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Li W, Guan X, Wang Y, Lv Y, Wu Y, Yu M, Sun Y. Cuproptosis-related gene identification and immune infiltration analysis in systemic lupus erythematosus. Front Immunol 2023; 14:1157196. [PMID: 37313407 PMCID: PMC10258330 DOI: 10.3389/fimmu.2023.1157196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/17/2023] [Indexed: 06/15/2023] Open
Abstract
Background Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by loss of tolerance to self-antigen, autoantibody production, and abnormal immune response. Cuproptosis is a recently reported cell death form correlated with the initiation and development of multiple diseases. This study intended to probe cuproptosis-related molecular clusters in SLE and constructed a predictive model. Methods We analyzed the expression profile and immune features of cuproptosis-related genes (CRGs) in SLE based on GSE61635 and GSE50772 datasets and identified core module genes associated with SLE occurrence using the weighted correlation network analysis (WGCNA). We selected the optimal machine-learning model by comparing the random forest (RF) model, support vector machine (SVM) model, generalized linear model (GLM), and the extreme gradient boosting (XGB) model. The predictive performance of the model was validated by nomogram, calibration curve, decision curve analysis (DCA), and external dataset GSE72326. Subsequently, a CeRNA network based on 5 core diagnostic markers was established. Drugs targeting core diagnostic markers were acquired using the CTD database, and Autodock vina software was employed to perform molecular docking. Results Blue module genes identified using WGCNA were highly related to SLE initiation. Among the four machine-learning models, the SVM model presented the best discriminative performance with relatively low residual and root-mean-square error (RMSE) and high area under the curve (AUC = 0.998). An SVM model was constructed based on 5 genes and performed favorably in the GSE72326 dataset for validation (AUC = 0.943). The nomogram, calibration curve, and DCA validated the predictive accuracy of the model for SLE as well. The CeRNA regulatory network includes 166 nodes (5 core diagnostic markers, 61 miRNAs, and 100 lncRNAs) and 175 lines. Drug detection showed that D00156 (Benzo (a) pyrene), D016604 (Aflatoxin B1), D014212 (Tretinoin), and D009532 (Nickel) could simultaneously act on the 5 core diagnostic markers. Conclusion We revealed the correlation between CRGs and immune cell infiltration in SLE patients. The SVM model using 5 genes was selected as the optimal machine learning model to accurately evaluate SLE patients. A CeRNA network based on 5 core diagnostic markers was constructed. Drugs targeting core diagnostic markers were retrieved with molecular docking performed.
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Affiliation(s)
- Wuquan Li
- College of Pharmacy, Binzhou Medical University, Yantai, China
| | - Xiaoran Guan
- College of Pharmacy, Binzhou Medical University, Yantai, China
| | - Yong Wang
- College of Pharmacy, Binzhou Medical University, Yantai, China
| | - Yan Lv
- College of Life Science, Yantai University, Yantai, China
| | - Yuyong Wu
- College of Pharmacy, Binzhou Medical University, Yantai, China
| | - Min Yu
- College of Pharmacy, Binzhou Medical University, Yantai, China
| | - Yeying Sun
- College of Pharmacy, Binzhou Medical University, Yantai, China
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Kósa F, Kunovszki P, Gimesi-Országh J, Kedves M, Szabó M, Karyekar CS, Nagy G. High risk of depression, anxiety, and an unfavorable complex comorbidity profile is associated with SLE: a nationwide patient-level study. Arthritis Res Ther 2022; 24:116. [PMID: 35590393 PMCID: PMC9118724 DOI: 10.1186/s13075-022-02799-6] [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: 11/15/2021] [Accepted: 05/07/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives The aim of this national population-based, retrospective database study is to compare the comorbidity profiles of systemic lupus erythematosus (SLE) patients and general population controls matched for age, gender, and region and assess the risk of depression or anxiety when controlled for age, gender and adjusted for the Charlson Comorbidity Index (CCI). Methods Claims data of 1051 patients diagnosed with SLE (full population between January 01, 2011, and December 31, 2014) from the Hungarian National Health Insurance Fund have been analyzed against matched controls (1:5 ratio) with a follow-up of 30 months. The first record of SLE diagnosis was considered the diagnosis date. The odds ratio (OR) and 99.9% confidence interval (CI) of having depression or anxiety among patients with SLE vs. controls have been assessed using logistic regression models. Results SLE patients report more comorbidities than the matched general population both in pre- and post-index periods (mean CCI 1.79 vs. 1.15 and 2.78 vs. 1.22 [both p<0.001], respectively). Both SLE patients and controls diagnosed with depression or anxiety had significantly higher CCI than those without comorbid depression or anxiety (p<0.001). However, SLE patients had a twofold higher risk of depression or anxiety than matched controls when controlled for age, gender, and adjusted for CCI. Conclusion Our analysis indicates the enormity of comorbidity burden in SLE, especially that of anxiety and depression. The size and complexity of the comorbidity burden emphasizes the importance of early diagnosis and intervention with comprehensive modalities incorporating attention to comorbidities in SLE patients. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-022-02799-6.
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Affiliation(s)
| | | | | | - Melinda Kedves
- Department of Rheumatology, Hospital of Bács-Kiskun County, Kecskemét, Hungary
| | - Melinda Szabó
- New Saint John Hospital and Outpatient Clinic, Budapest, Hungary
| | | | - György Nagy
- Department of Rheumatology and Clinical Immunology, Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary.,Heart and Vascular Center, Semmelweis University, Budapest, Hungary.,Department of Genetics, Cell- and Immunobiology, Semmelweis University, Budapest, Hungary
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Han Y, Kang L, Liu X, Zhuang Y, Chen X, Li X. Establishment and validation of a logistic regression model for prediction of septic shock severity in children. Hereditas 2021; 158:45. [PMID: 34772470 PMCID: PMC8588704 DOI: 10.1186/s41065-021-00206-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background Septic shock is the most severe complication of sepsis, and is a major cause of childhood mortality, constituting a heavy public health burden. Methods We analyzed the gene expression profiles of septic shock and control samples from the Gene Expression Omnibus (GEO). Four differentially expressed genes (DEGs) from survivor and control groups, non-survivor and control groups, and survivor and non-survivor groups were selected. We used data about these genes to establish a logistic regression model for predicting the survival of septic shock patients. Results Leave-one-out cross validation and receiver operating characteristic (ROC) analysis indicated that this model had good accuracy. Differential expression and Gene Set Enrichment Analysis (GSEA) between septic shock patients stratified by prediction score indicated that the systemic lupus erythematosus pathway was activated, while the limonene and pinene degradation pathways were inactivated in the high score group. Conclusions Our study provides a novel approach for the prediction of the severity of pathology in septic shock patients, which are significant for personalized treatment as well as prognostic assessment. Supplementary Information The online version contains supplementary material available at 10.1186/s41065-021-00206-9.
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Affiliation(s)
- Yujie Han
- Department of Neonatal, Qilu Children's Hospital of Shandong University, No. 23976, Huaiyin District, Jinan City, 250022, Shandong, People's Republic of China
| | - Lili Kang
- Department of Neonatal, Qilu Children's Hospital of Shandong University, No. 23976, Huaiyin District, Jinan City, 250022, Shandong, People's Republic of China
| | - Xianghong Liu
- Department of Neonatal, Qilu Children's Hospital of Shandong University, No. 23976, Huaiyin District, Jinan City, 250022, Shandong, People's Republic of China
| | - Yuanhua Zhuang
- Department of Neonatal, Qilu Children's Hospital of Shandong University, No. 23976, Huaiyin District, Jinan City, 250022, Shandong, People's Republic of China
| | - Xiao Chen
- Department of Neonatal, Qilu Children's Hospital of Shandong University, No. 23976, Huaiyin District, Jinan City, 250022, Shandong, People's Republic of China
| | - Xiaoying Li
- Department of Neonatal, Qilu Children's Hospital of Shandong University, No. 23976, Huaiyin District, Jinan City, 250022, Shandong, People's Republic of China.
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Meng X, Wang Q, Wu S, Pu D, Zhang A, Fang S, Zhou X, Lu H. Pharmacokinetics and Safety of Intravenous and Subcutaneous Auto-injector Single-dose Belimumab in Healthy Chinese Volunteers: A phase 1, Randomized, Open-label Study. Rheumatol Ther 2021; 8:1711-1724. [PMID: 34554352 PMCID: PMC8572285 DOI: 10.1007/s40744-021-00366-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/25/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Belimumab is a recombinant human immunoglobulin G1λ monoclonal antibody indicated as an intravenous (IV) 10 mg/kg and subcutaneous (SC) 200-mg dose for the treatment of systemic lupus erythematosus (SLE). Belimumab 10 mg/kg IV has been approved for the treatment of patients with SLE in China. This phase 1 study investigated the pharmacokinetics (PK), safety, and tolerability of belimumab 200 mg SC and the approved IV formulation in a healthy Chinese population. Methods This was a 13-week open-label, randomized, parallel-group study in healthy Chinese volunteers. Eligible volunteers were randomized (1:2) to receive a single dose of IV or SC (via auto-injector) belimumab 200 mg. PK and safety endpoints were evaluated using descriptive statistics. Results Thirty-six healthy Chinese volunteers were enrolled and all completed the study. Concentration–time profiles were as expected for both formulations. Overall, 130 adverse events (AEs) were reported, with 28 AEs reported in 11 (91.7%) volunteers in the IV group and 102 AEs in 24 (100%) volunteers in the SC group. Of the 130 AEs, 104 (80.0%) were considered to be treatment-related (27 [20.8% of total AEs] treatment-related AEs in the IV group; 77 [59.2% of total AEs] in the SC group). Although the occurrence of AEs was higher in the SC group, most volunteers (91.7%) experienced AEs of mild intensity. The most frequently reported AEs included injection site pain (n = 19 [79.2%]) and oropharyngeal pain (n = 5 [20.8%]) in the SC group, and positive bacterial test, upper respiratory tract infection, blood uric acid increase, white blood cell count increase, asthenia, and diarrhea (n = 2 [16.7%], each) in the IV group. Conclusions PK profiles of 200 mg SC and IV belimumab administrations were similar to previous studies, and safety profiles were acceptable, supporting the use of the SC dose in Chinese patients with SLE. Trial registration NCT04136145. Supplementary Information The online version contains supplementary material available at 10.1007/s40744-021-00366-0. Systemic lupus erythematosus (SLE) is a long-term autoimmune disease that affects patients’ quality of life. Belimumab is an antibody used in several countries in combination with standard therapy to treat patients with SLE. Belimumab can be given monthly either via a vein (intravenous, IV) or weekly under the skin (subcutaneous, SC). In China, only the IV belimumab has been approved for the treatment of patients with SLE. Therefore, we carried out a study in healthy Chinese volunteers to compare the concentration of a single dose of IV or SC belimumab in the body over time, and to investigate the safety of SC belimumab to assist its approval in China. In our study, the concentration and safety of both administration methods were similar; however, more volunteers from the SC treatment group had urinalysis-related side effects compared with the IV treatment group. All of these side effects were of mild intensity and did not require treatment. These results suggest that SC belimumab could be used for the treatment of Chinese patients with SLE.
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Affiliation(s)
- Xianmin Meng
- Department of Pharmacy, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Qianqian Wang
- Department of Internal Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | | | - Di Pu
- R&D, GlaxoSmithKline, Shanghai, China
| | | | - Sun Fang
- R&D, GlaxoSmithKline, Shanghai, China
| | - Xuan Zhou
- Clinical Pharmacology Modelling and Simulation, GlaxoSmithKline, Shanghai, China
| | - Hongzhou Lu
- Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Rd, Jinshan District, Shanghai, China.
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Zhou A, Mao K, Liu G, Li J, Lin X. lncRNA MALAT-1 Predicts Prognosis of Patients with Systemic Lupus Erythematosus. AKTUEL RHEUMATOL 2021. [DOI: 10.1055/a-1527-1197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Abstract
Objective To evaluate the association of MALAT-1 and the prognosis of patients with systemic lupus erythematosus (SLE).
Materials and Methods A total of 87 SLE patients and 50 healthy controls were recruited. The expression levels of MALAT-1 were measured by quantitative PCR at baseline. Multivariate Cox regression analysis was performed to assess the association of MALAT-1 levels with survival after adjusting for potential confounding factors.
Results The MALAT-1 levels in patients with SLE were significantly higher compared with healthy controls (p<0.01). The 10-year survival of patients with a higher MALAT-1 level was significantly lower than that of patients with a lower MALAT-1 level (HR=5.54; 95% CI: 1.49–20.55; p=0.01). Multivariate Cox regression indicated that the MALAT-1 level was significantly associated with a risk of mortality (HR=10.02, 95% CI: 1.14–88.14, p=0.04).
Conclusion The expression levels of MALAT-1 may be a promising biomarker for evaluating the prognosis of SLE patients.
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Affiliation(s)
- Aihong Zhou
- Department of Rheumatology immunology, The Second Affiliated Hospital of Shandong First Medical University, Tai’an, China
| | - Kunyun Mao
- Department of Nephrology and Rheumatology, Dongping County People Hospital of Tai’an, Dongping, China
| | - Guoqiang Liu
- Department of Emergency, The Central Hospital of Tai’an, Tai’an, China
| | - Jun Li
- Department of Emergency, Coal Taishan sanatorium of Shandong Province (Shandong Tai’an Coal Mine Hospital), Dongping, China
| | - Xia Lin
- Department of Nephrology and Rheumatology, Dongping County People Hospital of Tai’an, Dongping, China
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Fatoye F, Gebrye T, Svenson LW. Direct health system costs for systemic lupus erythematosus patients in Alberta, Canada. PLoS One 2021; 16:e0251409. [PMID: 33961687 PMCID: PMC8104382 DOI: 10.1371/journal.pone.0251409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/26/2021] [Indexed: 11/18/2022] Open
Abstract
Systemic lupus Erythematosus (SLE) is a chronic multi-system autoimmune disease that can affect a person's physical, mental, and social life. It imposes a substantial economic burden up on patients, carers, healthcare systems, and wider society. This is the first study to examine the direct health care costs of SLE in Alberta using real-world data. Alberta maintains a publicly funded, universally available health care system. Health service use and direct healthcare costs of SLE and non-SLE cases were determined from inpatient hospital services, fee-for-physician services, emergency services, and ambulatory care services. All costs were estimated for calendar year 2016. Data were analysed using central measures specifically the mean to determine the annual costs of SLE and non-SLE. A total number of 10,932 (Male = 2,546; Female = 8,386), and 41,851,36 (Male = 21,157,76; Female = 20,693,60) of SLE and non-SLE cases, respectively were included in this study. The mean annual costs of SLE, and non-SLE per case were $7,740.19 (Male = $7,986.59; Female = $7,665.38), and $2,479.53 (Male = $2,265.57; Female = $2,698.30), (p < 0.001) respectively. The mean annual costs of fee-for-physician services (SLE = $2,160.03; non-SLE = $840.00) (p < 0.001), inpatient hospital services (SLE = $3,462.86; non-SLE = $1,007.29), (p < 0.001) emergency services (SLE = $440.28; non-SLE = $176.65), (p < 0.001) and ambulatory care services (SLE = $1,677.03; non-SLE = $455.05) (p < 0.001) per case were estimated. The findings showed that the costs of SLE were considerably high for patients and healthcare system. This highlights the importance of appropriate treatment and management of SLE. Further studies are required to fully investigate both the direct and indirect economic burden of SLE including out-of-pocket expenses, costs to patients and caregivers and productivity loss.
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Affiliation(s)
- Francis Fatoye
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
- * E-mail:
| | - Tadesse Gebrye
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Lawrence W. Svenson
- Analytics and Performance Reporting Branch, Alberta Health, Edmonton, Canada
- Division of Preventive Medicine, University of Alberta, Edmonton, Canada
- School of Public Health, University of Alberta, Edmonton, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
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Zhang Q, Liang Y, Yuan H, Li S, Wang JB, Li XM, Tao JH, Pan HF, Ye DQ. Integrated analysis of lncRNA, miRNA and mRNA expression profiling in patients with systemic lupus erythematosus. Arch Med Sci 2019; 15:872-879. [PMID: 31360182 PMCID: PMC6657242 DOI: 10.5114/aoms.2018.79145] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 09/11/2018] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION A great deal of research has reported dysregulated expression of genes in systemic lupus erythematosus (SLE). This study aimed to analyze the lncRNA, miRNA and mRNA expression profile in SLE. MATERIAL AND METHODS RNA sequencing (RNA-seq) was used to detect the dysregulated RNAs in SLE. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways analysis were used to explore the function of these differentially expressed RNAs. RESULTS 2,353 lncRNAs, 827 mRNAs and 24 miRNAs were shown to be differentially expressed. GO analyses demonstrated that differentially expressed RNAs were enriched in a variety of molecular functions and biological processes including ribonucleotide, protein serine/threonine kinase activity function, regulation of B cell differentiation and others. KEGG pathway analyses revealed that differentially expressed mRNAs and lncRNAs were both enriched in FcγR-mediated phagocytosis, glycosaminoglycan biosynthesis-chondroitin sulfate/dermatan sulfate and glyoxylate and dicarboxylate metabolism pathways. The up-regulated miRNAs target genes were mainly enriched in the nuclear factor-κB (NF-κB) signaling pathway. The down-regulated miRNAs target genes were significantly enriched in metabolism of xenobiotics by cytochrome P450, bile secretion and terpenoid backbone biosynthesis pathways. CONCLUSIONS The current study reveals a comprehensive expression profile of lncRNAs, miRNAs and mRNAs and implies potential regulatory functions of these RNAs which are involved in the pathogenesis of SLE.
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Affiliation(s)
- Qin Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, China
| | - Yan Liang
- Department of Nephrology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Hui Yuan
- Department of Preventive Medicine, Wannan Medical College, Wuhu, Anhui, China
| | - Si Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, China
| | - Jie-Bing Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, China
| | - Xiao-Mei Li
- Department of Rheumatology and Immunology, Anhui Provincial Hospital, Hefei, Anhui, China
| | - Jin-Hui Tao
- Department of Rheumatology and Immunology, Anhui Provincial Hospital, Hefei, Anhui, China
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, China
| | - Dong-Qing Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, China
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Greenstein L, Makan K, Tikly M. Burden of comorbidities in South Africans with systemic lupus erythematosus. Clin Rheumatol 2019; 38:2077-2082. [PMID: 30963335 DOI: 10.1007/s10067-019-04511-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/28/2019] [Accepted: 02/10/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION To investigate the prevalence and spectrum of comorbidities in South Africans with systemic lupus erythematosus (SLE). PATIENTS AND METHODS A nested case-control study of a known alive group (AG) and deceased group (DG) of 200 and 40 patients, respectively, matched for age and sex, attending a tertiary Lupus Clinic. Comorbidities that were documented included, but not restricted to, those listed in the Charlson comorbidity index (CCI). Lupus disease severity was assessed using the lupus severity index (LSI). RESULTS Patients were mainly black female (94%), and the median age (IQR) and median disease duration (IQR) were 33 (25-42) and 6 (3-11) years, respectively. Overall, 191 (79.5%) patients experienced ≥ 1 comorbidities. The median (IQR) LSI and CCI scores were significantly higher in the DG than the AG (8.5 (6.7-9.1) vs 6.3 (5.2-8.3), p < 0.001 and 1 (1-3) vs 0 (0-2), p = 0.002, respectively). The commonest comorbidities were hypertension (42%), serious infections (36.6%) and tuberculosis (TB) (18.8%), the latter two being significantly more common in the DG (OR = 7.34, p < 0.0001 and OR = 3.40, p = 0.001, respectively). Of the CCI comorbidities, congestive cardiac failure (OR = 10.39, p = 0.0003), cerebrovascular disease (OR = 7.29, p = 0.01) and chronic kidney disease (OR = 3.08, p = 0.02) were more common in the DG. Both serious infections and TB were independent predictors of death. CONCLUSION In this study of predominantly black South African SLE patients, comorbidities were common, with serious infections and TB amongst the commonest comorbidities. Unlike in industrialised Caucasian populations, cardiovascular comorbidities were rare in spite of a high prevalence of HPT.
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Affiliation(s)
- L Greenstein
- Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - K Makan
- Division of Rheumatology, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, P.O. Bertsham, Johannesburg, 2013, South Africa
| | - Mohammed Tikly
- Division of Rheumatology, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, P.O. Bertsham, Johannesburg, 2013, South Africa.
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Calik Basaran N, Ascioglu S. Epidemiology and management of healthcare-associated bloodstream infections in non-neutropenic immunosuppressed patients: a review of the literature. Ther Adv Infect Dis 2017; 4:171-191. [PMID: 29662673 DOI: 10.1177/2049936117733394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Advancements in medicine have led to a considerable increase in the proportion of patients living with severe chronic diseases, malignancies, and HIV infections. Most of these conditions are associated with acquired immune-deficient states and treatment-related immunosuppression. Although infections as a result of neutropenia have long been recognized and strategies for management were developed, non-neutropenic immunosuppression has been overlooked. Recently, community-acquired infections in patients with frequent, significant exposure to healthcare settings and procedures have been classified as 'healthcare-associated infections' since they are more similar to hospital-acquired infections. Most of the non-neutropenic immunosuppressed patients have frequent contact with the healthcare system due to their chronic and severe diseases. In this review, we focus on the healthcare-associated bloodstream infections in the most common non-neutropenic immunosuppressive states and provide an update of the recent evidence for the management of these infections.
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Affiliation(s)
- Nursel Calik Basaran
- Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Sibel Ascioglu
- Department of Infectious Diseases and Microbiology, Hacettepe University Medical School, Ankara, Turkey; GlaxoSmithKline Pte Ltd., Singapore
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Yildiz CE, Conkbayir C, Tolgay HE, Ceviker K, Canikoglu M, Sayin OA, Ugurlucan M. Successful treatment of a 20-year nonhealing venous leg ulcer in a patient with systemic lupus erythematosus. Arch Med Sci 2017; 13:691-695. [PMID: 28507589 PMCID: PMC5420642 DOI: 10.5114/aoms.2017.67289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 07/20/2016] [Indexed: 11/17/2022] Open
Affiliation(s)
- Cenk Eray Yildiz
- Department of Cardiovascular Surgery, Institute of Cardiology, Istanbul University, Istanbul, Turkey
| | - Cenk Conkbayir
- Department of Cardiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Halil Erkam Tolgay
- Department of Cardiovascular Surgery, Institute of Cardiology, Istanbul University, Istanbul, Turkey
| | - Kadir Ceviker
- Department of Cardiovascular Surgery, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Mustafa Canikoglu
- Department of Cardiovascular Surgery, Private Clinic, Izmit, Kocaeli, Turkey
| | - Omer Ali Sayin
- Department of Cardiovascular Surgery, Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Murat Ugurlucan
- Department of Cardiovascular Surgery, Medical Faculty, Istanbul University, Istanbul, Turkey
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Medical costs incurred by organ damage caused by active disease, comorbidities and side effect of treatments in systemic lupus erythematosus patients: a Taiwan nationwide population-based study. Rheumatol Int 2016; 36:1507-1514. [DOI: 10.1007/s00296-016-3551-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 08/08/2016] [Indexed: 10/21/2022]
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Yang Y, Thumboo J, Earnest A, Yong SL, Fong KY. The effect of comorbidity on hospital mortality in patients with SLE from an Asian tertiary hospital. Lupus 2014; 23:714-20. [DOI: 10.1177/0961203314522340] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 01/08/2014] [Indexed: 01/04/2023]
Abstract
Objectives The objective of the study was to assess the disease burden of systemic lupus erythematosus (SLE) and the usefulness of the Charlson Comorbidity Index (CCI) as risk-adjusted hospital mortality predictors in patients with SLE using a hospital administrative database. Methods A historical cohort study of a hospital discharge database from 2004 to 2011 was used to identify cases with SLE and comorbidity using the International Statistical Classification of Diseases and Related Health Problems, ninth revision, Australian modification (ICD-9-AM) codes. Results Over the eight years, 841 patients met the criteria of SLE with a hospital mortality rate of 9.2%. The hospital mortality rates (2.4%, 15.7%, 25.0%, and 30.4%, respectively, p < 0.001) and hospital length of stay (geometric mean, 3.5, 5.6, 8.8, and 7.5 days, respectively, p < 0.001) were consistently increased for patients with CCI ranging from none, low, moderate to high grade, respectively. Cox proportional hazards model analysis showed that CCI (hazard ratio (HR) 7.8 high vs. none, p < 0.001) and infectious disease (HR 2.0, p = 0.016) were significant and independent predictors of hospital mortality. Similar results were also seen with hospital length of stay by zero-truncated negative binomial regression model analysis. Conclusion The SLE burden is high in this population. Comorbidities and infectious disease were some of the most important contributors to hospital mortality and resource utilization.
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Affiliation(s)
- Y Yang
- Department of Epidemiology, Medical Board, Singapore General Hospital, Singapore
- Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore
| | - J Thumboo
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore
- Duke-NUS Graduate Medical School, Singapore
| | - A Earnest
- Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore
| | - SL Yong
- Medical Board, Singapore General Hospital, Singapore
| | - KY Fong
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore
- Duke-NUS Graduate Medical School, Singapore
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