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ID PMID Title PublicationDate abstract
20591195 Anti-centromere antibody-seropositive Sjögren's syndrome differs from conventional subgro 2010 Jul 1 BACKGROUND: To clarify the clinicopathological characteristics of primary Sjögren's syndrome (pSS) with anti-centromere antibody (ACA). METHODS: Characteristics of 14 patients of pSS with ACA were evaluated. All patients were anti-SS-A/Ro and SS-B/La antibodies negative (ACA+ group) without sclerodactyly. The prevalence of Raynaud's phenomenon (RP), titer of IgG and focus score (FS) in the minor salivary glands (MSGs) were determined. Quantification analysis of Azan Mallory staining was performed to detect collagenous fiber. Forty eight patients in whom ACA was absent were chosen as the conventional (ACA-) pSS group. RESULTS: Prevalence of ACA+ SS patients was 14 out of 129 (10.85%) pSS patients. RP was observed in 61.5% of the patients with ACA. The level of IgG in the ACA+ group was significantly lower than that of the ACA- group (p = 0.018). Statistical difference was also found in the FS of MSGs from the ACA+ group (1.4 +/- 1.0) as compared with the ACA- group (2.3 +/- 1.6) (p = 0.035). In contrast, the amount of fibrous tissue was much higher in the ACA+ group (65052.2 +/- 14520.6 microm(2) versus 26251.3 +/- 14249.8 microm(2)) (p = 1.3 x 10(-12)). CONCLUSIONS: Low cellular infiltration but with an increase in fibrous tissues may explain the clinical feature of a high prevalence of RP and normal IgG concentration in ACA+ pSS.
20523173 A mandibular implant-supported fixed complete dental prosthesis in a patient with Sjogren 2010 Jun The article describes the treatment and 1 year follow-up of a patient with Sjogren syndrome, treated with 6 intraforaminal mandibular implants with delayed loading and an implant-retained fixed prosthesis. The maxillary arch has been treated with a complete denture. This made an enormous difference in comfort and function for the patient. Radiographic check-ups did not reveal any peri-implant bone loss after 1 year of loading.
20346359 Toll-like receptors in ocular surface disease. 2010 Jun The ability of the ocular surface to mount an immune response is in part attributed to a family of proteins called toll-like receptors (TLRs). The latter are evolutionary conserved receptors that recognize and respond to various microbes and endogenous ligands. In addition to their recognition function, TLR activation triggers a complex signal transduction cascade that induces the production of inflammatory cytokines and co-stimulatory molecules, thus initiating innate and adaptive immunity. Toll-like receptor expression at the ocular surface is modulated during infection (e.g. Herpes simplex, bacterial keratitis and fungal keratitis) as well as during various inflammatory conditions (allergic conjunctivitis and dry-eye syndrome). Here recent findings regarding TLR expression and their involvement in various ocular surface diseases are discussed.
20120352 [A case of anti-aquaporin 4 antibody-positive Sjögren syndrome associated with a relapsed 2010 Jan It is known that pregnancy influences the relapsing rate of multiple sclerosis (MS); however, interaction between pregnancy and relapse of neuromyelitis optica (NMO), a distinct disease from MS, remains unclear. A 34-year-old woman who 1 year previously had clinical history of Sjögren syndrome complicated by myelitis with the presence of anti-AQP4 antibody in her serum, although there was no optic neuritis involvement, was neurologically normal at time of becoming pregnant. In the 22nd week of her pregnancy, however, she developed abdominal belt-shaped numbness and sensory impairment followed by weakness of bilateral lower limb leading to difficulty of her gait. MR imaging revealed hyperintense lesions within the spinal cord extending from C2 to T2 vertebral level with marked spinal cord swelling, indicating relapse of myelitis associated with anti-AQP4 antibody. She was treated with intravenous corticosteroid with marked benefits for her neurological status; she was able to walk without assistance after the treatment. However, in the 30th week she relapsed with myelitis at T2 to T9 vertebral level on MR imaging. Intravenous steroid administration again elicited improvement. She delivered a baby via Caesarean section at 34 weeks of pregnancy. After delivery, she started taking oral corticosteroid as preventive therapy for further relapse of myelitis; thus far she has had no relapse at 7 months of follow-up. There are few reports regarding the influence of pregnancy on anti-AQP4 antibody-positive myelitis. Although further investigation should be done to clarify the difference of immunological changes during pregnancy between NMO and conventional MS, our case together with previous reports indicate increased risk of relapse during pregnancy in NMO. It is necessary to remain vigilant against possible risk of relapse during pregnancy in patients with NMO and/or positive anti-AQP4 antibody. Intravenous steroid administration seems safe and effective against relapse of NMO during pregnancy.
19520492 A quantitative analysis of sonographic images of the salivary gland: a comparison between 2009 Aug We performed three quantitative analyses (particle analysis, fractional Brownian motion [fBM] model analysis, two-dimensional [2-D] fractal analysis) of the ultrasonographic (US) images of the salivary gland and evaluated whether the obtained indices correlated with the sialographic stage of Rubin-Holt. Our study included 192 patients suspected of having Sjögren's syndrome (SS). In 89 patients, sialography demonstrated abnormal findings. Based on a particle analysis, we calculated both the average size of the particles (avg-area) and the area ratio to evaluate the presence of hypoechoic areas and echogenic lines, which are characteristic of SS. According to the fBM model, we calculated the Hurst index of the original image (Hurst-ori) and the background-subtracted image (Hurst-bs) to evaluate the complexity of the pixel value distribution. We also obtained the 2-D fractal dimension (2-D-FD) to evaluate the complexity of the contour lines. We entered these indices of the parotid glands (PG) into a logistic regression analysis and evaluated which indices were useful predictors for detecting an abnormal sialographic stage. Significant differences were observed between the normal and abnormal groups in all five indices of the PG (Mann-Whitney U test) and all five indices were correlated with the Rubin-Holt stage (Spearman's Rank Correlation Test). As the Rubin-Holt stage became more severe, both the Hurst-ori and 2-D-FD became smaller. Alternatively, the Hurst-bs, avg-area, and area ratio became higher. Three indices (avg-area, area ratio and Hurst-ori) were selected as useful predictors for detecting abnormal sialographic stages. This quantitative analysis system is therefore considered to have potentially useful clinical applications for the detection of abnormal sialographic findings.
20177398 IL-1 pathways in inflammation and human diseases. 2010 Apr Interleukin (IL)-1 was first cloned in the 1980s, and rapidly emerged as a key player in the regulation of inflammatory processes. The term IL-1 refers to two cytokines, IL-1alpha and IL-1beta, which are encoded by two separate genes. The effects of IL-1 are tightly controlled by several naturally occurring inhibitors, such as IL-1 receptor antagonist (IL-1Ra), IL-1 receptor type II (IL-1RII), and other soluble receptors. Numerous IL-1 inhibitors have been developed and tested primarily in rheumatoid arthritis, with only modest effects. By contrast, the use of IL-1 antagonists has been uniformly associated with beneficial effects in patients with hereditary autoinflammatory conditions associated with excessive IL-1 signaling, such as cryopyrinopathies and IL-1Ra deficiency. Successful treatment with IL-1 blockers has also been reported in other hereditary autoinflammatory diseases, as well as in nonhereditary inflammatory diseases, such as Schnizler syndrome, systemic-onset juvenile idiopathic arthritis and adult Still disease. The role of microcrystals in the regulation of IL-1beta processing and release has provided the rationale for the use of IL-1 inhibitors in crystal-induced arthritis. Finally, preliminary results indicating that IL-1 targeting is efficacious in type 2 diabetes and smoldering myeloma have further broadened the spectrum of IL-1-driven diseases.
21111933 Dentistry and internal medicine: from the focal infection theory to the periodontal medici 2010 Dec During past decades the relationship between dentistry and internal medicine and especially the concept of the so-called focal infection theory have long been a matter of debate. The pathogenesis of focal diseases has been classically attributed to dental pulp pathologies and periapical infections. Nonetheless, in recent years, their role is being dismissed while increasing interest is being devoted to the possible associations between periodontal infection and systemic diseases. In fact, periodontal pathogens and their products, as well as inflammatory mediators produced in periodontal tissues, might enter the bloodstream, causing systemic effects and/or contributing to systemic diseases. On the basis of this mechanism, chronic periodontitis has been suggested as a risk factor for cardiovascular diseases associated with atherosclerosis, bacterial endocarditis, diabetes mellitus, respiratory disease, preterm delivery, rheumatoid arthritis, and, recently, osteoporosis, pancreatic cancer, metabolic syndrome, renal diseases and neurodegenerative diseases such as Alzheimer's disease. Various hypotheses, including common susceptibility, systemic inflammation, direct bacterial infection and cross-reactivity, or molecular mimicry, between bacterial antigens and self-antigens, have been postulated to explain these relationships. In this scenario, the association of periodontal disease with systemic diseases has set the stage for introducing the concept of periodontal medicine. This narrative review summarizes the evolution of focal infection theory up to the current pathophysiology of periodontal disease, and presents an update on the relationships between chronic periodontitis and systemic diseases.
20842830 [Rituximab in systemic lupus erythematosus. Part II: review of clinical experience]. 2010 Aug Rituximab is a chimeric human-mouse monoclonal antibody, which binds to the CD20 antigen on B lymphocytes and causes depletion of CD20+ cells. Rituximab is currently registered for the treatment of non-Hodgkin's lymphoma, chronic lymphocytic leukemia and rheumatoid arthritis. Rituximab also demonstrated efficacy in a number of other autoimmune diseases, including systemic lupus erythematosus. Data available from over published 200 cases may indicate that 50-75% of patients with lupus achieve at least partial remission after rituximab therapy. This effect was not confirmed in a randomized, double-blind phase II/III clinical trial. However methodological inaccuracies which might have led to incorrect conclusions in this trial were pointed out. Further studies are needed to evaluate efficacy of rituximab in different clinical and immunological subtypes of systemic lupus erythematosus.
20806183 Chromogranin A (CgA)--the influence of various factors in vivo and in vitro, and existing 2010 Jul Chromogranin A (CgA) is regarded as a major, nonspecific neuroendocrine tumour (NET) marker. The results of CgA blood concentration, however, may actually be influenced by various factors or coexisting pathological conditions. Among the factors causing a substantial increase of the blood CgA concentration are: treatment with proton-pump inhibitors or Hâ‚‚-receptor blockers, chronic atrophic gastritis (type A), impaired renal function, prostate cancer and BPH, and rheumatoid arthritis with high level of RF IgM. In addition, the sort of investigated biological material (whether it is serum or plasma) is of importance. There are also many conditions which may have a moderate or little influence on the concentration of CgA, among them are: inflammatory bowel disease (ulcerative colitis and Crohn's disease), deteriorating liver function, untreated essential hypertension, heart failure, hypercortisolism, pregnancy, and, in some subjects, ingestion of a meal. Proper assessment of the CgA results requires detailed knowledge about various factors, drugs, and pathological conditions influencing its concentration in blood.
20727619 [Unilateral uveitis with HHV6-positive polymerase chain reaction in aqueous humor for an e 2010 Oct Human herpesvirus 6 is a ubiquitous Herpesviridae infecting patients during childhood. Its role in ocular disorders is mostly unknown. We report the case of a 47-year-old woman with a history of rheumatoid arthritis (treated with etanercept) and tuberculosis, who presented with sudden unilateral panuveitis. The patient was initially treated with ganciclovir, as the polymerase chain reaction in the aqueous humor was positive for HHV6, and with pyrimethamine and sulfadiazine because a toxoplasmic co-infection was highly suspected, which was biologically confirmed. Management of HHV6 in a nervous system disorder is challenging because its replication has been proved but its role remains unclear. HHV6 may be pathogenic by itself but can facilitate co-infection as can etanercept.
20663958 Fetal stem cell microchimerism: natural-born healers or killers? 2010 Nov After four decades of study, the biological role of fetal microchimerism (FMC) remains elusive. Transfer of fetal cells to the mother begins soon after implantation, and increases with gestational age. FMC cells then decline after delivery, but remain detectable for years post-partum. These cells have been implicated in rheumatoid arthritis remission during pregnancy and the prevention of breast cancer by graft-versus-tumor-effects. However, any beneficial effects contrast with their suspected malevolence in triggering of systemic sclerosis after childrearing or their stromal support for tumor formation. Recent evidence that FMC cells participate in disease and tissue repair has stirred controversy on their origin. The detection of FMC cells during early embryogenesis together with the diversity of hematopoietic, mesenchymal and endothelial markers, and plasticity of morphology when integrated into various tissues, provides evidence for their stemness. However, proof of their phenotype in conventional stem cell differentiation assays has been beset with difficulty in isolating and expanding them in culture. Unraveling the function of FMC cells will provide insight into both their engagement in disease and their therapeutic potential.
20655998 Oral pulsatile delivery: rationale and chronopharmaceutical formulations. 2010 Oct 15 Oral pulsatile/delayed delivery systems are designed to elicit programmable lag phases preceding a prompt and quantitative, repeated or prolonged release of drugs. Accordingly, they draw increasing interest because of the inherent suitability for accomplishing chronotherapeutic goals, which have recently been highlighted in connection with a number of widespread chronic diseases with typical night or early-morning recurrence of symptoms (e.g. bronchial asthma, cardiovascular disease, rheumatoid arthritis, early-morning awakening). In addition, time-based colonic release can be attained when pulsatile delivery systems are properly adapted to overcome unpredictable gastric emptying and provide delay phases that would approximately match the small intestinal transit time. Oral pulsatile delivery is pursued by means of a variety of release platforms, namely reservoir, capsular and osmotic devices. The aim of the present review is to outline the rationale and main formulation strategies behind delayed-release dosage forms intended for the pharmacological treatment of chronopathologies.
20642115 [The importance of determining the prognostic marker YKL-40 in serum and tissues]. 2010 Jun YKL-40 is detected in the early nineties not only a glycoprotein secreted by cancer cells, but also of neutrophils, chondrocytes and endothelial cells. Biological function of YKL-40 are not exactly known, it is suggested that this protein participates in many physiological and pathological processes such as proliferation, angiogenesis, mitogenesis and remodelling. It is also a factor antyapoptotic and growth factor for some cells. Increased levels of YKL-40 in serum have been described in many diseases running with inflammation such as rheumatoid arthritis, systemic lupus erythematosus and Crohn's disease, and also in the group of cardiovascular diseases. Determination of the concentration of serum YKL-40 was also used in oncology. The tumors at various sites were found elevated levels of this marker in serum, as well as overexpression in tumor tissue. It was observed that higher titers YKL-40 levels are associated with shorter overall survival and disease-free period. It is suggested that measuring the concentration of YKL-40 in serum and its expression in tumor tissues may serve as a valuable and independent prognostic factor.
20456998 Crosstalk between TNF and glucocorticoid receptor signaling pathways. 2010 Aug TNF is a Janus-faced protein. It possesses impressive anti-tumor activities, but it is also one of the strongest known pro-inflammatory cytokines, which hampers its use as a systemic anti-cancer agent. TNF has been shown to play a detrimental role in inflammatory diseases such as rheumatoid arthritis and inflammatory bowel disease. Glucocorticoids are strongly anti-inflammatory and exert their therapeutic effects through binding to their receptor, the glucocorticoid receptor. Therefore, glucocorticoids have been used for over half a century for the treatment of inflammatory diseases. However, many patients are or become resistant to the therapeutic effects of glucocorticoids. Inflammatory cytokines have been suggested to play an important role in this steroid insensitivity or glucocorticoid resistance. This review aims to highlight the mechanisms of mutual inhibition between TNF and GR signaling pathways.
20189392 Retro-odontoid pseudotumor without atlantoaxial subluxation. 2010 May A retro-odontoid pseudotumor (ROP) is commonly associated with atlantoaxial subluxation (AAS). Here, we report a patient with ROP but without AAS. The patient was a 72-year-old man who did not have a history of rheumatoid arthritis or trauma to the head and neck. The patient was admitted to our hospital with gait disturbance, progressive motor weakness in both upper extremities and sensory disturbance in all four extremities. MRI showed a retro-odontoid mass with severe compression of the cervical spinal cord. A CT scan showed spondylotic changes in C5, C6, and C7 and bilateral facet fusion between C3 and C4. Dynamic radiography showed no evidence of AAS; there was loss of mobility at C2-C7 and excessive mobility at C1. Intraoperative pathological examination revealed that the lesion was a pseudotumor; therefore, posterior C1-C2 fixation was performed. MRI performed 6 months after the operation revealed that the pseudotumor was markedly reduced. To the best of our knowledge, patients with ROP without AAS are uncommon.
20148068 Controversies on rituximab therapy in sjögren syndrome-associated lymphoproliferation. 2009 Sjögren's syndrome (SS) is a systemic autoimmune disease characterized by chronic inflammation of salivary and lachrymal glands, and frequently accompanied by systemic symptoms. A subgroup of SS patients develops malignant B cell non-Hodgkin's lymphoma (NHL), usually of the mucosa-associated lymphoid tissue (MALT) type and very often located in the major salivary glands. Currently, there is a lack of evidence-based intervention therapy which may influence SS-related chronic inflammation and lymphoproliferation. B cells are involved in the pathogenesis of SS, and B cell downregulation may lead to a decrease of disease activity. Rituximab (RTX), a chimeric monoclonal antibody targeting the CD20 antigen on the B cell surface, has been successfully investigated in other autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, ANCA-associated vasculitis, and mixed cryoglobulinemic syndrome. Preliminary experiences of RTX therapy in SS patients with or without a lymphoproliferative disorder suggest that SS patients with more residual exocrine gland function might better benefit from RTX. Efficacy of RTX in SS-associated B-cell lymphoma, mainly in low-grade salivary gland lymphomas, remains an open issue.
19604258 Translational Mini-Review Series on B Cell-Directed Therapies: The pathogenic role of B ce 2009 Aug B cell depletion therapy with rituximab (BCDT) is a licensed treatment for rheumatoid arthritis and has shown promising results in the treatment of severe, refractory patients with other autoantibody-associated autoimmune diseases (AAID). The exact role that B cells play in the pathogenesis of AAID and consequently the mechanisms by which BCDT is effective are not known. The two more widely discussed hypotheses are that BCDT is effective because it removes the precursors of plasma cells producing pathogenic autoantibody species, or because it depletes a critical mass of autoreactive B cell clones that present antigen to pathogenic autoreactive T cells. This review will focus on the effects of BCDT and whether the response of patients with AAID to BCDT could be due ultimately to its effects on autoantibodies. A better knowledge of the main role that B cells play in the pathogenesis of the different diseases and a better understanding of the most likely mechanism of relapse following an earlier response to BCDT would help to guide further developments of B cell targeting therapies and potentially increase the chance of designing a protocol that could induce a long-term remission.
20729962 Rituximab: a review of dermatological applications. 2009 May The treatment of many dermatological disorders, such as autoimmune and immune-mediated diseases, consists of the use of systemic corticosteroids alone or in combination with other steroid-sparing immunosuppressants. Often, these treatment regimens are sufficient to control disease activity with relatively few side effects if monitored by a diligent physician. Some patients, however, may be refractory to treatment or develop intolerable side effects from therapy. For these patients, alternative treatment modalities with less toxicity and greater efficacy are required. Rituximab is a genetically engineered, chimeric monoclonal antibody directed against the B-cell lineage specific CD20 antigen. Originally developed for the treatment of B-cell non-Hodgkin"s lymphoma, rituximab has increasingly been used to treat a variety of autoimmune and immune-mediated disorders, such as rheumatoid arthritis, pemphigus diseases, systemic lupus erythematosus, dermatomyositis, and idiopathic thrombocytopenic purpura to name a few. Since very few randomized, controlled, clinical trials exist regarding the use of rituximab in the treatment of dermatological disorders, guidelines for the off-label use of this medication come from anecdotal case reports and cohort studies. Further clinical studies are needed to validate the safety and efficacy of rituximab therapy in dermatological disorders. Until then, we present a literature review of the emerging use of this B-cell depletion therapy. (J Clin Aesthetic Dermatol. 2009;2(5):29-37.).
18725317 Interleukin-23: immunological roles and clinical implications. 2009 Apr Increasing evidence has revealed the importance of IL-23, which closely resembles IL-12 both structurally and immunologically, in linking innate and adaptive immunity. IL-23, produced by activated type 1 macrophages and dendritic cells (DC), possesses unique roles in the differentiation and expansion of memory T cells. IL-23 has been associated with several inflammatory diseases such as rheumatoid arthritis, inflammatory bowel disease (IBD) and Helicobacter pylori associated gastritis, mainly due to its capacity to induce a strong Th1 type immune response. IL-23 is also associated with Th17 responses and the cytokine produced by the antigen presenting cells (APC), i.e. IL-12 vs IL-23 determines in part if a response is Th1 or Th17. Recent studies have also associated chronic inflammatory diseases such as IBD, psoriasis and myocardial infarction with polymorphisms of the IL-23 receptor complex. The current review focuses on the immunological role of IL-23 and possible therapeutic avenues for inflammatory diseases.
18712523 Infliximab-induced lupus-like syndrome in a patient with ankylosing spondylitis. 2009 Feb Infliximab is a chimerical monoclonal antibody currently used in the treatment of various inflammatory diseases. Lupus-like syndrome is a rarely reported adverse event, and generally observed in rheumatoid arthritis cases. We hereby define and describe a case of a lupus-like syndrome, which developed following the 4th infliximab infusion in a 62-year-old patient with ankylosing spondylitis (AS). As far as we acknowledge, the present case is the third AS case with infliximab-induced lupus.