scholarly journals Evaluation of serum markers of the immune response and bone metabolism facilitates early detection of psoriatic arthritis in patients with psoriasis

2020 ◽  
Vol 49 ◽  
Author(s):  
K. M. Koreshkova ◽  
Z. R. Khismatullina
Keyword(s):  
Immune Response ◽  
Parathyroid Hormone ◽  
Psoriatic Arthritis ◽  
Bone Metabolism ◽  
Matrix Protein ◽  
Clinical Chemistry ◽  
Past History ◽  
Human Leukocyte ◽  
Control Group ◽  
Open Label

Relevance: Psoriatic arthritis (PA) is a severe complication of psoriasis, leading to progressive damage to the musculoskeletal system, a decrease in the quality of life and early disability. CASPAR criteria, widely used for PA diagnosis, are highly sensitive and specific. However, some patients with psoriasis score ≥ 3 with CASPAR criteria without an established PA diagnosis. At present, there is a search for PA biomarkers, which could mirror the stages of pathogenesis of joint and enthesis destruction in this disease.Aim: To identify the most significant changes in biochemical parameters in patients with PA, that would be pathophysiologically associated with the disease.Materials and methods: We performed an open label comparative parallel group study in 60 patients with PA and 40 patients with psoriasis without PA. Clinical assessments included filling in the questionnaires, past history, dermatologist consultation, severity of psoriasis by PASI, and PA activity. Clinical chemistry examination included the levels of antibodies to citrullinated peptide, erythrocyte sedimentation rate, C-reactive protein (CRP), human leukocyte antigen HLA B27, immunoglobulins A, M, and G, complement system components C3, C4, circulating immune complexes (CIC), as well as bone metabolism parameters (calcium, phosphorus, magnesium, seromucoid, alkaline phosphatase (AP), osteocalcin, parathyroid hormone, vitamin D, matrix metalloproteinases MMP-1, MMP-3, MMP-8, and cartilage oligomeric matrix protein (СОМР).Results: Psoriasis was diagnosed in 86.6% (n = 52) of the patients with PA. Family history of psoriasis was confirmed in 55.0% (n = 22) of the patients with psoriasis without PA and in 60.0% (n = 36) of the patients with PA (p = 0.681). Compared to the patients with psoriasis without PA, the patients with PA had higher prevalence of psoriatic onychodystrophy (71.6%, n = 43, vs. 35.0%, n = 14, p = 0.0004), dactylitis (28.3%, n = 17, vs. 5.0%, n = 2, p = 0.004), extra-articular bone proliferation signs (26.6%, n = 16, vs. 5.0%, n = 2, p = 0.006). In the patients with PA, compared to those without PA, there was a significant increase in CRP levels (27.4 vs. 9.5 mg/l, p = 0.002), more than 2-fold increase in IgM and IgG (IgM, 2.35 vs. 1.2 g/l, p = 0.023; IgG, 17.7 vs. 8.45 g/l, p < 0.0001), and CIC (89.3 vs. 29.5 mU/ml, p = 0.0003). Serum phosphorus and magnesium levels in the patients with PA were lower than in the psoriasis patients without PA (phosphorus 0.8 vs. 1.6 mmol/l, respectively, p = 0.045, magnesium 0.5 vs. 1.0 mmol/l, respectively, p = 0.001), with somewhat higher parathyroid hormone levels (67.3 vs. 25.1 ng/ml, respectively, p = 0.013). Osteocalcin levels in the PA patients were by 37.3% lower than in the patients with psoriasis without PA (17.57 vs. 24.13 ng/ml, respectively, p = 0.004). MMP-1 levels in the PA group were 12.3-fold higher than in the non-PA group (37.68 vs. 3.05 ng/ml, respectively, p < 0.0001), and MMP-3 levels were 3.7-fold higher (42.35 vs. 11.36 ng/ml, respectively, p = 0.022). In the patients with PA, AP levels were 2.52-fold higher than in the control group (150.2 vs. 59.5 U/ml, respectively, p = 0.007), and COMP levels were 2.08-fold higher (415.2 vs. 199.5 ng/ml, respectively, p = 0.006).Conclusion: The patients with PA have higher serum CRP, IgM, IgG, CIC, MMP-1, MMP-3, AP, and COMP levels and lower osteocalcin, phosphorus, and magnesium concentrations, than the patients with psoriasis. These parameters are not PA-specific; however, the search for the most sensitive biomarkers of the systemic immune response and bone remodeling seems to be a promising area of research, since identification of such markers would allow for timely prediction and detection of PA in patients with psoriasis.

scholarly journals Value of Entheseal Ultrasonography and Serum Cartilage Oligomeric Matrix Protein in the Preclinical Diagnosis of Psoriatic Arthritis

2010 ◽  
Vol 3 ◽  
pp. CMAMD.S4461 ◽  
Author(s):  
Hanan Mohamed Farouk ◽  
Afaf Abdel Alim Mostafa ◽  
Sahar S. Youssef ◽  
Moataz Mohammed Samy Elbeblawy ◽  
Naglaa Youssef Assaf ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Cartilage Oligomeric Matrix Protein ◽  
Matrix Protein ◽  
Serum Levels ◽  
Lower Limbs ◽  
Control Group ◽  
Group I ◽  
Significant Difference ◽  
Preclinical Diagnosis ◽  
Group Ii

Objective To evaluate the utility of entheseal ultrasonography and serum COMP in the preclinical diagnosis of psoriatic arthritis. Methods 60 psoriatic patients were divided into: 30 patients with psoriasis (group I) and 30 patients with psoriatic arthritis as control (group II). They underwent independent clinical and ultrasonographic examination of both lower limbs at the calcaneal insertions of Achilles tendons. Psoriatic arthritis disease activity and severity was assessed by modified DAS28 and Steinbrockers scores. Serum levels of COMP were measured for all patients by ELISA. Results On clinical examination, no entheseal abnormalities were detected in group I while they were present in 23.3% of group II with statistically significant difference between them ( P < 0.001). Ultrasonographic entheseal abnormalities were detected in 33.3% of group I and in 46.7% of group II with no significant difference between them ( P > 0.05). Serum COMP were significantly elevated in group I and II with no statistically significant difference between them (mean ± SD 5.9 ± 3 and 6.8 ± 12 respectively, P > 0.05). Entheseal ultrasound was more specific (67%) while serum COMP was more sensitive (87%) in the preclinical diagnosis of psoriatic arthritis. Serum COMP levels were significantly correlated with CRP in both groups and with DAS28 and Steinbrockers scores in group II ( P < 0.01). Conclusion Entheseal ultrasonography and serum COMP levels may be used complementary to each other for preclinical diagnosis of psoriatic arthritis. Serum COMP seems to be promising prognostic marker for psoriatic arthritis patients.

scholarly journals Distribution patterns of HLA-A*, B*, DRB1* allele groups among persons who underwent COVID-19

2021 ◽  
Vol 23 (3) ◽  
pp. 523-532
Author(s):  
L. N. Bubnova ◽  
I. E. Pavlova ◽  
A. S. Berkos ◽  
M. A. Terentyeva ◽  
T. V. Glazanova ◽  
...  
Keyword(s):  
Immune Response ◽  
Population Control ◽  
Human Leukocyte ◽  
Distribution Patterns ◽  
Clinical Severity ◽  
Control Group ◽  
Human Populations ◽  
The North ◽  
Environmental Pathogens ◽  
Hla Haplotypes

The main histocompatibility complex — HLA system (Human Leukocyte Antigens) is among the most important genetic factors determining response of humans to infectious agents. The key role that HLA molecules play in immune response is to present the pathogen-derived peptides. Enormous molecular variability of HLA alleles in human populations have attracted close attention and became the basis for numerous studies aimed at evaluating the role of HLA genotypes for individual features of immune response to COVID-19, the new infection caused by SARS-CoV-2 β-coronavirus. Many studies have focused on search of specific alleles associated with both susceptibility and resistance to this disease. Separate HLA patterns were reported already. These patterns may be either universal to several populations, or rather peculiar, since distribution of HLA genes is different for various populations, depending on the living conditions, including specific protection from environmental pathogens. Therefore, it is evident that individual effects of HLA genotype upon occurrence and course of SARS-CoV-2 infection should be performed in comparison with the HLA distribution among the residents of appropriate region. The objective of this study was to compare the distribution of HLA-A*, B*, DRB1* allele groups, and to analyze the frequencies of HLA-AB-DRB1 haplotypes in subjects with COVID-19 (n = 138), compared with the control group presented by residents of the North-Western Russia (n = 1456). The most significant differences between COVID-19 patients compared with a group from control population were revealed for the groups of HLA-A* alleles: the frequencies of HLA-A*02 and HLA-A*26 were significantly reduced (39.86% versus 51.72%, χ2 = 7,58, and 4.35% versus 9.07%, χ2 = 4.17, respectively). At the same time, the frequency of HLA-A*29 was increased more than 2-fold (5.80% versus 2.47%, χ2 = 4.03). This finding suggests that the allele groups A*02 and A*26 are associated with reduced likelihood of the disease, while A*29, is an apparent factor predisposing for susceptibility to the disease. It was found that occurrence of definite HLA haplotypes, including the A*02 allele group, is less common in persons who have undergone COVID-19, and are ranged at the 4th, 7th and 10th positions in frequency, while in the population control group such HLA haplotypes took the 3rd, 4th, 7th and 8th places. Further evaluation of the HLA gene polymorphism will allow to understand the predetermined immunogenetic basis for susceptibility, as well as clinical severity of COVID-19.

scholarly journals Intensive fever control using a therapeutic normothermia protocol in patients with febrile early septic shock: A randomized feasibility trial and exploration of the immunomodulatory effects

2020 ◽  
Vol 8 ◽  
pp. 205031212092873 ◽  
Author(s):  
Jutamas Saoraya ◽  
Khrongwong Musikatavorn ◽  
Patima Puttaphaisan ◽  
Atthasit Komindr ◽  
Nattachai Srisawat
Keyword(s):  
Septic Shock ◽  
Human Leukocyte ◽  
Feasibility Trial ◽  
Control Group ◽  
Immunomodulatory Effects ◽  
Open Label ◽  
Cd11b Expression ◽  
Reactive Protein ◽  
Short Term Mortality ◽  
Clinical Trials Registry

Objectives: Fever control has been shown to reduce short-term mortality in patients with septic shock. This study aimed to explore the feasibility of early intensive fever control in patients with septic shock and to assess the immunomodulatory effects of this intervention. Methods: In this single-center, randomized, open-label trial, febrile patients with septic shock presenting to the emergency department were assigned to either a standard fever control or therapeutic normothermia group. Therapeutic normothermia involved intensive fever control in maintaining normothermia below 37°C. The primary outcome was the feasibility of fever control for 24 h. Secondary outcomes included changes in immunomodulatory biomarkers and adverse events. Results: Fifteen patients were enrolled and analyzed. Fever control was comparable in both groups, but significantly more patients in the therapeutic normothermia group experienced shivering ( p = 0.007). Both groups demonstrated increased C-reactive protein and unchanged neutrophil chemotaxis and CD11b expression. The therapeutic normothermia group revealed significant decreased IL-6 and IL-10. The standard fever control group significantly expressed increased monocytic human leukocyte antigen. There were no significant differences between the groups in terms of immunomodulation. Conclusions: Therapeutic normothermia was feasible in patients with febrile septic shock but was not superior to standard fever control in terms of average body temperature and host defense function. Shivering was more frequent in the therapeutic normothermia group. Trial registration: Thai Clinical Trials Registry number: TCTR20160321001

scholarly journals Assessment of the Concentration of Bone Metabolism Markers: Sclerostin and FGF-23 in Children with Idiopathic Nephrotic Syndrome Treated with Glucocorticosteroids

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Agnieszka Pukajło-Marczyk ◽  
Anna Jakubowska ◽  
Agnieszka Bargenda-Lange ◽  
Katarzyna Kiliś-Pstrusińska ◽  
Danuta Zwolińska
Keyword(s):  
Nephrotic Syndrome ◽  
Parathyroid Hormone ◽  
Bone Metabolism ◽  
Idiopathic Nephrotic Syndrome ◽  
Fibroblast Growth Factor 23 ◽  
Control Group ◽  
Healthy Children ◽  
Positive Correlation ◽  
Long Term Treatment ◽  
Fgf 23

Recurring nature of idiopathic nephrotic syndrome (INS) and steroid dependence imply a long-term treatment with glucocorticosteroids (GCSs), which increases the risk of bone metabolism disorders. The search for new markers of that process is essential. The aims of this study were to assess the concentrations of sclerostin (Scl) and fibroblast growth factor-23 (FGF-23) in the plasma of children with INS and compare Scl and FGF-23 to existing markers of bone metabolism, mainly parathyroid hormone (PTH). The study involved 70 children, 50 with INS and 20 healthy children. Patients with INS were divided into 4 groups depending on the number of relapses and applied therapy. Significantly higher concentrations of FGF-23 and Scl were found in all patient groups with INS compared to the control group, and increase in the concentrations of examined parameters depending on the number of NS relapses was showed. In patients from the group with numerous relapses, higher concentrations of FGF-23 and Scl in the relapse phase than those in the remission phase were found. We observed positive correlation in these proteins with parathyroid hormone. Positive correlation of FGF-23 and Scl in the examined group was noted. Children having relapsing INS treated with steroids have higher levels of Scl and FGF-23 that can indicate the bone metabolism disorders. The significance of these observations requires further research.

MYCOPLASMA AND CHLAMYDIA AS ETHIOLOGICAL FACTORS OF BRONCHIAL ASTHMA IN TERMS OF ETHNOGENESIS

2013 ◽  
Vol 68 (7) ◽  
pp. 57-60
Author(s):  
O. A. Sharavii ◽  
S. V. Smirnova
Keyword(s):  
Immune Response ◽  
Chlamydia Trachomatis ◽  
Blood Serum ◽  
Bronchial Asthma ◽  
Mycoplasma Hominis ◽  
Acute Stage ◽  
Control Group ◽  
Clinical Markers ◽  
Chlamydophila Psittaci ◽  
Asthma Patients

 Aim. The study of the prevalence and clinical peculiarities of Mycoplasmosis and Chlamydiosis in patients with different pathogenic forms of bronchial asthma (BA) taking into account ethnicity of a patient. Subjects and Methods. The research covered 239 subjects – both the Europeoids and the Mongoloids in the city of Krasnoyarsk and the town of Kyzyl, all of them being BA patients of different stages, including acute stage and practically healthy. We had determined antigens Mycoplasma pneumoniae, Mycoplasma hominis, Chlamydophila pneumoniae, Chlamydophila psittaci and Chlamydia trachomatis in smears of mucosa of pharynx and antibodies to these antigens in peripheral blood serum. Results.  We found high frequency of Mycoplasmosis and Chlamydiosis in the inhabitants of Eastern Siberia, BA patients with different pathogenic forms as compared to control group. We had determined ethnic peculiarities of specific immune response: IgM to М. pneumoniae was revealed in the Europoids more frequently than in the Mongoloids, but IgM to С. pneumoniae and to C. trachomatis, C. trachomatis antigens had been revealed more often in the Mongoloids than in the Europoids. We accepted as clinical equivalents of Mycoplasmosis and Chlamydiosis diagnostics the following signs: temperature around 37C (subfebrile temperature), non-intensive but stable coughing with scanty mucous and muco-purulent sputum, dyspnea of mixed character. Conclusions. Mycoplasma and Chlamydia are meaningful etiologic factors of bronchial asthma. We have found the peculiarities of immune response depending on ethnicity of a patient (ethnic belonging). Clinical markers of Mycoplasmosis and Chlamydiosis should be taken into account in bronchial asthma in order to provide diagnostics timely as well as eradication of infection agents. Because of insufficient knowledge of problem of bronchial asthma related to contamination with Мycoplasma and Chlamydia we put the goal to study the frequency of Mycoplasmosis and Chlamydiosis occurrence in bronchial asthma patients and determine the characteristics clinical course of diseases. We defined antigens Мycoplasma pneumoniae, Мycoplasma hominis, Chlamydophila pneumoniaе, Chlamydophila psittaci, Chlamydia trachomatis in smears of oropharynx mucosa and antibodies to them in blood serum. 

Effects of feeding Isomaltooligosaccharides on the growth performance, carcass traits and immune response of broiler chickens

2014 ◽  
Vol 3 (1) ◽  
pp. 150-157
Author(s):  
Khalid M. Gaafar
Keyword(s):  
Immune Response ◽  
Growth Performance ◽  
Broiler Chickens ◽  
Carcass Traits ◽  
Dietary Supplementation ◽  
Control Group ◽  
Broiler Chicks ◽  
Feed Conversion ◽  
Flu Vaccine ◽  
Lipids Profile

The research was conducted to study the effect of feeding broiler chickens on diets containing isomaltooligosaccharides on the growth performance, carcass traits and immune response. 90-one day old broiler chicks were used according to completely randomized two treatment groups and one control, 30 birds each. Birds fed ad-libitum on basal starter and grower-finisher diets for 35 day. Diets of treatment`s groups contained 0.5 g/Kg and 1 g/Kg of Isomaltooligosaccharides, while the control group fed on the basal diets without Isomaltooligosaccharides supplementation. Dietary supplementation of broiler chickens with Isomaltooligosaccharides improved body weight, feed conversion, carcass traits, two lymphoid organs weight and log antibody titer against avian flu vaccine. Most of the highest values were for birds fed low levels of Isomaltooligosaccharides. Feed intake decreases as Isomaltooligosaccharides level increases. Dietary supplementation with Isomaltooligosaccharides did not affect the lipids profile (triglycerides, total cholesterol, LDL and HDL), however the blood VLDL levels decreased with increased levels of Malondialdehyde and Glutathione reductase. Collectively, Dietary supplementation of broiler chickens with 0.5 g/Kg diet of Isomaltooligosaccharides improved growth performance, carcass traits and immune status.

Investigating the Impact of Cognitive Training for Individuals With Bothersome Tinnitus: A Randomized Controlled Trial

2021 ◽  
pp. 019459982199474
Author(s):  
Maggie Xing ◽  
Dorina Kallogjeri ◽  
Jay F. Piccirillo
Keyword(s):  
Randomized Controlled Trial ◽  
Cognitive Training ◽  
Mixed Model ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Functional Index ◽  
Open Label ◽  
Randomized Controlled ◽  
The Impact

Objective To evaluate the effectiveness of cognitive training in improving tinnitus bother and to identify predictors of patient response. Study Design Prospective open-label randomized controlled trial. Setting Online. Methods Participants were adults with subjective idiopathic nonpulsatile tinnitus causing significant tinnitus-related distress. The intervention group trained by using auditory-intensive exercises for 20 minutes per day, 5 days per week, for 8 weeks. The active control group trained on the same schedule with non–auditory intensive games. Surveys were completed at baseline, 8 weeks, and 12 weeks. Results A total of 64 participants completed the study. The median age was 63 years (range, 25-69) in the intervention group and 61 years (34-68) in the control group. Mixed model analysis revealed that within-subject change in Tinnitus Functional Index in the intervention group was not different than the control group, with marginal mean differences (95% CI): 0.24 (–11.20 to 10.7) and 2.17 (–8.50 to 12.83) at 8 weeks and 2.33 (–8.6 to 13.3) and 3.36 (–7.91 to 14.6) at 12 weeks, respectively. When the 2 study groups were compared, the control group had higher Tinnitus Functional Index scores than the intervention group by 10.5 points at baseline (95% CI, –0.92 to 29.89), 8.1 at 8 weeks (95% CI, –3.27 to 19.42), and 9.4 at 12 weeks (95% CI, –2.45 to 21.34). Conclusion Auditory-intensive cognitive training was not associated with changes in self-reported tinnitus bother. Given the potential for neuroplasticity to affect tinnitus, we believe that future studies on cognitive training for tinnitus remain relevant.

scholarly journals Effect of Foot-and-Mouth Disease Vaccination on Acute Phase Immune Response and Anovulation in Hanwoo (Bos taurus coreanae)

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 419
Author(s):  
Daehyun Kim ◽  
Joonho Moon ◽  
Jaejung Ha ◽  
Doyoon Kim ◽  
Junkoo Yi
Keyword(s):  
Immune Response ◽  
Artificial Insemination ◽  
Bos Taurus ◽  
Foot And Mouth Disease ◽  
Test Group ◽  
Mouth Disease ◽  
Control Group ◽  
Amyloid A ◽  
Mouth Disease Virus ◽  
Foot And Mouth

Vaccination against foot-and-mouth disease is the most common method for preventing the spread of the disease; the negative effects include miscarriage, early embryo death, lower milk production, and decreased growth of fattening cattle. Therefore, in this study, we analyze the side effects of vaccination by determining the acute immune response and ovulation rate after vaccinating cows for foot-and-mouth disease. The test axis was synchronized with ovulation using 100 Hanwoo (Bos taurus coreanae) cows from the Gyeongsangbuk-do Livestock Research Institute; only individuals with estrus confirmed by ovarian ultrasound were used for the test. All test axes were artificially inseminated 21 days after the previous estrus date. The control group was administered 0.9% normal saline, the negative control was injected intramuscularly with lipopolysaccharide (LPS; 0.5 µg/kg), and the test group was administered a foot-and-mouth disease virus vaccine (FMDV vaccine; bioaftogen, O and A serotypes, inactivated vaccine) 2, 9, and 16 days before artificial insemination. White blood cells and neutrophils increased significantly 1 day after vaccination, and body temperature in the rumen increased for 16 h after vaccination. Ovulation was detected 1 day after artificial fertilization by ovarian ultrasound. The ovulation rates were as follows: control 89%, LPS 60%, FMDV vaccine (−2 d) 50%, FMDV vaccine (−9 d) 75%, and FMDV vaccine (−16 d) 75%. In particular, the FMDV vaccine (−2 d) test group confirmed that ovulation was delayed for 4 days after artificial insemination. In addition, it was confirmed that it took 9 days after inoculation for the plasma contents of haptoglobin and serum amyloid A to recover to the normal range as the main acute immune response factors. The conception rate of the FMDV vaccine (−2 d) group was 20%, which was significantly lower than that of the other test groups.

The changes in bone turnover markers of female systemic lupus erythematousus patients without glucocorticoid

Lupus ◽  
2021 ◽  
Vol 30 (6) ◽  
pp. 965-971
Author(s):  
Wang Tianle ◽  
Zhang Yingying ◽  
Hong Baojian ◽  
Gu Juanfang ◽  
Wang Hongzhi ◽  
...  
Keyword(s):  
Bone Resorption ◽  
Bone Formation ◽  
Bone Turnover ◽  
Bone Metabolism ◽  
Bone Turnover Markers ◽  
Control Group ◽  
Bone Resorption Marker ◽  
Amino Terminal ◽  
Normal People ◽  
Turnover Markers

Objectives SLE is a chronic autoimmune disease, which can affect the level of bone metabolism and increase the risk of osteoporosis and fracture. The purpose of this research is to study the effect of SLE on bone turnover markers without the influence of glucocorticoids. Methods A total of 865 female subjects were recruited from Zhejiang Provincial People’s Hospital and the First Hospital of Jiaxing, including 391 SLE patients without the influence of glucocorticoids and 474 non-SLE people. We detected Bone turnover markers including amino-terminal propeptide of type 1 procollagen (P1NP), C-terminal turnover of β - I collagen (β-CTX), N-terminal midfragment of osteocalcin (NMID) and 25(OH)D, and analyzed the difference in Bone turnover markers between the SLE group and the control group, as well as the influence of age and season on bone metabolism in female SLE patients. Results In the SLE group, the average age was 43.93±13.95 years old. In the control group, the average age was 44.84±11.42 years old. There was no difference between the two groups (t = 1.03, P = 0.30). P1NP, NMID and 25(OH)D in the SLE group were significantly lower than those in the control group (Z = 8.44, p < 0.001; Z = 14.41, p < 0.001; Z = 2.19, p = 0.029), and β-CTX in the SLE group was significantly higher than that in the control group (Z = 2.61, p = 0.009). In addition, the levers of β-CTX, NMID, P1NP and 25(OH)D in older SLE female patients were statistically significantly higher than those in younger (ρ = 0.104, p = 0.041; ρ = 0.223, p < 0.001; ρ = 0.105, p = 0.038; ρ = 0.289, p < 0.001). Moreover, β-CTX reached a high value in summer and PINP reached a low value in winter. Conclusion The bone formation markers of female SLE patients without glucocorticoid were lower than those of normal people and the bone resorption marker was higher than that of normal people. The 25 (OH) D of female SLE patients without glucocorticoid was lower than that of normal people. The risk of osteoporosis and fracture may be higher in elderly women with SLE. The bone resorption level of female SLE patients is high in summer and the bone formation level is low in winter.

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