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 AB0507 INVASIVE ASPERGILLOSIS IN ADULT RHEUMATOLOGICAL PATIENTS IN SAINT PETERSBURG, RUSSIA.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1551.1-1552
Author(s):  
V. Mazurov ◽  
O. Shadrivova ◽  
M. Shostak ◽  
L. Martynova ◽  
M. Tonkoshkur ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Renal Failure ◽  
Invasive Aspergillosis ◽  
Lupus Erythematosus ◽  
Granulomatosis With Polyangiitis ◽  
Control Group ◽  
Systemic Lupus ◽  
Anca Associated Vasculitis ◽  
Underlying Diseases

Background:Invasive aspergillosis (IA) is a severe opportunistic infection that is not well understood in rheumatological patients.Objectives:To study risk factors, etiology, clinical manifestations and results of treatment of IA in adult rheumatological patients.Methods:Retrospective analysis of 830 patients (1998-2019) with “proven” and “probable” IA (EORTC / MSG, 2019), adults - 699 (84%). The main group included 18 (3%) adult rheumatological patients with IA, a control group included 610 (87%) adult hematological patients. Rheumatological patients were older, the average age was 59 years (21–75) vs 45 years (18–79), p = 0.005, and among them there were more women – 56% vs 42%, p = 0.01.Results:In rheumatological patients with IA, underlying diseases were ANCA-associated vasculitis (28%), granulomatosis with polyangiitis (22%), periarteritis (11%), systemic lupus erythematosus (22%), rheumatic heart disease (11%) and ankylosing spondylitis (6%). In the control group, underlying diseases were acute leukemia (45%), lymphomas (34%), chronic leukemia (9%), multiple myeloma (7%), myelodysplastic syndrome (3%), and other hematological diseases (2%).The main risk factors for IA development in rheumatological patients were: systemic steroids use (89% vs 69%), prolonged lymphocytopenia (76% vs 65%, median - 14 vs 12 days), treatment in ICU (44% vs 18%, p = 0.01), acute or chronic renal failure (39% vs 1%, p = 0.0008) and immunosuppressive therapy (28% vs 25%). Severe neutropenia was noted significantly less frequently (18% vs 83%, p = 0.0001). Additional risk factors were decompensated diabetes mellitus (17% vs 2%, p = 0.004), previous surgery (17% vs 1%, p = 0.001) and organ transplantation (6% vs 0%). In rheumatological patients, lung (83% vs 98%, p = 0.0001) and ≥2 organs (6% vs 8%) involvement were less common. Heart (11% vs 0%), sinuses (6% vs 5%) and central nervous system (6% vs 4%) involvement more often developed. In rheumatological patients, respiratory failure (61 vs 37%, p = 0.03), hemoptysis (28% vs 7%, p = 0.0001) and chest pain (17% vs 7%, p = 0, 04) were noted more often, less often - fever ≥380С (67% vs 85%, p = 0.01) and cough (61% vs 70%). CT signs of lung damage were similar in both groups, but rheumatologic patients were more likely to show an «air crescent» sign and / or destruction cavity (44% vs 10%, p = 0.0001). In rheumatologic patients, IA was more often confirmed by isolation ofAspergillusspp. from BAL (80% vs 45%, p = 0.005) and by histological examination (22% vs 7%, p = 0.01). The main pathogens wereA. fumigatus(50% vs 43%),A. niger(29% vs 32%), andA. flavus(14% vs 17%).Rheumatological patients were less likely to receive antifungal therapy 89% vs 99%, p = 0,0003. The main drug in both groups was voriconazole. The overall 12-week survival did not significantly differ between groups, but was lower in rheumatological patients with IA (69% vs 81%).Conclusion:In rheumatological patients, invasive aspergillosis more often developed at an older age, mainly in women. The main background diseases were ANCA-associated vasculitis, granulomatosis with polyangiitis, and systemic lupus erythematosus. Typical risk factors were steroids and immunosuppressants use, prolonged lymphocytopenia, ICU stay, and renal failure. The main causative agents wereA. fumigatus,A. niger, andA. flavus. The main localization of infection were lungs. Respiratory failure, hemoptysis and heart involvement were typical. The overall 12-week survival of rheumatological patients with invasive aspergillosis was 69%.Disclosure of Interests:None declared

scholarly journals Risk factors for progression of carotid intima-media thickness in patients with systemic lupus erythematosus: protocol for an observational cohort study in China

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030721
Author(s):  
Haiyu Pang ◽  
Yicong Ye ◽  
Faming Ding ◽  
Mengtao Li ◽  
Xinglin Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Informed Consent ◽  
Lupus Erythematosus ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Systemic Lupus ◽  
Media Thickness ◽  
Artery Disease

IntroductionAccelerated atherosclerosis is a major complication of systemic lupus erythematosus (SLE), and it leads to increased cardiovascular morbidity and mortality in patients with SLE. This study aimed to investigate the natural progression of carotid intima-media thickness (CIMT), and to examine the risk factors for progression of CIMT and atherosclerotic plaques based on a Chinese SLE cohort.Methods and analysisParticipants were continuously enrolled as outpatients of the Department of Rheumatology in Peking Union Medical College Hospital (PUMCH) from October 2013 to December 2016. Inclusion criteria were as follows: (1) age ≥18 years, (2) fulfilment of clinical classification criteria of SLE and (3) provision of signed written informed consent. Patients with clinically overt coronary artery disease, a history of cardiovascular disease (previous stroke, heart failure, myocardial infarction, angina or symptomatic peripheral artery disease) and malignancy, and pregnant/lactating women were excluded. The primary outcome is progression of CIMT from baseline. A total of 440 patients with SLE will be enrolled. Participants will receive follow-up surveys ~5 years after their baseline visit. A standard structural survey form, including demographic data, medical history, clinical and laboratory assessments and CIMT measurement, is planned for data collection at baseline and follow-up. The risk prediction model for progression of CIMT will be created by using a mixed effect model.Ethics and disseminationThe study protocol was approved by the institutional review board of PUMCH (S-599). Informed consent was obtained from all participants according to the Declaration of Helsinki on Biomedical Research Involving Human Studies. All data will be managed confidentially according to guidelines and legislation. Dissemination will include publication of scientific papers and/or presentations of the study findings at international conferences.

scholarly journals Factors involved in the progress of preclinical atherosclerosis associated with systemic lupus erythematosus: a 2-year longitudinal study

2009 ◽  
Vol 69 (6) ◽  
pp. 1136-1139 ◽  
Author(s):  
I Rua-Figueroa ◽  
O Arencibia-Mireles ◽  
M Elvira ◽  
C Erausquin ◽  
S Ojeda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Linear Regression ◽  
Multiple Linear Regression ◽  
Lupus Erythematosus ◽  
High Sensitivity ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Systemic Lupus ◽  
C5a Anaphylatoxin

ObjectivesTo assess the changes in carotid intima-media thickness (IMT) and the associated risks factors in patients with low severity systemic lupus erythematosus (SLE).MethodsCommon carotid IMT measurements were obtained by ultrasound from 101 patients with SLE at an interval of 2 years. Cardiovascular risk factors, disease activity, accumulated damage, severity (Katz index) and biochemical parameters (including high sensitivity C-reactive protein, interleukin 6, C3a, C4a, C5a and homocysteine) were also assessed. Multiple linear regression was used to assess the effect of these variables on the end IMT measurement (eIMT) adjusted to the baseline measurement (bIMT).ResultsThe cohort comprised 94.1% women, with a mean age at entry of 41.5 years and a mean disease duration of 12.1 years. An increase of 0.078 mm in IMT was detected over 2 years, from a mean bIMT of 0.37 mm to a mean eIMT of 0.44 mm (p<0.001). When adjusted for the bIMT, multiple linear regression identified bIMT, age at diagnosis, homocysteine, C3 and C5a as risk factors for IMT progression.ConclusionsIMT significantly increases over 2 years in patients with SLE. Age, baseline IMT, C3, C5a anaphylatoxin and homocysteine are all associated risk factors, supporting a role for complement and homocysteine in the early stages of premature SLE-associated atherosclerosis.

Risk Factors for Development of Coronary Artery Disease in Women with Systemic Lupus Erythematosus

2009 ◽  
Vol 36 (11) ◽  
pp. 2454-2461 ◽  
Author(s):  
ROBERT J. GOLDBERG ◽  
MURRAY B. UROWITZ ◽  
DOMINIQUE IBAÑEZ ◽  
MANDANA NIKPOUR ◽  
DAFNA D. GLADMAN
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Prospective Study ◽  
Lupus Erythematosus ◽  
Control Group ◽  
Systemic Lupus ◽  
Artery Disease ◽  
A Prospective Study

Objective.To ascertain coronary artery disease (CAD) outcomes and predictive factors in a prospective study of patients with systemic lupus erythematosus (SLE) and matched healthy controls.Methods.SLE patients and non-SLE age-matched controls without a history of CAD were recruited into a prospective study between 1997 and 1999. CAD events were assessed at clinic visit for SLE patients and through telephone interview and chart review for controls. All events were verified with patient medical records.Results.Followup information was available on 237 controls and 241 SLE patients. The mean followup time was 7.2 years. Univariate analyses identified age and postmenopausal status as predictors of CAD in both the groups. Sedentary lifestyle, hypertension, the presence of metabolic syndrome, and the number of Framingham risk factors were predictive in the control group only. The 10-year risk of CAD score was predictive in both groups but was not as marked in the SLE group as in the controls. None of the lipid subfractions were predictive for CAD in the SLE group, whereas in the controls, a high triglyceride level ≥ 2.8 was predictive. Time-to-event multivariate analysis for CAD in all subjects revealed SLE itself, older age, and triglycerides ≥ 2.8 to be highly predictive for CAD.Conclusion.In a prospective study of patients with SLE and matched controls followed over a median of 8 years, patients with SLE developed significantly more CAD events than controls. Accounting for demographic variability, CAD risk factors, and lipid factors, SLE is an independent risk factor for the development of CAD.

scholarly journals Combined Detection of Mean Platelet Volume and Immunoglobins as a Strategy for the Diagnosis of Systemic Lupus Erythematosus

2019 ◽  
Vol 2 (4) ◽  
pp. 19
Author(s):  
Changzhi Xu ◽  
Zhizhi Xie ◽  
Yanhua Yi ◽  
Donglin Zhu ◽  
Yun Xi
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Renal Impairment ◽  
Lupus Erythematosus ◽  
Mean Platelet Volume ◽  
Test Method ◽  
Control Group ◽  
Systemic Lupus ◽  
Platelet Volume ◽  
Reactive Protein ◽  
Complex Process

Objective:To explore the possibility of diagnosing and monitoring patients with systemic lupus erythematosus (SLE) using the combination of mean platelet volume (MPV) and routine immunoglobulin test. Method:116 patients with SLE were divided into 3 groups according to their clinical characteristics, including 29 patients with renal impairment, 44 cases of active stage and 43 cases of inactive patients. 40 healthy subjects were randomly selected as controls. Subjects were tested for routine blood test and plasma Immunoglobins, such as IgG, IgA, IgM, C3, C4, CH50, CRP. The results were analyzed and the characteristics of each group of subjects were determined, the correlation between test results and diagnosis were studied. Result: In comparison to the control group, the serum level of MPV, C3 and C4 were decreased (P<0.05), and C reactive protein level was elevated (P<0.001) in the three groups of SLE patients. The IgG level in active and inactive SLE patients was increased (P<0.0001), CH50 level was decreased in patients with inactive SLE (P<0.05), IgA level of active SLE subjects was found to be elevated (P<0.05), IgM in patients with renal impairment was decreased (P<0.05). Other than that, no other significant characteristic were found. Conclusion: The pathogenesis of SLE is a complex process involving multiple factors. The changes of MPV, IgG, IgA, IgM, C3, C4, CH50 and CRP in SLE patients are characteristic parameters. The combination of the above indicators can help to determine the diagnosis and staging of SLE. The timely diagnosis and treatment of SLE patients has important clinical significance in protecting the organ function of SLE patients and improving the prognosis.

scholarly journals MODULASI SEL PUNCA MESENKIMAL DALAM MENURUNKAN KADAR HIGH SENSITIVITY C-REACTIVE PROTEIN SEBAGAI TERAPI NEFRITIS LUPUS

Biomedika ◽  
2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Indah Putri Maharani ◽  
Zainal Arifin Adnan ◽  
Arief Nurudhin
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
High Sensitivity ◽  
Control Group ◽  
C Reactive Protein ◽  
Systemic Lupus ◽  
Control Group Design ◽  
Group Design ◽  
Reactive Protein ◽  
Post Test

Systemic Lupus Erythematosus merupakan penyakit inflamasi autoimun kronis dengan gambaran klinis luas dan perjalanan penyakit beragam. Pemberian pristan intraperitoneal dapat menginduksi lupus pada mencit. Secretome sel punca mesenkimal bekerja secara parakrin memberikan efek antinflamasi dan imunomodulasi antara lain mensupresi sel T dan sel B autoreaktif. High Sensitivity C-Reactive Protein (hsCRP) terkait dengan patogenesis SLE dan selaras dengan aktifitas penyakit.Tujuan Penelitian adalah untuk mengetahui pengaruh secretome sel punca mesenkimal terhadap kadar hsCRP pada mencit model lupus dengan induksi pristan. Desain penelitian adalah eksperimental dengan randomisasi, post test only control group design, sampel 21 ekor mencit betina Mus Musculus galur Balb/C, dibagi 3 kelompok yaitu kelompok kontrol (injeksi intraperitoneal NaCl 0,9% 0,5 ml), kelompok perlakuan (injeksi pristan intraperitoneal 0,5 ml) dan kelompok terapi (injeksi intraperitoneal pristan 0,5 ml dan secretome 0,45 ml). Penelitian dilakukan selama 3 minggu, secretome diberikan pada akhir penelitian. Sesudah perlakuan dinilai kadar hsCRP secara ELISA. Analisis statistik menggunakan SPSS 22 for windows dengan uji Kruskal-Wallis dilanjutkan Mann-Whitney U test. P bermakna jika p<0,05. Hasil penelitian menunjukkan bahwa rata-rata kadar hsCRP pada ketiga kelompok yaitu kontrol 440.68(110.08-564.29) ng/ mL; perlakuan (pristan) 2964.26(601.13-3926.10) ng/mL; terapi pristan+secretome) 506.93(207.62-1473.46) ng/mL, dengan kemaknaan p=0.008. Terdapat perbedaan bermakna kadar hsCRP antara kelompok pristan vs pristan+secretome (2457.33 ng/mL; p=0.047). Secretome sel punca mesenkimal mampu menurunkan kadar hsCRP pada mencit model lupus dengan induksi pristan.Kata Kunci: High Sensitivity C-Reactive Protein, Nefritis lupus, Secretome

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