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Möttönen M, Teräsjärvi J, Rahikkala H, Kvist S, Mertsola J, He Q. Association of IL-17A and IL-10 Polymorphisms with Juvenile Idiopathic Arthritis in Finnish Children. Int J Mol Sci 2024; 25:8323. [PMID: 39125893 PMCID: PMC11311899 DOI: 10.3390/ijms25158323] [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: 05/16/2024] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 08/12/2024] Open
Abstract
To analyze the role of interleukin IL-17A and IL-10 polymorphisms in susceptibility to juvenile idiopathic arthritis (JIA), 98 Finnish children and adolescents with JIA were studied. Data from the 1000 Genomes Project, consisting of 99 healthy Finns, served as the controls. The patients were analyzed for four IL-17A and three IL-10 gene-promoter polymorphisms, and the serum IL-17A, IL-17F, IL-10, and IL-6 levels were determined. The IL-17A rs8193036 variant genotypes (CT/CC) were more common among the patients than controls, especially in those with polyarthritis (OR 1.93, 95% CI 1.11-3.36; p = 0.020). IL-17A rs2275913 minor allele A was more common in patients (OR 1.45, 95% Cl 1.08-1.94; p = 0.014) and especially among patients with oligoarthritis and polyarthritis than the controls (OR 1.61, 95%CI 1.06-2.43; p = 0.024). Carriers of the IL-17A rs4711998 variant genotype (AG/AA) had higher serum IL-17A levels than those with genotype GG. However, carriers of the variant genotypes of IL-17A rs9395767 and rs4711998 appeared to have higher IL-17F levels than those carrying wildtype. IL-10 rs1800896 variant genotypes (TC/CC) were more abundant in patients than in the controls (OR 1.97, 95%CI 1.06-3.70; p = 0.042). Carriers of the IL-10 rs1800896 variant genotypes had lower serum levels of IL-17F than those with wildtype. These data provide preliminary evidence of the roles of IL-17 and IL-10 in the pathogenesis of JIA and its subtypes in the Finnish population. However, the results should be interpreted with caution, as the number of subjects included in this study was limited.
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Affiliation(s)
- Milja Möttönen
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital, University of Turku, 20520 Turku, Finland; (M.M.); (H.R.); (J.M.)
| | - Johanna Teräsjärvi
- Institute of Biomedicine, Research Centre for Infections and Immunity, University of Turku, 20520 Turku, Finland; (J.T.); (S.K.)
| | - Heidi Rahikkala
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital, University of Turku, 20520 Turku, Finland; (M.M.); (H.R.); (J.M.)
- Research Unit of Clinical Medicine, University of Oulu, 90014 Oulu, Finland
| | - Sonja Kvist
- Institute of Biomedicine, Research Centre for Infections and Immunity, University of Turku, 20520 Turku, Finland; (J.T.); (S.K.)
| | - Jussi Mertsola
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital, University of Turku, 20520 Turku, Finland; (M.M.); (H.R.); (J.M.)
| | - Qiushui He
- Institute of Biomedicine, Research Centre for Infections and Immunity, University of Turku, 20520 Turku, Finland; (J.T.); (S.K.)
- InFLAMES Research Flagship Centre, University of Turku, 20520 Turku, Finland
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Bagri NK, King H, Ramanan AV. Secukinumab for children and adolescents with enthesitis-related arthritis and psoriatic arthritis: lessons from treatment in adults and the way forward. Expert Rev Clin Immunol 2024; 20:435-440. [PMID: 38186357 DOI: 10.1080/1744666x.2024.2303340] [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: 05/23/2023] [Accepted: 01/05/2024] [Indexed: 01/09/2024]
Abstract
INTRODUCTION Targeting IL-17A using Secukinumab, a humanized monoclonal immunoglobulin G1 (IgG1)/κ against IL-17A is a therapeutic option for immune-mediated disorders such as psoriasis and ankylosing spondylitis. The US Food and Drug Administration and the European Medicines Agency have approved it for the treatment of moderate to severe plaque psoriasis, active psoriatic arthritis, ankylosing spondylitis, and non-radiographic axial spondylarthritis. Recently it has also been approved for use in children with severe plaque psoriasis, active psoriatic arthritis, and enthesitis-related arthritis. AREAS COVERED This review focuses on the role of Secukinumab in the management of children and adolescents with enthesitis-related arthritis and psoriatic arthritis. We discuss the salient findings of pivotal RCTs and other studies supporting the use of Secukinumab in adults and children, in particular, focusing on its safety and efficacy. EXPERT OPINION Secukinumab is a therapeutic target for psoriasis, psoriatic arthritis, and spondyloarthropathies in both adults and children. No major safety signals are observed with its use in short-term follow-up. Thus far, Secukinumab has not been found to significantly increase the risk of tuberculosis (TB).
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Affiliation(s)
- Narendra Kumar Bagri
- Division of Pediatric Rheumatology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Hayley King
- Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
| | - A V Ramanan
- Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
- Translational Health Science, University of Bristol, Bristol, UK
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Çalışkan C, Durmuş B, Yıldırım HS, Demir F, Sözeri B. Comparison of Oral Health and Salivary Biomarkers in Children with Juvenile Idiopathic Arthritis and Healthy Individuals. Niger J Clin Pract 2023; 26:1808-1816. [PMID: 38158346 DOI: 10.4103/njcp.njcp_169_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 10/25/2023] [Indexed: 01/03/2024]
Abstract
AIM This study examines the effects of juvenile idiopathic arthritis (JIA) on the oral health and detectability of inflammatory biomarkers IL-17, tumour necrosis factor-alpha (TNF-α) and total antioxidant status (TAS) in the saliva of children with JIA. PATIENTS AND METHODS This study included 117 participants (39 patients with JIA and 78 systemically healthy subjects aged 8-12 years). Demographic data, responses to an oral health-related questionnaire, saliva samples, periodontal parameters [plaque index (PI), gingival index (GI) and bleeding on probing (BOP)] and dental recordings [facial profile (FP) and dental occlusion relationship (DOR)] were obtained. Enzyme-linked immunosorbent assays were used to determine the levels of salivary IL-17, TNF-α and TAS. RESULTS The Caries Assessment Spectrum and Treatment (CAST) index, FP and DOR distributions did not change between groups (P > 0.05). JIA patients had more temporomandibular joint (TMJ) discomfort than gingivitis patients and healthy subjects (P < 0.05). JIA patients had greater salivary IL-17 levels than healthy subjects (P < 0.05). The healthy group's TAS was higher than that of the JIA and gingivitis groups (P < 0.05). Saliva TNF-α levels were similar between groups (P > 0.05). PI, GI, BOP and TNF-α were positively associated with salivary IL-17 (P < 0.001). CONCLUSION Elevated salivary IL-17 and TAS levels could be used as biological markers for discriminating the clinical health status of children with JIA and gingivitis.
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Affiliation(s)
- C Çalışkan
- Department of Pediatric Dentistry, Faculty of Dentistry, Marmara University, Istanbul
| | - B Durmuş
- Department of Pediatric Dentistry, Faculty of Dentistry, Marmara University, Istanbul
| | - H S Yıldırım
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul
| | - F Demir
- University of Health Sciences, Umraniye Training and Research Hospital, Division of Pediatric Rheumatology, Istanbul, Turkey
| | - B Sözeri
- University of Health Sciences, Umraniye Training and Research Hospital, Division of Pediatric Rheumatology, Istanbul, Turkey
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Di Gennaro S, Di Matteo G, Stornaiuolo G, Anselmi F, Lastella T, Orlando F, Alessio M, Naddei R. Advances in the Diagnosis and Treatment of Enthesitis-Related Arthritis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1647. [PMID: 37892310 PMCID: PMC10605472 DOI: 10.3390/children10101647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023]
Abstract
Enthesitis-related arthritis (ERA) represents 5-30% of all cases of juvenile idiopathic arthritis (JIA) and belongs to the spectrum of the disorders included in the group of juvenile spondyloarthritis. In the last decade, there have been considerable advances in the classification, diagnosis, monitoring, and treatment of ERA. New provisional criteria for ERA have been recently proposed by the Paediatric Rheumatology INternational Trials Organisation, as part of a wider revision of the International League of Associations for Rheumatology criteria for JIA. The increased use of magnetic resonance imaging has shown that a high proportion of patients with ERA present a subclinical axial disease. Diverse instruments can be used to assess the disease activity of ERA. The therapeutic recommendations for ERA are comparable to those applied to other non-systemic JIA categories, unless axial disease and/or enthesitis are present. In such cases, the early use of a TNF-alpha inhibitor is recommended. Novel treatment agents are promising, including IL-17/IL-23 or JAK/STAT pathways blockers.
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Affiliation(s)
- Simona Di Gennaro
- Section of Pediatrics, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (S.D.G.); (G.D.M.); (G.S.); (T.L.); (M.A.)
| | - Gennaro Di Matteo
- Section of Pediatrics, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (S.D.G.); (G.D.M.); (G.S.); (T.L.); (M.A.)
| | - Gianmarco Stornaiuolo
- Section of Pediatrics, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (S.D.G.); (G.D.M.); (G.S.); (T.L.); (M.A.)
| | - Federica Anselmi
- Unit of Pediatric Infectious Diseases, Mother and Child Department, University Hospital Federico II, 80131 Naples, Italy;
| | - Teresa Lastella
- Section of Pediatrics, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (S.D.G.); (G.D.M.); (G.S.); (T.L.); (M.A.)
| | - Francesca Orlando
- General Pediatrics and Immuno-Rheumatology Unit, Santobono-Pausilipon Hospital, 80129 Naples, Italy;
| | - Maria Alessio
- Section of Pediatrics, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (S.D.G.); (G.D.M.); (G.S.); (T.L.); (M.A.)
| | - Roberta Naddei
- Section of Pediatrics, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (S.D.G.); (G.D.M.); (G.S.); (T.L.); (M.A.)
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Tomé C, Oliveira-Ramos F, Campanilho-Marques R, Mourão AF, Sousa S, Marques C, Melo AT, Teixeira RL, Martins AP, Moeda S, Costa-Reis P, Torres RP, Bandeira M, Fonseca H, Gonçalves M, Santos MJ, Graca L, Fonseca JE, Moura RA. Children with extended oligoarticular and polyarticular juvenile idiopathic arthritis have alterations in B and T follicular cell subsets in peripheral blood and a cytokine profile sustaining B cell activation. RMD Open 2023; 9:e002901. [PMID: 37652558 PMCID: PMC10476142 DOI: 10.1136/rmdopen-2022-002901] [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: 11/28/2022] [Accepted: 07/03/2023] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVES The main goal of this study was to characterise the frequency and phenotype of B, T follicular helper (Tfh) and T follicular regulatory (Tfr) cells in peripheral blood and the cytokine environment present in circulation in children with extended oligoarticular juvenile idiopathic arthritis (extended oligo JIA) and polyarticular JIA (poly JIA) when compared with healthy controls, children with persistent oligoarticular JIA (persistent oligo JIA) and adult JIA patients. METHODS Blood samples were collected from 105 JIA patients (children and adults) and 50 age-matched healthy individuals. The frequency and phenotype of B, Tfh and Tfr cells were evaluated by flow cytometry. Serum levels of APRIL, BAFF, IL-1β, IL-2, IL-4, IL-6, IL-10, IL-17A, IL-21, IL-22, IFN-γ, PD-1, PD-L1, sCD40L, CXCL13 and TNF were measured by multiplex bead-based immunoassay and/or ELISA in all groups included. RESULTS The frequency of B, Tfh and Tfr cells was similar between JIA patients and controls. Children with extended oligo JIA and poly JIA, but not persistent oligo JIA, had significantly lower frequencies of plasmablasts, regulatory T cells and higher levels of Th17-like Tfh cells in circulation when compared with controls. Furthermore, APRIL, BAFF, IL-6 and IL-17A serum levels were significantly higher in paediatric extended oligo JIA and poly JIA patients when compared with controls. These immunological alterations were not found in adult JIA patients in comparison to controls. CONCLUSIONS Our results suggest a potential role and/or activation profile of B and Th17-like Tfh cells in the pathogenesis of extended oligo JIA and poly JIA, but not persistent oligo JIA.
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Affiliation(s)
- Catarina Tomé
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Filipa Oliveira-Ramos
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Raquel Campanilho-Marques
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Ana F Mourão
- Rheumatology Department, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, EPE, Lisbon, Portugal
| | - Sandra Sousa
- Reumatology Department, Hospital Garcia de Orta, EPE, Almada, Portugal
| | - Cláudia Marques
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Ana T Melo
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Rui L Teixeira
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Ana P Martins
- Pediatric Surgery Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Lisbon, Portugal
| | - Sofia Moeda
- Department of Pediatrics, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Patrícia Costa-Reis
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Department of Pediatrics, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Rita P Torres
- Rheumatology Department, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, EPE, Lisbon, Portugal
| | - Matilde Bandeira
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Helena Fonseca
- Department of Pediatrics, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Miroslava Gonçalves
- Pediatric Surgery Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Lisbon, Portugal
| | - Maria J Santos
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Reumatology Department, Hospital Garcia de Orta, EPE, Almada, Portugal
| | - Luis Graca
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - João E Fonseca
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Rita A Moura
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
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Brunner HI, Foeldvari I, Alexeeva E, Ayaz NA, Calvo Penades I, Kasapcopur O, Chasnyk VG, Hufnagel M, Żuber Z, Schulert G, Ozen S, Rakhimyanova A, Ramanan A, Scott C, Sozeri B, Zholobova E, Martin R, Zhu X, Whelan S, Pricop L, Martini A, Lovell D, Ruperto N. Secukinumab in enthesitis-related arthritis and juvenile psoriatic arthritis: a randomised, double-blind, placebo-controlled, treatment withdrawal, phase 3 trial. Ann Rheum Dis 2023; 82:154-160. [PMID: 35961761 PMCID: PMC9811076 DOI: 10.1136/ard-2022-222849] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/03/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Treatment options in patients with enthesitis-related arthritis (ERA) and juvenile psoriatic arthritis (JPsA) are currently limited. This trial aimed to demonstrate the efficacy and safety of secukinumab in patients with active ERA and JPsA with inadequate response to conventional therapy. METHODS In this randomised, double-blind, placebo-controlled, treatment-withdrawal, phase 3 trial, biologic-naïve patients (aged 2 to <18 years) with active disease were treated with open-label subcutaneous secukinumab (75/150 mg in patients <50/≥50 kg) in treatment period (TP) 1 up to week 12, and juvenile idiopathic arthritis (JIA) American College of Rheumatology 30 responders at week 12 were randomised 1:1 to secukinumab or placebo up to 100 weeks. Patients who flared in TP2 immediately entered open-label secukinumab TP3 that lasted up to week 104. Primary endpoint was time to disease flare in TP2. RESULTS A total of 86 patients (median age, 14 years) entered open-label secukinumab in TP1. In TP2, responders (ERA, 44/52; JPsA, 31/34) received secukinumab or placebo. The study met its primary end point and demonstrated a statistically significant longer time to disease flare in TP2 for ERA and JPsA with secukinumab versus placebo (27% vs 55%, HR, 0.28; 95% CI 0.13 to 0.63; p<0.001). Exposure-adjusted incidence rates (per 100 patient-years (PY), 95% CI) for total patients were 290.7/100 PY (230.2 to 362.3) for adverse events and 8.2/100 PY (4.1 to 14.6) for serious adverse events in the overall JIA population. CONCLUSIONS Secukinumab demonstrated significantly longer time to disease flare than placebo in children with ERA and JPsA with a consistent safety profile with the adult indications of psoriatic arthritis and axial spondyloarthritis. TRIAL REGISTRATION NUMBER NCT03031782.
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Affiliation(s)
- Hermine I Brunner
- UC Department of Pediatrics, University of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Ivan Foeldvari
- Hamburger Zentrum fuer Kinder und Jugendrheumatologie, Hamburg, Germany
| | - Ekaterina Alexeeva
- National Scientific and Practical Center of Children's Health, Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Nuray Aktay Ayaz
- Istanbul University-Cerrahpasa, Faculty of Medicine, Department of Pediatric Rheumatology, Istanbul, Turkey
| | | | - Ozgur Kasapcopur
- Pediatric Rheumatology, Istanbul Universitesi-Cerrahpasa, Istanbul, Turkey
| | - Vyacheslav G Chasnyk
- State Pediatric Medical University, Department of Pediatric Rheumatology, Saint-Petersburg, Russian Federation
| | - Markus Hufnagel
- University Medical Center, Medical Faculty University of Freiburg, Department of Pediatrics and Adolescent Medicine, Freiburg, Germany
| | - Zbigniew Żuber
- Andrzej Frycz Modrzewski Krakow University, Faculty of Medicine and Health Sciences, Department of Pediatrics, Krakow, Poland
| | - Grant Schulert
- UC Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Seza Ozen
- Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Adelina Rakhimyanova
- Regional Children Clinical Hospital # 1, Ural State Medical University, Ministry of Healthcare of the Russian Federation, Department of Rheumatology, Yekaterinburg, Russian Federation
| | - Athimalaipet Ramanan
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- University of Bristol, Department of Pediatric Rheumatology, Bristol, UK
| | - Christiaan Scott
- Red Cross War Memorial Children's Hospital, University of Cape Town, Department of Pediatric Rheumatology, Cape Town, South Africa
| | - Betul Sozeri
- Umraniye Training and Research Hospital, Department of Pediatric Rheumatology, Istanbul, Turkey
| | - Elena Zholobova
- First Moscow State Medical University n.a. I.M.Sechenov, Department of Rheumatology, Moscow, Russian Federation
| | - Ruvie Martin
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - Xuan Zhu
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | | | - Luminita Pricop
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | | | - Daniel Lovell
- Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Nicolino Ruperto
- IRCCS Istituto Giannina Gaslini, UOSID Centro Trial, Genova, Italy
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Hidradenitis Suppurativa: Host-Microbe and Immune Pathogenesis Underlie Important Future Directions. JID INNOVATIONS 2021; 1:100001. [PMID: 34909706 PMCID: PMC8659377 DOI: 10.1016/j.xjidi.2021.100001] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/24/2020] [Accepted: 12/10/2020] [Indexed: 12/17/2022] Open
Abstract
Hidradenitis suppurativa (HS) is an inflammatory disease of the skin with a chronic, relapsing-remitting course. The pathogenesis of the disease is poorly understood and involves multiple factors, including genetics, environment, host-microbe interactions, and immune dysregulation. In particular, the composition of the cutaneous microbiome shifts as the disease progresses, although it is unclear whether this is a primary or secondary process. Trials with immunomodulatory therapy elucidate the role of specific immune pathways and cytokine signaling in disease mechanism, such as TNF-α, IL-1β, IL-12, IL-17, IL-23, and complement. Future studies should continue examining the causes of and contributing factors to microbial changes and immune dysregulation in HS pathogenesis.
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Key Words
- AMP, antimicrobial peptide
- BD, β-defensin
- BMI, body mass index
- DC, dendritic cell
- DCD, dermcidin
- GSC, γ-secretase complex
- HS, hidradenitis suppurativa
- HiSCR, hidradenitis suppurativa clinical response
- IBD, inflammatory bowel disease
- IHS4, International Hidradenitis Suppurativa Severity Score System
- KC, keratinocyte
- MMP, matrix metalloproteinase
- NET, neutrophil extracellular traps
- NMSC, nonmelanoma skin cancer
- PG, pyoderma gangrenosum
- RCT, randomized controlled trial
- SAPHO, synovitis, acne, pustulosis, hyperostosis, and osteitis
- TLR, toll-like receptor
- Th, T helper type
- iNOS, inducible nitric oxide synthase
- pDC, plasmacytoid dendritic cell
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Seroprevalence of Antibodies against SARS-CoV-2 in Children with Juvenile Idiopathic Arthritis a Case-Control Study. J Clin Med 2021; 10:jcm10081771. [PMID: 33921679 PMCID: PMC8073013 DOI: 10.3390/jcm10081771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 12/25/2022] Open
Abstract
There is limited data on the effect of the novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) on pediatric rheumatology. We examined the prevalence of antibodies against SARS-CoV-2 in children with juvenile idiopathic arthritis (JIA) and a negative history of COVID-19 and the correlation of the presence of these antibodies with disease activity measured by juvenile arthritis disease activity score (JADAS). In total, 62 patients diagnosed with JIA, under treatment with various antirheumatic drugs, and 32 healthy children (control group) were included. Serum samples were analyzed for inflammatory markers and antibodies and their state evaluated with the juvenile arthritis disease activity score (JADAS). JIA patients do not have a higher seroprevalence of anti-SARS-CoV-2 antibodies than healthy subjects. We found anti-SARS-CoV-2 antibodies in JIA patients who did not have a history of COVID-19. The study showed no unequivocal correlation between the presence of SARS-CoV-2 antibodies and JIA activity; therefore, this relationship requires further observation. We also identified a possible link between patients’ humoral immune response and disease-modifying antirheumatic treatment, which will be confirmed in follow-up studies.
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Koutsonikoli A, Taparkou A, Pratsidou-Gkertsi P, Sgouropoulou V, Dimitroulas T, Trachana M. Novel biomarkers for early targeted and individualized treatment in Juvenile Idiopathic Arthritis. Mediterr J Rheumatol 2020; 31:230-234. [PMID: 32676564 PMCID: PMC7362122 DOI: 10.31138/mjr.31.2.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/15/2020] [Accepted: 03/25/2020] [Indexed: 11/04/2022] Open
Abstract
Background The programmed cell death protein-1 (PD-1) and its ligands (PD-L 1 and 2) suppress immune responses, thus promoting self-tolerance. Among the immunomodulatory cells, acting through the PD-1 pathway, are the B-regulatory cells (Bregs). The role of the PD-1 pathway in Juvenile Idiopathic Arthritis (JIA) has not been adequately studied. Aims of the study To investigate the immunophenotypic profile of T- and B-cells and the activity of the PD-1 pathway in JIA patients. More specifically, we will examine the levels of: a) the soluble form of PD-1 (sPD-1), b) Bregs; and the expression levels of: c) PD-1 on CD4+ and CD8+ T-cells, d) PD-L1 on Bregs and CD19+ B-cells, in blood and synovial fluid samples, at various stages of the disease (onset, relapse, remission, on or off treatment). The above biomarkers will be investigated for correlation with JIA activity. Methods A case-control study of JIA patients (expected number: 60) and healthy controls (n: 20). Total expected number of samples: 100 of peripheral blood, 120 of serum (solely for soluble markers) and 60 of synovial fluid. The patients' demographic data and treatment will be recorded. JIA will be classified according to the ILAR and the recently proposed PReS/PRINTO criteria. JIA activity will be assessed using the JADAS-10 tool. The biomarkers will be determined using multiparametric-polychromatic flow cytometry (quintuple fluorescence protocol) and immunoenzymatic assay ELISA. Anticipated benefits Further elucidation of the immunophenotypic expression and variation of the abovementioned molecules and cells during active inflammation and remission in JIA. Thereby, the present study is expected to contribute to: a) the modern research and understanding of the confirmed immune dysfunction at the cellular level, which leads to the development of serious autoimmune diseases in childhood, such as JIA, and b) the search for biomarkers that could be targets of early "intelligent" treatment and thereby could support the implementation of precision-medicine. The early diagnosis and targeted treatment of JIA are crucial for the maintenance of normal physical functioning and the psychosocial balance of the still growing adolescent/child.
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Affiliation(s)
- Artemis Koutsonikoli
- Paediatric Immunology and Rheumatology Referral Centre, 1 Paediatric Department, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Anna Taparkou
- Paediatric Immunology and Rheumatology Referral Centre, 1 Paediatric Department, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Polyxeni Pratsidou-Gkertsi
- Paediatric Immunology and Rheumatology Referral Centre, 1 Paediatric Department, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Vassiliki Sgouropoulou
- Paediatric Immunology and Rheumatology Referral Centre, 1 Paediatric Department, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Theodoros Dimitroulas
- 4 Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Maria Trachana
- Paediatric Immunology and Rheumatology Referral Centre, 1 Paediatric Department, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
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