scholarly journals Serum IgG2 antibody multicomposition in systemic lupus erythematosus and lupus nephritis (Part 1): cross-sectional analysis

Rheumatology ◽  
2020 ◽  
Author(s):  
Maurizio Bruschi ◽  
Gabriella Moroni ◽  
Renato Alberto Sinico ◽  
Franco Franceschini ◽  
Micaela  Fredi ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Healthy Subjects ◽  
Serum Levels ◽  
Annexin A1 ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Renal Complication ◽  
Igg2 Antibody ◽  
Sectional Analysis ◽  
Higher Sensitivity

Abstract Objectives Serum anti-dsDNA and anti-nucleosome IgGs have been proposed as signatures for SLE and LN in limited numbers of patients. We sought to show higher sensitivity and specificity of the same antibodies with the IgG2 isotype and included IgG2 antibodies vs specific intracellular antigens in the analysis. Methods A total of 1052 SLE patients with (n = 479) and without (n = 573) LN, recruited at different times from the beginning of symptoms, were included in the study. Patients with primary APS (PAPS, n = 24), RA (RA, n = 24) and UCTD (UCTD, n = 96) were analysed for comparison. Anti-nucleosome (dsDNA, Histone2A, Histone3), anti-intracellular antigens (ENO1), anti-annexin A1 and anti-C1q IgG2 were determined by non-commercial techniques. Results The presence in the serum of the IgG2 panel was highly discriminatory for SLE/LN vs healthy subjects. Serum levels of anti-dsDNA and anti-C1q IgG2 were more sensitive than those of IgGs (Farr radioimmunoassay/commercial assays) in identifying SLE patients at low–medium increments. Of more importance, serum positivity for anti-ENO1 and anti-H2A IgG2 discriminated between LN and SLE (ROC T0–12 months), and high levels at T0–1 month were detected in 63% and 67%, respectively, of LN, vs 3% and 3%, respectively, of SLE patients; serum positivity for each of these was correlated with high SLEDAI values. Minor differences existed between LN/SLE and the other rheumatologic conditions. Conclusion Nephritogenic IgG2 antibodies represent a specific signature of SLE/LN, with a few overlaps with other rheumatologic conditions. High levels of anti-ENO1 and anti-H2A IgG2 correlated with SLE activity indexes and were discriminatory between SLE patients limited to the renal complication and other SLE patients. Trial registration The Zeus study was registered at https://clinicaltrials.gov, NCT02403115.

scholarly journals Assessing the expression of immunosuppressive cytokines in the newly diagnosed systemic lupus Erythematosus patients: a focus on B cells

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Mitra Abbasifard ◽  
Zahra Kamiab ◽  
Mohammad Hasani ◽  
Amir Rahnama ◽  
Pooya Saeed-Askari ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
B Cells ◽  
Immune Responses ◽  
Lupus Erythematosus ◽  
Healthy Subjects ◽  
Serum Levels ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Moderate Disease ◽  
Immunosuppressive Cytokines

Abstract Background The immunosuppressive effects of regulatory B-cells (Bregs) and their immunosuppressive cytokines on immune responses in autoimmune disorders, mainly systemic lupus erythematosus (SLE), have been recently established. Therefore, the purpose of this article has been the exploration of the expressions of cytokines produced by B cells in newly diagnosed SLE patients. Results The findings demonstrated that the gene expression of IL-10, TGF-β, IL-35, PD-L1, and FasL was significantly up-regulated in SLE patients compared to healthy subjects (P < 0.05). Additionally, the results revealed that serum levels of IL-10, TGF-β, IL-35, PD-L1 were remarkably increased in patients with SLE compared to healthy subjects (P < 0.0001). However, serum levels of IL-10 and TGF-β decreased significantly with increasing SLEDAI score in studied patients (P < 0.05). Conclusion It was concluded that the release of anti-inflammatory cytokines, particularly IL-10 and TGF-β, might inhibit immune responses and autoreactive immune cells in a compensatory manner in SLE patients with mild to moderate disease activity.

scholarly journals Vaccination coverage in systemic lupus erythematosus—a cross-sectional analysis of the German long-term study (LuLa cohort)

Rheumatology ◽  
2018 ◽  
Vol 57 (8) ◽  
pp. 1439-1447 ◽  
Author(s):  
Gamal Chehab ◽  
Jutta G Richter ◽  
Ralph Brinks ◽  
Rebecca Fischer-Betz ◽  
Borgi Winkler-Rohlfing ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Vaccination Coverage ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Term Study ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Long Term Study ◽  
Sectional Analysis

Medical adherence in patients with systemic lupus erythematosus in Germany: predictors and reasons for non-adherence – a cross-sectional analysis of the LuLa-cohort

Lupus ◽  
2018 ◽  
Vol 27 (10) ◽  
pp. 1652-1660 ◽  
Author(s):  
G Chehab ◽  
G M Sauer ◽  
J G Richter ◽  
R Brinks ◽  
R Willers ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Sufficient Information ◽  
Medical Adherence ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Long Term Study ◽  
High Adherence ◽  
Sectional Analysis

Objective Adherence to medication has a major impact on treatment control and success especially in chronic diseases but often remains unrecognized. Besides clinical, socioeconomic, disease-related and treatment-related parameters, general and personal health beliefs, as well as perception of health, can affect adherence. Our aim was to investigate the adherence to lupus-specific medications in German lupus patients and to assess influencing factors including detrimental or beneficial effects of health perceptions and beliefs. Methods The Lupus Erythematosus (LE) Long-Term Study (LuLa-study) is a nationwide longitudinal study among German Caucasian patients with systemic lupus erythematosus who have been assessed annually using a self-reported questionnaire since 2001. In 2013, we included questions concerning medical adherence (Morisky Medication Adherence Scale; MMAS-4), beliefs about medication prescribed (BMQ), illness perception and about the patients’ health locus of control (HLC). We present a cross-sectional analysis to assess predictors of adherence using a multivariable stepwise logistic regression. Results Five hundred and seventy-nine patients participated, 81 of whom did not take any lupus-specific medication and 40 of whom did not complete the MMAS-4 and were therefore omitted. Only 62.7% reported high adherence. Unintentional behaviour for low medical adherence exceeded the intentional behaviour by far. The use of azathioprine (OR: 1.85; 95% CI: 1.02–3.34), prednisone <7.5 mg (OR: 1.56; 95% CI: 0.97–2.49), a higher age (OR: 1.06; 95% CI: 1.03–1.08) and higher external HLC (OR: 1.15; 95% CI: 1.01–1.30) proved conducive for high adherence in our multivariable model. On the contrary, the general perception of medication being harmful or addictive (OR: 0.89; 95% CI: 0.82–0.97) was detrimental. Conclusion A low belief that one's own health is determined by healthcare providers (external HLC) and the belief of the harmfulness of medication were independent predictors of low adherence besides age and the choice of the medical agent. The recognition of these potential obstacles in physician–patient relationships is essential to ameliorate adherence. Provision of sufficient information and education might help to reach the best possible outcome.

scholarly journals AB0387 TREATMENT STATUS FOR OSTEOPOROSIS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: CROSS-SECTIONAL ANALYSIS FROM A LUPUS REGISTRY OF NATIONWIDE INSTITUTIONS (LUNA)

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1493.1-1494
Author(s):  
K. E. Sada ◽  
K. Hayashi ◽  
Y. Asano ◽  
Y. Katayama ◽  
S. Hiramatsu Asano ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Vitamin D ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Treatment Status ◽  
Bone Damage ◽  
Ckd Stage ◽  
Vitamin D Supplements ◽  
Sectional Analysis

Background:Osteoporosis is one of the most important adverse effects of glucocorticoids in patients with systemic lupus erythematosus (SLE). Because osteoporosis is accelerated by chronic kidney disease (CKD), more attention should be paid to the treatment for osteoporosis in SLE patients with CKD. Many treatment options for osteoporosis have emerged recently, but treatment status in patients with SLE is not elucidated.Objectives:The purpose of this study is to elucidate the treatment status for osteoporosis in patients with SLE among the CKD stages.Methods:Using data from lupus registry of nationwide institutions (LUNA), a cross-sectional analysis was performed. We firstly described treatment status for osteoporosis in all enrolled patients. Secondary, treatment status for osteoporosis was compared among CKD stages. Finally, bone damage in Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) was compared among CKD stages.Results:The median age (interquartile range [IQR]) of enrolled 917 patients was 44 (34- 57) years and 809 patients (88%) were female. CKD stages were follows: CKD stage 1, 234 (26%); CKD stage 2, 465 (51%); CKD stage 3, 189 (21%); CKD stage 4, 9 (1%); CKD stage 5, 16 (2%). Median (IQR) age, female sex, and median (IQR) previous maximum dose of prednisolone in patients with and without CKD (≥CKD stage 3) were 56 (46.5-66) and 41 (32-50), 191 (89%) and 615 (88%), and 40 (30-60) and 40 (30-55) mg/day, respectively. Bisphosphonate was administered in 388 (42%) patients, vitamin D supplements in 448 (49%), Ca supplements in 36 (4%), denosumab in 20 (2%) and teriparatide in 14 (2%), respectively. Of enrolled patients, any treatment for osteoporosis was not administered in 226 (25%) patients. In spite of more frequent bone damage in patients with CKD compared to those without CKD (15% vs 10%, p=0.036), treatment status did not differ between patients with and without CKD (bisphosphonate: 41% vs 46%, p=0.29; vitamin D supplements: 50% vs 44%, p=0.14).Conclusion:About a quarter of patients with SLE did not take any treatment for osteoporosis. Treatment for osteoporosis might be strengthened to prevent bone damage in SLE patients with CKD.Disclosure of Interests:KEN-EI SADA Speakers bureau: I received speaker’s fee from GSK and Astra Zeneca K.K., Keigo Hayashi: None declared, Yosuke ASANO: None declared, Yu Katayama: None declared, Sumie Hiramatsu Asano: None declared, Keiji Ohashi: None declared, Michiko Morishita: None declared, Haruki Watanabe: None declared, Mariko Narazaki: None declared, Yoshinori Matsumoto: None declared, Nobuyuki Yajima: None declared, Ryusuke Yoshimi: None declared, Yasuhiro Shimojima: None declared, Shigeru Ono: None declared, Hiroshi Kajiyama: None declared, Kunihiro Ichinose: None declared, Shuzo Sato: None declared, Michio Fujiwara: None declared, Jun Wada: None declared

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