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Elghali M, Bannour I, Touil I, Changuel M, Brahem Y, Jaoued O, Boudawara N, Amor HIH, Elatrous S, Knani J, Sakly N. Increased Rheumatoid Factor production in patients with severe COVID-19. Diagn Microbiol Infect Dis 2024; 109:116284. [PMID: 38604077 DOI: 10.1016/j.diagmicrobio.2024.116284] [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: 10/10/2023] [Revised: 03/13/2024] [Accepted: 03/21/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Searching for Rheumatoid Factors (RF) in patients with coronavirus disease (COVID-19) has rarely been described. OBJECTIVES To investigate the association between RF isotypes (IgM, IgA, and IgG) and different clinical presentations of COVID-19 in a series of Tunisian patients. STUDY DESIGN Eighty-two COVID-19 patients were enrolled in this study. Symptomatic cases were recruited from the Department of COVID-19 and the intensive care unit (ICU) of the University Hospital of Mahdia, Tunisia, from January 2021 to March 2021. Different RF isotypes were assessed using a commercial enzyme-linked immunosorbent assay (ELISA). RESULTS Forty-one patients (50%) had RF of any isotype. Thirty-two patients (39%) were tested positive for RF-IgM. Symptomatic forms of the disease were associated with RF-IgM positivity (p = 0.005). The mean concentration of RF-IgM was higher in the severe form than in the moderate and asymptomatic forms (p = 0.006). CONCLUSIONS Our study suggests that the production of RF-IgM isotype is increased in patients with severe COVID-19.
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Affiliation(s)
- Mourad Elghali
- Immunology department, University Hospital F.B., University of Monastir, Monastir, Tunisia
| | - I Bannour
- Immunology department, University Hospital F.B., University of Monastir, Monastir, Tunisia
| | - I Touil
- Pneumology department, Tahar Sfar hospital, University of Monastir, Mahdia, Tunisia
| | - M Changuel
- Immunology department, University Hospital F.B., University of Monastir, Monastir, Tunisia
| | - Y Brahem
- Pneumology department, Tahar Sfar hospital, University of Monastir, Mahdia, Tunisia
| | - O Jaoued
- Intensive Care Unit, Tahar Sfar hospital, University of Monastir, Mahdia, Tunisia
| | - N Boudawara
- Pneumology department, Tahar Sfar hospital, University of Monastir, Mahdia, Tunisia
| | - H Ibn Hadj Amor
- Cardiology Department, Tahar Sfar hospital, University of Monastir, Mahdia, Tunisia
| | - S Elatrous
- Intensive Care Unit, Tahar Sfar hospital, University of Monastir, Mahdia, Tunisia
| | - J Knani
- Pneumology department, Tahar Sfar hospital, University of Monastir, Mahdia, Tunisia
| | - N Sakly
- Immunology department, University Hospital F.B., University of Monastir, Monastir, Tunisia.
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2
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Omran E, Alzahrani AR, Ezzat SF, Ellithy G, Tarek M, Khairy E, Ghit MM, Elgeushy A, Ibrahim Al-Hazani TM, Aziz Ibrahim IA, Falemban AH, Bamagous GA, Elhawary NA, Jaremko M, Saied EM, Mohamed DI. Deciphering the therapeutic potential of trimetazidine in rheumatoid arthritis via targeting mi-RNA128a, TLR4 signaling pathway, and adenosine-induced FADD-microvesicular shedding: In vivo and in silico study. Front Pharmacol 2024; 15:1406939. [PMID: 38919260 PMCID: PMC11196411 DOI: 10.3389/fphar.2024.1406939] [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: 03/25/2024] [Accepted: 05/22/2024] [Indexed: 06/27/2024] Open
Abstract
Rheumatoid arthritis (RA) is a debilitating autoimmune condition characterized by chronic synovitis, joint damage, and inflammation, leading to impaired joint functionality. Existing RA treatments, although effective to some extent, are not without side effects, prompting a search for more potent therapies. Recent research has revealed the critical role of FAS-associated death domain protein (FADD) microvesicular shedding in RA pathogenesis, expanding its scope beyond apoptosis to include inflammatory and immune pathways. This study aimed to investigate the intricate relationship between mi-RNA 128a, autoimmune and inflammatory pathways, and adenosine levels in modulating FADD expression and microvesicular shedding in a Freund's complete adjuvant (FCA) induced RA rat model and further explore the antirheumatoid potency of trimetazidine (TMZ). The FCA treated model exhibited significantly elevated levels of serum fibrogenic, inflammatory, immunological and rheumatological diagnostic markers, confirming successful RA induction. Our results revealed that the FCA-induced RA model showed a significant reduction in the expression of FADD in paw tissue and increased microvesicular FADD shedding in synovial fluid, which was attributed to the significant increase in the expression of the epigenetic miRNA 128a gene in addition to the downregulation of adenosine levels. These findings were further supported by the significant activation of the TLR4/MYD88 pathway and its downstream inflammatory IkB/NFB markers. Interestingly, TMZ administration significantly improved, with a potency similar to methotrexate (MTX), the deterioration effect of FCA treatment, as evidenced by a significant attenuation of fibrogenic, inflammatory, immunological, and rheumatological markers. Our investigations indicated that TMZ uniquely acted by targeting epigenetic miRNA128a expression and elevating adenosine levels in paw tissue, leading to increased expression of FADD of paw tissue and mitigated FADD microvesicular shedding in synovial fluid. Furthermore, the group treated with TMZ showed significant downregulation of TLR4/MYD88 and their downstream TRAF6, IRAK and NF-kB. Together, our study unveils the significant potential of TMZ as an antirheumatoid candidate, offering anti-inflammatory effects through various mechanisms, including modulation of the FADD-epigenetic regulator mi-RNA 128a, adenosine levels, and the TLR4 signaling pathway in joint tissue, but also attenuation of FADD microvesicular shedding in synovial fluid. These findings further highlight the synergistic administration of TMZ and MTX as a potential approach to reduce adverse effects of MTX while improving therapeutic efficacy.
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Affiliation(s)
- Enas Omran
- Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Abdullah R. Alzahrani
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Samar F. Ezzat
- Department of Histology and Cell Biology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ghada Ellithy
- Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Marwa Tarek
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Eman Khairy
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Department of Clinical Biochemistry, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Mohamed M. Ghit
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Elgeushy
- Orthopedic Department, Faculty of Medicine, Alazhar University Hospitals, Cairo, Egypt
| | | | - Ibrahim Abdel Aziz Ibrahim
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Alaa Hisham Falemban
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ghazi A. Bamagous
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Nasser A. Elhawary
- Department of Medical Genetics, College of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Mariusz Jaremko
- Smart-Health Initiative and Red Sea Research Center, Division of Biological and Environmental Sciences and Engineering, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | - Essa M. Saied
- Chemistry Department, Faculty of Science, Suez Canal University, Ismailia, Egypt
- Institute for Chemistry, Humboldt Universität zu Berlin, Berlin, Germany
| | - Doaa I. Mohamed
- Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Chen C, Park AK, Monroy I, Ren Y, Kim SI, Chaurasiya S, Priceman SJ, Fong Y. Using Oncolytic Virus to Retask CD19-Chimeric Antigen Receptor T Cells for Treatment of Pancreatic Cancer: Toward a Universal Chimeric Antigen Receptor T-Cell Strategy for Solid Tumor. J Am Coll Surg 2024; 238:436-447. [PMID: 38214445 DOI: 10.1097/xcs.0000000000000964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND Chimeric antigen receptor (CAR) T cells targeting the B-cell antigen CD19 are standard therapy for relapsed or refractory B-cell lymphoma and leukemia. CAR T cell therapy in solid tumors is limited due to an immunosuppressive tumor microenvironment and a lack of tumor-restricted antigens. We recently engineered an oncolytic virus (CF33) with high solid tumor affinity and specificity to deliver a nonsignaling truncated CD19 antigen (CD19t), allowing targeting by CD19-CAR T cells. Here, we tested this combination against pancreatic cancer. STUDY DESIGN We engineered CF33 to express a CD19t (CF33-CD19t) target. Flow cytometry and ELISA were performed to quantify CD19t expression, immune activation, and killing by virus and CD19-CAR T cells against various pancreatic tumor cells. Subcutaneous pancreatic human xenograft tumor models were treated with virus, CAR T cells, or virus+CAR T cells. RESULTS In vitro, CF33-CD19t infection of tumor cells resulted in >90% CD19t cell-surface expression. Coculturing CD19-CAR T cells with infected cells resulted in interleukin-2 and interferon gamma secretion, upregulation of T-cell activation markers, and synergistic cell killing. Combination therapy of virus+CAR T cells caused significant tumor regression (day 13): control (n = 16, 485 ± 20 mm 3 ), virus alone (n = 20, 254 ± 23 mm 3 , p = 0.0001), CAR T cells alone (n = 18, 466 ± 25 mm 3 , p = NS), and virus+CAR T cells (n = 16, 128 ± 14 mm 3 , p < 0.0001 vs control; p = 0.0003 vs virus). CONCLUSIONS Engineered CF33-CD19t effectively infects and expresses CD19t in pancreatic tumors, triggering cell killing and increased immunogenic response by CD19-CAR T cells. Notably, CF33-CD19t can turn cold immunologic tumors hot, enabling solid tumors to be targetable by agents designed against liquid tumor antigens.
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Affiliation(s)
- Courtney Chen
- From the Departments of Surgery (Chen, Kim, Chaurasiya, Fong)
| | - Anthony K Park
- Hematology and Hematopoietic Cell Transplantation (Park, Monroy, Ren, Priceman)
- Irell and Manella Graduate School of Biological Sciences (Park), City of Hope, Duarte, CA
| | - Isabel Monroy
- Hematology and Hematopoietic Cell Transplantation (Park, Monroy, Ren, Priceman)
| | - Yuwei Ren
- Hematology and Hematopoietic Cell Transplantation (Park, Monroy, Ren, Priceman)
| | - Sang-In Kim
- From the Departments of Surgery (Chen, Kim, Chaurasiya, Fong)
| | | | - Saul J Priceman
- Hematology and Hematopoietic Cell Transplantation (Park, Monroy, Ren, Priceman)
- Immuno-Oncology, Beckman Research Institute (Priceman)
| | - Yuman Fong
- From the Departments of Surgery (Chen, Kim, Chaurasiya, Fong)
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Feyzkhanova GU, Voloshin SA, Novikov AA, Aleksandrova EN, Smoldovskaya OV, Rubina AY. Analysis of rheumatoid factor and acute phase proteins using microarrays in patients with rheumatoid arthritis. Klin Lab Diagn 2022; 67:43-47. [PMID: 35077069 DOI: 10.51620/0869-2084-2022-67-1-43-47] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
One of the biomarkers of biggest clinical importance in rheumatoid arthritis (RA) is rheumatoid factor (IgM RF). The rheumatoid factor has insufficient sensitivity and specificity, therefore, to increase the diagnostic information of the test, acute phase proteins were used as concomitant biomarkers. Using biological microchips, we measured IgM RF, C-reactive protein (CRP) and Serum amyloid protein A (SAA) in patients with RA (n = 60), ankylosing spondylitis (AS) (n=55), systemic lupus erythematosus (SLE) (n=20) and healthy donors (HD) (n=9). It was shown that the medians of IgM RF concentrations are significantly higher (p<0.01) in patients with RA compared to patients suffering from other diseases and healthy donors. CRP and SAA were also significantly increased (p<0.05) in patients with RA and AS compared with SLE and HD. It has been shown that the complex determination of three biomarkers in differentiating RA patients with the comparison group had a higher diagnostic sensitivity than the isolated determination of IgM RF, while the addition of SAA makes the greatest contribution to improving the diagnostic characteristics of the biomarker panel: the use of a logistic regression model based on IgM RF and SAA allowed to increase the diagnostic sensitivity of the analysis from 58.3% to 65%. Thus, the developed microarray-based method can be used to detect and elucidate the diagnostic characteristics of RA biomarkers; however, further use requires validation of the obtained results on an expanded sampling.
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Affiliation(s)
- G U Feyzkhanova
- FSBIS Engelhardt Institute of Molecular Biology, Russian Academy of Sciences
| | - S A Voloshin
- FSBIS Engelhardt Institute of Molecular Biology, Russian Academy of Sciences
| | - A A Novikov
- SBIHC Moscow Clinical Scientific Center n.a. A.S. Loginov
| | | | - O V Smoldovskaya
- FSBIS Engelhardt Institute of Molecular Biology, Russian Academy of Sciences
| | - A Yu Rubina
- FSBIS Engelhardt Institute of Molecular Biology, Russian Academy of Sciences
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Chaulin AM. Some Common Causes of False Positive Increases in Serum Levels of Cardiac Troponins. Curr Cardiol Rev 2022; 18:e130422203527. [PMID: 35422225 PMCID: PMC9893154 DOI: 10.2174/1573403x18666220413124038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/21/2022] [Accepted: 02/26/2022] [Indexed: 11/22/2022] Open
Abstract
Cardiac troponin molecules (cTnI and cTnT) are the most valuable and in-demand biomarkers for detecting various types of myocardial damage (reversible and irreversible, ischemic, inflammatory, toxic, etc.) in current clinical practice. These biomarkers are widely used for early diagnosis of acute myocardial infarction (AMI) and risk stratification of patients suffering from a number of cardiac (such as myocarditis, heart failure, cardiomyopathy, etc.) and extra-cardiac diseases (such as sepsis, renal failure, pulmonary embolism, neurological pathologies, etc.) that negatively affect the cells of cardiac muscle tissue. However, in daily routine clinical activities, internists and cardiologists often encounter cases of false increases in the concentrations of cardiospecific troponins. A false increase in the concentration of troponins contributes to an incorrect diagnosis and incorrect therapy, which can harm the patient. A false increase in the concentration of troponins contributes to an incorrect diagnosis and incorrect therapy, which can harm the patient, therefore, internists and cardiologists should be well aware of the main reasons and mechanisms for false-positive results cTnI and cTnT. This review article mainly focuses on the causes of falsepositive increases in serum levels of cTnI and cTnT, which provide helpful clues for the accurate diagnosis of AMI and evidence for the differential diagnosis.
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Affiliation(s)
- Aleksey Michailovich Chaulin
- Department of Cardiology and Cardiovascular Surgery, Medical Faculty, Samara State Medical University, Samara, Russia
- Department of Clinical Chemistry, Samara Regional Clinical Cardiological Dispensary, Samara, Russia
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Sokolova MV, Schett G, Steffen U. Autoantibodies in Rheumatoid Arthritis: Historical Background and Novel Findings. Clin Rev Allergy Immunol 2022; 63:138-151. [PMID: 34495490 PMCID: PMC9464122 DOI: 10.1007/s12016-021-08890-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2021] [Indexed: 01/13/2023]
Abstract
Autoantibodies represent a hallmark of rheumatoid arthritis (RA), with the rheumatoid factor (RF) and antibodies against citrullinated proteins (ACPA) being the most acknowledged ones. RA patients who are positive for RF and/or ACPA ("seropositive") in general display a different etiology and disease course compared to so-called "seronegative" patients. Still, the seronegative patient population is very heterogeneous and not well characterized. Due to the identification of new autoantibodies and advancements in the diagnosis of rheumatic diseases in the last years, the group of seronegative patients is constantly shrinking. Aside from antibodies towards various post-translational modifications, recent studies describe autoantibodies targeting some native proteins, further broadening the spectrum of recognized antigens. Next to the detection of new autoantibody groups, much research has been done to answer the question if and how autoantibodies contribute to the pathogenesis of RA. Since autoantibodies can be detected years prior to RA onset, it is a matter of debate whether their presence alone is sufficient to trigger the disease. Nevertheless, there is gathering evidence of direct autoantibody effector functions, such as stimulation of osteoclastogenesis and synovial fibroblast migration in in vitro experiments. In addition, autoantibody positive patients display a worse clinical course and stronger radiographic progression. In this review, we discuss current findings regarding different autoantibody types, the underlying disease-driving mechanisms, the role of Fab and Fc glycosylation and clinical implications.
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Affiliation(s)
- Maria V. Sokolova
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Universitätstrasse 25a, 91054 Erlangen, Germany ,Deutsches Zentrum Für Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Universitätstrasse 25a, 91054 Erlangen, Germany ,Deutsches Zentrum Für Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Ulrike Steffen
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Universitätstrasse 25a, 91054 Erlangen, Germany ,Deutsches Zentrum Für Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
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