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Tandaipan J, Guillén-Del-Castillo A, Simeón-Aznar CP, Carreira PE, De la Puente C, Narváez J, Lluch J, Rubio-Rivas M, Alegre-Sancho JJ, Bonilla G, Moriano C, Casafont-Sole I, García-Vicuña R, Ortiz-Santamaría V, Riera E, Atienza-Mateo B, Blanco R, Galisteo C, Gonzalez-Martin JJ, Pego-Reigosa JM, Pros A, Heredia S, Castellví I. Immunoglobulins in systemic sclerosis management. A large multicenter experience. Autoimmun Rev 2023; 22:103441. [PMID: 37708984 DOI: 10.1016/j.autrev.2023.103441] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/03/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVE To analyze the effectiveness and safety of intravenous immunoglobulin (IVIG) given in routine care to patients with systemic sclerosis (SSc). METHODS A retrospective multicenter observational study was conducted in SSc patients treated with IVIG. We collected data on epidemiological parameters and clinical outcomes. Firstly, we assessed changes in organ manifestations during IVIG treatment. Secondly, we analyzed the frequency of adverse effects. The following parameters were collected from baseline to the last follow-up: the patient's weight, modified Rodnan Skin Score (mRSS), modified manual muscle strength scale (MRC), laboratory test(creatine kinase(CK), hemoglobin and protein levels), The University of California Los Angeles Scleroderma Clinical Trials Consortium gastrointestinal tract 2.0 (UCLA GIT 2.0) questionnaire, pulmonary function tests, and echocardiography. RESULTS Data were collected on 78 patients (82% females; 59% with diffuse SSc). Inflammatory idiopathic myopathy was the most frequent concomitant overlap disease (41%). The time since Raynaud's phenomenon and SSc onset were 8.8 ± 18 and 6.2 ± 6.7 years respectively. The most frequent IVIG indication was myositis (38/78), followed by gastrointestinal (27/78) and cutaneous (17/78) involvement. The median number of cycles given were 5. 54, 53 and 9 patients have been treated previously with glucocorticoids, synthetic disease-modifying antirheumatic drugs and biologic therapies respectively. After IVIG use we found significant improvements in muscular involvement (MRC ≥ 3/5 92% IVIG, p = 0.001 and CK levels from 1149 ± 2026 UI to 217 ± 224 UI, p = 0.02), mRSS (15 ± 12.4 to 13 ± 12.5, p = 0.015) and improvement in total score of UCLA GIT 2.0 (p = 0.05). None Anti-RNA polymerase III patients showed an adequate response in gastrointestinal involvement (0/7) in comparison with other antibodies (0 vs. 25, p = 0,039). Cardiorespiratory involvement remained stable. A total of 12 adverse events were reported with only one withdrawn due to serious adverse effect. CONCLUSIONS this study suggest that IVIG may improve myositis, gastrointestinal and skin involvement in SSc patients treated in routine care and seems to have a good safety profile.
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Affiliation(s)
- J Tandaipan
- Department of Rheumatology and Systemic Autoinmune Diseases, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain
| | - A Guillén-Del-Castillo
- Unit of Systemic Autoimmune Diseases, Department of Internal Medicine, Hospital Universitari Vall d'Hebrón, Barcelona, Spain
| | - C P Simeón-Aznar
- Unit of Systemic Autoimmune Diseases, Department of Internal Medicine, Hospital Universitari Vall d'Hebrón, Barcelona, Spain
| | - P E Carreira
- Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - C De la Puente
- Department of Rheumatology, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - J Narváez
- Department of Rheumatology, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - J Lluch
- Department of Rheumatology, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - M Rubio-Rivas
- Department of Internal Medicine, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - J J Alegre-Sancho
- Department of Rheumatology, Hospital Universitario Doctor Peset, Valencia, Spain
| | - G Bonilla
- Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain
| | - C Moriano
- Department of Rheumatology, Complejo Asistencial Universitario de León, León, Spain
| | - I Casafont-Sole
- Department of Rheumatology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - R García-Vicuña
- Department of Rheumatology, Hospital Universitario de La Princesa, Madrid, Spain
| | - V Ortiz-Santamaría
- Department of Rheumatology, Hospital General de Granollers, Granollers, Spain
| | - E Riera
- Department of Rheumatology, Hospital Universitari Mútua de Terrassa, Terrassa, Spain
| | - B Atienza-Mateo
- Department of Rheumatology, Hospital Universitario Marques de Valdecilla, Santander, Spain
| | - R Blanco
- Department of Rheumatology, Hospital Universitario Marques de Valdecilla, Santander, Spain
| | - C Galisteo
- Department of Rheumatology, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - J J Gonzalez-Martin
- Department of Rheumatology, Hospital Universitario HM San Chinarro, Madrid, Spain
| | - J M Pego-Reigosa
- Department of Rheumatology, Complejo Hospitalario Universitario de Vigo, IRIDIS (Investigation in Rheumatology and Immune-Mediated Diseases)-VIGO Group, Galicia Sur Health Research Institute (IISGS), Vigo, Spain
| | - A Pros
- Department of Rheumatology, Hospital del Mar, Barcelona, Spain
| | - S Heredia
- Department of Rheumatology, Hospital Sant Joan Despí Moisès Broggi, Sant Joan Despí, Spain
| | - I Castellví
- Department of Rheumatology and Systemic Autoinmune Diseases, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Medicine, Universitat Autonoma de Barcelona, Spain.
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Carreira PE, Carmona L, Joven BE, Loza E, Andréu JL, Riemekasten G, Vettori S, Balbir-Gurman A, Airò P, Walker U, Damjanov N, Matucci-Cerinic M, Ananieva LP, Rednic S, Czirják L, Distler O, Farge D, Hesselstrand R, Corrado A, Caramaschi P, Tikly M, Allanore Y. Differences associated with age at onset in early systemic sclerosis patients: a report from the EULAR Scleroderma Trials and Research Group (EUSTAR) database. Scand J Rheumatol 2018; 48:42-51. [DOI: 10.1080/03009742.2018.1459830] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- PE Carreira
- Rheumatology Department, University Hospital 12 de Octubre, Madrid, Spain
| | - L Carmona
- Musculoskeletal Health Institute, Madrid, Spain
| | - BE Joven
- Rheumatology Department, University Hospital 12 de Octubre, Madrid, Spain
| | - E Loza
- Musculoskeletal Health Institute, Madrid, Spain
| | - JL Andréu
- Rheumatology Department, University Hospital Puerta de Hierro, Madrid, Spain
| | - G Riemekasten
- Department of Rheumatology, University of Lübeck, Lübeck, Germany
| | - S Vettori
- Rheumatology Unit, Department of Internal Medicine Clinical and Experimental ‘F Magrassi-A-Lanzara’, Second University of Naples, Naples, Italy
| | - A Balbir-Gurman
- B Shine Rheumatology Unit, Rambam Health Care Campus and Rappaport Faculty of Medicine-Technion, Haifa, Israel
| | - P Airò
- Rheumatology and Clinical Immunology Unit, Civil Hospitali, Brescia, Italy
| | - U Walker
- Rheumatology Department, Felix Platter Hospital, Basel, Switzerland
| | - N Damjanov
- University of Belgrade School of Medicine, Belgrade, Serbia
| | - M Matucci-Cerinic
- Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - LP Ananieva
- Institute of Rheumatology, Russian Academy of Medical Science, Moscow, Russia
| | - S Rednic
- Rheumatology Clinic, University of Medicine and Pharmacy ‘Iuliu Hatieganu’ Cluj, Cluj-Napoca, Romania
| | - L Czirják
- Department of Immunology and Rheumatology, Faculty of Medicine, University of Pécs, Pécs, Hungary
| | - O Distler
- Division of Rheumatology, University Hospital Zürich, Zürich, Switzerland
| | - D Farge
- Department of Internal Medicine, Saint-Louis Hospital, Paris, France
| | - R Hesselstrand
- Department of Rheumatology, Lund University Hospital, Lund, Sweden
| | - A Corrado
- Rheumatology Unit, University of Foggia, ‘Col. D’Avanzo’ Hospital, Foggia, Italy
| | | | - M Tikly
- Rheumatology Unit, Department of Medicine, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa
| | - Y Allanore
- Rheumatology A Department, Cochin Hospital, APHP, Paris Descartes University, Paris, France
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Johnson SR, Soowamber ML, Fransen J, Khanna D, Van Den Hoogen F, Baron M, Matucci-Cerinic M, Denton CP, Medsger TA, Carreira PE, Riemekasten G, Distler J, Gabrielli A, Steen V, Chung L, Silver R, Varga J, Müller-Ladner U, Vonk MC, Walker UA, Wollheim FA, Herrick A, Furst DE, Czirjak L, Kowal-Bielecka O, Del Galdo F, Cutolo M, Hunzelmann N, Murray CD, Foeldvari I, Mouthon L, Damjanov N, Kahaleh B, Frech T, Assassi S, Saketkoo LA, Pope JE. There is a need for new systemic sclerosis subset criteria. A content analytic approach. Scand J Rheumatol 2017; 47:62-70. [DOI: 10.1080/03009742.2017.1299793] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- SR Johnson
- Toronto Scleroderma Program, Division of Rheumatology, Department of Medicine, Toronto Western Hospital, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - ML Soowamber
- Toronto Scleroderma Program, Division of Rheumatology, Department of Medicine, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - J Fransen
- The Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - D Khanna
- Division of Rheumatology, University of Michigan Scleroderma Program, Ann Arbor, MI, USA
| | - F Van Den Hoogen
- The Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - M Baron
- Division of Rheumatology, Department of Medicine, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - M Matucci-Cerinic
- Department of Rheumatology AVC, Department of BioMedicine, Division of Rheumatology AOUC, Department of Medicine and Denothe Centre, University of Florence, Florence, Italy
| | - CP Denton
- Centre for Rheumatology and Connective Tissue Diseases, Royal Free Hospital, London, UK
| | - TA Medsger
- Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - PE Carreira
- Department of Rheumatology, University Hospital 12 de Octubre, Madrid, Spain
| | - G Riemekasten
- Department of Rheumatology, University of Lübeck, Lung Research Center Borstel, a Leibniz institute, Lübeck, Germany
| | - J Distler
- Department of Internal Medicine 3 and Institute for Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - A Gabrielli
- Department of Molecular and Clinical Sciences, Clinical Medicine, University of Marche, Ancona, Italy
| | - V Steen
- Department of Medicine, Division of Rheumatology, Clinical Immunology and Allergy, Georgetown University School of Medicine, Washington, DC, USA
| | - L Chung
- Department of Medicine and Dermatology, Division of Immunology and Rheumatology, Stanford University, Stanford, CA, USA
| | - R Silver
- Department of Medicine, Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - J Varga
- Department of Medicine, Division of Rheumatology, Clinical Immunology and Allergy, Northwestern University, Chicago, IL, USA
| | - U Müller-Ladner
- Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Kerckhoff Clinic, Bad Nauheim, Germany
| | - MC Vonk
- Department of Rheumatic Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - UA Walker
- Department of Rheumatology, University of Basel, Basel, Switzerland
| | - FA Wollheim
- Department of Rheumatology, Lund University Hospital, Lund, Sweden
| | - A Herrick
- Centre for Musculoskeletal Research, Institute of Inflammation and Repair, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - DE Furst
- Division of Rheumatology, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - L Czirjak
- Department of Rheumatology and Immunology, University of Pécs, Clinical Center, Pécs, Hungary
| | - O Kowal-Bielecka
- Department of Rheumatology and Internal Medicine, Medical University of Bialystok, Białystok, Poland
| | - F Del Galdo
- Scleroderma Programme, Leeds Institute of Rheumatic and Musculoskeletal Medicine, LMBRU, University of Leeds, Leeds, UK
| | - M Cutolo
- Research Laboratory and Academic Division of Clinical Rheumatology, University of Genova, IRCCS AOU S Martino, Genova, Italy
| | - N Hunzelmann
- Department of Dermatology, University of Cologne, Cologne, Germany
| | - CD Murray
- Inflammatory Bowel Disease Unit, Royal Free London NHS Foundation Trust, London, UK
| | - I Foeldvari
- Hamburg Center for Paediatric Rheumatology, Eilbek Clinic, Hamburg, Germany
| | - L Mouthon
- Department of Internal Medicine, Paris Descartes University, the Public Hospitals of Paris, Paris, France
| | - N Damjanov
- Institute of Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia
| | - B Kahaleh
- Division of Rheumatology, Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USA
| | - T Frech
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - S Assassi
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | - LA Saketkoo
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, Tulane University Lung Center, New Orleans, LA, USA
| | - JE Pope
- Division of Rheumatology, Department of Medicine, St Joseph Health Care, University of Western Ontario, London, ON, Canada
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Fernández-Nebro A, de la Fuente JLM, Carreño L, Izquierdo MG, Tomero E, Rúa-Figueroa I, Hernández-Cruz BE, Narváez J, Ucar E, Olivé A, Zea A, Fernández-Castro M, Raya-Álvarez E, Pego-Reigosa JM, Freire M, Martínez-Taboada VM, Pérez-Venegas J, Sánchez-Atrio AI, Villa-Blanco I, Manrique-Arija S, López-Longo FJ, Carreira PE, Martínez-Pérez R, García-Vicuña R. Multicenter longitudinal study of B-lymphocyte depletion in refractory systemic lupus erythematosus: the LESIMAB study. Lupus 2012; 21:1063-76. [PMID: 22786985 DOI: 10.1177/0961203312446627] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aimed to investigate the effectiveness and safety of single and repeated courses of rituximab in patients with refractory lupus. METHODS LESIMAB is a multicenter, retrospective, longitudinal study of lupus patients who have not responded to standard therapy and have been treated with rituximab. Response rates at six months and at follow-up were defined as efficacy outcomes. Complete response was defined as a SELENA-SLEDAI score ≤ two and a SELENA-SLEDAI Flare Index of zero. Partial response was defined as a reduction in the SELENA-SLEDAI score of ≥four points with no new or worsening of symptoms. Adverse events were collected. RESULTS Seventy-three (62.9%) of 116 patients achieved a response at six months (complete in 22 and partial in 51). Ninety-seven (77.6%) of 128 patients achieved a response after a mean follow-up of 20.0 ± 15.2 months (complete in 50 and partial in 47). High baseline SLEDAI score, previous treatment with ≥100 mg/day prednisone, and no history of severe hematologic flare were associated with response after the first treatment course. The median time to response was 6.5 months (95% CI, 5.0-8.0). Thirty-seven patients (38.1%) relapsed after the first infusion. The flare was severe in seven cases and mild to moderate in 29 cases. Serious infection rate was 12.6/100 patient-years. A schedule of four weekly doses was associated with more serious infections. Six patients died: two of infection and four of lupus complications. CONCLUSION Rituximab can be an effective treatment option for patients who have refractory lupus with severe or life-threatening disease with an acceptable tolerance profile.
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Affiliation(s)
- A Fernández-Nebro
- Rheumatology Service, Hospital Regional Universitario Carlos Haya, Spain.
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McKinney C, Broen JCA, Vonk MC, Beretta L, Hesselstrand R, Hunzelmann N, Riemekasten G, Scorza R, Simeon CP, Fonollosa V, Carreira PE, Ortego-Centeno N, Gonzalez-Gay MA, Airo P, Coenen M, Martin J, Radstake TRDJ, Merriman TR. Evidence that deletion at FCGR3B is a risk factor for systemic sclerosis. Genes Immun 2012; 13:458-60. [PMID: 22551723 DOI: 10.1038/gene.2012.15] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is increasing evidence that gene copy number (CN) variation influences clinical phenotype. The low-affinity Fc receptor 3B (FCGR3B) located in the FCGR gene cluster is a CN polymorphic gene involved in the recruitment of polymorphonuclear neutrophils to sites of inflammation and their activation. Given the genetic overlap between systemic lupus erythematosus and systemic sclerosis (SSc) and the strong evidence for FCGR3B CN in the pathology of SLE, we hypothesised that FCGR3B gene dosage influences susceptibility to SSc. We obtained FCGR3B deletion status in 777 European Caucasian cases and 1000 controls. There was an inverse relationship between FCGR3B CN and disease susceptibility. CN of ≤ 1 was a significant risk factor for SSc (OR=1.55 (1.13-2.14), P=0.007) relative to CN ≥ 2. Although requiring replication, these results suggest that impaired immune complex clearance arising from FCGR3B deficiency contributes to the pathology of SSc, and FCGR3B CN variation is a common risk factor for systemic autoimmunity.
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Affiliation(s)
- C McKinney
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
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Tyndall AJ, Bannert B, Vonk M, Airo P, Cozzi F, Carreira PE, Bancel DF, Allanore Y, Muller-Ladner U, Distler O, Iannone F, Pellerito R, Pileckyte M, Miniati I, Ananieva L, Gurman AB, Damjanov N, Mueller A, Valentini G, Riemekasten G, Tikly M, Hummers L, Henriques MJ, Caramaschi P, Scheja A, Rozman B, Ton E, Kumanovics G, Coleiro B, Feierl E, Szucs G, Von Muhlen CA, Riccieri V, Novak S, Chizzolini C, Kotulska A, Denton C, Coelho PC, Kotter I, Simsek I, de la Pena Lefebvre PG, Hachulla E, Seibold JR, Rednic S, Stork J, Morovic-Vergles J, Walker UA. Causes and risk factors for death in systemic sclerosis: a study from the EULAR Scleroderma Trials and Research (EUSTAR) database. Ann Rheum Dis 2010; 69:1809-15. [DOI: 10.1136/ard.2009.114264] [Citation(s) in RCA: 795] [Impact Index Per Article: 56.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Denton CP, Engelhart M, Tvede N, Wilson H, Khan K, Shiwen X, Carreira PE, Diaz Gonzalez F, Black CM, van den Hoogen FH. An open-label pilot study of infliximab therapy in diffuse cutaneous systemic sclerosis. Ann Rheum Dis 2008; 68:1433-9. [PMID: 18782794 DOI: 10.1136/ard.2008.096123] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM The safety and potential efficacy of a chimaeric anti-tumour necrosis factor alpha monoclonal antibody (infliximab) were examined in diffuse cutaneous systemic sclerosis (dcSSc). METHODS A 26-week open-label pilot study in which 16 cases of dcSSc received five infusions of infliximab (5 mg/kg). Clinical assessment included skin sclerosis score, scleroderma health assessment questionnaire, self-reported functional score and physician global visual analogue scale. Collagen turnover, skin biopsy analysis and full safety evaluation were performed. RESULTS There was no significant change in skin score at 26 weeks but a trend for lower modified Rodnan skin score at 22 weeks (OR 17, 95% CI 6 to 46) compared with peak value (OR 29, 95% CI 11 to 44; p = 0.10). Serum aminoterminal propeptide of type III collagen level was significantly lower at week 26 compared with baseline (p = 0.03). Secretion of type I collagen by dermal fibroblasts was reduced at 26 weeks compared with baseline (p = 0.02). There were no deaths during the study and no suspected unexpected serious adverse reactions. 21 serious adverse events (AE) occurred in seven subjects, mostly attributable to dcSSc. 127 distinct AE occurred in 16 subjects. Of these, 19 AE (15%) were probably or definitely related to infliximab treatment. Eight (50%) patients prematurely discontinued infliximab. Anti-infliximab antibodies developed during the study in five subjects and were significantly associated with suspected infusion reactions (p = 0.025). CONCLUSION In dcSSc infliximab did not show clear benefit at 26 weeks but was associated with clinical stabilisation and a fall in two laboratory markers of collagen synthesis. The frequency of suspected infusion reactions may warrant additional immunosuppression in any future studies in systemic sclerosis.
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Affiliation(s)
- C P Denton
- Centre for Rheumatology, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
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9
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Carreira PE, Dahm MW, Norris JS. Transcription activity in fibroblasts from the adult tight skin (TSK) mouse. Clin Exp Rheumatol 2004; 22:S77-80. [PMID: 15344603] [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: 04/30/2023]
Abstract
OBJECTIVE To assess if adult tight-skin mouse (TSK) skin fibroblasts have a parallel increase in transcription of collagen and non-collagen genes. METHODS One-year-old TSK/+ and +/+ (normal littermate) dermal fibroblasts were transfected (lipotransfection) with plasmid constructs containing Chloramphenicol Acetyl Transferse (CAT) gene, directed by promoters of mouse alpha1(I) alpha2(I) and alpha1(III) collagen genes, and by viral enhancers of Simian virus 40, Rous sarcoma virus and an LTR from a Syrian hamster tumour retrovirus. Syrian hamster derived tumour cell lines MF2B and GRI, and fibroblast cell line 3T3/NIH were used as controls. In some experiments, transfected cells were treated with hormones as transcription activating factors. Mixing experiments of tumour cells and TSK/+ or +/+ fibroblasts were done to study potential inhibitors. RESULTS Collagen genes promoters failed to induce transcriptional activity in TSK/+ or +/+ fibroblasts, even in the presence of hormone treatment. Mixing experiments did not reveal inhibitor factors acting in these fibroblasts. Viral enhancers induced 2 to 5 times more transcription activity in TSK/+ than in +/+ fibroblasts. CONCLUSION Increased transcription of viral enhancers and not of collagen genes in adult TSK fibroblasts, suggests the presence of transcription activating factors independent of collagen gene activation.
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Affiliation(s)
- P E Carreira
- Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain.
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Morales-Gutiérrez C, Vegh I, Colina F, Gómez-Cámara A, Ignacio Landa J, Ballesteros D, Carreira PE, Enríquez-De-Salamanca R. Survival of patients with colorectal carcinoma: possible prognostic value of tissular carbohydrate antigen 19.9 determination. Cancer 1999; 86:1675-81. [PMID: 10547539] [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: 02/14/2023]
Abstract
BACKGROUND An important goal of serum tumor marker research is to provide a test for detecting cancer in early stages. Expression of carbohydrate antigen (CA) 19.9 has been described in various malignancies. METHODS The possible prognostic value measuring cytosol CA 19.9 expression in tumors was evaluated in a study of 63 colorectal carcinoma (CRC) patients who were followed for at least 2 years. CA 19.9 expression in cytosol was determined by enzyme-linked immunoadsorbant assay, and measurement of this protein achieved by quantitative assay. RESULTS Mean levels of cytosol CA 19.9 found in tumor samples were significantly higher than those in nontumoral areas in CRC patients (P<0.0005). Patients with more than 3 positive lymph nodes had a higher expression of the marker (P<0.05). Univariate and multivariate analyses revealed that cytosol CA 19.9 concentration was an independent prognostic variable for relapse. Furthermore, the probability of relapse increased 4.2 times for every increase in cytosol tumor marker of 5000 U/mg, and tumors located in the rectum had a probability of relapse 9.5 times greater. CONCLUSIONS Cystol CA 19.9 expression in CRC can be an independent prognostic factor for relapse. Patients with high levels of CA 19.9 have worse prognosis than those with lower values. Therefore, this group of patients should receive special management with regard to their follow-up and treatment. Moreover, quantitative cytosol tumor marker measurement is an easy and highly effective method for determining the prognoses of CRC patients.
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Affiliation(s)
- C Morales-Gutiérrez
- Department of Gastroenterological Surgery, Hospital Doce de Octubre, Universidad Complutense, Madrid, Spain
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Gómez-Reino JJ, Pablos JL, Carreira PE, Santiago B, Serrano L, Vicario JL, Balsa A, Figueroa M, de Juan MD. Association of rheumatoid arthritis with a functional chemokine receptor, CCR5. Arthritis Rheum 1999. [PMID: 10323455 DOI: 10.1002/1529-0131(199905)42:5<989::aid-anr18>3.0.co;2-u] [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] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate whether the pathogenesis of rheumatoid arthritis (RA) is associated with the functional chemokine receptor CCR5, which is the primary CC chemokine receptor expressed by T cells in rheumatoid synovium, and its nonfunctional receptor, delta32CCR5, which is generated by the homozygous 32-basepair deletion (delta32) in the CCR5 gene. METHODS The frequency of the CCR5 genotype was compared among 673 patients with RA, 113 patients with systemic lupus erythematosus (SLE), and 815 control subjects. The CCR5 genotype was studied by polymerase chain reaction amplification of the region flanking the delta32 deletion (delta32CCR5). RESULTS Frequencies of the wild-type CCR5 alleles (0.929, 0.907, and 0.942, respectively) and delta32CCR5 alleles (0.071, 0.093, and 0.058, respectively) in controls, SLE patients, and RA patients did not differ significantly. However, none of the RA patients had the homozygous delta32CCR5 genotype, compared with a frequency of 0.009 in controls (P = 0.014 by Fisher's exact test; chi2 = 4.12 with Yates' correction, P = 0.042) and 0.027 in SLE patients (P = 0.003 by Fisher's exact test; chi2 = 11.63 with Yates' correction, P = 0.0006). CONCLUSION The results suggest that the CCR5 receptor plays an important role in RA and may be a suitable target for therapy.
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Gómez-Reino JJ, Pablos JL, Carreira PE, Santiago B, Serrano L, Vicario JL, Balsa A, Figueroa M, de Juan MD. Association of rheumatoid arthritis with a functional chemokine receptor, CCR5. Arthritis Rheum 1999; 42:989-92. [PMID: 10323455 DOI: 10.1002/1529-0131(199905)42:5<989::aid-anr18>3.0.co;2-u] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate whether the pathogenesis of rheumatoid arthritis (RA) is associated with the functional chemokine receptor CCR5, which is the primary CC chemokine receptor expressed by T cells in rheumatoid synovium, and its nonfunctional receptor, delta32CCR5, which is generated by the homozygous 32-basepair deletion (delta32) in the CCR5 gene. METHODS The frequency of the CCR5 genotype was compared among 673 patients with RA, 113 patients with systemic lupus erythematosus (SLE), and 815 control subjects. The CCR5 genotype was studied by polymerase chain reaction amplification of the region flanking the delta32 deletion (delta32CCR5). RESULTS Frequencies of the wild-type CCR5 alleles (0.929, 0.907, and 0.942, respectively) and delta32CCR5 alleles (0.071, 0.093, and 0.058, respectively) in controls, SLE patients, and RA patients did not differ significantly. However, none of the RA patients had the homozygous delta32CCR5 genotype, compared with a frequency of 0.009 in controls (P = 0.014 by Fisher's exact test; chi2 = 4.12 with Yates' correction, P = 0.042) and 0.027 in SLE patients (P = 0.003 by Fisher's exact test; chi2 = 11.63 with Yates' correction, P = 0.0006). CONCLUSION The results suggest that the CCR5 receptor plays an important role in RA and may be a suitable target for therapy.
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Abstract
Keratinocyte apoptosis may be induced by ultraviolet-B radiation and represents a potential source of fragmented autoantigens in autoimmune diseases. This study investigates whether excessive keratinocyte apoptosis occurs in the skin lesions of cutaneous lupus (CLE) and dermatomyositis (DM) and the potential mechanisms responsible for this phenomenon. Skin biopsies have been studied from 19 patients with CLE and DM, eight with scleroderma, and five healthy controls. Apoptosis was detected by in situ end-labelling of fragmented DNA. The expression of Bcl-2, PCNA, p53, and Ki-67 proteins was studied by immunohistochemistry. In DM and CLE skin, the number of apoptotic keratinocytes was significantly increased (p=0.008) compared with normal skin. In both diseases, a large accumulation of apoptotic keratinocytes and apoptotic bodies was present in the disrupted basal zone. Unlike normal skin, a large number of keratinocytes, particularly those morphologically apoptotic, expressed p53 protein. A significant increase in the number of proliferating Ki-67 positive (p=0.0007) and PCNA-positive (p=0.0008) nuclei was also observed. In both CLE and DM, exaggerated and inappropriate keratinocyte apoptosis occurs. It is associated with increased expression of p53 and PCNA. This suggests that normal solar radiation alone or in combination with additional local factors induces DNA damage and excessive keratinocyte apoptosis in these autoimmune diseases of the skin. Apoptosis can mediate the severe epidermal lesions observed in both diseases and the release of fragmented autoantigens into the dermis.
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Affiliation(s)
- J L Pablos
- Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain.
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Pablos JL, Caliz RA, Carreira PE, Atsumi T, Serrano L, Amengual O, Santiago B, Khamashta MA, Hughes GR, Gomez-Reino JJ. Risk of thrombosis in patients with antiphospholipid antibodies and factor V Leiden mutation. J Rheumatol 1999; 26:588-90. [PMID: 10090167] [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: 02/11/2023]
Abstract
OBJECTIVE Antiphospholipid antibodies (aPL) are thrombophilic risk markers in patients with systemic lupus erythematosus (SLE) or primary antiphospholipid syndrome (APS). The risk factors for recurrent venous or arterial thrombosis and indications for longterm anticoagulation therapy are debated. We hypothesized that carrying a second thrombophilic defect, factor V Leiden mutation, would increase the risk for thrombosis in patients with aPL. METHODS Seventy-five patients with primary APS and 83 with SLE and aPL with or without thrombosis followed at 2 university hospitals were studied. Factor V mutation rate was analyzed in patients and in 200 healthy blood donors by polymerase chain reaction analysis. RESULTS The prevalence of factor V Leiden mutation in patients with SLE and aPL or primary APS was similar to controls. Patients with deep vein thrombosis or arterial thrombosis did not have a significantly increased rate of factor V mutation compared to controls or to patients with aPL without thrombosis. CONCLUSION Factor V Leiden mutation is not significantly associated with vein thrombosis in patients with aPL. However, due to the sample size we cannot rule out synergy between both factor V Leiden and aPL. A trend toward increased risk for thrombosis was detected in patients with the mutation and this should be analyzed in a larger study.
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Affiliation(s)
- J L Pablos
- Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain.
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15
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Abstract
In vitro, prostaglandins (PG) have strong inhibitory effects on T cell activation and proliferation and inhibitors of PG synthesis (NSAID) increase proliferation and activation of T cells. Although most studies have failed to demonstrate cyclooxygenase (COX) activity in lymphocytes, there is contradictory evidence on the synthesis of different PG. We have studied by reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot the expression of COX-1 and -2 mRNA and protein in resting and activated peripheral blood or Jurkat T cells. Cells were activated by T cell receptor triggering with OKT3 antibodies and activation confirmed by flow cytometric analysis of surface CD69. COX enzymatic activity was measured by determination of arachidonic acid (AA)-induced PG synthesis. Both peripheral blood and Jurkat T cells expressed COX-1 and -2 mRNA and protein. COX-1 was constitutively expressed and did not change after OKT3 stimulation. COX-2 was inducible upon OKT3-induced activation. In spite of the presence of COX mRNA and immunoreactive protein, AA-induced PG synthesis was not detected at the EIA detection (pM) level. The potential role of cyclooxygenases in T cells deserves further study, since no PG of the studied series seem to be synthesized by T cells.
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Affiliation(s)
- J L Pablos
- Servicio de Reumatologia, Hospital 12 de Octubre, Madrid, Spain
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Iñiguez MA, Pablos JL, Carreira PE, Cabré F, Gomez-Reino JJ. Detection of COX-1 and COX-2 isoforms in synovial fluid cells from inflammatory joint diseases. Br J Rheumatol 1998; 37:773-8. [PMID: 9714356 DOI: 10.1093/rheumatology/37.7.773] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the expression of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) in cells from synovial fluid (SF) of patients with acute or chronic arthritis. METHODS SF was obtained from eight patients with acute crystal-induced arthritis, nine with rheumatoid arthritis and four with psoriatic arthritis. COX-1 and COX-2 gene expression was studied by reverse transcriptase-polymerase chain reaction (RT-PCR). Protein expression was detected by Western blotting and immunocytochemistry. RESULTS There was expression of COX-1 mRNA in all and COX-2 mRNA in most of the SF samples from acute or chronic arthritis. By immunocytochemistry, both COX-1 and COX-2 immunoreactivity was restricted to a variable fraction of mononuclear cells. COX-1 staining was observed in 10-fold more cells than COX-2. By Western blotting, COX-1 protein was detected in 60% of the SF samples and COX-2 in none. There were no differences in the pattern of COX-1 and COX-2 expression between chronic and acute SF samples. CONCLUSION In arthritis, both COX-1 and COX-2 isoforms are expressed by SF cells. COX-1 is the most abundant isoform. Since the strong COX-1 immunostaining observed in a fraction of mononuclear SF cells is not observed in peripheral blood leucocytes, it may be the result of either the activation or recruitment of a subset of mononuclear cells with a high COX-1 expression level.
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MESH Headings
- Arthritis, Gouty/enzymology
- Arthritis, Gouty/pathology
- Arthritis, Psoriatic/enzymology
- Arthritis, Psoriatic/pathology
- Arthritis, Rheumatoid/enzymology
- Arthritis, Rheumatoid/pathology
- Blotting, Western
- Cyclooxygenase 1
- Cyclooxygenase 2
- DNA Primers/chemistry
- Humans
- Immunoenzyme Techniques
- Isoenzymes/genetics
- Isoenzymes/metabolism
- Leukocytes, Mononuclear/enzymology
- Leukocytes, Mononuclear/pathology
- Membrane Proteins
- Prostaglandin-Endoperoxide Synthases/genetics
- Prostaglandin-Endoperoxide Synthases/metabolism
- RNA, Messenger/metabolism
- Synovial Fluid/cytology
- Synovial Fluid/enzymology
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Affiliation(s)
- M A Iñiguez
- Servicio de Reumatología y Unidad de Investigación, Hospital 12 de Octubre, Madrid, Spain
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Pablos JL, Carreira PE, Serrano L, Del Castillo P, Gomez-Reino JJ. Apoptosis and proliferation of fibroblasts during postnatal skin development and scleroderma in the tight-skin mouse. J Histochem Cytochem 1997; 45:711-9. [PMID: 9154158 DOI: 10.1177/002215549704500509] [Citation(s) in RCA: 25] [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: 02/04/2023] Open
Abstract
Tight-skin (Tsk) is a dominant gene mutation that causes a fibrotic skin disease in mice, similar to human scleroderma. Both conditions are characterized by increased numbers of dermal fibroblasts containing high levels of procollagen mRNA. Whether this fibroblast population arises from fibroblast growth or fibroblast transcriptional activation is debated. Proliferation and apoptosis of fibroblasts of normal and Tsk mice were studied in skin sections before, at onset, and in established fibrosis. Tissues sections were immunostained with proliferating cell nuclear antigen (PCNA) as proliferation marker. Apoptosis was investigated by in situ end-labeling of fragmented DNA and nuclear staining with propidium iodide. The expression of the apoptosis inhibitor Bcl-2 was investigated by immunohistochemistry. We demonstrate differences in fibroblast proliferation and apoptosis related to postnatal skin growth and development. Neonatal skin exhibits the highest levels of proliferation and apoptosis in fibroblasts. In contrast, low proliferation and absence of apoptosis characterizes adult fibroblasts. Skin fibroblasts express Bcl-2 only in newborns, and at other ages Bcl-2 was restricted to epithelial cells. Our results also suggest that neither increased fibroblast proliferation nor defective apoptosis accounts for the fibrotic phenotype of Tsk. Therefore, transcriptional activation of extracellular matrix genes appears more relevant in the pathogenesis of Tsk fibrosis.
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Affiliation(s)
- J L Pablos
- Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain
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Carreira PE, Montalvo MG, Kaufman LD, Silver RM, Izquierdo M, Gomez-Reino JJ. Antiphospholipid antibodies in patients with eosinophilia myalgia and toxic oil syndrome. J Rheumatol 1997; 24:69-72. [PMID: 9002013] [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: 02/03/2023]
Abstract
OBJECTIVE To explore whether antiphospholipid antibodies (aPL) are markers of vascular related damage or merely evidence of toxic related autoimmunity, we investigated the presence of different aPL in patients with toxic oil syndrome (TOS) and compared the profile with patients with eosinophilia myalgia syndrome (EMS). METHODS Reactivity against cardiolipin, P-serine, P-inositol, and P-choline was investigated by ELISA in the blood of 266 patients with acute and chronic TOS, 25 healthy relatives of TOS patients, and 48 patients with EMS. RESULTS 32% of TOS and 13% of EMS patients had IgG antibodies against cardiolipin and other polyanions. 20% of both TOS and EMS patients presented IgM antibodies against anionic and zwitterionic phospholipids. 36% of TOS healthy relatives had IgM antibodies against differently charged phospholipids. Among 200 patients with chronic TOS, there was no significant association between antibodies and clinical manifestations. CONCLUSION aPL with different specificity are present in a high percentage of patients with TOS and EMS. The significance of these antibodies remains unclear.
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Affiliation(s)
- P E Carreira
- Rheumatology Department, Hospital 12 de Octubre, Madrid, Spain
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Affiliation(s)
- J J Gómez-Reino
- Rheumatology Unit, Hospital Universitario Doce de Octubre, Madrid, Spain
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Pablos JL, Carreira PE, Gomez-Reino JJ. Lack of association between the MHC linked OTF3 gene and systemic lupus erythematosus. Lupus 1995; 4:390-2. [PMID: 8563733 DOI: 10.1177/096120339500400509] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The objective of this study was to investigate whether an octamer transcription factor gene (OTF3) located within the MHC region of chromosome 6 is involved in determining susceptibility to systemic lupus erythematosus (SLE) in a Spanish population. An OTF3 HindIII polymorphism was characterized by restriction fragment length polymorphism analysis of polymerase chain reaction amplified genomic DNA in 69 patients with SLE and 60 controls. No differences in the OTF3 allelic or genotypic distribution between healthy controls and patients with SLE were found. In the group of patients with diffuse proliferative glomerulonephritis, where we have previously detected the strongest MHC association, we did not observe OTF3 linkage either. In conclusion, the OTF3 gene does not appear to be associated with SLE in the Spanish population. This might be due to the distance of the gene from the HLA class II-III region where more relevant autoimmune-related genes are located.
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Affiliation(s)
- J L Pablos
- Rheumatology Unit, Hospital 12 de Octubre, Madrid, Spain
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Pablos JL, Carreira PE, Martín-Villa JM, Montalvo G, Arnaiz-Villena A, Gomez-Reino JJ. Polymorphism of the heat-shock protein gene HSP70-2 in systemic lupus erythematosus. Br J Rheumatol 1995; 34:721-3. [PMID: 7551654 DOI: 10.1093/rheumatology/34.8.721] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We investigate whether a heat-shock protein gene (HSP70-2) is involved in determining susceptibility to systemic lupus erythematosus (SLE) in a Spanish population. A HSP70-2 PstI polymorphism was characterized by restriction fragment length polymorphism analysis of polymerase chain reaction-amplified genomic DNA in 90 SLE patients and 117 controls. The PstI site containing allele (B) was significantly increased in SLE patients compared to healthy controls. This was due to a significant increase in the BB homozygous genotype in patients, particularly in those with diffuse proliferative nephritis. Neither allelic nor genotypic differences were detected when compared by the presence or absence of DR3. The HSP70-2 B allele seems tightly linked to the human leucocyte antigen (HLA) haplotypes carrying susceptibility to SLE in our population. An independent role for this gene cannot be confirmed due to its linkage with HLA DR3.
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Affiliation(s)
- J L Pablos
- Rheumatology Unit, Hospital 12 de Octubre, Madrid, Spain
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22
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Pablos JL, Carreira PE, Morillas L, Montalvo G, Ballestin C, Gomez-Reino JJ. Clonally expanded lymphocytes in the minor salivary glands of Sjögren's syndrome patients without lymphoproliferative disease. Arthritis Rheum 1994; 37:1441-4. [PMID: 7945468 DOI: 10.1002/art.1780371006] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To determine whether clonally expanded B cells are present in the early infiltrates of minor labial salivary glands (LSG) of Sjögren's syndrome (SS) patients. METHODS Available paraffin-embedded LSG biopsies from 14 patients with primary SS were studied. DNA from LSG tissue was amplified by a polymerase chain reaction directed toward rearranged immunoglobulin gene DNA. RESULTS All LSG specimens showed oligoclonal or monoclonal B cell expansion. In one patient with plasma cell neoplasm, tumor and LSG specimens obtained at the same operation displayed different immunoglobulin gene rearrangements. CONCLUSION Clonal expansion is characteristic of primary SS, and it is uniformly found in the early LSG infiltrates of patients who do not experience further progression to pseudolymphoma or lymphoma (mean followup 4.1 years after biopsy). This feature, together with the clonal discordance between the LSG and the B cell neoplasm found in one patient, suggests that additional steps are critical for the progression to malignancy.
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Carreira PE, Gutierrez-Larraya F, Gomez-Reino JJ. Successful intrauterine therapy with dexamethasone for fetal myocarditis and heart block in a woman with systemic lupus erythematosus. J Rheumatol 1993; 20:1204-1207. [PMID: 8371219] [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: 05/22/2023]
Abstract
We describe a case of successful intrauterine treatment with dexamethasone for fetal carditis in a woman with systemic lupus erythematosus. Targeted dual M-mode fetal echocardiogram showed disappearance of pericardial effusion and heart failure with therapy. The maternofetal pair had several of the factors considered a risk for passively transmitted autoimmune carditis. Our case further supports the evidence that dexamethasone could be effective for intrauterine treatment of this clinical situation.
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Affiliation(s)
- P E Carreira
- Section of Rheumatology, Hospital Doce de Octubre, Madrid, Spain
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24
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Gomez-Reino JJ, Sandberg M, Carreira PE, Vuorio E. Expression of types I, III and IV collagen genes in fibrotic skin and nerve lesions of toxic oil syndrome patients. Clin Exp Immunol 1993; 93:103-7. [PMID: 8391940 PMCID: PMC1554755 DOI: 10.1111/j.1365-2249.1993.tb06504.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [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: 01/30/2023] Open
Abstract
We have studied the skin and nerve fibrosis in toxic oil syndrome by in situ hybridization using specific cDNA probes for types I, III, and IV collagens. Fibroblasts with high levels of type I and III collagen mRNA were observed in biopsies from fibrotic skin areas. Similarly, type IV collagen mRNA was abundant in cells within the fibrotic process of the nerves. These results suggest that the excessive accumulation of collagen in toxic oil syndrome results from transcriptional activation of collagen genes in a subpopulation of fibroblasts.
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Abstract
We describe a female patient with primary Sjögren's syndrome (SS) associated with a subcutaneous tumor formed by amyloid surrounded by mature IgG-kappa plasma cells, in the absence of lymphoproliferation or amyloid deposit in other organs. This case represents an unusual presentation of localized amyloidosis, without systemic involvement. Together with other reported cases this suggests that only immunocytic and not reactive systemic amyloidosis develops in chronic SS patients.
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Affiliation(s)
- J L Pablos
- Department of Rheumatology, Hospital 12 de Octubre, Madrid, Spain
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Carreira PE, Mateo I, Garcia G, Garrido G, Gomez-Reino J. Antibodies to extractable cellular antigens in Spanish systemic lupus erythematosus (SLE) patients. Clin Rheumatol 1987; 6:80-3. [PMID: 3581702 DOI: 10.1007/bf02201006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We studied the frequency of antibodies to extractable cellular antigens in 90 Spanish SLE patients. Antibodies to Sm, nRNP, Ro and La were found, respectively, in 6 (6.6%), 18 (20%), 30 (33.3%) and 6 (6.6%) patients. In spite of HLA differences, these results are similar to those found by other authors in Caucasian SLE patients. Our only relevant association was the finding of severe renal disease and high frequency of anti-DNA and hypocomplementemia in patients with antibodies to Ro. Based on these and earlier findings, we discuss the possibility that the immune response to Ro in Spanish patients might be located in a unique extended HLA-complement haplotype.
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Carreira PE, Gómez-Reino JJ, Morillas L, Mateo I, Ibero I, Millet VG, Páramo MJ. [Therapy with corticoid pulses, plasmapheresis, and corticoid pulses combined with plasmapheresis in systemic lupus erythematosus]. Med Clin (Barc) 1986; 87:179-82. [PMID: 3736247] [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: 01/07/2023]
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Linares LF, Gomez-Reino JJ, Carreira PE, Morillas L, Ibero I. C-reactive protein (CRP) levels in systemic lupus erythematosus (SLE). Clin Rheumatol 1986; 5:66-9. [PMID: 3485499 DOI: 10.1007/bf02030970] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
CRP levels in 194 serum samples from 43 SLE patients were measured. Patients with inactive disease have levels below 10 micrograms/ml; patients with active SLE have higher levels, but never over 50 micrograms/ml. In the presence of infection or inflammatory processes, regardless of the activity of SLE, the levels are significantly higher (p less than 0.05), and well over 50 micrograms/ml. Both active SLE patients and inactive SLE patients with local infections have levels between 10 micrograms/ml and 50 micrograms/ml. In this situation, the presence of anti-DNA antibodies strongly suggests disease activity (82% versus 9%, p less than 0.05). The clinical and physiopathological meaning of these findings is discussed.
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