Serum Levels of Calreticulin in Correlation with Disease Activity in Patients with Rheumatoid Arthritis

Objective

The aim of our study was to investigate the contribution of serum calreticulin (CRT) in the assessment of disease activity in rheumatoid arthritis (RA).

Methods

Serum CRT levels were measured by ELISA in 70 patients with established RA, 30 systemic lupus erythematosus (SLE), 25 other autoimmune diseases, 20 osteoarthritis (OA), and 35 of healthy controls (HC). Correlations of CRT serum levels with disease activity [Disease Activity Score for 28 joints (DAS28)], erythrocyte sedimentation rate(ESR) and C-reactive protein (CRP) were assessed. Serum CRT levels were also detected in RA patients whose RF, anti-CCP and anti- MCV antibodies were positive and negative.

Results

Serum CRT levels in RA patients (4.817?±?2.425 ng/ml) was significantly higher (P <0.05) compared with those in the serum of OA (3.574?±?0.942 ng/ml), SLE (4.013?±?1.536 ng/ml), other autoimmune diseases (3.882?±?0.837 ng/ml) and HC (3.726?±?0.627 ng/ml). Significant positive correlation of CRT with DAS28, ESR and CRP was found in RA patients. Furthermore, RA patients whose anti-CCP and anti-MCV antibodies were positive had higher levels of CRT (P?<?0.01).

Conclusion

Serum CRT levels were increased in patients with RA compared with those controls. Moreover, a significant correlation was observed between serum CRT levels and disease activity in RA. It might be used as a potential biomarker for clinical diagnosis and provide additional information regarding disease activity along with the traditional indices such as ESR and CRP.     

Serum Growth Arrest-Specific Protein 6 Levels are a Reliable Biomarker of Disease Activity in Systemic Lupus Erythematosus

Purpose

Growth arrest-specific protein 6 (Gas6) has been suggested to be a biomarker of disease activity in patients with systemic lupus erthematosus (SLE). We investigated the clinical significance of this protein in Korean SLE.

Methods

Blood samples were collected from 150 SLE patients and 50 normal controls (NC). In addition, follow-up samples were collected from 50 SLE patients.

Results

Serum Gas6 levels of SLE patients (43.01?±?28.02 ng/mL) were higher than those of NC (20.15?±?9.23 ng/mL, p?<?0.001). When evaluated sensitivity and specificity of the Gas6 for diagnosing SLE using ROC curves, the sensitivity and specificity were 72.7 % and 84 % with a cut-off value of 25.3 ng/mL. In the ROC analysis of Gas6, anti-dsDNA antibody, ESR, complement 3 and complement 4 to identify patients with active lupus, area under the curve (AUC) of Gas6 was highest with 0.763. Serum Gas6 levels were significantly higher in the patients with serositis (70.04?±?30.85 ng/mL) and renal disorder (65.66 ±32.28 ng/mL) compared to those without (41.88?±?27.44 ng/mL, p?=?0.033, 40.3?±?26.33 ng/mL, p?=?0.001, respectively). Gas6 levels were correlated positively with anti-dsDNA antibody (r?=?0.199, p?=?0.015), ESR (r?=?0.204, p?=?0.013) and SLEDAI (r?=?0.512, p?<?0.001). In addition, serum Gas6 levels were correlated negatively with hemoglobin (r?=??0.165, p?=?0.043), lymphocyte count (r?=??0.165, p?=?0.043), complement 3 (r?=??0.343, p?<?0.001) and complement 4 (r?=??0.316, p?<?0.001). Furthermore, change in serum Gas6 levels was correlated with change in SLEDAI levels in the SLE patients that were followed up (r?=?0.524, p?<?0.001).

Conclusion

These results suggest that serum Gas6 can be a reliable clinical marker for monitoring disease activity and treatment response in SLE.     

Assessing vitamin D levels in an anti-DFS70 positive population: New insights emerging

Abstract

Background: Anti-dense fine speckled 70 (DFS70) autoantibodies have more often been described in apparently healthy individuals than in patients with systemic autoimmune rheumatic diseases (SARD). The aim of this study was to explore the link between anti-DFS70 autoantibodies and vitamin D (25(OH)D) levels in an Italian adult cohort.

Methods: Serum samples from 34 (five males and 29 females) anti-DFS70 positive patients (index cases), 34 ANA-negative healthy controls, 34 ANA-positive anti-DFS70 negative SLE patients, both groups age- and gender-matched with the index cases, 23 ANA-positive anti-DFS70 negative healthy blood donors and six female SARD patients showing mixed DFS positive pattern were collected and tested for 25(OH)D levels. Relevant demographics and lifestyle practices, body mass index (BMI), comorbidities, and use of medication were recorded for patients and healthy controls.

Results: Mean serum levels of 25(OH)D were significantly higher in anti-DFS70 positive subjects (mean?±?SD: 22.1?±?9.8?ng/ml) than in ANA-negative healthy controls (mean?±?SD: 17.3?±?6.7?ng/ml; p?=?.03), ANA-positive healthy controls (mean?±?SD: 15.2?±?6.8?ng/ml; p?=?.01), SLE patients (16.6?±?11.0?ng/ml; p?=?.01) and in patients with SARD (15.0?±?5.6?ng/ml; p?=?.01). No statistically relevant differences in BMI, clinical, or demographic parameters were found.

Conclusions: Our findings showed higher levels of vitamin D in anti-DFS70 positive subjects than in the controls, which is compatible with the hypothesis of the “benign” nature of anti-DFS70 antibodies.     

Exhaled IL-8 in Systemic Lupus Erythematosus with and without Pulmonary Fibrosis

The purpose of this study is to evaluate the relationship between the concentration of interleukin-8 (IL-8) in exhaled breath condensate (EBC) and bronchoalveolar lavage fluid (BALF) with the disease activity score and pulmonary function of systemic lupus erythematosus (SLE) patients with and without pulmonary fibrosis. Thirty-four SLE patients and 31 healthy controls were enrolled and evaluated using high-resolution computed tomography (HRCT), pulmonary function tests, systemic lupus activity measure (SLAM), assessing BALF and EBC. IL-8 levels in BALF and EBC samples were measured with an enzyme-immunosorbent assay kit. The mean (±SEM) IL-8 concentrations in BALF and EBC were higher in SLE patients compared to healthy controls (34.84 ± 95.0 vs. 7.65 ± 21.22 pg/ml, p < 0.001; 3.82 ± 0.52 pg/m vs. 1.7 ± 1.7 pg/ml, p < 0.001, respectively). SLE patients had increased percentage of neutrophils in BALF when compared with control group (1.00 ± 5.99 vs. 0.00 ± 0.56 %, p = 0.0003). Pulmonary fibrosis in HRCT was found in 50 % of SLE patients. The disease activity scored by SLAM was significantly higher and total lung capacity was significantly lower in SLE patients with pulmonary fibrosis (8.00 ± 3.17 vs. 6.00 ± 2.31, p = 0.01; 88.00 ± 28.29 vs. 112.00 ± 21.08 % predicted, p = 0.01, respectively). In SLE patients with pulmonary fibrosis, correlations were found between SLAM and IL-8 concentration in BALF, forced expiratory volume in 1 s and forced vital capacity (r = 0.65, p = 0.006; r = ?0.53, p = 0.035; r = ?0.67, p = 0.006, respectively). Our results indicate that IL-8 plays an important role in the pathogenesis of SLE. An increased concentration of IL-8 according to BALF could be considered as a useful biomarker of SLE activity and pulmonary fibrosis in SLE.     

Hyperferritinemia is Associated with Serologic Antiphospholipid Syndrome in SLE Patients

Ferritin may play a direct role on the immune system. We sought to determine if elevated levels of ferritin in lupus patients correlate with disease activity and organ involvement in a large cohort. Ferritin levels (gender and age adjusted) were assessed in 274 lupus serum samples utilizing the LIASON Ferritin automated immunoassay method. Significant disease activity was determined if European Consensus Lupus Activity Index (ECLAM)?>?2 or Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)?>?4. Utilizing an EXCEL database, we compared elevated ferritin levels to manifestations grouped by organ involvement, serology, and previous therapy. The patients were predominantly female (89%), median age was 37 years old, and disease duration was 10.6?±?7.7 years. Hyperferritinemia was found in 18.6% of SLE patients. Compared to subjects with normal ferritin levels, a significantly greater proportion of patients with hyperferritinemia had thrombocytopenia (15.4% vs. 33.3%, p?=?0.003) and lupus anticoagulant (11.3% vs. 29.0%, p?=?0.01). Additionally, compared to normoferritinemic subjects, hyperferritinemic subjects had significantly higher total aCL (99.7?±?369 vs. 30.9?±?17.3 GPI, p?=?0.02) and aCL IgM antibody levels (75.3?±?357.4 vs. 9.3?±?10.3 GPI, p?=?0.02), and marginally lower aCL IgG antibody levels (9.2?±?4.9 vs. 9.7?±?3.9 GPI, p?=?0.096). While the ECLAM score significantly correlated with hyperferritinemia (p?=?0.04), the SLEDAI score was marginally associated with hyperferritinemia (p?=?0.1). Serositis was marginally associated with hyperferritinemia, but not with other manifestations. An association with serologic APS was encountered. Hyperferritinemia was associated with thrombocytopenia, lupus anticoagulant, and anti-cardiolipin antibodies suggest that it may be an early marker for secondary antiphospholipid syndrome in SLE patients.     

Influence of selenium and vitamin E supplementation on energy metabolism in horses used in policing activity

This study evaluated the effect of supplementation with selenium and vitamin E on some blood variables in 11 adult male horses used in policing activity. Each animal was treated with 2.8 mg/400 kg of selenium and 2.000 UI/400 kg of vitamin E of body weight, orally, for a period of 30 days. On days 0 (before) and 30 (after), the animals were assessed, and blood samples were obtained before and after exercise. Glucose and lactate and plasma cortisol and serum insulin were determined. On day 0, serum cortisol concentrations were 56.8?±?12.1 ng/ml and 43.4?±?19.2 ng/ml, plasma lactate were 6.2?±?0.7 mg/dl and 12.3?±?9.2 mg/dl, serum glucose levels were 69.2?±?5.2 mg/dl and 77.5?±?6.6 mg/dl, and serum insulin were 3.1?±?5.1 μUI/ml and 1.5?±?1.6 μUI/ml, respectively, before and after exercise (M1 and M2). On day 30, serum cortisol concentrations were 55.6?±?15.6 ng/ml and 27.6?±?12.2 ng/mL, plasma lactate were 7.0?±?0.9 mg/dl and 8.4?±?1.7 mg/dl, plasma glucose were 76.0?±?4.1 mg/dl and 77.1?±?8.9 mg/dl, and serum insulin were 3.3?±?6.9 μUI/ml and 2.1?±?3.7 μUI/ml, respectively, before and after exercise (M1S and M2S). As a result of the exercise, it was shown a reduction in serum insulin and an increase in plasma lactate and glucose. Supplementation with selenium and vitamin E resulted in decreased levels of cortisol and lactate after physical activity, possibly indicating that supplementation contributed to better utilization of plasma glucose and improved adaptation to physical exercise.     

TNF-α-308 promoter G/A and PTPN22 (1858 C/T) genes polymorphisms in Egyptian patients with systemic lupus erythematosus

Tumor necrosis factor alpha (TNF-α) promoter gene polymorphism at position 308 and that of the protein tyrosine phosphatase nonreceptor type 22 (PTPN22) at position 1858 C/T have been inconsistently implicated as genetic risk factors for systemic lupus erythematosus (SLE) in some populations. We investigated the possible association of these polymorphisms with SLE susceptibility, and whether serum TNF-α level is related to different genotypes and disease activity in Egyptian SLE patients. TNF-α-308 G/A and PTPN22 C1858T polymorphisms were determined by PCR-restriction fragment length polymorphism analysis in 40 SLE patients and 40 unrelated healthy controls. Serum TNF-α level was measured by ELISA method. The median serum TNF-α was significantly higher in SLE patients than in controls (P?<?0.001). A significant positive correlation was detected between serum TNF-α and SLE activity index (r?=?0.723, P?<?0.001). There was no significant difference in TNF-α-308 G/A genotypes or allele frequency between SLE cases and controls (P?=?0.108 and P?=?0.133, respectively). Diabetes was the only clinical feature in SLE patients that showed significant higher frequency with GA genotype than with GG genotype (P?=?0.001). Risk estimation for the TNF-α-308 genotypes was of no significant (odds ratio?=?2.429; 95 % CI?=?0.8–7.2; P?=?0.108). Concerning PTPN22 1858 C/T, there was no significant difference in PTPN22 C/T genotypes or allele frequency between SLE cases and controls (P?=?0.152 and P?=?0.155, respectively). TNF-α-308 G/A and PTPN22 (1858 C/T) polymorphisms do not exhibit a significant influence on the susceptibility of SLE in Egyptian patients. However, serum TNF-α level could be a sensitive marker of SLE disease activity.     

Effects of venom immunotherapy on serum level of CCL5/RANTES in patients with Hymenoptera venom allergy

Abstract

Hymenoptera venoms are known to cause life-threatening IgE-mediated anaphylactic reactions in allergic individuals. Venom immunotherapy is a recommended treatment of insect allergy with still the mechanism not being completely understood. We decided to assess the serum CCL5/RANTES level in patients who experienced severe anaphylactic reaction to Hymenoptera venom and to find out changes in the course of immunotherapy. Twenty patients (9 men, 11 women, mean age: 31.91?±?7.63 years) with history of anaphylactic reaction after insect sting were included into the study. Diagnosis was made according to sIgE and skin tests. All of them were enrolled into rush venom immunotherapy with bee or wasp venom extracts (Pharmalgen, ALK-Abello, Horsholm, Denmark). Serum levels of CCL5/RANTES were measured using a commercially available ELISA kit (R&D Systems, Minneapolis, MN). CCL5/RANTES serum concentration are higher in insect venom allergic patients than in healthy controls (887.5?±?322.77 versus 387.27?±?85.11?pg/ml). Serum concentration of CCL5/RANTES in insect venom allergic patient was significantly reduced in the course of allergen immunotherapy already after 6 days of vaccination (887.5?±?322.77 versus 567.32?±?92.16?pg/ml). CCL5/RANTES serum doesn’t correlate with specific IgE. Chemokine CCL5/RANTES participates in allergic inflammation induced by Hymenoptera venom allergens. Specific immunotherapy reduces chemokine CCL5/RANTES serum level already after initial days of venom immunotherapy.     

Pregnancy and Systemic Lupus Erythematosus: Review of Clinical Features and Outcome of 51 Pregnancies at a Single Institution

Systemic lupus erythematosus (SLE) is mainly a disease of fertile women and the coexistence of pregnancy is by no means a rare event. How SLE and its treatment affects pregnancy outcome is still a matter of debate. Assessment of the reciprocal clinical impact of SLE and pregnancy was investigated in a cohort study. We reviewed the clinical features, treatment, and outcomes of 43 pregnant SLE patients with 51 pregnancies followed from 1993 to 2007 at a tertiary university hospital. The age of patients was 28.7?±?5.4 years and SLE was diagnosed at age of 23.0?±?6.1 years. Previous manifestations of SLE included lupus nephritis (14 patients) and secondary antiphospholipid syndrome (11 patients). Thirty-five pregnant patients (69%) were in remission for more than 6 months at the onset of pregnancy. Patients were being treated with low doses of prednisone (29), hydroxychloroquine (20), azathioprine (five), acetylsalicylic acid (51), and low molecular weight heparin (13). Sixteen pregnancy-associated flares were documented, mainly during the second trimester (42%) and also in the following year after delivery (25%). Renal involvement was found in 11 cases (68%). Spontaneous abortion occurred in 6%, 16% had premature deliveries, and 74% were delivered at term. No cases of maternal mortality occurred. No cases of fetal malformation were recorded. There was one intrauterine fetal death and one neonatal death at 24 gestational weeks. Pregnant women with SLE are high risk patients, but we had a 90% success rate in our cohort. A control disease activity strategy to target clinical remission is essential.     

White Blood Cell Subtypes after STEMI: Temporal Evolution, Association with Cardiovascular Magnetic Resonance��Derived Infarct Size and Impact on Outcome

The evolution of white blood cells after ST elevation myocardial infarction (STEMI) and their association with infarct size and major adverse cardiac events (MACE) remains unclear. Two hundred eleven patients underwent CMR after STEMI. Infarct mass (grams) was determined. Neutrophil, lymphocyte, and monocyte counts (×1,000 cells/ml) were measured upon arrival and at 12, 24, 48, 72, and 96 h. Patients with large infarctions (3rd tertile????28.5 g vs. 1st and 2nd tertiles?<?28.5 g) showed a larger neutrophil count at 12 h (14.8?±?4.8 vs. 11.4?±?3.3, p?<?0.0001) and an increased monocyte count (maximum at 24 h (0.65[0.50?C0.91] vs. 0.55[0.42?C0.71], p?=?0.004)) but no difference in lymphocyte count. Neutrophil count at 12 h independently predicted large infarctions (OR 1.14, 95%CI [1.04?C1.26], p?=?0.008). During follow-up (median 504 days), 25 MACE occurred. Neutrophil count at 96 h independently predicted MACE (HR 1.2, 95%CI [1.1?C1.4], p?=?0.003). Large infarctions show a marked neutrophil peak and an increasing monocyte count. Neutrophil count independently predicts large infarctions and MACE.     

Serum C-reactive Protein Level and Distribution in Chronic Obstructive Pulmonary Disease Versus Healthy Controls: a Case–Control Study from Iran

Inflammation has a contributive role in the development and progression of chronic obstructive pulmonary disease (COPD).The present study was designed to determine the level and the distribution of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in COPD compared with controls. Ninety patients with COPD presented to an outpatient hospital clinic and 50 controls who were selected among personals of the same hospital entered the study. Serum high sensitive CRP (hs-CRP) was measured by immunoturbidimetric method and the ESR by Westergren method. Receiver operating characteristic curve was applied to determine a cutoff point for differentiation of the COPD and control group. In statistical analysis, the patients and controls were compared regarding levels and distribution of hs-CRP and ESR. Mean age of patients and controls was 67?±?11.6 and 51.3?±?6.7 years, respectively (p?=?0.001). Mean hs-CRP was significantly higher (4.76?±?5.6 vs 1.72?±?1.68 mg/L, p?=?0.001) but mean ESR was nonsignificantly higher (9.1?±?11.2 vs 7.2?±?7.4 m/h, p?=?0.95) in patients than control. Serum hs-CRP at 1.55 mg/L, differentiated patients and controls at sensitivity of 77.3 % and specificity of 60 %. Serum hs-CRP >3 mg/L was observed in 39 (44.3 %) patients and 9 (18 %) controls (p?=?0.001) and >6 mg/L in 22 (25 %) patients and 2 (4 %) controls (p?=?0.001).Serum hs-CRP was significantly correlated with ESR in patient but not in control group (Spearman correlation coefficient?=?0.516, p?=?0.001). Serum hs-CRP and ESR was not correlated with age, weigh, smoking, and the severity of COPD. The results of this study indicated a systemic inflammatory process in COPD. Since inflammation has an important contribution in development of future pulmonary and extrapulmonary complications, serum CRP assessment will provide additional information beyond that achieved by conventional method of pulmonary function test.     

Acute-phase proteins and oxidative stress biomarkers in water buffalo calves subjected to transportation stress

The objective of the present study was to determine the effect of the transportation stress on water buffalo calves. A total of 50 buffalo calves (8?±?1 months old, 165?±?13 kg) were assigned to one of two equal groups; the first group represented clinically healthy non-transported calves (control non-transported group; n?=?25) whereas calves of the second group were subjected to transportation (transported group; n?=?25). Blood samples were collected from control non-transported calves and from transported calves immediately after unloading (post-transportation). The present findings indicated that the examined hematological and biochemical parameters were not significantly (P?≤?0.05) changed in transported calves when compared with the control non-transported group. Furthermore, serum concentration of the investigated acute-phase proteins (APP) namely, haptoglobin (0.37?±?0.01), serum amyloid A (75.43?±?2.11), and fibrinogen (7.51?±?0.25) were significantly (P?≤?0.05) higher in transported calves when compared with control calves (0.1?±?0.01 g/l, 23.9?±?0.56 mg/l, and 4.2?±?0.16 g/l), respectively. Lipid peroxidation represented as malonaldhyde (56.78?±?3.42) was higher significantly (P?≤?0.05), whereas antioxidant biomarkers in the form of nitric oxide (17.68?±?0.89) levels, and activities of superoxide dismutase (7.37?±?0.53) and reduced glutathione (5.25?±?0.95) were lower significantly (P?≤?0.05) in the serum of transported calves when all were compared with the control group (24.68?±?0.19 nmol/g Hb, 21.80?±?0.24 mmol/ml, 9.24?±?0.1 U/g Hb, and 7.23?±?0.21 mmol/l), respectively. Conclusively, the present study demonstrated that transportation were significantly enough to trigger changes in APP and oxidative stress biomarkers in buffalo calves.     

Serum Cardiotrophin-1 and IL-6 Levels in Patients with Obstructive Sleep Apnea Syndrome

Obstructive sleep apnea syndrome (OSAS) is associated with increased rates of cardiovascular diseases (CVD). Basic mechanisms involved in the increased cardiovascular risk of OSAS remain unclear. Inflammation has been shown to potentially play a critical role in this association. The aim of the present study was to investigate the level of cardiotrophin-1 (CT-1) in patients with OSAS. Forty-eight newly diagnosed OSAS patients and 37 nonapneic controls were enrolled in this study. Demographic data, cigarette smoking status, previous history of chronic diseases including CVD and metabolic diseases and drugs, and habits were obtained by a standardized questionnaire. All patients underwent polysomnographic evaluation. The mean age was 48.3?±?12.3 (24–74) years in OSAS group. Median apnea–hypopnea index was 23.6 (6–91.8) and median body mass index was 30.4 (24.2–49.4) in the OSAS group. Plasma CT-1 levels in OSAS and control groups, respectively, were 12.03?±?1.08 and 11.85?±?1.18 pg/ml. There was no significant difference in the plasma levels of CT-1 and IL-6 between the OSAS group and the controls.     

Drug concentrations in the serum and cerebrospinal fluid of patients treated with norvancomycin after craniotomy

Intracranial infection by gram-positive cocci is commonly found after craniotomy. Norvancomycin was independently developed in China, and had demonstrated therapeutic capability against gram-positive infection. This study investigated the serum and cerebrospinal fluid (CSF) concentrations in patients that received intravenous injection of norvancomycin after craniotomy. Patients with an indwelling catheter in the operational area/ventricle after craniotomy were administered norvancomycin by two approaches: (1) The conventional group consisted of 14 cases that were infused with 0.8 g norvancomycin for 1 h, every 12 h; (2) The continuous administration group consisted of 14 cases that were infused with 0.8 g norvancomycin for 1 h, and then another 0.4 g for 11 h with extended infusion, followed by continuous infusion of 0.4 g norvancomycin for 12 h. Samples of serum and CSF were collected at different time-points to measure norvancomycin levels after administration. In the conventional and continuous administration groups, the peak serum concentrations of norvancomycin were 55.52?±?26.04 and 59.22?±?41.88 mg/L, respectively, while those at 24 h were 8.21?±?6.04 and 8.01?±?4.17 mg/L, respectively. Meanwhile, peak CSF concentrations were 16.31?±?11.15 and 8.82?±?8.91 mg/L, respectively, while those at 24 h were 6.12?±?2.34 and 6.24?±?4.38 mg/L, respectively. This preliminary study showed that for the early administration of standard doses of norvancomycin post-neurosurgery, the CSF concentration in both the conventional and continuous administration groups reached or exceeded the 90 % minimum inhibitory concentration (MIC₉₀, 2 mg/L) of target bacteria such as methicillin-resistant Staphylococcus aureus (MRSA).     

Decreased Flow-Mediated Dilatation in Patients with Systemic Lupus Erythematosus: a Meta-analysis

Premature atherosclerosis, the hallmark of cardiovascular diseases, has been found to be a significant cause of late deaths in systemic lupus erythematosus (SLE) patients. Therefore, early identification of atherosclerosis before the overt disease is curial for the management program of SLE. Flow-mediated dilatation (FMD%) is a reliable, noninvasive, easy to use, reproducible, and pathogenically relevant index for early atherosclerosis. In recent years, a number of studies have been performed to compare the mean FMD% difference between patients with SLE and healthy controls. However, these studies have shown inconclusive or even contradictory findings. In this study, to derive a more precise comparison of FMD% difference between SLE patients and healthy controls, a meta-analysis was performed. Databases were searched to identify all available studies comparing FMD% between SLE patients and healthy controls. The study eligibility criteria were cohort or case–control studies with data on both patients diagnosed with SLE and healthy controls, and use of high-resolution ultrasonography to detect FMD. Random effect meta-analysis was conducted to evaluate the overall mean FMD% difference between the two groups. Publication bias was detected by funnel plot and Egger’s test. Meta-regression analysis was performed to investigate the potential influencing factors on FMD% difference. Of the 434 articles initially identified, 22 were finally included in the meta-analysis. Compared to healthy controls, SLE patients had significantly lower FMD% (standardized mean difference, ?1.19; 95 % CI, ?1.63, ?0.74; P?I ²?=?94.3 %, P?P?=?0.006). However, after the correction for potential publication bias by using the trim-and-fill method, the main results for all studies combined were still significant (P?相似文献   

Type-III interferons and rheumatoid arthritis: Correlation between interferon lambda 1 (interleukin 29) and antimutated citrullinated vimentin antibody levels

Aim: To assess serum type III or lambda (λ) interferons (IFN) levels and its clinical and laboratory associations in rheumatoid arthritis (RA). Methods: A cross-sectional study including 43 patients with RA (86% females; age 45.3?±?10.3 years) and 43 healthy individuals was performed. Clinical data including disease activity, acute-phase reactants, rheumatoid factor and anticyclic citrullinated peptide (anti-CCP) antibodies were collected. Serum IFNλ1, IFNλ2, IFNλ3, CXCL8 and anti-mutated citrullinated vimentin (anti-MCV) antibody levels were measured. Results: Patients with RA had higher IFNλ1 (113.5?±?118.6?pg/mL versus 55.9?±?122.3?pg/mL; p?<?0.0001) and IFNλ2 (245.4?±?327.7?pg/mL versus 5.1?±?11.0?pg/mL; p?=?0.009) levels than controls, but not IFNλ3 levels. Notably, IFNλ1 levels were found to be higher in both patients with active disease (124.9?±?135.9?pg/mL; p?<?0.001) and quiescent disease (99.0?±?93.7?pg/mL; p?<?0.01), while IFNλ2 levels were higher only in patients with active disease (264.0?±?356.1?pg/mL; p?=?0.02). A noteworthy association between serum IFNλ1 levels and anti-MCV antibody titers (Spearman's rho coefficient 0.36, 95% CI 0.36 to 0.61; p?=?0.02) was observed. Conclusion: Serum IFNλ1 and IFNλ2 levels are abnormally elevated in patients with RA and the former are linearly associated with circulating anti-MCV antibody levels. These results may place type-III IFN as an attractive new therapeutic target in RA.     

Increased Serum GP88 (Progranulin) Concentrations in Rheumatoid Arthritis

GP88 (Progranulin; PGRN) is a secreted glycosylated protein with important functions in several processes, including immune response and cancer growth. Recent reports have shown that PGRN is a therapeutic target for rheumatoid arthritis (RA) because of its capability to bind with tumor necrosis factor receptor (TNFR). However, the serum PGRN level in RA patients has not been investigated. We used enzyme-linked immunosorbent assay (ELISA) to quantify the serum levels of PGRN in 417 healthy subjects, 56 patients with RA and 31 patients with osteoarthritis (OA). In RA patients, we also measured the serum TNF-α and sTNFR concentration. Immunohistochemical staining of PGRN was performed using synovectomy tissue of RA patients. The serum PGRN normal range was established as 40.1?±?8.7 ng/ml. PGRN levels were not influenced by sex or age. A significant increase in serum PGRN levels was observed in RA (50.2?±?11.1 ng/ml) and OA (45.4?±?6.6 ng/ml) groups compared to those in age-matched healthy controls (40.4?±?9.9 ng/ml) (p?TNF-α and sTNFR 2 concentration. Furthermore, PGRN/TNF-α ratio was correlated the stage of the disease in RA patients. The concentrations of serum PGRN in RA were found to be significantly higher than those in age-matched healthy controls, although it remains to be clarified how blood PGRN is related to the pathogenesis of RA. Our results showed that the serum PGRN may be a useful approach to monitor the disease activity in RA patients.     

Correlation between disease activity of pediatric-onset systemic lupus erythematosus and level of vitamin D in Taiwan: A case–cohort study

Background

Vitamin D deficiency has been associated with systemic lupus erythematosus (SLE), but there is no consensus on the role of serum vitamin D in evaluating or predicting disease activity. This study aimed to demonstrate the direct correlation between vitamin D level and pediatric-onset SLE disease activity by a retrospective cohort study design.

Body Image in Patients with Systemic Lupus Erythematosus

Background

Systemic lupus erythematosus (SLE), a multisystemic disease of young women may be disfiguring and affect physical and emotional health. Body image literature in SLE is scant and controversial.

Purpose

We compared body image-related quality of life in subjects with (n?=?87) and without (n?=?78) SLE and determined its correlates using the body image quality of life inventory (BIQLI).

Method

The tool was self-administered to consenting individuals. Demographic information along with disease activity and damage assessments for SLE patients were obtained. T test, chi square test, correlational, and regression analyses were used to make comparisons.

Results

Mean age (±SD) were 42.4?±?13.1 and 38.7?±?13.2?years for SLE and non-SLE subjects, respectively. Mean (±SD) BIQLI scores were significantly worse in SLE than non-SLE subjects: 19.9?±?33.2 and 41.6?±?24.8 (p?=?0.001). In SLE, BIQLI scores correlated inversely with overall damage, irreversible cutaneous damage, alopecia, and self-reported depression, and directly with age and health status.

Conclusion

Body image in SLE is poor, and effective interventions may be directed at cutaneous disease activity, damage, and depression.     

Glucocorticoid Regulates Interleukin-37 in Systemic Lupus Erythematosus

The aim of this study was to research the expression of IL-37 in systemic lupus erythematosus (SLE) patients and the effect of glucocorticoid on IL-37. Thirty newly diagnosed severe SLE patients receiving prednisone 1 mg/kg/day for 14 consecutive days and 30 healthy subjects were enrolled into this study. The plasma levels of IL-37 and other cytokines were detected by ELISA and the relative mRNA amounts of IL-37 and other cytokines were detected by RT-PCR. The plasma levels of IL-37, IL-18, IL-18BP, IFN-γ, and IL-6 in SLE patients increased significantly compared with healthy controls (p?<?0.05). The relative amount of IL-37 mRNA increased by 2.45-fold in pre-treatment SLE patients compared with controls (p?<?0.05). Plasma concentrations of IL-37 correlated with IL-18, IL-18BP, IFN-γ, IL-6 and SLEDAI score in both pre-treatment and post-treatment SLE patients. The plasma levels of IL-37 decreased significantly after treatment of glucocorticoid. The relative amount of IL-37 mRNA decreased by 24.5 % in post-treatment SLE patients compared with pre-treatment ones (p?<?0.01). In conclusion, IL-37 is upregulated in active SLE patients. IL-37 is correlated with pro-inflammatory cytokines and SLEDAI. Glucocorticoid can downregulate the expression of IL-37 and other cytokines in SLE patients.