COVID-19: a Great Mime or a Trigger Event of Autoimmune Manifestations?

2020 ◽  
Vol 16 ◽  
Author(s):  
Maria Celeste Fatone
Keyword(s):  
Autoimmune Diseases ◽  
Systemic Vasculitis ◽  
Skin Lesions ◽  
Endothelial Damage ◽  
Direct Role ◽  
Acute Interstitial Pneumonia ◽  
Trigger Event ◽  
The Common ◽  
Microvascular Inflammation ◽  
Autoimmune Phenomena

: Viruses can induce autoimmune diseases, in addition to genetic predisposition and environmental factors. Particularly, coronaviruses are mentioned among the viruses implicated in autoimmunity. Today, the world's greatest threat derives from the pandemic of a new human coronavirus, called “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2), the responsible agent of coronavirus disease 2019 (COVID-19). COVID-19 originated in Wuhan, the capital of Hubei, China in December 2019 and, to date, has spread to at least 187 countries. This review focuses on autoimmune manifestations described during COVID-19, including pro-thrombothic state associated to antiphospholipid antibodies (aPL), acute interstitial pneumonia, macrophage activation syndrome, lymphocytopenia, systemic vasculitis, and autoimmune skin lesions. This offers the opportunity to highlight the pathogenetic mechanisms common to COVID19 and several autoimmune diseases, in order to identify new therapeutic targets. In a supposed preliminary pathogenetic model, SARS-CoV-2 plays a direct role in triggering widespread microthrombosis and microvascular inflammation, because it is able to induce transient aPL, endothelial damage and complement activation at the same time. Hence, endothelium might represent the common pathway in which autoimmunity and infection converge. In addition, autoimmune phenomena in COVID-19 can be explained by regulatory T cells impairment and cytokines cascade.

Hyperstimulation of the immune system as a cause of autoimmune diseases

2020 ◽  
Vol 75 (3) ◽  
pp. 204-213
Author(s):  
Varvara A. Ryabkova ◽  
Leonid P. Churilov ◽  
Yehuda Shoenfeld
Keyword(s):  
Immune System ◽  
Autoimmune Diseases ◽  
Genetic Basis ◽  
Threshold Model ◽  
Subsequent Development ◽  
Threshold Effect ◽  
Successful Management ◽  
Polygenic Inheritance ◽  
Autoimmune Pathology ◽  
The Common

The pathogenesis of autoimmune diseases is very complex and multi-factorial. The concept of Mosaics of Autoimmunity was introduced to the scientific community 30 years ago by Y. Shoenfeld and D.A. Isenberg, and since then new tiles to the puzzle are continuously added. This concept specifies general pathological ideas about the multifactorial threshold model for polygenic inheritance with a threshold effect by the action of a number of external causal factors as applied to the field of autoimmunology. Among the external factors that can excessively stimulate the immune system, contributing to the development of autoimmune reactions, researchers are particularly interested in chemical substances, which are widely used in pharmacology and medicine. In this review we highlight the autoimmune dynamics i.e. a multistep pathogenesis of autoimmune diseases and the subsequent development of lymphoma in some cases. In this context several issues are addressed namely, genetic basis of autoimmunity; environmental immunostimulatory risk factors; gene/environmental interaction; pre-clinical autoimmunity with the presence of autoantibodies; and the mechanisms, underlying lymphomagenesis in autoimmune pathology. We believe that understanding the common model of the pathogenesis of autoimmune diseases is the first step to their successful management.

scholarly journals AB0463 ETIOLOGY OF PALPABLE PURPURA; A SINGLE CENTER EXPERIENCE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1530.1-1530
Author(s):  
G. Kaynar ◽  
O. C. İçaçan ◽  
S. Çelik ◽  
M. Yalçin Mutlu ◽  
C. Bes
Keyword(s):  
Drug Use ◽  
Histopathological Examination ◽  
Leukocytoclastic Vasculitis ◽  
Systemic Vasculitis ◽  
Skin Lesions ◽  
Serological Tests ◽  
Recent Infection ◽  
Important Place ◽  
Palpable Purpura ◽  
Underlying Diseases

Background:Purpura are lesions that occur after bleeding on the skin, mucous or serosal surfaces. Purpura can be classified into 2 subgroups; which are linked to thrombocytopenia and non-trombocytopenic purpura. While thrombocytopenic purpura often occurs due to a hematological disease; in non-trombocytopenic purpura etiological causes are very variable, and systemic vasculitis has an important place among them.Objectives:The demographic features of the patients applying with purpura and the underlying causes and diseases were aimed to be revealed.Methods:44 consecutive patients (22 women, 22 men) who were admitted to the hospital in the last 6 months, due to purpura were evaluated. Average age of patients was 49.6 ± 19.6 years. Patients were questioned about a recent infection, drug use, concomitant or underlying diseases. The serological tests and other laboratory tests for etiology were performed and biopsy was taken from the skin lesions which are appropriate.Results:While 4 (9%) patients had widespread purpura on the trunk-upper-lower extremities, in 22 (50%) patients purpuric lesions were limited only to the lower limb. The period between the onset of the first symptom and the admission to the hospital was longer than 4 weeks in 35 (79.5%) patients, and shorter than 1 week in 9 (20.5%) patients. 24 (54%) patients had an anamnesis of infection 2-3 weeks before purpura, and 20 (45%) patients had an anamnesis of drug use. The most common accompanying symptom was abdominal pain and was present in 15 (34%) patients. Biopsy was performed from the skin lesion in 37 patients. Histopathological examination of all was compatible with leukocytoclastic vasculitis. In indirect immunofluorescence staining, 17 were found to be IgA positive. 2 (4.5%) patients were diagnosed PR3-ANCA positive granulomatosis with polyangiitis. 1 patient had Hepatitis B virus infection was detected in 1 patient (2.2%), HIV infection was detected in 1 patient (2.2%) and malignancy was detected in 1 patient (2.2%).Conclusion:In our study, the most common reason was found as IgA vasculitis in patients presenting with palpable purpura. Although vasculitic involvement was limited to the skin in most patients, organ-threatening systemic vasculitis was detected in a few patients. Patients applying with Purpura should be questioned for infection and drug use, should be examined for underlying diseases including systemic vasculitis, and closely monitored for organ involvement.Disclosure of Interests:None declared

scholarly journals HDAC stimulates gene expression through BRD4 availability in response to IFN and in interferonopathies

2018 ◽  
Vol 215 (12) ◽  
pp. 3194-3212 ◽  
Author(s):  
Isabelle J. Marié ◽  
Hao-Ming Chang ◽  
David E. Levy
Keyword(s):  
Autoimmune Diseases ◽  
Histone Deacetylases ◽  
Elongation Factor ◽  
Positive Function ◽  
Transcriptional Elongation ◽  
Hdac Inhibition ◽  
Transcriptional Initiation ◽  
Inducible Promoters ◽  
The Common

In contrast to the common role of histone deacetylases (HDACs) for gene repression, HDAC activity provides a required positive function for IFN-stimulated gene (ISG) expression. Here, we show that HDAC1/2 as components of the Sin3A complex are required for ISG transcriptional elongation but not for recruitment of RNA polymerase or transcriptional initiation. Transcriptional arrest by HDAC inhibition coincides with failure to recruit the epigenetic reader Brd4 and elongation factor P-TEFb due to sequestration of Brd4 on hyperacetylated chromatin. Brd4 availability is regulated by an equilibrium cycle between opposed acetyltransferase and deacetylase activities that maintains a steady-state pool of free Brd4 available for recruitment to inducible promoters. An ISG expression signature is a hallmark of interferonopathies and other autoimmune diseases. Combined inhibition of HDAC1/2 and Brd4 resolved the aberrant ISG expression detected in cells derived from patients with two inherited interferonopathies, ISG15 and USP18 deficiencies, defining a novel therapeutic approach to ISG-associated autoimmune diseases.

Steroid Effects on the Course of Abdominal Pain in Children With Henoch-Schonlein Purpura

PEDIATRICS ◽  
1987 ◽  
Vol 79 (6) ◽  
pp. 1018-1021
Author(s):  
NORMAN D. ROSENBLUM ◽  
HARLAND S. WINTER
Keyword(s):  
Abdominal Pain ◽  
Gastrointestinal Symptom ◽  
Systemic Vasculitis ◽  
Skin Lesions ◽  
Intestinal Bleeding ◽  
Controlled Trials ◽  
Henoch Schonlein Purpura ◽  
Intestinal Lesions ◽  
Schonlein Purpura ◽  
Henoch Schönlein Purpura

Henoch-Schonlein purpura is a systemic vasculitis of unknown cause that is characterized primarily by abdominal pain, arthritis, and purpuric skin lesions. Abdominal pain is the most common gastrointestinal symptom, but intestinal bleeding and intussusception may occur. Previous studies have supported the use of steroids in managing the abdominal pain of Henoch-Schonlein purpura.1,2 Because there are no controlled trials using steroids in this disease, their value in affecting the intestinal lesions of Henoch-Schonlein purpura remains unknown. The purpose of this retrospective study was to assess the effect of corticosteroids on the outcome of abdominal pain in children with Henoch-Schonlein purpura. PATIENTS AND METHODS

scholarly journals Behaviour and Skin Injuries of Piglets Originating from a Novel Group Farrowing System Before and After Weaning

Agriculture ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. 93 ◽  
Author(s):  
Lilith Schrey ◽  
Nicole Kemper ◽  
Michaela Fels
Keyword(s):  
Body Weight ◽  
Weight Gain ◽  
Body Weight Gain ◽  
Skin Lesions ◽  
Lesion Score ◽  
Skin Injuries ◽  
Individual Housing ◽  
Common Area ◽  
Before And After ◽  
The Common

The aim of this study was to analyse a novel group farrowing system (GH) concerning piglets’ behaviour, skin injuries and body weight gain, to test its animal friendliness. Skin injuries and weight gain were compared to piglets originating from conventional individual housing (IH) before and after weaning. The GH system had five farrowing pens without crates, a common area and an area only available for piglets. In total, 34 litters were studied. Four days after the GH-piglets had left the pens during lactation, the lesion score of piglets in GH was higher than in IH. However, piglets from the GH sustained fewer injuries after mixing at weaning, compared to the piglets from IH and had higher daily weight gains, during the early nursery phase. The common area in GH was intensively used for active behaviour, since standing/walking and playing were observed there, most frequently, whereas lying occurred most frequently inside the pens. Immediately after the piglets had left the pens in the GH, the piglets preferred proximity to the sow, compared to the pens where they were born. The GH system enabled social enrichment, offered increased space for activity and led to fewer skin lesions, after weaning; thus, potentially increasing animal welfare.

scholarly journals Primer immunhiány és autoimmun betegségek

2018 ◽  
Vol 159 (23) ◽  
pp. 908-918
Author(s):  
Györgyi Műzes ◽  
Ferenc Sipos
Keyword(s):  
Immune System ◽  
Autoimmune Diseases ◽  
Primary Immunodeficiency ◽  
Adaptive Immune System ◽  
Infectious Complications ◽  
Primary Immunodeficiencies ◽  
Cellular Mechanisms ◽  
Adaptive Immune ◽  
Solid Malignancies ◽  
Autoimmune Phenomena

Abstract: Primary immunodeficiencies consist of a group of genetically heterogeneous immune disorders affecting distinct elements of the innate and adaptive immune system. Patients with primary immunodeficiency are more prone to develop not only recurrent infections, but non-infectious complications, like inflammatory or granulomatous conditions, lymphoproliferative and solid malignancies, autoinflammatory disorders, and a broad spectrum of autoimmune diseases. The concomitant appearance of primary immunodeficiency and autoimmunity appears to be rather paradoxical, therefore making the diagnosis of immunodeficiency patients with autoimmune complications challenging. Mutations of one or more genes playing a fundamental role in immunoregulation and/or immune tolerance network are thought to be responsible for primary immunodeficiencies. The diverse immunological abnomalities along with the compensatory and excessive sustained inflammatory response result in tissue damage and finally in manifestation of organ-, cell-specific or systemic autoimmune diseases. Several forms of primary immunodeficiency disorders are characterized by a variety of specific autoimmune phenomena. This overview addresses the spectrum of autoimmune diseases associated with primary immunodeficiencies, and explores the molecular and cellular mechanisms underlying abnormalities of the immune system. The case presented finally highlights that both the recognition of autoimmune diseases in association with immunodeficiencies and the diagnosis of immunodefiency in those phenotypes with predominant autoimmunity could be challenging. Orv Hetil. 2018; 159(23): 908–918.

DECREASED PROSTACYCLIN-LIKE ACTIVITY IN HENOCH-SCHONBEIN PURPURA

1987 ◽  
Author(s):  
J J F Belch ◽  
S Turi ◽  
M MacLaren ◽  
T J Beattie ◽  
C D Forbes
Keyword(s):  
Platelet Rich Plasma ◽  
Skin Lesions ◽  
Endothelial Damage ◽  
Common Type ◽  
Intestinal Involvement ◽  
Childhood Vasculitis ◽  
The Difference ◽  
Umbilical Arteries ◽  
And Control

Henoch-Schoniein purpura (HSP) is the most common type of childhood vasculitis. The skin lesions are the most obvious sign but visceral involvement carries a more serious prognosis. Increasing amounts of data are available regarding the possible role of prostacyclin (PGI2) in the pathogenesis of other vasculo-pathies, but no-one has previously investigated HSP. 17 HSP patients (mean age (SD) 5.7 (2.5) years) and 17 matched controls were studied. The ability of plasma (patient and control) to support PGI2 -like activity was tested. Human umbilical arteries were chopped into rings and incubated in buffer at 37° C. Aliquots of the supernatant were added to platelet rich plasma (PRP) and platelet aggregation measured (Malin's aggregometer). Repeated washings of the rings then depleted PGI. production. The rings were then incubated with test platelet poor plasma (PPP) at 37° C. PGI2 like activity was assessed as before and the results expressed as a percentage of the aggregation obtained by the same exhausted ring before addition of PPP. The results show that the ability of test PPP to support PGI2 like activity was reduced in 13/17 HSP patients. The difference between patients (21.3 (SD 20.5%) and controls (57.2 (SD 12.2%) was significant (p<0.001). Patients with renal and gastro-intestinal involvement (7.5 (SD 18.1%) were significantly different from those patients with only skin involvement (32.3 (SD 23.5%) (p<0.01). Plasma from six patients in which PGI^like activity was undetectable using the above method were further studied to detect PGI2 -inhibitory activity. Unexhausted umbilical rings were incubated at 37°C for 5mins. The baseline PGI2 like activity of the supernatant was compared with that produced after 5mins. incubation with test PPP (o patients, 6 controls). Less like activity was produced by the unexhausted rings when incubated with PPP from the HSP patients than with either control buffer or control PPP (both p<0.01). It seems likely that these abnormalities, having been demonstrated in yet another vasculitic syndrome, are secondary to endothelial damage. The disturbances, however, may well be of importance in extending the primary microvascular insult

scholarly journals Clinical study of herpes zoster in 109 patients in central referral hospital, Gangtok

2019 ◽  
Vol 5 (4) ◽  
pp. 849
Author(s):  
Rukma L. Sharma ◽  
Rekha Sharma
Keyword(s):  
Herpes Zoster ◽  
Dorsal Root ◽  
Skin Lesions ◽  
Age Group ◽  
Female Ratio ◽  
Varicella Zoster ◽  
Single Nerve ◽  
Male Female Ratio ◽  
The Common

<p class="abstract"><strong>Background:</strong> Herpes zoster results from the reactivation of varicella-zoster virus lying dormant in the dorsal root ganglia following an earlier primary infection (chickenpox), usually in childhood. The reactivation occurs due to multifactorial causes leading to decreased immunity.</p><p class="abstract"><strong>Methods:</strong> This study was conducted on 109 cases of herpes zoster. Patient’s particulars were noted. A detailed history was recorded; morphology, the site and side of skin lesions were recorded. Any other associated diseases were noted.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 109 patients 66 were male and 43 were female. The total of 53 (48.6%) patients were under the age of 40 years and 56 (51.4%) patients above 40 years. Bhutias were affected in highest number (18.4%) followed by Sharma community (15.6%). The ophthalmic division of trigeminal nerve was the most commonly affected single nerve with 13.8% followed by T10 and T7 dermatome at 9.17% and 7.3% respectively. Thoracic nerves the most commonly involved thoracic nerves with 44 cases. Single dermatomal eruptions were found in 55 patients. The dissemination of herpes zoster was although very rare but was present in three patients. Type 2 diabetes mellitus was the common associated systemic illness with 10.09% of patients.</p><p class="abstract"><strong>Conclusions:</strong> From this study it was revealed that both young adults and older age group people were affected almost equally. The male: female ratio was 1.5:1 with Bhutia community being mostly affected. Thoracic dermatome was the most common dermatome involved and in half the patients some form of associated disease noted.</p>

scholarly journals Behcet’s Disease in an Adult Male From Nepal: A Case Report

2021 ◽  
Author(s):  
Madan Basnet ◽  
Abisha Phudong ◽  
Kamal Gautam ◽  
Bishnu Pathak ◽  
Suman Gaire ◽  
...  
Keyword(s):  
Case Report ◽  
Blood Vessels ◽  
Behçet’S Disease ◽  
Adult Male ◽  
Acute Inflammation ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Systemic Vasculitis ◽  
Skin Lesions ◽  
Behcet's Disease

Behcet’s Disease is a rare systemic vasculitis characterized by recurrent episodes of acute inflammation affecting blood vessels of all sizes. Symptoms include orogenital apthosis, cutaneous skin lesions, and uveitis. We present the case of a 38-year-old Nepalese man with Behcet’s Disease. In Nepal, Behcet’s Disease may still be under-reported.

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