology, Ohio State University, Columbus, OH 43210 USA
| | | | - Bryan Scott
- grid.431911.fBioInVision, Inc., Mayfield, OH 44143 USA
| | - Debashish Roy
- grid.431911.fBioInVision, Inc., Mayfield, OH 44143 USA
| | - Barton F. Haynes
- grid.26009.3d0000 0004 1936 7961Department of Medicine, Duke University School of Medicine, Durham, NC 27710 USA
| | - Jesse J. Kwiek
- grid.261331.40000 0001 2285 7943Department of Microbiology, Ohio State University, Columbus, OH 43210 USA
| | - Timothy A. J. Haystead
- grid.26009.3d0000 0004 1936 7961Department of Pharmacology and Cancer Biology, Duke University School of Medicine, 308 Research Drive, Durham, NC 27710 USA
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7
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Alsulami S, Alotaibi RM, Alotaibi FF, Almatrafi FB, Filmban DM, Alneefia S, Alahmed A, Hafiz WA. IgA Vasculitis With Adalimumab Therapy for Hidradenitis Suppurativa: A Case Report and Review of Literature. Cureus 2022; 14:e30122. [PMID: 36381912 PMCID: PMC9644201 DOI: 10.7759/cureus.30122] [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] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Immunoglobulin A (IgA) vasculitis is a systemic vasculitis characterized by inflammation of the small vessels, with cutaneous, musculoskeletal, gastrointestinal, and renal involvement, usually seen in pediatric populations. Hidradenitis suppurativa is a chronic inflammatory disorder of the skin, which can be treated by tumor necrosis factor-α (TNFα) inhibitor therapy. TNFα inhibitor therapy is used as an important milestone in the treatment of various rheumatological and autoimmune disorders. Unexpected adverse effects might occur. However, they are usually mild and do not warrant treatment withdrawal. We present a case of IgA vasculitis complicating adalimumab therapy for hidradenitis suppurativa. We also review and discuss similar cases reported in the literature.
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8
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Gueudry J, Leclercq M, Saadoun D, Bodaghi B. Old and New Challenges in Uveitis Associated with Behçet's Disease. J Clin Med 2021; 10:jcm10112318. [PMID: 34073249 PMCID: PMC8198480 DOI: 10.3390/jcm10112318] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 12/13/2022] Open
Abstract
Behçet’s disease (BD) is a systemic vasculitis disease of unknown origin occurring in young people, which can be venous, arterial or both, classically occlusive. Ocular involvement is particularly frequent and severe; vascular occlusion secondary to retinal vasculitis may lead to rapid and severe loss of vision. Biologics have transformed the management of intraocular inflammation. However, the diagnosis of BD is still a major challenge. In the absence of a reliable biological marker, diagnosis is based on clinical diagnostic criteria and may be delayed after the appearance of the onset sign. However, therapeutic management of BD needs to be introduced early in order to control inflammation, to preserve visual function and to limit irreversible structural damage. The aim of this review is to provide current data on how innovations in clinical evaluation, investigations and treatments were able to improve the prognosis of uveitis associated with BD.
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Affiliation(s)
- Julie Gueudry
- Department of Ophthalmology, Hôpital Charles Nicolle, F-76000 Rouen, France
- Correspondence: ; Tel.: +33-2-32-88-80-57
| | - Mathilde Leclercq
- Department of Internal Medicine, Hôpital Charles Nicolle, F-76000 Rouen, France;
| | - David Saadoun
- Department of Internal Medicine and Clinical Immunology, AP-HP, Centre National de Références Maladies Autoimmunes et Systémiques Rares et Maladies Autoinflammatoires Rares, Groupe Hospitalier Pitié-Salpêtrière, F-75013 Paris, France;
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), F-75005 Paris, France
- Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, AP-HP, F-75651 Paris, France
| | - Bahram Bodaghi
- Department of Ophthalmology, IHU FOReSIGHT, Sorbonne-AP-HP, Groupe Hospitalier Pitié-Salpêtrière, F-75013 Paris, France;
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9
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Kokar S, Kayhan Ö, Şencan S, Gündüz OH. The Role of Sacroiliac Joint Steroid Injections in the Treatment of Axial Spondyloarthritis. Arch Rheumatol 2021; 36:80-88. [PMID: 34046572 PMCID: PMC8140859 DOI: 10.46497/archrheumatol.2021.8043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 05/25/2020] [Indexed: 02/02/2023] Open
Abstract
Objectives
This study aims to investigate the effects of fluoroscopy-guided sacroiliac joint steroid injection in patients with acute bilateral sacroiliitis diagnosed with axial spondyloarthritis (axSpA) and how those injections affect the current need for nonsteroidal anti-inflammatory drug (NSAID) usage. Patients and methods
We retrospectively evaluated 43 patients (28 males, 15 females; mean age, 31.7±6.3 years; range, 18 to 44 years) fulfilling the Assessment of SpondyloArthritis international Society 2009 criteria for axSpA between June 2015 and May 2016. One group included 22 patients (injection group) treated with sacroiliac joint steroid injection (triamcinolone acetonide) and the other group included 21 patients (non-injection group) not receiving the injection. All 43 patients in both groups were treated with indomethacin peroral. Pre-treatment, first week and first, third and sixth month follow-up examinations were evaluated. Results
A ≥50% reduction in the numeric rating scale score compared with the baseline was considered as significant pain relief. The mean pain relief rates in patients receiving injections were higher at all inspections. This difference was statistically significant at first week (p<0.05). When groups were compared, no difference was found in the Bath Ankylosing Spondylitis Disease Activity Index scores (p>0.05). There was no statistically significant difference between the two groups when indomethacin dose was evaluated cumulatively for six months (p>0.05). Conclusion Fluoroscopy-guided sacroiliac joint steroid injections can be recommended in patients with active sacroiliitis, particularly in those with severe axial pain, for rapid analgesia in the initial term. It was concluded that steroid injections applied to the sacroiliac joint did not affect disease activity. It is noteworthy that there is a trend to reduce the use of NSAIDs in patients receiving these injections, although it does not make a statistically significant difference in the long term.
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Affiliation(s)
- Serdar Kokar
- Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Önder Kayhan
- Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Savaş Şencan
- Department of Physical Medicine and Rehabilitation, Division of Pain Management Section, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Osman Hakan Gündüz
- Department of Physical Medicine and Rehabilitation, Division of Pain Management Section, Marmara University Faculty of Medicine, Istanbul, Turkey
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10
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Marino F, D'Angelo S, Masala IF, Gerratana E, Nucera V, La Corte L, Giallanza M, Sarzi-Puttini P, Atzeni F. Toxicological considerations in the treatment of axial spondylo-arthritis. Expert Opin Drug Metab Toxicol 2020; 16:663-672. [PMID: 32552128 DOI: 10.1080/17425255.2020.1783240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION The first-line treatment of axial spondyloarthritis (SpA) is with non-steroidal anti-inflammatory drugs (NSAIDs) and is followed by tumor necrosis factor (TNF) inhibitors (the main treatment for patients not responding to NSAIDs) or drugs targetting the IL-23/IL-17 pathway. The efficacy of disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate and sulfasalazine (SSZ) has not been demonstrated, although SSZ can be considered in patients with concomitant peripheral arthritis. AREAS COVERED This review describes the beneficial and toxicological effects of the drugs used to treat axial SpA. EXPERT COMMENTARY Growing concerns about the safety of anti-TNF drugs underline the need to ensure that all clinicians are capable of taking appropriate preventive action and adequately treating affected patients.
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Affiliation(s)
- Francesca Marino
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina , Messina, Italy
| | - Salvatore D'Angelo
- Rheumatology Institute of Lucania (Irel) and Rheumatology Department of Lucania, San Carlo Hospital of Potenza , Italy
| | | | - Elisabetta Gerratana
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina , Messina, Italy
| | - Valeria Nucera
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina , Messina, Italy
| | - Laura La Corte
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina , Messina, Italy
| | - Manuela Giallanza
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina , Messina, Italy
| | | | - Fabiola Atzeni
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina , Messina, Italy
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11
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Choi DH, Lee D, Jo BS, Park KS, Lee KE, Choi JK, Park YJ, Lee JY, Park YS. A Synthetic Cell-Penetrating Heparin-Binding Peptide Derived from BMP4 with Anti-Inflammatory and Chondrogenic Functions for the Treatment of Arthritis. Int J Mol Sci 2020; 21:ijms21124251. [PMID: 32549254 PMCID: PMC7352680 DOI: 10.3390/ijms21124251] [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: 05/27/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 12/30/2022] Open
Abstract
We report dual therapeutic effects of a synthetic heparin-binding peptide (HBP) corresponding to residues 15–24 of the heparin binding site in BMP4 in a collagen-induced rheumatic arthritis model (CIA) for the first time. The cell penetrating capacity of HBP led to improved cartilage recovery and anti-inflammatory effects via down-regulation of the iNOS-IFNγ-IL6 signaling pathway in inflamed RAW264.7 cells. Both arthritis and paw swelling scores were significantly improved following HBP injection into CIA model mice. Anti-rheumatic effects were accelerated upon combined treatment with Enbrel® and HBP. Serum IFNγ and IL6 concentrations were markedly reduced following intraperitoneal HBP injection in CIA mice. The anti-rheumatic effects of HBP in mice were similar to those of Enbrel®. Furthermore, the combination of Enbrel® and HBP induced similar anti-rheumatic and anti-inflammatory effects as Enbrel®. We further investigated the effect of HBP on damaged chondrocytes in CIA mice. Regenerative capacity of HBP was confirmed based on increased expression of chondrocyte biomarker genes, including aggrecan, collagen type II and TNFα, in adult human knee chondrocytes. These findings collectively support the utility of our cell-permeable bifunctional HBP with anti-inflammatory and chondrogenic properties as a potential source of therapeutic agents for degenerative inflammatory diseases.
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Affiliation(s)
- Da Hyeon Choi
- School of Biological Sciences, College of Natural Sciences, Chungbuk National University, Cheongju 28644, Korea; (D.H.C.); (K.E.L.); (J.K.C.)
| | - Dongwoo Lee
- Central Research Institute, Nano Intelligent Biomedical Engineering Corporation (NIBEC), School of Dentistry, Seoul National University, Seoul 03080, Korea; (D.L.); (B.S.J.); (Y.J.P.)
| | - Beom Soo Jo
- Central Research Institute, Nano Intelligent Biomedical Engineering Corporation (NIBEC), School of Dentistry, Seoul National University, Seoul 03080, Korea; (D.L.); (B.S.J.); (Y.J.P.)
| | - Kwang-Sook Park
- Department of Dental Regenerative Bioengineering and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea;
| | - Kyeong Eun Lee
- School of Biological Sciences, College of Natural Sciences, Chungbuk National University, Cheongju 28644, Korea; (D.H.C.); (K.E.L.); (J.K.C.)
| | - Ju Kwang Choi
- School of Biological Sciences, College of Natural Sciences, Chungbuk National University, Cheongju 28644, Korea; (D.H.C.); (K.E.L.); (J.K.C.)
| | - Yoon Jeong Park
- Central Research Institute, Nano Intelligent Biomedical Engineering Corporation (NIBEC), School of Dentistry, Seoul National University, Seoul 03080, Korea; (D.L.); (B.S.J.); (Y.J.P.)
- Department of Dental Regenerative Bioengineering and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea;
| | - Jue-Yeon Lee
- Central Research Institute, Nano Intelligent Biomedical Engineering Corporation (NIBEC), School of Dentistry, Seoul National University, Seoul 03080, Korea; (D.L.); (B.S.J.); (Y.J.P.)
- Correspondence: (J.-Y.L.); (Y.S.P.); Tel.: +82-2-765-1976 (J.-Y.L.); +82-43-261-2303 (Y.S.P.)
| | - Yoon Shin Park
- School of Biological Sciences, College of Natural Sciences, Chungbuk National University, Cheongju 28644, Korea; (D.H.C.); (K.E.L.); (J.K.C.)
- Correspondence: (J.-Y.L.); (Y.S.P.); Tel.: +82-2-765-1976 (J.-Y.L.); +82-43-261-2303 (Y.S.P.)
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12
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Atzeni F, Nucera V, Gerratana E, Cirillo M, Marino F, Miceli G, Sangari D, Boccassini L, Masala IF. Concerns about the safety of anti-TNF agents when treating rheumatic diseases. Expert Opin Drug Saf 2020; 19:695-705. [DOI: 10.1080/14740338.2020.1763299] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Fabiola Atzeni
- Rheumatology Unit, University of Messina, Messina, Italy
| | - Valeria Nucera
- Rheumatology Unit, University of Messina, Messina, Italy
| | | | | | | | | | | | - Laura Boccassini
- Department of Rheumatology, ASST Fatebenefratelli-Sacco, Milan, Italy
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Inflammatory bowel disease and targeted oral anti-TNFα therapy. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY 2020; 119:157-198. [PMID: 31997768 DOI: 10.1016/bs.apcsb.2019.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Antibodies have provided invaluable treatment options for many diseases, with immunotherapy revolutionising the treatment of several inflammatory disorders including inflammatory bowel disease (IBD). Accumulating evidence suggests that IBD results from an inappropriate response to intestinal microbes and environmental factors in genetically susceptible individuals, with overactivity of the pro-inflammatory pathways. On a pathophysiological level, IBD is a complex disease with intestinal fibrosis, stenosis and an increased incidence of cancer observed in those whose disease is inadequately controlled over time. Regulating the actions of the pro-inflammatory cytokine human tumor necrosis factor-alpha (hTNFα) through the use of anti-TNFα monoclonal antibodies (e.g. infliximab, certolizumab, adalimumab and golimumab) has proven an effective intervention for IBD with their increased use a testament of their effectiveness. These agents are administered systemically thereby causing their distribution throughout the body in a condition that is localised to the gastrointestinal (GI) tract. Immunogenicity, the induction of anti-drug antibodies (ADAs), serum sickness and other undesirable side effects limit their use, whilst up to 50% of patients do not respond to initial therapy. Diseases confined to the GI tract are ideal for targeting by oral therapy which mitigates side effects and allows for lower doses to be administered. Several oral anti-TNFα agents have been investigated with success but are not yet in general clinical use. This partially reflects the fact that the oral administration of antibodies has many barriers including the harsh environment of the GI tract and the presence of enzymes including pepsin, trypsin and chymotrypsin in the intestine which provide significant challenges to targeted oral therapy.
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14
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Kim KE, Jeon S, Song J, Kim TS, Jung MK, Kim MS, Park S, Park SB, Park JM, Park HJ, Cho D. The Novel Synthetic Peptide AESIS-1 Exerts a Preventive Effect on Collagen-Induced Arthritis Mouse Model via STAT3 Suppression. Int J Mol Sci 2020; 21:ijms21020378. [PMID: 31936141 PMCID: PMC7013888 DOI: 10.3390/ijms21020378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/27/2019] [Accepted: 01/03/2020] [Indexed: 12/31/2022] Open
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disease that is associated with systemic inflammation and results in the destruction of joints and cartilage. The pathogenesis of RA involves a complex inflammatory process resulting from the action of various proinflammatory cytokines and, therefore, many novel therapeutic agents to block cytokines or cytokine-mediated signaling have been developed. Here, we tested the preventive effects of a small peptide, AESIS-1, in a mouse model of collagen-induced arthritis (CIA) with the aim of identifying a novel safe and effective biological for treating RA. This novel peptide significantly suppressed the induction and development of CIA, resulting in the suppression of synovial inflammation and cartilage degradation in vivo. Moreover, AESIS-1 regulated JAK/STAT3-mediated gene expression in vitro. In particular, the gene with the most significant change in expression was suppressor of cytokine signaling 3 (Socs3), which was enhanced 8-fold. Expression of the STAT3-specific inhibitor, Socs3, was obviously enhanced dose-dependently by AESIS-1 at both the mRNA and protein levels, resulting in a significant reduction of STAT3 phosphorylation in splenocytes from severe CIA mice. This indicated that AESIS-1 regulated STAT3 activity by upregulation of SOCS3 expression. Furthermore, IL-17 expression and the frequency of Th17 cells were considerably decreased by AESIS-1 in vivo and in vitro. Collectively, our data suggest that the novel synthetic peptide AESIS-1 could be an effective therapeutic for treating RA via the downregulation of STAT3 signaling.
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Affiliation(s)
- Kyung Eun Kim
- Department of Cosmetic Sciences, Sookmyung Women’s University, Chungpa-Dong 2-Ka, Yongsan-ku, Seoul 04310, Korea;
- Nano-Bio Resources Center, Sookmyung Women’s University, Chungpa-Dong 2-Ka, Yongsan-ku, Seoul 04310, Korea;
| | - Suwon Jeon
- Institute of Convergence Science, Korea University, Anam-ro 145, Seongbuk-ku, Seoul 02841, Korea;
| | - Jisun Song
- Department of Life Sciences, College of Life Sciences and Biotechnology, Korea University, Anam-dong 5-ga, Seongbuk-gu, Seoul 02841, Korea; (J.S.); (T.S.K.)
| | - Tae Sung Kim
- Department of Life Sciences, College of Life Sciences and Biotechnology, Korea University, Anam-dong 5-ga, Seongbuk-gu, Seoul 02841, Korea; (J.S.); (T.S.K.)
| | - Min Kyung Jung
- Nano-Bio Resources Center, Sookmyung Women’s University, Chungpa-Dong 2-Ka, Yongsan-ku, Seoul 04310, Korea;
| | - Myun Soo Kim
- Kine Sciences, 525, Seolleung-ro, Gangnam-gu, Seoul 06149, Korea; (M.S.K.); (S.P.)
| | - Sunyoung Park
- Kine Sciences, 525, Seolleung-ro, Gangnam-gu, Seoul 06149, Korea; (M.S.K.); (S.P.)
| | - Seung Beom Park
- Cent’l Res. Inst., Ilyang Pharm. Co., Ltd., Hagal-ro 136beon-gil, Giheung-gu, Yongin-si, Gyeonggi-do 17096, Korea; (S.B.P.); (J.M.P.)
| | - Jeong Min Park
- Cent’l Res. Inst., Ilyang Pharm. Co., Ltd., Hagal-ro 136beon-gil, Giheung-gu, Yongin-si, Gyeonggi-do 17096, Korea; (S.B.P.); (J.M.P.)
| | - Hyun Jeong Park
- Department of Dermatology, Yeouido St. Mary’s Hospital, The Catholic University of Korea, Seoul 07345, Korea
- Correspondence: (H.J.P.); (D.C.); Tel.: +82-02-3779-1230 (H.J.P.); +82-02-3290-4015 (D.C.)
| | - Daeho Cho
- Institute of Convergence Science, Korea University, Anam-ro 145, Seongbuk-ku, Seoul 02841, Korea;
- Kine Sciences, 525, Seolleung-ro, Gangnam-gu, Seoul 06149, Korea; (M.S.K.); (S.P.)
- Correspondence: (H.J.P.); (D.C.); Tel.: +82-02-3779-1230 (H.J.P.); +82-02-3290-4015 (D.C.)
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15
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Mangoni AA, Al Okaily F, Almoallim H, Al Rashidi S, Mohammed RHA, Barbary A. Relapse rates after elective discontinuation of anti-TNF therapy in rheumatoid arthritis: a meta-analysis and review of literature. BMC Rheumatol 2019; 3:10. [PMID: 30886998 PMCID: PMC6408847 DOI: 10.1186/s41927-019-0058-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 02/26/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Inhibitors of tumor necrosis factor alpha (TNF-α) are current mainstay of therapies for rheumatoid arthritis (RA). The decision when to withdraw TNF-α inhibitors after achieving remission and the incidence of relapse rates with elective discontinuation are both important questions that demand intense survey in these patients. In this meta-analysis we aimed to estimate the magnitude of relapse rate after elective TNF-α inhibitor discontinuation in RA patients with remission. METHODS Systematic searches of PubMed/MEDLINE, Cochrane Library databases, grey literature (unpublished and ongoing trials) from the WHO International Clinical Trials Registry Platform and the US National Institutes of Health were performed for studies reporting the outcomes of elective discontinuation of TNF-α inhibitor in RA patients after remission. Random-effects models for meta-analyses were conducted on extracted data. RESULTS Out of 390 references screened, 16 RCTs were included. Meta-analysis of 1264 patient data revealed a relapse rate of 0.47 (95% CI 0.41-0.54). Sensitivity analysis showed that none of the studies had higher influence on the results. CONCLUSIONS Almost half of all the RA patients in remission relapse after elective TNF-α inhibitor discontinuation. This information might be useful when considering this management option with individual patients.
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Affiliation(s)
- Arduino A Mangoni
- 1Department of Clinical Pharmacology, Flinders University and Flinders Medical Centre, Bedford Park, SA 5042 Australia
| | | | - Hani Almoallim
- 3Department of Medicine, Umm Alqura University, Jeddah, Kingdom of Saudi Arabia
| | | | - Reem Hamdy A Mohammed
- 4Rheumatology and Clinical Immunology, Department of Rheumatology and Rehabilitation, School of Medicine, Cairo University Hospitals, Cairo, Egypt
- 5Internal Medicine Department, Alhada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | - Amal Barbary
- 6Department of Rheumatology and Rehabilitation, Tanta University Faculty of Medicine, Elgesh Street, Tanta, Gharbeia Egypt
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16
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Scharnhorst V, Schmitz EMH, van de Kerkhof D, Derijks LJJ, Broeren MAC. A value proposition for trough level-based anti-TNFα drug dosing. Clin Chim Acta 2018; 489:89-95. [PMID: 30521801 DOI: 10.1016/j.cca.2018.11.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/20/2018] [Accepted: 11/30/2018] [Indexed: 02/08/2023]
Abstract
Treatment of inflammatory bowel diseases and rheumatic disorders with anti-tumor necrosis factor alpha (TNFα) drugs is expensive, while a significant proportion of patients does not show adequate clinical response. Therapeutic drug monitoring (TDM) enables patient-specific anti-TNFα therapy. The role of laboratory tests in clinical care has recently been described in a value proposition framework. It describes care processes, stakeholders, costs, risks, benefits and patient outcomes based on the use of a laboratory test in a clinical care pathway. We have applied this concept to the use of TDM for anti-TNFα drugs, describing evidence that supports the intervention and its cost effectiveness, steps that need to be adjusted in the care pathway, possible treatment algorithms and measures to assess adoption of this framework into clinical practice. For effective TDM, an assay for measurement of drug levels together with appropriate target ranges and an anti-drug-antibody assay have to be implemented. Also, instead of only reporting the drug concentration, laboratorians, pharmacists and clinicians should deliver added value by introducing a TDM-based treatment algorithm into clinical practice. Thus, to maximize effectiveness of TDM of anti-TNFα therapy in routine care, adjustment of current care pathways and cooperation of many stakeholders are needed.
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Affiliation(s)
- V Scharnhorst
- Expert Center Clinical Chemistry Eindhoven, Eindhoven, the Netherlands; Clinical Laboratory, Catharina Hospital, Eindhoven, the Netherlands; Laboratory of Chemical Biology and Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands.
| | - E M H Schmitz
- Expert Center Clinical Chemistry Eindhoven, Eindhoven, the Netherlands; Clinical Laboratory, Catharina Hospital, Eindhoven, the Netherlands; Laboratory of Chemical Biology and Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands; Clinical Laboratory, Máxima Medical Center, Veldhoven, the Netherlands
| | - D van de Kerkhof
- Expert Center Clinical Chemistry Eindhoven, Eindhoven, the Netherlands; Clinical Laboratory, Catharina Hospital, Eindhoven, the Netherlands
| | - L J J Derijks
- Department of Clinical Pharmacy and Pharmacology, Máxima Medical Center, Veldhoven, the Netherlands
| | - M A C Broeren
- Expert Center Clinical Chemistry Eindhoven, Eindhoven, the Netherlands; Clinical Laboratory, Máxima Medical Center, Veldhoven, the Netherlands
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17
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Ilan Y. Immune rebalancing by oral immunotherapy: A novel method for getting the immune system back on track. J Leukoc Biol 2018; 105:463-472. [PMID: 30476347 DOI: 10.1002/jlb.5ru0718-276rr] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/14/2018] [Accepted: 10/17/2018] [Indexed: 12/11/2022] Open
Abstract
Immune modulating treatments are often associated with immune suppression or an opposing anti-inflammatory paradigm. As such, there is a risk of exposing patients to infections and malignancies. Contrarily, eliciting only mild immune modulation can be insufficient for alleviating immune-mediated damage. Oral immunotherapy is a novel approach that uses the inherent ability of the gut immune system to generate signals that specifically suppress inflammation at affected sites, without inducing generalized immune suppression. Oral immunotherapy is being developed as a method to rebalance systemic immunity and restore balance, getting it back on track, rather than pushing the immune response too much or too little in opposing directions. Here, I review recent preclinical and clinical data examining the technique and describe its primary advantages.
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Affiliation(s)
- Yaron Ilan
- Gastroenterology and Liver Units, Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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18
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Arens K, Filippis C, Kleinfelder H, Goetzee A, Reichmann G, Crauwels P, Waibler Z, Bagola K, van Zandbergen G. Anti-Tumor Necrosis Factor α Therapeutics Differentially Affect Leishmania Infection of Human Macrophages. Front Immunol 2018; 9:1772. [PMID: 30108591 PMCID: PMC6079256 DOI: 10.3389/fimmu.2018.01772] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 07/17/2018] [Indexed: 01/18/2023] Open
Abstract
Tumor necrosis factor α (TNFα) drives the pathophysiology of human autoimmune diseases and consequently, neutralizing antibodies (Abs) or Ab-derived molecules directed against TNFα are essential therapeutics. As treatment with several TNFα blockers has been reported to entail a higher risk of infectious diseases such as leishmaniasis, we established an in vitro model based on Leishmania-infected human macrophages, co-cultured with autologous T-cells, for the analysis and comparison of anti-TNFα therapeutics. We demonstrate that neutralization of soluble TNFα (sTNFα) by the anti-TNFα Abs Humira®, Remicade®, and its biosimilar Remsima® negatively affects infection as treatment with these agents significantly reduces Leishmania-induced T-cell proliferation and increases the number of infected macrophages. By contrast, we show that blockade of sTNFα by Cimzia® does not affect T-cell proliferation and infection rates. Moreover, compared to Remicade®, treatment with Cimzia® does not impair the expression of cytolytic effector proteins in proliferating T-cells. Our data demonstrate that Cimzia® supports parasite control through its conjugated polyethylene glycol (PEG) moiety as PEGylation of Remicade® improves the clearance of intracellular Leishmania. This effect can be linked to complement activation, with levels of complement component C5a being increased upon treatment with Cimzia® or a PEGylated form of Remicade®. Taken together, we provide an in vitro model of human leishmaniasis that allows direct comparison of different anti-TNFα agents. Our results enhance the understanding of the efficacy and adverse effects of TNFα blockers and they contribute to evaluate anti-TNFα therapy for patients living in countries with a high prevalence of leishmaniasis.
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Affiliation(s)
- Katharina Arens
- Division of Immunology, Paul-Ehrlich-Institut, Langen, Germany
| | | | | | - Arthur Goetzee
- Division of Immunology, Paul-Ehrlich-Institut, Langen, Germany
| | | | - Peter Crauwels
- Division of Immunology, Paul-Ehrlich-Institut, Langen, Germany
| | - Zoe Waibler
- Division of Immunology, Paul-Ehrlich-Institut, Langen, Germany
| | - Katrin Bagola
- Division of Immunology, Paul-Ehrlich-Institut, Langen, Germany
| | - Ger van Zandbergen
- Division of Immunology, Paul-Ehrlich-Institut, Langen, Germany.,Institute of Immunology, Johannes Gutenberg University, Mainz, Germany
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19
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Bhattaram P, Muschler G, Wixler V, Lefebvre V. Inflammatory Cytokines Stabilize SOXC Transcription Factors to Mediate the Transformation of Fibroblast-Like Synoviocytes in Arthritic Disease. Arthritis Rheumatol 2018; 70:371-382. [PMID: 29193895 PMCID: PMC5826855 DOI: 10.1002/art.40386] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 11/16/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Fibroblast-like synoviocytes (FLS) produce key synovial fluid and tissue components to ensure joint integrity under healthy conditions, whereas they become cancer-like and aggressively contribute to joint degeneration in inflammatory arthritis. The aim of this study was to determine whether the SOXC transcription factors SOX4 and SOX11, whose functions are critical in joint development and many cancer types, contribute to FLS activities under normal and inflammatory conditions. METHODS We inactivated the SOXC genes in FLS from adult mice and studied the effect on joint homeostasis and tumor necrosis factor (TNF)-induced arthritis. We used primary cells and synovial biopsy specimens from arthritis patients to analyze the interactions between inflammatory signals and SOXC proteins. RESULTS Postnatal inactivation of the SOXC genes had no major effect on joint integrity in otherwise healthy mice. However, it hampered synovial hyperplasia and joint degeneration in transgenic mice expressing human TNF. These effects were explained by the ability of SOX4/11 to amplify the pathogenic impact of TNF on FLS by increasing their survival and migration. SOXC RNA levels were not changed by TNF and other proinflammatory cytokines, but SOXC proteins were strongly stabilized and able to potentiate the TNF-induced up-regulation of genes involved in FLS transformation. Substantiating the relevance of these findings in human disease, SOXC protein levels, but not RNA levels, were significantly higher in inflamed synovium than in noninflamed synovium from arthritis patients. CONCLUSION SOXC proteins are targets and pivotal mediators of proinflammatory cytokines during FLS transformation in arthritic diseases. Targeting of these proteins could thus improve current strategies to treat arthritic diseases and possibly other inflammatory diseases.
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Affiliation(s)
| | | | - Viktor Wixler
- Muenster University Hospital Medical School, Muenster, Germany
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20
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Kalden JR, Schulze-Koops H. Immunogenicity and loss of response to TNF inhibitors: implications for rheumatoid arthritis treatment. Nat Rev Rheumatol 2017; 13:707-718. [PMID: 29158574 DOI: 10.1038/nrrheum.2017.187] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The availability of monoclonal antibodies has revolutionized the treatment of an increasingly broad spectrum of diseases. Inflammatory diseases are among those most widely treated with protein-based therapeutics, termed biologics. Following the first large-scale clinical trials with monoclonal antibodies performed in the 1990s by rheumatologists and clinical immunologists, the approval of these agents for use in daily clinical practice led to substantial progress in the treatment of rheumatic diseases. Despite this progress, however, only a proportion of patients achieve a long-term clinical response. Data on the use of agents blocking TNF, which were among the first biologics introduced into clinical practice, provide ample evidence of primary and secondary treatment inefficacy in patients with rheumatoid arthritis (RA). Important issues relevant to primary and secondary failure of these agents in RA include immunogenicity, methodological problems for the detection of antidrug antibodies and trough drug levels, and the implications for treatment strategies. Although there is no strong evidence to support the routine estimation of antidrug antibodies or serum trough levels during anti-TNF therapy, these assessments might be helpful in a few clinical situations; in particular, they might guide decisions on switching the therapeutic biologic in certain instances of secondary clinical failure.
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Affiliation(s)
- Joachim R Kalden
- Friedrich-Alexander University Erlangen-Nürnberg, Division of Molecular Immunology, Nikolaus-Fiebiger Center, Glückstraße 6, D-91054 Erlangen, Germany
| | - Hendrik Schulze-Koops
- Ludwig-Maximilians-University, Division of Rheumatology and Clinical Immunology, Department of Internal Medicine IV, Pettenkoferstraße 8a, D-80336 Munich, Germany
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21
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Abstract
The protein disulfide isomerase (PDI) gene family is a protein family classically characterized by endoplasmic reticulum (ER) localization and isomerase and redox activity. ERp57, a prominent multifunctional member of the PDI family, is detected at various levels in multiple cellular localizations outside of the ER. ERp57 has been functionally linked to a host of physiological processes and numerous studies have demonstrated altered expression and aberrant functionality of ERp57 in association with diverse pathological states. Here, we summarize available knowledge of ERp57's functions in subcellular compartments and the roles of dysregulated ERp57 in various diseases toward an emphasis on the potential utility of therapeutic development of ERp57.
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Affiliation(s)
- Aubryanna Hettinghouse
- Department of Orthopaedic Surgery, New York University Medical Center, New York, NY 10003, USA
| | - Ronghan Liu
- Department of Orthopaedic Surgery, New York University Medical Center, New York, NY 10003, USA
| | - Chuan-Ju Liu
- Department of Orthopaedic Surgery, New York University Medical Center, New York, NY 10003, USA; Department of Cell Biology, New York University School of Medicine, New York, NY 10016, USA.
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22
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Abstract
Monoclonal antibodies (mAbs) and fusion proteins with an Fc portion of immunoglobulin G (IgG) are emblematic of the remarkable expansion of biopharmaceuticals. Despite their biological origin, these products display an interindividual variability in their efficacy and/or side effects, which must be taken into consideration. Biological monitoring allowing for adapted prescription and dose adjustments may lead to therapeutic optimization and limitation of the high costs of these drugs. Herein, we review the biological theranostic of mAbs and Fc fusion proteins, including pre-treatment analyses, monitoring of efficacy, therapeutic drug monitoring, and monitoring of side effects. Supported by concrete evidence, a specific interest is given to individualised therapeutic monitoring that combines intention to treat, biomarkers of efficacy and adaptation of serum concentrations.
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Affiliation(s)
- Benjamin Chaigne
- Université Paris Descartes, Faculté de Médecine, Service de Médecine Interne, Centre de Référence Pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France; Institut Cochin, INSERM U1016, CNRS UMR 8104, Université Paris Descartes, Paris, France
| | - Hervé Watier
- CHRU de Tours, Laboratoire d'Immunologie, France; Université François-Rabelais de Tours, France; CNRS, UMR 7292, Tours, France.
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23
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Gueudry J, Thorne JE, Bansie R, Braun J, van Hagen PM, Bodaghi B. Biologic Therapy for HLA-B27-associated Ocular Disorders. Ocul Immunol Inflamm 2016; 25:169-178. [DOI: 10.1080/09273948.2016.1234625] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Julie Gueudry
- Department of Ophthalmology, Charles Nicolle University Hospital, Rouen, France
| | - Jennifer E. Thorne
- Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Rakesh Bansie
- Department of Clinical Immunology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Juergen Braun
- Department of Rheumatology, Rheumazentrum Ruhrgebiet, Herne, Germany
| | - P. Martin van Hagen
- Department of Clinical Immunology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Bahram Bodaghi
- Department of Ophthalmology, University of Paris, VI Pitié-Salpêtrière Hospital, Paris, France
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24
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Riveiro-Naveira RR, Valcárcel-Ares MN, Almonte-Becerril M, Vaamonde-García C, Loureiro J, Hermida-Carballo L, López-Peláez E, Blanco FJ, López-Armada MJ. Resveratrol lowers synovial hyperplasia, inflammatory markers and oxidative damage in an acute antigen-induced arthritis model. Rheumatology (Oxford) 2016; 55:1889-900. [DOI: 10.1093/rheumatology/kew255] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Indexed: 12/17/2022] Open
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25
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Targeting of Tumor Necrosis Factor Alpha Receptors as a Therapeutic Strategy for Neurodegenerative Disorders. Antibodies (Basel) 2015. [DOI: 10.3390/antib4040369] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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26
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Campa M, Ryan C, Menter A. An overview of developing TNF-α targeted therapy for the treatment of psoriasis. Expert Opin Investig Drugs 2015; 24:1343-54. [PMID: 26289788 DOI: 10.1517/13543784.2015.1076793] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Three biologic drugs targeting TNF-α are approved to treat moderate-to-severe cutaneous psoriasis. These are adalimumab, etanercept and infliximab. These drugs are given by subcutaneous injection or intravenous infusion, and while generally safe and effective, they are expensive with potential for side effects. Thus, numerous new drug candidates are under development that also target TNF-α. AREAS COVERED In this review, the authors detail several drugs under development that target TNF-α, focusing on those drugs in preclinical, Phase I and II trials. The authors describe emerging biologic psoriasis therapies, including biosimilars and novel biologics, in addition to several synthetic and naturally derived small-molecule drug candidates. EXPERT OPINION The currently approved TNF-α antagonists benefit from over 10 years of safety and efficacy data. The expense and method of administration of these biologics, however, can be cumbersome, and less expensive alternatives have the potential to benefit patients with psoriasis. It is inevitable, despite the introduction of new anti-IL-17 therapies, that established TNF-α targeted therapies, as well as newcomers targeting TNF-α, will continue to play an important role in the lifelong management of psoriasis.
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Affiliation(s)
- Molly Campa
- a Baylor University Medical Center, Division of Dermatology , Dallas, TX, USA
| | - Caitriona Ryan
- a Baylor University Medical Center, Division of Dermatology , Dallas, TX, USA
| | - Alan Menter
- a Baylor University Medical Center, Division of Dermatology , Dallas, TX, USA
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