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Cheng JH, Cai WX, Xiang XH, Zhou MY, Sun X, Ye H, Li R. Platelet-to-lymphocyte ratios as a haematological marker of synovitis in rheumatoid arthritis with normal acute phase reactant level. Ann Med 2024; 56:2346546. [PMID: 38847883 PMCID: PMC11164179 DOI: 10.1080/07853890.2024.2346546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/27/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Although normal acute phase reactants (APRs) play an important role in assessing disease activity of rheumatoid arthritis (RA), some studies pointed out the discordance between disease activity and APR level. Neutrophil-to-lymphocyte ratios (NLRs), platelet-to-lymphocyte ratios (PLRs) and lymphocyte-to-monocyte ratios (LMRs) have been reported to be sensitive measures of inflammatory reaction. This study aims to explore the value of these haematological makers in assessment of APR-negative RA patients. METHODS Out of a cohort of 418 consecutive patients with RA, we enrolled 135 patients with normal APR for this study. We performed ultrasound assessments to evaluate synovitis and bone erosion in the affected joints. Synovitis was evaluated by ultrasound grey scale (GS) and power Doppler (PD) with semi-quantitative scoring (0-3). Demographic, clinical and laboratory data were collected from the patients. Disease Activity Score-28 joints (DAS28), NLR, MLR and PLR were calculated. RESULTS In RA patients with normal APR, PLR exhibited a positive correlation with ultrasound-detected synovitis and bone erosion, whereas NLR, MLR showed no significant correlation with ultrasonography parameters. The area under the ROC curve (AUC) for identifying synovitis with a GS grade ≥2 based on a PLR cutoff value of ≥159.6 was 0.7868 (sensitivity: 80.95%, specificity: 74.24%). For synovitis with a PD grade ≥2, the AUC was 0.7690, using a PLR cutoff value of ≥166.1 (sensitivity: 68.0%, specificity: 83.87%). CONCLUSIONS Our findings suggested that PLR might be a reliable and cost-effective marker for identifying moderate-to-severe synovitis in RA patients with normal APR.
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Affiliation(s)
- Jia-Hui Cheng
- Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China
| | - Wen-Xin Cai
- Department of Rheumatology and Immunology, Beijing Hospital, Beijing, China
| | - Xiao-Hong Xiang
- Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China
| | - Meng-yan Zhou
- Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China
| | - Xing Sun
- Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China
| | - Hua Ye
- Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China
| | - Ru Li
- Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing, China
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Selim AM, Elsabagh YA, El-Sawalhi MM, Ismail NA, Senousy MA. Serum lncRNA ITGB2-AS1 and ICAM-1 as novel biomarkers for rheumatoid arthritis and osteoarthritis diagnosis. BMC Med Genomics 2024; 17:247. [PMID: 39379962 PMCID: PMC11462822 DOI: 10.1186/s12920-024-01993-6] [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: 03/25/2024] [Accepted: 08/19/2024] [Indexed: 10/10/2024] Open
Abstract
BACKGROUND The complete circulating long non-coding RNAs (lncRNAs) signature of rheumatoid arthritis (RA) and osteoarthritis (OA) is still uncovered. The lncRNA integrin subunit beta 2 (ITGB2)-anti-sense RNA 1 (ITGB2-AS1) affects ITGB2 expression; however, there is a gap in knowledge regarding its expression and clinical usefulness in RA and OA. This study investigated the potential of serum ITGB2-AS1 as a novel diagnostic biomarker and its correlation with ITGB2 expression and its ligand intercellular adhesion molecule-1 (ICAM-1), disease activity, and severity in RA and primary knee OA patients. SUBJECTS Forty-three RA patients, 35 knee OA patients, and 22 healthy volunteers were included. RESULTS Compared with healthy controls, serum ITGB2-AS1 expression was upregulated in RA patients but wasn't significantly altered in knee OA patients, whereas serum ICAM-1 protein levels were elevated in both diseases. ITGB2-AS1 showed discriminative potential for RA versus controls (AUC = 0.772), while ICAM-1 displayed diagnostic potential for both RA and knee OA versus controls (AUC = 0.804, 0.914, respectively) in receiver-operating characteristic analysis. In the multivariate analysis, serum ITGB2-AS1 and ICAM-1 were associated with the risk of developing RA, while only ICAM-1 was associated with the risk of developing knee OA. A panel combining ITGB2-AS1 and ICAM-1 showed profound diagnostic power for RA (AUC = 0.9, sensitivity = 86.05%, and specificity = 91.67%). Interestingly, serum ITGB2-AS1 positively correlated with disease activity (DAS28) in RA patients and with ITGB2 mRNA expression in both diseases, while ICAM-1 positively correlated with ITGB2 expression in knee OA patients. CONCLUSION Our study portrays serum ITGB2-AS1 as a novel potential diagnostic biomarker of RA that correlates with disease activity. A predictive panel combining ITGB2-AS1 and ICAM-1 could have clinical utility in RA diagnosis. We also spotlight the association of ICAM-1 with knee OA diagnosis. The correlation of serum ITGB2-AS1 with ITGB2 expression in both diseases may be insightful for further mechanistic studies.
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Affiliation(s)
- Aliaa M Selim
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, 23 Kasr El-Ainy Street, Cairo, 11562, Egypt.
| | - Yumn A Elsabagh
- Department of Rheumatology and Clinical Immunology, Internal Medicine, Kasr Al-Ainy, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maha M El-Sawalhi
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, 23 Kasr El-Ainy Street, Cairo, 11562, Egypt.
| | - Nabila A Ismail
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, 23 Kasr El-Ainy Street, Cairo, 11562, Egypt
| | - Mahmoud A Senousy
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, 23 Kasr El-Ainy Street, Cairo, 11562, Egypt
- Department of Biochemistry, Faculty of Pharmacy and Drug Technology, Egyptian Chinese University, Cairo, 11786, Egypt
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Hidayat R, Fauzia F, Parlindungan F, Wibowo SAK, Ariane A, Damanik J, Araminta AP. Predictive factors of methotrexate monotherapy success in patients with rheumatoid arthritis in a national referral center: a cohort study. BMC Rheumatol 2024; 8:42. [PMID: 39261961 PMCID: PMC11391786 DOI: 10.1186/s41927-024-00412-8] [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: 06/25/2024] [Accepted: 09/02/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Methotrexate (MTX) remains the recommended first-line treatment for rheumatoid arthritis (RA); however, its response varies and is influenced by various factors. This study aimed to identify predictors of MTX monotherapy treatment success in an Indonesian cohort. METHODS This retrospective cohort study included newly diagnosed RA patients receiving MTX monotherapy. Treatment success was defined as achieving remission or low disease activity according to Disease Activity Score-28 with erythrocyte sedimentation rate (DAS28-ESR) after 12 months of MTX therapy. The association between demographic, clinical, and laboratory factors and achieving therapy targets was evaluated using multivariate logistic regression analysis. RESULTS Among 254 subjects, 59.4% achieved treatment success with MTX monotherapy, with remission attained in 33% and low disease activity in 26.4%. Most subjects were female (95.7%) with a mean age of 48 ± 11 years. Multivariate analysis revealed that lower disease activity (OR 1.97; 95% CI [1.04-3.72]), normal ESR (OR 2.58; 95% CI [1.05-6.34]), normoweight (OR 2.55, 95% CI [1.45-4.49]), and tender joint count ≤ 5 (OR 2.45, 95% CI [1.31-4.58]) were significant predictors of treatment success. CONCLUSION The rate of MTX monotherapy success in our study was 59.4%. Lower disease activity, normal ESR, normoweight, and fewer tender joints at baseline were significant predictors of treatment success.
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Affiliation(s)
- Rudy Hidayat
- Rheumatology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Fara Fauzia
- Jakarta Rheumatic & Autoimmune Disease Study Group (Jak-RAIDS), Jakarta, Indonesia
| | - Faisal Parlindungan
- Rheumatology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
- Medical Staff Group of Internal Medicine, Universitas Indonesia Hospital, Depok, Indonesia.
| | - Suryo Anggoro Kusumo Wibowo
- Rheumatology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Anna Ariane
- Rheumatology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Johanda Damanik
- Rheumatology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Abirianty Priandani Araminta
- Rheumatology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
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Angela S, Fadhilah G, Hsiao WWW, Lin HY, Ko J, Lu SCW, Lee CC, Chang YS, Lin CY, Chang HC, Chiang WH. Nanomaterials in the treatment and diagnosis of rheumatoid arthritis: Advanced approaches. SLAS Technol 2024; 29:100146. [PMID: 38844139 DOI: 10.1016/j.slast.2024.100146] [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: 10/02/2023] [Revised: 04/06/2024] [Accepted: 05/22/2024] [Indexed: 06/11/2024]
Abstract
Rheumatoid arthritis (RA), a chronic inflammatory condition that affects persons between the ages of 20 and 40, causes synovium inflammation, cartilage loss, and joint discomfort as some of its symptoms. Diagnostic techniques for RA have traditionally been split into two main categories: imaging and serological tests. However, significant issues are associated with both of these methods. Imaging methods are costly and only helpful in people with obvious symptoms, while serological assays are time-consuming and require specialist knowledge. The drawbacks of these traditional techniques have led to the development of novel diagnostic approaches. The unique properties of nanomaterials make them well-suited as biosensors. Their compact dimensions are frequently cited for their outstanding performance, and their positive impact on the signal-to-noise ratio accounts for their capacity to detect biomarkers at low detection limits, with excellent repeatability and a robust dynamic range. In this review, we discuss the use of nanomaterials in RA theranostics. Scientists have recently synthesized, characterized, and modified nanomaterials and biomarkers commonly used to enhance RA diagnosis and therapy capabilities. We hope to provide scientists with the promising potential that nanomaterials hold for future theranostics and offer suggestions on further improving nanomaterials as biosensors, particularly for detecting autoimmune disorders.
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Affiliation(s)
- Stefanny Angela
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Gianna Fadhilah
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Wesley Wei-Wen Hsiao
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Hsuan-Yi Lin
- Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Joshua Ko
- The Ph.D. Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Steven Che-Wei Lu
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Cheng-Chung Lee
- The Ph.D. Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Yu-Sheng Chang
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Shuang Ho Hospital, New Taipei City, Taiwan; Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ching-Yu Lin
- The Ph.D. Program in Medical Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Huan-Cheng Chang
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan; Institute of Atomic and Molecular Sciences, Academia Sinica, Taipei, Taiwan; Department of Chemistry, National Taiwan Normal University, Taipei, Taiwan
| | - Wei-Hung Chiang
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan; Sustainable Electrochemical Energy Development (SEED) Center, National Taiwan University of Science and Technology, Taipei, Taiwan; Advanced Manufacturing Research Center, National Taiwan University of Science and Technology, Taipei, Taiwan.
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Ciurtin C, Helmy GA, Ferreira AC, Manson JJ, Jury EC, McDonnell T. A tale of two functions: C-reactive protein complement-ary structures and their role in rheumatoid arthritis. Clin Immunol 2024; 265:110281. [PMID: 38885803 DOI: 10.1016/j.clim.2024.110281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/31/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024]
Abstract
C-reactive protein (CRP) is an inflammatory biomarker with associated clinical utility in a wide number of inflammatory disorders, including rheumatoid arthritis (RA). The interaction of CRP with pro-inflammatory cytokines has been explored before, however its role in complement regulation is more subtle, where CRP is capable of both up and downregulating the complement cascade. CRP is produced in a pentameric form and can dissociate to a monomeric form in circulation which has significant implications for its ability to interact with receptors and binding partners. This dichotomy of CRP structure could have relevance in patients with RA who have significant dysfunction in their complement cascade and also widely varying CRP levels including at the time of flare. This review aims to bring together current knowledge of CRP in its various forms, its effects on complement function and how this could influence pathology in the context of RA.
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Affiliation(s)
- Coziana Ciurtin
- Centre for Adolescent Rheumatology, Division of Medicine, University College London (UCL), London WC1E 6JF, UK
| | - Ghada Adly Helmy
- University College London Medical School, University College London, WC1E 6DE, UK
| | | | - Jessica J Manson
- Department of Rheumatology, University College London Hospital NHS Trust, London NW1 2PG, UK
| | - Elizabeth C Jury
- Centre for Rheumatology Research, Division of Medicine, University College London, London WC1E 6JF, UK
| | - Thomas McDonnell
- Centre for Rheumatology Research, Division of Medicine, University College London, London WC1E 6JF, UK.
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Karpouzas GA, Ormseth SR, van Riel PLCM, Gonzalez-Gay MA, Corrales A, Rantapää-Dahlqvist S, Sfikakis PP, Dessein P, Tsang L, Hitchon C, El-Gabalawy H, Pascual-Ramos V, Contreras-Yáñez I, Colunga-Pedraza IJ, Galarza-Delgado DA, Azpiri-Lopez JR, Semb AG, Misra DP, Hauge EM, Kitas G. Biological use influences the impact of inflammation on risk of major adverse cardiovascular events in rheumatoid arthritis. RMD Open 2024; 10:e004546. [PMID: 39043615 PMCID: PMC11268070 DOI: 10.1136/rmdopen-2024-004546] [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: 05/16/2024] [Accepted: 07/05/2024] [Indexed: 07/25/2024] Open
Abstract
OBJECTIVES Chronic inflammation promotes cardiovascular risk in rheumatoid arthritis (RA). Biological disease-modifying antirheumatic drugs (bDMARDs) improve disease activity and cardiovascular disease outcomes. We explored whether bDMARDs influence the impact of disease activity and inflammatory markers on long-term cardiovascular risk in RA. METHODS We studied 4370 participants without cardiovascular disease in a 10-country observational cohort of patients with RA. Endpoints were (1) major adverse cardiovascular events (MACE) encompassing myocardial infarction, stroke and cardiovascular death; and (2) any ischaemic cardiovascular events (iCVE) including MACE plus revascularisation, angina, transient ischaemic attack and peripheral arterial disease. RESULTS Over 26 534 patient-years, 239 MACE and 362 iCVE occurred. The interaction between 28-joint Disease Activity Score with C-reactive protein (DAS28-CRP) and bDMARD use was significant for MACE (p=0.017), suggesting the effect of DAS28-CRP on MACE risk differed among bDMARD users (n=515) and non-users (n=3855). DAS28-CRP (per unit increase) is associated with MACE risk in bDMARD non-users (HR 1.21 (95% CI 1.07 to 1.37)) but not users (HR 0.69 (95% CI 0.40 to 1.20)). The interaction between CRP (per log unit increase) and bDMARD use was also significant for MACE (p=0.011). CRP associated with MACE risk in bDMARD non-users (HR 1.16 (95% CI 1.04 to 1.30)), but not users (HR 0.65 (95% CI 0.36 to 1.17)). No interaction was observed between bDMARD use and DAS28-CRP (p=0.167) or CRP (p=0.237) for iCVE risk. CONCLUSIONS RA activity and inflammatory markers associated with risk of MACE in bDMARD non-users but not users suggesting the possibility of biological-specific benefits locally on arterial wall independently of effects on systemic inflammation.
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Affiliation(s)
- George Athanasios Karpouzas
- Internal Medicine - Rheumatology, The Lundquist Institute, Torrance, California, USA
- Rheumatology, Harbor-UCLA Medical Center, Torrance, California, USA
| | | | | | - Miguel A Gonzalez-Gay
- Rheumatology, Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain
- IIS-Fundacion Jimenez Diaz, Madrid, Spain
| | - Alfonso Corrales
- Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain
| | | | - Petros P Sfikakis
- First Dept. of Propedeutic Medicine, University of Athens, Athens, Attica, Greece
| | - Patrick Dessein
- School of Physiology, University of the Witwatersrand Johannesburg, Johannesburg, South Africa
| | - Linda Tsang
- Vrije Universiteit Brussel, Brussel, Belgium
| | - Carol Hitchon
- Rheumatology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Hani El-Gabalawy
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Virginia Pascual-Ramos
- Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico City, Mexico
| | - Irazú Contreras-Yáñez
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Mexico
| | - Iris J Colunga-Pedraza
- Rheumatology, Hospital Universitario Dr José Eleuterio González, Monterrey, Nuevo León, Mexico
| | | | | | - Anne Grete Semb
- Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Durga Prasanna Misra
- Clinical Immunology and Rheumatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ellen-Margrethe Hauge
- Department of Joint and Connective Tissue Diseases, Aarhus Universitetshospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus Universitet, Aarhus, Midtjylland, Denmark
| | - George Kitas
- Department of Rheumatology, The Dudley Group NHS Foundation Trust, Dudley, West Midlands, UK
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Warjukar PR, Mohabey AV, Jain PB, Bandre GR. Decoding the Correlation Between Inflammatory Response Marker Interleukin-6 (IL-6) and C-reactive Protein (CRP) With Disease Activity in Rheumatoid Arthritis. Cureus 2024; 16:e62954. [PMID: 39050325 PMCID: PMC11265957 DOI: 10.7759/cureus.62954] [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: 01/26/2024] [Accepted: 06/23/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Excessive interleukin-6 (IL-6) production in rheumatoid arthritis (RA) leads to joint destruction, inflammation, and systemic symptoms. IL-6 inhibitors alleviate symptoms. C-reactive protein (CRP), an inflammation biomarker, correlates with RA activity. In this study, we assess IL-6 and CRP levels in RA patients to understand their association with disease activity. MATERIALS AND METHODS This cross-sectional study was conducted at a tertiary care hospital in central India for 15 months, from July 2022 to September 2023. The study involved 75 participants diagnosed with RA and receiving outpatient treatment. Exclusion criteria included anti-IL-6 drug treatment, bedridden individuals, proxy patients, and those without consent. Disease activity was assessed using the 28-joint disease activity score (DAS28), while IL-6 and CRP levels were measured following the standard procedures. RESULTS The average CRP levels were found to be 51.67 ± 47.49 mg/L, while IL-6 levels averaged 65.16 ± 43.67 pg/ml. The results revealed a substantial positive correlation between IL-6 levels and DAS28 (r = 0.603, p value < 0.001), indicating a significant association. Additionally, a moderate correlation between CRP levels and DAS28 (r = 0.493, p value < 0.001) highlighted a significant relationship between these variables. CONCLUSIONS The analysis showed that higher IL-6 levels were associated with increased disease activity and suggested IL-6 as a valuable indicator for assessing RA severity. Also, CRP levels had a moderate correlation with disease activity. Overall, IL-6 is a better marker for disease activity when compared to CRP levels in patients with RA.
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Affiliation(s)
- Prajakta R Warjukar
- Biochemistry, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Ankush V Mohabey
- Orthopedics, All India Institute of Medical Sciences, Nagpur, Nagpur, IND
| | - Pradeep B Jain
- Biochemistry, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Gulshan R Bandre
- Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Lu Z, Xie Z, Shen K, Wu X, Feng E. Association of dietary inflammatory index with immune-inflammatory biomarkers in rheumatoid arthritis patients: results from NHANES 1999-2018. Front Nutr 2024; 11:1353964. [PMID: 38860155 PMCID: PMC11163113 DOI: 10.3389/fnut.2024.1353964] [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: 12/11/2023] [Accepted: 04/29/2024] [Indexed: 06/12/2024] Open
Abstract
Background Synovial inflammation is the main reason for joint damage in patients with rheumatoid arthritis (RA). Diet is recognized as one of the therapeutic strategies to control the inflammatory activity in RA. However, few studies have investigated the association between diet and immune-inflammatory biomarkers in RA patients. Our study aims to examine the correlation between dietary inflammatory potential and systemic immune-inflammation Index (SII), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) in the RA population. Materials and methods The National Health and Nutrition Examination Survey (NHANES) was the data source utilized in this study, spanning from 1999 to 2018. The study encompassed 2,500 RA participants in total. The dietary inflammatory potential was calculated by the dietary inflammation index (DII) score based on dietary recall interviews. The generalized multiple linear regression analyses were used to evaluate the relationship between DII and immune-inflammatory markers. Furthermore, subgroup analyses and restricted cubic spline models were performed. Results After full adjustments, there were significant positive correlations between DII levels and SII/NLR in RA patients (SII, β: 14.82, 95% CI: 5.14-24.50, p = 0.003; NLR, β: 0.04, 95% CI: 0.01-0.08, p = 0.005). It was noteworthy that inconsistent results were observed in the association between DII and SII as well as NLR in subgroups of red blood cell levels (Interaction p-value <0.001). Conclusion Pro-inflammatory dietary status in the RA population is significantly positively correlated with SII and NLR, influenced by variations in red blood cell levels.
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Affiliation(s)
- Zhiming Lu
- Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhiheng Xie
- Department of Orthopaedic, Anxi County Hospital, Quanzhou, China
| | - Kaiwei Shen
- Faculty of Medicine, Institute of Biochemistry and Molecular Biology, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
| | - Xunyuan Wu
- Fujian Medical University Union Hospital, Fuzhou, China
| | - Eryou Feng
- Fujian Medical University Union Hospital, Fuzhou, China
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Kaplan H, Cengiz G, Cuce I, Sas S, Senkoy E, Calis M, Ozturk O, Demir H, Kirnap M. Rheumatoid factor titers, but not Fc fragments, may be strongly associated with drug survival of anti-TNF agents in patients with rheumatoid arthritis. North Clin Istanb 2024; 11:147-157. [PMID: 38757098 PMCID: PMC11095329 DOI: 10.14744/nci.2023.01643] [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: 03/03/2023] [Revised: 03/27/2023] [Accepted: 04/24/2023] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVE To investigate the effects of both the Fc fragment in tumor necrosis factor (TNF) inhibitors and rheumatoid factor (RF) titers on treatment survival, disease activity, and laboratory parameters in patients with rheumatoid arthritis (RA). METHODS In this retrospective cohort study, patients with RA who had started any anti-TNF therapy between January 2017 and March 2020 and who had stayed on this treatment for at least six months were included. The data of the patients were compared separately according to continuation or discontinuation of treatment and the presence or absence of Fc portion in the structure of anti-TNFs. Patients who were taking certolizumab pegol (CZP) without the Fc fragment were placed in the "without Fc group" (wo/Fc), while patients who were taking other drugs (adalimumab, etanercept, golimumab, and infliximab) were placed in the "with Fc group" (w/Fc). RESULTS Among the 221 RA patients whose data were available, 52 patients met the inclusion criteria and were included in the study. There was a significant difference in the DAS28-CRP score between wo/Fc group and w/Fc group in the third month of treatment (p=0.012). However, this difference did not persist at the sixth month of treatment (p=0.384). According to the cox-regression results, RF titers were determined to have a significant impact on the drug survival of anti-TNF agents when adjustments were made for the effects of other candidate predictors (Hazard ratio: 1.007 (1.002-1.012), p=0.009). CONCLUSION Our results suggest that compared to the Fc fragment, RF titers were the more important risk factor in survival of anti-TNF drugs.
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Affiliation(s)
- Huseyin Kaplan
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Erciyes University Faculty of Medicine, Kayseri, Turkiye
| | - Gizem Cengiz
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Erciyes University Faculty of Medicine, Kayseri, Turkiye
| | - Isa Cuce
- Department of Physical Medicine and Rehabilitation, Erciyes University Faculty of Medicine, Kayseri, Turkiye
| | - Senem Sas
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Erciyes University Faculty of Medicine, Kayseri, Turkiye
| | - Emre Senkoy
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Erciyes University Faculty of Medicine, Kayseri, Turkiye
| | - Mustafa Calis
- Department of Physical Medicine and Rehabilitation, Erciyes University Faculty of Medicine, Kayseri, Turkiye
| | - Orhun Ozturk
- Department of Statistics, Hacettepe University, Ankara, Turkiye
| | - Huseyin Demir
- Department of Physical Medicine and Rehabilitation, Medical Palace Hospital, Kayseri, Turkiye
| | - Mehmet Kirnap
- Department of Physical Medicine and Rehabilitation, Erciyes University Faculty of Medicine, Kayseri, Turkiye
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10
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Yu X, Wang Q, Zhuang L, Cai G, Li Z, Ren M, Jin Z, Xi J. Study on the Correlation between 7-joint Ultrasound Score and Disease Activity in Patients with Rheumatoid Arthritis. J Med Ultrasound 2024; 32:134-138. [PMID: 38882619 PMCID: PMC11175366 DOI: 10.4103/jmu.jmu_43_23] [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: 04/16/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/18/2024] Open
Abstract
Background The objective of this study was to investigate the correlation between the 7-joint ultrasound score (US7) and disease activity in patients with rheumatoid arthritis (RA). Methods Forty-four patients with active RA were assessed, and the correlation between US7 and disease activity indicators such as the disease activity score (DAS28), rheumatoid factor (RF), the erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) was analyzed. In addition, the proportions of US7 points accounted for by different joint regions and joint surfaces were analyzed. Results RF, CRP, and ESR were significantly increased in the RA group compared with the control group (P < 0.05). In the RA group, DAS28 (r = 0.0.561, P < 0.01), RF (r = 0.635, P < 0.01), ESR (r = 0.585, P < 0.01), and CRP (r = 0.492, P < 0.01) were positively correlated with US7. In terms of contributions to US7, the most susceptible joint surface is the dorsal surface, and the most susceptible joint area is the dorsal wrist. Conclusion US7 is positively correlated with disease activity indicators of RA, which can objectively reflect disease activity in RA patients and provide a reference for clinical diagnosis and efficacy evaluation.
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Affiliation(s)
- Xiaolong Yu
- Science and Education Section, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
- Department of Ultrasonics, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Qiang Wang
- Department of Surgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
| | - Lin Zhuang
- Department of Surgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
| | - Gaojun Cai
- Department of Cardiology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
| | - Zun Li
- Department of Ultrasonics, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Min Ren
- Department of Rheumatology and Immunology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
| | - Zihan Jin
- Clinical Lab, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu, China
| | - Jing Xi
- Science and Education Section, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
- Department of Ultrasonics, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
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11
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Zubrzycka-Sienkiewicz A, Klama K, Ullmann M, Petit-Frere C, Baker P, Monnet J, Illes A. Comparison of the efficacy and safety of a proposed biosimilar MSB11456 with tocilizumab reference product in subjects with moderate-to-severe rheumatoid arthritis: results of a randomised double-blind study. RMD Open 2024; 10:e003596. [PMID: 38316489 PMCID: PMC11148666 DOI: 10.1136/rmdopen-2023-003596] [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: 08/09/2023] [Accepted: 01/20/2024] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVE To evaluate the efficacy, immunogenicity and safety of the proposed biosimilar MSB11456 versus European Union (EU)-approved tocilizumab reference product in patients with rheumatoid arthritis (RA) in a multicentre, randomised, double-blind, multinational, parallel-group study (NCT04512001). METHODS Adult patients with moderate-to-severe active RA and inadequate clinical response to ≥1 disease-modifying antirheumatic drug (synthetic or biologic) receiving methotrexate were randomised to receive 24 weekly subcutaneous 162 mg injections of either MSB11456 or EU-approved tocilizumab. Equivalence between treatments was considered if the 95% CI (European Medicines Agency)/90% CI (US Food and Drug Administration) for the difference in mean change from baseline to week 24 in Disease Activity Score-28 Joint Count with erythrocyte sedimentation rate (DAS28-ESR) between treatments was entirely within prespecified equivalence intervals (-0.6 to 0.6 and -0.6 to 0.5, respectively). At week 24, patients were rerandomised to continued treatment or MSB11456. Secondary efficacy endpoints to week 52, and safety and immunogenicity to week 55 were also evaluated. RESULTS At week 24, the least squares mean difference in the change from baseline in DAS28-ESR between treatments was 0.01 (95% CI -0.19 to 0.22) in the 604 randomised patients. Similarity between treatments was shown for all other efficacy, safety and immunogenicity endpoints, including in patients who switched from EU-approved tocilizumab to MSB114466. CONCLUSIONS Therapeutic equivalence was demonstrated for efficacy endpoints, and safety and immunogenicity analyses support the similarity of the two treatments. The results of this study strengthen the evidence that the proposed biosimilar MSB11456 and EU-approved tocilizumab exert similar clinical effects.
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Affiliation(s)
| | | | | | | | - Peter Baker
- Fresenius Kabi SwissBioSim GmbH, Eysins, Switzerland
| | - Joëlle Monnet
- Fresenius Kabi SwissBioSim GmbH, Eysins, Switzerland
| | - Andras Illes
- Fresenius Kabi SwissBioSim GmbH, Eysins, Switzerland
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12
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Aboul Naser AF, Ahmed YR, Mohammed MA, Aboelmagd M, Aboutabl ME, Hassan EE, Khalil WKB, Hamed MA. Inflammatory mediators, oxidative stress and genetic disturbance in rheumatoid arthritis rats supported by alfalfa seeds metabolomic constituents via blocking interleukin-1receptor. Chem Biodivers 2024; 21:e202301653. [PMID: 38158718 DOI: 10.1002/cbdv.202301653] [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: 10/19/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/03/2024]
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease characterized by aggressive cartilage and bone erosion. This work aimed to evaluate the metabolomic profile of Medicago sativa L. (MS) (alfalfa) seeds and explore its therapeutic impact against RA in rats. Arthritis was induced by complete Freund's adjuvant (CFA) and its severity was assessed by the arthritis index. Treatment with MS seeds butanol fraction and interlukin-1 receptor antagonist (IL-1RA) were evaluated through measuring interlukin-1 receptor (IL-1R) type 1 gene expression, interlukin-1 beta (IL-1β), oxidative stress markers, C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), prostaglandin E2 (PGE2), caspase-3 (Cas-3), intracellular adhesion molecule-1 (ICAM-1), DNA fragmentation, and chromosomal damage. Total phenolics/ flavonoids content in the ethyl acetate, butanol fraction and crude extract of MS seeds were estimated. The major identified compounds were Quercetin, Trans-taxifolin, Gallic acid, 7,4'-Dihydroxyflavone, Cinnamic acid, Kudzusaponin SA4, Isorhamnetin 3-O-beta-D-2'',3'',4''-triacetylglucopyranoside, Apigenin, 5,7,4'-Trihydroxy-3'-methoxyflavone, Desmethylxanthohumol, Pantothenic acid, Soyasapogenol E, Malvidin, Helilandin B, Stigmasterol, and Wairol. Treatment with MS seeds butanol fraction and IL-1RA enhanced all the biochemical parameters and the histopathological features of the ankle joint. In conclusion, Trans-taxifolin was isolated for the first time from the genus Medicago. MS butanol fraction seeds extract and IL-1 RA were considered as anti-rheumatic agents.
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Affiliation(s)
- Asmaa F Aboul Naser
- Department of Therapeutic Chemistry, National Research Centre, Dokki, Giza, Egypt
| | - Yomna R Ahmed
- Department of Therapeutic Chemistry, National Research Centre, Dokki, Giza, Egypt
| | - Mona A Mohammed
- Medicinal and Aromatic Plants Research Department, National Research Centre, Dokki, Giza, Egypt
| | - Mohamed Aboelmagd
- Pharmacognosy Department, National Research Centre, Dokki, Giza, Egypt
| | - Mona E Aboutabl
- Medicinal and Pharmaceutical Chemistry Department (Pharmacology Group), National Research Centre, Dokki, Giza, Egypt
| | - Entesar E Hassan
- Department of Genetics and Cytology, National Research Centre, Dokki, Giza, Egypt
| | - Wagdy K B Khalil
- Department of Cell Biology, National Research Centre, Dokki, Giza, Egypt
| | - Manal A Hamed
- Department of Therapeutic Chemistry, National Research Centre, Dokki, Giza, Egypt
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13
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Cieśla M, Darmochwal-Kolarz DA, Kwaśniak K, Pałka A, Kolarz B. Plasma Circular-RNA 0005567 as a Potential Marker of Disease Activity in Rheumatoid Arthritis. Int J Mol Sci 2023; 25:417. [PMID: 38203588 PMCID: PMC10779327 DOI: 10.3390/ijms25010417] [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: 11/20/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
Circular RNAs (circRNAs) are noncoding molecules and are generated through back splicing, during which the 5' and 3' ends are covalently joined. Consequently, the lack of free ends makes them stable and resistant to exonucleases, and they become more suitable biomarkers than other noncoding RNAs. The aim of the study was to find an association between selected circRNAs and disease activity in patients with RA. A total of 71 subjects, 45 patients with RA and 26 healthy controls (HCs), were enrolled. In the RA group, 24 patients had high disease activity (DAS-28-ESR > 5.1) and 21 individuals were in remission (DAS-28-ESR ≤ 2.6). The cell line SW982 was used to evaluate the biological function of circ_0005567. The concentration of circ_0005567 in RA patients was elevated compared to HCs (median, 177.5 [lower-upper quartile, 83.13-234.6] vs. 97.83 [42.03-145.4], p = 0.017). Patients with high disease activity had a higher concentration of circ_0005567 than the control group (185.4 [112.72-249.25] vs. 97.83 [42.03-145.4], p = 0.015). In the cell line model, we found an association between circ_0005567 and miR-194-5p concentration and increased expression of mRNAs that may be related to cell proliferation. The plasma concentration of circ_0005567 may be a new potential biomarker associated with disease activity in patients with RA.
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Affiliation(s)
- Marek Cieśla
- Institute of Medical Sciences, College of Medical Sciences, University of Rzeszow, 35-959 Rzeszow, Poland; (D.A.D.-K.); (B.K.)
| | - Dorota A. Darmochwal-Kolarz
- Institute of Medical Sciences, College of Medical Sciences, University of Rzeszow, 35-959 Rzeszow, Poland; (D.A.D.-K.); (B.K.)
| | - Konrad Kwaśniak
- Centre for Innovative Research in Medical and Natural Sciences, Medical College of Rzeszów University, 35-310 Rzeszow, Poland
| | - Anna Pałka
- Institute of Medical Sciences, College of Medical Sciences, University of Rzeszow, 35-959 Rzeszow, Poland; (D.A.D.-K.); (B.K.)
| | - Bogdan Kolarz
- Institute of Medical Sciences, College of Medical Sciences, University of Rzeszow, 35-959 Rzeszow, Poland; (D.A.D.-K.); (B.K.)
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14
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Pan YJ, Su KY, Shen CL, Wu YF. Correlation of Hematological Indices and Acute-Phase Reactants in Rheumatoid Arthritis Patients on Disease-Modifying Antirheumatic Drugs: A Retrospective Cohort Analysis. J Clin Med 2023; 12:7611. [PMID: 38137680 PMCID: PMC10744259 DOI: 10.3390/jcm12247611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/24/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
Acute-phase markers are often used to evaluate the disease activity of rheumatoid arthritis (RA). Occasionally, the serum levels of acute-phase reactants remain normal in patients with obvious inflamed joints. Hematological indices derived from complete blood counts have been shown to correlate with disease activity. This provides a potential practical implementation in daily practice. Only a few studies have evaluated the relation between hematological indices and novel RA treatment (i.e., biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs); no research has examined the changes in hematological indices in RA treatments longitudinally. We conducted a retrospective study involving 273 RA patients with b/tsDMARD treatment and followed them for at least a year. Baseline, 3-month, and 6-month lab data were collected. The results indicated a reduction in the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII) post-treatment. Higher baseline PLRs and SIIs were associated with a more significant reduction in ESR at three months (η2 = 0.03/0.13, p = 0.21/0.023). NLR and SII correlated with CRP moderately at three months (r = 0.373/0.394, p < 0.001/< 0.001). A correlation comparison showed that the correlation of NLR and PLR with CRP differs during different periods (p = 0.037/0.004). Subgroup analysis revealed that the time effect on correlation is related to treatment with Janus kinase inhibitor and anti-interleukin-6 but not antitumor necrosis factors.
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Affiliation(s)
- Yu-Jen Pan
- Division of Allergy, Immunology and Rheumatology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan; (Y.-J.P.); (K.-Y.S.); (C.-L.S.)
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
| | - Kuei-Ying Su
- Division of Allergy, Immunology and Rheumatology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan; (Y.-J.P.); (K.-Y.S.); (C.-L.S.)
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
| | - Chih-Lung Shen
- Division of Allergy, Immunology and Rheumatology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan; (Y.-J.P.); (K.-Y.S.); (C.-L.S.)
- Department of Hematology and Oncology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan
| | - Yi-Feng Wu
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
- Department of Hematology and Oncology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan
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15
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Gravand A, Alesaeidi S, Khoshbakht S, Saghaei M, Kenarangi T, Mosallaei M, Soosanabadi M. Demethylation of CDKN2A in systemic lupus erythematosus and rheumatoid arthritis: a blood biomarker for diagnosis and assessment of disease activity. Clin Rheumatol 2023; 42:3387-3395. [PMID: 37597101 DOI: 10.1007/s10067-023-06736-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/21/2023] [Accepted: 08/04/2023] [Indexed: 08/21/2023]
Abstract
INTRODUCTION/OBJECTIVES Considering the phenotypic and serological heterogeneity of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), significant challenges may intervene with the precise diagnosis. In this regard, numerous studies have shown that changes in DNA methylation levels can be used to distinguish between healthy individuals and those with SLE and RA, as well as to predict disease activity and prognosis. METHODS In the current study, we evaluated quantitative methylation level of CDKN2A promoter in peripheral blood mononuclear cells (PBMCs) of SLE and RA patients, and healthy controls by methylation-quantification of endonuclease-resistant DNA (MethyQESD), a bisulfite conversion-independent method. RESULTS Our findings revealed an excessive hypomethylation of CDKN2A in SLE and RA patients compared to healthy individuals (P < 0.001). Besides, by determining efficient cutoff value, the specificity of CDKN2A for correct diagnosis of healthy subjects was measured to be 77.30% and the sensitivity for SLE and RA diagnosis were 81.33%, and 72%, respectively. Furthermore, CDKN2A methylation level was shown to be positively associated with C3 and C4 levels and negatively associated with anti‑dsDNA concentration (P < 0.001). Moreover, a statistically significant difference in the DNA methylation levels of CDKN2A promoter was identified between SLE cases with age of ≤ 18 and patients with > 18 years of age (P = 0.025). CONCLUSION Our findings demonstrated that CDKN2A methylation levels in PBMCs of SLE and RA patients could be used as a promising diagnostic biomarker. The significant association between hypomethylation of CDKN2A promoter and disease activity factors in SLE patients, is suggesting that CDKN2A hypomethylation could be used as an alternative biomarker for assessment of disease activity. Key Points • Several studies have reported increased expression of CDKN2A in SLE and RA suggesting that it may be involved in the pathogenesis of these disorders. • CDKN2A hypomethylation has been implicated in different autoimmune diseases. • Our findings demonstrated that CDKN2A methylation levels in PBMCs of SLE and RA patients could be used as a promising diagnostic and prognostic biomarker.
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Affiliation(s)
- Abdollah Gravand
- Department of Genetics, Faculty of Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Samira Alesaeidi
- Department of Internal Medicine and Rheumatology, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrouz Khoshbakht
- Student Research Committee, University of Social Welfare and Rehabilitation Science, Tehran, Iran
| | - Mozhdeh Saghaei
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Taiebe Kenarangi
- Student Research Committee, Faculty of Statistics, University of Social Welfare and Rehabilitation Science, Tehran, Iran
| | - Meysam Mosallaei
- Personalized Medicine and Genometabolomics Research Center, Hope Generation Foundation, Tehran, Iran
| | - Mohsen Soosanabadi
- Department of Medical Genetics, Semnan University of Medical Sciences, Semnan, Iran.
- Abnormal Uterine Bleeding Research Center, Semnan University of Medical Sciences, Semnan, Iran.
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16
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Flores-Alvarado DE, Esquivel-Valerio JA, Vega-Morales D, Garza-Cisneros AN, Balderas-Palacios MA, Galarza-Delgado DA, Garcia-Leal M. Impact of obesity and overweight on C-reactive protein concentrations and disease activity in rheumatoid arthritis: A systematic review and meta-analysis. Int J Rheum Dis 2023; 26:2498-2508. [PMID: 37888904 DOI: 10.1111/1756-185x.14948] [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: 01/16/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
AIM This study aims to assess the association of obesity and CRP concentrations in adult patients with rheumatoid arthritis (RA), and its influence on measures of disease activity. METHODS A comprehensive search was performed using Scopus, Web of Science, MEDLINE, and EMBASE, from the time of their inception to November 2021. Observational studies that evaluated the association between CRP concentrations and obesity or overweight in patients with RA were considered eligible. Correlation coefficients were pooled using the inverse variance method, while effect sizes were pre-calculated for adjusted standardized regression coefficients (β). RESULTS A total of 10 studies, which comprised 4024 patients, were included in this systematic review. Individually, most studies report a significant association between CRP concentrations and a higher body mass index or other adiposity measures, but the statistical significance was not sustained when pooling their data together. Through the estimates provided in the present review, it is noted that CRP tends to be more elevated in female patients with RA that have a higher BMI. However, this association is not present in men. CONCLUSION CRP tends to be elevated in female patients with RA that have a higher BMI. Further research is required to assess this possible sex-related difference and to aid shared decision-making in order to avoid over-treatment and increased burden in patients with obesity and RA. PROSPERO registration number: CRD42022314580.
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Affiliation(s)
- Diana E Flores-Alvarado
- Rheumatology Division, Department of Internal Medicine, University Hospital "Dr. José E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - Jorge A Esquivel-Valerio
- Rheumatology Division, Department of Internal Medicine, University Hospital "Dr. José E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - David Vega-Morales
- Rheumatology Division, Department of Internal Medicine, University Hospital "Dr. José E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - Andrea N Garza-Cisneros
- Rheumatology Division, Department of Internal Medicine, University Hospital "Dr. José E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - Mario A Balderas-Palacios
- Rheumatology Division, Department of Internal Medicine, University Hospital "Dr. José E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - Dionicio A Galarza-Delgado
- Rheumatology Division, Department of Internal Medicine, University Hospital "Dr. José E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - Mariana Garcia-Leal
- Plataforma INVEST UANL-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
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17
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Kaplan H, Cengiz G, Şaş S, Eldemir YÖ. Is the C-reactive protein-to-albumin ratio the most remarkable simple inflammatory marker showing active disease in patients with axial spondyloarthritis, psoriatic arthritis, and rheumatoid arthritis? Clin Rheumatol 2023; 42:2959-2969. [PMID: 37470884 DOI: 10.1007/s10067-023-06703-8] [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: 03/18/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To learn which of the simple inflammation markers obtained from routine laboratory tests showed active disease best. METHODS The study included 256 patients (102 patients with axial spondyloarthritis [axSpA], 54 with psoriatic arthritis [PsA], and 100 with rheumatoid arthritis [RA]). The results of the routine laboratory tests requested during the outpatient clinic visits of the patients were noted. Inflammation-related ratio/indices were then calculated from these laboratory tests. Active and inactive diseases were defined according to the disease activity scores for each disease. Logistic regression and receiver operating characteristic (ROC) analyses were performed to determine the best laboratory marker(s) showing active disease and its cutoff value for all three diseases. RESULTS C-reactive protein to albumin ratio (CAR) was significantly higher in patients with active axSpA, PsA, and RA diseases than those with inactive diseases (p < 0.001, p = 0.006, and p < 0.001, respectively). In the logistic regression analysis, the CAR was the most important predictor of active disease in patients with axSpA, PsA, and RA. CAR had also showed the active disease at an acceptable level in axSpA and PsA and very well in RA. The cutoff values for active disease in axSpA, PsA, and RA were 0.75, 0.92, and 0.89, respectively. CONCLUSION CAR may be a promising simple laboratory marker to distinguish active disease in patients with axSpA, PsA, and RA. Key Points • Acute phase reactants and circulating blood cells have become an important target because of the search for a disease activity marker that can be used cheaply and quickly in the daily outpatient routine. • One or more of these simple markers have been previously discussed in various studies with different hypotheses. • We aimed to determine which of the inflammation markers obtained from routine laboratory tests showed active disease and to determine a cutoff value for this/these marker(s). • CAR was the most important simple laboratory marker to distinguish active disease in patients with axSpA, PsA, and RA. In addition, CAR showed the active disease at an acceptable level in axSpA and PsA, and very well in RA.
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Affiliation(s)
- Hüseyin Kaplan
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
| | - Gizem Cengiz
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Senem Şaş
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Yasemin Özden Eldemir
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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18
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Liao X, Huo W, Zeng W, Qin F, Dong F, Wei W, Lei L. Efficacy and safety of different Janus kinase inhibitors combined with methotrexate for the treatment of rheumatoid arthritis: a single-center randomized trial. Adv Rheumatol 2023; 63:50. [PMID: 37845778 DOI: 10.1186/s42358-023-00331-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE To compare the efficacy and safety between baricitinib (BARI) and tofacitinib (TOFA) for the treatment of the rheumatoid arthritis (RA) patients receiving methotrexate (MTX) in clinical practice. METHODS This retrospective study recruited 179 RA patients treated with BARI (2-4 mg/d) or TOFA (10 mg/d) at The First Affiliated Hospital of Guangxi Medical University from September 2019 to January 2022. The rate of low disease activity (LDA) was used as the primary end point. Secondary end points included the Disease Activity Scale-28 (DAS-28)-C-reactive protein (CRP); the rate of DAS28-CRP remission; visual analogue scale (VAS) for pain, swollen joint, and tender joint counts; and adverse events at the 6-month follow-up. Several factors affecting LDA achievement were also analyzed. RESULTS Seventy-four patients were treated with BARI and 105 were treated with TOFA, including 83.24% females, with a median (IQR) age of 56.0 (53.0-56.0) years old and disease duration of 12.0 (6.0-12.0) months. There was no difference of the rate of LDA between the BARI and TOFA treatment groups. All disease indices in the two groups were significantly improved, including a significantly lower VAS in the BARI group (P < 0.05), reflecting the drug efficacy after 1 and 6 months of treatment. The incidence of adverse reactions was similar in these two groups. CONCLUSION The treatment efficacy and safety of BARI and TOFA in the RA patients were similar, but BARI was more effective in pain relief than TOFA. An older baseline age was more likely to achieve LDA in the BARI group, while a low baseline erythrocyte sedimentation rate (ESR) was more likely to achieve LDA in the TOFA group.
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Affiliation(s)
- Xiaoling Liao
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, 530000, China
| | - Wang Huo
- Department of Rheumatology, Liu Zhou People's Hospital, Guangxi, China
| | - Wen Zeng
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, 530000, China
| | - Fang Qin
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, 530000, China
| | - Fei Dong
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, 530000, China
| | - Wanling Wei
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, 530000, China
| | - Ling Lei
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, 530000, China.
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19
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Liu X, Li J, Sun L, Wang T, Liang W. The association between neutrophil-to-lymphocyte ratio and disease activity in rheumatoid arthritis. Inflammopharmacology 2023; 31:2237-2244. [PMID: 37418101 DOI: 10.1007/s10787-023-01273-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/15/2023] [Indexed: 07/08/2023]
Abstract
The inflammatory response is responsible for the promotion of pannus development over the joint, which is the primary factor in joint injury in rheumatoid arthritis (RA). More in-depth investigations have been conducted in recent years leading to a greater understanding of RA. Yet, it's difficult to gauge inflammation levels in RA patients. Some people who have RA do not exhibit normal symptoms, which makes it more challenging to make a diagnosis. Typical RA evaluations are subject to a few restrictions. Earlier research demonstrated that some patients continued to experience the progression of bone and joint degeneration even while in clinical remission. This progression was attributed to ongoing synovial inflammation. As a result, performing a precise evaluation of the level of inflammation is of the utmost importance. The neutrophil-to-lymphocyte ratio (NLR) has consistently been one of the most interesting novel non-specific inflammatory indicators. It is a reflection of the equilibrium between lymphocytes and neutrophils, which are inflammatory regulators and inflammatory activators, respectively. A higher NLR is linked to more severe levels of imbalance and inflammation. The aim of this study was to depict the role of NLR in RA progression and to show if NLR could predict the response to disease-modifying antirheumatic drugs (DMARDs) therapy in RA.
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Affiliation(s)
- Xiangsu Liu
- General Practice Medicine, Yanqing District Hospital, Yanqing Hospital, Peking University Third Hospital, Beijing, 102100, China
| | - Jiaqi Li
- General Practice Medicine, Yanqing District Hospital, Yanqing Hospital, Peking University Third Hospital, Beijing, 102100, China
| | - Leilei Sun
- Department of Endocrinology, Yanqing District Hospital, Yanqing Hospital, Peking University Third Hospital, Beijing, 102100, China
| | - Tong Wang
- Department of Laboratory Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, 050030, China
| | - Wenxia Liang
- General Practice Medicine, Yanqing District Hospital, Yanqing Hospital, Peking University Third Hospital, Beijing, 102100, China.
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Tv P, Kumar B, Chidambaram Y, Thangavelu S. Correlation of Rheumatoid arthritis disease severity with serum vitamin D levels. Clin Nutr ESPEN 2023; 57:697-702. [PMID: 37739725 DOI: 10.1016/j.clnesp.2023.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/31/2023] [Accepted: 08/24/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND AND AIM Rheumatoid arthritis (RA) is an autoimmune disorder marked by characteristic inflammation of the small joints in addition to diverse systemic manifestations. Vitamin D has immunomodulatory properties, and its deficiency has a significant role in the clinical course of RA. The present research was conducted to study the correlation between serum vitamin D levels and disease activity scores in RA patients. METHODS A cross sectional study was carried out on a sample of 50 patients presenting with RA. Disease activity was measured using Modified Disease Activity Score (DAS) criteria. Estimation of serum Vitamin D levels were done using the electrochemiluminescence method and values less than 20 ng/ml were considered as deficiency. Vitamin D levels were then correlated with disease activity scores. RESULTS The Vitamin D deficiency was observed in 50% of the study population. Rheumatoid arthritis showed female preponderance in this study. Inflammatory markers such as C - reactive protein (CRP) levels and Erythrocyte Sedimentation Rate (ESR) did not differ with RA disease activity. More the number of large joints involved lesser were the vitamin D levels. There was an inverse correlation between Vitamin D levels and RA disease activity. CONCLUSION Vitamin D deficiency is significantly correlated with disease severity of RA. This study points to the importance of screening for deficit of vitamin D among RA patients and treat it as early as possible.
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Affiliation(s)
- Padmapriya Tv
- Department of Medicine, PSG Institute of Medical Sciences & Research, Coimbatore, Tamil Nadu 641004, India.
| | - Bhargavi Kumar
- Department of Medicine, PSG Institute of Medical Sciences & Research, Coimbatore, Tamil Nadu 641004, India.
| | - Yoganathan Chidambaram
- Department of Medicine, PSG Institute of Medical Sciences & Research, Coimbatore, Tamil Nadu 641004, India.
| | - Saravanan Thangavelu
- Department of Medicine, PSG Institute of Medical Sciences & Research, Coimbatore, Tamil Nadu 641004, India.
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21
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Liou LB, Tsai PH, Fang YF, Chen YF, Chen CC, Lai JH. Sialic-Acid-Related Enzymes of B Cells and Monocytes as Novel Markers to Discriminate Improvement Categories and to Fulfill Two Remission Definitions in Rheumatoid Arthritis. Int J Mol Sci 2023; 24:12998. [PMID: 37629178 PMCID: PMC10455111 DOI: 10.3390/ijms241612998] [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: 06/16/2023] [Revised: 08/10/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
The enzymes α-2,6-sialyltransferase 1 (ST6Gal1), neuraminidase 1 (Neu1), α-2,3-sialyltransferase 1 (ST3Gal1), and neuraminidase 3 (Neu3) are known to affect immune cell function. However, it is not known whether the levels of these enzymes relate to remission definitions or differentiate American College of Rheumatology (ACR), European League Against Rheumatism (EULAR), and Simplified Disease Activity Index (SDAI) responses in patients with rheumatoid arthritis (RA). We measured the ST6Gal1, Neu1, ST3Gal1, and Neu3 levels of B cells and monocytes in RA patients and correlated the cells' enzyme levels/ratios with the improvement in the ACR, EULAR and SDAI responses and with the two remission definitions. The difference in the B-cell Neu1 levels differed between the ACR 70% improvement and non-improvement groups (p = 0.043), between the EULAR good major response (improvement) and non-good response groups (p = 0.014), and also between the SDAI 50% or 70% improvement and non-improvement groups (p = 0.001 and 0.018, respectively). The same held true when the RA patients were classified by positive rheumatoid factor or the use of biologics. The B-cell Neu1 levels significantly indicated 2005 modified American Rheumatism Association and 2011 ACR/EULAR remission definitions (area under the curve (AUC) = 0.674 with p = 0.001, and AUC = 0.682 with p < 0.001, respectively) in contrast to the CRP and ESR (all AUCs < 0.420). We suggest that B-cell Neu1 is superior for discriminating ACR, EULAR, and SDAI improvement and is good for predicting two kinds of remission definitions.
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Affiliation(s)
- Lieh-Bang Liou
- Division of Rheumatology, Allergy and Immunology, New Taipei Municipal Tucheng Hospital, New Taipei City 236, Taiwan; (P.-H.T.); (C.-C.C.)
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-F.F.); (Y.-F.C.); (J.-H.L.)
- School of Medicine, Chang Gung University College of Medicine, Taoyuan 333, Taiwan
| | - Ping-Han Tsai
- Division of Rheumatology, Allergy and Immunology, New Taipei Municipal Tucheng Hospital, New Taipei City 236, Taiwan; (P.-H.T.); (C.-C.C.)
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-F.F.); (Y.-F.C.); (J.-H.L.)
| | - Yao-Fan Fang
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-F.F.); (Y.-F.C.); (J.-H.L.)
| | - Yen-Fu Chen
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-F.F.); (Y.-F.C.); (J.-H.L.)
| | - Chih-Chieh Chen
- Division of Rheumatology, Allergy and Immunology, New Taipei Municipal Tucheng Hospital, New Taipei City 236, Taiwan; (P.-H.T.); (C.-C.C.)
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-F.F.); (Y.-F.C.); (J.-H.L.)
| | - Jenn-Haung Lai
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-F.F.); (Y.-F.C.); (J.-H.L.)
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Chen DP, Wen YH, Lin WT, Hsu FP, Yu KH. Exploration of the association between the single-nucleotide polymorphism of co-stimulatory system and rheumatoid arthritis. Front Immunol 2023; 14:1123832. [PMID: 37457686 PMCID: PMC10344454 DOI: 10.3389/fimmu.2023.1123832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/01/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction The human leukocyte antigen (HLA) has been linked to the majority of autoimmune diseases (ADs). However, non-HLA genes may be risk factors for ADs. A number of genes encoding proteins involved in regulating T-cell and B-cell function have been identified as rheumatoid arthritis (RA) susceptibility genes. Methods In this study, we investigated the association between RA and single-nucleotide polymorphisms (SNPs) of co-stimulatory or co-inhibitory molecules in 124 RA cases and 100 healthy controls without immune-related diseases [including tumor necrosis factor superfamily member 4 (TNFSF4), CD28, cytotoxic T-lymphocyte-associated protein 4 (CTLA4), and programmed cell death protein 1 (PDCD1)]. Results The results showed that there were 13 SNPs associated with RA, including rs181758110 of TNFSF4 (CC vs. CT, p = 0.038); rs3181096 of CD28 (TT vs. CC + CT, p = 0.035; CC vs. TT, p = 0.047); rs11571315 (TT vs. CT, p = 0.045), rs733618 (CC vs. TT + CT, p = 0.043), rs4553808 (AA vs. AG vs. GG, p = 0.035), rs11571316 (GG vs. AG vs. AA, p = 0.048; GG vs. AG + AA, p = 0.026; GG vs. AG, p = 0.014), rs16840252 (CC vs. CT vs. TT, p = 0.007; CC vs. CT, p = 0.011), rs5742909 (CC vs. CT vs. TT, p = 0.040), and rs11571319 of CTLA4 (GG vs. AG vs. AA, p < 0.001; GG vs. AG + AA, p = 0.048; AA vs. GG + AG, p = 0.001; GG vs. AA, p = 0.008; GG vs. AG, p ≤ 0.001); and rs10204525 (TT vs. CT + CC, p = 0.024; TT vs. CT, p = 0.021), rs2227982 (AA vs. GG, p = 0.047), rs36084323 (TT vs. CT vs. CC, p = 0.022; TT vs. CT + CC, p = 0.013; CC vs. TT + CT, p = 0.048; TT vs. CC, p = 0.008), and rs5839828 of PDCD1 (DEL vs. DEL/G vs. GG, p = 0.014; DEL vs. DEL/G + GG, p = 0.014; GG vs. DEL + DEL/G, p = 0.025; DEL vs. GG, p = 0.007). Discussion Consequently, these SNPs may play an important role in immune regulation, and further research into the role of these SNPs of immune regulatory genes in the pathogenesis of RA is required.
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Affiliation(s)
- Ding-Ping Chen
- Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ying-Hao Wen
- Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Tzu Lin
- Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Fang-Ping Hsu
- Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kuang-Hui Yu
- Division of Rheumatology, Allergy, and Immunology, Linkou Chang Gung University and Memorial Hospital, Taoyuan, Taiwan
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Ščudla V, Horák P. Differential diagnosis of increased Erythrocyte Sedimentation rate. VNITRNI LEKARSTVI 2023; 69:48-56. [PMID: 36931882 DOI: 10.36290/vnl.2023.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
The paper is aimed at differential diagnosis of increased sedimentation rate (ESR) from the point of internal medicine. After the interpretation of the term we describe the technique of the examination and possible errors in pre-analytical as well as analytical phase. The paper includes ranges for conventional FW assessment (analysis of ESR based on Fahraeus-Westergren) and the characteristics of newer methods. We list the overview of the most common causes that affect faster or slower ESR. The stress is put on the assessment of the causes of increased ESR and its persistence from the perspective of clinical practice, we also describe diseases with slower ESR. Attention is drawn to the comparison of the results of the most common acute phase reactants, especially to discordant results of ESR, CRP and procalcitonin in the serum, and to the contribution of the analysis of ESR and CRP in selected diseases. The final part is aimed at the correct diagnostic approach when assessing increased ESR of unknown etiology, underlining the significance of the patient´s history, physical examination and the position of basic as well as complementary laboratory methods and examinations including imaging techniques.
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24
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Druce KL, Gibson DS, McEleney K, Yimer BB, Meleck S, James B, Hellman B, Dixon WG, McBeth J. Remote sampling of biomarkers of inflammation with linked patient generated health data in patients with rheumatic and musculoskeletal diseases: an Ecological Momentary Assessment feasibility study. BMC Musculoskelet Disord 2022; 23:770. [PMID: 35964066 PMCID: PMC9375303 DOI: 10.1186/s12891-022-05723-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 04/21/2022] [Indexed: 11/17/2022] Open
Abstract
Background People with rheumatic diseases experience troublesome fluctuations in fatigue. Debated causes include pain, mood and inflammation. To determine the relationships between these potential causes, serial assessments are required but are methodologically challenging. This mobile health (mHealth) study explored the viability of using a smartphone app to collect patient-reported symptoms with contemporaneous Dried Blood Spot Sampling (DBSS) for inflammation. Methods Over 30 days, thirty-eight participants (12 RA, 13 OA, and 13 FM) used uMotif, a smartphone app, to report fatigue, pain and mood, on 5-point ordinal scales, twice daily. Daily DBSS, from which C-reactive Protein (CRP) values were extracted, were completed on days 1–7, 14 and 30. Participant engagement was determined based on frequency of data entry and ability to calculate within- and between-day symptom changes. DBSS feasibility and engagement was determined based on the proportion of samples returned and usable for extraction, and the number of days between which between-day changes in CRP which could be calculated (days 1–7). Results Fatigue was reported at least once on 1085/1140 days (95.2%). Approximately 65% of within- and between-day fatigue changes could be calculated. Rates were similar for pain and mood. A total of 287/342 (83.9%) DBSS, were returned, and all samples were viable for CRP extraction. Fatigue, pain and mood varied considerably, but clinically meaningful (≥ 5 mg/L) CRP changes were uncommon. Conclusions Embedding DBSS in mHealth studies will enable researchers to obtain serial symptom assessments with matched biological samples. This provides exciting opportunities to address hitherto unanswerable questions, such as elucidating the mechanisms of fatigue fluctuations. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05723-w.
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Affiliation(s)
- Katie L Druce
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, Manchester, UK.,Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
| | - David S Gibson
- Northern Ireland Centre for Stratified Medicine, School of Biomedical Sciences, Biomedical Sciences Research Institute, Ulster University, Londonderry, UK
| | - Kevin McEleney
- Northern Ireland Centre for Stratified Medicine, School of Biomedical Sciences, Biomedical Sciences Research Institute, Ulster University, Londonderry, UK
| | - Belay B Yimer
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, Manchester, UK.,Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
| | | | | | | | - William G Dixon
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, Manchester, UK.,Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK.,The NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - John McBeth
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, Manchester, UK. .,Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK. .,The NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
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25
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Xu L, Chang C, Jiang P, Wei K, Zhang R, Jin Y, Zhao J, Xu L, Shi Y, Guo S, He D. Metabolomics in rheumatoid arthritis: Advances and review. Front Immunol 2022; 13:961708. [PMID: 36032122 PMCID: PMC9404373 DOI: 10.3389/fimmu.2022.961708] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 07/25/2022] [Indexed: 12/11/2022] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease accompanied by metabolic alterations. The metabolic profiles of patients with RA can be determined using targeted and non-targeted metabolomics technology. Metabolic changes in glucose, lipid, and amino acid levels are involved in glycolysis, the tricarboxylic acid cycle, the pentose phosphate pathway, the arachidonic acid metabolic pathway, and amino acid metabolism. These alterations in metabolic pathways and metabolites can fulfill bio-energetic requirements, promote cell proliferation, drive inflammatory mediator secretion, mediate leukocyte infiltration, induce joint destruction and muscle atrophy, and regulate cell proliferation, which may reflect the etiologies of RA. Differential metabolites can be used as biomarkers for the diagnosis, prognosis, and risk prediction, improving the specificity and accuracy of diagnostics and prognosis prediction. Additionally, metabolic changes associated with therapeutic responses can improve the understanding of drug mechanism. Metabolic homeostasis and regulation are new therapeutic strategies for RA. In this review, we provide a comprehensive overview of advances in metabolomics for RA.
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Affiliation(s)
- Lingxia Xu
- Guanghua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Rheumatology, Shanghai Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Cen Chang
- Guanghua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Rheumatology, Shanghai Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Ping Jiang
- Guanghua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Rheumatology, Shanghai Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Kai Wei
- Guanghua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Rheumatology, Shanghai Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Runrun Zhang
- Department of Rheumatology, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yehua Jin
- Guanghua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Rheumatology, Shanghai Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jianan Zhao
- Guanghua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Rheumatology, Shanghai Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Linshuai Xu
- Guanghua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Rheumatology, Shanghai Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yiming Shi
- Guanghua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Rheumatology, Shanghai Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Shicheng Guo
- Department of Medical Genetics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Computation and Informatics in Biology and Medicine, University of Wisconsin-Madison, Madison, WI, United States
- *Correspondence: Shicheng Guo, ; Dongyi He,
| | - Dongyi He
- Guanghua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Rheumatology, Shanghai Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Shicheng Guo, ; Dongyi He,
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Koh JH, Lee Y, Kim HA, Kim J, Shin K. Comparison of remission criteria in patients with rheumatoid arthritis treated with biologic or targeted synthetic disease-modifying anti-rheumatic drugs: results from a nationwide registry. Ther Adv Musculoskelet Dis 2022; 14:1759720X221096363. [PMID: 35586514 PMCID: PMC9109493 DOI: 10.1177/1759720x221096363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/31/2022] [Indexed: 11/15/2022] Open
Abstract
Background Biologic or targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARD) are widely used for treatment of rheumatoid arthritis (RA), enabling patients to better achieve remission. Objective The objective of the study was to investigate and compare remission rates in RA patients treated with different b/tsDMARDs during the period 2013-2019. Design A longitudinal observational analysis was performed on data from a nationwide RA registry. Methods Remission rates in the KOBIO-RA registry were defined by a disease activity score in 28 joints (DAS28), clinical disease activity index (CDAI), simplified disease activity index (SDAI), and Boolean-based assessment. After initiating treatment with b/tsDMARDs, yearly remission rates in response to b/tsDMARDs, either all or as subgroups (tumor necrosis factor-α inhibitors, tocilizumab, abatacept, and Janus kinase inhibitors), were investigated for 5 years. Sustained remission was defined as remission maintained for two consecutive years. Results Patients (N = 1805) who completed at least one follow-up visit were analyzed (mean age = 55 years; 83.2% female). At month 12, 56.0% of patients achieved remission based on DAS28-C-reactive protein (CRP), 36.2% on DAS28-erythrocyte sedimentation rate (ESR), 10.4% on CDAI, 12.7% on SDAI, and 12.9% on Boolean criteria. Sustained remission rates were 62%, 40%, 13%, 11%, and 8% for the DAS28-CRP, DAS28-ESR, Boolean, SDAI, and CDAI remission criteria, respectively. Remission rates using the DAS28 definition varied most among the b/tsDMARD subgroups. Conclusion Assessment of sustained remission using the CDAI, SDAI, or Boolean criteria is more stringent, yet congruous with the DAS28-based criteria in RA patients treated with b/tsDMARDs.
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Affiliation(s)
- Jung Hee Koh
- Division of Rheumatology, Department of
Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The
Catholic University of Korea, Seoul, Korea
| | | | - Hyoun-Ah Kim
- Department of Rheumatology, Ajou University
School of Medicine, Suwon, Korea
| | - Jinhyun Kim
- Division of Rheumatology, Department of
Internal Medicine, College of Medicine, Chungnam National University,
Daejeon, Korea
| | - Kichul Shin
- Department of Internal Medicine, College of
Medicine, Seoul National University, Seoul, Korea
- Division of Rheumatology, Department of
Internal Medicine, Seoul Metropolitan Government – Seoul Boramae Medical
Center, 20 Boramae-ro-5-gil, Dongjak-gu, Seoul 07061, Korea
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Hematological markers and ultrasound 7-joint inflammation score as add-on tools in the assessment of inflammation in rheumatoid arthritis patients. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2022. [PMCID: PMC9066990 DOI: 10.1186/s43166-022-00126-0] [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] [Indexed: 11/16/2022] Open
Abstract
Background Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovial inflammation and joint destruction that eventually induces severe disability. Inflammation is the key determinant and primary underlying mechanism leading to disability and increased mortality in patients with RA. This study aimed to correlate the hematological markers and ultrasound 7-joint inflammation score to disease activity in rheumatoid arthritis patients. Results The current study involved 54 RA patients diagnosed according to the 2010 ACR/EULAR classification criteria for RA and thirty healthy control subjects. There were 48 females (88.9%) and 6 males (11.1%). The age of patients ranged from 32 to 60 years, with a mean of 46.04 ± 5.65 years. Using disease activity score 28-ESR, total white blood cell count and absolute lymphocytic count were significantly lower in RA patients with high disease activity. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume, ESR, and CRP were significantly higher in patients with high disease activity using disease activity score 28 CRP. Also, a statistically significant positive correlation was detected between neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and both clinical disease activity scores. Red cell distribution width but not platelet distribution width was significantly higher in RA patients but both parameters had no association or correlation with clinical disease activity scores. Neutrophil-to-lymphocyte ratio was found to have a statistically significant positive correlation with the tenosynovitis score by powered Doppler ultrasound. There were statistically significant positive correlations between disease activity score 28 ESR and CRP and synovitis and tenosynovitis scores by greyscale and powered Doppler ultrasound using the ultrasound 7 score. Conclusion Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume could be potential inflammatory markers for follow-up of disease activity in RA patients. The ultrasound 7 score is a simple and practical scoring system for use in the detection of inflammation, even subclinically in RA patients, which may help the physician in his clinical decisions. The combined use of both hematological markers and the ultrasound 7 score may be of great value.
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Subclinical Atherosclerosis Measure by Carotid Ultrasound and Inflammatory Activity in Patients with Rheumatoid Arthritis and Spondylarthritis. J Clin Med 2022; 11:jcm11030662. [PMID: 35160112 PMCID: PMC8836873 DOI: 10.3390/jcm11030662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/14/2022] [Accepted: 01/24/2022] [Indexed: 02/01/2023] Open
Abstract
Objective: To compare the effect of inflammation on subclinical atherosclerosis using carotid ultrasound in patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA). Methods: Cross-sectional study including 347 participants (148 RA, 159 SpA, and 40 controls). We measured the carotid intima media thickness (cIMT) and detection of atheromatous plaques using carotid ultrasound. We recorded disease activity (DAS28-CRP/ASDAS-CRP) and traditional cardiovascular risk factors. We performed descriptive, bivariate, and linear multivariate analyses (dependent variable: cIMT) to evaluate the influence of diagnosis on cIMT in all patients. Two additional multivariate analyses were performed by stratifying patients according to their inflammatory activity. Results: cIMT correlated with the mean CRP during the previous 5 years in RA, but not with CRP at the cut-off date. We did not find such differences in patients with SpA. The first multivariate model revealed that increased cIMT was more common in patients with RA than in those with SpA (β coefficient, 0.045; 95% confidence interval (95% CI), 0.0002–0.09; p = 0.048) after adjusting for age, sex, disease course, and differential cardiovascular risk factors (arterial hypertension, smoking, statins, and corticosteroids). The second model revealed no differences in cIMT between the 2 groups of patients classified as remission–low activity (β coefficient, 0.020; 95% CI, −0.03 to 0.080; p = 0.500). However, when only patients with moderate–high disease activity were analysed, the cIMT was 0.112 mm greater in those with RA (95% CI, 0.013–0.212; p = 0.026) than in those with SpA after adjusting for the same variables. Conclusions: Subclinical atherosclerosis measured by carotid ultrasound in patients with RA and SpA is comparable when the disease is well controlled. However, when patients have moderate–high disease activity, cIMT is greater in patients with RA than in those with SpA after adjusting for age, sex, disease course, and cardiovascular risk factors. Our results point to greater involvement of disease activity in subclinical atherosclerosis in patients with RA than in those with SpA.
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Role of Polypeptide Inflammatory Biomarkers in the Diagnosis and Monitoring of COVID-19. Int J Pept Res Ther 2022; 28:59. [PMID: 35095356 PMCID: PMC8785374 DOI: 10.1007/s10989-022-10366-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 01/08/2023]
Abstract
The COVID-19 (coronavirus disease 2019) pandemic that took over the world in December 2019 has had everlasting devastating impacts on the lives of people globally. It manifests a huge symptom spectrum ranging from asymptomatic to critically ill patients with an unpredictable outcome. Timely diagnosis and assessment of disease severity is imperative for effective treatment. Possibilities exist that by the time symptoms appear the viral load might increase beyond control. However, it is advisable to get adequately diagnosed as soon as the first symptom appears. There is an immediate requirement of reliable biomarkers of COVID-19 manifesting an early onset for effective clinical management, stratification of high risk patients and ensuring ideal resource allocation. In this review, we attempt to explore and describe important polypeptide inflammatory biomarkers, namely C-reactive protein, Procalcitonin, Ferritin, Lactate Dehydrogenase, Serum amyloid A, Interleukin-6, Tumor necrosis factor-alpha and LIGHT used in the detection and management of COVID-19. Viral pathogenesis and the role of these inflammatory biomarkers is highlighted, based on the evidences available till date. An integrative data monitoring along with their correlation with the natural disease progression is of utmost importance in the management of COVID-19. So further research and in-depth analysis of these biomarkers is warranted in the present scenario.
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Salesi M, Dehabadi MH, Salehi R, Salehi A, Pakzad B. Differentially methylation of IFI44L gene promoter in Iranian patients with systemic lupus erythematosus and rheumatoid arthritis. Mol Biol Rep 2022; 49:3065-3072. [DOI: 10.1007/s11033-022-07134-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 01/10/2022] [Indexed: 10/19/2022]
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Value of Remission in Patients with Rheumatoid Arthritis: A Targeted Review. Adv Ther 2022; 39:75-93. [PMID: 34787822 PMCID: PMC8799574 DOI: 10.1007/s12325-021-01946-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/01/2021] [Indexed: 11/03/2022]
Abstract
The treat-to-target strategy, which defines clinical remission as the primary therapeutic goal for rheumatoid arthritis (RA), is a widely recommended treatment approach in clinical guidelines. Achieving remission has been associated with improved clinical outcomes, quality of life, and productivity. These benefits are likely to translate to reduced economic burden in terms of lower healthcare costs and resource utilization. As such, a literature review was conducted to better understand the economic value of remission. Despite the large heterogeneity found in RA-related economic outcomes across studies, patients in remission consistently had lower direct medical and indirect costs, less healthcare resource utilization, and greater productivity compared to those without remission. Remission was associated with 19–52% savings in direct medical costs and 37–75% savings in indirect costs. The economic value of remission should thus be considered in economic analyses of RA therapies to inform treatment and reimbursement decisions.
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Ali DA, Esmail DM, Mohammed HA, Yonis RL, El-Sharaby RM. Serum Dickkopf-1 as a potential prognostic marker in patients with rheumatoid arthritis. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2021. [DOI: 10.1186/s43166-021-00088-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Rheumatoid arthritis (RA) is a disease of an autoimmune nature that involves all types of joints structures and manifested by chronic joints inflammations and thus their erosions and damage. Dickkopf-1 (DKK-1) is a molecule that has an inhibitory regulation of wingless/integrated genes (Wnt) pathway and has a major role in models of animals with arthritis or joint destruction. Increased DKK-1 levels are implicated in higher resorption of the bone in cases of rheumatoid arthritis and thus with higher probability for joint deformities, while low levels associated with formation of new bone by osteoblasts, we aimed to study the prognostic role of circulating Dickkopf-1 in rheumatoid arthritis.
Results
The present study revealed that the DKK-1 levels were significantly increased in RA patients in relation to the control group (P=0.001). We found a significant positive correlation between DKK-1 level and ESR (P=0.001), Disease Activity Score (DAS 28) (P=0.001), the disease duration (P=0.001), and the presence of bone erosions in plain X-ray of hands (P =0.001). Moreover, we revealed that, at cutoff value 2150, the DKK-1 in RA has 90% sensitivity and 85% specificity.
Conclusions
DKK-l serum level can be used as a potential prognostic biomarker for monitoring of joint erosions and destruction in RA patients. Furthermore, it could be a possible target molecule in the future therapy to control the process of joint destruction.
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Lu CH, Chen LF, Huang YM, Cheng CF, Hsieh SC, Li KJ. Anti-Cyclic Citrullinated Peptide Antibodies Correlate to Ultrasound Synovitis in Rheumatoid Arthritis Better Than C-Reactive Protein. J Clin Rheumatol 2021; 27:e412-e417. [PMID: 32604244 PMCID: PMC8612904 DOI: 10.1097/rhu.0000000000001499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to compare ultrasound (US) grading and laboratory measures in patients with rheumatoid arthritis. METHODS Two-hundred four patients with rheumatoid arthritis who received US evaluation for synovitis were included after excluding those using tocilizumab. Ultrasound grading of synovial hypertrophy (SH) and power Doppler (PD) at the most severe site were recorded. An assessment of the correlation of laboratory measures and US grading was conducted by reviewing the electronic medical records. RESULTS High-titer anti-cyclic citrullinated peptide (anti-CCP) antibodies positivity was associated with SH grade ≥2 (odds ratio [OR], 6.00; 95% confidence interval [CI], 1.78-20.2) and PD grade ≥2 (OR, 5.56; 95% CI, 1.82-16.9). Recent C-reactive protein (CRP) levels ≥0.3 mg/dL were associated with SH grade ≥2 (OR, 3.13; 95% CI, 1.38-7.10) and PD grade ≥2 (OR, 2.38; 95% CI, 1.31-4.31). Anti-CCP antibody levels correlated with US scores better than the levels of CRP with higher Spearman ρ correlation coefficients. Most of the patients with recent CRP levels <0.3 mg/dL had US synovitis. In logistic regression, high levels of anti-CCP antibodies and CRP were both independently associated with SH grade ≥2 and PD grade ≥2. CONCLUSIONS Higher levels of anti-CCP antibodies and CRP may predict synovitis on US, whereas discrepancies existed between inflammatory markers and US grading. These findings suggest that US has a role in the comprehensive assessment of disease activity, especially for patients with high-titer positive anti-CCP antibodies.
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Affiliation(s)
- Cheng-Hsun Lu
- From the Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University
| | - Lung-Fang Chen
- Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei
| | - Yi-Min Huang
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yunlin, Taiwan
| | - Chiao-Feng Cheng
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yunlin, Taiwan
| | - Song-Chou Hsieh
- From the Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital
| | - Ko-Jen Li
- From the Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital
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Hamed MA, Aboul Naser AF, Aboutabl ME, Osman AF, Hassan EES, Aziz WM, Khalil WKB, Farghaly AA, El-Hagrassi AM. Bioactive compounds and therapeutic role of Brassica oleracea L. seeds in rheumatoid arthritis rats via regulating inflammatory signalling pathways and antagonizing interleukin-1 receptor action. Biomarkers 2021; 26:788-807. [PMID: 34704882 DOI: 10.1080/1354750x.2021.1999504] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/23/2021] [Indexed: 12/20/2022]
Abstract
CONTEXT Rheumatoid arthritis (RA) is a chronic, progressive autoimmune disease characterized by aggressive and systematic polyarthritis. OBJECTIVE The present study aimed to isolate and identify the phenolic constituents in Brassica oleracea L. (Brassicaceae) seeds methanolic extract and evaluates its effect against rheumatoid arthritis in rats referring to the new therapy; interleukin-1 receptor antagonist (IL-1RA). MATERIALS AND METHODS The GC/MS profiling of the plant was determined. Arthritis induction was done using complete Freund's adjuvant. Arthritis severity was assessed by percentage of edema and arthritis index. IL-1 receptor type I gene expression, interleukin-1β (IL-1β), oxidative stress markers, protein content, inflammatory mediators, prostaglandin-E2 (PGE2), genetic abnormalities and the histopathological features of ankle joint were evaluated. RESULTS For the first time twelve phenolic compounds had been isolated from the seeds extract. Treatment with extract and IL-1RA improved the tested parameters by variable degrees. CONCLUSIONS RA is an irreversible disease, where its severity increases with the time of induction. Brassica oleracea L. seeds extract is considered as a promising anti-arthritis agent. IL-1 RA may be considered as an unusual therapeutic agent for RA disease. More studies are needed to consider the seeds extract as a nutraceutical agent and to recommend IL-1RA as a new RA drug.
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MESH Headings
- Animals
- Arthritis, Experimental/chemically induced
- Arthritis, Experimental/metabolism
- Arthritis, Experimental/prevention & control
- Arthritis, Rheumatoid/genetics
- Arthritis, Rheumatoid/metabolism
- Arthritis, Rheumatoid/prevention & control
- Biomarkers/blood
- Brassica/chemistry
- Freund's Adjuvant
- Gene Expression Regulation/drug effects
- Humans
- Inflammation Mediators/metabolism
- Interleukin 1 Receptor Antagonist Protein/metabolism
- Interleukin-1beta/metabolism
- Male
- Molecular Structure
- Oxidative Stress/drug effects
- Phytochemicals/chemistry
- Phytochemicals/pharmacology
- Phytotherapy/methods
- Plant Extracts/chemistry
- Plant Extracts/pharmacology
- Rats, Wistar
- Receptors, Interleukin-1 Type I/antagonists & inhibitors
- Receptors, Interleukin-1 Type I/genetics
- Receptors, Interleukin-1 Type I/metabolism
- Seeds/chemistry
- Signal Transduction/drug effects
- Rats
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Affiliation(s)
- Manal A Hamed
- Department of Therapeutic Chemistry, National Research Centre (ID: 60014618), Dokki, Giza, Egypt
| | - Asmaa F Aboul Naser
- Department of Therapeutic Chemistry, National Research Centre (ID: 60014618), Dokki, Giza, Egypt
| | - Mona E Aboutabl
- Medicinal and Pharmaceutical Chemistry Department (Pharmacology Group), National Research Centre (ID: 60014618), Dokki, Giza, Egypt
| | - Abeer F Osman
- Chemistry of Natural Compounds Department, National Research Centre (ID: 60014618), Dokki, Giza, Egypt
| | - Entesar E S Hassan
- Department of Genetics and Cytology, National Research Centre (ID: 60014618), Dokki, Giza, Egypt
| | - Wessam M Aziz
- Department of Therapeutic Chemistry, National Research Centre (ID: 60014618), Dokki, Giza, Egypt
| | - Wagdy K B Khalil
- Department of Cell Biology, National Research Centre (ID: 60014618), Dokki, Giza, Egypt
| | - Ayman A Farghaly
- Department of Genetics and Cytology, National Research Centre (ID: 60014618), Dokki, Giza, Egypt
| | - Ali M El-Hagrassi
- Phytochemistry and Plant Systematics Department, National Research Centre (ID: 60014618), Dokki, Giza, Egypt
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Zhang XP, Ma JD, Mo YQ, Jing J, Zheng DH, Chen LF, Wu T, Chen CT, Zhang Q, Zou YY, Lin JZ, Xu YH, Zou YW, Yang ZH, Ling L, Miossec P, Dai L. Addition of Fibroblast-Stromal Cell Markers to Immune Synovium Pathotypes Better Predicts Radiographic Progression at 1 Year in Active Rheumatoid Arthritis. Front Immunol 2021; 12:778480. [PMID: 34887865 PMCID: PMC8650215 DOI: 10.3389/fimmu.2021.778480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/02/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives This study aims to investigate if addition of fibroblast-stromal cell markers to a classification of synovial pathotypes improves their predictive value on clinical outcomes in rheumatoid arthritis (RA). Methods Active RA patients with a knee needle synovial biopsy at baseline and finished 1-year follow-up were recruited from a real-world prospective cohort. Positive staining for CD20, CD38, CD3, CD68, CD31, and CD90 were scored semiquantitatively (0-4). The primary outcome was radiographic progression defined as a minimum increase of 0.5 units of the modified total Sharp score from baseline to 1 year. Results Among 150 recruited RA patients, 123 (82%) had qualified synovial tissue. Higher scores of CD20+ B cells, sublining CD68+ macrophages, CD31+ endothelial cells, and CD90+ fibroblasts were associated with less decrease in disease activity and greater increase in radiographic progression. A new fibroblast-based classification of synovial pathotypes giving more priority to myeloid and stromal cells classified samples as myeloid-stromal (57.7%, 71/123), lymphoid (31.7%, 39/123), and paucicellular pathotypes (10.6%, 13/123). RA patients with myeloid-stromal pathotype showed the highest rate of radiographic progression (43.7% vs. 23.1% vs. 7.7%, p = 0.011), together with the lowest rate of Boolean remission at 3, 6, and 12 months. Baseline synovial myeloid-stromal pathotype independently predicted radiographic progression at 1 year (adjusted OR: 3.199, 95% confidence interval (95% CI): 1.278, 8.010). Similar results were obtained in a subgroup analysis of treatment-naive RA. Conclusions This novel fibroblast-based myeloid-stromal pathotype could predict radiographic progression at 1 year in active RA patients which may contribute to the shift of therapeutic decision in RA.
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Affiliation(s)
- Xue-Pei Zhang
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jian-Da Ma
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ying-Qian Mo
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jun Jing
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Dong-Hui Zheng
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Le-Feng Chen
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Tao Wu
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Chu-Tao Chen
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Qian Zhang
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yao-Yao Zou
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jian-Zi Lin
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yan-Hui Xu
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yao-Wei Zou
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ze-Hong Yang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Pierre Miossec
- Department of Clinical Immunology and Rheumatology, Immunogenomics and Inflammation Research Unit, University of Lyon and Hospices Civils de Lyon, Lyon, France
| | - Lie Dai
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
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Lijuan W, Yuting Z, Chaoyang L, Ju Y. Neutrophil-lymphocyte, platelet-lymphocyte and lymphocyte-monocyte ratios may not be useful markers to assess disease activity in rheumatoid arthritis: A STROBE-compliant article. Medicine (Baltimore) 2021; 100:e27631. [PMID: 34766563 PMCID: PMC8589242 DOI: 10.1097/md.0000000000027631] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 10/08/2021] [Indexed: 01/05/2023] Open
Abstract
The associations among the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) and disease activity in rheumatoid arthritis remains unclear.To evaluate these indicators as potential markers of disease activity in patients with rheumatoid arthritis (RA).This cross-sectional study included 547 adult patients with RA. The patients were divided into two groups according to the disease activity score (DAS) system: remission and disease activity. Differences in the NLR, PLR and LMR of the two groups were assessed. Correlations were analyzed using Spearman analysis, and receiver operating characteristic (ROC) curves were used to identify the sensitivity, specificity, and optimal cutoff values to differentiate active RA patients from inactive RA patients.There was a statistically significant difference in the NLR (4.2 ± 3.2 vs 3.4 ± 2.4, P = .034) and PLR (222.3 ± 136.4 vs 176.9 ± 89.8, P = .006) between the two groups, but not for the LMR (3.0 ± 1.8 vs 3.4 ± 2.4, P = .115). In addition, the DAS28 and traditional inflammatory markers, including ESR and CRP, were weakly positively correlated with the NLR and PLR. Based on the ROC curves, the NLR (sensitivity 31.8%, specificity 77.8%) and PLR (sensitivity 57.3%, specificity 63.9%) were less valuable than the ESR (sensitivity 67.2%, specificity 91.7%) and CRP (sensitivity 76.2%, specificity 91.7%) for differentiating inactive RA patients from active RA patients due to low sensitivity and specificity and combining NLR or PLR also cannot significantly improved the diagnostic value of ESR and CRP.NLR, PLR and LMR may not be an useful independent diagnostic or complementary marker for disease activity in RA patients.
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Affiliation(s)
- Wang Lijuan
- Chengdu Medical College, Chengdu, China
- Department of Rheumatology, The First People's Hospital of Yibin, Yibin, China
| | - Zhou Yuting
- North Sichuan Medical College, Nanchong, China
- Department of Rheumatology, The First People's Hospital of Yibin, Yibin, China
| | - Liang Chaoyang
- Department of Rheumatology, The First People's Hospital of Yibin, Yibin, China
| | - Yang Ju
- Department of Rheumatology, The First People's Hospital of Yibin, Yibin, China
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Association of polymorphisms in promoter region of TNF-α -238 and -308 with clinical outcomes in patients with immune-mediated inflammatory diseases on anti-TNF therapy. Rheumatol Int 2021; 41:2195-2203. [PMID: 34623480 DOI: 10.1007/s00296-021-05016-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/27/2021] [Indexed: 10/20/2022]
Abstract
The hypothesis of the study was that polymorphisms in promoter regions -238 and -308 of TNF-α could be associated with different clinical outcomes in inflammatory bowel diseases (IBD) and immune-mediated rheumatic diseases (IMRD). The aim was to examine the possible association of both polymorphisms with concentration of C-reactive protein (CRP) and fecal calprotectin (fCAL), onset of the remission and development of the ADA in patients on therapy with anti-TNF inhibitors. The prospective study was done in patients with IBD and IMRD on infliximab (IFX) or adalimumab (ADM). Patients were genotyped for TNF-α -238 and -308 polymorphisms. The concentration of CRP, fCAL, IFX or ADM and antibodies to drugs were measured according to manufacturer's instructions and followed-up for 6 or 12 months. Out of all patients (N = 112), number of patients in remission did not differ according to genotypes (for IBD patients P = 0.509 vs 0.223; for IMRD patients P = 0.541 vs 0.132 for TNF-α -238 and -308, respectively). Initial CRP concentration was higher in IBD patients with TNF-α -308 GG than GA/AA genotypes in patients who failed to achieve remission [11.8 (4.4-39.6) vs 3.1 (1.5-6.5), P = 0.033]. In IBD patients with remission, fCAL concentration after at least 6 months of therapy was higher in TNF-α-308 GG than in GA genotype [52 (25-552) vs 20 (20-20) µg/g, P = 0.041]. Our results showed the association of TNF-α -308 GG genotype with a higher concentration of CRP and fecal calprotectin in patients with inflammatory bowel diseases on IFX or ADM therapy. Clinical remission and development of antibodies to anti-TNF drugs were not associated with TNF-α -238 and -308 polymorphisms.
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Radiological Evaluation of Cervical Spine Involvement in Rheumatoid Arthritis: A Cross-Sectional Retrospective Study. J Clin Med 2021; 10:jcm10194587. [PMID: 34640605 PMCID: PMC8509796 DOI: 10.3390/jcm10194587] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/17/2021] [Accepted: 10/03/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Cervical spine lesions are a common manifestation of rheumatoid arthritis (RA). The purpose of this study was to conduct a retrospective analysis of radiological lesions in cervical spine in patients with RA and to correlate findings with clinical and laboratory parameters. Methods: Overall, 240 consecutive patients with RA were referred for imaging by clinicians based on symptoms suggesting cervical spine involvement and/or long disease duration. In each patient, lateral radiographs and MRI of the cervical spine were performed. The imaging data were correlated with clinical records and laboratory data. Results: The cervical spine was affected in 179 patients (75%). The most common lesions were anterior atlanto-axial subluxation (AAS; 58%), subaxial subluxation (58%), and demineralization (48%). Cervical spine involvement was linked to longer disease duration (p = 0.007), the presence of rheumatoid factor (RF; p = 0.010), elevated C-reactive protein (CRP) levels (p = 0.016), and accelerated erythrocyte sedimentation rate (ESR; p = 0.025). Longer disease duration was associated with anterior AAS (p = 0.005), subaxial subluxation (p = 0.005), and basilar settling (p = 0.003). Conclusions: As many as 75% of RA patients develop lesions that can be observed on radiographs and through MRI. The most frequent radiological findings include anterior AAS and subaxial subluxation. Long disease duration, RF seropositivity, and elevated inflammatory markers were risk factors for cervical spine involvement.
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Lu J, Bi Y, Zhu Y, Huipeng S, Duan W, Zhou J. CD3D, GZMK, and KLRB1 Are Potential Markers for Early Diagnosis of Rheumatoid Arthritis, Especially in Anti-Citrullinated Protein Antibody-Negative Patients. Front Pharmacol 2021; 12:726529. [PMID: 34603038 PMCID: PMC8483717 DOI: 10.3389/fphar.2021.726529] [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: 06/17/2021] [Accepted: 08/16/2021] [Indexed: 12/29/2022] Open
Abstract
Early diagnosis and monitoring of rheumatoid arthritis (RA) progress are critical for effective treatment. In clinic, the detection of rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA) are usually combined to diagnose early RA. However, the poor specificity of RF and high heterogeneity of ACPA make the early diagnosis of RA still challenging. Bioinformatics analysis based on high-throughput omics is an emerging method to identify novel and effective biomarkers, which has been widely used in many diseases. Herein, utilizing an integrated strategy based on expression correlation analysis and weighted gene coexpression network analysis (WGCNA), we identified 76 RA-trait different expression genes (DEGs). Combined with protein-protein interaction (PPI) network construction and clustering, new hub genes associated in RA synovia, CD3D, GZMK, and KLRB1, were identified. We verified the specificity of these genes in the synovium of RA patients through three external datasets. We also observed high sensitivity and specificity of them for ACPA-negative patients. CD3D, GZMK, and KLRB1 are potentially key mediators of RA pathogenesis and markers for RA diagnosis.
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Affiliation(s)
- Junqin Lu
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yihui Bi
- Department of Orthopedics, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yapeng Zhu
- Department of Interventional Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Shi Huipeng
- Department of Orthopedics, Shanghai Sixth People's Hospital, Shanghai, China
| | - Wenxiu Duan
- Department of Interventional Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jian Zhou
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Naffaa ME, Hassan F, Golan-Cohen A, Merzon E, Green I, Saab A, Paz Z. Factors associated with drug survival on first biologic therapy in patients with rheumatoid arthritis: a population-based cohort study. Rheumatol Int 2021; 41:1905-1913. [PMID: 34529109 DOI: 10.1007/s00296-021-04989-y] [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: 05/23/2021] [Accepted: 09/02/2021] [Indexed: 11/24/2022]
Abstract
Lack of sufficient head-to-head trials comparing biologic disease-modifying antirheumatic drugs (bDMARDs) in rheumatoid arthritis (RA), makes the choice of the first bDMARD a matter of rheumatologist's preference. Longer drug survival on the first bDMARD usually correlates with early remission. We aimed to identify factors associated with longer drug survival. We conducted a population-based retrospective longitudinal cohort study. We identified RA patients using the relevant International Classification of Disease 9th codes. "True" RA patients were defined as patients fulfilling, additionally, at least one of the following: receiving conventional DMARDs (cDMARDs), being positive for rheumatoid factor or anti-cyclic citrullinated peptide, or being diagnosed by a rheumatologist. We compared drug survival times and identified factors associated with longer drug survival. We identified 4268 true RA patients between the years of 2000-2017. 820 patients (19.2%) received at least one bDMARD. The most commonly prescribed bDMARDs were etanercept (352, 42.9%), adalimumab (143, 17.4%), infliximab (142, 17.3%) and tocilizumab (58, 7.1%). Infliximab was associated with the longest drug survival (47.1 months ± 46.3) while golimumab was associated with the shortest drug survival (14.9 months ± 15.1). Male gender [hazard ratio (HR) = 0.76, 95% confidence interval (CI), 0.63-0.86, p = 0.001], concurrent conventional DMARDs use (HR = 0.79, 95% CI 0.68 - 0.98, p = .031) and initiating bDMARD therapy in earlier calendric years (HR = 1.12, 95% CI 1.10 -1.18, p = 0.0001) were associated with longer drug survival. Male gender, concomitant cDMARDs and initiating biologic therapy at earlier calendric years are associated with longer drug survival.
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Affiliation(s)
- Mohammad E Naffaa
- Rheumatology Unit, Galilee Medical Center, Road 89, Naharyia, Israel. .,Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel.
| | - Fadi Hassan
- Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel.,Internal Medicine "E", Galilee Medical Center, Naharyia, Israel
| | - Avivit Golan-Cohen
- Leumit Health Services, Tel Aviv-Yafo, Israel.,Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | | | - Ilan Green
- Leumit Health Services, Tel Aviv-Yafo, Israel.,Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Amir Saab
- Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel.,Internal Medicine "E", Galilee Medical Center, Naharyia, Israel
| | - Ziv Paz
- Rheumatology Unit, Galilee Medical Center, Road 89, Naharyia, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel
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41
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Ciregia F, Nys G, Cobraiville G, Badot V, Di Romana S, Sidiras P, Sokolova T, Durez P, Fillet M, Malaise MG, de Seny D. A Cross-Sectional and Longitudinal Study to Define Alarmins and A-SAA Variants as Companion Markers in Early Rheumatoid Arthritis. Front Immunol 2021; 12:638814. [PMID: 34489924 PMCID: PMC8418532 DOI: 10.3389/fimmu.2021.638814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 08/04/2021] [Indexed: 11/24/2022] Open
Abstract
Nowadays, in the study of rheumatoid arthritis (RA), more and more interest is directed towards an earlier effective therapeutic intervention and the determination of companion markers for predicting response to therapy with the goal to prevent progressive joint damage, deformities, and functional disability. With the present work, we aimed at quantifying in a cohort of early RA (ERA) patients naïve to DMARD therapy, proteins whose increase was previously found associated with RA: serum amyloid A (A-SAA) and alarmins. Five A-SAA variants (SAA1α, SAA1β, SAA1γ, SAA2α, and SAA2β) but also S100A8 and S100A9 proteins were simultaneously quantified in plasma applying a method based on single targeted bottom-up proteomics LC-MS/MS. First, we compared their expression between ERA (n = 100) and healthy subjects (n = 100), then we focused on their trend by monitoring ERA patients naïve to DMARD treatment, 1 year after starting therapy. Only SAA1α and SAA2α levels were increased in ERA patients, and SAA2α appears to mostly mediate the pathological role of A-SAA. Levels of these variants, together with SAA1β, only decreased under biologic DMARD treatment but not under methotrexate monotherapy. This study highlights the importance to better understand the modulation of expression of these variants in ERA in order to subsequently better characterize their biological function. On the other hand, alarmin expression increased in ERA compared to controls but remained elevated after 12 months of methotrexate or biologic treatment. The work overcomes the concept of considering these proteins as biomarkers for diagnosis, demonstrating that SAA1α, SAA1β, and SAA2α variants but also S100A8 and S100A9 do not respond to all early treatment in ERA and should be rather considered as companion markers useful to improve the follow-up of treatment response and remission state. Moreover, it suggests that earlier use of biologics in addition to methotrexate may be worth considering.
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Affiliation(s)
- Federica Ciregia
- Laboratory of Rheumatology, University of Liège, Centre Hospitalier Universitaire (CHU) de Liège, Liège, Belgium
| | - Gwenaël Nys
- Laboratory for the Analysis of Medicines, Centre Interdisciplinaire De Recherche Sur Le Médicament (CIRM), Department of Pharmacy, University of Liège, Liège, Belgium
| | - Gaël Cobraiville
- Laboratory of Rheumatology, University of Liège, Centre Hospitalier Universitaire (CHU) de Liège, Liège, Belgium
| | - Valérie Badot
- Department of Rheumatology, Centre Hospitalier Universitaire (CHU) Brugmann, Bruxelles, Belgium
| | - Silvana Di Romana
- Department of Rheumatology, Centre Hospitalier Universitaire (CHU) Saint–Pierre, Bruxelles, Belgium
| | - Paschalis Sidiras
- Department of Rheumatology, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Tatiana Sokolova
- Department of Rheumatology, Cliniques Universitaires Saint–Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Bruxelles, Belgium
| | - Patrick Durez
- Department of Rheumatology, Cliniques Universitaires Saint–Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Bruxelles, Belgium
| | - Marianne Fillet
- Laboratory for the Analysis of Medicines, Centre Interdisciplinaire De Recherche Sur Le Médicament (CIRM), Department of Pharmacy, University of Liège, Liège, Belgium
| | - Michel G. Malaise
- Laboratory of Rheumatology, University of Liège, Centre Hospitalier Universitaire (CHU) de Liège, Liège, Belgium
| | - Dominique de Seny
- Laboratory of Rheumatology, University of Liège, Centre Hospitalier Universitaire (CHU) de Liège, Liège, Belgium
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42
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Kamal SM, Winters JM, Al Othman BA, Kini AT, Beaver HA, Lee AG. Immune-Mediated Optic Neuropathy in Chronically Immunosuppressed Transplant Patients. J Neuroophthalmol 2021; 41:e180-e183. [PMID: 32826713 DOI: 10.1097/wno.0000000000001030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Sarah M Kamal
- McGovern Medical School (SK), Houston, Texas; Texas Tech University Health Sciences Center (JW), El Paso Paul L. Foster School of Medicine, El Paso, Texas; Department of Ophthalmology (BAO, AK, HB, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Department of Ophthalmology (HB, AGL), Weill Cornell Medicine, New York, New York; Department of Ophthalmology (HB, AGL), University of Texas Medical Branch, Galveston, Texas; Departments of Neurology and Neurosurgery (AGL), Weill Cornell Medicine, New York, New York; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; Texas A and M College of Medicine (AGL), Bryan, Texas; and Department of Ophthalmology (AGL), The University of Iowa Hospitals and Clinics, Iowa City, Iowa
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43
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Expression of the myeloid inhibitory receptor CLEC12A correlates with disease activity and cytokines in early rheumatoid arthritis. Sci Rep 2021; 11:11248. [PMID: 34045571 PMCID: PMC8160002 DOI: 10.1038/s41598-021-90631-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/29/2021] [Indexed: 01/08/2023] Open
Abstract
The myeloid inhibitory receptor CLEC12A negatively regulates inflammation. Reduced CLEC12A expression enhances inflammation in CLEC12A knock-out mice with collagen antibody-induced arthritis. Moreover, CLEC12A internalisation augments human neutrophil activation. We thus postulated that CLEC12A expression on circulating myeloid cells of rheumatoid arthritis patients is associated with disease manifestations. Cell-surface, CLEC12A receptor expression was determined on circulating neutrophils and monocytes of eRA patients and of healthy donors. Generalized estimating equations model, Student’s t-test and Spearman’s correlations were performed to compare CLEC12A expression between groups and test its association with disease activity and clinical parameters. Plasma cytokines were measured by multiplex immunoassay. Patients with reduced neutrophil or monocyte CLEC12A expression at baseline and at 3 months have an increased simple disease activity index. Low baseline CLEC12A expression also correlates with a higher SDAI at 6 months. In contrast, positive correlations were observed between baseline CLEC12A expression and several cytokines. Moreover, neutrophil and monocyte CLEC12A expression is significantly higher in early rheumatoid arthritis patients at baseline than healthy controls. Circulating neutrophil and monocyte CLEC12A expression correlates with disease activity at baseline and is predictive of SDAI at later stages of the disease indicative of a regulatory role for CLEC12A in RA.
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Torgutalp M, Yayla ME, Eroglu DS, Dincer ABK, Yurteri EU, Okatan IE, Sezer S, Guloksuz EGA, Us E, Turgay TM, Kinikli G, Ates A. Serum Calprotectin is Indicating Clinical and Ultrasonographic Disease Activity in Rheumatoid Arthritis, even with Normal C-Reactive Protein Levels. Mediterr J Rheumatol 2021; 32:56-65. [PMID: 34386702 PMCID: PMC8314882 DOI: 10.31138/mjr.32.1.56] [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: 05/15/2020] [Revised: 09/28/2020] [Accepted: 10/13/2020] [Indexed: 11/23/2022] Open
Abstract
Objective: Calprotectin is an inflammatory biomarker which assesses disease activity in rheumatoid arthritis (RA). The objective of this study was to test whether serum calprotectin is associated with clinical and ultrasonographic disease activity in patients with RA, and to analyse its predicting value for disease activity evaluation despite normal C-Reactive protein (CRP) levels. Methods: We included 80 patients with RA and 30 healthy subjects. Patients were examined clinically and by ultrasound, (US7 score) along with laboratory parameters (calprotectin, CRP, erythrocyte sedimentation rate [ESR]). Disease activity scores (DAS28) were calculated to assess disease activity. Firstly, patients were divided into four subgroups according to the DAS28-ESR (high, moderate, low disease activity, and remission), then into two subgroups; group-1 (DAS-28≤3.2) and group-2 (DAS28>3.2). The predicting value of calprotectin for disease activity in patients with normal CRP was analysed with univariate and multivariate analysis and receiver operating characteristic curves. Results: Calprotectin levels were higher in RA patients than controls (96.3±45.9 ng/ml, 54.7±50.0 ng/ml, respectively; p<0.001). Calprotectin levels were 74.8±45.5 ng/ml in group-1 (n=37) and 114.7±37.9 ng/ml in group-2 (n=43) (p<0.001). In univariate analyses, calprotectin was significantly correlated with clinical, laboratory, and ultrasound parameters (p<0.05), and was a better predictor of power doppler synovitis than CRP in multivariate analysis (OR=1.014; 95%CI 1.002–1.027; p=0.024). The discriminatory capacity for calprotectin to distinguish ultrasonographically active disease in patients with normal CRP levels using AUC was 0.75 (95%CI 0.56–0.90, p=0.023). Conclusions: Calprotectin represents disease activity, even in patients who are clinical and ultrasonographical active but have normal CRP levels.
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Affiliation(s)
- Murat Torgutalp
- Division of Rheumatology, Department of Internal Medicine, and
| | | | | | | | | | | | - Serdar Sezer
- Division of Rheumatology, Department of Internal Medicine, and
| | | | - Ebru Us
- Department of Medical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | | | - Gulay Kinikli
- Division of Rheumatology, Department of Internal Medicine, and
| | - Askin Ates
- Division of Rheumatology, Department of Internal Medicine, and
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45
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Pope JE, Choy EH. C-reactive protein and implications in rheumatoid arthritis and associated comorbidities. Semin Arthritis Rheum 2020; 51:219-229. [PMID: 33385862 DOI: 10.1016/j.semarthrit.2020.11.005] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/19/2020] [Accepted: 11/05/2020] [Indexed: 02/07/2023]
Abstract
C-reactive protein (CRP) is routinely assessed as a marker of systemic inflammation in rheumatoid arthritis (RA). However, it is also an immune regulator that plays an important role in inflammatory pathways associated with RA and promotes atherogenic effects. Comorbidities linked to systemic inflammation are common in RA, and CRP has been associated with the risk for cardiovascular disease, diabetes, metabolic syndrome, pulmonary diseases, and depression. The relationship between systemic inflammation, CRP, and comorbidities in RA is complex, and it is challenging to determine how changing CRP levels may affect the risk or progression of these comorbidities. We review the biological role of CRP in RA and its implications for disease activity and treatment response. We also discuss the impact of treatment on CRP levels and whether reducing systemic inflammation and inhibiting CRP-mediated inflammatory pathways may have an impact on conditions commonly comorbid with RA.
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Affiliation(s)
- Janet E Pope
- Janet E. Pope: Schulich School of Medicine, University of Western Ontario, St. Joseph's Health Care, London, ON, Canada
| | - Ernest H Choy
- Ernest H. Choy: Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom.
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46
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Hejrati A, Taghadosi M, Alizadeh-Navaei R, Hosseinzadeh S, Bashash D, Esmaili M, Zafari P. Neopterin serum level does not reflect the disease activity in rheumatoid arthritis: A systematic review and meta-analysis. IUBMB Life 2020; 72:2563-2571. [PMID: 33089617 DOI: 10.1002/iub.2398] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/09/2020] [Accepted: 10/09/2020] [Indexed: 02/06/2023]
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disease caused by established chronic inflammation. Neopterin levels have extensively been considered as a marker of immune activation during inflammation. In this study, we performed a systematic evaluation and meta-analysis to elucidate the overall relationship between neopterin concentration and RA disease activity. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a systematic review was conducted using PubMed, Google Scholar, Web of Science, and Scopus from 2000 to August 2020. The Newcastle-Ottawa scale was used to assess the quality of eligible studies. The effect size (ES) and corresponding 95% confidence intervals (CIs) were calculated to evaluate this association. A total of 15 studies out of 98 met our inclusion criteria. The pooled analysis found that patients with RA had high level of neopterin; however, no statistically significant association was found between neopterin levels with high, intermediate, and low diseases activity score (DAS)-28 (ES =11.18, 95% CI: 6.02 to 16.34, and I2 = 91.8%; and ES = 8.57, 95% CI: 6.41 to 10.37, and I2 = 99.5%; and ES =12.45, 95% CI: -1.68 to 26.58, and I2 = 99.0%, respectively). Our results indicated that the neopterin concentration does not seem to have any substantial impact on the RA disease activity.
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Affiliation(s)
- Alireza Hejrati
- Department of Internal Medicine, Hazrate-Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdi Taghadosi
- Department of Immunology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shahnaz Hosseinzadeh
- Department of Immunology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Davood Bashash
- Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mozhgan Esmaili
- Department of Immunology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Parisa Zafari
- Department of Immunology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
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47
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Jin Z, Cai G, Zhang P, Li X, Yao S, Zhuang L, Ren M, Wang Q, Yu X. The value of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as complementary diagnostic tools in the diagnosis of rheumatoid arthritis: A multicenter retrospective study. J Clin Lab Anal 2020; 35:e23569. [PMID: 32951253 PMCID: PMC7843258 DOI: 10.1002/jcla.23569] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/21/2020] [Accepted: 08/19/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have drawn attention in recent years as novel non-specific inflammatory markers; however, only a few studies have been conducted to investigate their value in RA. OBJECTIVE To investigate the value of the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) as complementary diagnostic tools in rheumatoid arthritis (RA). METHOD This study included 1009 patients with RA, 170 patients with other rheumatic diseases, and 245 healthy individuals from four medical centers. The patients' general data, including complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF), were retrospectively analyzed, and the NLR and PLR were calculated. Potential effective indicators were screened by logistic regression analysis, and a receiver operating characteristic (ROC) curve was plotted to evaluate their diagnostic value for RA. RESULTS (a) The NLR and PLR were significantly higher in the RA group than in the non-RA group and the control group (P < .05). (b) Spearman's Rho showed that the NLR was positively correlated with the PLR (r = .584, P < .05), RF (r = .167, P < .01), and CRP (r = .280, P < .01) but was not significantly correlated with ESR (r = .100, P > .05). The PLR was positively correlated with RF (r = .139, P < .01), CRP (r = .297, P < .01), and ESR (r = .262, P < .05). (c) Logistic analysis showed that RF, CRP, ESR, and the NLR had diagnostic value for RA. (d) For the NLR, the area under the curve (AUC) of the ROC curve was 0.831; at the cutoff value of 2.13, the diagnostic sensitivity, specificity, accuracy, and Youden index were 76.7%, 75.9%, 76.4%, and 0.5424, respectively. CONCLUSION The NLR was less effective than CRP and RF but was superior to ESR in the diagnosis of RA. The NLR can thus be used as a complementary diagnostic indicator in the diagnosis of RA.
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Affiliation(s)
- Zihan Jin
- Clinical Lab, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou City, China
| | - Gaojun Cai
- Department of Cardiology, Wujin Hospital Affiliated with Jiangsu University, Changzhou City, China
| | - Ping Zhang
- Clinical Lab, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou City, China
| | - Xiaohong Li
- Clinical Lab, Changzhou TCM Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, Changzhou City, China
| | - Shuang Yao
- Clinical Lab, The Third Affiliated Hospital of Soochow University, Changzhou City, China
| | - Lin Zhuang
- Department of Surgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou City, China
| | - Min Ren
- Department of Rheumatology, Wujin Hospital Affiliated with Jiangsu University, Changzhou City, China
| | - Qiang Wang
- Department of Surgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou City, China
| | - Xiaolong Yu
- Science and Education Section, Wujin Hospital Affiliated with Jiangsu University, Changzhou City, China.,Department of Ultrasonics, The Wujin Clinical College of Xuzhou Medical University, Changzhou City, China
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Elshal MF, El Shinnawy SM, ElShabacy FA, Hasabelnaby AS. Immunogenic analysis for involvement of CD200R1 molecule in rheumatoid arthritis patients. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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49
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Boyapati A, Schwartzman S, Msihid J, Choy E, Genovese MC, Burmester GR, Lam G, Kimura T, Sadeh J, Weinreich DM, Yancopoulos GD, Graham NMH. Association of High Serum Interleukin-6 Levels With Severe Progression of Rheumatoid Arthritis and Increased Treatment Response Differentiating Sarilumab From Adalimumab or Methotrexate in a Post Hoc Analysis. Arthritis Rheumatol 2020; 72:1456-1466. [PMID: 32343882 PMCID: PMC7496495 DOI: 10.1002/art.41299] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 04/23/2020] [Indexed: 12/11/2022]
Abstract
Objective The development of biomarkers to guide treatment decisions is a major research focus in rheumatoid arthritis (RA). Patients with RA have elevated interleukin‐6 (IL‐6) levels; however, the utility of IL‐6 as a predictor of treatment response is unclear. This study was undertaken to investigate, by post hoc analysis, whether baseline IL‐6 levels are predictive of sarilumab treatment responses in 2 phase III studies. Methods Serum IL‐6 concentrations were measured in patients with RA prior to receiving sarilumab 200 mg (n = 148) or adalimumab 40 mg (n = 152) every 2 weeks (in the MONARCH trial; ClinicalTrials.gov identifier: NCT02332590) or sarilumab 150 mg, sarilumab 200 mg, or placebo every 2 weeks plus methotrexate (MTX) (n = 401, n = 396, and n = 397, respectively) (in the MOBILITY trial; ClinicalTrials.gov identifier: NCT01061736). Efficacy and patient‐reported outcomes were compared between and within groups according to IL‐6 tertile using linear and logistic regression. Results In MONARCH, patients with high baseline IL‐6 levels (all ≥3 times the upper limit of normal; n = 100) had higher disease activity at baseline than those with low IL‐6 levels (n = 100). The magnitude of clinical improvement over 24 weeks with sarilumab versus adalimumab was greater in patients with high compared to those with low baseline IL‐6 levels. In MOBILITY, compared to patients with low IL‐6 levels (n = 397), patients with high IL‐6 levels (n = 398) had higher disease activity and joint damage at baseline, were more likely to have joint progression, and had less clinical improvement over 52 weeks’ treatment with placebo plus MTX compared to sarilumab 150 mg or 200 mg plus MTX. Baseline IL‐6 and C‐reactive protein levels were both predictive of outcomes. Safety profiles were similar between defined IL‐6 tertiles. Conclusion IL‐6 may be a prognostic marker of disease progression and severity, and patients with high IL‐6 levels may be likely to benefit from sarilumab compared to adalimumab or MTX. Prospective validation is warranted to confirm the results of these post hoc analyses.
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Affiliation(s)
| | | | | | - Ernest Choy
- Cardiff University School of Medicine, Cardiff, UK
| | | | | | - Gordon Lam
- Atrium Health, Charlotte, North Carolina
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50
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Mortazavi-Jahromi SS, Aslani M, Mirshafiey A. A comprehensive review on miR-146a molecular mechanisms in a wide spectrum of immune and non-immune inflammatory diseases. Immunol Lett 2020; 227:8-27. [PMID: 32810557 DOI: 10.1016/j.imlet.2020.07.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/10/2020] [Accepted: 07/21/2020] [Indexed: 12/12/2022]
Abstract
MicroRNAs (miRNAs) are single-strand endogenous and non-coding RNA molecules with a length of about 22 nucleotides, which regulate genes expression, through modulating the translation and stability of their target mRNAs. miR-146a is one of the most studied miRNAs, due to its central role in immune system homeostasis and control of the innate and acquired immune responses. Accordingly, abnormal expression or function of miR-146a results in the incidence and progression of immune and non-immune inflammatory diseases. Its deregulated expression pattern and inefficient function have been reported in a wide spectrum of these illnesses. Based on the existing evidence, this miRNA qualifies as an ideal biomarker for diagnosis, prognosis, and activity evaluation of immune and non-immune inflammatory disorders. Moreover, much attention has recently been paid to therapeutic potential of miR-146a and several researchers have assessed the effects of different drugs on expression and function of this miRNA at diverse experimental, animal, besides human levels, reporting motivating results in the treatment of the diseases. Here, in this comprehensive review, we provide an overview of miR-146a role in the pathogenesis and progression of several immune and non-immune inflammatory diseases such as Rheumatoid arthritis, Systemic lupus erythematosus, Inflammatory bowel disease, Multiple sclerosis, Psoriasis, Graves' disease, Atherosclerosis, Hepatitis, Chronic obstructive pulmonary disease, etc., discuss about its eligibility for being a desirable biomarker for these disorders, and also highlight its therapeutic potential. Understanding these mechanisms underlies the selecting and designing the proper therapeutic targets and medications, which eventually facilitate the treatment process.
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Affiliation(s)
| | - Mona Aslani
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Mirshafiey
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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