Reproductive function in women with immune-mediated inflammatory rheumatic diseases

2019 ◽  
Vol 10_2019 ◽  
pp. 51-59
Author(s):  
Vlasova G.A. Vlasova ◽  
Perminova S.G. Perminova ◽  
Kosheleva N.M. Kosheleva ◽  
Nazarenko T.A. Nazarenko ◽  
◽  
...  
Keyword(s):  
Rheumatic Diseases ◽  
Reproductive Function ◽  
Inflammatory Rheumatic Diseases ◽  
Immune Mediated

BARICITINIB: NEW PHARMACOTHERAPY OPTIONS FOR RHEUMATOID ARTHRITIS AND OTHER IMMUNE-MEDIATED INFLAMMATORY RHEUMATIC DISEASES

2020 ◽  
Vol 58 (3) ◽  
pp. 304-316
Author(s):  
E. L. Nasonov ◽  
A. M. Lila
Keyword(s):  
Rheumatoid Arthritis ◽  
Rheumatic Diseases ◽  
Janus Kinase ◽  
Inflammatory Rheumatic Diseases ◽  
Jak Inhibitors ◽  
Oral Medications ◽  
Immune Mediated ◽  
Wide Range ◽  
Promising Area ◽  
Medical Advances

Deciphering the mechanisms of the pathogenesis of immune-mediated inflammatory rheumatic diseases (IMIRDs) in conjunction with designing a wide range of biological agents is one of the major medical advances in the 21st century. A new promising area of pharmacotherapy for IMIRDs is associated with the design of the so-called targeted oral medications that primarily include Janus kinase (JAK) inhibitors. The review presents new data on the efficacy and safety of the new JAK inhibitor baricitinib in treating rheumatoid arthritis and other IMIRDs.

scholarly journals Coronavirus disease 2019 (COVID-19) and immune-mediated inflammatory rheumatic diseases: at the crossroads of thromboinflammation and autoimmunity

2020 ◽  
Vol 58 (4) ◽  
pp. 353-367
Author(s):  
E. L. Nasonov ◽  
T. V. Beketova ◽  
T. M. Reshetnyak ◽  
A. M. Lila ◽  
L. P. Ananieva ◽  
...  
Keyword(s):  
Rheumatic Diseases ◽  
Complement System ◽  
Vascular Endothelial Cells ◽  
Basic Mechanism ◽  
Pathological Process ◽  
Human Organism ◽  
Inflammatory Rheumatic Diseases ◽  
Irreversible Damage ◽  
Immune Mediated ◽  
The Complement System

Inflammation and coagulation are key basic mechanism of protection against all potentially pathogenic mechanical and biological factors targeting human organism from inner and outer environment. On the other hand, uncontrolled inflammation results in hypercoagulation, inhibition of anticoagulation and alteration of mechanisms responsible for resolution of inflammation, while production of “procoagulant” mediators (thrombin, tissue factor and others), activation of platelets and of vascular endothelial cells maintains inflammation. All factors taken together serve as the basis for a pathological process called thromboinflammation or immunothrombosis. Currently thromboinflammation is considered in the broad sense as a universal pathogenetic mechanism of numerous widespread acute and chronic conditions, including immune-mediated (autoimmune) inflammatory rheumatic diseases, oftentimes complicated by severe irreversible damage to vital organs. Thromboinflammation gained specific attention during СОVID-19 (coronavirus disease 2019) pandemic, caused by SARS-Cov-2 (severe acute respiratory syndrome Coronavirus-2). COVID-19 is considered currently as systemic thromboinflammation syndrome, manifesting via generalized thrombosis of arterial and venous macro- and microvasculature, termed as COVID-19-coagulopathy. The paper discusses common pathogenetic coagulopathy mechanisms in COVID-19 and immune-mediated (autoimmune) inflammatory rheumatic diseases (IMRDs), associated with overproduction of antiphospholipid antibodies, activation of the complement system, and dis-regulated synthesis of proinflammatory cytokines, etc. Delineating the autoimmune subtype of thromboinflammation, identification of genetic (i.e., genes encoding the complement system and others) and molecular-biologic biomarkers associated with higher occurrence of COVID-19-coagulopathy are the most relevant undertakings for the current practice. Gaining insights into mechanisms of thromboinflammation and converting them into potential pharmacotherapies of IMDs would facilitate and accelerate the drafting of effective therapeutic strategies for COVID-19. 

scholarly journals Autoimmune inflammatory syndrome induced by adjuvants (silicone breast implants and lip fillers)

2021 ◽  
Vol 72 (1) ◽  
pp. 1-5
Author(s):  
Božidar Pocevski ◽  
Slavica Pavlov-Dolijanović
Keyword(s):  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Systemic Disease ◽  
Breast Implants ◽  
Inflammatory Rheumatic Diseases ◽  
Silicone Breast Implants ◽  
Immune Mediated ◽  
Systemic Symptoms ◽  
Patients Experience ◽  
Inflammatory Syndrome

Introduction: Silicone breast implants (SBI) have been used since 1962 in the reconstruction of post-mastectomy cases, in augmentation of the breast, or for cosmetic purposes, while fillers with biopolymer (FB) have been used since the 1990s. Today, they are considered adjuvants of the immune system. Most complications of SBI and FB are local in nature, but some patients experience systemic symptoms, which are defined as adjuvant-induced autoimmune inflammatory syndrome (ASIA). Aim: The aim of this study is to demonstrate the possible association of silicone breast implants and FB with the development of immune-mediated inflammatory rheumatic diseases (IMIRD). Material and methods: The research represents retrospective study which involved 15 female patients with immune-mediated inflammatory rheumatic diseases, 6 of whom were patients with implanted silicone breast implants for cosmetic reasons, and 9 patients with placement of fillers with biopolymer on the lips. Results: The average time from silicone implantation to the onset of the first symptoms was 6.10 ± 5.3 (range 6 months to 24 years). The following immune-mediated inflammatory rheumatic diseases were recorded: 3 patients with systemic sclerosis (SSc), 3 patients with undifferentiated arthritis, 3 patients with seropositive rheumatoid arthritis, 1 patient with systemic lupus erythematosus, 2 patients with undifferentiated SCTD, 2 patients with mixed connective tissue disease, and one patient with unexplained systemic disease. Seven patients had the Raynaud phenomenon. Spontaneous abortions were reported in 2 patients. Conclusion: Earlier reports that silicone breast implants and biopolymer fillers are safe, today are changing with the description of ASIA syndrome.

scholarly journals Main Oral Manifestations in Immune-Mediated and Inflammatory Rheumatic Diseases

2018 ◽  
Vol 8 (1) ◽  
pp. 21 ◽  
Author(s):  
Roberta Gualtierotti ◽  
Angelo Marzano ◽  
Francesco Spadari ◽  
Massimo Cugno
Keyword(s):  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Adverse Reactions ◽  
Systemic Disease ◽  
Signs And Symptoms ◽  
Temporomandibular Joint Disorders ◽  
Inflammatory Rheumatic Diseases ◽  
Oral Manifestations ◽  
Dental Clinics ◽  
Immune Mediated

Oral manifestations are frequent in patients with rheumatic diseases. The aim of this review is to offer readers practical advice concerning the onset, diagnosis and treatment of the main oral manifestations encountered in rheumatological and dental clinics. Signs and symptoms such as oral hyposalivation, xerostomia, temporomandibular joint disorders, periodontal disease, and dysphagia may be the first expression of a number of rheumatic diseases. Some of these manifestations are aspecific and very frequent, such as oral aphthosis, which can be the first manifestation in patients with systemic lupus erythematosus; some are potentially dangerous, such as jaw claudication during the course of giant cell arteritis; and some are very rare but peculiar, such as strawberry-like gingivitis in patients with granulomatosis with polyangiitis. Other oral manifestations are due to adverse reactions to disease-modifying anti-rheumatic drugs. Oral alterations in rheumatic diseases are frequently overlooked in clinical practice, but their prompt recognition not only allows the local lesions to be appropriately treated, but also makes it possible to identify an underlying systemic disease.

scholarly journals Vaccination in Rheumatology: New Data (Based on Recommendations of the European League Against Rheumatism)

2020 ◽  
Vol 65 (1-2) ◽  
pp. 61-67
Author(s):  
B. S. Belov ◽  
G. M. Tarasova ◽  
N. V. Muravyova
Keyword(s):  
Rheumatic Diseases ◽  
Adult Patients ◽  
Morbidity And Mortality ◽  
Future Research ◽  
Inflammatory Rheumatic Diseases ◽  
European League Against Rheumatism ◽  
Immune Mediated ◽  
Prevention Of Infections ◽  
European League

Comorbid infections have a significant effect on morbidity and mortality in modern rheumatology, especially in immune-mediated inflammatory rheumatic diseases (IMIRD). In this regard, vaccination is becoming increasingly important in the prevention of infections in IMIRD. The article analyzes an updated version of the recommendations for vaccination of adult patients with IMIRD, proposed by experts of the European League Against Rheumatism at the end of 2019. The safety and immunogenicity of vaccination associated with the prevention of various infections in patients with IMIRD are discussed. The main directions of future research on this issue are outlined.

scholarly journals Cancer alertness in patients with rheumatic diseases

2020 ◽  
Vol 14 (2) ◽  
pp. 117-122
Author(s):  
A. S. Sycheva ◽  
A. M. Lila ◽  
A. L. Vertkin ◽  
D. A. Khlanta
Keyword(s):  
Rheumatic Diseases ◽  
Early Stage ◽  
Correct Diagnosis ◽  
Malignant Neoplasms ◽  
Inflammatory Rheumatic Diseases ◽  
Cytostatic Therapy ◽  
Cancer Treatments ◽  
Common Features ◽  
Immune Mediated ◽  
Specific Cancer

The processes that vary in nature and underlie the pathogenesis of malignant neoplasms (MNs) and immune-mediated inflammatory rheumatic diseases (RDs) share just the same some common features. Thus, many early-stage neoplasias can mask autoimmune diseases, requiring that physicians of various specialties should comply with the principle of cancer alertness. When specific cancer treatments (immunotherapy, cytostatic therapy, radiotherapy) are performed, there may be certain rheumatic syndromes (arthritis, myalgia, serositis, etc.) that require a differential diagnosis. At the same time, the course of a number of RDs (rheumatoid arthritis, Sjögren's syndrome, and polymyositis) can be accompanied by the development of MNs, which is relevant for real clinical practice and calls for further investigation.The community of etiological factors and a genetic predisposition in the development of RDs and MNs remain to be of no less importance. At the same time, therapists should pay attention to the presence of rheumatic masks in many MNs, which undoubtedly prolongs the time between onset of the first symptoms and correct diagnosis.

scholarly journals COVID-19 and immune-mediated inflammatory rheumatic diseases

2021 ◽  
Vol 30 (1) ◽  
pp. 24-29
Author(s):  
E.L. Nasonov
Keyword(s):  
Rheumatic Diseases ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Drug Repurposing ◽  
Medical Community ◽  
Inflammatory Rheumatic Diseases ◽  
Immune Disorders ◽  
Jak Inhibitors ◽  
Off Label ◽  
Immune Mediated

During the pandemics of COVID-19 associated with SARS-CoV-2, great attention in the medical community was devoted to the new clinical and basic issues of immune pathogenesis of human diseases. The detailed analysis of clinical signs and symptomes and immune disorders that occur in COVID-19 patients suggested that SARS-CoV-2 infection is associated with various extrapulmonary clinical manifestations and laboratory abnormalitites that are typical for immune-mediated rheumatic diseases. These data justified drug repurposing and the off-label administration of various medications specially designed for patients with immune-mediated rheumatic diseases for the treatment of COVID-19. The author reviews the prospects for administration of glucocorticoids, biologic agents, JAK inhibitors and other anti-cytokine agents in patients with COVID-19.

scholarly journals Immune responses to mRNA vaccines against SARS-CoV-2 in patients with immune-mediated inflammatory rheumatic diseases

RMD Open ◽  
2022 ◽  
Vol 8 (1) ◽  
pp. e001898
Author(s):  
Cristiana Sieiro Santos ◽  
Sara Calleja Antolin ◽  
Clara Moriano Morales ◽  
Juan Garcia Herrero ◽  
Elvira Diez Alvarez ◽  
...  
Keyword(s):  
Immune Responses ◽  
B Cell ◽  
Rheumatic Diseases ◽  
Cellular Responses ◽  
Phase Iii ◽  
Inflammatory Rheumatic Diseases ◽  
Vaccine Responses ◽  
Immune Mediated ◽  
Antibody Titres ◽  
Immunosuppressed Patients

BackgroundPatients with immune-mediated rheumatic diseases (IMRDs) are commonly treated with immunosuppressors and prone to infections. Recently introduced mRNA SARS-CoV-2 vaccines have demonstrated extraordinary efficacy across all ages. Immunosuppressed patients were excluded from phase III trials with SARS-CoV-2 mRNA vaccines.AimsTo fully characterise B-cell and T-cell immune responses elicited by mRNA SARS-CoV-2 vaccines in patients with rheumatic diseases under immunotherapies, and to identify which drugs reduce vaccine’s immunogenicity.MethodsHumoral, CD4 and CD8 immune responses were investigated in 100 naïve patients with SARS-CoV-2 with selected rheumatic diseases under immunosuppression after a two-dose regimen of SARS-CoV-2 mRNA vaccine. Responses were compared with age, gender and disease-matched patients with IMRD not receiving immunosuppressors and with healthy controls.ResultsPatients with IMRD showed decreased seroconversion rates (80% vs 100%, p=0.03) and cellular immune responses (75% vs 100%, p=0.02). Patients on methotrexate achieved seroconversion in 62% of cases and cellular responses in 80% of cases. Abatacept decreased humoral and cellular responses. Rituximab (31% responders) and belimumab (50% responders) showed impaired humoral responses, but cellular responses were often preserved. Antibody titres were reduced with mycophenolate and azathioprine but preserved with leflunomide and anticytokines.ConclusionsPatients with IMRD exhibit impaired SARS-CoV-2 vaccine immunogenicity, variably reduced with immunosuppressors. Among commonly used therapies, abatacept and B-cell depleting therapies show deleterious effects, while anticytokines preserved immunogenicity. The effects of cumulative methotrexate and glucocorticoid doses on immunogenicity should be considered. Humoral and cellular responses are weakly correlated, but CD4 and CD8 tightly correlate. Seroconversion alone might not reflect the vaccine’s immunogenicity.

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