scholarly journals AB0033 MACROPHAGE ACTIVATION IN PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS AND SYSTEMIC LUPUS ERYTHEMATOSUS (PRELIMINARY DATA)

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1049.3-1050
Author(s):  
E. Gerasimova ◽  
T. Popkova ◽  
T. Kirichenko ◽  
А . Markin ◽  
Y. Markina ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Macrophage Activation ◽  
Disease Duration ◽  
Monocyte Activation ◽  
Systemic Lupus ◽  
Early Ra ◽  
Traditional Risk Factors

Background:The study of the ability of monocytes to activate associated with the clinical activity of immunological markers of inflammation in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) will provide important and fundamentally new information on the involvement of these cells in the development of autoimmune rheumatic diseases (ARDs).Objectives:To study macrophage activation in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients (pts).Methods:A total of 21 active ARDs pts (11 RA, 10 SLE) were enrolled in the study (median age was 55[44; 63] years; disease duration was 8 [2; 14] months). There are 11 pts with early RA (disease duration was ≤12 months), moderate to high activity (DAS28 was 6.1[4.9;6.7]; SDAI was 25(22;31); ACCP was positive in 73% and RF in 87% cases) and 10 pts with active SLE (SLADAI-2K was 7 [6;8]) in the study. All early RA pts and 4 SLE pts were not treated with glucocorticoids and disease-modifying antirheumatic drugs. Six SLE pts received low-dose glucocorticoids and hydroxychloroquine.All pts were assessed for macrophage activation and laboratory data: ESR, RF, ACCP, CRP, ANA, anti-dsDNA. Isolation of monocytes was carried out according to the standard procedure for obtaining a leukocyte fraction in a Ficoll gradient and subsequent selection of CD14 + cells using magnetic separation. After isolation, the cells were cultured in X-Vivo medium. To assess the degree of monocyte activation, cells were stimulated by the addition of LPS. The value of monocyte activation was expressed as a ratio of the level of secretion of proinflammatory cytokines by monocytes cultured with and without LPS addition. Secretion levels were determined by ELISA. The belonging of the isolated cells to CD14 + monocytes was additionally confirmed by flow cytometry.Results:Macrophage activation was 2.6 (2.0;5.4) and 4.8 (2.8;7.3) in RA and SLE pts, respectively (p>0.05). In RA and SLE pts macrophage activation was independent of age, sex, body mass index, traditional risk factors (arterial hypertension, overweight, smoking, family history of cardiovascular diseases), RA activity scores (DAS28, SDAI), and SLADAI-2K. No association was found between macrophage activation and levels of ESR, RF, ACCP, CRP, ANA, and anti-dsDNA.Conclusion:No differences in macrophage activation were found in RA and SLE pts. Macrophage activation was independent of age, sex, traditional risk factors, and ARD-related parameters. A study on a larger number of pts will clarify the link between macrophage activation and autoimmune disorders.This work was supported by the Russian Science Foundation (Grant № 21-15-00225).Disclosure of Interests:None declared

scholarly journals Atherosclerotic plaque in carotid arteries in systemic lupus erythematosus: frequency and associated risk factors

2005 ◽  
Vol 123 (3) ◽  
pp. 137-142 ◽  
Author(s):  
Alexandre Wagner Silva de Souza ◽  
Francisca Satomi Hatta ◽  
Fausto Miranda Jr. ◽  
Emília Inoue Sato
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Atherosclerotic Plaque ◽  
Lupus Erythematosus ◽  
Carotid Plaque ◽  
Carotid Arteries ◽  
Disease Duration ◽  
Significant Risk ◽  
Older Age ◽  
Systemic Lupus

CONTEXT AND OBJECTIVE: Atherosclerotic disease is an important cause of morbidity and mortality in systemic lupus erythematosus (SLE) patients. No previous study has estimated carotid disease prevalence in such patients in Brazil. The aim was to evaluate the prevalence of atherosclerotic plaque in carotid arteries, in SLE patients and controls, and to verify possible associations between risk factors and carotid plaque. DESIGN AND SETTING: Cross-sectional study, at Universidade Federal de São Paulo - Escola Paulista de Medicina. METHODS: Carotid plaque prevalence was assessed by B-mode ultrasound in 82 female SLE patients of mean age 34.0 years and 62 controls of mean age 35.7 years. Plaque was defined as a distinct area of hyperechogenicity and/or focal protrusion of the vessel wall into the lumen. Risk factors for coronary disease and SLE-related variables were determined. RESULTS: 50% of patients and 29% of controls presented carotid plaque. Older age, longer disease duration, higher Systemic Lupus International Collaborating Clinics (SLICC) score, higher levels of low-density lipoprotein and greater diabetes, obesity, premature ovarian failure and family history of coronary artery disease were found in patients with carotid plaque than in those without plaque. Patients with plaque were younger than controls with plaque. SLE diagnosis, obesity, older age, higher SLICC score and longer disease duration were independent risk factors for carotid plaque. CONCLUSION: Young patients with SLE present higher prevalence of carotid plaque than controls. SLE diagnosis was a significant risk factor for carotid atherosclerosis.

A comparative study on clinical and serological characteristics between patients with rhupus and those with systemic lupus erythematosus and rheumatoid arthritis

Lupus ◽  
2020 ◽  
Vol 29 (10) ◽  
pp. 1216-1226
Author(s):  
Beatriz Frade-Sosa ◽  
Javier Narváez ◽  
Tarek Carlos Salman-Monte ◽  
Raul Castellanos-Moreira ◽  
Vera Ortiz-Santamaria ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Autoimmune Diseases ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Classification Criteria ◽  
Systemic Lupus ◽  
Cross Sectional

Background The concomitant presence of two autoimmune diseases – systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) – in the same patient is known as rhupus. We evaluated a group of patients with rhupus to clarify further their clinical, serological and immunogenic features in a multi-centre cohort. In addition, the study aimed to explore the utility of the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) SLE classification criteria in our group of patients with rhupus. Methods This was a cross-sectional study. We included rhupus patients from 11 different rheumatology departments, and compared them to SLE and RA patients at a ratio of 2:1. All information was recorded following a pre-established protocol. Results A total of 200 patients were included: 40 rhupus patients and 80 each of SLE and RA patients as controls. Disease duration was similar among SLE and rhupus groups (around 13 years), but the RA group had a significantly lower disease duration. Main clinical manifestations were articular (94.2%), cutaneous (77.5%) and haematological (72.5%). Rhupus patients had articular manifestations similar to those expected in RA. Only 10% of rhupus patients had renal involvement compared with 25% of those with SLE ( p < 0.05), while interstitial lung disease was more common in patients affected by RA. The 2019 EULAR/ACR SLE criteria were met in 92.5% of the rhupus patients and in 96.3% of the SLE cohort ( p > 0.05). Excluding the joint domain, there were no differences between the numbers of patients who met the classification criteria. Conclusion Rhupus patients follow a particular clinical course, with full expression of both SLE and RA in terms of organ involvement, except for a lower prevalence of kidney affection. The new 2019 EULAR/ACR SLE criteria are not useful for differentiating SLE and rhupus patients. A new way of classifying autoimmune diseases is needed to identify overlapping clusters.

scholarly journals Risk and protective factors for thrombosis in systemic lupus erythematosus: results from a large, multi-ethnic cohort

2008 ◽  
Vol 68 (2) ◽  
pp. 238-241 ◽  
Author(s):  
R Kaiser ◽  
C M Cleveland ◽  
L A Criswell
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Asian Americans ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Medication Use ◽  
Small Sample ◽  
Antiphospholipid Antibody ◽  
Systemic Lupus ◽  
History Of

Objectives:Few studies have examined thrombosis in systemic lupus erythematosus (SLE), none have included Asian-Americans, and most have had small sample sizes. We analysed risk factors for thrombosis in a large, multi-ethnic SLE cohort.Methods:We studied 1930 SLE subjects, including Caucasians, African-Americans, Asian-Americans and Hispanics. Data were derived from questionnaires and medical records. Documented history of thrombosis was the primary outcome. Explanatory variables included age at SLE diagnosis, gender, ethnicity, disease duration, smoking, antiphospholipid antibody (aPL) status, nephritis and specific medications.Results:Smoking (OR 1.26, p = 0.011), longer disease duration (OR 1.26 per 5 years p = 0.027×10−7), nephritis (OR 1.35, p = 0.036), aPL positivity (OR 3.22, p<10−9) and immunomodulating medication use (OR 1.40, p = 0.011) were statistically significant risk factors for thrombosis. Younger age at SLE onset was protective (OR 0.52 for age ⩽20, p = 0.001). After adjusting for disease severity and incorporating propensity scores, hydroxychloroquine use remained significantly protective for thrombosis (OR 0.62, p = 4.91×10−4).Conclusions:This study confirms that older age at onset, longer disease duration, smoking, aPL positivity, history of nephritis and immunomodulating medication use are risk factors for thrombosis in SLE. These data are the first to confirm in a large and ethnically diverse SLE cohort that hydroxychloroquine use is protective for thrombosis.

ROLE OF INFLAMMATION AND PLATELETS ACTIVATION IN ATHEROSCLERISIS PROGRESSION IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

2018 ◽  
Author(s):  
А.В. Аршинов ◽  
Н.Ю. Левшин ◽  
И.Г. Маслова ◽  
А.Н. Лужинский
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Intima Media Thickness ◽  
Control Group ◽  
Systemic Lupus ◽  
Reactive Protein ◽  
Traditional Risk Factors ◽  
Atherosclerosis Development ◽  
Aggregation Activity

Цель исследования: выявить взаимосвязь между дислипидемией, активностью воспаления и функцией тромбоцитов в развитии атеросклероза у пациентов с системной красной волчанкой (СКВ), а также оценить сходство и различия механизмов атерогенеза у больных СКВ и ишемической болезнью сердца. Материалы и методы. Обследовано 102 женщины, из них — 50 больных СКВ, 31 — с инфарктом миокарда (ИМ); контрольную группу составили здоровые женщины (n = 21). Определяли показатели липидного спектра, содержание антител к окисленным липопротеинам низкой плотности (АТ-оксЛПНП), высокочувствительного С-реактивного белка (вчСРБ), интерлейкина 6 (ИЛ-6), тромбоцитарного фактора 4 (ТФ4), агрегационную функцию тромбоцитов и толщину комплекса интима-медиа (ТКИМ) общих сонных артерий. Результаты. У больных СКВ и у пациентов с ИМ выявлено значительное увеличение ТКИМ сонной артерии и выраженная активация воспаления: повышение содержания вчСРБ, ИЛ-6 и увеличение СОЭ. За исключением значений ИЛ-6, лабораторные показатели воспаления у больных СКВ и с ИМ достоверно не различались. Также у пациентов с СКВ и ИМ установлена значительная активация тромбоцитов (достоверный рост содержания ТФ4). Несмотря на наличие дислипидемии в обеих группах, у больных СКВ данные изменения были выражены более отчётливо и сопровождались повышением уровня АТ-оксЛПНП. Заключение. Кроме традиционных факторов риска развития сердечно-сосудистых заболеваний, ассоциация между СКВ и атеросклерозом может быть объяснена дополнительными факторами риска — воспалением и аутоиммунными процессами. Aim: to reveal a relationship between dyslipidemia, infl ammatory activity and platelets reactivity in atherosclerosis development in patients with systemic lupus erythematosus (SLE) and also to assess the similarity and diff erences of atherogenesis mechanisms in patients with SLE and ischemic heart disease. Materials and methods. The study included 102 women: 50 patients with SLE, 31 — with myocardial infarction (MI); control group included 21 healthy women. We measured parameters of lipid spectrum, levels of antibodies against oxidized low density lipoproteins (oxLDL), high-sensitive C-reactive protein (hsCRP), interleukin 6 (IL-6), platelets factor 4 (PF4), platelets aggregation activity and complex intima-media thickness (TCIM) of carotid arteries. Results. Patient with SLE and MI had markedly increased TCIM. Increased infl ammation activity was the second sign of two groups of patients, including increased hsCRP, IL-6, erythrocyte sedimentation test. Laboratory signs of infl ammation did not markedly diff er in two groups except IL-6. Our study also revealed considerable platelets activation in patients with SLE and MI (signifi cant growth of PF4 content). Despite dyslipidemia, all indicated changes were more clearly expressed in patients with SLE; they were accompanied by increased level of antibodies against oxLDL. Conclusion. Except traditional risk factors for cardiovascular diseases development the association between SLE and atherosclerosis. can be explained by additional risk factors — infl ammation and autoimmune processes.

scholarly journals Macrophage Activation Syndrome as Onset of Systemic Lupus Erythematosus: A Case Report and a Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Guido Granata ◽  
Dario Didona ◽  
Giuseppina Stifano ◽  
Aldo Feola ◽  
Massimo Granata
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Lupus Erythematosus ◽  
Macrophage Activation Syndrome ◽  
Macrophage Activation ◽  
Treatment Options ◽  
Review Of The Literature ◽  
Systemic Lupus ◽  
Activation Syndrome

Macrophage activation syndrome (MAS) is a potentially fatal condition. It belongs to the hemophagocytic lymphohistiocytosis group of diseases. In adults, MAS is rarely associated with systemic lupus erythematosus, but it also arises as complication of several systemic autoimmune disorders, like ankylosing spondylitis, rheumatoid arthritis, and adult-onset Still’s disease. Several treatment options for MAS have been reported in the literature, including a therapeutic regimen of etoposide, dexamethasone, and cyclosporine. Here we report a case of 42-year-old woman in whom MAS occurred as onset of systemic lupus erythematosus.

scholarly journals Combining Calcitonin and Procalcitonin and Rheumatoid Arthritis-Related Biomarkers Improve Diagnostic Outcomes in Early Rheumatoid Arthritis

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Yingwen Liu ◽  
Jing Shi ◽  
Bo Wang ◽  
Lijing Zhou ◽  
Xiaolan Zhou ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Gouty Arthritis ◽  
Healthy Controls ◽  
Diagnostic Efficiency ◽  
Systemic Lupus ◽  
Roc Curve Analysis ◽  
Early Ra ◽  
Median Serum

Objective. To demonstrate whether procalcitonin (PCT) combined with calcitonin (CT) could provide additional diagnostic value to other clinically available rheumatoid arthritis- (RA-) related biomarkers in the early diagnosis of RA. Method. The blood samples aseptically collected by venipuncture were centrifuged within 1 hour and frozen at -80°C. PCT and CT levels were measured using electrochemiluminescence immunoassay (ECLIA) in 260 subjects (48 patients with early RA, 34 patients with established RA, 37 patients with systemic lupus erythematosus, 30 with osteoarthritis, 31 with gouty arthritis, and 80 healthy participants). Anti-cyclic citrullinated peptide (Anti-CCP) and anti-RA33 antibodies (Anti-RA33) were analyzed by ELISA. RF was detected by transmission immunoturbidimetry. Mann–Whitney U tests and Kruskal-Wallis tests compared differences among groups. Spearman’s rank correlation analysis determined the relationship between biomarkers. Receiver-operator characteristic (ROC) curves were generated, and diagnostic performance was assessed by area under the curve (AUC), as well as specificity, sensitivity, likelihood ratios (LR). Results. Median serum PCT concentrations were significantly higher ( p < 0.0001 ) in patients with early RA (0.065 ng/ml) when compared with healthy controls (0.024 ng/ml), and patients with osteoarthritis (0.025 ng/ml). When compared with gouty arthritis (GA) controls (0.072 ng/ml) and systemic lupus erythematosus (SLE) controls (0.093 ng/ml), median serum PCT concentrations were not significant in patients with early RA (0.065 ng/ml). Median serum CT concentrations were significantly lower ( p < 0.0001 ) in patients with early RA (0.880 pg/ml) compared with healthy controls (3.159 pg/ml), patients with SLE (2.480 pg/ml), and patients with GA (2.550 pg/ml). When compared with osteoarthritis controls (0.586 pg/ml), median serum CT concentrations were not significant in patients with early RA (0.880 pg/ml). ROC curve analysis comparing early RA with healthy controls demonstrated that the AUC of RF, anti-CCP, and anti-RA33 were 0.66, 0.73, and 0.64, respectively; the additions of PCT and CT further improved the diagnostic ability of early RA with the AUC of 0.97, 0.98, and 0.97, respectively ( p < 0.01 ). The sensitivities of RF, anti-CCP, and anti-RA33 for early RA were 33.33%, 44.74%, and 58.33%, respectively, and the additions of PCT and CT showed very high sensitivities of 83.33%, 92.11%, and 87.50%. The high-value groups of PCT moderately correlated with the anti-RA33 levels ( r = 0.417 , p < 0.05 ). CT had no significant correlation with disease duration, radiographic progression, or clinical/serological variables, such as ESR levels, CRP levels, RF, anti-CCP, and anti-RA33 levels in early RA. Conclusions. Serum PCT and CT combined with clinically available RA-related biomarkers could further improve the diagnostic efficiency of early RA.

scholarly journals Insulin resistance and type 2 diabetes mellitus risk factors in systemic lupus erythematosus

2021 ◽  
Vol 59 (4) ◽  
pp. 406-410
Author(s):  
L. V. Kondratyeva ◽  
T. V. Popkova ◽  
M. V. Cherkasova ◽  
A. M. Lila ◽  
E. L. Nasonov
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Traditional Risk Factors

Objective. To clarify the frequency of insulin resistance (IR) in patients with systemic lupus erythematosus (SLE), traditional and associated with rheumatic disease risk factors for its development, to assess the possibility of using the Finnish Type 2 Diabetes Risk Assessment Score (FINDRISC) questionnaire to detect IR.Material and methods. The cross-sectional study included 49 patients with SLE (46 women, 3 men) without diabetes mellitus and hyperglycemia, observed at the V.A. Nasonova Research Institute of Rheumatology in 2019–2020. The median age of the patients was 40 [33; 48] years, the duration of the disease was 3.0 [0.7; 8.0] years. Glucocorticoids (GC) were received by 41 (84%) patients, hydroxychloroquine – by 38 (78%), immunosuppressive drugs – by 10 (20%), biological agents – by 5 (10%). The glucose and fasting immunoreactive insulin levels were examined, and the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index was calculated in all patients. HOMA-IR value ≥2.77 corresponded to IR. Traditional risk factors for type 2 diabetes and the risk of its development in the next 10 years in patients with SLE were assessed using the Russian version of the FINDRISC questionnaire.Results. The median HOMA-IR level in SLE patients was 1.7 [1.2; 2.5]. IR was detected in 10 (20%) of 49 patients with SLE. Patients with and without IR were comparable in terms of sex, age, duration and activity of SLE, therapy, and type 2 diabetes traditional risk factors. BMI, WC and insulin levels were higher in patients with IR. HOMA-IR correlated with body mass index (BMI) (r=0.6; p<0.001), waist circumference (WC) (r=0.5; p<0.001), risk categories for developing type 2 diabetes according to FINDRISС (r=0.3; p=0.03), SLEDAI-2K index (r=–0.4; p<0.01), C3 complement levels in serum (r=0.3; p=0.04) and the duration of GC therapy (r=0.3; p=0.03).Conclusion. IR was diagnosed in 20% of SLE patients without a history of diabetes and with normal fasting glucose in venous blood. The lower SLE activity, the longer GC intake in patient, the higher the HOMA-IR index was detected in him. However, the IR appearance was reliably associated only with an increasing BMI and WC. The use of the FINDRISC questionnaire, which allows to stratify respondents in the general population by the risk of developing type 2 diabetes mellitus, did not help to identify SLE patients with IR.

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