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Gil-Rodríguez J, Callejas-Rubio JL, García Martín P. Mesenteric panniculitis simulating early lymphoma recurrence. Med Clin (Barc) 2024:S0025-7753(24)00026-5. [PMID: 38378333 DOI: 10.1016/j.medcli.2023.11.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 02/22/2024]
Affiliation(s)
- Jaime Gil-Rodríguez
- Departamento de Medicina Interna, Hospital Universitario Clínico San Cecilio, Granada, España.
| | - José-Luis Callejas-Rubio
- Unidad de Enfermedades Autoinmunes Sistémicas, Hospital Universitario Clínico San Cecilio , España; Instituto de Investigación Biosanitaria ibs.GRANADA , Granada, España
| | - Paloma García Martín
- Departamento de Hematología, Hospital Universitario Clínico San Cecilio , Granada, España
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2
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Ortiz-Fernández L, Carmona EG, Kerick M, Lyons P, Carmona FD, López Mejías R, Khor CC, Grayson PC, Tombetti E, Jiang L, Direskeneli H, Saruhan-Direskeneli G, Callejas-Rubio JL, Vaglio A, Salvarani C, Hernández-Rodríguez J, Cid MC, Morgan AW, Merkel PA, Burgner D, Smith KG, Gonzalez-Gay MA, Sawalha AH, Martin J, Marquez A. Identification of new risk loci shared across systemic vasculitides points towards potential target genes for drug repurposing. Ann Rheum Dis 2023; 82:837-847. [PMID: 36797040 PMCID: PMC10314028 DOI: 10.1136/ard-2022-223697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/04/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVES The number of susceptibility loci currently associated with vasculitis is lower than in other immune-mediated diseases due in part to small cohort sizes, a consequence of the low prevalence of vasculitides. This study aimed to identify new genetic risk loci for the main systemic vasculitides through a comprehensive analysis of their genetic overlap. METHODS Genome-wide data from 8467 patients with any of the main forms of vasculitis and 29 795 healthy controls were meta-analysed using ASSET. Pleiotropic variants were functionally annotated and linked to their target genes. Prioritised genes were queried in DrugBank to identify potentially repositionable drugs for the treatment of vasculitis. RESULTS Sixteen variants were independently associated with two or more vasculitides, 15 of them representing new shared risk loci. Two of these pleiotropic signals, located close to CTLA4 and CPLX1, emerged as novel genetic risk loci in vasculitis. Most of these polymorphisms appeared to affect vasculitis by regulating gene expression. In this regard, for some of these common signals, potential causal genes were prioritised based on functional annotation, including CTLA4, RNF145, IL12B, IL5, IRF1, IFNGR1, PTK2B, TRIM35, EGR2 and ETS2, each of which has key roles in inflammation. In addition, drug repositioning analysis showed that several drugs, including abatacept and ustekinumab, could be potentially repurposed in the management of the analysed vasculitides. CONCLUSIONS We identified new shared risk loci with functional impact in vasculitis and pinpointed potential causal genes, some of which could represent promising targets for the treatment of vasculitis.
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Affiliation(s)
| | - Elio G Carmona
- Institute of Parasitology and Biomedicine "López- Neyra", CSIC, Granada, Spain
- Unidad de Enfermedades Autoinmunes Sistémicas, Hospital Clínico San Cecilio, Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, Granada, Spain
| | - Martin Kerick
- Institute of Parasitology and Biomedicine "López- Neyra", CSIC, Granada, Spain
| | - Paul Lyons
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, UK
| | - Francisco David Carmona
- Departamento de Genética e Instituto de Biotecnología, Centro de Investigación Biomédica, Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Raquel López Mejías
- Research Group on Genetic Epidemiology and Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the Musculoskeletal System, IDIVAL, Santander, Spain
| | - Chiea Chuen Khor
- Duke-NUS Medical School, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Peter C Grayson
- Systemic Autoimmunity Branch, NIAMS, National Institutes of Health, Bethesda, Maryland, USA
| | - Enrico Tombetti
- Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Hospital, Milan, Italy
- Department of Biomedical and Clinical Sciences L. Sacco, Milan University, Milan, Italy
| | - Lindi Jiang
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China
- Evidence-Based Medicine Center, Fudan University, Shanghai, China
| | - Haner Direskeneli
- Department of Internal Medicine, Division of Rheumatology, Marmara University, Faculty of Medicine, Istanbul, Turkey
| | | | - José-Luis Callejas-Rubio
- Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Augusto Vaglio
- Department of Biomedical Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
- Nephrology and Dialysis Unit, Meyer Children's Hospital, Florence, Italy
| | - Carlo Salvarani
- Rheumatology Unit, Azienda USL-IRCCS di Reggio Emilia and Azienda Ospedaliero - Universitaria di Modena, Università di Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Jose Hernández-Rodríguez
- Department of Autoimmune Diseases, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Maria Cinta Cid
- Department of Autoimmune Diseases, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Ann W Morgan
- School of Medicine and Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Centre and NIHR Leeds Medtech and In vitro Diagnostics Co-Operative, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Peter A Merkel
- Division of Rheumatology, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of General Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Kenneth Gc Smith
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, UK
| | - Miguel Angel Gonzalez-Gay
- Research Group on Genetic Epidemiology and Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the Musculoskeletal System, IDIVAL, University of Cantabria, Santander, Spain
| | - Amr H Sawalha
- Division of Rheumatology, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Lupus Center of Excellence, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Immunology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Javier Martin
- Institute of Parasitology and Biomedicine "López- Neyra", CSIC, Granada, Spain
| | - Ana Marquez
- Institute of Parasitology and Biomedicine "López- Neyra", CSIC, Granada, Spain
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Correa-Rodríguez M, Rueda-Medina B, Callejas-Rubio JL, Ríos-Fernández R, Gil-Gutiérrez R, Ortego-Centeno N. Adherence to antimalarials and glucocorticoids treatment and its association with self-reported disease activity in systemic lupus erythematosus patients. Lupus 2023; 32:74-82. [PMID: 36346921 DOI: 10.1177/09612033221138360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES We aimed to investigate the rate of non-adherence to antimalarials and glucocorticoids (GCs) and to analyze their potential relationships with sociodemographic characteristics, disease activity and accumulate damage in a cohort of Systemic lupus erythematosus (SLE) patients. METHODS A cross-sectional study was conducted among 670 patients. The Systemic Lupus Erythematosus Activity Questionnaire (SLAQ) and the Lupus Damage Index Questionnaire (LDIQ) were used to assess disease activity and accumulated damage. RESULTS The prevalence of non-adherence to antimalarials and GCs were 10.67% and 39.61%. 86.9% of participants indicated that the reason for stopping therapy was the presence of side effects. SLE patients with non-adherence to antimalarials and GCs had significantly higher scores in disease severity (SLAQ) compared to adherence patients (5.03 (2.12) vs 4.39 (2.61); p = .004 and (4.75 (2.29) vs 4.05 (2.78); p ≤ .001). CONCLUSION Adherence to the treatment indicated in SLE differs from drug to drug. Findings highlight the importance of developing interventions to support adherence and improve outcomes among patients.
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Affiliation(s)
- María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, 16741University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Blanca Rueda-Medina
- Department of Nursing, Faculty of Health Sciences, 16741University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - José-Luis Callejas-Rubio
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Systemic Autoimmune Diseases Unit, 16581San Cecilio University Hospital, Granada, Spain
| | - Raquel Ríos-Fernández
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Systemic Autoimmune Diseases Unit, 16581San Cecilio University Hospital, Granada, Spain
| | - Rocío Gil-Gutiérrez
- Department of Nursing, Faculty of Health Sciences, 16741University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Norberto Ortego-Centeno
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Medicine, Faculty of Medicine, 16741University of Granada, Granada, Spain
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Correa-Rodríguez M, Callejas-Rubio JL, Rueda-Medina B, Ríos-Fernández R, Hera-Fernández JDL, Ortego-Centeno N. Clinical course of Covid-19 in a cohort of patients with Behçet disease. Medicina Clínica (English Edition) 2022; 159:262-267. [PMID: 36157838 PMCID: PMC9483749 DOI: 10.1016/j.medcle.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/12/2021] [Indexed: 11/28/2022]
Abstract
Objective The implications of Covid-19 in patients with Behçet's disease (BD) are unknown. Patients with BD usually take long-term therapy with therapeutic agents that have been tested in Covid-19 patients. We aimed to assess the prevalence of Covid-19 in a cohort of patients with BD and investigate whether those patients with a long-term treatment with colchicine, tumor necrosis factor inhibitors (TNFi) or glucocorticoids are at reduced or increased prevalence of Covid-19 related clinical outcomes. Methods A retrospective study was conducted among 244 patients with BD (86.1% females; mean age 43.95 ± 11.11 years). Each participant completed an online questionnaire regarding demographics, medical conditions, dispensed colchicine, TNFi or oral glucocorticoids, Covid-19 infection, clinical symptoms and recovery. Results The prevalence of Covid-19 infection was 14.75%. Regarding dose of colchicine, the presence of ageusia was lower in patients taking 0.5 mg/day of colchicine compared to those taking 1.5 mg/day (p = 0.021). The prevalence of dyspnea was significantly higher in patients taking TNFi compared with those without therapy (p = 0.032). With regards to oral glucocorticoids, no significant differences were found. Conclusions The prevalence of Covid-19 among patients with BD seems to be higher than that among the general population in Spain. Continuous TNFi therapy might increase the prevalence of worse clinical outcomes such as dyspnea; oral glucocorticoids and colchicine apparently provided no protection against the Covid-19 related clinical outcomes of patients with BD.
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Affiliation(s)
- María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - José-Luis Callejas-Rubio
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
| | - Blanca Rueda-Medina
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Raquel Ríos-Fernández
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
| | - Javier de la Hera-Fernández
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
| | - Norberto Ortego-Centeno
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Medicine, Faculty of Medicine, University of Granada, Granada, Spain
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5
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Correa-Rodríguez M, Rueda-Medina B, Callejas-Rubio JL, Ríos-Fernández R, de la Hera-Fernández J, Ortego-Centeno N. The Relationship Between Health Literacy and Quality of Life, Attitudes and Perceptions of Covid-19 and Vaccination Among Patients with Systemic Autoimmune Diseases. Clin Nurs Res 2022; 31:981-990. [PMID: 35484917 DOI: 10.1177/10547738221090558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We aimed to evaluate health literacy in a population of patients with systemic autoimmune diseases (SAD), and to analyze their potential relationships with health-related quality of life (HRQoL), attitudes and beliefs of Covid-19 and vaccination, and perceptions of changes in medical care during the pandemic. A cross-sectional study was conducted among 395 patients (81.1% were living in Spain). An anonymous online survey was distributed to an online SAD association. Health literacy was measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q16) and the SF-36 tool was used to assess HRQoL. More than half of patients (57.7%) have inadequate health literacy and the mean health literacy level was 9.63(5.66). Patients with inadequate health literacy levels presented the lowest HRQoL scores in all SF-36 domains (p < .001). Health literacy scores were positively correlated with all SF-36 domains (p < .001). The reservations to get vaccinated against Covid-19 were linked to health literacy level (p = 0.024). There are high levels of inadequate health literacy among patients with SAD and it is associated with worse HRQoL and risk attitudes about Covid-19 vaccination and medical care during the pandemic.
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Affiliation(s)
- María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Blanca Rueda-Medina
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - José-Luis Callejas-Rubio
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain.,Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
| | - Raquel Ríos-Fernández
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain.,Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
| | - Javier de la Hera-Fernández
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain.,Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
| | - Norberto Ortego-Centeno
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain.,Department of Medicine, University of Granada, Granada, Spain
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Correa-Rodríguez M, Rueda-Medina B, Callejas-Rubio JL, Ríos-Fernández R, de la Hera-Fernández J, Ortego-Centeno N. COVID-19 vaccine literacy in patients with systemic autoimmune diseases. Curr Psychol 2022; 42:1-16. [PMID: 35068910 PMCID: PMC8764502 DOI: 10.1007/s12144-022-02713-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 12/22/2022]
Abstract
COVID-19 related infodemic is a threat to the successful COVID-19 vaccination campaigns. This might be especially apparent for patients with autoimmune diseases since there is no data available about the balance between benefits and risks of the newly developed COVID-19 vaccines in this population. We aim (i) to evaluate vaccine literacy skills in a population of patients with systemic autoimmune diseases, (ii) to examine the potential associations between vaccine literacy skills and sociodemographic characteristics and (iii) to analyze the relationships between attitudes, perceptions and beliefs about current vaccinations and vaccine literacy skills and sociodemographic characteristics. A cross-sectional study was conducted among 319 patients with systemic autoimmune diseases (92% females; 49.5% of patients in the 31-50 years age category). The vaccine literacy levels were determined using the Health Literacy about Vaccination in adulthood in Italian (HLVa-IT). Sociodemographic characteristics including gender, age, country and area of residence, civil status, socioeconomic status, educational attainment and occupational status were evaluated. The mean vaccine literacy functional and interactive-critical scores were 2.59 ± 0.74 and 3.07 ± 0.60, respectively. The vaccine literacy interactive-critical score was higher in females than in males (p = 0.048). Interactive-critical scores were associated with the area of residence, civil status and socioeconomic status, with the highest score in urban area of ≥ 100.000 inhabitants (p = 0.045), in widow patients (p = 0.023) and in patients with high socioeconomic status (p = 0.018). Significant differences were observed between the different education levels, for both the functional and the interactive-critical scores (p = 0.002 and p < 0.001, respectively), the highest score was observed in patients who completed a university degree. The level of vaccine literacy for functional and interactive-critical scales were medium. Area of residence, civil status and socioeconomic status represented determinants of vaccine literacy interactive-critical scale. Educational attainment also contributes to vaccine literacy functional scale. Insight into these factors is required to ensure an optimal vaccine literacy level in patients with autoimmune diseases. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12144-022-02713-y.
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Affiliation(s)
- María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Blanca Rueda-Medina
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - José-Luis Callejas-Rubio
- Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
- Present Address: Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Raquel Ríos-Fernández
- Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
- Present Address: Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Javier de la Hera-Fernández
- Systemic Autoimmune Diseases Unit, San Cecilio University Hospital, Granada, Spain
- Present Address: Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Norberto Ortego-Centeno
- Present Address: Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- School of Medicine, University of Granada, Granada, Spain
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Correa-Rodríguez M, DelOlmo-Romero S, Pocovi-Gerardino G, Callejas-Rubio JL, Ríos-Fernández R, Ortego-Centeno N, Rueda-Medina B. Dietary Sodium, Potassium, and Sodium to Potassium Ratio in Patients With Systemic Lupus Erythematosus. Biol Res Nurs 2022; 24:235-244. [PMID: 34978207 DOI: 10.1177/10998004211065491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Purpose: The aim of this study was to investigate the association between dietary sodium, potassium, and sodium:potassium ratio and clinical disease activity parameters, damage accrual, and cardiovascular disease risk factors in a population of patients with systemic lupus erythematous (SLE). Research design and study sample: A cross-sectional study including a total of 280 patients was conducted (90.4% females; mean age 46.9 ± 12.85 years). Data collection: The SLE Disease Activity Index (SLEDAI-2K) and the SDI Damage Index were used to assess disease activity and disease-related damage, respectively. A 24-hour diet recall was used to estimate dietary intake of sodium and potassium. Results: Dietary sodium intake was significantly associated with anti-dsDNA (β = -.005; 95% CI [.002 .008]; p = .001) and complement C4 level (β = -.002; 95% CI [-.003, .000]; p = .039). Dietary potassium intake was also significantly associated with complement C3 level (β = -.004; 95% CI [-.007, -.001]; p = .021). Multiple logistic regression models revealed a positive association between dietary sodium intake and the risk of having hsCRP > 3 (p = .005) and an inverse association between dietary potassium intake and the risk of having hsCRP > 3 (p = .004). Conclusions: SLE patients with higher dietary sodium and lower dietary potassium intakes had an increased risk of higher hsCRP. Dietary sodium intake was significantly associated with anti-dsDNA and complement C4 level, while dietary potassium intake was associated with complement C3 level, supporting that dietary sodium and potassium intakes might play a key role in markers related to disease activity in SLE patients.
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Affiliation(s)
- María Correa-Rodríguez
- Institute of Biomedical Research (IBS), Granada, Spain.,Nursing Department, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Sara DelOlmo-Romero
- Nursing Department, Faculty of Health Sciences, University of Granada, Granada, Spain
| | | | - José-Luis Callejas-Rubio
- Institute of Biomedical Research (IBS), Granada, Spain.,Systemic Autoimmune Diseases Unit, 16581San Cecilio University Hospital, Granada, Spain.,Faculty of Medicine, University of Granada, Granada, Spain
| | - Raquel Ríos-Fernández
- Institute of Biomedical Research (IBS), Granada, Spain.,Systemic Autoimmune Diseases Unit, 16581San Cecilio University Hospital, Granada, Spain.,Faculty of Medicine, University of Granada, Granada, Spain
| | - Norberto Ortego-Centeno
- Institute of Biomedical Research (IBS), Granada, Spain.,Faculty of Medicine, University of Granada, Granada, Spain
| | - Blanca Rueda-Medina
- Institute of Biomedical Research (IBS), Granada, Spain.,Nursing Department, Faculty of Health Sciences, University of Granada, Granada, Spain
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Pocovi-Gerardino G, Correa-Rodríguez M, Callejas-Rubio JL, Ríos-Fernández R, Martín-Amada M, Cruz-Caparros MG, Rueda-Medina B, Ortego-Centeno N. Beneficial effect of Mediterranean diet on disease activity and cardiovascular risk in systemic lupus erythematosus patients: a cross-sectional study. Rheumatology (Oxford) 2021; 60:160-169. [PMID: 32594173 DOI: 10.1093/rheumatology/keaa210] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 03/31/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To analyse the influence of the Mediterranean diet (Med Diet) on SLE activity, damage accrual and cardiovascular disease risk markers. METHODS A cross-sectional study was conducted on 280 patients with SLE [46.9 (12.85) years]. Med Diet adherence was assessed through a 14-item questionnaire on food consumption frequency and habits (total score from 0 to 14 points; higher score is greater adherence to the Med Diet). CRP, homocysteine, SLEDAI-2K (SLE disease activity), and SLICC/ACR and SDI (damage accrual) were measured. Obesity, diabetes mellitus, hypertension and blood lipids, among others, were considered cardiovascular disease risk factors. RESULTS Greater adherence to the Med Diet was significantly associated with better anthropometric profiles, fewer cardiovascular disease risk factors, and lower disease activity and damage accrual scores (P ≤ 0.001 for SLEDAI and SDI). An inverse relationship between the Med Diet score and SLEDAI (P ≥ 0.001; β = -0.380), SDI (P ≤ 0.001; β = -0.740) and hsCRP (P = 0.039; β = -0.055) was observed. The odds ratio for having active SLE (SLEDAI ≥5) or the presence of damage (SDI ≥1) was lower among patients whose Med Diet score was higher (P ≤ 0.001). Finally, greater consumption of Med Diet foods (olive oil, fruits, vegetables, fish, etc.) and abstaining from red meat and meat products, sugars and pastries was associated with less SLE clinical activity and damage. CONCLUSION Greater adherence to the Med Diet seems to exert a beneficial effect on disease activity and cardiovascular risk in SLE patients. To confirm these findings, further longitudinal studies would be of interest.
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Affiliation(s)
| | - María Correa-Rodríguez
- Instituto de Investigación Biosanitaria, IBS, Granada.,Nursing Department, Faculty of Health Sciences, University of Granada, Armilla, Granada
| | - José-Luis Callejas-Rubio
- Instituto de Investigación Biosanitaria, IBS, Granada.,Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario San Cecilio, Granada
| | - Raquel Ríos-Fernández
- Instituto de Investigación Biosanitaria, IBS, Granada.,Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario San Cecilio, Granada
| | - María Martín-Amada
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Complejo Hospitalario de Jaén, Jaén
| | - María-Gracia Cruz-Caparros
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital de Poniente, El Ejido
| | | | - Norberto Ortego-Centeno
- Instituto de Investigación Biosanitaria, IBS, Granada.,Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario San Cecilio, Granada.,Departamento de Medicina, Facultad de Medicina, Universidad of Granada, Granada, Spain
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9
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Correa-Rodríguez M, Pocovi-Gerardino G, Callejas-Rubio JL, Ríos-Fernández R, Rueda-Medina B, Ortego-Centeno N. Disease Damage Accrual and Low Bone Mineral Density in Female Patients with Systemic Lupus Erythematosus. Biol Res Nurs 2021; 23:575-583. [PMID: 33787331 DOI: 10.1177/10998004211005550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Osteoporosis is a common comorbidity in patients with systemic lupus erythematosus (SLE), but the potential contribution of disease-associated factors to bone status in SLE is not well known because the reported risk factors from different studies differ greatly. We aimed to examine frequency of reduced bone mass in women with SLE, and determine their potential associations with disease activity, damage accrual and SLE-related clinical markers. A cross-sectional study including 121 Caucasian pre-menopausal and postmenopausal women was conducted (mean age 49.2 ± 12.4 years). The SLE Disease Activity Index (SLEDAI-2 K) and the SDI Damage Index were used to assess disease activity and disease-related damage, respectively. Bone mineral density (BMD) of the left femoral neck and lumbar spine (L2-L4) were measured by dual-energy X-ray absorptiometry. Ten patients (8.3%) had osteoporosis, 63 (52.1%) patients had osteopenia and 6.8% of women had history of previous fracture. Patients with low bone mass had a significantly higher mean SDI (1.3 ± 1.2 versus 0.7 ± 1.0 p = 0.003). T-score at lumbar spine was inversely correlated with SDI score (r = -0.222, p = 0.014) and complement C3 level (r = -0.206, p = .024). SDI scores were significantly different between patients with osteoporosis, osteopenia, and normal BMD after adjusting for covariates (p = .004). There is a high prevalence of low BMD in Caucasian women with SLE, and this status was associated with higher damage accrual scores, supporting that disease damage may itself be a major contributor to the low BMD. Women with SLE with organ damage require regular bone status monitoring to prevent further musculoskeletal damage.
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Affiliation(s)
- María Correa-Rodríguez
- Biohealth Research Institute in Granada (ibs.GRANADA), Pabellón de consultas externas 2, Granada, Spain.,Department of Nursing, Health Sciences Faculty, University of Granada, Spain
| | - Gabriela Pocovi-Gerardino
- Biohealth Research Institute in Granada (ibs.GRANADA), Pabellón de consultas externas 2, Granada, Spain
| | - José-Luis Callejas-Rubio
- Biohealth Research Institute in Granada (ibs.GRANADA), Pabellón de consultas externas 2, Granada, Spain.,Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario San Cecilio, Avenida de la Investigación, Granada, Spain
| | - Raquel Ríos-Fernández
- Biohealth Research Institute in Granada (ibs.GRANADA), Pabellón de consultas externas 2, Granada, Spain.,Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario San Cecilio, Avenida de la Investigación, Granada, Spain
| | - Blanca Rueda-Medina
- Biohealth Research Institute in Granada (ibs.GRANADA), Pabellón de consultas externas 2, Granada, Spain.,Department of Nursing, Health Sciences Faculty, University of Granada, Spain
| | - Norberto Ortego-Centeno
- Biohealth Research Institute in Granada (ibs.GRANADA), Pabellón de consultas externas 2, Granada, Spain.,Department of Medicine, Faculty of Medicine, University of Granada, Spain
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10
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Correa-Rodríguez M, Pocovi-Gerardino G, Callejas-Rubio JL, Ríos-Fernández R, Martín-Amada M, Cruz-Caparrós MG, DelOlmo-Romero S, Ortego-Centeno N, Rueda-Medina B. Vitamin D Levels are Associated with Disease Activity and Damage Accrual in Systemic Lupus Erythematosus Patients. Biol Res Nurs 2020; 23:455-463. [PMID: 33380211 DOI: 10.1177/1099800420983596] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Vitamin D has immunosuppressive properties and is considered a therapeutic option, although there is controversy about the role of this vitamin in the pathogenesis of systemic lupus erythematosus (SLE). We aimed to determine the prevalence of vitamin D insufficiency and deficiency and their potential association with disease activity, damage accrual, SLE-related clinical manifestations, and cardiovascular risk factors in SLE patients. A cross-sectional study of 264 patients was conducted (89.4% females; mean age 46.7 ± 12.9 years). The SLE Disease Activity Index (SLEDAI-2 K) and the SDI Damage Index were used to assess disease activity and disease-related damage, respectively. The mean 25(OH)D value was 25.1 ± 13.0 ng/ml. Eleven patients (4.2%) had 25(OH)D <10 (deficiency) and 178 patients (70.6%) had 25(OH)D <30 (insufficiency). In the 25(OH)D deficiency group, SLEDAI was significantly higher than the insufficiency (p = 0.001) and normal groups (p < 0.001). Also, patients with vitamin D deficiency presented significantly higher SDI scores than patients with 25(OH)D insufficiency (p = 0.033) and 25(OH)D normal levels (p = 0.029). There is a high prevalence of both vitamin D deficiency and insufficiency in Caucasian SLE patients and this status was associated with higher SLEDAI and SDI scores, supporting the impact of vitamin D levels on disease activity and damage accrual in SLE patients. Longitudinal studies on the relationship between vitamin D status and disease activity and progression are therefore required.
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Affiliation(s)
- María Correa-Rodríguez
- Instituto de Investigación Biosanitaria, IBS, Granada, Spain.,Department of Nursing, Health Sciences Faculty, 16741University of Granada (UGR), Spain
| | - Gabriela Pocovi-Gerardino
- Instituto de Investigación Biosanitaria, IBS, Granada, Spain.,Department of Nursing, Health Sciences Faculty, 16741University of Granada (UGR), Spain
| | - José-Luis Callejas-Rubio
- Instituto de Investigación Biosanitaria, IBS, Granada, Spain.,Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, 16581Hospital Universitario San Cecilio, Granada, Spain
| | - Raquel Ríos-Fernández
- Instituto de Investigación Biosanitaria, IBS, Granada, Spain.,Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, 16581Hospital Universitario San Cecilio, Granada, Spain
| | - María Martín-Amada
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Complejo Hospitalario de Jaén, Spain
| | - María-Gracia Cruz-Caparrós
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, 16579Hospital de Poniente, Carretera de Almerimar, Almería, Spain
| | - Sara DelOlmo-Romero
- Department of Nursing, Health Sciences Faculty, 16741University of Granada (UGR), Spain
| | - Norberto Ortego-Centeno
- Instituto de Investigación Biosanitaria, IBS, Granada, Spain.,Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, 16581Hospital Universitario San Cecilio, Granada, Spain
| | - Blanca Rueda-Medina
- Instituto de Investigación Biosanitaria, IBS, Granada, Spain.,Department of Nursing, Health Sciences Faculty, 16741University of Granada (UGR), Spain
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11
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Álvarez-Cienfuegos A, Cantero-Nieto L, García-Gomez JA, Callejas-Rubio JL, González-Gay MA, Ortego-Centeno N. Association Between Homocysteine Serum Level and Bone Mineral Density in Patients With Rheumatoid Arthritis. J Clin Densitom 2020; 23:561-567. [PMID: 31005409 DOI: 10.1016/j.jocd.2019.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/24/2019] [Accepted: 03/25/2019] [Indexed: 11/25/2022]
Affiliation(s)
| | | | - J A García-Gomez
- Infectious Diseases Unit, Hospital General de Elche, Alicante, Spain
| | - J L Callejas-Rubio
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitario San Cecilio, Granada, Spain
| | - M A González-Gay
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain; School of Medicine, University of Cantabria, Santander, Spain; Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - N Ortego-Centeno
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitario San Cecilio, Granada, Spain
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12
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Correa-Rodríguez M, Pocovi-Gerardino G, Callejas-Rubio JL, Fernández RR, Martín-Amada M, Cruz-Caparros MG, Ortego-Centeno N, Rueda-Medina B. The Prognostic Nutritional Index and Nutritional Risk Index Are Associated with Disease Activity in Patients with Systemic Lupus Erythematosus. Nutrients 2019; 11:E638. [PMID: 30884776 PMCID: PMC6471040 DOI: 10.3390/nu11030638] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 03/12/2019] [Accepted: 03/13/2019] [Indexed: 12/17/2022] Open
Abstract
The prognostic nutritional index (PNI), controlling nutritional status (CONUT) score and nutritional risk index (NRI) have been described as useful screening tools for patient prognosis in several diseases. The aim of this study was to examine the relationship between PNI, CONUT and NRI with clinical disease activity and damage in 173 patients with systemic lupus erythematous (SLE). Disease activity was assessed with the SLE disease activity index (SLEDAI-2K), and disease-related organ damage was assessed using the SLICC/ACR damage index (SDI) damage index. PNI and NRI were significantly lower in active SLE patients than in inactive SLE patients (p < 0.001 and p = 0.012, respectively). PNI was inversely correlated with the SLEDAI score (p < 0.001) and NRI positively correlated with SLEDAI and SDI scores (p = 0.027 and p < 0.001). Linear regression analysis adjusting for age, sex and medications showed that PNI was inversely correlated with SLEDAI (β (95% CI) = -0.176 (-0.254, -0.098), p < 0.001) and NRI positively correlated with SLEDAI (β (95% CI) = 0.056 (0.019, 0.093), p = 0.003) and SDI (β (95% CI) = 0.047 (0.031, 0.063), p < 0.001). PNI (odds ratio (OR) 0.884, 95% confidence interval (CI) 0.809⁻0.967, p = 0.007) and NRI ((OR) 1.067, 95% CI 1.028⁻1.108, p = 0.001) were independent predictors of active SLE. These findings suggest that PNI and NRI may be useful markers to identify active SLE in clinical practice.
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Affiliation(s)
- María Correa-Rodríguez
- Department of Nursing, Health Sciences Faculty, University of Granada (UGR), Avenida de la Ilustración s/n, 18100-Armilla (Granada), Spain.
| | - Gabriela Pocovi-Gerardino
- Health Sciences Facultuy. PhD student of the Public Health and Clinic Medicine program of the University of Granada (UGR), Avenida de la Ilustración s/n, 18100-Armilla (Granada), Spain.
- Instituto de Investigación Biosanitaria, IBS. Avda. de Madrid, 15. Pabellón de consultas externas 2, 2ª planta, 18012 Granada, Spain.
| | - José-Luis Callejas-Rubio
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario San Cecilio, Av. de la Investigación, s/n, 18016 Granada, Spain.
| | - Raquel Ríos Fernández
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario San Cecilio, Av. de la Investigación, s/n, 18016 Granada, Spain.
| | - María Martín-Amada
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Complejo Hospitalario de Jaén, Av. del Ejército Español, 10, 23007 Jaén, Spain.
| | - María-Gracia Cruz-Caparros
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital de Poniente, Carretera de Almerimar, 31, 04700 El Ejido, Almería, Spain.
| | - Norberto Ortego-Centeno
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario San Cecilio, Av. de la Investigación, s/n, 18016 Granada, Spain.
| | - Blanca Rueda-Medina
- Department of Nursing, Health Sciences Faculty, University of Granada (UGR), Avenida de la Ilustración s/n, 18100-Armilla (Granada), Spain.
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13
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Martín-Varillas JL, Calvo-Río V, Beltrán E, Sánchez-Bursón J, Mesquida M, Adán A, Hernandez MV, Garfella MH, Pascual EV, Martínez-Costa L, Sellas-Fernández A, Cordero-Coma M, Díaz-Llopis M, Gallego R, Salom D, Ortego N, García-Serrano JL, Callejas-Rubio JL, Herreras JM, García-Aparicio Á, Maíz O, Blanco A, Torre I, Díaz-Valle D, Pato E, Aurrecoechea E, Caracuel MA, Gamero F, Minguez E, Carrasco-Cubero C, Olive A, Vázquez J, Ruiz-Moreno O, Manero J, Muñoz-Fernández S, Martinez MG, Rubio-Romero E, Toyos-Sáenz de Miera FJ, López Longo FJ, Nolla JM, Revenga M, González-Vela C, Loricera J, Atienza-Mateo B, Demetrio-Pablo R, Hernández JL, González-Gay MA, Blanco R. Successful Optimization of Adalimumab Therapy in Refractory Uveitis Due to Behçet's Disease. Ophthalmology 2018; 125:1444-1451. [DOI: 10.1016/j.ophtha.2018.02.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 02/07/2018] [Accepted: 02/13/2018] [Indexed: 12/30/2022] Open
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14
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Sánchez-Cano D, Callejas-Rubio JL, Vilanova-Mateu A, Gómez-Morales M, Ortego-Centeno N. Intravascular lymphoma in a patient with systemic lupus erythematosus: a case report. Lupus 2016; 16:525-8. [PMID: 17670853 DOI: 10.1177/0961203307079461] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Intravascular lymphoma IVL is a rare and aggressive disorder characterized by proliferation of large lymphoid cells (most commonly B-cells) within the lumen of small vessels of nearly every organ. Obliteration of vessels leads to the different clinical signs, being cutaneous lesions and neurological signs the most frequent presentations, whereas lymph node and reticuloendothelial system involvement is typically absent.1—4 No association with SLE has been described up to the present. We report a case of IVL in a patient with systemic lupus erythematosus (SLE) involving skin, central nervous system (CNS) and bone marrow. Lupus (2007) 16, 525—528.
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Affiliation(s)
- D Sánchez-Cano
- Unidad de Enfermedades Autoinmunes Sistémicas, Hospital Clínico San Cecilio, Granada, Spain.
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15
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Peralta-Ramírez MI, Coín-Mejías MA, Jiménez-Alonso J, Ortego-Centeno N, Callejas-Rubio JL, Caracuel-Romero A, Pérez-García M. Stress as a predictor of cognitive functioning in lupus. Lupus 2016; 15:858-64. [PMID: 17211991 DOI: 10.1177/0961203306071404] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this study was to investigate the possible effects of the daily stress experienced during a six-month period on the cognitive functioning of patients with systemic lupus erythematosus (SLE). For this purpose, we evaluated the daily stress of 21 patients with lupus every day for six months. Later, we carried out a neuropsychological exam that included an evaluation of attention and memory. At the same time, scores on depression and anxiety were recorded with the objective of controlling other emotional variables that might be influencing these cognitive processes. The results show that daily stress was able to predict the scores on the neuropsychological variables studied. Specifically, the daily stress experienced in the previous six months is the variable with the greatest explanatory-predictive power on the scores for delayed recall visual memory, visual fluency and attention speed. This relationship proved to be negative in all three cases ( R2 corr = 0.290; t = −2.712, P < 0.014); ( R2 corr = 0.318; t = −2.818, P < 0.012); ( R2 corr = 0.319; t −2.906, P < 0.009), which means that the greater the daily stress, the lower the score on visual memory, fluency and total attention speed. We can state that daily stress is related to impairments in visual memory, fluency and attention in patients with SLE. This effect was not found with other emotional variables, such as depression and anxiety.
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16
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Simeón-Aznar CP, Fonollosa-Plá V, Tolosa-Vilella C, Espinosa-Garriga G, Campillo-Grau M, Ramos-Casals M, García-Hernández FJ, Castillo-Palma MJ, Sánchez-Román J, Callejas-Rubio JL, Ortego-Centeno N, Egurbide-Arberas MV, Trapiellla-Martínez L, Caminal-Montero L, Sáez-Comet L, Velilla-Marco J, Camps-García MT, de Ramón-Garrido E, Esteban-Marcos EM, Pallarés-Ferreres L, Navarrete-Navarrete N, Vargas-Hitos JA, Torre RGDL, Salvador-Cervello G, Rios-Blanco JJ, Vilardell-Tarrés M. Registry of the Spanish Network for Systemic Sclerosis: Survival, Prognostic Factors, and Causes of Death. Medicine (Baltimore) 2015; 94:e1728. [PMID: 26512564 PMCID: PMC4985378 DOI: 10.1097/md.0000000000001728] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Systemic sclerosis (SSc) is a rare, multisystem disease showing a large individual variability in disease progression and prognosis. In the present study, we assess survival, causes of death, and risk factors of mortality in a large series of Spanish SSc patients. Consecutive SSc patients fulfilling criteria of the classification by LeRoy were recruited in the survey. Kaplan-Meier and Cox proportional-hazards models were used to analyze survival and to identify predictors of mortality. Among 879 consecutive patients, 138 (15.7%) deaths were registered. Seventy-six out of 138 (55%) deceased patients were due to causes attributed to SSc, and pulmonary hypertension (PH) was the leading cause in 23 (16.6%) patients. Survival rates were 96%, 93%, 83%, and 73% at 5, 10, 20, and 30 years after the first symptom, respectively. Survival rates for diffuse cutaneous SSc (dcSSc) and limited cutaneous SSc were 91%, 86%, 64%, and 39%; and 97%, 95%, 85%, and 81% at 5, 10, 20, and 30 years, respectively (log-rank: 67.63, P < 0.0001). The dcSSc subset, male sex, age at disease onset older than 65 years, digital ulcers, interstitial lung disease (ILD), PH, heart involvement, scleroderma renal crisis (SRC), presence of antitopoisomerase I and absence of anticentromere antibodies, and active capillaroscopic pattern showed reduced survival rate. In a multivariate analysis, older age at disease onset, dcSSc, ILD, PH, and SRC were independent risk factors for mortality. In the present study involving a large cohort of SSc patients, a high prevalence of disease-related causes of death was demonstrated. Older age at disease onset, dcSSc, ILD, PH, and SRC were identified as independent prognostic factors.
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Affiliation(s)
- C P Simeón-Aznar
- From the Department of Internal Medicine, Hospital Valld'Hebron (CPS-A, VF-P, MV-T); Department of Internal Medicine, Hospital Parc Taulí, Sabadell (CT-V); Department of Autoimmune Diseases, Hospital Clinic (GE-G, MR-C); Laboratori of Computacional Medicine, Bioestatistics Unit, Universitat Autònoma de Barcelona, Bellaterra, Barcelona (MC-G); Unit of Connective Tissue Diseases, Department of Internal Medicine, Hospital Virgen del Rocio, Sevilla (FJG-H, MJC-P, JS-R); Unit of Autoimmune Systemic Diseases, Department of Internal Medicine, Hospital Clínico San Cecilio, Granada (JLC-R, NO-C); Department of Internal Medicine, Hospital de Cruces, Galdakano, Bilbao (MVE-A); Department of Internal Medicine, Hospital de Cabueñes, Gijón (LT-M); Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo (LC-M); Department of Internal Medicine, Hospital Miguel Servet, Zaragoza (LS-C, JV-M); Department of Internal Medicine, Hospital Carlos Haya, Málaga (MTC-G, ER-G); Department of Internal Medicine, Hospital Son Espases, Palma de Mallorca (EME-M, LP-F); Department of Internal Medicine, Hospital Virgen de las Nieves, Granada (NN-N, JAV-H); Department of Internal Medicine, Hospital San Agustín, Avilés (RGT); Department of Internal Medicine, Hospital La Fe, Valencia (GS-C); and Department of Internal Medicine, Hospital La Paz, Madrid (JJR-B), Systemic Autoimmune Diseases Group (GEAS), Spanish Scleroderma Study Group (SSSG), Spanish Society of Internal Medicine, Spain
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17
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López-Robles C, Ríos-Fernández R, Callejas-Rubio JL, Moreno-Escobar E, Ortego-Centeno N. Low bone mass and carotid atherosclerosis in lupus erythematosus patients from Granada, a city in the south of Spain. Lupus 2015; 25:223-4. [DOI: 10.1177/0961203315608255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 08/25/2015] [Indexed: 11/15/2022]
Affiliation(s)
- C López-Robles
- Clinical Internal Medicine Unit, Hospital General de Antequera, Antequera, Málaga, Spain
| | - R Ríos-Fernández
- Autoimmune Diseases Unit, Hospital Universitario San Cecilio, Granada, Spain
| | - J L Callejas-Rubio
- Autoimmune Diseases Unit, Hospital Universitario San Cecilio, Granada, Spain
| | - E Moreno-Escobar
- Clinical Cardiology Unit, Hospital Universitario San Cecilio, Granada, Spain
| | - N Ortego-Centeno
- Autoimmune Diseases Unit, Hospital Universitario San Cecilio, Granada, Spain
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18
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González-Moreno J, Callejas-Rubio JL, Ríos-Fernández R, Ortego-Centeno N. Antiphospholipid syndrome, antiphospholipid antibodies and solid organ transplantation. Lupus 2015; 24:1356-63. [DOI: 10.1177/0961203315595129] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 06/17/2015] [Indexed: 11/16/2022]
Abstract
Antiphospholipid syndrome is considered a high risk factor for any kind of surgery. Considering that all solid organ transplants are critically dependent on the patency of vascular anastomosis, there is much concern about the consequences this pro-thrombotic condition may have on transplantation. Relatively little information is available in the literature assessing the real risk that antiphospholipid syndrome or the presence of antiphospholipid antibodies represent in solid organ transplantation. The aim of this article is to review the literature related to transplantation of solid organs in patients diagnosed with antiphospholipid syndrome or patients with positive antiphospholipid antibodies.
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Affiliation(s)
- J González-Moreno
- Internal Medicine Department, Hospital Son Llàtzer, Palma de Mallorca, Illes Balears, Spain
| | - J L Callejas-Rubio
- Autoimmune Diseases Unit, Internal Medicine Department, Hospital Clínico San Cecilio, Granada, Spain
| | - R Ríos-Fernández
- Autoimmune Diseases Unit, Internal Medicine Department, Hospital Clínico San Cecilio, Granada, Spain
| | - N Ortego-Centeno
- Autoimmune Diseases Unit, Internal Medicine Department, Hospital Clínico San Cecilio, Granada, Spain
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19
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Coín MA, Vilar-López R, Peralta-Ramírez I, Hidalgo-Ruzzante N, Callejas-Rubio JL, Ortego-Centeno N, Pérez-García M. The role of antiphospholipid autoantibodies in the cognitive deficits of patients with systemic lupus erythematosus. Lupus 2015; 24:875-9. [DOI: 10.1177/0961203315572717] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 01/21/2015] [Indexed: 11/17/2022]
Abstract
Objective: To analyze the role of the antiphospholipid autoantibodies (aPL) on the neuropsychological deficits in systemic lupus erythematosus (SLE) patients, comparing groups of patients with antiphospholipid syndrome (APS; n = 15), SLE with aPL ( n = 12), and SLE without aPL ( n = 27), and a healthy control group ( n = 31). Methods: Patients fulfilled the American College of Rheumatology SLE classification criteria or the Sydney criteria for APS. All participants were woman, and groups were matched on age and education. A standardized cognitive examination classified patients as cognitively declined or impaired according to the American College of Rheumatology. Results: Differences between the groups were found in all of the studied variables, comprising attention and executive functions (sustained and selective attention, fluency, and inhibition), and memory (verbal and visual). Post-hoc analyses showed cognitive performance was equivalent between APS and SLE with aPL. Differences between SLE without aPL and control groups were found only in four of the 10 studied variables, while differences in all but two memory variables were found between SLE without aPL and control groups. Furthermore, cognitive deficit was three times more frequent in APS and SLE with aPL patients than for the control group (80%, 75%, and 16%, respectively), and two times more frequent compared to SLE patients without aPL (48%). Conclusions: Our results support the relationship between aPL and cognitive symptoms in SLE. Also, almost half of the patients with SLE and no aPL showed cognitive problems, pointing to the multifactorial causes of cognitive problems in SLE. Future research with larger sample size is guaranteed to replicate our results.
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Affiliation(s)
- M A Coín
- Facultad de Psicología, Universidad de Jaén, Spain
| | - R Vilar-López
- Facultad de Psicología, Universidad de Granada, Spain
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada, Spain
| | - I Peralta-Ramírez
- Facultad de Psicología, Universidad de Granada, Spain
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada, Spain
| | - N Hidalgo-Ruzzante
- Facultad de Psicología, Universidad de Granada, Spain
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada, Spain
| | - J L Callejas-Rubio
- Internal Medicine Unit, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - N Ortego-Centeno
- Internal Medicine Unit, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - M Pérez-García
- Facultad de Psicología, Universidad de Granada, Spain
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada, Spain
- Centro de Investigaciones Biomédica en Red de Salud Mental (CIBERSAM), University of Granada, Spain
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20
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Ortego-Jurado M, Ríos-Fernández R, Callejas-Rubio JL, Gonzalez-Gay MA, Ortego-Centeno N. Vitamin D levels and response to biphosphonates in postmenopausal women receiving glucocorticoid therapy. Osteoporos Int 2014; 25:2157-8. [PMID: 24803328 DOI: 10.1007/s00198-014-2713-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 04/08/2014] [Indexed: 11/30/2022]
Affiliation(s)
- M Ortego-Jurado
- Unidad de Enfermedades Autoinmunes Sistémicas, Hospital Universitario San Cecilio, Granada, Spain
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21
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Ortego-Centeno N, Callejas-Rubio JL, Ríos-Fernández R, Simeón-Aznar CP. Health-Related Internet Use by Patients With Systemic Sclerosis and Other Autoimmune Diseases: Comment on the Article by van der Vaart et al. Arthritis Care Res (Hoboken) 2014; 66:334. [DOI: 10.1002/acr.22157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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22
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Pavón EJ, Zumaquero E, Rosal-Vela A, Khoo KM, Cerezo-Wallis D, García-Rodríguez S, Carrascal M, Abian J, Graeff R, Callejas-Rubio JL, Ortego-Centeno N, Malavasi F, Zubiaur M, Sancho J. Increased CD38 expression in T cells and circulating anti-CD38 IgG autoantibodies differentially correlate with distinct cytokine profiles and disease activity in systemic lupus erythematosus patients. Cytokine 2013; 62:232-43. [PMID: 23538292 DOI: 10.1016/j.cyto.2013.02.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 02/14/2013] [Accepted: 02/16/2013] [Indexed: 01/05/2023]
Abstract
CD38 is a multifunctional protein possessing ADP-ribosyl cyclase activity responsible for both the synthesis and the degradation of several Ca(2+)-mobilizing second messengers. In mammals, CD38 also functions as a receptor. In this study CD38 expression in CD4(+), CD8(+), or CD25(+) T cells was significantly higher in systemic lupus erythematosus (SLE) patients than in Normal controls. Increased CD38 expression in SLE T cells correlated with plasma levels of Th2 (IL-4, IL-10, IL-13) and Th1 (IL-1β, IL-12, IFN-γ, TNF-α) cytokines, and was more prevalent in clinically active SLE patients than in Normal controls. In contrast, elevated anti-CD38 IgG autoantibodies were more frequent in clinically quiescent SLE patients (SLEDAI=0) than in Normal controls, and correlated with moderate increased plasma levels of IL-10 and IFN-γ. However, clinically active SLE patients were mainly discriminated from quiescent SLE patients by increased levels of IL-10 and anti-dsDNA antibodies, with odds ratios (ORs) of 3.7 and 4.8, respectively. Increased frequency of anti-CD38 autoantibodies showed an inverse relationship with clinical activity (OR=0.43), and in particular with the frequency of anti-dsDNA autoantibodies (OR=0.21). Increased cell death occurred in CD38(+) Jurkat T cells treated with anti-CD38(+) SLE plasmas, and not in these cells treated with anti-CD38(-) SLE plasmas, or Normal plasmas. This effect did not occur in CD38-negative Jurkat T cells, suggesting that it could be attributed to anti-CD38 autoantibodies. These results support the hypothesis that anti-CD38 IgG autoantibodies or their associated plasma factors may dampen immune activation by affecting the viability of CD38(+) effector T cells and may provide protection from certain clinical SLE features.
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Affiliation(s)
- Esther J Pavón
- Instituto de Parasitología y Biomedicina López-Neyra (IPBLN), Consejo Superior de Investigaciones Científicas (CSIC), Parque Tecnológico de Ciencias de la Salud (PTS), Avenida del Conocimiento s/n, 18016 Armilla, Spain
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23
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Carmona FD, Cénit MC, Diaz-Gallo LM, Broen JCA, Simeón CP, Carreira PE, Callejas-Rubio JL, Fonollosa V, López-Longo FJ, González-Gay MA, Hunzelmann N, Riemekasten G, Witte T, Kreuter A, Distler JHW, Madhok R, Shiels P, van Laar JM, Schuerwegh AJ, Vonk MC, Voskuyl AE, Fonseca C, Denton CP, Herrick A, Worthington J, Arnett FC, Tan FK, Assassi S, Radstake TRDJ, Mayes MD, Martín J. New insight on the Xq28 association with systemic sclerosis. Ann Rheum Dis 2013; 72:2032-8. [PMID: 23444193 DOI: 10.1136/annrheumdis-2012-202742] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate whether the systemic sclerosis (SSc)-associated IRAK1 non-synonymous single-nucleotide polymorphism rs1059702 is responsible for the Xq28 association with SSc or whether there are other independent signals in the nearby methyl-CpG-binding protein 2 gene (MECP2). METHODS We analysed a total of 3065 women with SSc and 2630 unaffected controls from five independent Caucasian cohorts. Four tag single-nucleotide polymorphisms of MECP2 (rs3027935, rs17435, rs5987201 and rs5945175) and the IRAK1 variant rs1059702 were genotyped using TaqMan predesigned assays. A meta-analysis including all cohorts was performed to test the overall effect of these Xq28 polymorphisms on SSc. RESULTS IRAK1 rs1059702 and MECP2 rs17435 were associated specifically with diffuse cutaneous SSc (PFDR=4.12×10(-3), OR=1.27, 95% CI 1.09 to 1.47, and PFDR=5.26×10(-4), OR=1.30, 95% CI 1.14 to 1.48, respectively), but conditional logistic regression analysis showed that the association of IRAK1 rs1059702 with this subtype was explained by that of MECP2 rs17435. On the other hand, IRAK1 rs1059702 was consistently associated with presence of pulmonary fibrosis (PF), because statistical significance was observed when comparing SSc patients PF+ versus controls (PFDR=0.039, OR=1.30, 95% CI 1.07 to 1.58) and SSc patients PF+ versus SSc patients PF- (p=0.025, OR=1.26, 95% CI 1.03 to 1.55). CONCLUSIONS Our data clearly suggest the existence of two independent signals within the Xq28 region, one located in IRAK1 related to PF and another in MECP2 related to diffuse cutaneous SSc, indicating that both genes may have an impact on the clinical outcome of the disease.
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Affiliation(s)
- F David Carmona
- Instituto de Parasitología y Biomedicina 'López-Neyra', CSIC, , Granada, Spain
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24
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Pavón EJ, García-Rodríguez S, Zumaquero E, Perandrés-López R, Rosal-Vela A, Lario A, Longobardo V, Carrascal M, Abián J, Callejas-Rubio JL, Ortego-Centeno N, Zubiaur M, Sancho J. Increased expression and phosphorylation of the two S100A9 isoforms in mononuclear cells from patients with systemic lupus erythematosus: a proteomic signature for circulating low-density granulocytes. J Proteomics 2011; 75:1778-91. [PMID: 22230807 DOI: 10.1016/j.jprot.2011.12.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Revised: 11/03/2011] [Accepted: 12/14/2011] [Indexed: 10/14/2022]
Abstract
Proteins differentially expressed in peripheral blood mononuclear cells (PBMCs) from systemic lupus erythematosus (SLE) patients versus Normal controls were identified by 2-DE and MALDI-MS. Thus, S100A9 expression was significantly increased in SLE PBMCs relative to Normal PBMCs at both mRNA and protein levels. Increased S100A9 levels in SLE PBMCs correlated positively with the abnormal presence of low-density granulocytes (LDGs) detected by flow-cytometry in the mononuclear cell fractions. Another set of proteins that were differentially expressed in SLE PBMCs formed S100A9-independent clusters, suggesting that these differences in protein expression are in fact reflecting changes in the abundance of specific cell types. In SLE PBMCs spots of the two S100A9 isoforms, S100A9-l and S100A9-s, and their phosphorylated counterparts were identified and confirmed to be phosphorylated at Thr(113) by MS/MS analyses. In addition, the phorbol ester PMA alone or in combination with ionomycin induced a stronger increase in threonine phosphorylation of S100A9 in SLE than in Normal PBMCs, while the same stimuli caused the opposite effect on phosphorylation and activation of Erk1/2, suggesting the existence of an abnormal S100A9 signaling in SLE PBMCs. Therefore, the expansion and activation of LDGs in SLE seems to underlie this prominent S100A9 signature.
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Affiliation(s)
- Esther J Pavón
- Departamento de Biología Celular e Inmunología, Instituto de Parasitología y Biomedicina "López-Neyra", IPBLN-CSIC, Armilla, Spain
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25
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Díaz-Lagares C, Croca S, Sangle S, Vital EM, Catapano F, Martínez-Berriotxoa A, García-Hernández F, Callejas-Rubio JL, Rascón J, D'Cruz D, Jayne D, Ruiz-Irastorza G, Emery P, Isenberg D, Ramos-Casals M, Khamashta MA. Efficacy of rituximab in 164 patients with biopsy-proven lupus nephritis: pooled data from European cohorts. Autoimmun Rev 2011; 11:357-64. [PMID: 22032879 DOI: 10.1016/j.autrev.2011.10.009] [Citation(s) in RCA: 162] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Accepted: 10/09/2011] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To present a pooled analysis of the efficacy of rituximab from European cohorts diagnosed with biopsy-proven lupus nephropathy (LN) who were treated with rituximab. METHODS Consecutive patients with biopsy-proven LN treated with rituximab in European reference centers were included. Complete response (CR) was defined as normal serum creatinine with inactive urinary sediment and 24-hour urinary albumin <0.5 g, and partial response (PR) as a >50% improvement in all renal parameters that were abnormal at baseline, with no deterioration in any parameter. RESULTS 164 patients were included (145 women and 19 men, with a mean age of 32.3 years). Rituximab was administered in combination with corticosteroids (162 patients, 99%) and immunosuppressive agents in 124 (76%) patients (cyclophosphamide in 58 and mycophenolate in 55). At 6- and 12-months, respectively, response rates were 27% and 30% for CR, 40% and 37% for PR and 33% for no response. Significant improvement in 24-h proteinuria (4.41 g. baseline vs 1.31 g. post-therapy, p=0.006), serum albumin (28.55 g. baseline to 36.46 g. post-therapy, p<0.001) and protein/creatinine ratio (from 421.94 g/mmol baseline to 234.98 post-therapy, p<0.001) at 12 months was observed. A better response (CR+PR) was found in patients with type III LN in comparison with those with type IV and type V (p=0.007 and 0.03, respectively). Nephrotic syndrome and renal failure at the time of rituximab administration predicted a worse response (no achievement of CR at 12 months) (p<0.001 and p=0.024, respectively). CONCLUSION Rituximab is currently being used to treat refractory systemic autoimmune diseases. Rituximab may be an effective option for patients with lupus nephritis, especially those refractory to standard treatment or who experience a new flare after intensive immunosuppressive treatment.
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Affiliation(s)
- Cándido Díaz-Lagares
- Laboratory of Autoimmune Diseases "Josep Font", Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain
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26
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López-Robles C, Rios-Fernández R, Callejas-Rubio JL, Ortego-Centeno N. Vitamin D deficiency in a cohort of patients with systemic lupus erythematous from the South of Spain. Lupus 2010; 20:330-1. [DOI: 10.1177/0961203310378670] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- C López-Robles
- Autoimmune Diseases Unit, Hospital Universitario San Cecilio, Avd Dr. Oloriz s/n, Granada, Spain
| | - R Rios-Fernández
- Autoimmune Diseases Unit, Hospital Universitario San Cecilio, Avd Dr. Oloriz s/n, Granada, Spain
| | - JL Callejas-Rubio
- Autoimmune Diseases Unit, Hospital Universitario San Cecilio, Avd Dr. Oloriz s/n, Granada, Spain
| | - N Ortego-Centeno
- Autoimmune Diseases Unit, Hospital Universitario San Cecilio, Avd Dr. Oloriz s/n, Granada, Spain
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27
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Husein-Elahmed H, Callejas-Rubio JL, Ortega Del Olmo R, Ríos-Fernandez R, Ortego-Centeno N. Severe Raynaud syndrome induced by adjuvant interferon alfa in metastatic melanoma. Curr Oncol 2010; 17:122-3. [PMID: 20697523 DOI: 10.3747/co.v17i4.519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Melanoma is the most lethal form of skin malignancy because of its aggressive behaviour. In advanced disease, interferon alfa can be used as adjuvant therapy. However, this therapy is not free of side effects. We present a case of severe Raynaud syndrome and digital necrosis induced by interferon alfa in a patient with melanoma. Pathogenic mechanisms are discussed.
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Affiliation(s)
- H Husein-Elahmed
- Department of Dermatology, San Cecilio University Hospital, Granada, Spain.
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28
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Navarrete-Navarrete N, Peralta-Ramírez MI, Sabio-Sánchez JM, Coín MA, Robles-Ortega H, Hidalgo-Tenorio C, Ortego-Centeno N, Callejas-Rubio JL, Jiménez-Alonso J. Efficacy of cognitive behavioural therapy for the treatment of chronic stress in patients with lupus erythematosus: a randomized controlled trial. Psychother Psychosom 2010; 79:107-15. [PMID: 20090397 DOI: 10.1159/000276370] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2008] [Accepted: 04/03/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND Chronic stress worsens the quality of life (QOL) of lupus patients by affecting their physical and psychological status. The effectiveness of a cognitive-behavioural intervention in a group of patients with lupus and high levels of daily stress was investigated. METHODS Forty-five patients with lupus and high levels of daily stress were randomly assigned to a control group (CG) or a therapy group (TG); they received cognitive behavioural therapy (CBT) which consisted of ten consecutive weekly sessions. The following variables were evaluated at baseline and at 3, 9 and 15 months: (1) stress, anxiety, depression, (2) Systemic Lupus Erythematosus Disease Activity Index, somatic symptoms, number of flares, (3) anti-nDNA antibodies, complement fractions C3 and C4 and (4) QOL. A multivariate analysis of repeated measures and various analyses of variance were carried out. RESULTS We found a significant reduction in the level of depression, anxiety and daily stress in the TG compared to the CG and a significant improvement in QOL and somatic symptoms in the TG throughout the entire follow-up period. We did not find any significant changes in the immunological parameters. CONCLUSIONS CBT is effective in dealing with patients suffering from lupus and high levels of daily stress as it significantly reduces the incidence of psychological disorders associated with lupus and improves and maintains patients' QOL, despite there being no significant reduction in the disease activity index.
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Affiliation(s)
- N Navarrete-Navarrete
- Autoimmune Diseases Unit, Internal Medicine Service, University Hospital Virgen de Las Nieves, Granada, Spain.
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29
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Sánchez-Cano D, Callejas-Rubio JL, Ríos-Fernández R, Gutiérrez-Salmerón MT, Fernández Pugnaire MA, Ortego-Centeno N. Efalizumab for subacute cutaneous lupus: report of two different outcomes. Lupus 2009; 18:1334-6. [DOI: 10.1177/0961203309106761] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- D. Sánchez-Cano
- Unidad de Enfermedades Autoinmunes Sistémicas, Hospital Universitario San Cecilio, Granada, Spain,
| | - JL Callejas-Rubio
- Unidad de Enfermedades Autoinmunes Sistémicas, Hospital Universitario San Cecilio, Granada, Spain
| | - R. Ríos-Fernández
- Unidad de Enfermedades Autoinmunes Sistémicas, Hospital Universitario San Cecilio, Granada, Spain
| | | | | | - N. Ortego-Centeno
- Unidad de Enfermedades Autoinmunes Sistémicas, Hospital Universitario San Cecilio, Granada, Spain
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30
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Arias-Santiago SA, Girón-Prieto MS, Callejas-Rubio JL, Fernández-Pugnaire MA, Ortego-Centeno N. Lupus Pernio or Chilblain Lupus? Chest 2009; 136:946-947. [DOI: 10.1378/chest.09-1005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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31
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Sánchez E, González-Gay MA, Callejas-Rubio JL, Ortego-Centeno N, Sabio JM, Jiménez-Alonso J, Micó L, Suarez A, Gutierrez C, de Ramón E, Camps M, Garcia-Portales R, Tolosa C, López-Nevot MA, Sánchez-Román J, Hernández FJ, González-Escribano MF, Martín J. No evidence for genetic association of interferon regulatory factor 3 in systemic lupus erythematosus. Lupus 2009; 18:230-4. [PMID: 19213861 DOI: 10.1177/0961203308096256] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The aim of this study was to determine the potential role of three IRF3 gene polymorphisms (rs2304204, rs7251 and rs2304207) with systemic lupus erythematosus (SLE). Our study population consisted of 610 patients with SLE and 730 healthy controls. All individual were of Spanish Caucasian origin. The IRF3 polymorphisms were genotyped using a PCR system with pre-developed TaqMan allelic discrimination assay. No statistically significant differences were found when allele and genotype distribution of rs2304204, rs7251 and rs2304207 polymorphisms were compared between patients with SLE and controls [overall P values: rs7251, P = 0.06; rs2304204, P = 0.26 and rs2304207, P = 0.36, by chi-squared test on a 3 x 2 contingency table. Overall allelic P values: rs7251, P = 0.8, OR (95%CI) = 1.03 (0.87-1.22); rs2304204, P = 0.2, OR (95%CI) = 1.12 (0.93-1.34) and rs2304207, P = 0.8, OR (95%CI) = 1.02 (0.82-1.26)]. In addition, no evidence of association with haplotypes and clinical features of SLE was found. Our data suggest that the IRF3 polymorphisms do not appear to play a major role in the susceptibility or severity of SLE in a Spanish population.
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Affiliation(s)
- E Sánchez
- Instituto de Parasitología y Biomedicina López-Neyra, CSIC, Granada, Spain.
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Sánchez E, Callejas-Rubio JL, Sabio JM, Gónzalez-Gay MA, Jimenez-Alonso J, Micó L, de Ramón E, Camps M, Suarez A, Gutierrez C, Garcia-Portales R, Tolosa C, Ortego-Centeno N, Sánchez-Román J, Garcia-Hernández FJ, Gónzalez-Escribano MF, Martin J. Investigation of TLR5 and TLR7 as candidate genes for susceptibility to systemic lupus erythematosus. Clin Exp Rheumatol 2009; 27:267-271. [PMID: 19473567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the relevance of genetic variants of TLR5 (rs5744168) and TLR7 (rs179008) gene in systemic lupus erythematosus (SLE) in a Spanish population. MATERIAL AND METHODS Our study population consisted of 752 SLE patients and 1107 healthy controls. All individual were of Spanish Caucasian origin. The TLR5 and TLR7 polymorphisms were genotyped using a PCR system with pre-developed TaqMan allelic discrimination assay. RESULTS No statistically significant differences were observed when the allele and genotype distribution of TLR5 rs5744168 and TLR7 rs179008 polymorphisms was compared between SLE patients and healthy controls. A significant increase frequency in the CC genotype of the TLR5 rs5744168 polymorphism among SLE patients without nephritis was found (93% vs. 87% in SLE patients with nephritis, p=0.03, OR=2.11 95%CI 0.93-3.51). However, this difference did not reach statistical significance in the allele frequencies (p=0.08). CONCLUSION These results suggest that the tested variations of TLR5 and TLR7 genes do not confer a relevant role in the susceptibility or severity to SLE in the Spanish population.
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Affiliation(s)
- E Sánchez
- Instituto de Parasitología y Biomedicina López-Neyra, CSIC, Granada, Spain.
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Sánchez-Cano D, Callejas-Rubio JL, Ruiz-Villaverde R, Ortego-Centeno N. Recalcitrant, recurrent aphthous stomatitis successfully treated with adalimumab. J Eur Acad Dermatol Venereol 2009; 23:206. [DOI: 10.1111/j.1468-3083.2008.02790.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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34
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Montes-Romero JA, Callejas-Rubio JL, Sánchez-Cano D, González-Martínez FJ, Navas-Parejo A, Ortego-Centeno N. Amyloidosis secondary to hidradenitis suppurativa. Exceptional response to infliximab. Eur J Intern Med 2008; 19:e32-3. [PMID: 18848164 DOI: 10.1016/j.ejim.2007.11.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Accepted: 11/09/2007] [Indexed: 11/17/2022]
Affiliation(s)
- J A Montes-Romero
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario San Cecilio, Granada, Spain
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35
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36
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Ríos-Fernández R, Callejas-Rubio JL, Sánchez-Cano D, Martín-Ruiz JL, Ortego-Centeno N. [Paniculitis, polyarthritis and pancreatitis]. Rev Clin Esp 2008; 208:156-7. [PMID: 18275770 DOI: 10.1157/13115824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- R Ríos-Fernández
- Unidad de Enfermedades Sistémicas, Hospital Clínico San Cecilio, Granada, España
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Pavón EJ, Muñoz P, Lario A, Longobardo V, Carrascal M, Abián J, Martin AB, Arias SA, Callejas-Rubio JL, Sola R, Navarro-Pelayo F, Raya-Alvarez E, Ortego-Centeno N, Zubiaur M, Sancho J. Proteomic analysis of plasma from patients with systemic lupus erythematosus: increased presence of haptoglobin alpha2 polypeptide chains over the alpha1 isoforms. Proteomics 2008; 6 Suppl 1:S282-92. [PMID: 16544281 DOI: 10.1002/pmic.200500404] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
In the present study plasma samples from 15 systemic lupus erythematosus (SLE) patients and 16 healthy controls of initially unknown haptoglobin (Hp) phenotype were separated by 2-DE, and tryptic digests of the excised Hpalpha polypeptide chain spots were analyzed by MALDI-TOF-MS. Selected tryptic peptides were sequenced by nano-(n)ESI-IT MS/MS. The six major Hp phenotypes were present, although with distinct frequencies in controls and SLE patients. Thus, there were an increased proportion of SLE patients with Hp 2-2, or Hp 2-1S phenotypes. The Hp phenotype distribution resulted in allele frequencies of 0 625 (Hp(2)), 0.281 (Hp(1S)), and 0.093 (Hp(1F)) in healthy controls, correlating fairly well with the allele frequencies of European populations. In contrast, the Hp allele frequencies of the SLE patients were 0.733 (Hp(2)), 0.233 (Hp(1S)), and 0.033 (Hp1(1F)), which clearly indicated an increased frequency of Hp(2), a similar proportion of Hp(1S) and a diminished proportion of Hp(1F) in SLE patients compared with that in healthy controls. Preferential Hpalpha2 expression in SLE patients may contribute to some of the clinical manifestations of the disease such as hypergammaglobulinemia, systemic vasculitis, and cardiovascular disorders.
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Affiliation(s)
- Esther J Pavón
- Departamento de Biología Celular e Inmunología, Instituto de Parasitología y Biomedicina López-Neyra, CSIC, Armilla, Spain
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Ríos Fernández R, Callejas-Rubio JL, Guerrero Fernández M, Serrano Falcón MM, Ortego-Centeno N. [Necrotizing systemic sarcoidosis with pulmonary and central nervous system involvement]. ACTA ACUST UNITED AC 2008; 25:23-6. [PMID: 18377191 DOI: 10.4321/s0212-71992008000100006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Sarcoidosis is a multisystemic disease which diagnosis depends on the presence of nonnecrotizing granulomas in the biopsy. However there are variants such as necrotizing sarcoidal granulomas or nodular sarcoidosis which have atypical findings and make difficult the differential diagnosis with other infectious processes. We describe a case of a man who develops granulomas with extensive necrosis in a systemic sarcoidosis that affected the lung and the central nervous system. This finding made us to make the diagnosis of tuberculosis and delay the specific treatment.
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Affiliation(s)
- R Ríos Fernández
- Unidad de Enfermedades Sistémicas, Nuerología, Anatomía Patológica, Hospital Clínico San Cecilio, Granada.
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Sánchez-Cano D, Callejas-Rubio JL, Lara-Jiménez MA, López-Trascasa M, Circadi M, Ortego-Centeno N. Successful use of rituximab in acquired C1 inhibitor deficiency secondary to Sjögren’s syndrome. Lupus 2008; 17:228-9. [DOI: 10.1177/0961203307087405] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- D Sánchez-Cano
- Hospital Universitario San Cecilio, Unidad de Enfermedades Autoinmunes Sistémicas, Granada, Spain
| | - JL Callejas-Rubio
- Hospital Universitario San Cecilio, Unidad de Enfermedades Autoinmunes Sistémicas, Granada, Spain
| | - MA Lara-Jiménez
- Hospital Universitario San Cecilio, Unidad de Alergología, Granada, Spain
| | | | - M Circadi
- Dipartimento di Medicina Interna, Università degli Studi di Milano, Milano, Italy
| | - N Ortego-Centeno
- Hospital Universitario San Cecilio, Unidad de Enfermedades Autoinmunes Sistémicas, Granada, Spain
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Ortego-Centeno N, Callejas-Rubio JL, Sanchez-Cano D, Caballero-Morales T. Refractory chronic erythema nodosum successfully treated with adalimumab. J Eur Acad Dermatol Venereol 2007; 21:408-10. [PMID: 17309478 DOI: 10.1111/j.1468-3083.2006.01893.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Sànchez-Cano D, Callejas-Rubio JL, Ortego-Centeno N, Ruiz-Villaverde R. Urticaria and angioedema in a patient with Behçet's disease treated with adalimumab. Clin Exp Rheumatol 2006; 24:S128. [PMID: 17067448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Pavón EJ, Muñoz P, Navarro MDC, Raya-Alvarez E, Callejas-Rubio JL, Navarro-Pelayo F, Ortego-Centeno N, Sancho J, Zubiaur M. Increased association of CD38 with lipid rafts in T cells from patients with systemic lupus erythematosus and in activated normal T cells. Mol Immunol 2006; 43:1029-39. [PMID: 15964076 DOI: 10.1016/j.molimm.2005.05.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2005] [Indexed: 11/20/2022]
Abstract
In this study we have determined whether there is a relationship between CD38 expression on T cells, its distribution in different membrane microdomains, and T cell activation in SLE patients. The data show that CD38 expression is augmented in ex vivo CD3+, CD4+, CD8+, and CD25+ SLE T cells, which correlates with its increased insolubility in Brij 98 detergent, and its translocation into lipid rafts. Moreover, SLE T cells show an altered CD4:CD8 ratio, which is due to a decreased proportion of CD4+ T cells and a concomitant increase in the proportion of CD8+ T cells. These data are consistent with the increased CD38 expression and lipid raft formation, and the significant reduction in the CD4:CD8 ratio observed in mitogen-stimulated normal T cells as compared with that in ex vivo untouched normal T cells. Increased expression of CD38 in floating rafts from SLE T cells, or from activated normal T cells may modulate TCR signaling by providing or sequestering signaling molecules to the engaged TCR.
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Affiliation(s)
- Esther J Pavón
- Departamento de Biología Celular e Inmunología, Instituto de Parasitología y Biomedicina López-Neyra, CSIC, Parque Tecnológico de Ciencias de la Salud, Avenida del Conocimiento s/n, 18100 Armilla, Granada, Spain
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Jiménez-Alonso J, Sabio JM, Carrillo-Alascio PL, Jiménez-Jáimez J, Ortego-Centeno N, Jiménez-Jáimez E, Hidalgo-Tenorio C, Guzmán-Ubeda M, Jáimez L, Cáliz R, García-Sánchez A, Gallego M, Caminal L, Callejas-Rubio JL, Cervera R, Font J. [Intolerance to hydroxychloroquine marketed in Spain (Dolquine) in patients with autoimmune conditions]. Rev Clin Esp 2005; 204:588-91. [PMID: 15511405 DOI: 10.1157/13067369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BASIS A significant proportion of our patients has described to have problems from tolerance to Dolquine, a new presentation of hydroxychloroquine recently marketed in Spain, compared to Plaquenil. The objective was to know the tolerability and the adverse effects of this new presentation. PATIENTS AND METHOD A cross-sectional multicenter study on 133 patients treated with Dolquine was conducted. RESULTS Of the 133 patients (87% women; average age [AA]: 32.9 [15.4] years) who received Dolquine during an average period of 6.7 (1.4) months, 32 patients (24%) described to have more problems with this drug in comparison with other antimalarial. The adverse effects experienced were: bitter taste (62.4%), difficulty in swallowing the tablet (13.5%), dyspepsia (9.8%), nausea (7.5%), vomiting (1.5%), pruritus (1.5%), diarrhea (0.7%), and instability feeling (0.7%). The presence of gastrointestinal adverse effects was not related to the consumption of gastroerosive drugs, gastric protectors, or a high number of drugs. The attrition rate was 9.8%. Conclusions. Dolquine induces lower tolerance and more gastrointestinal adverse effects than Plaquenil, pointing out its bitter taste and the difficulty in swallowing it. Despite this higher intolerance there was not an increase in the attition rate from the antimalarial treatment in comparison to other series.
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Affiliation(s)
- J Jiménez-Alonso
- Unidad de Enfermedades Autoinmunes Sistémicas, Hospital Universitario Virgen de las Nieves, Facultad de Medicina, Granada.
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Muñoz-Medina L, Callejas-Rubio JL, Troncoso-García E, Ortego-Centeno N. Utility of HLA typing in the differential diagnosis of severe aphthosis and Behçet's disease. Dermatology 2001; 201:280-1. [PMID: 11096210 DOI: 10.1159/000018481] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Ortego-Centeno N, Callejas-Rubio JL, López-Mañas JG, Troncoso-García E, de la Higuera Torres-Puchol J. Ileitis terminalis in a patient with Henoch-Schönlein purpura. Dig Dis Sci 1999; 44:1590-3. [PMID: 10492137 DOI: 10.1023/a:1026662926918] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- N Ortego-Centeno
- Service of Internal Medicine B, San Cecilio University Hospital, Granada, Spain
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Callejas-Rubio JL, Ortego N, Díez A, Castro M, De La Higuera J. Recurrent epididymo-orchitis secondary to Behçets disease. J Urol 1998; 160:496. [PMID: 9679909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- J L Callejas-Rubio
- Department of Internal Medicine, San Cecilio University Hospital, Granada, Spain
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