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Avagimyan A, Fogacci F, Pogosova N, Kakturskiy L, Jndoyan Z, Faggiano A, Bairamyan T, Agati L, Sattar Y, Mkrchyan L, Avetisyan G, Ginosyan K, Aznauryan A, Sahakyan K, Trofimenko A, Urazova O, Mikhaleva L, Vandysheva R, Kogan E, Demura T, Kc M, Shafie D, Nicola S, Brussino L, Cicero A, Biondi-Zoccai G, Sarrafzadegan N. Methotrexate & rheumatoid arthritis associated atherosclerosis: A narrative review of multidisciplinary approach for risk modification by the international board of experts. Curr Probl Cardiol 2024; 49:102230. [PMID: 38040221 DOI: 10.1016/j.cpcardiol.2023.102230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 11/28/2023] [Indexed: 12/03/2023]
Abstract
Rheumatoid arthritis (RA) is an idiopathic, autoimmune connective tissue disorder that primarily affects the synovial joints, causing symmetric, erosive-deforming polyarthritis. It is also associated with extra-articular manifestations, particularly cardiovascular (CV) diseases (CVD). CV risk modification in RA remains unsolved despite recent advances in the management of RA. RA is an independent risk factor for atherosclerosis. RA and atherosclerosis share similar pathophysiological features (such as the pro-inflammatory cascade activation including interleukin-6) and risk factors (such as microflora dysbacteriosis and smoking). Patients with RA experience an exacerbation of atherogenesis, with atheromas destabilization, endothelial dysfunction, vasculitis, and hypercytokinemia. Consequently, the inflammatory response associated with RA is the basis for CVD development. The treat-to-target strategy not only improved RA control but also had a favorable effect on the morpho-functional state of the CV system in patients living with RA. Thus, disease-modifying antirheumatic drugs (DMARDs) - in particular methotrexate - may have a beneficial effect on the prevention of CV events in RA. It must be mentioned that RA is a serious multi-system disease, not only because of a window period during which the course of RA can be reversed, but also due to early damage to the heart and blood vessels. For this reason, a thorough cardiological assessment must be performed for all patients with RA, regardless of sex, age, disease stage, and disease activity score.
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Affiliation(s)
- Ashot Avagimyan
- MD, PhD, Assistant Professor, Department of Anatomical Pathology and Clinical Morphology, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia.
| | - Federica Fogacci
- MD, Research Fellow, Atherosclerosis and Metabolic Disorders Research Unit, University of Bologna, Bologna, Italy
| | - Nana Pogosova
- MD, PhD, Professor, Head of Laboratory of Preventive Cardiology, Deputy Director for Science and Preventive Cardiology, National Medical Research Center of Cardiology named after academician E. Chazov, Moscow, Russia
| | - Lev Kakturskiy
- MD, Ph.D, Scientific Director, A. P. Avtsyn Research Institute of Human Morphology of Petrovskiy NRCS, Moscow, Russia
| | - Zinaida Jndoyan
- MD, PhD, Head of Internal Diseases Propaedeutic Department, Head of Internal Medicine Unit of University Clinical Hospital, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Andrea Faggiano
- MD, PhD, Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Italy; Department of Clinical Sciences and Community Health, University of Milano, Italy
| | - Tamara Bairamyan
- MD, PhD, Associate Professor, Department of Rheumatology, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Luciano Agati
- MD, PhD, Head of Cardiology Unit Aziendo Umberto II, Department of Cardiology, La Sapienza University of Rome, Rome, Italy
| | - Yasar Sattar
- MD, Department of Cardiology, West Virginia University, Morgantown, WV, USA
| | - Lusine Mkrchyan
- MD, PhD, Associate Professor, Department of Cardiology, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Gayane Avetisyan
- MD, PhD, Associate Professor, Department of Topographical Anatomy and Operative Surgery, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Knarik Ginosyan
- MD, PhD, Head of Rheumatology Department, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Anahit Aznauryan
- PhD, Associate Professor, Histology Department, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Karmen Sahakyan
- PhD, Professor, Head of Histology Department, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Artem Trofimenko
- MD, PhD, Associate Professor, Department of Pathophysiology, Kuban State Medical University, Krasnodar, Russia
| | - Olga Urazova
- MD, PhD, Professor, Head of Pathophysiology Department, Siberian State Medical University, Tomsk, Russia
| | - Liudmila Mikhaleva
- MD, PhD, Director, A. P. Avtsyn Research Institute of Human Morphology of Petrovskiy NRCS, Moscow, Russia
| | - Rositsa Vandysheva
- MD, PhD, A. P. Avtsyn Research Institute of Human Morphology of Petrovskiy NRCS, Moscow, Russia
| | - Eugenia Kogan
- MD, PhD, Professor, Head of Anatomical Pathology Department, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Tatiana Demura
- MD, PhD, Professor, Director of Institute of Clinical Morphology and Digital Pathology, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Manish Kc
- MD, North Alabama Medical Centre, Florence, Alabama, USA
| | - Davood Shafie
- MD, PhD, Director of Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Stefania Nicola
- MD, PhD, Immunology and Allergy Unit, AO Ordine Mauriziano di Torino and Department of Medical Sciences, University of Turin, Italy
| | - Luisa Brussino
- MD, PhD, Director of the Allergy and Immunology unit AO Ordine Mauriziano di Torino - Department of Medical Sciences, University of Turin, Italy
| | - Arrigo Cicero
- MD, PhD, Professor, Atherosclerosis and Metabolic Disorders Research Unit, University of Bologna, Bologna, Italy
| | - Giuseppe Biondi-Zoccai
- MD, PhD, Professor, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Mediterranea Cardiocentro, Napoli, Italy
| | - Nizal Sarrafzadegan
- MD, Professor, Director of Isfahan Cardiovascular Research Center (WHO Collaboration Center), Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Al-Ewaidat OA, Naffaa MM. Stroke risk in rheumatoid arthritis patients: exploring connections and implications for patient care. Clin Exp Med 2024; 24:30. [PMID: 38294723 PMCID: PMC10830780 DOI: 10.1007/s10238-023-01288-7] [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: 09/17/2023] [Accepted: 11/04/2023] [Indexed: 02/01/2024]
Abstract
Rheumatoid arthritis (RA) can independently increase the risk of stroke, affecting both young and adult RA patients. Recent attention has been drawn to the association between stroke and RA, supported by mounting evidence. Given that stroke is a significant and an urgent public health concern, this review aims to highlight the relationship between stroke and RA, covering mechanisms, underlying risk factors, early detection tools, and treatment implications. By uncovering the connection that links RA to stroke, we can pave the way for targeted healthcare practices and the development of preventive strategies for individuals with RA. Therefore, further research is imperative to deepen our understanding of this association and, ideally, guide treatment decisions for individuals at risk of both RA and stroke.
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Affiliation(s)
- Ola A Al-Ewaidat
- Department of Internal Medicine, Ascension Saint Francis Hospital, Evanston, IL, 60202, USA
| | - Moawiah M Naffaa
- Department of Psychology and Neuroscience, Duke University, Durham, NC, 27708, USA.
- Department of Cell Biology, Duke University School of Medicine, Durham, NC, 27710, USA.
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Arafat MAM, Khalil MNA, Mohamed OG, Abd El-Ghafar OAM, Tripathi A, Mahrous EA, Abd El-Kader EM, El-Hawary S. Vetiver aerial parts and roots ameliorate rheumatoid arthritis in complete Freund's adjuvant rat model, a phytochemical profiling and mechanistic study. JOURNAL OF ETHNOPHARMACOLOGY 2023; 317:116764. [PMID: 37315650 DOI: 10.1016/j.jep.2023.116764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 06/16/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Vetiver (Chrysopogon zizanioides) is indigenous to India where it is traditionally used to relief rheumatisms, lumbagos and sprains. Vetiver anti-inflammatory activity has not been previously investigated, and its specific interactions with body inflammation cascade remain largely unknown. AIM OF THE STUDY The present work was performed to validate the ethnobotanical use of the plant and compare the anti-inflammatory activities of the ethanolic extracts of the most traditionally used part (aerial part) to that of the root. Furthermore, we attempt to reveal the molecular mechanism of this anti-inflammatory activity in correlation to the chemical composition of C. zizanioides aerial (CA) and root parts (CR). MATERIALS AND METHODS Ultraperformance liquid chromatography coupled to high resolution mass spectrometry (UHPLC/HRMS) was used for comprehensive analysis of both CA and CR. The anti-inflammatory effect of both extracts was evaluated in complete Freund's adjuvant (CFA)-induced RA model in Wistar rats. RESULTS Phenolic metabolites were predominant in CA and 42 were identified for the first time, while only 13 were identified in CR. Meanwhile, triterpenes and sesquiterpenes were confined to the root extract. In CFA arthritis model, CA showed better anti-inflammatory activity than CR marked by an increase in serum level of IL-10 with simultaneous decrease in pro-inflammatory markers; IL-6, ACPA and TNF-α and was evident in histopathological examination. This anti-inflammatory effect was accompanied by down-regulation of JAK2/STAT3/SOCs3, ERK1/ERK2, TRAF6/c-FOS/NFATC1, TRAF6/NF-κB/NFATC1 and RANKL pathways which were all upregulated after CFA injection. These pathways were modulated to larger extent by CA, except for ERK1/ERK2 which was downregulated more effectively by CR. This differential effect between CA and CR can be explained by the variability in their phytoconstituents profile. CONCLUSION In agreement with the ethnobotanical preference, CA extract was more effective than CR extract in reducing the symptoms of RA probably due to its enrichment with flavonoids, lignans, and flavolignans. Both CA and CR reduced the production of inflammatory cytokines through modulating various biological signaling pathways. These findings support the traditional use of vetiver leaves as a remedy for RA and suggest that the use of the whole plant may offer advantage by synergistically affecting more inflammatory pathways.
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Affiliation(s)
- Mahmoud A M Arafat
- Pharmacognosy Department, Faculty of Pharmacy, Heliopolis University, 11361, Egypt.
| | - Mohammed N A Khalil
- Pharmacognosy Department, Faculty of Pharmacy, Cairo University, Kasr El Aini St., Cairo, 11562, Egypt
| | - Osama G Mohamed
- Pharmacognosy Department, Faculty of Pharmacy, Cairo University, Kasr El Aini St., Cairo, 11562, Egypt; Natural Products Discovery Core, Life Sciences Institute, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Omnia A M Abd El-Ghafar
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Nahda University, Beni-sueif, Egypt
| | - Ashootosh Tripathi
- Natural Products Discovery Core, Life Sciences Institute, University of Michigan, Ann Arbor, MI, 48109, USA; Department of Medicinal Chemistry, College of Pharmacy, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Engy A Mahrous
- Pharmacognosy Department, Faculty of Pharmacy, Cairo University, Kasr El Aini St., Cairo, 11562, Egypt; Pharmacognosy Department, Faculty of Pharmacy, Ahram Canadian University, 6th of October City, Giza, Egypt
| | - Essam M Abd El-Kader
- Timber Tree Research Department, Horticulture Research Institute, Agriculture Research Center, Cairo, Egypt
| | - Seham El-Hawary
- Pharmacognosy Department, Faculty of Pharmacy, Cairo University, Kasr El Aini St., Cairo, 11562, Egypt
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Liao C, Tao S, Xiong Y, Dai J, Bai Y, Wang X, Li Y, Wu P. The Effects and Potential Mechanisms of Moxibustion for Rheumatoid Arthritis-Related Pain: A Randomized, Controlled Trial. J Pain Res 2023; 16:1739-1749. [PMID: 37261035 PMCID: PMC10228586 DOI: 10.2147/jpr.s408814] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/09/2023] [Indexed: 06/02/2023] Open
Abstract
Purpose To investigate the effects of moxibustion in relieving pain, and other clinical symptoms for patients with rheumatoid arthritis (RA), and explore the potential mechanism of moxibustion treatment for RA. Patients and Methods Seventy qualified RA patients were randomly assigned in a 1:1 ratio to the moxibustion group or the routine group. The routine group only took oral methotrexate tablets and folic acid tablets. The moxibustion group was treated with moxibustion based on oral pharmaceutical. Moxibustion was performed two times weekly for 8 weeks, a total of 16 sessions. Patients scored their pain on a visual analog scale (VAS). The American College of Rheumatology improvement criteria of 20%, 50% and 70% (ACR20, ACR50 and ACR70) after treatment were investigated. Clinical symptoms, a disease activity score using 28 joint counts (DAS28), simplified disease activity index (SDAI), clinical disease activity index (CDAI), health assessment questionnaire (HAQ), interleukin 1β (IL-1β), tumor necrosis factor-alpha (TNF-α), and vascular endothelial growth factor (VEGF) of RA patients were analyzed before and after treatment. Results After treatment, the VAS scores, tender and swollen joint counts, morning stiffness scores, disease activity scores (DAS28, SDAI, CDAI), HAQ scores in the two groups were both improved, and the effects of moxibustion group were more obvious (P < 0.05). The ACR20 and ACR50 of the moxibustion group were greater than that of the routine group (P < 0.05), no significant difference of the ACR70 existed between the two groups (P > 0.05). In addition, the decreases of IL-1β, TNF-α, VEGF of the moxibustion group were better than that of the routine group (P < 0.05). Conclusion Moxibustion could effectively relieve pain, ameliorate the clinical symptoms, and decrease the disease activity of RA. The potential mechanism may be the decrease in the level of serum inflammatory factors.
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Affiliation(s)
- Chenxi Liao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Siyu Tao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Yan Xiong
- Department of Osteoporosis, Huaxi Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Jingyang Dai
- Department of Traditional Chinese Medicine, Chengdu Fifth People’s Hospital, Chengdu, People’s Republic of China
| | - Yu Bai
- Department of Traditional Chinese Medicine, Chengdu Second People’s Hospital, Chengdu, People’s Republic of China
| | - Xue Wang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Yuan Li
- Department of Rheumatology, The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Ping Wu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
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Exploring potential shared genetic influences between rheumatoid arthritis and blood lipid levels. Atherosclerosis 2022; 363:48-56. [PMID: 36455308 DOI: 10.1016/j.atherosclerosis.2022.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/11/2022] [Accepted: 11/04/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND AIMS The association between rheumatoid arthritis (RA) and blood lipid levels has often been described as paradoxical, despite the strong association between RA and cardiovascular disease (CVD) risk. We aimed to clarify the genetic architecture that would explain the relationship between RA and blood-lipid levels, while considering inflammation as measured by C-reactive protein (CRP). METHODS Genome-wide association study (GWAS) summary statistics were collected from the CHARGE Consortium and Global Lipids Genetics Consortium. Blood-lipid levels includes HDL-C, LDL-C, triglycerides (TG), and total cholesterol (TC). Causality was examined by assessing Mendelian Randomization (MR) analysis. Pleiotropy, the identification of shared causal variants between traits, was assessed by conducting colocalization analyses. RESULTS Using the MR Egger method, RA did not appear to causally predict alterations in lipid factors, rather the MR Egger intercept revealed that the genetic relationship between RA and HDL-C, LDL-C and TC may be explained by horizontal pleiotropy (p=0.003, 0.006, and 0.018, respectively). MR was suggestive of a horizontally pleiotropic relationship between CRP and lipid factors, while a causal relationship could not be ruled out. Recurring genes arising from shared causal genetic variants between RA and varying lipid factors included NAT2/PSD3, FADS2/FADS1, SH2B3, and YDJC. CONCLUSIONS Horizontal pleiotropy appears to explain the genetic relationship between RA and blood-lipid levels. In addition, blood-lipid levels appear to suggest a horizontally pleiotropic relationship to CRP, if not mediated through RA as well. Consideration of the pleiotropic genes between RA and blood lipid levels may aid in enhancing diagnostic means to predict CVD.
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Norouzi S, Khalaji A, Namazi M, Rezaei SS, Behnoush AH, Masoumi M. Ventricular and atrial function assessment with transthoracic echocardiography in patients with rheumatic inflammatory disease. Egypt Heart J 2022; 74:81. [PMID: 36434413 PMCID: PMC9700529 DOI: 10.1186/s43044-022-00319-0] [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: 09/12/2022] [Accepted: 11/20/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Inflammatory rheumatic diseases, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and systemic sclerosis (SSc), can cause cardiovascular complications in many cases. This study aimed to compare the ventricular and atrial functions of the heart between rheumatic patients and healthy controls using transthoracic echocardiography (TTE). RESULTS The study was performed between 64 patients with mentioned rheumatic diseases and 64 age- and sex-matched healthy controls who all underwent detailed history-taking and TTE. Echocardiographic parameters were measured and compared between the two groups. TTE showed significant differences in many echocardiographic parameters. Left ventricular end-diastolic diameter, left ventricular end-systolic diameter, right atrium area, inferior vena cava diameter, and systolic pulmonary artery pressure were significantly higher in patients compared to the controls (P < 0.001). Left ventricular ejection fraction and right ventricular end-diastolic diameter were not statistically different between the groups (P > 0.05). Right ventricular septal strain, right ventricular free wall strain, average longitudinal right ventricular strain, tricuspid annular plane systolic excursion, right ventricular systolic myocardial velocity, and right ventricular fractional area change were lower in inflammatory rheumatic patients (P < 0.001). The subgroup analysis showed the same results' trend for each disease and its own control group comparison. CONCLUSIONS Cardiac involvement in rheumatologic diseases, especially SLE, RA, and SSc, should always be taken into consideration as there may be silent changes affecting the overall prognosis of patients. Using TTE helps diagnose and make a treatment plan for cardiovascular complications in rheumatic disease patients.
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Affiliation(s)
- Somayyeh Norouzi
- grid.444830.f0000 0004 0384 871XDepartment of Internal Medicine Science, Qom University of Medical Sciences, Qom, Iran
| | - Amirmohammad Khalaji
- grid.411705.60000 0001 0166 0922School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansoor Namazi
- grid.444830.f0000 0004 0384 871XCardiology Research Department, Qom University of Medical Sciences, Qom, Iran
| | - Somaye Sadat Rezaei
- grid.444830.f0000 0004 0384 871XFaculty of Medicine, Qom University of Medical Sciences, Qom, Iran
| | - Amir Hossein Behnoush
- grid.411705.60000 0001 0166 0922School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Masoumi
- grid.444830.f0000 0004 0384 871XClinical Research and Development Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
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Pan SY, Tian HM, Zhu Y, Gu WJ, Zou H, Wu XQ, Cheng RJ, Yang Z. Cardiac damage in autoimmune diseases: Target organ involvement that cannot be ignored. Front Immunol 2022; 13:1056400. [PMID: 36483559 PMCID: PMC9722763 DOI: 10.3389/fimmu.2022.1056400] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
Autoimmune diseases are diseases that cause damage to the body's own tissues as a result of immune dysfunction, often involving multiple organs and systems. The heart is one of the common target organs of autoimmune diseases. The whole structure of the heart can be affected, causing microcirculatory disorders, arrhythmias, pericardial damage, myocarditis, myocardial fibrosis, and impaired valvular function. However, early clinical manifestations of autoimmune heart damage are often overlooked because they are insidious or have no typical features. The damage is often severe and irreversible when symptoms are apparent, even life-threatening. Therefore, early detection and treatment of heart damage in autoimmune diseases is particularly important. Herein, we review the clinical features and mechanisms of cardiac damage in common rheumatic diseases.
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Affiliation(s)
- Shu-Yue Pan
- Department of Rheumatology and Immunology, The Fifth People’s Hospital Affiliated to Chengdu University of Traditional Chinese Medicine/Chengdu Fifth People’s Hospital, Chengdu, China
| | - Hui-Min Tian
- Department of Rheumatology and Immunology, The Fifth People’s Hospital Affiliated to Chengdu University of Traditional Chinese Medicine/Chengdu Fifth People’s Hospital, Chengdu, China
| | - Yong Zhu
- Department of Rheumatology and Immunology, The Fifth People’s Hospital Affiliated to Chengdu University of Traditional Chinese Medicine/Chengdu Fifth People’s Hospital, Chengdu, China
| | - Wei-Jie Gu
- Department of Rheumatology and Immunology, The Fifth People’s Hospital Affiliated to Chengdu University of Traditional Chinese Medicine/Chengdu Fifth People’s Hospital, Chengdu, China
| | - Hao Zou
- Department of Rheumatology and Immunology, The Fifth People’s Hospital Affiliated to Chengdu University of Traditional Chinese Medicine/Chengdu Fifth People’s Hospital, Chengdu, China
| | - Xu-Qiang Wu
- Department of Rheumatology and Immunology, The Fifth People’s Hospital Affiliated to Chengdu University of Traditional Chinese Medicine/Chengdu Fifth People’s Hospital, Chengdu, China
| | - Rui-Juan Cheng
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhi Yang
- Department of Radiology, The Fifth People’s Hospital Affiliated to Chengdu University of Traditional Chinese Medicine/Chengdu Fifth People’s Hospital, Chengdu, China
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Study on Mechanism of Invigorating Qi and Promoting Blood Circulation in Treatment of Angiogenesis after Myocardial Infarction Using Network Pharmacology. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:5093486. [PMID: 35656461 PMCID: PMC9152384 DOI: 10.1155/2022/5093486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/29/2022] [Indexed: 12/05/2022]
Abstract
Objective This article aims to explore the impact and mechanism of invigorating qi and promoting blood circulation (IQPBC) on angiogenesis after myocardial infarction (AMI) by using network pharmacology approach. Methods First, IQPBC was searched on the traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP), and the main active ingredients and targets of IQPBC were screened and obtained. Second, by virtue of GeneCards and Online Mendelian Inheritance in Man (OMIM) databases, the targets related to AMI are screened and then obtained. Then, the intersection targets between IQPBC and AMI can be obtained by using online tool Venny 2.1.0. Third, based on the STRING database, the interaction of target proteins is established and some key targets can be analyzed and obtained. Finally, the IQPBC-AMI interaction network is constructed by using Cytoscape, and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses are executed by DAVID and OmicShare databases. Results 143 intersection targets between IQPBC and AMI are obtained. Besides, key active ingredients, namely, quercetin, tanshinone, kaempferol, and luteolin, are shown. Furthermore, AKT1, VEGFA, STAT3, HIF-1α, and other 10 key targets are obtained. A total of 752 enrichment results are acquired by using GO analysis. KEGG pathway enrichment analysis shows 241 signaling pathways, focusing on cancer, fluid shear stress and atherosclerosis, and TNF and PI3K/AKT signaling pathways. Conclusion This article studies the potential targets and signaling pathways of IQPBC drugs acting on AMI via the network pharmacology approach, which better illustrates the effect and mechanism, and provides some good ideas for the following mechanism research studies.
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Canillas M, de Lima GG, de Sá MJC, Nugent MJD, Rodríguez MA, Devine DM. Self-Photopolymerizable Hydrogel-Ceramic Composites with Scavenger Properties. Polymers (Basel) 2022; 14:polym14061261. [PMID: 35335593 PMCID: PMC8950735 DOI: 10.3390/polym14061261] [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: 02/11/2022] [Revised: 03/07/2022] [Accepted: 03/16/2022] [Indexed: 11/16/2022] Open
Abstract
The photocatalytic behaviours of semiconductive ceramic nanoparticles such as TiO2, ZnO, Fe2O3, and Fe3O4, have been extensively studied in photocatalysis and photopolymerization, due to their ability to produce radical species under ultraviolet-visible light, and even in dark conditions. In addition, in the form of microparticles, TiO2 and its Magnéli phases are capable of neutralizing radical species, and a heterogeneous catalytic process has been suggested to explain this property, as it is well known as scavenging activity. Thus, in this study, we demonstrate that these ceramic powders, in the form of microparticles, could be used as photoinitiators in UV polymerization in order to synthesize a hydrogel matrix. Them, embedded ceramic powders could be able to neutralize radical species of physiological media once implanted. The hydrogel matrix would regulate the exchange of free radicals in any media, while the ceramic particles would neutralize the reactive species. Therefore, in this work, the scavenger activities of TiO2, ZnO, Fe2O3, and Fe3O4 microparticles, along with their photoinitiation yield, were evaluated. After photopolymerization, the gel fraction and swelling behaviour were evaluated for each hydrogel produced with different ceramic initiators. Gel fractions were higher than 60%, exhibiting variation in their scavenging activity. Therefore, we demonstrate that ceramic photoinitiators of TiO2, ZnO, Fe2O3, and Fe3O4 can be used to fabricate implantable devices with scavenger properties in order to neutralize radical species involved in inflammatory processes and degenerative diseases.
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Affiliation(s)
- Maria Canillas
- Consejo Superior de Investigaciones Cientificas, Instituto de Cerámica y Vidrio, Calle Kelsen, 5, 28049 Madrid, Spain;
- Correspondence: (M.C.); (D.M.D.)
| | - Gabriel Goetten de Lima
- Programa de Pós-Graduação em Engenharia e Ciência dos Materiais—PIPE, Universidade Federal do Paraná, Av. Cel. Francisco H. dos Santos, 100, Jardim das Américas, Curitiba 81530-000, Brazil;
- Materials Research Institute, Technological University of the Shannon, Midlands Midwest, Athlone Campus, University Road, N37 HD68 Athlone, Ireland; (M.J.C.d.S.); (M.J.D.N.)
| | - Marcelo J. C. de Sá
- Materials Research Institute, Technological University of the Shannon, Midlands Midwest, Athlone Campus, University Road, N37 HD68 Athlone, Ireland; (M.J.C.d.S.); (M.J.D.N.)
- Programa de Pós-Graduação em Medicina Veterinária—PPGMV, Universidade Federal de Campina Grande, Avenida Universitária, s/n, Patos, Santa Cecilia, Sao Paulo 58708-110, Brazil
| | - Michael J. D. Nugent
- Materials Research Institute, Technological University of the Shannon, Midlands Midwest, Athlone Campus, University Road, N37 HD68 Athlone, Ireland; (M.J.C.d.S.); (M.J.D.N.)
| | - Miguel A. Rodríguez
- Consejo Superior de Investigaciones Cientificas, Instituto de Cerámica y Vidrio, Calle Kelsen, 5, 28049 Madrid, Spain;
| | - Declan M. Devine
- Materials Research Institute, Technological University of the Shannon, Midlands Midwest, Athlone Campus, University Road, N37 HD68 Athlone, Ireland; (M.J.C.d.S.); (M.J.D.N.)
- Correspondence: (M.C.); (D.M.D.)
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10
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Alves C, Penedones A, Mendes D, Marques FB. Risk of Cardiovascular and Venous Thromboembolic Events Associated With Janus Kinase Inhibitors in Rheumatoid Arthritis: A Systematic Review and Network Meta-analysis. J Clin Rheumatol 2022; 28:69-76. [PMID: 34741000 DOI: 10.1097/rhu.0000000000001804] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND/OBJECTIVE The Janus kinases are cytoplasmic tyrosine kinases associated with membrane cytokine receptors that mediate signaling of multiple cytokines and growth factors, contributing to the pathogenesis of multiple autoimmune disorders. Janus kinase inhibitors (JKIs) are a new class of targeted therapies with proven efficacy in treating rheumatoid arthritis but are associated with an increased risk of infections. This study is aimed at assessing the risk of cardiovascular and venous thromboembolic events associated with JKIs in patients with rheumatoid arthritis. METHODS PUBMED, EMBASE, Cochrane Library, and clinicaltrials.gov were searched to identify randomized controlled trials evaluating the efficacy and safety of JKIs in patients with rheumatoid arthritis. The outcomes assessed were the risk of major adverse cardiovascular events, venous thromboembolic events, and any cardiovascular event. Sensitivity analysis disaggregated the results according to background therapy, JKI licensed doses, and studies' methodological quality. RESULTS Forty-two randomized controlled trials met the inclusion criteria. No statistically significant risk differences were observed between the JKIs for any of the assessed outcomes. Compared with placebo, tofacitinib (odds ratio, 0.32; 95% confidence interval, 0.11-0.89) reduces the risk of venous thromboembolism. The results of the sensitivity analysis are in line with the initial findings. CONCLUSIONS Current evidence suggests that the risk of cardiovascular and venous thromboembolic events is similar among the JKIs. Postmarketing pharmacovigilance evidence will be of utmost importance in confirming the cardiovascular safety of these drugs.
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11
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Hasan I, Hossain A, Bhuiyan P, Miah S, Rahman H. A system biology approach to determine therapeutic targets by identifying molecular mechanisms and key pathways for type 2 diabetes that are linked to the development of tuberculosis and rheumatoid arthritis. Life Sci 2022; 297:120483. [DOI: 10.1016/j.lfs.2022.120483] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 12/17/2022]
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12
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Emerging Role of Cardiac Magnetic Resonance Imaging in Diagnosing Myocarditis: A Blunder or The Way To Get the Problem Sorted? J Thorac Imaging 2022; 37:W12-W27. [PMID: 35191862 DOI: 10.1097/rti.0000000000000634] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Acute myocarditis is a disease affecting the myocardial tissue, which is caused by infections, rheumatic diseases, especially sarcoidosis, or certain therapies. Its diagnosis may be difficult, owing to its variable clinical presentation. In this setting, cardiac magnetic resonance plays a pivotal role in detecting myocardial inflammation through qualitative, semiquantitative, and quantitative parameters, in particular with the new quantitative techniques such as T1 and T2 mapping, combined or not with late gadolinium enhancement evaluation. This is in accordance with the revised Lake Louise criteria. In this review, the emerging role of the new cutting-edge cardiac magnetic resonance imaging techniques in diagnosing myocarditis is extensively presented.
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13
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Tokonami A, Ohta R, Tanaka Y, Amano S, Sano C. Pericarditis With Cardiac Tamponade Mimicking Yellow Nail Syndrome in a Patient With Rheumatoid Arthritis and a Paucity of Joint Symptoms. Cureus 2022; 14:e21523. [PMID: 35223299 PMCID: PMC8863119 DOI: 10.7759/cureus.21523] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2022] [Indexed: 12/18/2022] Open
Abstract
Pericarditis is a cardiac disease that commonly manifests with rheumatoid arthritis, and its complications are related to rheumatoid arthritis disease activity. The diagnosis can be complicated in patients with multiple extra-joint complications of rheumatoid arthritis. We report a case of pericarditis in an 82-year-old woman with few joint symptoms who was admitted to the hospital due to worsening edema of the lower legs and dyspnea, which progressed to cardiac tamponade. The patient presented with gradual onset of edema of both lower limbs and bilateral pleural effusion and was initially diagnosed with yellow nail syndrome. Ultimately, the patient was diagnosed with rheumatoid pericarditis due to a rapid increase in pericardial effusion. She was treated with non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine; however, the symptoms were progressive and required pericardiocentesis. After pericardiocentesis, the patient responded well to NSAIDs and colchicine, and systemic edema was relieved. This case highlights the fact that pericarditis associated with rheumatoid arthritis is not necessarily related to the severity of joint symptoms. Moreover, it can be difficult to differentiate pericarditis from multiple other diseases, such as yellow nail syndrome, in patients with rheumatoid arthritis who mainly have extra-articular symptoms.
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Affiliation(s)
| | | | | | - Shiho Amano
- Community Care, Unnan City Hospital, Unnan, JPN
| | - Chiaki Sano
- Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN
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14
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del-Sueldo MA, Mendonça-Rivera MA, Sánchez-Zambrano MB, Zilberman J, Múnera-Echeverri AG, Paniagua M, Campos-Alcántara L, Almonte C, Paix-Gonzales A, Anchique-Santos CV, Coronel CJ, Castillo G, Parra-Machuca MG, Duro I, Varletta P, Delgado P, Volberg VI, Puente-Barragán AC, Rodríguez A, Rotta-Rotta A, Fernández A, Izeta-Gutiérrez AC, Ancona-Vadillo AE, Aquieri A, Corrales A, Simeone A, Rubilar B, Artucio C, Pimentel-Fernández C, Marques-Santos C, Saldarriaga C, Chávez C, Cáceres C, Ibarrola D, Barranco D, Muñoz-Ortiz E, Ruiz-Gastelum ED, Bianco E, Murguía E, Soto E, Rodríguez-Caballero F, Otiniano-Costa F, Valentino G, Rodríguez-Cermeño IB, Rivera IR, Gándara-Ricardo JA, Velásquez-Penagos JA, Torales J, Scavenius K, Dueñas-Criado K, García L, Roballo L, Kazelian LR, Coussirat-Liendo M, Costa-Almeida MC, Drever M, Lujambio M, Castro ML, Rodríguez-Sifuentes M, Acevedo M, Giambruno M, Ramírez M, Gómez N, Gutiérrez-Castillo N, Greatty O, Harwicz P, Notaro P, Falcón R, López R, Montefilpo S, Ramírez-Flores S, Verdugo S, Murguía S, Constantini S, Vieira TC, Michelis V, Serra CM. Clinical practice guideline of the Interamerican Society of Cardiology on primary prevention of cardiovascular disease in women. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2022; 92:1-68. [PMID: 35666723 PMCID: PMC9290436 DOI: 10.24875/acm.22000071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/20/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - Claudia Almonte
- Sociedad Dominicana de Cardiología, Santo Domingo, República Dominicana
| | | | | | | | | | | | - Ivanna Duro
- Sociedad Uruguaya de Cardiología, Montevideo, Uruguay
| | - Paola Varletta
- Sociedad Chilena de Cardiología y Cirugía Cardiovascular, Santiago, Chile
| | | | | | | | | | | | | | | | | | - Analía Aquieri
- Sociedad Argentina de Cardiología, Buenos Aires, Argentina
| | - Andrea Corrales
- Federación Argentina de Cardiología, Buenos Aires, Argentina
| | | | | | | | | | | | - Clara Saldarriaga
- Sociedad Colombiana de Cardiología y Cirugía Cardiovascular, Medellín, Colombia
| | | | | | | | | | - Edison Muñoz-Ortiz
- Sociedad Colombiana de Cardiología y Cirugía Cardiovascular, Medellín, Colombia
| | | | | | - Elena Murguía
- Sociedad Uruguaya de Cardiología, Montevideo, Uruguay
| | - Enrique Soto
- Sociedad Uruguaya de Cardiología, Montevideo, Uruguay
| | | | | | - Giovanna Valentino
- Sociedad Chilena de Cardiología y Cirugía Cardiovascular, Santiago, Chile
| | | | - Ivan R. Rivera
- Sociedad Brasileña de Cardiología, Río de Janeiro, Brasil
| | | | | | | | | | - Karen Dueñas-Criado
- Sociedad Colombiana de Cardiología y Cirugía Cardiovascular, Medellín, Colombia
| | - Laura García
- Sociedad Paraguaya de Cardiología, Asunción, Paraguay
| | - Laura Roballo
- Sociedad Uruguaya de Cardiología, Montevideo, Uruguay
| | | | | | | | | | | | | | | | - Mónica Acevedo
- Sociedad Chilena de Cardiología y Cirugía Cardiovascular, Santiago, Chile
| | | | - Mónica Ramírez
- Federación Argentina de Cardiología, Buenos Aires, Argentina
| | - Nancy Gómez
- Sociedad Paraguaya de Cardiología, Asunción, Paraguay
| | | | | | - Paola Harwicz
- Sociedad Argentina de Cardiología, Buenos Aires, Argentina
| | | | - Rocío Falcón
- Sociedad Paraguaya de Cardiología, Asunción, Paraguay
| | - Rosario López
- Sociedad Chilena de Cardiología y Cirugía Cardiovascular, Santiago, Chile
| | | | | | | | | | | | | | | | - César M. Serra
- Federación Argentina de Cardiología, Buenos Aires, Argentina
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15
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Polyakova EA, Mikhaylov EN, Galagudza MM, Shlyakhto EV. Hyperleptinemia results in systemic inflammation and the exacerbation of ischemia-reperfusion myocardial injury. Heliyon 2021; 7:e08491. [PMID: 34901513 PMCID: PMC8640453 DOI: 10.1016/j.heliyon.2021.e08491] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/09/2021] [Accepted: 11/24/2021] [Indexed: 12/01/2022] Open
Abstract
Aim Hyperleptinemia potentiates the effects of many atherogenic factors, such as inflammation, platelet aggregation, migration, hypertrophy, proliferation of vascular smooth muscle cells, and endothelial cell dysfunction. The present study analysed the effects of long-term hyperleptinemia in an in vivo myocardial ischemia-reperfusion model to demonstrate whether the in vivo deleterious effect also affects cardiac structure and function. Main methods Rats were subcutaneously administered leptin for 8 days to estimate the involvement of the JAK/STAT pathway. Data from 58 male Wistar rats were included in the final analysis. Myocardial infarction (MI) was modelled by the 30-minute ligation of the main left coronary artery followed by 120-minute reperfusion. Hemodynamic measurements, electrocardiography monitoring, echocardiography, myocardial infarct size and area at risk, blood biochemical parameters, leptin, IL-6, TNF-alpha, FGF-21, and cardiomyocyte morphology were measured. The expression of JAK2, p-JAK2, STAT3, p-STAT3 was assessed by Western Blot analysis. Statistical analyses were performed using IBM SPSS Statistics v.26. Key findings Eight-day hyperleptinemia in rats leads to an increase in blood pressure and heart rate, myocardial hypertrophy, impaired LV function, the frequency of ischemic arrhythmias, dyslipidemia, systemic inflammation, and the size of induced myocardial infarction. Significance: The blockade of the JAK/STAT signalling pathway effectively reverses the negative effects of leptin, including increased blood pressure and total cholesterol.
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Affiliation(s)
- Ekaterina A Polyakova
- Almazov National Medical Research Centre, Institute of Experimental Medicine, Saint-Petersburg, Russian Federation
| | - Evgeny N Mikhaylov
- Almazov National Medical Research Centre, Institute of Experimental Medicine, Saint-Petersburg, Russian Federation
| | - Michael M Galagudza
- Almazov National Medical Research Centre, Institute of Experimental Medicine, Saint-Petersburg, Russian Federation
| | - Evgeny V Shlyakhto
- Almazov National Medical Research Centre, Institute of Experimental Medicine, Saint-Petersburg, Russian Federation
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16
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Ye Z, Chen L, Fang Y, Zhao L. Blood MALT1, Th1, and Th17 cells are dysregulated, inter-correlated, and correlated with disease activity in rheumatoid arthritis patients; meanwhile, MALT1 decline during therapy relates to treatment outcome. J Clin Lab Anal 2021; 36:e24112. [PMID: 34788483 PMCID: PMC8761436 DOI: 10.1002/jcla.24112] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/19/2021] [Accepted: 10/31/2021] [Indexed: 12/29/2022] Open
Abstract
Objective Mucosa‐associated lymphoid tissue lymphoma translocation protein 1 (MALT1) participates in inflammatory and autoimmune diseases via activating various signaling pathways and promoting the differentiation of T‐helper (Th) 1 and Th17 cells; however, it is rarely reported in rheumatoid arthritis (RA). This study aimed to assess the correlation of MALT1 with Th1 and Th17 cells and evaluate its potential as a biomarker for evaluating disease activity and treatment outcomes in RA patients. Methods This study enrolled 139 RA patients and 45 health controls (HCs); then, blood MALT1, Th1, and Th17 cells were determined. For RA patients only, blood MALT1 at week (W) 6 and W12 after treatment was also detected. Additionally, clinical response and remission of RA patients were assessed at W12. Results MALT1 (p < 0.001), Th1 (p = 0.011), and Th17 (p < 0.001) cells were all increased in RA patients than HCs; meanwhile, increased MALT1 was associated with elevated Th1 (p = 0.003) and Th17 (p < 0.001) cells in RA patients. Besides, MALT1, Th1, and Th17 cells were positively correlated with parts of disease activity indexes in RA patients (all p < 0.050). In addition, MALT1 was gradually declined from W0 to W12 (p < 0.001) in RA patients. Specifically, MALT1 at W6 and W12 was lower in response patients than no response patients (both p < 0.010), also in remission patients than no remission patients (both p < 0.050). Conclusion MALT1, Th1, and Th17 cells are dysregulated, inter‐correlated, and correlated with disease activity in RA patients; meanwhile, the decline of MALT1 expression can partly reflect RA treatment response and remission.
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Affiliation(s)
- Zhuang Ye
- Department of Rheumatology, The First Hospital of Jilin University, Changchun, China
| | - Lu Chen
- Department of Rheumatology, The First Hospital of Jilin University, Changchun, China
| | - Ying Fang
- Department of Rheumatology, The First Hospital of Jilin University, Changchun, China
| | - Ling Zhao
- Department of Rheumatology, The First Hospital of Jilin University, Changchun, China
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17
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Hee JY, Protani MM, Koh ET, Leong KP. Metabolic syndrome and its effect on the outcomes of rheumatoid arthritis in a multi-ethnic cohort in Singapore. Clin Rheumatol 2021; 41:649-660. [PMID: 34655002 DOI: 10.1007/s10067-021-05945-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/22/2021] [Accepted: 09/25/2021] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Over-expression of common inflammatory mediators in the metabolic syndrome (MetS) and in rheumatoid arthritis (RA) may lead to mutually adverse outcomes. AIM We investigate the prevalence of MetS in a multi-ethnic population of RA patients and its effect on clinical and patient-reported outcomes. METHOD Six hundred sixty RA (561 women) patients from a public-sector specialist clinic in a hospital in Singapore were assessed for MetS according to the 2009 Joint Consensus (JC) and the 2004 National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) definitions. Univariable and multivariable regression modelling were used to investigate the associations between patients' demographics with MetS and MetS with RA outcomes. RESULTS The prevalence of MetS in our RA cohort was 49.4% and 44.9% according to the JC and NCEP ATP III definitions, respectively. The diagnosis of MetS was largely due to hypertriglyceridemia, hypertension, and obesity. MetS was associated with older age (OR 1.06 [95% CI 1.04-1.08]), Malay ethnicity (OR 1.78 [95% CI 1.02-3.09]), or Indian ethnicity (OR 3.07 [95% CI 1.68-5.59]). No significant associations between MetS and RA outcomes were observed. RA patients with MetS are more likely to suffer from stroke and ischemic heart disease. CONCLUSION The prevalence of MetS in RA patients in Singapore was almost double that in the general population. MetS does not adversely affect RA outcomes but raises the risks of stroke and heart disease. RA patients, especially those older and of Indian and Malay ethnicities, should be routinely screened for MetS. Any MetS-defining condition should be actively controlled. Key Points • Approximately half of the RA sample from the Singapore RA population can be diagnosed with MetS. • Older patients, and patients of Malay and Indian ethnicities have higher odds of MetS. • MetS does not adversely affect RA outcomes but raises the risks of stroke and heart disease.
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Affiliation(s)
- Jia Yi Hee
- School of Public Health, The University of Queensland, 288 Herston Road, Brisbane, Queensland, 4006, Australia.
| | - Melinda M Protani
- School of Public Health, The University of Queensland, 288 Herston Road, Brisbane, Queensland, 4006, Australia
| | - Ee Tzun Koh
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Khai Pang Leong
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
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18
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Rezuș E, Macovei LA, Burlui AM, Cardoneanu A, Rezuș C. Ischemic Heart Disease and Rheumatoid Arthritis-Two Conditions, the Same Background. Life (Basel) 2021; 11:life11101042. [PMID: 34685413 PMCID: PMC8537055 DOI: 10.3390/life11101042] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 12/20/2022] Open
Abstract
Rheumatoid arthritis (RA) is one of the most frequent inflammatory rheumatic diseases, having a considerably increased prevalence of mortality and morbidity due to cardiovascular disease (CVD). RA patients have an augmented risk for ischemic and non-ischemic heart disease. Increased cardiovascular (CV) risk is related to disease activity and chronic inflammation. Traditional risk factors and RA-related characteristics participate in vascular involvement, inducing subclinical changes in coronary microcirculation. RA is considered an independent risk factor for coronary artery disease (CAD). Endothelial dysfunction is a precocious marker of atherosclerosis (ATS). Pro-inflammatory cytokines (such as TNFα, IL-1, and IL-6) play an important role in synovial inflammation and ATS progression. Therefore, targeting inflammation is essential to controlling RA and preventing CVD. Present guidelines emphasize the importance of disease control, but studies show that RA- treatment has a different influence on CV risk. Based on the excessive risk for CV events in RA, permanent evaluation of CVD in these patients is critical. CVD risk calculators, designed for the general population, do not use RA-related predictive determinants; also, new scores that take into account RA-derived factors have restricted validity, with none of them encompassing imaging modalities or specific biomarkers involved in RA activity.
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Affiliation(s)
- Elena Rezuș
- Department of Rheumatology and Rehabilitation, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania; (E.R.); (A.M.B.); (A.C.)
| | - Luana Andreea Macovei
- Department of Rheumatology and Rehabilitation, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania; (E.R.); (A.M.B.); (A.C.)
- Correspondence:
| | - Alexandra Maria Burlui
- Department of Rheumatology and Rehabilitation, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania; (E.R.); (A.M.B.); (A.C.)
| | - Anca Cardoneanu
- Department of Rheumatology and Rehabilitation, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania; (E.R.); (A.M.B.); (A.C.)
| | - Ciprian Rezuș
- Department of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania;
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Kessler J, Totoson P, Devaux S, Moretto J, Wendling D, Demougeot C. Animal models to study pathogenesis and treatments of cardiac disorders in rheumatoid arthritis: Advances and challenges for clinical translation. Pharmacol Res 2021; 170:105494. [PMID: 34139344 DOI: 10.1016/j.phrs.2021.105494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 11/15/2022]
Abstract
Although cardiac diseases such as acute myocardial infarction, heart failure and arrhythmias are the leading cause of cardiovascular complications in rheumatoid arthritis (RA), their pathogenesis is far from being understood and optimal therapeutic options to treat specifically these disorders in RA are lacking. Preclinical studies on animal models of arthritis can help to decipher the complex link between arthritis and the heart, and to identify critical pathways and novel therapeutic targets. This review presented the available data on cardiac disorders in animal models of RA, as well as the current knowledge on pathophysiology and pharmacology of these disorders. Future directions for translational studies in a cardiorheumatic perspective are proposed.
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Affiliation(s)
- Julie Kessler
- PEPITE EA 4267, FHU INCREASE, Univ. Bourgogne Franche-Comté, F-25000 Besançon, France; Service de Rhumatologie, CHU Minjoz, 25000 Besançon, France
| | - Perle Totoson
- PEPITE EA 4267, FHU INCREASE, Univ. Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Sylvie Devaux
- PEPITE EA 4267, FHU INCREASE, Univ. Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Johnny Moretto
- PEPITE EA 4267, FHU INCREASE, Univ. Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Daniel Wendling
- Service de Rhumatologie, CHU Minjoz, 25000 Besançon, France; EA 4266 " Agents Pathogènes et Inflammation ", EPILAB, Univ. Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Céline Demougeot
- PEPITE EA 4267, FHU INCREASE, Univ. Bourgogne Franche-Comté, F-25000 Besançon, France.
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20
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Zhang Y, Feng B, Dong J, Zhong Y, Wang L, Zhao L. Rheumatoid arthritis coexisting with ankylosing spondylitis: A report of 22 cases with delayed diagnosis. Medicine (Baltimore) 2021; 100:e25051. [PMID: 33787586 PMCID: PMC8021346 DOI: 10.1097/md.0000000000025051] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 02/14/2021] [Indexed: 01/04/2023] Open
Abstract
Coexisting rheumatoid arthritis (RA) and ankylosing spondylitis (AS) in the same patient is often thought to be rare, and thus misdiagnosis is common. The aim of our study was to describe the main characteristics of RA coexisting with AS in patients with delayed diagnoses and improve awareness of the disease association.Between 2012 and 2018, data from 22 patients who had RA and AS (RA/AS) were retrospectively reviewed. All patients had a history of delayed diagnosis for RA or AS. The clinical features and radiographic changes of RA and AS patients were obtained at baseline and after 2 years. Disease activity score 28 (DAS28) or bath ankylosing spondylitis disease activity index (BASDAI) were used as outcome measures. The mean age at the time of diagnosis of RA/AS was 51.8 years, while the mean duration of diagnostic delay was 5.5 years. Middle-aged women were the most common subgroup among the RA/AS cohort. The common clinical manifestations were systemic, symmetric, peripheral, and axial arthritis. The erythrocyte sedimentation rate and C-reactive protein levels in RA/AS patients were elevated at the time diagnosis of RA/AS. The typical radiologic changes for the 2 diseases coexisted in RA/AS patients. The DAS28 and BASDAI scores at the 2-year follow-up evaluation were lower than the initial assessment.Coexisting RA and AS is often misdiagnosed for many years; a lack of recognition of RA and AS together is one of the most common reasons. Systemic, symmetric, peripheral, and axial arthritis in middle-aged women were the most frequent presentations at onset.
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Affiliation(s)
- Yuanyuan Zhang
- The Rheumatology and Clinical Immunology Department, the Affiliated Hospital of Qingdao University
| | - Bo Feng
- Jiaozhou Central Hospital of Qingdao, Qingdao, China
| | - Jing Dong
- The Rheumatology and Clinical Immunology Department, the Affiliated Hospital of Qingdao University
| | - Yanyan Zhong
- The Rheumatology and Clinical Immunology Department, the Affiliated Hospital of Qingdao University
| | - Liqin Wang
- The Rheumatology and Clinical Immunology Department, the Affiliated Hospital of Qingdao University
| | - Lei Zhao
- The Rheumatology and Clinical Immunology Department, the Affiliated Hospital of Qingdao University
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21
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Yazdani K, Xie H, Avina-Zubieta JA, Zheng Y, Abrahamowicz M, Lacaille D. Has the excess risk of acute myocardial infarction in rheumatoid arthritis relative to the general population declined? A population study of trends over time. Semin Arthritis Rheum 2021; 51:442-449. [PMID: 33735663 DOI: 10.1016/j.semarthrit.2021.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/03/2021] [Accepted: 03/01/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To evaluate secular trend in ten-year risk of incident acute myocardial infarction (AMI) in incident rheumatoid arthritis (RA) relative to the general population. METHODS We conducted a retrospective study of population-based incident RA cohorts with RA incidence from 1997 to 2004 in British Columbia, Canada, with matched general population comparators, using administrative health data. RA and their matched cohorts were divided according to the year of RA incidence, defined according to the first RA visit of the case definition. Incident AMI was defined as the first event occurring within 10 years from RA incidence. Secular trend was assessed using delayed-entry Cox models with an interaction term between the year of RA onset and indicator of RA vs. general population. Linear, quadratic and spline functions of year of RA onset were compared to assess possibility of nonlinear trends. The model with the lowest AIC was selected to interpret the results. Sensitivity analyses were conducted to account for potential effect of unmeasured (e.g. smoking) or partially measured (e.g. obesity) confounders in administrative data, on the interaction term. RESULTS Overall, 23,237 RA and 46,474 general population controls experienced 1,133 and 1,606 incident AMIs, respectively. A linear Cox model was selected as the model best fitting the AMI events. Overall, RA patients were found to have a 21% higher risk of AMI than the matched general population controls [1.21 (1.10, 1.32); p < 0.001]. A significant linear decline in risk of AMI was observed in RA patients [0.94 (95% CI 0.91, 0.97) p = <0.0001], and in the general population [0.93 (0.91, 0.95); p = <0.0001]. The change in AMI risk over time did not differ in RA compared to the general population [p-value of interaction term=0.49]. Our results remained similar after adjusting for the potential effect of confounders on the interaction term, and no difference in the change in risk of AMI over time was observed between RA and the general population. CONCLUSION Our findings suggest a decline in 10-year risk of AMI in RA, and in the general population. The decline in the risk of AMI over time did not differ between RA and the general population, such that the excess risk of AMI in RA relative to the general population, has remained the same.
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Affiliation(s)
- Kiana Yazdani
- Arthritis Research Canada, 5591 Number 3 Rd, Richmond V6X 2C7, British Columbia, Canada; Experimental Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Hui Xie
- Arthritis Research Canada, 5591 Number 3 Rd, Richmond V6X 2C7, British Columbia, Canada; Faculty of Health Science, Simon Fraser University, Vancouver, Canada
| | - J Antonio Avina-Zubieta
- Arthritis Research Canada, 5591 Number 3 Rd, Richmond V6X 2C7, British Columbia, Canada; Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of British Columbia, Canada; Experimental Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Yufei Zheng
- Arthritis Research Canada, 5591 Number 3 Rd, Richmond V6X 2C7, British Columbia, Canada
| | - Michal Abrahamowicz
- Arthritis Research Canada, 5591 Number 3 Rd, Richmond V6X 2C7, British Columbia, Canada; Department of Epidemiology, Biostatistics and Occupational Health McGill University, Montreal, Quebec, Canada
| | - Diane Lacaille
- Arthritis Research Canada, 5591 Number 3 Rd, Richmond V6X 2C7, British Columbia, Canada; Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of British Columbia, Canada; Experimental Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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22
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Conventional disease-modifying agents in rheumatoid arthritis - a review of their current use and role in treatment algorithms. Reumatologia 2020; 58:390-400. [PMID: 33456082 PMCID: PMC7792546 DOI: 10.5114/reum.2020.101400] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/10/2020] [Indexed: 12/29/2022] Open
Abstract
Despite the development of targeted therapies, conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) remain the cornerstone of treatment of rheumatoid arthritis (RA). A literature search was conducted on treatment recommendations and relevant papers regarding new insights on therapeutics in rheumatoid arthritis. Methotrexate is considered the “anchor drug” due to its high efficacy as monotherapy and in combination with other conventional and targeted agents. Leflunomide and sulfasalazine are sound alternatives, whereas (hydroxy)chloroquine is primarily used in combination with other csDMARDs. Their use is encouraged in all treatment phases – in combination with targeted agents, and with other csDMARDs. Combining different csDMARDs is especially attractive in lower income settings given the evidence proving (almost) equal efficacy and safety of the csDMARD combination approach compared to the combination of targeted agents with a csDMARD. The aim of this review is to provide a clinically oriented insight into the pharmacology of each csDMARD and their place in treatment algorithms.
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23
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Sen G, Gordon P, Sado DM. Cardiac manifestations of rheumatological disease: a synopsis for the cardiologist. Heart 2020; 107:1173-1181. [PMID: 33310886 DOI: 10.1136/heartjnl-2019-316460] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Gautam Sen
- Cardiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Patrick Gordon
- Department of Rheumatology, King's College Hospital, London, UK
| | - Daniel M Sado
- Cardiology, King's College Hospital NHS Foundation Trust, London, UK
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Zhang Q, Yue QY. Tumor necrosis factor inhibitor-induced pleuropericarditis: A retrospective evaluation using data from VigiBase. Int Immunopharmacol 2020; 89:107049. [PMID: 33045578 DOI: 10.1016/j.intimp.2020.107049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/18/2020] [Accepted: 09/23/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The aim of this study was to assess the causality of anti-TNFα agents-associated pleuropericarditis in VigiBase with a focus on its diverse types. METHODS All variables contained in the pleuropericarditis reports were reviewed. Well-documented reports, vigiGrade completeness score ≥ 0.80 or with an informative narrative, were analyzed and with a focus on the clinical features of the cases. Bradford-Hill criteria were used in the case series assessment of causality. RESULTS From 1968 up to 18 December 2019, there were 94 unique cases from 18 countries reporting pleuropericarditis with anti-TNFα agents as a suspected or interacting medicine. Among the 94 reports, 42 were identified as well-documented and further assessed for clinical features. Of the 42 cases, 39 were serious, including three fatal and seven life-threatening. In 35 cases, an anti-TNFα agent was the only suspected drug. Positive de- and re-challenge were reported in 95% and 17% of the 42 cases, respectively. The times to onset (TTO) varied greatly among individual cases, ranging from one month to 75 months (mean = 24 months). The most commonly involved anti-TNFα agents were adalimumab, infliximab and etanercept; and the mostly reported pleuropericarditis types were classified as autoimmune-related with (n = 17) or without (n = 15) co-reported drug-induced lupus (DIL), or infection-related (n = 8). While adalimumab was the most reported in the infection-related cases (7/8), infliximab was the most frequent in the autoimmune-related cases, in particular co-reported with DIL (9/17). There were four cases where the reaction occurred one to two months after the anti-TNFα agents (infliximab and adalimumab) were stopped. Based on the review of the case series using Bradford-Hill criteria the anti-TNFα agents associated pleuropericarditis are considered as a class effect. CONCLUSIONS To clinically recognize and manage these potentially life-threatening serious cardiopulmonary complications, health care professionals should be aware of this possible risk. Meanwhile, attention should be paid to the clinical features of pleuropericarditis cases, since they may cause diagnostic and therapeutic difficulties. Considering the long elimination time, clinicians need to be reminded to remain vigilant for the adverse reactions even after discontinuing anti-TNFα therapy.
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Affiliation(s)
- Qingxia Zhang
- Department of Pharmacy, Xuan Wu Hospital, Capital Medical University, Beijing, PR China
| | - Qun-Ying Yue
- Uppsala Monitoring Centre, Box 1051, Uppsala 75140, Sweden.
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25
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Shi YY, Li YQ, Xie X, Zhou YT, Zhang Q, Yu JL, Li P, Mi N, Li F. Homotherapy for heteropathy active components and mechanisms of Qiang-Huo-Sheng-Shi decoction for treatment of rheumatoid arthritis and osteoarthritis. Comput Biol Chem 2020; 89:107397. [PMID: 33035753 DOI: 10.1016/j.compbiolchem.2020.107397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/29/2020] [Accepted: 09/29/2020] [Indexed: 12/23/2022]
Abstract
Qiang-Huo-Sheng-Shi decoction (QHSSD), a classic traditional Chinese herbal formula, which has been reported to be effective in rheumatoid arthritis (RA) and osteoarthritis (OA). However, the concurrent targeting mechanism of how the aforementioned formula is valid in the two distinct diseases OA and RA, which represents the homotherapy-for-heteropathy principle in traditional Chinese medicine (TCM), have not yet been clarified. In the present study, network pharmacology was adopted to analyze the potential molecular mechanism, and therapeutic effective components of QHSSD on both OA and RA. A total of 153 active ingredients in QHSSD were identified, 142 of which associated with 59 potential targets for the two diseases were identified. By constructing the protein-protein interaction network and the compound-target-disease network, 72 compounds and 10 proteins were obtained as the hub targets of QHSSD against OA and RA. The hub genes of ESR1, PTGS2, PPARG, IL1B, TNF, MMP2, IL6, CYP3A4, MAPK8, and ALB were mainly involved in osteoclast differentiation, the NF-κB and TNF signaling pathways. Moreover, molecular docking results showed that the screened active compounds had a high affinity for the hub genes. This study provides new insight into the molecular mechanisms behind how QHSSD presents homotherapy-for-heteropathy therapeutic efficacy in both OA and RA. For the first time, a two-disease model was linked with a TCM formula using network pharmacology to identify the key active components and understand the common mechanisms of its multi-pathway regulation. This study will inspire more innovative and important studies on the modern research of TCM formulas.
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Affiliation(s)
- Yuan-Yuan Shi
- College of Pharmacy, Xinjiang Medical University, Urumqi, 830011, China; State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Ying-Qi Li
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Xiang Xie
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Yu-Ting Zhou
- College of Pharmacy, Xinjiang Medical University, Urumqi, 830011, China
| | - Qian Zhang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Jia-Lin Yu
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Ping Li
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China.
| | - Na Mi
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China.
| | - Fei Li
- College of Pharmacy, Xinjiang Medical University, Urumqi, 830011, China; State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China; Jiangsu Key Laboratory of Druggability of Biopharmaceuticals, China Pharmaceutical University, Nanjing, 210009, China.
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26
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Kim JW, Suh CH. Systemic Manifestations and Complications in Patients with Rheumatoid Arthritis. J Clin Med 2020; 9:jcm9062008. [PMID: 32604884 PMCID: PMC7356332 DOI: 10.3390/jcm9062008] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 11/30/2022] Open
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The GEF Cytohesin-2/ARNO Mediates Resistin induced Phenotypic Switching in Vascular Smooth Muscle Cells. Sci Rep 2020; 10:3672. [PMID: 32111889 PMCID: PMC7048779 DOI: 10.1038/s41598-020-60446-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 02/12/2020] [Indexed: 12/27/2022] Open
Abstract
The pro-inflammatory adipokine resistin induces a phenotypic switch of vascular smooth muscle cells (VSMC), a process decisive for atherosclerosis, including morphological changes, increased synthetic activity, proliferation and migration. The guanine-exchange factor ARNO (Cytohesin-2) has been shown to be important for morphological changes and migration of other cell types. In this study we dissected the role of ARNO in resistin induced VSMC phenotypic switching and signalling. Firstly, treatment with the cytohesin inhibitor Secin H3 prevented the resistin mediated induction of morphological changes in VSMC. Secondly, Secin H3 treatment as well as expression of an inactive ARNO (EK) reduced resistin induced VSMC synthetic activity, as assessed by matrix metalloproteinase 2 (MMP-2) expression, as well as the migration into a wound in vitro compared to ARNO WT expression. Thirdly, we found ARNO to influence MMP-2 expression and migration via activation of p38 MAPK and the JNK/AP-1 pathway. Interestingly, these processes were shown to be dependent on the binding of PIP3, as mutation of the ARNO PH-domain inhibited VSMC migration, MMP-2 expression as well as p38 MAPK and JNK signalling. Thus, we demonstrate that ARNO is an important link in resistin dependent cell signalling leading to morphological changes, MMP-2 production and migration of VSMC.
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28
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Halacoglu J, Shea LA. Cardiovascular Risk Assessment and Therapeutic Implications in Rheumatoid Arthritis. J Cardiovasc Transl Res 2020; 13:878-890. [PMID: 32080804 DOI: 10.1007/s12265-020-09964-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/28/2020] [Indexed: 12/14/2022]
Abstract
Patients with rheumatoid arthritis (RA) suffer from a magnitude of excess cardiovascular risk. A paradoxical lipid pattern has been observed in rheumatoid arthritis patients where low levels of total cholesterol and low-density lipoprotein are associated with a higher risk of cardiovascular disease. This paper aims to break down the evidence explaining why patients with low to normal LDL, and total cholesterol have such excess cardiovascular risk. A component of the enhanced cardiovascular risk is systemic inflammation and the subsequent pro-atherogenic dyslipidemia patterns. Due to this "lipid paradox," current risk algorithms and guidelines designed for the general population may underestimate cardiovascular risk in patients with rheumatoid arthritis. The purpose of this paper is to critically evaluate some of the discrepancies and layers of cardiovascular risk in RA patients, the role RA medication may have in mitigating or increasing cardiovascular risk, and the possible role of statin therapy.
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Affiliation(s)
- Juli Halacoglu
- Rueckert-Hartman College for Health Professions, School of Pharmacy, Regis University, 3333 Regis Blvd H-28, Denver, CO, 80221, USA
| | - Leticia A Shea
- Rueckert-Hartman College for Health Professions, School of Pharmacy, Regis University, 3333 Regis Blvd H-28, Denver, CO, 80221, USA.
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29
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Piovezana Bossolani GD, Silva BT, Colombo Martins Perles JV, Lima MM, Vieira Frez FC, Garcia de Souza SR, Sehaber-Sierakowski CC, Bersani-Amado CA, Zanoni JN. Rheumatoid arthritis induces enteric neurodegeneration and jejunal inflammation, and quercetin promotes neuroprotective and anti-inflammatory actions. Life Sci 2019; 238:116956. [DOI: 10.1016/j.lfs.2019.116956] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/08/2019] [Accepted: 10/10/2019] [Indexed: 02/07/2023]
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30
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Chan MM, Yang X, Wang H, Saaoud F, Sun Y, Fong D. The Microbial Metabolite Trimethylamine N-Oxide Links Vascular Dysfunctions and the Autoimmune Disease Rheumatoid Arthritis. Nutrients 2019; 11:E1821. [PMID: 31394758 PMCID: PMC6723051 DOI: 10.3390/nu11081821] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/21/2019] [Accepted: 08/05/2019] [Indexed: 12/13/2022] Open
Abstract
Diet and microbiota each have a direct impact on many chronic, inflammatory, and metabolic diseases. As the field develops, a new perspective is emerging. The effects of diet may depend on the microbiota composition of the intestine. A diet that is rich in choline, red meat, dairy, or egg may promote the growth, or change the composition, of microbial species. The microbiota, in turn, may produce metabolites that increase the risk of cardiovascular disease. This article reviews our current understanding of the effects of the molecule trimethylamine-N-oxide (TMAO) obtained from food or produced by the microbiota. We review the mechanisms of actions of TMAO, and studies that associate it with cardiovascular and chronic kidney diseases. We introduce a novel concept: TMAO is one among a group of selective uremic toxins that may rise to high levels in the circulation or accumulate in various organs. Based on this information, we evaluate how TMAO may harm, by exacerbating inflammation, or may protect, by attenuating amyloid formation, in autoimmune diseases such as rheumatoid arthritis.
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Affiliation(s)
- Marion M Chan
- Department of Microbiology and Immunology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA.
| | - Xiaofeng Yang
- Center for Inflammation, Translational and Clinical Lung Research, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Hong Wang
- Department of Microbiology and Immunology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
- Center for Metabolic Disease Research, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Fatma Saaoud
- Center for Metabolic Disease Research, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Yu Sun
- Center for Metabolic Disease Research, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Dunne Fong
- Department of Cell Biology and Neuroscience, Rutgers, the State University of New Jersey, Piscataway, NJ 08854, USA
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