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Guiot J, Henket M, Ernst M, Seidel L, Winandy M, Denis A, Frix AN, Gester F, Thys M, Giltay L, Garah O, Njock MS, Canivet P, Meunier P, Corhay JL, Regnier C, Malaise O, Malaise M, Louis R. Airflow obstruction as a marker of adverse prognosis in rheumatoid arthritis. Front Med (Lausanne) 2023; 10:1063012. [PMID: 36968825 PMCID: PMC10033600 DOI: 10.3389/fmed.2023.1063012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/16/2023] [Indexed: 03/12/2023] Open
Abstract
ObjectivesIn our study, we explored the specific subgroup of patients with rheumatoid arthritis (RA) suffering from obstructive lung disease (OLD) and its impact on morbi-mortality.MethodsOur retrospective study included 309 patients suffering from RA with either obstructive (O-RA) or non-obstructive patterns (non-O-RA). OLD was defined based on the Tiffeneau index at the first available pulmonary functional test (PFT). Survival was then calculated and represented by a Kaplan–Meier curve. The comparison between the populations considered was performed by the Log-Rank test.ResultsOut of the 309 RA patients, 102 (33%) had airway obstruction. The overall survival time was significantly lower in the O-RA group than in the non-O-RA group (n = 207) (p < 0.001). The median survival time was 11.75 years in the O-RA group and higher than 16 years in the non-O-RA group. Multivariate analysis identified OLD as an independent risk factor for mortality (HR 2.20; 95% CI 1.21–4.00, p < 0.01).ConclusionAirway obstruction can be an independent risk factor of mortality in RA and should be considered as an early marker of poor prognosis. Further prospective longitudinal studies are required in order to determine the best clinical management for O-RA patients.
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Affiliation(s)
- Julien Guiot
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
- *Correspondence: Julien Guiot,
| | - Monique Henket
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
| | - Marie Ernst
- Biostatistics and Research Method Center (B-STAT), CHU Liège, Liège, Belgium
| | - Laurence Seidel
- Biostatistics and Research Method Center (B-STAT), CHU Liège, Liège, Belgium
| | - Marie Winandy
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
| | - Anna Denis
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
| | | | - Fanny Gester
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
| | - Marie Thys
- Department of Medico-Economic and Data, CHU Liège, Liège, Belgium
| | - Laurie Giltay
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
| | - Omaima Garah
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
| | | | | | - Paul Meunier
- Department of Radiology, CHU Liège, Liège, Belgium
| | | | | | | | | | - Renaud Louis
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
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Lopez-Olivo MA, Sharma G, Singh G, James J, Krause KJ, Cinciripini P, Volk RJ, Suarez-Almazor ME. A systematic review with meta-analysis of the effects of smoking cessation strategies in patients with rheumatoid arthritis. PLoS One 2022; 17:e0279065. [PMID: 36520847 PMCID: PMC9754184 DOI: 10.1371/journal.pone.0279065] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 11/14/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Smoking rates among patients with rheumatoid arthritis (RA) exceed those in the general population. This study identified smoking cessation strategies used in patients with RA and synthesized data on their effects. METHODS We conducted a systematic review of studies that reported effects of interventions for smoking cessation in patients with RA. We searched 5 electronic databases until March 2022. Screening, quality appraisal, and data collection were done independently by 2 reviewers. RESULTS We included 18 studies reporting interventions for patients or providers: 14 evaluated strategies for patients (5 education on cardiovascular risk factors including smoking, 3 educational interventions on smoking cessation alone, 3 education with nicotine replacement and counseling, and 1 study each: education with nicotine replacement, counseling sessions alone, and a social marketing campaign). Smoking cessation rates ranged from 4% (95% CI: 2%-6%, 24 to 48 weeks) for cardiovascular risk education to 43% (95% CI: 21%-67%, 104 weeks) for counseling sessions alone. The pooled cessation rate for all interventions was 22% (95% CI: 8%-41%, 4 weeks to 104 weeks; 9 studies). Four interventions trained providers to ascertain smoking status and provide referrals for smoking cessation. The pooled rates of referrals to quit services increased from 5% in pre-implementation populations to 70% in post-implementation populations. CONCLUSION Studies varied in patient characteristics, the interventions used, and their implementation structure. Only 3 studies were controlled clinical trials. Additional controlled studies are needed to determine best practices for smoking cessation for patients with RA.
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Affiliation(s)
- Maria A. Lopez-Olivo
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Gaurav Sharma
- Department of Internal Medicine, University of South Alabama, Mobile, Alabama, United States of America
| | | | - Justin James
- City University of New York School of Medicine, New York, New York, United States of America
| | - Kate J. Krause
- Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Paul Cinciripini
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Robert J. Volk
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Maria E. Suarez-Almazor
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
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Anghel D, Petrache O, Groseanu M, Sirbu CA, Opris Belinski D, Ionita Radu F. The assessment of the cardiovascular risk in rheumatoid arthritis patients on anti TNF therapy. ROMANIAN JOURNAL OF MILITARY MEDICINE 2022. [DOI: 10.55453/rjmm.2022.125.3.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Auto-immune rheumatic diseases are characterised by high levels of inflammation that accelerate the development of atherosclerosis, increasing the cardiovascular risk. Direct evaluation of arteries such as of intima media thickness measurement is a simple test that asesses the cerebral and cardiovascular risk. In the initial stages, an increase of the intimal media thickness can be observed. Later on, atherosclerosis (plaques), stenosis and occlusion of the arteries can be identified. Indirect evaluation of the cardiovascular risk can be performed using serological markers - fibrinogen, C reactive protein, estimated sedimentation rate, total cholesterol, low density lipoproteins and high density lipoproteins, homocysteine levels etc. The presence of certain lifestyle factors that increase the risk, such as smoking, sedentarism and associated pathologies such as obesity, diabetes, hypertension were assesed in patients with rheumatoid arthritis. The aim of the study is to prove the relationship between anti-tumor necrosis factor alpha therapy effect on the cardiovascular risk in rheumatoid arthritis patients
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Kim SY, Oh Y, Jo S, Ji JD, Kim TH. Inhibition of Human Osteoclast Differentiation by Kynurenine through the Aryl-Hydrocarbon Receptor Pathway. Cells 2021; 10:3498. [PMID: 34944003 PMCID: PMC8700497 DOI: 10.3390/cells10123498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/22/2021] [Accepted: 12/07/2021] [Indexed: 02/06/2023] Open
Abstract
Aryl-hydrocarbon receptor (AhR) is a ligand-activated transcription factor and regulates differentiation and function of various immune cells such as dendritic cells, Th17, and regulatory T cells. In recent studies, it was reported that AhR is involved in bone remodeling through regulating both osteoblasts and osteoclasts. However, the roles and mechanisms of AhR activation in human osteoclasts remain unknown. Here we show that AhR is involved in human osteoclast differentiation. We found that AhR expressed highly in the early stage of osteoclastogenesis and decreased in mature osteoclasts. Kynurenine (Kyn), formylindolo[3,4-b] carbazole (FICZ), and benzopyrene (BaP), which are AhR agonists, inhibited osteoclast formation and Kyn suppressed osteoclast differentiation at an early stage. Furthermore, blockade of AhR signaling through CH223191, an AhR antagonist, and knockdown of AhR expression reversed Kyn-induced inhibition of osteoclast differentiation. Overall, our study is the first report that AhR negatively regulates human osteoclast differentiation and suggests that AhR could be good therapeutic molecule to prevent bone destruction in chronic inflammatory diseases such as rheumatoid arthritis (RA).
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Affiliation(s)
- So-Yeon Kim
- Institute for Rheumatology Research, Hanyang University, Seoul 04763, Korea; (S.-Y.K.); (Y.O.); (S.J.)
- Department of Translational Medicine, Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul 04763, Korea
| | - Younseo Oh
- Institute for Rheumatology Research, Hanyang University, Seoul 04763, Korea; (S.-Y.K.); (Y.O.); (S.J.)
- Department of Rheumatology, College of Medicine, Korea University, Seoul 02841, Korea
| | - Sungsin Jo
- Institute for Rheumatology Research, Hanyang University, Seoul 04763, Korea; (S.-Y.K.); (Y.O.); (S.J.)
| | - Jong-Dae Ji
- Department of Rheumatology, College of Medicine, Korea University, Seoul 02841, Korea
| | - Tae-Hwan Kim
- Institute for Rheumatology Research, Hanyang University, Seoul 04763, Korea; (S.-Y.K.); (Y.O.); (S.J.)
- Department of Translational Medicine, Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul 04763, Korea
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul 04763, Korea
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