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lupus activity

Yin-Chi Cheng, Chin-Chou Huang, Wei-Sheng Chen, De-Feng Huang, Shiow-Ching Shun, Shao-Yu Tsai
BACKGROUND: Sleep disturbances and hypertension are common health issues in patients with systemic lupus erythematosus (SLE). Limited information is available regarding the objective sleep quality and the variation of diurnal blood pressure (BP) in patients with SLE. Moreover, the relationship between sleep patterns and diurnal BP variation in SLE patients is not clear. PURPOSE: To explore the subjective/objective sleep patterns and the diurnal BP variation in women with SLE, to identify the factors associated with diurnal BP variation, and to identify the predictors of this variation...
April 2018: Hu Li za Zhi the Journal of Nursing
Vikas Pathak, Robert Aris, Brian C Jensen, Wei Huang, Hubert James Ford
BACKGROUND: Plasma pro-BNP (brain natriuretic peptide) levels are often elevated in response to right ventricular (RV) volume and pressure overload, parameters potentially affected by exercise. Plasma pro-BNP levels change in association with long-term changes in pulmonary hemodynamics, thereby serving as a potential biomarker in pulmonary arterial hypertension (PAH). The 6-min Walk Test (6MWT) and pro-BNP level are often checked in a single office visit. There is no universal standard for measuring Pro-BNP levels relative to the timing of the 6MWT...
March 21, 2018: Lung
Mei Liu, Qiang Guo, Chunmei Wu, Delphine Sterlin, Shyamal Goswami, Ying Zhang, Teng Li, Chunde Bao, Nan Shen, Qiong Fu, Xiaoming Zhang
A hallmark of systemic lupus erythematosus (SLE) is the breaking of B-cell tolerance with the generation of high-affinity autoantibodies; however, the antibody-independent features of the B-cell compartment in SLE are less understood. In this study, we performed an extensive examination of B-cell subsets and their proinflammatory properties in a Chinese cohort of new-onset SLE patients. We observed that SLE patients exhibited an increased frequency of transitional B cells compared with healthy donors and rheumatoid arthritis patients...
March 21, 2018: Cellular & Molecular Immunology
Seung-Chul Choi, Zhiwei Xu, Wei Li, Hong Yang, Derry C Roopenian, Herbert C Morse, Laurence Morel
Mouse models of lupus have shown that multiple immune cell types contribute to autoimmune disease. This study sought to investigate the involvement of B cells and dendritic cells in supporting the expansion of inflammatory and regulatory CD4+ T cells that are critical for lupus pathogenesis. We used lupus-prone B6.NZM2410.Sle1.Sle2.Sle3 (TC) and congenic C57BL/6J (B6) control mice to investigate how the genetic predisposition of these two cell types controls the activity of normal B6 T cells. Using an allogeneic in vitro assay, we showed that TC B1-a and conventional B cells expanded Th17 cells significantly more than their B6 counterparts...
March 21, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
Joan T Merrill, William R Shanahan, Morton Scheinberg, Kenneth C Kalunian, David Wofsy, Renee S Martin
BACKGROUND: Targeted inhibitors of B-cell activating factor (BAFF) have been evaluated in phase III trials in over 4000 patients with systemic lupus erythematosus (SLE). Post hoc analyses of these studies identify greater treatment effect in patients entering with higher disease activity, greater corticosteroid doses, anti double-stranded DNA (dsDNA) and low complement C3 or C4. OBJECTIVES: To evaluate the efficacy and safety of blisibimod, a BAFF inhibitor, in a population of patients with SLE enriched for high disease activity...
March 21, 2018: Annals of the Rheumatic Diseases
Sherry Masoud, Stephen P McAdoo, Rachna Bedi, Thomas D Cairns, Liz Lightstone
Objective: B cell depletion, most commonly with rituximab, is an evolving therapeutic approach in SLE. Infusion reactions after rituximab are common, and may prevent re-treatment in patients who previously demonstrated beneficial response. We have used ofatumumab, a fully humanized anti-CD20 mAb, as an alternative B cell-depleting agent in patients with SLE who are rituximab-intolerant due to severe infusion reactions. Methods: A single-centre retrospective case series of 16 patients were treated with ofatumumab for SLE between 2012 and 2015...
March 19, 2018: Rheumatology
Rudra Prosad Goswami, Geetabali Sircar, Hiramanik Sit, Alakendu Ghosh, Parasar Ghosh
OBJECTIVE: We report comparative efficacy between high-dose cyclophosphamide (HDCyC), low-dose cyclophosphamide (LDCyC), mycophenolate mofetil (MMF) and rituximab in patients with lupus nephritis (LN). METHODS: We analyzed comparative efficacy of 4 induction regimens of biopsy-proven LN: LDCyC: 500 mg fortnightly, HDCyC: 750 to 1200 mg monthly, MMF: 1.5 to 3 g/d, and rituximab. Outcomes of 4 groups were analyzed at the sixth month. RESULTS: Among total 222 patients, 26 received LDCyC (3-g total dose), 113 received HDCyC (mean, 5...
March 21, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Theresa L Wampler Muskardin, Timothy B Niewold
The type I interferon pathway has been implicated in the pathogenesis of a number of rheumatic diseases, including systemic lupus erythematosus, Sjögren syndrome, myositis, systemic sclerosis, and rheumatoid arthritis. In normal immune responses, type I interferons have a critical role in the defence against viruses, yet in many rheumatic diseases, large subgroups of patients demonstrate persistent activation of the type I interferon pathway. Genetic variations in type I interferon-related genes are risk factors for some rheumatic diseases, and can explain some of the heterogeneity in type I interferon responses seen between patients within a given disease...
March 21, 2018: Nature Reviews. Rheumatology
Petrus Linge, Paul R Fortin, Christian Lood, Anders A Bengtsson, Eric Boilard
Dysregulation of lymphocyte function, accumulation of autoantibodies and defective clearance of circulating immune complexes and apoptotic cells are hallmarks of systemic lupus erythematosus (SLE). Moreover, it is now evident that an intricate interplay between the adaptive and innate immune systems contributes to the pathogenesis of SLE, ultimately resulting in chronic inflammation and organ damage. Platelets circulate in the blood and are chiefly recognized for their role in the prevention of bleeding and promotion of haemostasis; however, accumulating evidence points to a role for platelets in both adaptive and innate immunity...
March 21, 2018: Nature Reviews. Rheumatology
Zbigniew Zdrojewski
Recognizing the antiphospholipid syndrome (APS) in patients with lupus (SLE) can be difficult and therefore underestimated. Detection of antiphospholipid antibodies (aPL) in each patient with SLE should be done as a rule. Introduction of the new classification criteria of this syndrome will certainly improve the recognition of APS in the future. The Sapporo APS classification criteria (1998) were replaced by the Sydney criteria in 2006. Based on the most recent criteria, classification with APS requires one clinical and one laboratory manifestation...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Magdalena Dryglewska, Bogdan Kolarz, Maria Majdan
Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that results in uncontrolled immune system activation and overproduction of autoantibodies. The pathogenesis of the disease is complex and not fully understood, nevertheless, genetic and environmental factors play an important role. So far, about 30 genes have been identified to be involved in the SLE pathomechanism. However, not all genetically predisposed individuals develop the disease. This phenomenon can be associated with epigenetic changes that occur under the influence of environmental factors...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Iwona Żychowska, Dorota Suszek, Magdalena Dryglewska, Dorota Nurzyńska, Helena Donica, Maria Majdan
OBJECTIVE: Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease leading to chronic inflammation of numerous tissues and organs. The search for clinically useful markers of its activity is ongoing. At present, it is suggested that serum free light chains (FLC) may be useful in assessing SLE activity. The aim of study: To investigate the relationship between serum levels of free light chains (FLC) and the activity of SLE. PATIENTS AND METHODS: Material and methods: Eighty-four SLE patients (75 female; 9 men) aged 34...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Jing Du, Ying Wang, Yan-Chun Li, Tong-Tong Wang, Yong-Lie Zhou, Zhen-Hua Ying
Systemic lupus erythematosus (SLE) is an autoimmune disease that affects many organs, but multisystem dysfunction is rare. Here, we report a case of a 29-year-old woman who was initially diagnosed with SLE complications including lupus nephritis, lupus encephalopathy, renal hypertension, thrombocytopenia, anaemia and hyperkalaemia. She recovered following treatment with high dose methylprednisolone, intravenous immunoglobulin (IVIG) and continuous renal replacement therapy (CRRT). However, a few days after hospital discharge, she developed gastrointestinal bleeding...
January 1, 2018: Journal of International Medical Research
Cemile Sonmez, Aysegul Atak Yucel, Turan Hilmi Yesil, Hamit Kucuk, Berna Sezgin, Ridvan Mercan, Ahmet Eftal Yucel, Gulderen Yanikkaya Demirel
Behcet's disease is a chronic multisystemic disease with remissions and relapses. Several studies have shown that immune mechanisms play an important role in the development of the disease. In order to assess the association of disease activity with IL-17A/F, IL-23, IL-12/23 (p40) and IL-35 expression, we aimed to investigate production of these cytokines in peripheral blood mononuclear cells (PBMCs) from Behcet's patients and normal controls. Furthermore, we included Systemic Lupus Erythematosus (SLE) as disease control to evaluate the specificity of our data for immunopathogenesis of BD...
March 20, 2018: Clinical Rheumatology
Yemil Atisha-Fregoso, Guadalupe Lima, Eduardo Carrillo-Maravilla, Rosalinda Posadas-Sánchez, Nonanzit Pérez-Hernández, Miguel Baños-Peláez, Alejandra Iturralde-Chávez, Nora Hernández-Díaz, Juan Jakez-Ocampo, José Manuel Rodríguez-Pérez, Gilberto Vargas-Alarcón, Luis Llorente, Juanita Romero-Díaz
To evaluate the association of C-reactive protein (CRP) polymorphisms with risk of development SLE in a group of Mexican individuals. Five CRP polymorphisms (rs3093059, rs3093062, rs1800947, rs1130864, and rs1205) were determined by PCR-restriction fragment length polymorphism and SNP rs3093061 by refractory mutation system PCR assay in 126 SLE patients and 131 controls. Four of the polymorphisms showed differences between patients and controls. rs3093061 polymorphism was associated with a lower risk of developing lupus principally in the codominant 2 (OR = 0...
March 20, 2018: Clinical Rheumatology
Junli Liu, Xinfang Huang, Shumeng Hao, Yan Wang, Manman Liu, Jing Xu, Xingli Zhang, Tao Yu, Shucheng Gan, Dongfang Dai, Xuan Luo, Qingyan Lu, Chaoming Mao, Yanyun Zhang, Nan Shen, Bin Li, Mingzhu Huang, Xiaodong Zhu, Jin Jin, Xuhong Cheng, Shao-Cong Sun, Yichuan Xiao
Systemic lupus erythematosus (SLE) is characterized by uncontrolled secretion of autoantibodies by plasma cells. Although the functional importance of plasma cells and autoantibodies in SLE has been well established, the underlying molecular mechanisms of controlling autoantibody production remain poorly understood. Here we show that Peli1 has a B cell-intrinsic function to protect against lupus-like autoimmunity in mice. Peli1 deficiency in B cells induces autoantibody production via noncanonical NF-κB signaling...
March 19, 2018: Nature Communications
Antonis Fanouriakis, Christina Adamichou, Sofia Koutsoviti, Stylianos Panopoulos, Chrysanthi Staveri, Anastasia Klagou, Christina Tsalapaki, Lamprini Pantazi, Styliani Konsta, Clio P Mavragani, Despoina Dimopoulou, Styliani Ntali, Georgios Katsikas, Kyriaki A Boki, Dimitrios Vassilopoulos, Pinelopi Konstantopoulou, Stamatis-Nick Liossis, Antonia Elezoglou, Maria Tektonidou, Prodromos Sidiropoulos, Abdulsamet Erden, Petros P Sfikakis, George Bertsias, Dimitrios T Boumpas
BACKGROUND: Low disease activity is a validated target of current systemic lupus erythematosus (SLE) therapy. The aim of this study was to assess the ability of belimumab to achieve low disease activity states in real-life settings. METHODS: Multicentre prospective observational study of consecutive SLE patients receiving belimumab for at least 3 months, due to active disease refractory to at least one conventional immunosuppressant. Disease activity, including the recently defined lupus low disease activity state (LLDAS) and remission (clinical SLEDAI-2K = 0), accrual of organ damage, flares and side effects were documented...
February 23, 2018: Seminars in Arthritis and Rheumatism
Franchesca Cruz-Pérez, Salvador Vilá, Grissel Ríos, Luis M Vilá
Macrophage-activating syndrome (MAS) is a rare condition characterized by dysfunctional macrophage activation leading to overproduction of cytokines and phagocytosis of erythrocytes, leukocytes, and platelets. MAS is associated with infectious diseases, malignancies, and autoimmune rheumatic disorders. Herein, we present a 22-year-old Hispanic woman with SLE who was hospitalized because of a three-week history of fever, fatigue, polyarthralgia, nausea, and abdominal pain. Initial laboratories showed severe pancytopenia with marked elevation of liver enzymes and ferritin levels...
2018: Case Reports in Rheumatology
Zhi-Wei Lai, Ryan Kelly, Thomas Winans, Ivan Marchena, Ashwini Shadakshari, Julie Yu, Maha Dawood, Ricardo Garcia, Hajra Tily, Lisa Francis, Stephen V Faraone, Paul E Phillips, Andras Perl
BACKGROUND: Patients with systemic lupus erythematosus have T-cell dysfunction that has been attributed to the activation of the mammalian target of rapamycin (mTOR). Rapamycin inhibits antigen-induced T-cell proliferation and has been developed as a medication under the generic designation of sirolimus. We assessed safety, tolerance, and efficacy of sirolimus in a prospective, biomarker-driven, open-label clinical trial. METHODS: We did a single-arm, open-label, phase 1/2 trial of sirolimus in patients with active systemic lupus erythematosus disease unresponsive to, or intolerant of, conventional medications at the State University of New York Upstate Medical University (Syracuse, NY, USA)...
March 15, 2018: Lancet
Ruru Guo, Yang Tu, Shaowei Xie, Xue Song Liu, Yang Song, Suli Wang, Xiaoxiang Chen, Liangjing Lu
BACKGROUND/AIMS: Neutrophil extracellular traps (NETs) are known to play an important role in systemic lupus erythematosus (SLE) by triggering innate and adaptive immune responses. The molecular mechanisms responsible for their formation in SLE are still unclear. In this study, we aim to characterize the role of the receptor-interacting protein kinase-1 (RIPK1), a homologous serine/threonine kinase previously implicated in the regulation of necroptosis and tissue injury, in decreasing neutrophil death and formation of NETs, and to investigate the clinical implications of RIPK1 in SLE...
March 13, 2018: Cellular Physiology and Biochemistry
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