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https://www.readbyqxmd.com/read/29672364/role-of-direct-immunofluorescence-in-cutaneous-small-vessel-vasculitis-experience-from-a-tertiary-center
#1
Khushboo Lath, Debajyoti Chatterjee, Uma Nahar Saikia, Biman Saikia, Ranjana Minz, Dipankar De, Sanjeev Handa, Bishan Radotra
Skin is commonly affected by vasculitic process and often subjected to biopsy. Cutaneous vasculitis can be either primary or part of a systemic vasculitic process. This study was conducted to evaluate the diagnostic utility of direct immunofluorescence (DIF) in determination of etiology of cutaneous vasculitis. All histologically proven cases of cutaneous vasculitis over the past two and half years were retrospectively analyzed along with their clinical and DIF findings (IgG, IgA, IgM, and C3). Within this study period, a total of 198 cases of small-vessel vasculitis were diagnosed based on skin biopsy and DIF findings...
April 17, 2018: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/29671280/efficacy-and-safety-of-subcutaneous-belimumab-in-anti-dsdna-positive-hypocomplementemic-patients-with-systemic-lupus-erythematosus
#2
A Doria, W Stohl, A Schwarting, M Okada, M Scheinberg, R van Vollenhoven, A E Hammer, J Groark, D Bass, N L Fox, D Roth, D Gordon
OBJECTIVE: To investigate the efficacy and safety of belimumab, a human immunoglobulin monoclonal antibody against B lymphocyte stimulator, in a subset of patients with systemic lupus erythematosus (SLE) who were hypocomplementemic (C3 [<90 mg/dL] and/or C4 [<10 mg/dL]) and anti-double-stranded(ds)DNA-positive (≥30 IU/mL) at baseline. METHODS: This Phase III, double-blind, placebo-controlled study (BEL112341; NCT01484496) randomized patients (2:1) with moderate-to-severe SLE (Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index ≥8) to weekly subcutaneous (SC) belimumab 200 mg or placebo, plus standard SLE therapy, for 52 weeks...
April 18, 2018: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29669944/neutrophil-subsets-and-their-gene-signature-associate-with-vascular-inflammation-and-coronary-atherosclerosis-in-lupus
#3
Philip M Carlucci, Monica M Purmalek, Amit K Dey, Yenealem Temesgen-Oyelakin, Simantini Sakhardande, Aditya A Joshi, Joseph B Lerman, Alice Fike, Michael Davis, Jonathan H Chung, Martin P Playford, Mohammad Naqi, Pragnesh Mistry, Gustavo Gutierrez-Cruz, Stefania Dell'Orso, Faiza Naz, Taufiq Salahuddin, Balaji Natarajan, Zerai Manna, Wanxia L Tsai, Sarthak Gupta, Peter Grayson, Heather Teague, Marcus Y Chen, Hong-Wei Sun, Sarfaraz Hasni, Nehal N Mehta, Mariana J Kaplan
BACKGROUND: Systemic lupus erythematosus (SLE) is associated with enhanced risk of atherosclerotic cardiovascular disease not explained by Framingham risk score (FRS). Immune dysregulation associated to a distinct subset of lupus proinflammatory neutrophils (low density granulocytes; LDGs) may play key roles in conferring enhanced CV risk. This study assessed if lupus LDGs are associated with in vivo vascular dysfunction and inflammation and coronary plaque. METHODS: SLE subjects and healthy controls underwent multimodal phenotyping of vascular disease by quantifying vascular inflammation (18F-fluorodeoxyglucose-PET/CT [18F-FDG-PET/CT]), arterial dysfunction (EndoPAT and cardio-ankle vascular index), and coronary plaque burden (coronary CT angiography)...
April 19, 2018: JCI Insight
https://www.readbyqxmd.com/read/29669247/a-hen-in-the-wolf-den-a-pathobiont-tale
#4
Matteo M Guerrini, Alexis Vogelzang, Sidonia Fagarasan
Disruption of the gut microbiota is thought to contribute to disease onset in individuals with a genetic predisposition to autoimmunity. In a recent issue of Science, Manfredo Vieira et al. (2018) identify translocation of the gut commensal Enterococcus gallinarum into the liver as a trigger for the autoimmune disease systemic lupus erythematous.
April 17, 2018: Immunity
https://www.readbyqxmd.com/read/29667857/determining-risk-factors-that-increase-hospitalizations-in-patients-with-systemic-lupus-erythematosus
#5
D Li, H M Madhoun, W N Roberts, W Jarjour
Introduction Systemic lupus erythematosus (SLE) is a complex disease that is associated with significant mortality and an increased risk of hospitalization. Several validated instruments are available to measure disease activity in SLE patients. However, these instruments were not designed to screen for SLE patients at an increased risk of hospitalization. These instruments also fail to incorporate some data that are easily obtainable from electronic health records, such as the frequency of missed outpatient appointments...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29665863/effect-of-combined-treatment-with-bisphosphonate-and-vitamin-d-on-atherosclerosis-in-patients-with-systemic-lupus-erythematosus-a-propensity-score-based-analysis
#6
Kazumasa Ohmura, Masaru Kato, Toshiyuki Watanabe, Kenji Oku, Toshiyuki Bohgaki, Tetsuya Horita, Shinsuke Yasuda, Yoichi M Ito, Norihiro Sato, Tatsuya Atsumi
BACKGROUND: Premature atherosclerosis is one of the major complications of systemic lupus erythematosus (SLE). Recently, the biological linkage between atherosclerosis and osteoporosis has garnered much attention. The aim of this study is to explore correlation between the development of atherosclerosis and anti-osteoporotic treatment. METHODS: Consecutive patients with SLE (n = 117) who underwent carotid ultrasonography were retrospectively analyzed using propensity scoring...
April 17, 2018: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29665758/the-efficacy-of-adjunct-tacrolimus-treatment-in-pregnancy-outcomes-in-patients-with-systemic-lupus-erythematosus
#7
K Ichinose, S Sato, Y Kitajima, Y Horai, K Fujikawa, M Umeda, S Fukui, A Nishino, T Koga, S Y Kawashiri, N Iwamoto, M Tamai, H Nakamura, T Origuchi, I Yasuhi, H Masuzaki, A Kawakami
Systemic lupus erythematosus (SLE) involves multiple organ systems and primarily affects women during their reproductive years. Pregnancy in a woman with SLE may lead to higher rates of disease flares. Little is known regarding which medications are safe to maintain remission and/or treat flares throughout such pregnancies. Here we retrospectively analyzed the efficacy of tacrolimus (TAC) in the pregnancy outcomes of SLE patients. We studied the 54 deliveries of 40 SLE patients over an eight-year period from 2008 to 2016...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29665757/severe-brady-arrhythmias-in-systemic-lupus-erythematosus-prevalence-etiology-and-associated-factors
#8
K Tselios, D D Gladman, P Harvey, J Su, M B Urowitz
Background Severe brady-arrhythmias, requiring a permanent pacemaker (PPM), have been sparsely reported in systemic lupus erythematosus (SLE). The aim of this study was to describe the characteristics of such arrhythmias in a defined lupus cohort. Patients and methods The database of the Toronto Lupus Clinic ( n = 1366) was searched for patients who received a PPM. Demographic, clinical, immunological and therapeutic variables along with electrocardiographic (ECG) and echocardiographic findings (based on the last available test prior to PPM) were analyzed...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29665755/incremental-direct-medical-costs-of-systemic-lupus-erythematosus-patients-in-the-years-preceding-diagnosis-a-general-population-based-study
#9
N McCormick, C A Marra, M Sadatsafavi, J A Aviña-Zubieta
Objective We estimated the incremental (extra) direct medical costs of a population-based cohort of newly diagnosed systemic lupus erythematosus (SLE) for five years before and after diagnosis, and the impact of sex and socioeconomic status (SES) on pre-index costs for SLE. Methods We identified all adults newly diagnosed with SLE over 2001-2010 in British Columbia, Canada, and obtained a sample of non-SLE individuals from the general population, matched on sex, age, and calendar-year of study entry. We captured costs for all outpatient encounters, hospitalisations, and dispensed medications each year...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29662164/transcription-factors-operate-across-disease-loci-with-ebna2-implicated-in-autoimmunity
#10
John B Harley, Xiaoting Chen, Mario Pujato, Daniel Miller, Avery Maddox, Carmy Forney, Albert F Magnusen, Arthur Lynch, Kashish Chetal, Masashi Yukawa, Artem Barski, Nathan Salomonis, Kenneth M Kaufman, Leah C Kottyan, Matthew T Weirauch
Explaining the genetics of many diseases is challenging because most associations localize to incompletely characterized regulatory regions. Using new computational methods, we show that transcription factors (TFs) occupy multiple loci associated with individual complex genetic disorders. Application to 213 phenotypes and 1,544 TF binding datasets identified 2,264 relationships between hundreds of TFs and 94 phenotypes, including androgen receptor in prostate cancer and GATA3 in breast cancer. Strikingly, nearly half of systemic lupus erythematosus risk loci are occupied by the Epstein-Barr virus EBNA2 protein and many coclustering human TFs, showing gene-environment interaction...
April 16, 2018: Nature Genetics
https://www.readbyqxmd.com/read/29661540/mif-functional-polymorphisms-794-catt-5-8-and-173-g-c-are-associated-with-mif-serum-levels-severity-and-progression-in-male-multiple-sclerosis-from-western-mexican-population
#11
V A Castañeda-Moreno, U De la Cruz-Mosso, N Torres-Carrillo, M A Macías-Islas, O Padilla-De la Torre, M A Mireles-Ramírez, O González-Pérez, J L Ruiz-Sandoval, M Huerta, X Trujillo, D Ortuño-Sahagún, Muñoz-Valle Jf
Macrophage migration inhibitory factor (MIF) is a cytokine associated with tissue damage in multiple autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis and psoriatic arthritis. The role of MIF in multiple sclerosis (MS) and the contribution of its polymorphisms are unknown in our population. Therefore, we decided to investigate the genetic association of -794 CATT5-8 (rs5844572) and -173 G>C (rs755622) MIF polymorphisms with MS, clinical variables and MIF serum levels in the population of western Mexico...
April 10, 2018: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/29657872/therapeutic-plasma-exchange-for-refractory-sle-a-comparison-of-outcomes-between-different-sub-phenotypes
#12
Aynur Soyuöz, Ömer Karadağ, Tülay Karaağaç, Levent Kılıç, Şule Apraş Bilgen, Osman İlhami Özcebe
Objective: Therapeutic plasma exchange (TPE) offers an alternative therapeutic modality for patients with systemic lupus erythematosus (SLE) and primary antiphospholipid syndrome (APS). However, there is conflicting evidence regarding its efficacy in different sub-phenotypes. This study aimed to investigate the main clinical characteristics and outcomes of patients with different phenotypes of SLE and APS treated with TPE at a tertiary care center. Methods: The database of the Blood and Apheresis Unit between 2001 and 2013 was screened for patients with SLE and primary APS...
March 2018: European Journal of Rheumatology
https://www.readbyqxmd.com/read/29657150/causes-and-predictors-of-early-hospital-readmission-in-systemic-lupus-erythematosus
#13
Angelica Nangit, Connie Lin, Mariko L Ishimori, Brennan M R Spiegel, Michael H Weisman
OBJECTIVE: We investigated characteristics of adult patients with systemic lupus erythematosus (SLE) readmitted to the hospital within 30 days of discharge, in an attempt to identify the causes of early readmission. METHODS: We performed a retrospective case-control study examining all inpatient electronic health records of patients with SLE at Cedars-Sinai Medical Center over a 2.5-year period (2012-2014). Patients were included if they had an International Classification of Diseases, 9th ed diagnosis of SLE and were readmitted within 30 days of their initial hospitalization...
April 15, 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/29651573/metabolic-syndrome-in-systemic-lupus-erythematosus-patients-relationship-to-disease-activity-and-neuropsychiatric-lupus
#14
N Hammam, S M Rashad, A A A Mohamed
OBJECTIVE: The study aims to evaluate the presence of metabolic syndrome (MetS) among Egyptian systemic lupus erythematosus (SLE) patients. Additionally, we intended to determine the association of MetS with disease activity, clinical and laboratory features. PATIENTS AND METHODS: This cross-sectional study included adult SLE patients diagnosed and followed in rheumatology outpatient clinics. The demographic data, clinical and laboratory parameters were assessed for all patients...
April 12, 2018: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/29648687/lipid-testing-and-statin-prescription-among-medicaid-recipients-with-systemic-lupus-erythematosus-diabetes-mellitus-and-the-general-medicaid-population
#15
Sarah K Chen, Medha Barbhaiya, Michael A Fischer, Hongshu Guan, Tzu-Chieh Lin, Candace H Feldman, Brendan M Everett, Karen H Costenbader
OBJECTIVE: Cardiovascular disease (CVD) risks among patients with systemic lupus erythematosus (SLE) are similar to those in diabetes mellitus (DM). We investigated whether patients with SLE receive lipid testing and statin prescriptions comparably to DM patients and to individuals without either disease. METHODS: We identified U.S. Medicaid beneficiaries ages 18-65, residing in 29 states from 2007-2010 with prevalent SLE. Each SLE patient was age- and sex-matched to two DM, and four general Medicaid recipients without either disease...
April 12, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29648686/development-and-validation-of-a-novel-evidence-based-lupus-multivariable-outcome-score-for-clinical-trials
#16
Michal Abrahamowicz, John M Esdaile, Rosalind Ramsey-Goldman, Lee S Simon, Vibeke Strand, Peter E Lipsky
BACKGROUND: Trials of new SLE treatments are hampered by the lack of effective outcome measures. To address this, we developed a new Lupus Multivariable Lupus Outcome Score (LuMOS). METHOD: The LuMOS formula was developed by analyzing raw data of two pivotal trials: BLISS-52 and BLISS-76, the basis for approval of belimumab (Bel). Using data from BLISS-76 as the learning dataset, we optimized discrimination between outcomes for patients treated with 10mg/kg Bel versus placebo over the first 52 weeks of follow-up using multivariable logistic regression analyses...
April 12, 2018: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29644082/characterisation-of-anifrolumab-a-fully-human-anti-interferon-receptor-antagonist-antibody-for-the-treatment-of-systemic-lupus-erythematosus
#17
Jeffrey M Riggs, Richard N Hanna, Bhargavi Rajan, Kamelia Zerrouki, Jodi L Karnell, Divya Sagar, Inna Vainshtein, Erika Farmer, Kimberly Rosenthal, Chris Morehouse, Melissa de Los Reyes, Kevin Schifferli, Meina Liang, Miguel A Sanjuan, Gary P Sims, Roland Kolbeck
Objective: We investigated the mechanistic and pharmacological properties of anifrolumab, a fully human, effector-null, anti-type I interferon (IFN) alpha receptor 1 (IFNAR1) monoclonal antibody in development for SLE. Methods: IFNAR1 surface expression and internalisation on human monocytes before and after exposure to anifrolumab were assessed using confocal microscopy and flow cytometry. The effects of anifrolumab on type I IFN pathway activation were assessed using signal transducer and activator of transcription 1 (STAT1) phosphorylation, IFN-stimulated response element-luciferase reporter cell assays and type I IFN gene signature induction...
2018: Lupus Science & Medicine
https://www.readbyqxmd.com/read/29643425/a-novel-two-score-system-for-interferon-status-segregates-autoimmune-diseases-and-correlates-with-clinical-features
#18
Y M El-Sherbiny, A Psarras, M Y Md Yusof, E M A Hensor, R Tooze, G Doody, A A A Mohamed, D McGonagle, M Wittmann, P Emery, E M Vital
Measurement of type I interferon (IFN-I) has potential to diagnose and stratify autoimmune diseases, but existing results have been inconsistent. Interferon-stimulated-gene (ISG) based methods may be affected by the modularity of the ISG transcriptome, cell-specific expression, response to IFN-subtypes and bimodality of expression. We developed and clinically validated a 2-score system (IFN-Score-A and -B) using Factor Analysis of 31 ISGs measured by TaqMan selected from 3-IFN-annotated modules. We evaluated these scores using in-vitro IFN stimulation as well as in sorted cells then clinically validated in a cohort of 328 autoimmune disease patients and healthy controls...
April 11, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29642752/lupus-myocarditis-a-single-center-experience-and-a-comparative-analysis-of-observational-cohort-studies
#19
J Tanwani, K Tselios, D D Gladman, J Su, M B Urowitz
Background Lupus myocarditis (LM) is reported in 3-9% of patients with systemic lupus erythematosus (SLE) but limited evidence exists regarding optimal treatment and prognosis. This study aims to describe LM in a defined lupus cohort as compared with the existing literature. Patients and methods Patients with LM were identified from the University of Toronto Lupus Clinic database. Diagnosis was based on clinical manifestations and electrocardiographic, imaging, and biochemical criteria. Demographic, clinical, diagnostic and therapeutic variables and outcomes were collected in a standardized data retrieval form...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29629607/predictors-of-fracture-risk-in-patients-with-systemic-lupus-erythematosus
#20
M Dey, M Bukhari
Objectives Bone loss in systemic lupus erythematosus is multifactorial. Recent studies demonstrate corticosteroids, previous fractures and increasing age decrease bone mineral density. The effect of body mass index and fat mass are less well characterized. We sought to determine fracture risk factors in patients undergoing dual-energy X-ray absorptiometry scanning at a district hospital in 2004-2015. Methods Standard dual-energy X-ray absorptiometry parameters were recorded, plus rheumatoid arthritis diagnosis, smoking status, alcohol consumption, family history of fractures, history of secondary operation and corticosteroid use...
January 1, 2018: Lupus
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