Abstract 13456: Association of Chronic Inflammatory Diseases With Incident Atrial Fibrillation

Introduction: Inflammation plays a vital role on the pathophysiology of atrial fibrillation (AF). Although it is hypothesized that chronic inflammatory diseases (CIDs) may increase the risk for incident AF, data are scarce regarding whether CIDs are associated with incidence of AF. Objectives: To determine associations of CIDs with incident AF in a large cohort comprised of patients with multiple different CIDs. Methods: Patients who visited outpatient clinic regularly due to CIDs (human immunodeficiency virus infection, inflammatory bowel disease, psoriasis, rheumatoid arthritis, systemic sclerosis [SSc], and systemic lupus erythematosus [SLE]) and frequency-matched controls (in regular primary care/general medicine clinic) were extracted from the Northwestern electronic health records between 1/1/2000-1/1/2019. Multiple imputation was used for imputing missing values and all following statistical analyses. Cumulative incidence of AF was estimated by the Kaplan Meier Curve, and adjusted Cox proportional hazard models were used to compute hazard ratio (HR) for each CID. Results: We analyzed a total number of 37,601 patients (18,847 CIDs and 19,871 controls without CIDs, median age 48.4 years, male 43%). During a median follow-up period of 3.6 years, 1076 cases (2.9%) of incident AF were observed. After adjusting for covariates included in CHARGE-AF risk score, baseline year, insurance type, baseline hypertension, and estimated glomerular filtration rate, both SSc (HR, 2.29: 95% confidence interval [CI], 1.72 - 3.06; p < 0.01) and SLE (HR, 2.18; 95% CI, 1.65 - 2.90; p < 0.01) were associated with a significantly elevated incidence of AF (Table). Conclusions: Patients with SSc or SLE had a significantly elevated incidence of AF after multivariable adjustment. Future studies should investigate mechanisms underlying these findings to generate both disease-specific knowledge and more generalizable knowledge regarding inflammatory contributors to AF.

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False Positive Results in SARS-CoV-2 Serological Tests for Samples From Patients With Chronic Inflammatory Diseases

Frontiers in Immunology ◽

10.3389/fimmu.2021.666114 ◽

2021 ◽

Vol 12 ◽

Author(s):

Nastya Kharlamova ◽

Nicky Dunn ◽

Sahl K. Bedri ◽

Svante Jerling ◽

Malin Almgren ◽

...

Keyword(s):

Lupus Erythematosus ◽

False Positive ◽

Inflammatory Diseases ◽

Serological Tests ◽

Chronic Inflammatory Diseases ◽

Negative Results ◽

False Positive Signal ◽

Lateral Flow Assays ◽

Positive Results ◽

Multiplex Bead

Patients with chronic inflammatory diseases are often treated with immunosuppressants and therefore are of particular concern during the SARS-CoV-2 pandemic. Serological tests will improve our understanding of the infection and immunity in this population, unless they tests give false positive results. The aim of this study was to evaluate the specificity of SARS-Cov-2 serological assays using samples from patients with chronic inflammatory diseases collected prior to April 2019, thus defined as negative. Samples from patients with multiple sclerosis (MS, n=10), rheumatoid arthritis (RA, n=47) with or without rheumatoid factor (RF) and/or anti-cyclic citrullinated peptide antibodies (anti-CCP2) and systemic lupus erythematosus (SLE, n=10) with or without RF, were analyzed for SARS-CoV-2 antibodies using 17 commercially available lateral flow assays (LFA), two ELISA kits and one in-house developed IgG multiplex bead-based assay. Six LFA and the in-house validated IgG assay correctly produced negative results for all samples. However, the majority of assays (n=13), gave false positive signal for samples from patients with RA and SLE. This was most notable in samples from RF positive RA patients. No false positive samples were detected in any assay using samples from patients with MS. Poor specificity of commercial serological assays could possibly be, at least partly, due to interfering antibodies in samples from patients with chronic inflammatory diseases. For these patients, the risk of false positivity should be considered when interpreting results of the SARS-CoV-2 serological assays.

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SARS-CoV-2 serological tests can generate false positive results for samples from patients with chronic inflammatory diseases

10.1101/2020.11.13.20231076 ◽

2020 ◽

Author(s):

Nastya Kharlamova ◽

Nicky Dunn ◽

Sahl K Bedri ◽

Svante Jerling ◽

Malin Almgren ◽

...

Keyword(s):

Lupus Erythematosus ◽

False Positive ◽

Inflammatory Diseases ◽

Serological Tests ◽

Chronic Inflammatory Diseases ◽

Negative Results ◽

False Positive Signal ◽

Lateral Flow Assays ◽

Positive Results ◽

Multiplex Bead

AbstractObjectivesPatients with chronic inflammatory diseases are often treated with immunosuppressants and therefore are of particular concern during the SARS-CoV-2 pandemic. Serological tests will improve our understanding of the infection and immunity in this population, unless the tests give false positive results. The aim of this study was to evaluate the specificity of SARS-Cov-2 serological assays with samples from patients with chronic inflammatory diseases collected before April 2019, thus defined as negative.MethodsSamples from patients with multiple sclerosis (MS, n=10), rheumatoid arthritis (RA, n=47) with or without rheumatoid factor (RF) and/or anti-cyclic citrullinated peptide antibodies (anti-CCP2) and RF +/- systemic lupus erythematosus (SLE, n=10), were tested with 17 commercially available lateral flow assays (LFA), two ELISA kits and one in-house developed multiplex bead-based assay.ResultsSix LFA and the in-house IgG assay gave the correct negative results for all samples. However, the majority of assays (n=13), gave false positive signal with samples from patients with RA and SLE. This was most notable in RF positive RA samples. MS samples did not give any false positive in any of the assays.ConclusionThe majority of the verified serological assays were sensitive to interfering antibodies in samples from patients with chronic inflammatory diseases and therefore may have poor specificity in this context. For these patients, the risk of false positivity should be considered when interpreting results of the SARS-CoV-2 serological assays.

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Cytokines and Transgenic Matrix in Autoimmune Diseases: Similarities and Differences

Biomedicines ◽

10.3390/biomedicines8120559 ◽

2020 ◽

Vol 8 (12) ◽

pp. 559

Author(s):

Ludmiła Szewczak ◽

Katarzyna Donskow-Łysoniewska

Keyword(s):

Autoimmune Diseases ◽

Lupus Erythematosus ◽

Inflammatory Diseases ◽

Special Focus ◽

Preclinical Models ◽

Systemic Lupus ◽

Chronic Inflammatory Diseases ◽

Organ Specific ◽

Disease Entities ◽

Similarities And Differences

Autoimmune diseases are increasingly recognized as disease entities in which dysregulated cytokines contribute to tissue-specific inflammation. In organ-specific and multiorgan autoimmune diseases, the cytokine profiles show some similarities. Despite these similarities, the cytokines have different roles in the pathogenesis of different diseases. Altered levels or action of cytokines can result from changes in cell signaling. This article describes alterations in the JAK-STAT, TGF-β and NF-κB signaling pathways, which are involved in the pathogenesis of multiple sclerosis and systemic lupus erythematosus. There is a special focus on T cells in preclinical models and in patients afflicted with these chronic inflammatory diseases.

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CD28null CD4 T-cell expansions in autoimmune disease suggest a link with cytomegalovirus infection

F1000Research ◽

10.12688/f1000research.17119.1 ◽

2019 ◽

Vol 8 ◽

pp. 327 ◽

Cited By ~ 7

Author(s):

Aalia Bano ◽

Alejandra Pera ◽

Ahmad Almoukayed ◽

Thomas H.S. Clarke ◽

Sukaina Kirmani ◽

...

Keyword(s):

T Cells ◽

Autoimmune Disease ◽

Lupus Erythematosus ◽

Cd4 T Cells ◽

Cytomegalovirus Infection ◽

Inflammatory Diseases ◽

Cytotoxic T Cells ◽

Cd4 T Cell ◽

Chronic Inflammatory Diseases ◽

The Common

Immunosenescence is thought to contribute to the increase of autoimmune diseases in older people. Immunosenescence is often associated with the presence of an expanded population of CD4 T cells lacking expression of CD28 (CD28null). These highly cytotoxic CD4 T cells were isolated from disease-affected tissues in patients with rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, or other chronic inflammatory diseases and their numbers appeared to be linked to disease severity. However, we recently demonstrated that the common herpes virus, cytomegalovirus (CMV), not ageing, is the major driver of this subset of cytotoxic T cells. In this review, we discuss how CMV might potentiate and exacerbate autoimmune disease through the expansion of CD28null CD4 T cells.

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Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.757738 ◽

2021 ◽

Vol 8 ◽

Author(s):

Arjun Sinha ◽

Adovich S. Rivera ◽

Simran A. Chadha ◽

Sameer Prasada ◽

Anna E. Pawlowski ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Disease Severity ◽

Lupus Erythematosus ◽

Inflammatory Diseases ◽

Coronary Revascularization ◽

Cox Models ◽

Chronic Inflammatory Diseases ◽

Adjusted Risk ◽

Chd Risk

Background: Chronic inflammatory diseases (CIDs) are considered risk enhancing factors for coronary heart disease (CHD). However, sparse data exist regarding relative CHD risks across CIDs.Objective: Determine relative differences in CHD risk across multiple CIDs: psoriasis, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), human immunodeficiency virus (HIV), systemic sclerosis (SSc), and inflammatory bowel disease (IBD).Methods: The cohort included patients with CIDs and controls without CID in an urban medical system from 2000 to 2019. Patients with CIDs were frequency-matched with non-CID controls on demographics, hypertension, and diabetes. CHD was defined as myocardial infarction (MI), ischemic heart disease, and/or coronary revascularization based on validated administrative codes. Multivariable-adjusted Cox models were used to determine the risk of incident CHD and MI for each CID relative to non-CID controls. In secondary analyses, we compared CHD risk by disease severity within each CID.Results: Of 17,049 patients included for analysis, 619 had incident CHD (202 MI) over an average of 4.4 years of follow-up. The multivariable-adjusted risk of CHD was significantly higher for SLE [hazard ratio (HR) 1.9, 95% confidence interval (CI) 1.2, 3.2] and SSc (HR 2.1, 95% CI 1.2, 3.9). Patients with SLE also had a significantly higher risk of MI (HR 3.6, 95% CI 1.9, 6.8). When CIDs were categorized by markers of disease severity (C-reactive protein for all CIDs except HIV, for which CD4 T cell count was used), greater disease severity was associated with higher CHD risk across CIDs.Conclusions: Patients with SLE and SSc have a higher risk of CHD. CHD risk with HIV, RA, psoriasis, and IBD may only be elevated in those with greater disease severity. Clinicians should personalize CHD risk and treatment based on type and severity of CID.

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Abstract 16122: Comparative Risk of Incident Coronary Heart Disease Across Multiple Chronic Inflammatory Diseases

Circulation ◽

10.1161/circ.142.suppl_3.16122 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Arjun Sinha ◽

Adovich Rivera ◽

Simran Chadha ◽

Sameer Prasada ◽

Anna Pawlowski ◽

...

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Lupus Erythematosus ◽

Inflammatory Diseases ◽

Coronary Revascularization ◽

Immune Dysfunction ◽

Chronic Inflammatory Diseases ◽

Chd Risk ◽

Chd Risk Factors

Introduction: Inflammation plays an important role in the pathogenesis of coronary heart disease (CHD). Chronic inflammatory diseases (CIDs) may serve as models to provide insights into the relationships between immune dysfunction, inflammation, and CHD. To investigate this further, we analyzed the risk of incident CHD across different CIDs. Methods: We created a cohort of individuals with CIDs and non-CID controls (frequency-matched on demographics and CHD risk factors), free of baseline CHD, receiving regular outpatient care in a large medical system from 2000 to 2019. CIDs included psoriasis, rheumatoid arthritis (RA), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), human immunodeficiency virus (HIV), and inflammatory bowel disease (IBD). CHD was defined as myocardial infarction (MI), angina, or coronary revascularization. We used adjusted hazards models to determine incident CHD risk for each CID relative to controls. We also analyzed incident CHD risk by severity of inflammation (baseline C-reactive protein) or immune dysfunction (baseline CD4 T cell level in HIV). Results: Of 18,129 individuals with CIDs and 18,988 controls, there were 1,011 incident CHD events over a median of 3.5 years. After adjusting for demographics and CHD risk factors, CHD risk was significantly elevated in SLE [hazard ratio (HR) 2.85, 95% confidence interval (CI) 2.19-3.71, p<0.01], SSc (HR 2.14, 95% CI 1.54-2.99, p<0.01), HIV (HR 1.38, 95% CI 1.12-1.69, p<0.01), and RA (HR 1.22, 95% CI 1.00-1.49, p=0.05). Findings were similar with MI as the lone outcome. When CIDs were categorized by inflammation or immune dysfunction, there was a pattern of higher CHD risk with higher levels of inflammation/immune dysfunction across CIDs (Figure). Conclusions: Our results show that SLE, SSc, HIV, and RA were associated with significantly elevated risks of incident CHD and MI. Higher levels of inflammation or immune dysfunction were associated with heightened CHD risk within CIDs.

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PERIODONTAL DISEASE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: CARDIOVASCULAR RISK AND SIDE EFFECTS OF CORTICOTHERAPY INVOLVING ORAL HEALTH

Romanian Journal of Rheumatology ◽

10.37897/rjr.2015.3.1 ◽

2015 ◽

Vol 24 (3) ◽

pp. 125-131

Author(s):

Dan Piperea-Sianu ◽

◽

Alexandru G. Croitoru ◽

Adela Maria Ceau ◽

Alice Piperea-Sianu ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Periodontal Disease ◽

Lupus Erythematosus ◽

Cardiovascular Events ◽

Inflammatory Diseases ◽

Periodontal Tissue ◽

Systemic Lupus ◽

Chronic Inflammatory Diseases ◽

Major Cardiovascular Events ◽

The Impact

Systemic lupus erythematosus (SLE) and periodontal disease (PD) are two chronic inflammatory diseases that share common pathogenetic mechanisms. Therefore, it is thought that a correlation between the two pathologies might exist. PD itself, when not associated with SLE, does not cause major cardiovascular events, but it contributes to the development of atherosclerosis, which is the major cause of death among patients with SLE. This article aims to summarize the available literature concerning the association between these two disorders (PD prevalence in patients with SLE, correlations between periodontal damage and SLEDAI activity score), to present the main mechanisms by which the two pathologies affect the cardiovascular system and to evaluate the impact of SLE corticosteroid therapy on periodontal tissue.

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