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Nayfeh M, DiGregorio H, Saad JM, Al-Mallah M, Al Rifai M. The Emerging Specialty of Cardio-Rheumatology. Curr Atheroscler Rep 2024; 26:499-509. [PMID: 38913292 DOI: 10.1007/s11883-024-01221-7] [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] [Accepted: 06/07/2024] [Indexed: 06/25/2024]
Abstract
PURPOSE OF REVIEW In this review, we aimed to summarize the different aspects of the field of cardio-rheumatology, the role of the cardio-rheumatologist, and future research in the field. RECENT FINDINGS Cardio-rheumatology is an emerging subspecialty within cardiology that focuses on addressing the intricate relationship between systemic inflammation and cardiovascular diseases. It involves understanding the cardiovascular impact of immune-mediated inflammatory diseases on the heart and vascular system. A cardio-rheumatologist's role is multifaceted. First, they should understand the cardiac manifestations of rheumatological diseases. They should also be knowledgeable about the different immunotherapies available and side effects. Additionally, they should know how to utilize imaging modalities, either for diagnosis, prognosis, or treatment monitoring. This field is constantly evolving with new research on both treatment and imaging of the effects of inflammation on the cardiovascular system.
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Affiliation(s)
- Malek Nayfeh
- Houston Methodist Academic Institute, Houston Methodist DeBakey Heart & Vascular Center, 6550 Fannin Street, Smith Tower - Suite 1801, Houston, TX, 77030, USA
| | | | | | - Mouaz Al-Mallah
- Houston Methodist Academic Institute, Houston Methodist DeBakey Heart & Vascular Center, 6550 Fannin Street, Smith Tower - Suite 1801, Houston, TX, 77030, USA
| | - Mahmoud Al Rifai
- Houston Methodist Academic Institute, Houston Methodist DeBakey Heart & Vascular Center, 6550 Fannin Street, Smith Tower - Suite 1801, Houston, TX, 77030, USA.
- Weill Cornell Medicine, Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin Street, Smith Tower - Suite 1801, Houston, TX, 77030, USA.
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Li G, Yang H, Zhang D, Zhang Y, Liu B, Wang Y, Zhou H, Xu ZX, Wang Y. The role of macrophages in fibrosis of chronic kidney disease. Biomed Pharmacother 2024; 177:117079. [PMID: 38968801 DOI: 10.1016/j.biopha.2024.117079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/23/2024] [Accepted: 06/29/2024] [Indexed: 07/07/2024] Open
Abstract
Macrophages are widely distributed throughout various tissues of the body, and mounting evidence suggests their involvement in regulating the tissue microenvironment, thereby influencing disease onset and progression through direct or indirect actions. In chronic kidney disease (CKD), disturbances in renal functional homeostasis lead to inflammatory cell infiltration, tubular expansion, glomerular atrophy, and subsequent renal fibrosis. Macrophages play a pivotal role in this pathological process. Therefore, understanding their role is imperative for investigating CKD progression, mitigating its advancement, and offering novel research perspectives for fibrosis treatment from an immunological standpoint. This review primarily delves into the intrinsic characteristics of macrophages, their origins, diverse subtypes, and their associations with renal fibrosis. Particular emphasis is placed on the transition between M1 and M2 phenotypes. In late-stage CKD, there is a shift from the M1 to the M2 phenotype, accompanied by an increased prevalence of M2 macrophages. This transition is governed by the activation of the TGF-β1/SMAD3 and JAK/STAT pathways, which facilitate macrophage-to-myofibroblast transition (MMT). The tyrosine kinase Src is involved in both signaling cascades. By thoroughly elucidating macrophage functions and comprehending the modes and molecular mechanisms of macrophage-fibroblast interaction in the kidney, novel, tailored therapeutic strategies for preventing or attenuating the progression of CKD can be developed.
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Affiliation(s)
- Guangtao Li
- Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun 130021, China
| | - Hongxia Yang
- Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun 130021, China
| | - Dan Zhang
- Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun 130021, China
| | - Yanghe Zhang
- Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun 130021, China
| | - Bin Liu
- Department of Urology, The First Hospital of Jilin University, Changchun 130021, China
| | - Yuxiong Wang
- Department of Urology, The First Hospital of Jilin University, Changchun 130021, China
| | - Honglan Zhou
- Department of Urology, The First Hospital of Jilin University, Changchun 130021, China.
| | - Zhi-Xiang Xu
- Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun 130021, China.
| | - Yishu Wang
- Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun 130021, China.
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Milella MS, Geminiani M, Trezza A, Visibelli A, Braconi D, Santucci A. Alkaptonuria: From Molecular Insights to a Dedicated Digital Platform. Cells 2024; 13:1072. [PMID: 38920699 PMCID: PMC11201470 DOI: 10.3390/cells13121072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 06/27/2024] Open
Abstract
Alkaptonuria (AKU) is a genetic disorder that affects connective tissues of several body compartments causing cartilage degeneration, tendon calcification, heart problems, and an invalidating, early-onset form of osteoarthritis. The molecular mechanisms underlying AKU involve homogentisic acid (HGA) accumulation in cells and tissues. HGA is highly reactive, able to modify several macromolecules, and activates different pathways, mostly involved in the onset and propagation of oxidative stress and inflammation, with consequences spreading from the microscopic to the macroscopic level leading to irreversible damage. Gaining a deeper understanding of AKU molecular mechanisms may provide novel possible therapeutical approaches to counteract disease progression. In this review, we first describe inflammation and oxidative stress in AKU and discuss similarities with other more common disorders. Then, we focus on HGA reactivity and AKU molecular mechanisms. We finally describe a multi-purpose digital platform, named ApreciseKUre, created to facilitate data collection, integration, and analysis of AKU-related data.
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Affiliation(s)
- Maria Serena Milella
- ONE-HEALTH Lab, Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy; (M.S.M.); (A.T.); (A.V.); (D.B.); (A.S.)
| | - Michela Geminiani
- ONE-HEALTH Lab, Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy; (M.S.M.); (A.T.); (A.V.); (D.B.); (A.S.)
- SienabioACTIVE-SbA, Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
| | - Alfonso Trezza
- ONE-HEALTH Lab, Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy; (M.S.M.); (A.T.); (A.V.); (D.B.); (A.S.)
| | - Anna Visibelli
- ONE-HEALTH Lab, Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy; (M.S.M.); (A.T.); (A.V.); (D.B.); (A.S.)
| | - Daniela Braconi
- ONE-HEALTH Lab, Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy; (M.S.M.); (A.T.); (A.V.); (D.B.); (A.S.)
| | - Annalisa Santucci
- ONE-HEALTH Lab, Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy; (M.S.M.); (A.T.); (A.V.); (D.B.); (A.S.)
- SienabioACTIVE-SbA, Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
- ARTES 4.0, Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
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Gill VS, Boddu SP, Abujbarah S, Mathis KL, Merchea A, Brady JT. Secondary amyloidosis in inflammatory bowel disease patients: findings from three tertiary medical centers. Clin J Gastroenterol 2024:10.1007/s12328-024-02003-z. [PMID: 38880849 DOI: 10.1007/s12328-024-02003-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 06/11/2024] [Indexed: 06/18/2024]
Abstract
Secondary amyloidosis (AA) is a disorder of protein conformation associated with inflammatory disorders. Detailed reports of patients diagnosed with AA and inflammatory bowel disease (IBD) are limited. This study reports the cases of eight patients, across three tertiary medical centers, diagnosed with both IBD and AA between 2000 and 2020. Seven patients had a diagnosis of Crohn disease (CD), while one had ulcerative colitis (UC). All patients were diagnosed with AA after being diagnosed with IBD (median: 15 years later). The small bowel (62.5%) and the colon (62.5%) were the most common IBD locations. 4 patients had undergone TNF-alpha inhibitor therapy and all CD patients required surgical treatment of their IBD. A history of fistula or abscess was identified in 5 patients. The most common initial site of AA was the kidney (75%). All 8 patients presented with some form of renal dysfunction and proteinuria (median: 1500 mg/24 h). Hypoalbuminemia was found in most patients. Six patients developed chronic kidney disease and 4 required dialysis. Anti TNF-alpha antibody therapy led to rapid improvement of renal function in one of four patients who received it. Three patients required a renal transplant. Four patients had died upon the latest follow-up (5-year survival: 75%). The presence of proteinuria, fistula, or abscess should serve as indicators for potentially increased AA risk in CD patients.
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Affiliation(s)
- Vikram S Gill
- Mayo Clinic Alix School of Medicine, 5777 East Mayo Boulevard, Scottsdale, AZ, 85054, USA.
| | - Sayi P Boddu
- Mayo Clinic Alix School of Medicine, 5777 East Mayo Boulevard, Scottsdale, AZ, 85054, USA
| | - Sami Abujbarah
- Mayo Clinic Alix School of Medicine, 5777 East Mayo Boulevard, Scottsdale, AZ, 85054, USA
| | | | - Amit Merchea
- Department of Surgery, Mayo Clinic, Jacksonville, FL, USA
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Rauf SA, Shah HH, Khatri R, Ul Haq M, Dave T, Ali JP, Ali SK. Gastrointestinal amyloidosis in a 50-year-old patient with miliary tuberculosis: A case report. Clin Case Rep 2024; 12:e8978. [PMID: 38799515 PMCID: PMC11126638 DOI: 10.1002/ccr3.8978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/23/2024] [Accepted: 05/08/2024] [Indexed: 05/29/2024] Open
Abstract
This case highlights the importance of considering tuberculosis as an underlying cause of gastrointestinal amyloidosis, even in patients previously treated for the infection. Clinicians should maintain a high index of suspicion for atypical presentations of amyloidosis, especially in individuals with chronic inflammation, enabling early diagnosis and tailored management for improved patient outcomes. Abstract Gastrointestinal amyloidosis is a rare condition often associated with chronic inflammation. We present a unique case of a 50-year-old female with a history of miliary tuberculosis who developed gastrointestinal amyloidosis. The patient exhibited chronic loose stools, weight loss, abdominal pain, and urinary incontinence symptoms. Diagnostic workup revealed characteristic findings of amyloidosis on biopsy. Despite treatment for tuberculosis, her symptoms persisted, highlighting the challenging nature of managing this condition. This case underscores the importance of considering tuberculosis as a potential cause of secondary amyloidosis in patients with ongoing symptoms of inflammation and infection. Early recognition and tailored management are crucial in optimizing patient outcomes.
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Affiliation(s)
- Sameer Abdul Rauf
- Department of Internal MedicineLiaquat National Hospital and Medical CollegeKarachiPakistan
| | - Hussain Haider Shah
- Department of Internal MedicineDow University of Health SciencesKarachiPakistan
| | - Rahul Khatri
- Department of Internal MedicineLiaquat National Hospital and Medical CollegeKarachiPakistan
| | - Mansoor Ul Haq
- Department of GastroenterologyLiaquat National Hospital and Medical CollegeKarachiPakistan
| | - Tirth Dave
- Bukovinian State Medical UniversityChernivtsiUkraine
| | - Javaria Parwez Ali
- Department of HistopathologyLiaquat National Hospital and Medical CollegeKarachiPakistan
| | - Syed Khizar Ali
- Department of Internal MedicineLiaquat National Hospital and Medical CollegeKarachiPakistan
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Qin Y, Shao B, Ren SH, Ye K, Qin H, Wang HD, Sun C, Zhu Y, Wang Z, Zhang J, Li X, Wang H. Interleukin-37 contributes to endometrial regenerative cell-mediated immunotherapeutic effect on chronic allograft vasculopathy. Cytotherapy 2024; 26:299-310. [PMID: 38159090 DOI: 10.1016/j.jcyt.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 11/26/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND AIMS Chronic allograft vasculopathy (CAV) remains a predominant contributor to late allograft failure after organ transplantation. Several factors have already been shown to facilitate the progression of CAV, and there is still an urgent need for effective and specific therapeutic approaches to inhibit CAV. Human mesenchymal-like endometrial regenerative cells (ERCs) are free from the deficiencies of traditional invasive acquisition methods and possess many advantages. Nevertheless, the exact immunomodulation mechanism of ERCs remains to be elucidated. METHODS C57BL/6 (B6) mouse recipients receiving BALB/c mouse donor abdominal aorta transplantation were treated with ERCs, negative control (NC)-ERCs and interleukin (IL)-37-/-ERCs (ERCs with IL-37 ablation), respectively. Pathologic lesions and inflammatory cell infiltration in the grafts, splenic immune cell populations, circulating donor-specific antibody levels and cytokine profiles were analyzed on postoperative day (POD) 40. The proliferative capacities of Th1, Th17 and Treg subpopulations were assessed in vitro. RESULTS Allografts from untreated recipients developed typical pathology features of CAV, namely endothelial thickening, on POD 40. Compared with untreated and IL-37-/-ERC-treated groups, IL-37-secreting ERCs (ERCs and NC-ERCs) significantly reduced vascular stenosis, the intimal hyperplasia and collagen deposition. IL-37-secreting ERCs significantly inhibited the proliferation of CD4+T cells, reduced the proportions of Th1 and Th17 cells, but increased the proportion of Tregs in vitro. Furthermore, in vitro results also showed that IL-37-secreting ERCs significantly inhibited Th1 and Th17 cell responses, abolished B-cell activation, diminished donor-specific antibody production and increased Treg proportions. Notably, IL-37-secreting ERCs remarkably downregulated the levels of pro-inflammatory cytokines (interferon-γ, tumor necrosis factor-α, IL-1β, IL-6 and IL-17A) and increased IL-10 levels in transplant recipients. CONCLUSIONS The knockdown of IL-37 dramatically abrogates the therapeutic ability of ERCs for CAV. Thus, this study highlights that IL-37 is indispensable for ERC-mediated immunomodulation for CAV and improves the long-term allograft acceptance.
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Affiliation(s)
- Yafei Qin
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, PR China; Department of Vascular Surgery, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, PR China.
| | - Bo Shao
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, PR China; Tianjin General Surgery Institute, Tianjin Medical University General Hospital, Tianjin, PR China.
| | - Shao-Hua Ren
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, PR China; Tianjin General Surgery Institute, Tianjin Medical University General Hospital, Tianjin, PR China.
| | - Kui Ye
- Department of Vascular Surgery, Tianjin Fourth Central Hospital, The Fourth Central Clinical College, Tianjin Medical University, Tianjin, PR China.
| | - Hong Qin
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, PR China; Tianjin General Surgery Institute, Tianjin Medical University General Hospital, Tianjin, PR China.
| | - Hong-da Wang
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, PR China; Tianjin General Surgery Institute, Tianjin Medical University General Hospital, Tianjin, PR China.
| | - Chenglu Sun
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, PR China; Tianjin General Surgery Institute, Tianjin Medical University General Hospital, Tianjin, PR China.
| | - Yanglin Zhu
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, PR China; Tianjin General Surgery Institute, Tianjin Medical University General Hospital, Tianjin, PR China.
| | - Zhaobo Wang
- School of Basic Medical Sciences, Tianjin Medical University, Tianjin, PR China.
| | - Jingyi Zhang
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, PR China; Tianjin General Surgery Institute, Tianjin Medical University General Hospital, Tianjin, PR China.
| | - Xiang Li
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, PR China; Tianjin General Surgery Institute, Tianjin Medical University General Hospital, Tianjin, PR China.
| | - Hao Wang
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, PR China; Tianjin General Surgery Institute, Tianjin Medical University General Hospital, Tianjin, PR China.
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Collet A, Attias P, Lacou M, Fieschi C, Moktefi A, Sannier A, Grateau G, Buob D, Georgin-Lavialle S. AA-type amyloidosis associated with lymphoma: a study of 19 cases including 5 new French cases and a systematic literature review. Leuk Lymphoma 2023; 64:1857-1863. [PMID: 37493601 DOI: 10.1080/10428194.2023.2239971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/18/2023] [Indexed: 07/27/2023]
Affiliation(s)
- Aurore Collet
- Sorbonne Université, GRC 28 SU, AP-HP, Hôpital Tenon, Service de médecine interne, Centre de référence des maladies auto-inflammatoires et des amyloses d'origine inflammatoire (CEREMAIA), Paris, France
| | - Philippe Attias
- Hôpital privé Nord Parisien, Service de néphrologie, Paris, France
| | - Mathieu Lacou
- CHU de Nantes, service de médecine interne, Nantes, France
| | - Claire Fieschi
- Clinical Immunology Department, Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris (APHP) Université Paris Diderot, Paris, France
| | - Anissa Moktefi
- APHP (Assistance Publique-Hôpitaux de Paris), Département de Pathologie, Hôpitaux Universitaires Henri Mondor, Univ Paris Est Créteil, Créteil, France
| | - Aurélie Sannier
- Département de Pathologie, Université de Paris, INSERM U1148, Hôpital Bichat, Paris, France
| | - Gilles Grateau
- Sorbonne Université, GRC 28 SU, AP-HP, Hôpital Tenon, Service de médecine interne, Centre de référence des maladies auto-inflammatoires et des amyloses d'origine inflammatoire (CEREMAIA), Paris, France
| | - David Buob
- AP-HP, Hôpital Tenon, Anatomie et cytologie pathologiques, Paris, France
| | - Sophie Georgin-Lavialle
- Sorbonne Université, GRC 28 SU, AP-HP, Hôpital Tenon, Service de médecine interne, Centre de référence des maladies auto-inflammatoires et des amyloses d'origine inflammatoire (CEREMAIA), Paris, France
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Khanal UP, Ghimire P, Shahi T, Dhakal TR, Jha S. Secondary cardiac amyloidosis in a patient with mixed connective tissue disease: A case report. Clin Case Rep 2023; 11:e07669. [PMID: 37426686 PMCID: PMC10323719 DOI: 10.1002/ccr3.7669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/06/2023] [Accepted: 06/19/2023] [Indexed: 07/11/2023] Open
Abstract
We report the case of a 62-year-old man who presented with shortness of breath, cough, bilateral lower limbs' swelling, and blackish discoloration of multiple fingertips over the past 2 months. Anti-Ribonucleoprotein antibodies were found to be present, and gadolinium-based cardiac MRI showed non-vascular subendocardial enhancement with diffuse symmetrical thickening of the left ventricular wall. A diagnosis of Mixed connective tissue disease with secondary cardiac amyloidosis was thus made, and the patient was successfully managed with intravenous cyclophosphamide, corticosteroids, and other supportive measures. Although extremely rare, this case shows that secondary cardiac amyloidosis should be considered while managing patients with MCTD.
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Affiliation(s)
| | - Prinska Ghimire
- Institute of Medicine, Tribhuwan University Teaching HospitalKathmanduNepal
| | - Tejash Shahi
- Institute of Medicine, Tribhuwan University Teaching HospitalKathmanduNepal
| | - Tulsi Ram Dhakal
- Institute of Medicine, Tribhuwan University Teaching HospitalKathmanduNepal
| | - Saket Jha
- Institute of Medicine, Tribhuwan University Teaching HospitalKathmanduNepal
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Lee TH, Maruthai Y, Abd Aziz NH, Chua KH, Hamdan N, Lee CH, Azmi NA. Chemopreventive and immunoadjuvant properties of standardised edible bird’s nest extract on human breast cancer cell line. INTERNATIONAL FOOD RESEARCH JOURNAL 2023; 30:472-486. [DOI: 10.47836/ifrj.30.2.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
The present work investigated the chemopreventive and immunoadjuvant properties of edible bird’s nest (EBN) extract on breast cancer cell line (MCF-7). Specifically, the cytotoxicity level of EBN extracts (HMG, EHMG, pHMG) against MCF-7, human immune cells of cytotoxic T cells, and monocytes (CD8+ and CD14+) were evaluated by measuring the production of pro-apoptotic and anti-apoptotic molecules released in single and co-culture of MCF-7, CD8+, and CD14+ cells, before and after EBN treatment. The highest cytotoxic effect towards MCF-7 using IC50 of 15 µg/mL was demonstrated by HMG but no effects on CD8+ and CD14+, with cell viability of more than 90%. At the mRNA level, activated CD8+ and CD14+ depicted increased pro-apoptotic gene expression after HMG treatment in co-culture. Additionally, HMG treatment increased apoptosis by down-regulating the regulation of anti-apoptotic genes and up-regulating the pro-apoptotic genes in MCF-7. ELISA and multiplex assay reflected increased pro-apoptotic factors, and decreased anti-apoptotic soluble factors, by non-activated and activated CD8+ and CD14+, in a single or co-culture with MCF-7 after HMG treatment. In conclusion, HMG extract possesses immunoadjuvant properties that can be a potential anticancer agent without causing any deleterious effects on the human immune cells.
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L-theanine protects rat kidney from D-galactose-induced injury via inhibition of the AGEs/RAGE signaling pathway. Eur J Pharmacol 2022; 927:175072. [PMID: 35636523 DOI: 10.1016/j.ejphar.2022.175072] [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: 02/27/2022] [Revised: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 11/20/2022]
Abstract
As the irreversible products of the non-enzymatic reduction of sugars and the amino groups of proteins or peptides, advanced glycation end products (AGEs) are metabolized and excreted via the kidneys. However, if AGEs are not metabolized, they are deposited in the kidneys and bind to AGE receptors (RAGE), which can induce various pathological changes, including oxidative stress, apoptosis, and inflammation. This study used the D-galactose (DG)-induced rat model to explore the potential role and mechanism of L-theanine in inhibiting AGEs/RAGE-related signaling pathways in renal tissues. L-theanine increased the activities of glutathione peroxidase (GSH-Px) and total antioxidant capacity (T-AOC) while downregulating the contents of malondialdehyde (MDA) and AGEs in renal tissues induced by DG (P < 0.05). By inhibiting the upregulation of RAGE protein expression attributed to AGEs accumulation (P < 0.05), L-theanine downregulated phosphorylated nuclear factor (p-NF-κB (p65)), Bax, and cleaved-caspase-3 expression and increased Bcl-2 protein expression (P < 0.05), thereby alleviating the oxidative stress damage and reducing the inflammation and cell injury induced by DG. In addition, the Congo red staining section of renal tissue also showed that the natural product L-theanine can protect against AGEs-induced renal damage in DG-induced rat model.
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11
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Amatruda M, Carucci NS, Fede C, Conti G. Subclinical TRAPS treated with canakinumab. Reumatismo 2021; 73:131-134. [PMID: 34342215 DOI: 10.4081/reumatismo.2021.1406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 06/13/2021] [Indexed: 11/23/2022] Open
Abstract
Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is a rare autoinflammatory disease characterized by recurrent episodes of fever and systemic inflammation. We describe the case of a 19-year-old patient who was referred to our attention with frequent subclinical TRAPS episodes characterized by mild arthralgias and crampy abdominal pain, without fever. Inflammatory markers, including serum amyloid A which increases the risk of long-term amyloidosis, were persistently high also when the patient was in good general conditions. Therapy with human anti-interleukin 1β monoclonal antibody, canakinumab, led to disease control and normalization of the inflammatory markers, which are currently still normal. This clinical case supports the need to treat also subclinical TRAPS. In this respect, canakinumab is effective and reduces the risk of developing amyloidosis.
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Affiliation(s)
- M Amatruda
- Pediatric Nephrology and Rheumatology Unit with Dialysis, Department of Human Pathology in Adulthood and Childhood "G. Barresi"; AOU Policlinic "G. Martino", Messina University.
| | - N S Carucci
- Pediatric Nephrology and Rheumatology Unit with Dialysis, Department of Human Pathology in Adulthood and Childhood "G. Barresi"; AOU Policlinic "G. Martino", Messina University.
| | - C Fede
- Pediatric Nephrology and Rheumatology Unit with Dialysis, Department of Human Pathology in Adulthood and Childhood "G. Barresi"; AOU Policlinic "G. Martino", Messina University.
| | - G Conti
- Pediatric Nephrology and Rheumatology Unit with Dialysis, Department of Human Pathology in Adulthood and Childhood "G. Barresi"; AOU Policlinic "G. Martino", Messina University.
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Wopara I, Modo EU, Mobisson SK, Olusegun GA, Umoren EB, Orji BO, Mounmbegna PE, Ujunwa SO. Synthetic Food dyes cause testicular damage via up-regulation of pro-inflammatory cytokines and down-regulation of FSH-R and TESK-1 gene expression. JBRA Assist Reprod 2021; 25:341-348. [PMID: 33565293 PMCID: PMC8312291 DOI: 10.5935/1518-0557.20200097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: This study investigated the effects of Tartrazine and Erythrosine (T+E) on the reproductive hormones and expression of some pro-inflammatory cytokines and testicular genes in testis of male Wistar rats. Methods: 25 male Wistar rats (150-180g) were divided into 5 groups (n=5). Group 1 received distilled water while groups 2, 3, 4 and 5 were treated with T+E (2.5mg/kg, 5mg/kg, 10mg/kg and 20mg/kg) for the period of 23 days. Toxicity studies of the combined dye were investigated by evaluating serum reproductive hormones [Follicle stimulating hormone (FSH), Luteinizing hormone (LH), Testosterone], gene expression and profiling, and testes histology. Results: male Wistar rats (150-180g) were divided into 5 groups (n=5). Group 1 received distilled water while groups 2, 3, 4 and 5 were treated with T+E (2.5mg/kg, 5mg/kg, 10mg/kg and 20mg/kg) for the period of 23 days. Toxicity studies of the combined dye were investigated by evaluating serum reproductive hormones [Follicle stimulating hormone (FSH), Luteinizing hormone (LH), Testosterone], gene expression and profiling, and testes histology. Conclusions: This present study reveals that the dyes could impair testicular function as evident in the up-regulation of pro-inflammatory cytokines and down-regulation of TESK-1 gene expression and architecture of the testes leading to Orchitis.
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Affiliation(s)
- Iheanyichukwu Wopara
- Department of Biochemistry, Faculty of Basic Medical Sciences, PAMO University of Medical Sciences, Nigeria
| | - Emmanuel U Modo
- Department of Biochemistry, Faculty of Sciences, Madonna University, Nigeria
| | - Samuel Kelechi Mobisson
- Department of Human Physiology, Faculty of Basic Medical Sciences, Madonna University, Nigeria
| | - G Adebayo Olusegun
- Department of Physiology, Faculty of Basic Medical Sciences, PAMO University of Medical Sciences, Nigeria
| | - E B Umoren
- Department of Physiology, Faculty of Basic Medical Sciences, PAMO University of Medical Sciences, Nigeria
| | - Blessing O Orji
- Department of Biochemistry and Molecular Biology, Federal university Dutsin-ma, Katsina State, Nigeria
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13
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Azeez OM, Amid SA, Abdulkadir ZS, Biobaku KT. Maintenance Impact of Large Dose of Vitamin C on Proinflammatory Cytokines, Insulin, and Electrocardiographic Parameters of Wistar Rats Following Partial Pancreatectomy. J Interferon Cytokine Res 2021; 41:187-194. [PMID: 34003682 DOI: 10.1089/jir.2020.0261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We investigated serum tumor necrosis factor alpha (TNF-α) and interleukins (IL-6 and IL-8) in rats undergoing pancreatic wound healing after partial pancreatectomy. In addition, we studied the effects of partial pancreatectomy on the insulin and the electrocardiography (ECG). We proposed that vitamin C (VitC) could have maintenance impact on TNF-α, IL-6, IL-8, insulin, and ECG parameters of pancreatic wound healing of Wistar rats that had partial pancreatectomy surgery, if administered in large dose. Thirty-five male adult Wistar rats (180-250 g) were randomized into 7 groups, with 5 rats in each group. Group 1 was control. Groups 2, 3, and 4 (phase 1) received oral 1,000 mg/kg VitC, while groups 5, 6, and 7 (phase 2) received only water and feed ad libitum postoperatively for 14 days. One-quarter (¼) pancreatectomy was performed in groups 2 and 5, half (½) pancreatectomy was performed in groups 3 and 6, and three-quarter (¾) pancreatectomy was performed in groups 4 and 7. Significant (P < 0.5) decrease in IL-6 was observed in phase 1 when compared with the control. Significant increase in IL-6 was observed when compared with control. Significant increase in IL-8 was observed in phase 1 (groups 2 and 3) and phase 2 when compared with the control. Significant decrease in TNF-α was observed in phase 1 when compared with the control. Significant decrease in TNF-α was observed in phase 2 (groups 6 and 7) when compared with the control. Insulin level decreased and increased insignificantly in phase 2 and phase 1, respectively, when compared with the control. Although atrial fibrillation was recorded in phase 2 (group 7), normal ECG was seen in the control and phase 1 (group 2). Large dose vitC may be helpful in the reduction of proinflammatory cytokines as well as elevation of insulin and normalization of ECG in rats that had undergone partial pancreatectomy.
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Affiliation(s)
- Oyebisi Mistura Azeez
- Department of Veterinary Physiology and Biochemistry, Faculty of Veterinary Medicine, University of Ilorin, Ilorin, Nigeria
| | - Sadudeen Adetayo Amid
- Department of Veterinary Surgery and Radiology and Faculty of Veterinary Medicine, University of Ilorin, Ilorin, Nigeria
| | - Zubair Salman Abdulkadir
- Department of Veterinary Surgery and Radiology and Faculty of Veterinary Medicine, University of Ilorin, Ilorin, Nigeria
| | - Khalid Talha Biobaku
- Department of Veterinary Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Ilorin, Ilorin, Nigeria
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Kridin K, Patel PM, Amber KT, Cohen AD. 'Hidradenitis suppurativa and amyloidosis: a possible association with the pyrin inflammasome': reply from authors. Clin Exp Dermatol 2021; 46:1118-1119. [PMID: 33908073 DOI: 10.1111/ced.14638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 11/28/2022]
Affiliation(s)
- K Kridin
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - P M Patel
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
| | - K T Amber
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
| | - A D Cohen
- Department of Quality Measurements and Research, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel.,Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Convolutional neural networks with image representation of amino acid sequences for protein function prediction. Comput Biol Chem 2021; 92:107494. [PMID: 33930742 DOI: 10.1016/j.compbiolchem.2021.107494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/21/2021] [Indexed: 01/11/2023]
Abstract
Proteins are one of the most important molecules that govern the cellular processes in most of the living organisms. Various functions of the proteins are of paramount importance to understand the basics of life. Several supervised learning approaches are applied in this field to predict the functionality of proteins. In this paper, we propose a convolutional neural network based approach ProtConv to predict the functionality of proteins by converting the amino-acid sequences to a two dimensional image. We have used a protein embedding technique using transfer learning to generate the feature vector. Feature vector is then converted into a square sized single channel image to be fed into a convolutional network. The neural network architecture used here is a combination of convolutional filters and average pooling layers followed by dense fully connected layers to predict a binary function. We have performed experiments on standard benchmark datasets taken from two very important protein function prediction task: proinflammatory cytokines and anticancer peptides. Our experiments show that the proposed method, ProtConv achieves state-of-the-art performances on both of the datasets. All necessary details about implementation with source code and datasets are made available at: https://github.com/swakkhar/ProtConv.
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Serum Amyloid A Is a Biomarker of Disease Activity and Health-Related Quality-of-Life in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis. DISEASE MARKERS 2020; 2020:8847306. [PMID: 33488845 PMCID: PMC7787824 DOI: 10.1155/2020/8847306] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 11/26/2020] [Accepted: 12/04/2020] [Indexed: 11/17/2022]
Abstract
Serum amyloid A (SAA) is one of the acute phase proteins synthesized in hepatocytes and secreted by various inflammation or infectious stimuli. We investigated the clinical implication of measuring SAA in patients with antineutrophil cytoplasmic antibody- (ANCA-) associated vasculitis (AAV). Seventy-five patients who had been classified as AAV and enrolled in our prospective observational cohort for AAV patients were included. Clinical and laboratory data were obtained on the day of blood sampling, and SAA was measured by ELISA kits. Birmingham Vasculitis Activity Score (BVAS) and Short-Form 36-Item Health Survey (SF-36) were assessed for disease activity and health-related quality-of-life (HRQoL) measures. We stratified patients into having high BVAS when the BVAS was over the median values, and those with either low SF-36 PCS or low SF-36 MCS were defined as having poor HRQoL. Multivariate logistic regression analysis was conducted to estimate independent predictors of high BVAS. The relative risk (RR) was analyzed using the contingency tables and the chi-squared test. SAA was positively correlated with BVAS (r = 0.642) and FFS (r = 0.367) and was inversely correlated with both the SF-36 physical component summary (r = -0.456) and mental component summary scores (r = -0.394). Furthermore, SAA was significantly correlated with acute phase reactants ESR (r = 0.611) and CRP (r = 0.629). Patients with high BVAS exhibited significantly higher SAA than those with low BVAS (1317.1 ng/mL vs. 423.1 ng/mL). In multivariable logistic regression analysis, serum albumin (odds ratio (OR) 0.132) and SAA > 1173.6 ng/mL (OR 15.132) were independently associated with high BVAS. The risk of having high BVAS and poor HRQoL in patients with SAA > 1173.6 ng/mL was higher than in those with SAA ≤ 1173.6 ng/mL (RR 3.419 and 1.493). Our results suggest that SAA might be a useful biomarker in assessing disease activity and HRQoL in AAV.
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Khatun MS, Hasan MM, Shoombuatong W, Kurata H. ProIn-Fuse: improved and robust prediction of proinflammatory peptides by fusing of multiple feature representations. J Comput Aided Mol Des 2020; 34:1229-1236. [DOI: 10.1007/s10822-020-00343-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 09/16/2020] [Indexed: 12/11/2022]
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Interplay between Oxidative Stress, Inflammation, and Amyloidosis in the Anterior Segment of the Eye; Its Pathological Implications. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:6286105. [PMID: 32566091 PMCID: PMC7291327 DOI: 10.1155/2020/6286105] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/02/2020] [Accepted: 05/11/2020] [Indexed: 12/11/2022]
Abstract
There are different pathologies associated with amyloidogenic processes caused by the increase of reactive oxygen species (ROS) and the overactivation of inflammatory responses. These alterations are present in different regions of the anterior segment of the eye, and they have been associated with the development and progression of ocular pathologies, such as glaucoma, dry eye syndrome, keratitis, and cataracts among other pathologies. Aim. To discuss briefly the anatomical characteristics of the anterior segment of the eye and describe the interaction between oxidative stress (OS) and inflammatory responses, emphasizing the misfolding of several proteins leading to amyloidogenic processes occurring in the anterior segment and their implications in the development of ocular diseases. We performed a search on PubMed, CINAHL, and Embase using the MeSH terms “eye,” “anterior segment”, “inflammation”, “oxidative stress”, and “amyloidosis”. The search encompassed manuscripts published up to April 2019. A hundred forty-four published studies met the inclusion criteria. We present the current knowledge regarding the interaction between OS and the activation of inflammatory processes and how both can cause conformational changes in several peptides and proteins in each compartment of the anterior segment. However, we found that there is no consensus about which factor is the first to cause amyloidosis. Our conclusions suggest that there is an interplay among these factors forming a vicious cycle that leads to the loss of protein structure in ocular pathologies, and multifactorial therapies should be developed to avoid protein misfolding and to stop the progression of ocular pathologies.
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Duncan SE, Gao S, Sarhene M, Coffie JW, Linhua D, Bao X, Jing Z, Li S, Guo R, Su J, Fan G. Macrophage Activities in Myocardial Infarction and Heart Failure. Cardiol Res Pract 2020; 2020:4375127. [PMID: 32377427 PMCID: PMC7193281 DOI: 10.1155/2020/4375127] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 02/06/2023] Open
Abstract
Heart diseases remain the major cause of death worldwide. Advances in pharmacological and biomedical management have resulted in an increasing proportion of patients surviving acute heart failure (HF). However, many survivors of HF in the early stages end up increasing the disease to chronic HF (CHF). HF is an established frequent complication of myocardial infarction (MI), and numerous influences including persistent myocardial ischemia, shocked myocardium, ventricular remodeling, infarct size, and mechanical impairments, as well as hibernating myocardium trigger the development of left ventricular systolic dysfunction following MI. Macrophage population is active in inflammatory process, yet the clear understanding of the causative roles for these macrophage cells in HF development and progression is actually incomplete. Long ago, it was thought that macrophages are of importance in the heart after MI. Also, though inflammation is as a result of adverse HF in patients, but despite the fact that broad immunosuppression therapeutic target has been used in various clinical trials, no positive results have showed up, but rather, the focus on proinflammatory cytokines has proved more benefits in patients with HF. Therefore, in this review, we discuss the recent findings and new development about macrophage activations in HF, its role in the healthy heart, and some therapeutic targets for myocardial repair. We have a strong believe that there is a need to give maximum attention to cardiac resident macrophages due to the fact that they perform various tasks in wound healing, self-renewal of the heart, and tissue remodeling. Currently, it has been discovered that the study of macrophages goes far beyond its phagocytotic roles. If researchers in future confirm that macrophages play a vital role in the heart, they can be therapeutically targeted for cardiac healing.
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Affiliation(s)
- Sophia Esi Duncan
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
| | - Shan Gao
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Michael Sarhene
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
| | - Joel Wake Coffie
- State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Deng Linhua
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
| | - Xingru Bao
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
| | - Zhang Jing
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
| | - Sheng Li
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
| | - Rui Guo
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
| | - Jing Su
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
| | - Guanwei Fan
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
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Amid AS, Makinde OA, Akinrinmade FJ. Effects of Melatonin and Flavonoid-Rich Fractions of Chromolaena odorata on the Alteration of Proinflammatory Cytokines and Nitric Oxide Induced by Aflatoxin B1 in the Gastric Mucosa of Wistar Rats. J Interferon Cytokine Res 2020; 40:182-187. [PMID: 32083508 DOI: 10.1089/jir.2019.0101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In this study, we investigated serum interleukin-1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α) after ingestion of aflatoxin B1 (AFB1) in rats. We also studied the effects of nitric oxide (NO) on the stomach after consumption of AFB1. Therefore, we hypothesized that a standard anti-inflammatory agent-melatonin (MEL), and the flavonoid-rich fractions from Chromolaena odorata (FRFC) could counteract the deleterious effects of IL-1β, TNF-α, and NO after consumption of AFB1. Thirty-five Wistar rats (211.86 ± 27.23 g) were randomly selected into 5 groups, with 7 rats in each group. Group A (control); all rats in groups B, C, D, and E received 2.5 mg/kg AFB1 each orally on day 5, whereas those of groups C, D, and E received oral administration of 10 mg/kg MEL, 50 mg/kg FRFC1, and 100 mg/kg FRFC2, respectively, for 7 days. All of them were killed on the 8th day, 24 h after last treatment. Serum samples were analyzed for IL-1β and TNF-α, whereas stomach tissue was evaluated for NO level. Significant (P < 0.5) increase in serum IL-1β and TNF-α in rats given AFB1 only was recorded when compared with those in the control group. Conversely, we observed significant reduction in serum IL-1β and TNF-α in all the groups that received MEL, FRFC1, and FRFC2 after pretreatment with AFB1 when compared with those that were given AFB1 only. In addition, there was a significant increase in NO in rats given AFB1 only when compared with control, whereas reduction in NO was significant in the groups C, D, and E that were given MEL, FRFC1, and FRFC2, respectively, when compared with AFB1 group. MEL and FRFC may be responsible for the prevention of increased gastric mucosal NO and inflammatory effects of proinflammatory cytokines induced by AFB1.
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Affiliation(s)
- Adetayo Sadudeen Amid
- Department of Veterinary Surgery and Radiology, Faculty of Veterinary Medicine, University of Ilorin, Ilorin, Nigeria
| | - Oludele Ayobami Makinde
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Nigeria
| | - Fadeyemi Joseph Akinrinmade
- Department of Veterinary Surgery and Radiology, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
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Murakami M, Johkoh T, Hayashi S, Ohshima S, Mizuki M, Nakatsuka SI, Tomobe M, Kuroyanagi K, Nakasone A, Nishimoto N. Clinicopathologic characteristics of 342 patients with multicentric Castleman disease in Japan. Mod Rheumatol 2020; 30:843-851. [DOI: 10.1080/14397595.2019.1704983] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Miho Murakami
- Osaka Rheumatology Clinic, Osaka, Japan
- Department of Molecular Regulation for Intractable Diseases, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
| | - Takeshi Johkoh
- Department of Radiology, Kansai Rosai Hospital, Hyogo, Japan
| | - Seiji Hayashi
- National Hospital Organization Kinki Chuo Chest Medical Center, Osaka, Japan
| | - Shiro Ohshima
- Department of Rheumatology and Allergology, National Hospital Organization, Osaka Minami Medical Center, Osaka, Japan
| | - Masao Mizuki
- Department of Chemotherapy, Osaka University Hospital, Osaka, Japan
| | - Shin-ichi Nakatsuka
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
| | - Minako Tomobe
- Chugai Pharmaceutical Co., Ltd., Tokyo, Japan; and Safety Evaluation Committee of tocilizumab for Castleman disease
| | - Kazuyuki Kuroyanagi
- Chugai Pharmaceutical Co., Ltd., Tokyo, Japan; and Safety Evaluation Committee of tocilizumab for Castleman disease
| | - Ayako Nakasone
- Chugai Pharmaceutical Co., Ltd., Tokyo, Japan; and Safety Evaluation Committee of tocilizumab for Castleman disease
| | - Norihiro Nishimoto
- Osaka Rheumatology Clinic, Osaka, Japan
- Department of Molecular Regulation for Intractable Diseases, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
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Usefullnes of atherogenic indices and Ca-LDL level to predict subclinical atherosclerosis in patients with psoriatic arthritis? Adv Rheumatol 2019; 59:49. [PMID: 31727163 DOI: 10.1186/s42358-019-0096-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 11/01/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND To investigate the link between carbamylated low-density lipoprotein (ca-LDL), atherogenic index of plasma (AIP), atherogenic coefficient (AC), Castelli's risk indices I and II (CRI I and II) and subclinic atherosclerosis in psoriatic arthritis (PsA). METHODS Thirty-ninepatients and 19 age, sex, body mass index matched healthy controls were included. Insulin resistance (IR) was assessed with homeostasis of model assessment-IR (HOMA-IR). Carotid intima-media thickness (CIMT) was measured at both common carotid arteries and mean CIMT was calculated. RESULTS The mean age was 49.50 ± 11.86 years and 64.1% were females in PsA group. In the PsA group, CIMT and HOMA-IR were significantly higher (p = 0.003, p = 0.043, respectively). AIP, AC, TG/HDL, CRI-1, CRI-2 and ca-LDL levels were similar between groups. In PsA group, CIMT was positively correlated with HOMA-IR, TG/HDL and AIP. Although ca-LDL was positively correlated with serum amyloid A (r = 0.744, p < 0.001), no correlation was detected between ca-LDL and CIMT (r = 0.215, p = 0.195). PsA patients with IR tended to have higher ca-LDL levels than patients without IR, but this difference lacked statistical significance (33.65 ± 26.94, 28.63 ± 28.06, respectively, p = 0.237). CONCLUSIONS A significant increase in CIMT was seen in PsA patients without clinically evident cardiovascular disease or any traditional atherosclerosis risk factors. CIMT was correlated with HOMA-IR, TG/HDL and AIP.
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Lin Y, He S, Gong J, Ding X, Liu Z, Gong J, Zeng Z, Cheng Y. Continuous veno-venous hemofiltration for severe acute pancreatitis. Cochrane Database Syst Rev 2019; 10:CD012959. [PMID: 31618443 PMCID: PMC6953293 DOI: 10.1002/14651858.cd012959.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Severe acute pancreatitis is associated with high rates of mortality and life-threatening complications. Continuous veno-venous hemofiltration (CVVH) has been used in some centers to reduce mortality and avoid local or systemic complications, however its efficiency and safety is uncertain. OBJECTIVES To assess the benefits and harms of CVVH in patients suffering from severe acute pancreatitis; to compare the effects of different CVVH techniques; and to evaluate the optimal time for delivery of CVVH. SEARCH METHODS We searched the Cochrane Library (2019, Issue 8), MEDLINE (1946 to 13 September 2019), Embase (1974 to 13 September 2019), and Science Citation Index Expanded (1982 to 13 September 2019). SELECTION CRITERIA We included all randomized controlled trials (RCTs) that compared CVVH versus no CVVH in participants with severe acute pancreatitis. We also included RCTs that compared different types of CVVH and different schedules for CVVH in participants with severe acute pancreatitis. DATA COLLECTION AND ANALYSIS Two review authors independently identified the trials for inclusion, collected the data, and assessed the risk of bias. We performed the meta-analyses using Review Manager 5. We calculated the risk ratio (RR) for dichotomous outcomes, and the mean difference (MD) for continuous outcomes, with 95% confidence intervals (CIs). MAIN RESULTS We included two studies, involving a total of 94 participants, in the review.Continuous veno-venous hemofiltration versus no interventionWe included one study in which 64 participants with severe acute pancreatitis were randomized to undergo CVVH (32 participants) or no intervention (32 participants). There were no deaths in either group (very low-quality evidence). Adverse events, length of stay in the intensive care unit (ICU), length of hospital stay, total hospital cost, and quality of life were not reported in the study.One type of continuous veno-venous hemofiltration versus a different type of continuous veno-venous hemofiltrationWe included one study in which 30 participants with severe acute pancreatitis were randomized to undergo high-volume CVVH (15 participants) or standard CVVH (15 participants). High-volume CVVH may lead to little or no difference in in-hospital mortality rates (20.0% in the high-volume CVVH group versus 33.3% in the standard CVVH group; risk ratio (RR) 0.60, 95% confidence interval (CI) 0.17 to 2.07; 30 participants; 1 study; low-quality evidence). We are uncertain whether high-volume hemofiltration reduces rates of adverse events (13.3% in both groups; RR 1.00, 95% CI 0.16 to 6.20; 30 participants; 1 study; very low-quality evidence). Length of ICU stay, length of hospital stay, total hospital cost, and quality of life were not reported in the study. AUTHORS' CONCLUSIONS The quality of the current evidence is very low or low. For both comparisons addressed in this review, data are sparse. It is unclear whether CVVH has any effect on mortality or complications in patients with severe acute pancreatitis. It is also unclear whether high-volume CVVH is superior, equivalent or inferior to standard CVVH in patients with severe acute pancreatitis.
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Affiliation(s)
- Yanjun Lin
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University, No. 74, Lin Jiang Road, Chongqing, China, 400010
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Bakan A, Oral A, Alışır Ecder S, Şaşak Kuzgun G, Elçioğlu ÖC, Demirci R, Aydın Bahat K, Odabas AR. Assessment of Mean Platelet Volume in Patients with AA Amyloidosis and AA Amyloidosis Secondary to Familial Mediterranean Fever: A Retrospective Chart - Review Study. Med Sci Monit 2019; 25:3854-3859. [PMID: 31123243 PMCID: PMC6545066 DOI: 10.12659/msm.914343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background Amyloidosis is a protein-misfolding disease characterized by the deposition of aggregated proteins in the form of abnormal fibrils that disrupt tissue structure, ultimately causing disease. Amyloidosis is very frequent in untreated familial Mediterranean fever (FMF) patients and it is the most important feature that determines the prognosis of FMF disease. The mean platelet volume (MPV) in FMF has been previously studied. However, whether MPV level in FMF patients is lower or higher compared to healthy controls remains a topic of ongoing debate. In this study, we aimed to investigate MPV values and to assess the correlation between MPV and proteinuria in patients with AA amyloidosis and AA amyloidosis secondary to familial Mediterranean fever (AA-FMF) through a retrospective chart-review. Material/Methods This study was carried out on 27 patients with AA amyloidosis, 36 patients with AA amyloidosis secondary to FMF (a total of 63 patients with AA), and 29 healthy controls. There was no statistically significant difference between the AA patients and the control group (p=0.06) or between the AA-FMF group and the control group in terms of MPV values (p=0.12). Results We found a statistically significant negative correlation between MPV and thrombocyte count in all groups (p<0.05 for all groups), but there was no correlation between MPV and proteinuria levels in AA patients (p=0.091). Conclusions While similar results also exist, these findings are contrary to the majority of previous studies. Therefore, further controlled clinical prospective trials are necessary to address this inconsistency.
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Affiliation(s)
- Ali Bakan
- Internal Medicine Clinic, Ministry of Health lstanbul Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey
| | - Alihan Oral
- Department of Intenal Medicine, Istanbul Bilim University, Istanbul, Turkey
| | - Sabahat Alışır Ecder
- Department of Nephrology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Gulsah Şaşak Kuzgun
- Department of Nephrology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ömer Celal Elçioğlu
- Department of Nephrology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey
| | - Recep Demirci
- Internal Medicine Clinic, Ministry of Health lstanbul Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey
| | - Kübra Aydın Bahat
- Department of Nephrology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Ali Rıza Odabas
- Department of Nephrology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
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Keaton SA, Madaj ZB, Heilman P, Smart L, Grit J, Gibbons R, Postolache T, Roaten K, Achtyes E, Brundin L. An inflammatory profile linked to increased suicide risk. J Affect Disord 2019; 247:57-65. [PMID: 30654266 PMCID: PMC6860980 DOI: 10.1016/j.jad.2018.12.100] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 11/25/2018] [Accepted: 12/24/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Suicide risk assessments are often challenging for clinicians, and therefore, biological markers are warranted as guiding tools in these assessments. Suicidal patients display increased cytokine levels in peripheral blood, although the composite inflammatory profile in the subjects is still unknown. It is also not yet established whether certain inflammatory changes are specific to suicidal subjects. To address this, we measured 45 immunobiological factors in peripheral blood and identified the biological profiles associated with cross-diagnostic suicide risk and depression, respectively. METHODS Sixty-six women with mood and anxiety disorders underwent computerized adaptive testing for mental health, assessing depression and suicide risk. Weighted correlation network analysis was used to uncover system level associations between suicide risk, depression, and the immunobiological factors in plasma. Secondary regression models were used to establish the sensitivity of the results to potential confounders, including age, body mass index (BMI), treatment and symptoms of depression and anxiety. RESULTS The biological profile of patients assessed to be at increased suicide risk differed from that associated with depression. At the system level, a biological cluster containing increased levels of interleukin-6, lymphocytes, monocytes, white blood cell count and polymorphonuclear leukocyte count significantly impacted suicide risk, with the latter two inferring the strongest influence. The cytokine interleukin-8 was independently and negatively associated with increased suicide risk. The results remained after adjusting for confounders. LIMITATIONS This study is cross-sectional and not designed to prove causality. DISCUSSION A unique immunobiological profile was linked to increased suicide risk. The profile was different from that observed in patients with depressive symptoms, and indicates that granulocyte mediated biological mechanisms could be activated in patients at risk for suicide.
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Affiliation(s)
- Sarah A Keaton
- Department of Physiology, Michigan State University, East Lansing, MI, USA,Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Zachary B Madaj
- Bioinformatics and Biostatistics Core, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Patrick Heilman
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA
| | - LeAnn Smart
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Jamie Grit
- Center for Cancer and Cell Biology, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Robert Gibbons
- Center for Health Statistics, Departments of Medicine and Public Health Sciences, University of Chicago, Illinois, USA
| | - Teodor Postolache
- Department of Psychiatry, University of Maryland-Baltimore School of Medicine, Baltimore, MD, USA,Rocky Mountain Mirecc, Denver, CO, USA
| | - Kimberly Roaten
- Department of Psychiatry, University of Texas Southwestern, Dallas, TX, USA
| | - Eric Achtyes
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA,Division of Psychiatry & Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA
| | - Lena Brundin
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA.
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26
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Hossen I, Hua W, Ting L, Mehmood A, Jingyi S, Duoxia X, Yanping C, Hongqing W, Zhipeng G, Kaiqi Z, Fang Y, Junsong X. Phytochemicals and inflammatory bowel disease: a review. Crit Rev Food Sci Nutr 2019; 60:1321-1345. [PMID: 30729797 DOI: 10.1080/10408398.2019.1570913] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Gastrointestinal tract is the second largest organ in the body that mainly functions in nutrients and minerals intake through the intestinal barrier. Intestinal permeability maintains the circulation of minerals and nutrients from digested foods. Life and all the metabolic processes depend either directly or indirectly on proper functioning of GI tract. Compromised intestinal permeability and related disorders are common among all the patients with inflammatory bowel disease (IBD), which is a collective term of inflammatory diseases including Crohn's disease and ulcerative colitis. Many synthetic drugs are currently in use to treat IBD such as 5-aminosalicylic acid corticosteroids. However, they all have some drawbacks as long-term use result in many complications. These problems encourage us to look out for alternative medicine. Numerous in vitro and in vivo experiments showed that the plant-derived secondary metabolites including phenolic compounds, glucosinolates, alkaloids, terpenoids, oligosaccharides, and quinones could reduce permeability, ameliorate-related dysfunctions with promising results. In addition, many of them could modulate enzymatic activity, suppress the inflammatory transcriptional factors, ease oxidative stress, and reduce pro-inflammatory cytokines secretion. In this review, we summarized the phytochemicals, which were proven potent in treating increased intestinal permeability and related complication along with their mechanism of action.
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Affiliation(s)
- Imam Hossen
- School of Food and Chemical Engineering, Beijing Technology and Business University, Beijing, China.,Beijing Key Lab of Plant Resource Research and Development, Beijing, China.,Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing, China
| | - Wu Hua
- School of Food and Chemical Engineering, Beijing Technology and Business University, Beijing, China.,Beijing Key Lab of Plant Resource Research and Development, Beijing, China
| | - Luo Ting
- Department of Pharmacology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Arshad Mehmood
- School of Food and Chemical Engineering, Beijing Technology and Business University, Beijing, China.,Beijing Key Lab of Plant Resource Research and Development, Beijing, China.,Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing, China
| | - Song Jingyi
- School of Food and Chemical Engineering, Beijing Technology and Business University, Beijing, China.,Beijing Key Lab of Plant Resource Research and Development, Beijing, China
| | - Xu Duoxia
- School of Food and Chemical Engineering, Beijing Technology and Business University, Beijing, China.,Beijing Key Lab of Plant Resource Research and Development, Beijing, China.,Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing, China
| | - Cao Yanping
- School of Food and Chemical Engineering, Beijing Technology and Business University, Beijing, China.,Beijing Key Lab of Plant Resource Research and Development, Beijing, China.,Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing, China
| | - Wu Hongqing
- School of Food and Chemical Engineering, Beijing Technology and Business University, Beijing, China.,Beijing Key Lab of Plant Resource Research and Development, Beijing, China
| | - Gao Zhipeng
- School of Food and Chemical Engineering, Beijing Technology and Business University, Beijing, China.,Beijing Key Lab of Plant Resource Research and Development, Beijing, China.,Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing, China
| | - Zhang Kaiqi
- School of Food and Chemical Engineering, Beijing Technology and Business University, Beijing, China.,Beijing Key Lab of Plant Resource Research and Development, Beijing, China.,Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing, China
| | - Yang Fang
- School of Food and Chemical Engineering, Beijing Technology and Business University, Beijing, China.,Beijing Key Lab of Plant Resource Research and Development, Beijing, China
| | - Xiao Junsong
- School of Food and Chemical Engineering, Beijing Technology and Business University, Beijing, China.,Beijing Key Lab of Plant Resource Research and Development, Beijing, China.,Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing, China.,Beijing Engineering and Technology Research Center of Food Additives, Beijing, China
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27
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Bindoli S, Franceschet G, Galozzi P, Zaninotto M, Camozzi V, Sfriso P. Osteoporosis in Systemic Autoinflammatory Diseases: A Case-Control Study. Front Endocrinol (Lausanne) 2019; 10:636. [PMID: 31620089 PMCID: PMC6759948 DOI: 10.3389/fendo.2019.00636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 09/03/2019] [Indexed: 01/22/2023] Open
Abstract
Objective: To assess if patients affected by systemic autoinflammatory diseases (SAIDs) present an increased risk of osteoporosis (OP). Methods: Forty adults patients referred to the Rheumatology Unit of Padova University Hospital affected by Familial Mediterranean Fever (FMF), TNF-Receptor Associated Periodic Syndrome (TRAPS), and Mevalonate Kinase Deficiency (MKD) and 40 healthy subjects were enrolled. Blood and urine samples were collected in order to define phosphocalcic metabolism, including Receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG), and among inflammatory markers serum amyloid A (SAA). Femur and lumbar dual-energy X-ray absorptiometry (DXA) scans were performed and Trabecular Bone Score (TBS) was calculated on DXA lumbar images. Results: We did not observe a statistically significant difference between Bone Mineral Density (BMD) and TBS of patients compared to controls. Also, the values of phosphocalcic metabolites in patients did not statistically differ from those in controls. However, SAA and OPG levels were significantly higher in patients compared to healthy subjects (p = 0.0244 and p = 0.0064, respectively). Conclusion: Patients of our cohort affected by FMF, TRAPS, and MKD do not present an increased risk of OP compared to the healthy controls. TBS and BMD are similar between the two groups underlining a preserved bone quality in patients. High OPG levels could suggest a protective role and a bone re-balancing action in response to an inflammatory background. Finally, it should be taken into account a modulatory role played by a pro-inflammatory cytokine such as SAA on bone homeostasis.
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Affiliation(s)
- Sara Bindoli
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Giulio Franceschet
- Endocrinology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Paola Galozzi
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Martina Zaninotto
- Department of Laboratory Medicine, University-Hospital of Padova, Padova, Italy
| | - Valentina Camozzi
- Endocrinology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Paolo Sfriso
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
- *Correspondence: Paolo Sfriso
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28
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Mast cells participate in allograft rejection: can IL-37 play an inhibitory role? Inflamm Res 2018; 67:747-755. [PMID: 29961151 DOI: 10.1007/s00011-018-1166-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/18/2018] [Accepted: 06/20/2018] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the role of mast cells (MCs) in allograft rejection, eventually inhibited by IL-37. Immune cells including MCs participate in allograft rejection by generating IL-1, IL-33, TNF and other cytokines. METHODS We evaluated allograft rejection on the experience of our experimental data and using the relevant literature. RESULTS MCs are involved in initiation and regulation of innate and adaptive immune responses-pathways. MCs are important pro-inflammatory cells which express high-affinity receptor FceRI and can be activated by IgE and some pro-inflammatory cytokines, such as IL-1 and IL-33. The cross-linkage of high affinity IgE receptor on MCs by antigen ligation has a crucial role in allergy, asthma, anaphylaxis, cancer and allograft rejection. MCs mediate immunity in organ transplant, leading to the activation of allospecific T cells implicated in the rejection and generate pro-inflammatory cytokines/chemokines. IL-1 pro-inflammatory cytokine family members released by MCs mediate allograft rejection and inflammation. IL-37 is also an IL-1 family member generated by macrophage cell line in small amounts, which binds to IL-18Rα and produces an anti-inflammatory effect. IL-37 provokes the inhibition of TLR signaling, TLR-induced mTOR and (MyD88)-mediated responses, suppressing pro-inflammatory IL-1 family members and increasing IL-10. CONCLUSION IL-37 inhibition offers the opportunity to immunologically modulate MCs, by suppressing their production of IL-1 family members and reducing the risk of allograft rejection, resulting as a potential good therapeutic new cytokine. Here, we report the relationship between inflammatory MCs, allograft rejection and pro-inflammatory and anti-inflammatory IL-37.
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Kuret T, Lakota K, Mali P, Čučnik S, Praprotnik S, Tomšič M, Sodin-Semrl S. Naturally occurring antibodies against serum amyloid A reduce IL-6 release from peripheral blood mononuclear cells. PLoS One 2018; 13:e0195346. [PMID: 29617422 PMCID: PMC5884545 DOI: 10.1371/journal.pone.0195346] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 03/20/2018] [Indexed: 12/14/2022] Open
Abstract
Serum amyloid A (SAA) is a sensitive inflammatory marker rapidly increased in response to infection, injury or trauma during the acute phase. Resolution of the acute phase and SAA reduction are well documented, however the exact mechanism remains elusive. Two inducible SAA proteins, SAA1 and SAA2, with their variants could contribute to systemic inflammation. While unconjugated human variant SAA1α is already commercially available, the variants of SAA2 are not. Antibodies against SAA have been identified in apparently healthy blood donors (HBDs) in smaller, preliminary studies. So, our objective was to detect anti-SAA and anti-SAA1α autoantibodies in the sera of 300 HBDs using ELISA, characterize their specificity and avidity. Additionally, we aimed to determine the presence of anti-SAA and anti-SAA1α autoantibodies in intravenous immunoglobulin (IVIg) preparations and examine their effects on released IL-6 from SAA/SAA1α-treated peripheral blood mononuclear cells (PBMCs). Autoantibodies against SAA and SAA1α had a median (IQR) absorbance OD (A450) of 0.655 (0.262–1.293) and 0.493 (0.284–0.713), respectively. Both anti-SAA and anti-SAA1α exhibited heterogeneous to high avidity and reached peak levels between 41–50 years, then diminished with age in the oldest group (51–67 years). Women consistently exhibited significantly higher levels than men. Good positive correlation was observed between anti-SAA and anti-SAA1α. Both anti-SAA and anti-SAA1α were detected in IVIg, their fractions subsequently isolated, and shown to decrease IL-6 protein levels released from SAA/SAA1α-treated PBMCs. In conclusion, naturally occurring antibodies against SAA and anti-SAA1α could play a physiological role in down-regulating their antigen and proinflammatory cytokines leading to the resolution of the acute phase and could be an important therapeutic option in patients with chronic inflammatory diseases.
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Affiliation(s)
- Tadeja Kuret
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Katja Lakota
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Mathematics, Natural Science and Information Technologies, University of Primorska, Koper, Slovenia
| | - Polonca Mali
- Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
| | - Saša Čučnik
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Sonja Praprotnik
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Matija Tomšič
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Snezna Sodin-Semrl
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Mathematics, Natural Science and Information Technologies, University of Primorska, Koper, Slovenia
- * E-mail:
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30
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Cheng Y, Gong J, Ding X, Liu Z, Gong J, Zeng Z. Continuous veno‐venous hemofiltration for severe acute pancreatitis. Cochrane Database Syst Rev 2018; 2018:CD012959. [PMCID: PMC6491106 DOI: 10.1002/14651858.cd012959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the benefits and harms of CVVH in people suffering from severe acute pancreatitis, compare the effects of different CVVH techniques, and evaluate the optimal time for delivery of CVVH.
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Affiliation(s)
- Yao Cheng
- The Second Affiliated Hospital, Chongqing Medical UniversityDepartment of Hepatobiliary SurgeryChongqingChina
| | - Junhua Gong
- First Affiliated Hospital of Kunming Medical UniversityOrgan Transplant CenterNo. 295, Xi Chang RoadKunmingChina650032
| | - Xiong Ding
- The Second Affiliated Hospital, Chongqing Medical UniversityDepartment of Hepatobiliary SurgeryChongqingChina
| | - Zuojin Liu
- The Second Affiliated Hospital, Chongqing Medical UniversityDepartment of Hepatobiliary SurgeryChongqingChina
| | - Jianping Gong
- The Second Affiliated Hospital, Chongqing Medical UniversityDepartment of Hepatobiliary SurgeryChongqingChina
| | - Zhong Zeng
- First Affiliated Hospital of Kunming Medical UniversityOrgan Transplant CenterNo. 295, Xi Chang RoadKunmingChina650032
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31
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Benech N, Lustig S, Chidiac C, Ferry T. Chronic and severe prosthetic joint infection complicated by amyloid A amyloidosis with renal and bladder impairment. BMJ Case Rep 2018; 2018:bcr-2017-223491. [PMID: 29437745 DOI: 10.1136/bcr-2017-223491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Nicolas Benech
- Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Sebastien Lustig
- Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Service de Chirurgie Orthopédique, Centre Albert Trillat, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Christian Chidiac
- Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Tristan Ferry
- Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
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32
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Yang XR, Zhang XF, Zhang XM, Gao HY. Analgesic and anti-inflammatory activities and mechanisms of 70% ethanol extract of Zygophyllum macropodum in animals. CHINESE HERBAL MEDICINES 2018. [DOI: 10.1016/j.chmed.2017.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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33
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Matsumoto K, Kikuchi J, Kaneko Y, Yasuoka H, Suzuki K, Tokuyama H, Kameyama K, Yamaoka K, Takeuchi T. Persistent fever and destructive arthritis caused by dialysis-related amyloidosis: A case report. Medicine (Baltimore) 2018; 97:e9359. [PMID: 29505515 PMCID: PMC5943088 DOI: 10.1097/md.0000000000009359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
RATIONALE Dialysis-related amyloidosis (DRA) can present rheumatic manifestations in patients on long-term hemodialysis. Typical articular symptoms with DRA involve carpal-tunnel syndrome, effusion in large joints, spondyloarthropathy, or cystic bone lesions, which are usually with non-inflammatory processes. PATIENT CONCERNS A 64-year-old man on hemodialysis for >30 years was admitted because of intermittent fever, polyarthritis, and elevated serum C-reactive protein (CRP) level, which was continuous for 2 years. Several antibiotics were ineffective for 3 months before his admission. On physical examination, joint swelling was observed at bilateral wrists, knees, ankles, and hip joints. Laboratory tests revealed elevation of serum inflammatory markers and β2-microglobulin (β2-MG). Synovial fluid showed predominant infiltration of polymorphonuclear leukocytes and the increase of β2-MG level. DIAGNOSIS Significant deposition of β2-MG with inflammatory cell infiltration was found in biopsied samples from synovium, skin, and ileum. INTERVENTIONS We decided to switch to the hemodialysis column with membrane that can effectively absorb β2-MG in circulation. OUTCOMES The relief of symptoms and a decrease of CRP level by changing the membrane lead to the final diagnosis of DRA. LESSONS Our case demonstrates that DRA arthropathy can be inflammatory and destructive, and also develop systemic inflammatory signs and symptoms. In such cases, aggressive absorption of β2-MG in circulation might help the amelioration of symptoms.
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Affiliation(s)
| | | | | | | | | | | | - Kaori Kameyama
- Department of Diagnostic Pathology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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Cocchiaro P, De Pasquale V, Della Morte R, Tafuri S, Avallone L, Pizard A, Moles A, Pavone LM. The Multifaceted Role of the Lysosomal Protease Cathepsins in Kidney Disease. Front Cell Dev Biol 2017; 5:114. [PMID: 29312937 PMCID: PMC5742100 DOI: 10.3389/fcell.2017.00114] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 12/07/2017] [Indexed: 12/18/2022] Open
Abstract
Kidney disease is worldwide the 12th leading cause of death affecting 8–16% of the entire population. Kidney disease encompasses acute (short-lasting episode) and chronic (developing over years) pathologies both leading to renal failure. Since specific treatments for acute or chronic kidney disease are limited, more than 2 million people a year require dialysis or kidney transplantation. Several recent evidences identified lysosomal proteases cathepsins as key players in kidney pathophysiology. Cathepsins, originally found in the lysosomes, exert important functions also in the cytosol and nucleus of cells as well as in the extracellular space, thus participating in a wide range of physiological and pathological processes. Based on their catalytic active site residue, the 15 human cathepsins identified up to now are classified in three different families: serine (cathepsins A and G), aspartate (cathepsins D and E), or cysteine (cathepsins B, C, F, H, K, L, O, S, V, X, and W) proteases. Specifically in the kidney, cathepsins B, D, L and S have been shown to regulate extracellular matrix homeostasis, autophagy, apoptosis, glomerular permeability, endothelial function, and inflammation. Dysregulation of their expression/activity has been associated to the onset and progression of kidney disease. This review summarizes most of the recent findings that highlight the critical role of cathepsins in kidney disease development and progression. A better understanding of the signaling pathways governed by cathepsins in kidney physiopathology may yield novel selective biomarkers or therapeutic targets for developing specific treatments against kidney disease.
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Affiliation(s)
- Pasquale Cocchiaro
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy.,Faculty of Medicine, Institut National de la Santé Et de la Recherche Médicale, "Défaillance Cardiaque Aigüe et Chronique", Nancy, France.,Université de Lorraine, Nancy, France.,Institut Lorrain du Coeur et des Vaisseaux, Center for Clinical Investigation 1433, Nancy, France.,CHRU de Nancy, Hôpitaux de Brabois, Nancy, France
| | - Valeria De Pasquale
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
| | - Rossella Della Morte
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | - Simona Tafuri
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | - Luigi Avallone
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | - Anne Pizard
- Faculty of Medicine, Institut National de la Santé Et de la Recherche Médicale, "Défaillance Cardiaque Aigüe et Chronique", Nancy, France.,Université de Lorraine, Nancy, France.,Institut Lorrain du Coeur et des Vaisseaux, Center for Clinical Investigation 1433, Nancy, France.,CHRU de Nancy, Hôpitaux de Brabois, Nancy, France
| | - Anna Moles
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Luigi Michele Pavone
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
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35
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AA Amylodisis Associated with Jugular Paraganglioma as a Rare Cause of Chronic Diarrhea. ACG Case Rep J 2017; 4:e100. [PMID: 28848772 PMCID: PMC5559658 DOI: 10.14309/crj.2017.100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 06/23/2017] [Indexed: 11/28/2022] Open
Abstract
We report a case of a 64-year-old man with chronic diarrhea who was diagnosed of a systemic reactive (AA) amyloidosis associated with a jugular paraganglioma. This neoplasm was diagnosed 30 years previously and it was not removed after extensive evaluation by a multidisciplinary team. Chronic inflammatory diseases are the major cause of AA amyloidosis. However, benign tumors, such as jugular paragangliomas, are considered to be one of the tumors that can result in AA amyloidosis.
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36
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Mesquita ET, Jorge AJL, Souza CV, Andrade TRD. Cardiac Amyloidosis and its New Clinical Phenotype: Heart Failure with Preserved Ejection Fraction. Arq Bras Cardiol 2017; 109:71-80. [PMID: 28678923 PMCID: PMC5524478 DOI: 10.5935/abc.20170079] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 03/09/2017] [Indexed: 12/24/2022] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) is now an emerging
cardiovascular epidemic, being identified as the main phenotype observed in
clinical practice. It is more associated with female gender, advanced age and
comorbidities such as hypertension, diabetes, obesity and chronic kidney
disease. Amyloidosis is a clinical disorder characterized by the deposition of
aggregates of insoluble fibrils originating from proteins that exhibit anomalous
folding. Recently, pictures of senile amyloidosis have been described in
patients with HFpEF, demonstrating the need for clinical cardiologists to
investigate this etiology in suspect cases. The clinical suspicion of
amyloidosis should be increased in cases of HFPS where the cardio imaging
methods are compatible with infiltrative cardiomyopathy. Advances in cardio
imaging methods combined with the possibility of performing genetic tests and
identification of the type of amyloid material allow the diagnosis to be made.
The management of the diagnosed patients can be done in partnership with centers
specialized in the study of amyloidosis, which, together with the new
technologies, investigate the possibility of organ or bone marrow
transplantation and also the involvement of patients in clinical studies that
evaluate the action of the new emerging drugs.
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37
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Fentoğlu Ö, Dinç G, Bağcı Ö, Doğru A, İlhan I, Kırzıoğlu FY, Orhan H. R202Q/M694V as novel MEFV gene mutations in chronic periodontitis and familial Mediterranean fever. J Periodontal Res 2017; 52:994-1003. [PMID: 28590056 DOI: 10.1111/jre.12467] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Familial Mediterranean fever (FMF) and chronic periodontitis are inflammatory diseases leading to an increase in the number of inflammasomes. To date, no published studies have reported on mutations in the Mediterranean fever (MEFV) gene in patients with chronic periodontitis, although the roles of MEFV gene mutations in FMF and FMF-associated amyloidosis (FMF-A) are well known. Therefore, the aim of this study was to evaluate the frequencies of MEFV gene mutations and serum amyloid A (SAA) and high-sensitivity C-reactive protein (hs-CRP) levels in patients with chronic periodontitis, FMF and FMF-A. MATERIAL AND METHODS The study population included 122 patients with FMF and 128 subjects who were systemically healthy. Clinical periodontal parameters, including the plaque index, gingival index, probing pocket depth, clinical attachment level and percentage of bleeding on probing were recorded. Blood samples were obtained from patients with FMF and systemically healthy controls, and all mutations located on exons 2 and 10 of the MEFV gene were analyzed by DNA Sanger Sequencing, which is the gold standard. SAA and high-sensitive CRP levels were also assessed. RESULTS Mean gingival index, percentage of bleeding on probing, probing pocket depth and clinical attachment level, and the levels of SAA and hs-CRP were higher in the FMF-A group than those in the FMF and control groups. The two most relevant mutations in patients with FMF were heterozygous M694V (46.2%), and heterozygous R202Q (32.7%). The frequencies of the homozygous M694V and R202Q mutations in the FMF-A group were 53.8% and 46.1%, respectively. The complex R202Q/M694V homozygous state led to an increased risk of chronic periodontitis (odds ratio: 3.6), and FMF-A (odds ratio: 7.6). CONCLUSION This is the first study to report the R202Q mutation in patients with periodontitis. Furthermore, the MEFV gene-mediated inflammatory pathway increased serum acute phase reactants, and the changes in the R202Q and M694V could play a role in inflammatory-genetic diseases, such as FMF, FMF-associated amyloidosis and chronic periodontitis.
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Affiliation(s)
- Ö Fentoğlu
- Department of Periodontology, Faculty of Dentistry, University of Süleyman Demirel, Isparta, Turkey
| | - G Dinç
- Department of Periodontology, Faculty of Dentistry, University of Süleyman Demirel, Isparta, Turkey
| | - Ö Bağcı
- Department of Medical Genetics, Faculty of Medicine, University of Süleyman Demirel, Isparta, Turkey
| | - A Doğru
- Department of Internal Medicine, Division of Rheumatology, University of Süleyman Demirel, Isparta, Turkey
| | - I İlhan
- Department of Medical Biochemistry, Faculty of Medicine, University of Süleyman Demirel, Isparta, Turkey
| | - F Y Kırzıoğlu
- Department of Periodontology, Faculty of Dentistry, University of Süleyman Demirel, Isparta, Turkey
| | - H Orhan
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, University of Süleyman Demirel, Isparta, Turkey
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Scarpioni R, Ricardi M, Albertazzi V, De Amicis S, Rastelli F, Zerbini L. Dialysis-related amyloidosis: challenges and solutions. Int J Nephrol Renovasc Dis 2016; 9:319-328. [PMID: 27994478 PMCID: PMC5153266 DOI: 10.2147/ijnrd.s84784] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Amyloidosis refers to the extracellular tissue deposition of fibrils composed of low-molecular-weight subunits of a variety of proteins. These deposits may result in a wide range of clinical manifestations depending upon their type, location, and the amount of deposition. Dialysis-related amyloidosis is a serious complication of long-term dialysis therapy and is characterized by the deposition of amyloid fibrils, principally composed of β2 microglobulins (β2M), in the osteoarticular structures and viscera. Most of the β2M is eliminated through glomerular filtration and subsequent reabsorption and catabolism by the proximal tubules. As a consequence, the serum levels of β2M are inversely related to the glomerular filtration rate; therefore, in end-stage renal disease patients, β2M levels increase up to 60-fold. Serum levels of β2M are also elevated in several pathological conditions such as chronic inflammation, liver disease, and above all, in renal dysfunction. Retention of amyloidogenic protein has been attributed to several factors including type of dialysis membrane, prolonged uremic state and/or decreased diuresis, advanced glycation end products, elevated levels of cytokines and dialysate. Dialysis treatment per se has been considered to be an inflammatory stimulus, inducing cytokine production (such as interleukin-1, tumor necrosis factor-α, interleukin-6) and complement activation. The released cytokines are thought to stimulate the synthesis and release of β2M by the macrophages and/or augment the expression of human leukocyte antigens (class I), increasing β2M expression. Residual renal function is probably the best determinant of β2M levels. Therefore, it has to be maintained as long as possible. In this article, we will focus our attention on the etiology of dialysis-related amyloidosis, its prevention, therapy, and future solutions.
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Affiliation(s)
- R Scarpioni
- Department of Nephrology and Dialysis, Azienda Unità Sanitaria Local (AUSL) Hospital "Guglielmo da Saliceto", Piacenza, Italy
| | - M Ricardi
- Department of Nephrology and Dialysis, Azienda Unità Sanitaria Local (AUSL) Hospital "Guglielmo da Saliceto", Piacenza, Italy
| | - V Albertazzi
- Department of Nephrology and Dialysis, Azienda Unità Sanitaria Local (AUSL) Hospital "Guglielmo da Saliceto", Piacenza, Italy
| | - S De Amicis
- Department of Nephrology and Dialysis, Azienda Unità Sanitaria Local (AUSL) Hospital "Guglielmo da Saliceto", Piacenza, Italy
| | - F Rastelli
- Department of Nephrology and Dialysis, Azienda Unità Sanitaria Local (AUSL) Hospital "Guglielmo da Saliceto", Piacenza, Italy
| | - L Zerbini
- Department of Nephrology and Dialysis, Azienda Unità Sanitaria Local (AUSL) Hospital "Guglielmo da Saliceto", Piacenza, Italy
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Abstract
A subgroup of patients with gouty arthritis have a chronic recurring form that is particularly difficult to treat. Such patients experience repeated flares and often have abundant tophi. Many also have underlying comorbidities, such as renal impairment, cardiovascular disease, gastrointestinal disorders, obesity, and hypertension, which contraindicate the use of standard anti-inflammatory medications. Five patients with difficult to treat gouty arthritis who were either candidates and/or treated with anti-IL therapy are described.
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