scholarly journals Sarcopenia in Autoimmune and Rheumatic Diseases: A Comprehensive Review

2020 ◽  
Vol 21 (16) ◽  
pp. 5678
Author(s):  
Hyo Jin An ◽  
Kalthoum Tizaoui ◽  
Salvatore Terrazzino ◽  
Sarah Cargnin ◽  
Keum Hwa Lee ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Autoimmune Diseases ◽  
Rheumatic Diseases ◽  
Autoimmune Diabetes ◽  
Clinical Importance ◽  
Underlying Disease ◽  
Age Related ◽  
Significant Disability ◽  
Definition Of ◽  
And Function

Sarcopenia refers to a decrease in skeletal muscle mass and function. Because sarcopenia affects mortality, and causes significant disability, the clinical importance of sarcopenia is emerging. At first, sarcopenia was recognized as an age-related disease but, recently, it has been reported to be prevalent also in younger patients with autoimmune diseases. Specifically, the association of sarcopenia and autoimmune diseases such as rheumatoid arthritis has been studied in detail. Although the pathogenesis of sarcopenia in autoimmune diseases has not been elucidated, chronic inflammation is believed to contribute to sarcopenia, and moreover the pathogenesis seems to be different depending on the respective underlying disease. The definition of sarcopenia differs among studies, which limits direct comparisons. Therefore, in this review, we cover various definitions of sarcopenia used in previous studies and highlight the prevalence of sarcopenia in diverse autoimmune diseases including rheumatoid arthritis, spondyloarthritis, systemic sclerosis, inflammatory bowel disease, and autoimmune diabetes. In addition, we cover the pathogenesis and treatment of sarcopenia in autoimmune and rheumatic diseases. This review provides a comprehensive understanding of sarcopenia in various autoimmune diseases and highlights the need for a consistent definition of sarcopenia.

GIANT BAKER'S CYST AND PSEUDOTHROMBOPHLEBITIS IN PATIENTS WITH RHEUMATIC DISEASES: A NEW INSIGHT INTO OLD COMPLICATIONS

2013 ◽  
Vol 16 (02) ◽  
pp. 1350009
Author(s):  
Massoud Saghafi ◽  
Azita Azarian
Keyword(s):  
Rheumatoid Arthritis ◽  
Rheumatic Diseases ◽  
Imaging Techniques ◽  
Cyst Formation ◽  
Underlying Disease ◽  
Popliteal Cyst ◽  
Baker’S Cyst ◽  
Baker's Cyst ◽  
Study Results ◽  
Prevalent Disease

Background: The knee joint is the most common site for cyst formation. Popliteal cyst may become large and its compressive effects produce complications particularly in subacute and chronic rheumatic diseases. Methods: We evaluated predisposing factors, underlying diseases, complications, course and management of giant Baker's cysts in our patients with rheumatic diseases. Patients with popliteal cysts that extended down lower than inferior level of the popliteal fossa, confirmed by imaging techniques were included in this retrospective study. Results: A total of 40 patients had giant Baker's cysts during last 20 years. Rheumatoid arthritis was the most prevalent disease in 21 patients (52.5%). Our cases included a large series of patients with seronegative spondyloarthropathies complicated with giant Baker's cyst in 10 patients (25%). Localized bulging, pain and tenderness of the calf region were observed in 15 patients (37.5%). A total of 25 patients had symptoms and signs similar to thrombophlebitis (62.5%). Rupture of Baker's cyst was detected in 10 patients (25%). A patient had giant Baker's cyst concurrent with thrombophlebitis. Management was mostly conservative including rest and intra-articular depoglucocorticoid injection with satisfactory results. Conclusions: In this study, rheumatoid arthritis was the most prevalent underlying disease and the pseudothrombophlebitis syndrome was the most prevalent presenting feature of patients with giant Baker's cysts.

scholarly journals IL-7 and IL-15 combined with strong TCR stimulation decrease Treg suppressive activity in healthy donors and patients with rheumatoid arthritis

2020 ◽  
Author(s):  
Daniil Shevyrev ◽  
Valeriy Tereshchenko ◽  
Alexey Sizikov ◽  
Vladimir Kozlov
Keyword(s):  
Rheumatoid Arthritis ◽  
T Cell ◽  
Autoimmune Diseases ◽  
Homeostatic Proliferation ◽  
Suppressive Activity ◽  
Cd8 Cells ◽  
Cell Clones ◽  
Healthy Donors ◽  
Tcr Signals ◽  
And Function

Homeostatic proliferation (HP) is a physiological process to reconstitute the T-cell pool after lymphopenia with IL-7 and IL-15 being the key cytokines regulating the process. However, there is no evidence whether these cytokines influence the function of regulatory T cells (Tregs). Since lymphopenia often accompanies autoimmune diseases, we decided to study the proliferation rate and function of Tregs stimulated by IL-7 and IL-15 in patients with rheumatoid arthritis (RA) compared to healthy donors (HD). The study used peripheral blood from 14 RA patients and 18 HD. Proliferation of purified CD3CD4CD25CD127 cells was assessed by flow cytometry using CFSE. Tregs were stimulated by anti-CD3, IL-7, IL-15, IL-7, or IL-15 combined with anti-CD3, and by IL-2+anti-CD3, and their functional activity was evaluated in each case by CD4 and CD8 cells proliferation inhibition. The suppressive activity of peripheral Tregs did not differ between RA and HD; however, it significantly decreased when IL-7 or IL-15 were applied together with strong TCR stimulation with anti-CD3 antibodies. Herewith Treg proliferation caused by IL-7 and IL-15 was lower in RA than in HD. The revealed decrease in Treg suppressive activity can lead to the proliferation of potentially self-reactive T-cell clones, which can receive relatively strong TCR signals. This may be another explanation of why lymphopenia is associated with the development of autoimmune diseases. The revealed decrease of Treg proliferation under IL-7 and IL-15 may lead to a delay in Treg pool reconstitution in patients with rheumatoid arthritis.

scholarly journals NEUROMUSCULAR CHANGES WITH AGING AND SARCOPENIA

2018 ◽  
pp. 1-3
Author(s):  
B.C. Clark
Keyword(s):  
Skeletal Muscle ◽  
Muscle Mass ◽  
Muscle Function ◽  
Skeletal Muscle Mass ◽  
The Past ◽  
Conceptual Definition ◽  
Age Related ◽  
Per Se ◽  
Definition Of ◽  
And Function

Sarcopenia was originally conceptualized as the age-related loss of skeletal muscle mass. Over the ensuing decades, the conceptual definition of sarcopenia has changed to represent a condition in older adults that is characterized by declining muscle mass and function, with “function” most commonly conceived as muscle weakness and/or impaired physical performance (e.g., slow gait speed). Findings over the past 15-years, however, have demonstrated that changes in grip and leg extensor strength are not primarily due to muscle atrophy per se, and that to a large extent, are reflective of declines in the integrity of the nervous system. This article briefly summarizes findings relating to the complex neuromuscular mechanisms that contribute to reductions in muscle function associated with advancing age, and the implications of these findings on the development of effective therapies.

Impact of a new coronavirus infection on the clinical course of immunoinflammatory rheumatic diseases

2021 ◽  
Vol 13 (2) ◽  
pp. 39-47
Author(s):  
Vadim I. Mazurov ◽  
Irina B. Belyaeva ◽  
Lubov E. Sarantseva ◽  
Anton L. Chudinov ◽  
Roman A. Bashkinov ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Viral Infection ◽  
Rheumatic Diseases ◽  
Biological Therapy ◽  
Clinical Course ◽  
Underlying Disease ◽  
Clinical Rheumatology ◽  
Undifferentiated Arthritis ◽  
Saint Petersburg ◽  
Coronavirus Infection

BACKGROUND: The COVID-19 pandemic poses a particular threat to patients suffering from immunoinflammatory rheumatic diseases. New coronavirus infection has been found to be accompanied by the development of a wide range of extrapulmonary clinical and laboratory manifestations, which are characteristic of a number of immunoinflammatory rheumatic diseases. AIM: To evaluate the features of the clinical course of immunoinflammatory rheumatic diseases in patients who underwent new coronavirus infection. MATERIALS AND METHODS: The clinical course of immunoinflammatory rheumatic diseases was analyzed in 324 patients who underwent new coronavirus infection from March 2020 to February 2021 and were treated at the Clinical Rheumatology Hospital No. 25, Saint Petersburg, for exacerbation of the underlying disease. RESULTS: Analysis showed that the risk factors for severe new coronavirus infection in patients with immunoinflammatory rheumatic diseases were: age over 60, comorbidities, use of prednisolone in a dose greater than 12,5 mg, and ESR values 40 mm/hour before the development of new coronavirus infection. There was no effect of immunosuppressive and biological therapy on the severity of the course of viral infection. There was no effect of immunosuppressive therapy and biological therapy on the severity of the course of viral infection in patients with immunoinflammatory rheumatic diseases. The development of the postinfectious syndrome was observed in 1/4 of patients, which was characterized by the formation of postinfectious arthritis in 3,6% of patients, transformation of undifferentiated arthritis into various rheumatic diseases in 49% of patients (more often into early rheumatoid arthritis), as well as exacerbation of the underlying disease in 83,4% of patients with an advanced stage of rheumatoid arthritis. In patients with mixed connective tissue disease, there was a significant increase in immunologic activity due to antinuclear factor (up to a maximum of 1:163 840). Clinical cases of the development of arthritis associated with viral infection and the debut of rheumatoid arthritis after an new coronavirus infection are presented. CONCLUSIONS: New coronavirus infection in the cohort of patients with immunoinflammatory rheumatic diseases observed in the Clinical Rheumatology Hospital No. 25, Saint Petersburg, proceeded in the variant of medium severity in half of patients, initiated the development of lung lesions in 68,6% of patients, arthritis associated with viral infection in 3,6% of patients, immunoinflammatory rheumatic diseases which transformed from undifferentiated arthritis in 49% of cases and exacerbation of the main disease in an overwhelming number of patients. Patients with immunoinflammatory rheumatic diseases have a high risk of adverse outcome of new coronavirus infection, especially in cases of unstable course of the disease or exacerbation of this group of diseases.

Cytokines and other mediators

2020 ◽  
pp. 95-106
Author(s):  
Marina Frleta-Gilchrist ◽  
Iain B. McInnes
Keyword(s):  
Rheumatoid Arthritis ◽  
Autoimmune Diseases ◽  
Immune Cells ◽  
Immune Dysregulation ◽  
Structure And Function ◽  
Innate Immune Cells ◽  
Holistic Understanding ◽  
Inflammatory Processes ◽  
The Individual ◽  
And Function

Cytokine-mediated pathways are pivotal to the pathogenesis of many autoimmune diseases, including rheumatoid arthritis (RA). Since their discovery, cytokine biology has changed the way we understand pathogenetic inflammatory processes, leading to the creation of novel biologic treatments, and transforming patient outcomes. This chapter will elucidate the structure and function of key cytokines that drive autoimmune, inflammatory processes in different stages of RA. In particular, we will describe individual and combinatorial roles of cytokines in adaptive and innate immune cells that promote disease. We will focus especially on critical regulators of RA pathogenesis, such as TNFα‎ and IL-6. Pleotropic effects of cytokines stretch far beyond immune dysregulation, thus precipitating multiple RA comorbidities. Deciphering the individual and combinatorial roles of cytokines is essential to a holistic understanding of RA pathogenesis, in turn, promising to lead to further meaningful clinical and therapeutic discovery.

The Impact of Anemia on Mortality, Cognition and Function in a Racially Diverse Community-Dwelling Elderly Population.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1627-1627
Author(s):  
Susan Denny ◽  
Maragatha Kuchibhatla ◽  
Harvey Jay Cohen
Keyword(s):  
Disease Status ◽  
The Elderly ◽  
Epidemiologic Studies ◽  
Cognitive Status ◽  
Community Dwelling ◽  
Mild Anemia ◽  
Age Related ◽  
Definition Of ◽  
And Function ◽  
The Impact

Abstract The WHO definition of anemia, Hgb<12g/dL (W) and <13g/dL (M) is largely based on studies in younger populations. As our population is aging it is important to explore the impact of varying Hgb levels on mortality and function in representative populations of older persons. The Duke Established Populations for Epidemiologic Studies for the Elderly (EPESE) is a random household sample, over sampled for African Americans (AA), initiated in 1986. In 1992 we obtained Hgb levels for 1744 subjects age >71 and evaluated functional and cognitive status at baseline and 4 years later, and mortality for 8 years. Using WHO criteria, the prevalence of anemia was 24%. It was age related; 17% (65–74), 25% (75–79), 32% (>80) p<.0001, but not gender related. There was a strong racial difference, 33.6% AA, 13.8% Caucasians (p=<.0001) with an odds ratio, adjusted for age, education, renal insufficiency and comorbidity of 3.0 (95%CI 2.3 – 3.9) Baseline functional status was worse in anemic subjects (p<.0001) but cognition was not (p=.06). The risk ratio for 8 year mortality was 1.7 (95% CI 1.5, 2.0) for anemic subjects (p=.0001). This did not differ by gender nor, despite the increased prevalence, by race (RR AA: caucasian = 0.85; 95% CI 0.6–1.2). Assessing survival by Hgb level, a nonlinear relationship was seen, with highest % survival between 13–14 g/dL for women (p<.0001) and 14–15g/dL for men (p=.09). Using the WHO standard as reference, controlling for baseline characteristics, women with Hgb 10–11 g/dL had higher mortality (RR 2.1, 95% CI. 1.5 –3.1) but with 11–12 g/dL did not. Similarly men with Hgb 10–11 g/dL had increased mortality (RR2.0, 95% CI 1.1, 3.7). In women there was a progressively greater decline in function at 4 years with each decrement of Hgb level from 16 to 10g/dL, but not in men. Both women and men with mild anemia (11–12 g/dL and 10–11g/dL respectively) had greater decreases in cognition than those at higher levels (p=.01). Thus in an elderly community based population, anemia is significantly more common in AA independent of disease status, and is independently associated with increased mortality over eight years for both races and genders, and with declines in function and cognition most prominently in women. Further investigation of the etiology of these relationships is warranted.

scholarly journals Prevention and treatment of autoimmune diseases with plant virus nanoparticles

2020 ◽  
Vol 6 (19) ◽  
pp. eaaz0295
Author(s):  
Roberta Zampieri ◽  
Annalisa Brozzetti ◽  
Eva Pericolini ◽  
Elena Bartoloni ◽  
Elena Gabrielli ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Autoimmune Diseases ◽  
Plant Virus ◽  
Autoimmune Diabetes ◽  
Plant Viruses ◽  
New Materials ◽  
Preclinical Testing ◽  
Design And Synthesis ◽  
Self Assembling ◽  
Prevention And Treatment

Plant viruses are natural, self-assembling nanostructures with versatile and genetically programmable shells, making them useful in diverse applications ranging from the development of new materials to diagnostics and therapeutics. Here, we describe the design and synthesis of plant virus nanoparticles displaying peptides associated with two different autoimmune diseases. Using animal models, we show that the recombinant nanoparticles can prevent autoimmune diabetes and ameliorate rheumatoid arthritis. In both cases, this effect is based on a strictly peptide-related mechanism in which the virus nanoparticle acts both as a peptide scaffold and as an adjuvant, showing an overlapping mechanism of action. This successful preclinical testing could pave the way for the development of plant viruses for the clinical treatment of human autoimmune diseases.

scholarly journals Comparative Analyses of mTOR/Akt and Muscle Atrophy-Related Signaling in Aged Respiratory and Gastrocnemius Muscles

2020 ◽  
Vol 21 (8) ◽  
pp. 2862
Author(s):  
Kun Woo Kim ◽  
Hye-Jeong Cho ◽  
Sana Abdul Khaliq ◽  
Kuk Hui Son ◽  
Mee-Sup Yoon
Keyword(s):  
Respiratory Muscles ◽  
Underlying Disease ◽  
Molecular Signaling ◽  
Forkhead Box ◽  
Vital Functions ◽  
Age Related ◽  
Ubiquitin Proteasome ◽  
Old Rats ◽  
And Function ◽  
Gastrocnemius Muscles

Sarcopenia is the degenerative loss of skeletal muscle mass and function associated with aging and occurs in the absence of any underlying disease or condition. A comparison of the age-related molecular signaling signatures of different muscles has not previously been reported. In this study, we compared the age-related molecular signaling signatures of the intercostal muscles, the diaphragm, and the gastrocnemii using 6-month and 20-month-old rats. The phosphorylation of Akt, ribosomal S6, and Forkhead box protein O1 (FoxO1) in diaphragms significantly increased with age, but remained unchanged in the intercostal and gastrocnemius muscles. In addition, ubiquitin-proteasome degradation, characterized by the levels of MuRF1 and Atrogin-1, did not change with age in all rat muscles. Interestingly, an increase in LC3BII and p62 levels marked substantial blockage of autophagy in aged gastrocnemii but not in aged respiratory muscles. These changes in LC3BII and p62 levels were also associated with a decrease in markers of mitochondrial quality control. Therefore, our results suggest that the age-related signaling events in respiratory muscles differ from those in the gastrocnemii, most likely to preserve the vital functions played by the respiratory muscles.

Development and Evaluation of Fuzzy Criteria for the Diagnosis of Rheumatoid Arthritis

1996 ◽  
Vol 35 (04/05) ◽  
pp. 334-342 ◽  
Author(s):  
K.-P. Adlassnig ◽  
G. Kolarz ◽  
H. Leitich
Keyword(s):  
Rheumatoid Arthritis ◽  
Reference Model ◽  
American Rheumatism Association ◽  
Uniform Definition ◽  
Sensitivity Rate ◽  
Fuzzy Techniques ◽  
Definition Of ◽  
Different Levels ◽  
Specificity Rate

Abstract:In 1987, the American Rheumatism Association issued a set of criteria for the classification of rheumatoid arthritis (RA) to provide a uniform definition of RA patients. Fuzzy set theory and fuzzy logic were used to transform this set of criteria into a diagnostic tool that offers diagnoses at different levels of confidence: a definite level, which was consistent with the original criteria definition, as well as several possible and superdefinite levels. Two fuzzy models and a reference model which provided results at a definite level only were applied to 292 clinical cases from a hospital for rheumatic diseases. At the definite level, all models yielded a sensitivity rate of 72.6% and a specificity rate of 87.0%. Sensitivity and specificity rates at the possible levels ranged from 73.3% to 85.6% and from 83.6% to 87.0%. At the superdefinite levels, sensitivity rates ranged from 39.0% to 63.7% and specificity rates from 90.4% to 95.2%. Fuzzy techniques were helpful to add flexibility to preexisting diagnostic criteria in order to obtain diagnoses at the desired level of confidence.

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