scholarly journals Favourable antibody responses to human coronaviruses in children and adolescents with autoimmune rheumatic diseases

2021 ◽  
Author(s):  
Claire T. Deakin ◽  
Georgina H. Cornish ◽  
Kevin W. Ng ◽  
Nikhil Faulkner ◽  
William Bolland ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Immunosuppressive Treatment ◽  
Immune Dysfunction ◽  
Inflammatory Rheumatic Diseases ◽  
Igg Antibodies ◽  
Autoimmune Rheumatic Diseases ◽  
Human Coronaviruses ◽  
The Impact

AbstractDifferences in humoral immunity to coronaviruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), between children and adults remain unexplained and the impact of underlying immune dysfunction or suppression unknown. Here, we examined the antibody immune competence of children and adolescents with prevalent inflammatory rheumatic diseases, juvenile idiopathic arthritis (JIA), juvenile dermatomyositis (JDM) and juvenile systemic lupus erythematosus (JSLE), against the seasonal human coronavirus (HCoV)-OC43 that frequently infects this age group. Despite immune dysfunction and immunosuppressive treatment, JIA, JDM and JSLE patients mounted comparable or stronger responses than healthier peers, dominated by IgG antibodies to HCoV-OC43 spike, and harboured IgG antibodies that cross-reacted with SARS-CoV-2 spike. In contrast, responses to HCoV-OC43 and SARS-CoV-2 nucleoproteins exhibited delayed age-dependent class-switching and were not elevated in JIA, JDM and JSLE patients, arguing against increased exposure. Consequently, autoimmune rheumatic diseases and their treatment were associated with a favourable ratio of spike to nucleoprotein antibodies.

scholarly journals A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases

2020 ◽  
Author(s):  
Nina M de Gruijter ◽  
Meena Naja ◽  
Hannah Peckham ◽  
Anna Radziszewska ◽  
Matthew Kinsella ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Meta Analysis ◽  
Severe Disease ◽  
Delayed Puberty ◽  
Future Research ◽  
Autoimmune Rheumatic Diseases ◽  
Bidirectional Relationship ◽  
The Impact

Abstract Background: Autoimmune rheumatic diseases (ARDs) are associated with a significant sex-bias which becomes more evident post-puberty. This systematic review aims to elucidate the bidirectional relationship between puberty and ARDs related outcomes.Methods: Studies published in English until October 2019 were identified using a systematic search of endocrinology and rheumatology literature. Information was extracted on study design, sample size, demographics, puberty outcome measures, and main findings. The methodological quality of the studies included was analysed using the Newcastle-Ottawa Scale (NOS).Results: 14 non-randomised studies reporting on the impact of puberty on ARD outcomes (n = 7), ARD impact on puberty-related outcomes (n = 6), or both (n = 1) have been identified. The impact of puberty on ARD outcomes have been investigated in patients with juvenile idiopathic arthritis (JIA)-associated uveitis (n = 1), juvenile systemic lupus erythematosus (JSLE) (n = 5) or in healthy controls who developed adult-onset SLE (n = 1) or had non-specific symptoms (n = 1). The impact of ARD on puberty outcomes was explored in JIA (n = 4) and JSLE (n = 3). Quality assessment of studies showed a small to moderate risk of bias overall (NOS 4–9/9). Due to large heterogeneity of the studies it was not possible to perform a meta-analysis. Multiple studies reported on delayed puberty in patients with JIA/JSLE, menstrual and hormonal abnormalities, and lower height and weight than controls. Earlier (pre-pubertal) onset of JSLE was correlated with more severe disease and more need for systemic treatment.Conclusion: A bidirectional relationship exists between puberty and ARDs; however, more and better research is required to elucidate the complexity of this relationship. We propose puberty-related clinical assessments in patients with ARDs, which can improve patient outcomes and facilitate future research.

Prevention of autoimmune rheumatic disease: state of the art and future perspectives

2010 ◽  
Vol 69 (12) ◽  
pp. 2062-2066 ◽  
Author(s):  
Lars Klareskog ◽  
Peter K Gregersen ◽  
Tom W J Huizinga
Keyword(s):  
Public Health ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Low Frequency ◽  
Specific Gene ◽  
Inflammatory Rheumatic Diseases ◽  
Autoimmune Rheumatic Diseases ◽  
Autoimmune Rheumatic Disease ◽  
Road Map ◽  
Sequence Of Events

Prevention of disease can in principle be accomplished by identification of environmental and/or lifestyle risk and protective factors followed by public health measures (such as for smoking and lung cancer), or by modification of the individual's reactions to disease-inducing factors (such as in vaccinations against microbes). This review discusses both options based on emerging understanding of aetiologies in inflammatory rheumatic diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). The major current opportunity for public health-based prevention lies in avoiding smoking. In RA, recent studies have calculated that, in Sweden (a country characterised by a low frequency of smoking), 20% of all RA cases and 33% of all cases of ACPA-positive RA would not have occurred in a smoke-free society. Smoking is also a major risk factor for SLE but no population attribution is yet available. New avenues for individualised and biology-based prevention are provided by the demonstration that several autoimmune rheumatic diseases are preceded by emergence of subclinical autoimmunity followed by laboratory-based signs of inflammation and finally overt disease. Examples of this process are provided from studies of autoimmunity to citrullinated proteins (in RA), to dsDNA (in SLE in general) and to Ro52 epitopes (in the case of neonatal heart block). The recognition of this sequence of events provides opportunities to intervene specifically and potentially curatively before onset of full-blown disease. Such prevention can be accomplished by modification of inciting antigens (environment), by modification of immunity (more or less specific immunomodulation) or by modification of specific gene functions. In all cases, prevention will be different in different subsets of disease and differ at different time points of disease development. Thus, the road map towards prevention of autoimmune rheumatic diseases includes increased understanding of how genes, environment and immunity interact.

scholarly journals Impact of autoimmune rheumatic diseases on birth outcomes: a population-based study

RMD Open ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e000878 ◽  
Author(s):  
Jennifer Strouse ◽  
Brittney M Donovan ◽  
Munazza Fatima ◽  
Ruth Fernandez-Ruiz ◽  
Rebecca J Baer ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Birth Outcomes ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Congenital Anomalies ◽  
Birth Certificate ◽  
Large Cohort ◽  
Childbearing Age ◽  
Autoimmune Rheumatic Diseases ◽  
The Impact

ObjectivesAutoimmune rheumatic diseases (ARDs) affect women of childbearing age and have been associated with adverse birth outcomes. The impact of diseases like ankylosing spondylitis and psoriatic arthritis (PsA) on birth outcomes remains less studied to date. Our objective was to evaluate the impact of ARDs on preterm birth (PTB), congenital anomalies, low birth weight (LBW) and small for gestational age (SGA), in a large cohort of women.MethodsWe conducted a propensity score-matched analysis to predict ARD from a retrospective birth cohort of all live, singleton births in California occurring between 2007 and 2012. Data were derived from birth certificate records linked to hospital discharge International Classification of Diseases, ninth revision codes.ResultsWe matched 10 244 women with a recorded ARD diagnosis (rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), antiphospholipid syndrome, PsA); ankylosing spondylitis and juvenile idiopathic arthritis (JIA) to those without an ARD diagnosis. The adjusted OR (aOR) of PTB was increased for women with any ARD (aOR 1.93, 95% CI 1.78 to 2.10) and remained significant for those with RA, SLE, PsA and JIA. The odds of LBW and SGA were also significantly increased among women with an ARD diagnosis. ARDs were not associated with increased odds of congenital anomalies.ConclusionConsistent with prior literature, we found that women with ARDs are more likely to have PTB or deliver an SGA infant. Some reassurance is provided that an increase in congenital anomalies was not found even in this large cohort.

scholarly journals A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases

2020 ◽  
Author(s):  
Nina M de Gruijter ◽  
Meena Naja ◽  
Hannah Peckham ◽  
Anna Radziszewska ◽  
Matthew Kinsella ◽  
...  
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Severe Disease ◽  
Delayed Puberty ◽  
Future Research ◽  
Autoimmune Rheumatic Diseases ◽  
Bidirectional Relationship ◽  
The Impact

Abstract BackgroundAutoimmune rheumatic diseases (ARDs) are associated with a significant sex-bias, which becomes more evident post-puberty. This systematic review aims to elucidate the bidirectional relationship between puberty and ARD-related outcomes.MethodsStudies published in English until October 2019 were identified using a systematic search of endocrinology and rheumatology literature. Information was extracted on study design, sample size, demographics, puberty outcome measures, disease outcome measures, and main findings. The methodological quality of the studies included was analysed using the Newcastle-Ottawa Scale (NOS).Results16 non-randomised studies reporting on the impact of puberty on ARD outcomes (n=7), ARD impact on puberty-related outcomes (n=8), or both (n=1) have been identified. The impact of puberty on ARD outcomes were investigated in patients with juvenile idiopathic arthritis (JIA)-associated uveitis (n=1), juvenile systemic lupus erythematosus (JSLE) (n=5) or in healthy controls who developed adult-onset SLE (n=1) or had non-specific symptoms (n=1). The impact of ARD on puberty outcomes was explored in JIA (n=4) and JSLE (n=3). Quality assessment of studies showed a small to moderate risk of bias overall (NOS 4-9/9). Due to large heterogeneity of the studies it was not possible to perform a meta-analysis. Multiple studies reported on delayed puberty in patients with JIA/JSLE, menstrual and hormonal abnormalities, and lower height and weight than controls. Earlier (pre-pubertal) onset of JSLE was correlated with more severe disease and more need for systemic treatment.ConclusionA bidirectional relationship exists between puberty and ARDs; however, more and better research is required to elucidate the complexity of this relationship. We propose puberty-related clinical assessments in patients with ARDs, which can improve patient outcomes and facilitate future research.

scholarly journals Favourable antibody responses to human coronaviruses in children and adolescents with autoimmune rheumatic diseases

Med ◽  
2021 ◽  
Author(s):  
Claire T. Deakin ◽  
Georgina H. Cornish ◽  
Kevin W. Ng ◽  
Nikhil Faulkner ◽  
William Bolland ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Rheumatic Diseases ◽  
Antibody Responses ◽  
Autoimmune Rheumatic Diseases ◽  
Human Coronaviruses

scholarly journals Disease activity and humoral response in patients with inflammatory rheumatic diseases after two doses of the Pfizer mRNA vaccine against SARS-CoV-2

2021 ◽  
pp. annrheumdis-2021-220503
Author(s):  
Yolanda Braun-Moscovici ◽  
Marielle Kaplan ◽  
Maya Braun ◽  
Doron Markovits ◽  
Samy Giryes ◽  
...  
Keyword(s):  
Side Effects ◽  
Rheumatic Diseases ◽  
Messenger Rna ◽  
Disease Duration ◽  
Humoral Response ◽  
Inflammatory Rheumatic Diseases ◽  
Igg Antibodies ◽  
Activity Assessment ◽  
The Impact ◽  
Immunomodulating Drugs

BackgroundThe registration trials of messenger RNA (mRNA) vaccines against SARS-CoV-2 did not address patients with inflammatory rheumatic diseases (IRD).ObjectiveTo assess the humoral response after two doses of mRNA vaccine against SARS-CoV-2, in patients with IRD treated with immunomodulating drugs and the impact on IRD activity.MethodsConsecutive patients treated at the rheumatology institute, who received their first SARS-CoV-2 (Pfizer) vaccine, were recruited to the study, at their routine visit. They were reassessed 4–6 weeks after receiving the second dose of vaccine, and blood samples were obtained for serology. IRD activity assessment and the vaccine side effects were documented during both visits. IgG antibodies (Abs) against SARS-CoV-2 were detected using the SARS-CoV-2 IgG II Quant (Abbott) assay.ResultsTwo hundred and sixty-four patients with stable disease, (mean(SD) age 57.6 (13.18) years, disease duration 11.06 (7.42) years), were recruited. The immunomodulatory therapy was not modified before or after the vaccination. After the second vaccination, 227 patients (86%) mounted IgG Ab against SARS-CoV-2 (mean (SD) 5830.8 (8937) AU/mL) and 37 patients (14%) did not, 22/37 were treated with B cell-depleting agents. The reported side effects of the vaccine were minor. The rheumatic disease remained stable in all patients.ConclusionsThe vast majority of patients with IRD developed a significant humoral response following the administration of the second dose of the Pfizer mRNA vaccine against SARS-CoV-2 virus. Only minor side effects were reported and no apparent impact on IRD activity was noted.

scholarly journals HPV infections of the uterine cervix in women with rheumatic diseases

2021 ◽  
Vol 29 (1) ◽  
pp. 52-58
Author(s):  
N. Nikolov ◽  
T. Totev
Keyword(s):  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Immunosuppressive Treatment ◽  
Hpv Infection ◽  
Reproductive Age ◽  
Cervical Lesions ◽  
Lower Genital Tract ◽  
Cervical Cells ◽  
High Risk Hpv ◽  
The Impact

The relation between systemic autoimmune diseases that affect women in their reproductive age and the neoplasms of the lower genital tract caused by high-risk HPV strains are studied in many investigations. The studies have been focused mainly on patients with systemic lupus erythematosus exposed to glucocorticoids and immunosuppressive therapy. A higher risk of HPV infection persistence and premalignant and malignant cervical lesions formation is found among them. There are similar, though scantier data about other systemic rheumatic diseases – rheumatoid arthritis, Sjögren‘s syndrome, and systemic sclerosis. Presumably, this fact is determined by specific features of autoimmune inflammation and the impact of immunosuppressive treatment. It contributes to human papilloviruses persistence and their integration into cervical cells. HPV vaccines use in these patients have proved to be safe and effective, and is an object of special interest.

scholarly journals Immunogenicity and safety of routine vaccines in children and adolescents with rheumatic diseases on immunosuppressive treatment — a systematic review

2021 ◽  
Author(s):  
Michèle Keller ◽  
Laure F. Pittet ◽  
Petra Zimmermann
Keyword(s):  
Systematic Review ◽  
Disease Activity ◽  
Children And Adolescents ◽  
Rheumatic Diseases ◽  
Geometric Mean ◽  
Immunosuppressive Treatment ◽  
Safety Concerns ◽  
Vaccine Responses ◽  
Autoimmune Rheumatic Diseases ◽  
Increased Risk

AbstractThe immunogenicity of vaccines in children with juvenile autoimmune rheumatic diseases (JARDs) can be reduced, there are additional safety concerns around vaccination, and there is a potential for worsening in disease activity. In this systematic review, we summarise studies that investigated the immunogenicity and safety of routine vaccines in children and adolescents with JARD on immunosuppressive treatment. We identified 37 studies investigating 2571 children and adolescents with JARD on immunosuppressive treatment and 4895 control children. Of the 56 geometric mean antibody titres measured, 19 (34%) were lower, six (11%) higher, and 31 (55%) similar; of the 39 seroprotection rates measured, 10 (26%) were lower, two (5%) higher, and 27 (69%) similar; and of the 27 seroconversion rates measured, nine (33%) were lower, two (8%) higher, and 16 (59%) similar in children with JARD on immunosuppressive treatment compared with control children. However, many of the studies were underpowered, and not designed to show non-inferiority between children with JARD and controls. Subgroup analysis for different types of immunosuppressive treatments was not feasible, as most studies did not report results by treatment. Severe adverse events were reported in 38 children (33 with juvenile idiopathic arthritis, four with systemic lupus erythematosus, and one in a healthy child); most of them were likely not related to the vaccination (e.g. elective hospitalisation or surgery). A worsening in disease activity was reported in 44 (2%) children with JARD; again, many of them were likely not related to the vaccination. There were no safety concerns with live attenuated vaccines; however, only few studies reported results for this.Conclusion: Vaccination in children with JARD on immunosuppressive treatment is safe and should be promoted, especially since these children are at increased risk for infection. The importance for the completion of vaccination schedules should be stressed. Strategies to compensate for the lower vaccine responses, which are found in approximately one-third of these children, include measuring antibody levels to determine the optimal timing for the administration of additional booster doses. What is Known: • Children with juvenile autoimmune rheumatic diseases (JARDs) are at higher risk for infections, due to their underlying disease and their immunosuppressive treatment. • In children with JARD, the immunogenicity of vaccines might be reduced, and concerns about safety or the potential for worsening in disease activity after vaccination exist. What is New: • Our systematic review shows that vaccines in children with JARDs on immunosuppressive treatment are safe and immunogenic. • There are several limitations of the currently published studies, including random timing of measuring vaccine responses and age differences between children with JARD and control groups. Many of the studies were underpowered, and not designed to show non-inferiority between children with JARD and controls.

scholarly journals A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Nina M. de Gruijter ◽  
Meena Naja ◽  
Hannah Peckham ◽  
Anna Radziszewska ◽  
Matthew Kinsella ◽  
...  
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Severe Disease ◽  
Delayed Puberty ◽  
Future Research ◽  
Autoimmune Rheumatic Diseases ◽  
Bidirectional Relationship ◽  
The Impact

Abstract Background Autoimmune rheumatic diseases (ARDs) are associated with a significant sex-bias, which becomes more evident post-puberty. This systematic review aims to elucidate the bidirectional relationship between puberty and ARD-related outcomes. Methods Studies published in English until October 2019 were identified using a systematic search of endocrinology and rheumatology literature. Information was extracted on study design, sample size, demographics, puberty outcome measures, disease outcome measures, and main findings. The methodological quality of the studies included was analysed using the Newcastle-Ottawa Scale (NOS). Results Sixteen non-randomised studies reporting on the impact of puberty on ARD outcomes (n = 7), ARD impact on puberty-related outcomes (n = 8), or both (n = 1) have been identified. The impact of puberty on ARD outcomes were investigated in patients with juvenile idiopathic arthritis (JIA)-associated uveitis (n = 1), juvenile systemic lupus erythematosus (JSLE) (n = 5) or in healthy controls who developed adult-onset SLE (n = 1) or had non-specific symptoms (n = 1). The impact of ARD on puberty outcomes was explored in JIA (n = 4) and JSLE (n = 3). Quality assessment of studies showed a small to moderate risk of bias overall (NOS 4–9/9). Due to large heterogeneity of the studies it was not possible to perform a meta-analysis. Multiple studies reported on delayed puberty in patients with JIA/JSLE, menstrual and hormonal abnormalities, and lower height and weight than controls. Earlier (pre-pubertal) onset of JSLE was correlated with more severe disease and more need for systemic treatment. Conclusion A bidirectional relationship exists between puberty and ARDs; however, more and better research is required to elucidate the complexity of this relationship. We propose puberty-related clinical assessments in patients with ARDs, which can improve patient outcomes and facilitate future research.

scholarly journals Association of Particulate Matter with Autoimmune Rheumatic Diseases among Adults in South Korea

Rheumatology ◽  
2021 ◽  
Author(s):  
Jun Seok Park ◽  
Seulggie Choi ◽  
Kyuwoong Kim ◽  
Jooyoung Chang ◽  
Sung Min Kim ◽  
...  
Keyword(s):  
Particulate Matter ◽  
Adverse Effects ◽  
South Korea ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Cox Regression ◽  
Statistical Significance ◽  
Cox Regression Analysis ◽  
Autoimmune Rheumatic Diseases ◽  
Quartile Group

Abstract Objective The primary objective is to investigate adverse effects of ambient particulate matter (PM) in various size on the incidence of prevalent autoimmune rheumatic diseases (AIRDs): Rheumatoid Arthritis (RA), Ankylosing Spondylitis (AS), and Systemic Lupus Erythematosus (SLE). Methods We investigated 230,034 participants in three metropolitan cities of South Korea from the National Health Insurance Service-National Sample Cohort (NHIS-NSC). Starting from January 2010, subjects were followed up until the first event of prevalent AIRDs, death, or December 2013. 2008-2009 respective averages of PM2.5 (< 2.5μm) and PMcoarse (2.5μm to 10μm) were linked with participants’ administrative district codes. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated using Cox regression analysis in one- and two-pollutant model. Results Adjusted for age, sex, region, and household income in two-pollutant model, RA incidence was positively associated with 10μg/m³ increment of PM2.5 (aHR = 1.74, 95% CI: 1.06-2.86), but not with PMcoarse (aHR = 1.27, 95% CI: 0.87-1.85). In one-pollutant model, an elevated incidence rate of RA was slightly attenuated (PM2.5 aHR = 1.61, 95% CI: 0.99-2.61; PMcoarse aHR = 1.13, 95% CI: 0.80-1.61), with marginal statistical significance of PM2.5. RA incidence was also higher in 4th quartile group of PM2.5 compared to 1st quartile group (aHR = 1.83, 95% CI: 1.07-3.11). No adverse effects of PM were found on AS or SLE in one- and two-pollutant models. Conclusion Important components of PM10 associated with RA incidence were fine fractions (PM2.5), while no positive association was found between PM and AS or SLE.

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