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ID PMID Title PublicationDate abstract
20672910 The dangerous liaison between iNKT cells and dendritic cells: does it prevent or promote a 2011 Feb Invariant natural killer T (iNKT) cells represent an important regulatory T-cell subset that perceives signals of danger and/or cellular distress and modulate the adaptive immune response accordingly. In the presence of pathogens, iNKT cells acquire an adjuvant function that is fundamental to boost anti-microbial and anti-tumor immunity. At the same time, iNKT cells can play a negative regulatory function to maintain peripheral T-cell tolerance toward self-antigens and to prevent autoimmune disease. Both these effects of iNKT cells involve the modulation of the activity of dendritic cells (DCs) through cell-cell interaction. Indeed, iNKT cells can either boost Th1 immunity by enhancing maturation of pro-inflammatory DCs or promote immune tolerance through the maturation of tolerogenic DCs. This dual action of iNKT cells opens questions on the modalities by which a single-cell subset can exert opposite effects on DCs and may even put in question the overall immunosuppressive properties of iNKT cells. This review presents the large body of evidence that shows the ability of iNKT cells to negatively regulate autoimmunity and to prevent autoimmune diseases including multiple sclerosis, type 1 diabetes, rheumatoid arthritis, and systemic lupus erythematosus. In addition, an update is provided on the mechanisms of iNKT-DCs interactions and how this can result in inflammatory or tolerogenic responses.
20168284 The non tumour uptake of (111)In-octreotide creates new clinical indications in benign dis 2010 Feb The use of somatostatin (SS) analogues in humans takes advantage by the availability of many related chemical forms that can be used for receptor therapy and, after radiolabelling, for diagnostic imaging and radionuclide therapy. The first proposed radiocompound, yet clinically widely diffuse, has been (111)In-octreotide (OCT), followed by positron emission tomography (PET) and beta emitter tracers. The main field of clinical applications is in neuroendocrine tumours (NET), starting by the demonstration of SS receptors (SSR) on the majority of NET, particularly on gastroenteropancreatic (GEP) tumours. Uptake of SS analogues can also be due to a SSR expression on non malignant cells when activated, as lymphocytes, macrophages, fibroblasts , vascular cells. Because of this uptake clinical indications can be found also in active benign diseases, as Grave's ophthalmopathy, rheumatoid arthritis, histiocitosis, sarcoidosis, idiopatic pulmonary fibrosis. Moreover, these cells can also determine the OCT in vivo uptake in tumours non expressing in vitro SSR, as non-snall cell lung cancer (NSCLC). Because of a different kinetic respect to SCLC a differential histotype diagnosis could be obtained. Starting from this premise OCT can also allows radioguided surgery in tumours non expressing SSR. Finally a relevant clinical role can be defined in the a priori recruitment and as marker of therapeutic efficacy in all the therapeutic strategies utilizing SSR, both in malignant and benign diseases.
20051862 Genetics of vasculitis. 2010 Mar PURPOSE OF REVIEW: Evidence for a genetic contribution to risk for developing different forms of vasculitis has accumulated recently. Cohorts have been assembled that are of sufficient size to allow application of up-to-date methods of genetic analysis. This review will summarize the current understanding of the genetics of several forms of vasculitis. RECENT FINDINGS: The first genome-wide association studies (GWAS) in vasculitis have been published, in Behçet's disease and Kawasaki disease; none of the genes identified in these studies had been previously investigated. Associations of various HLA alleles with different vasculitides have been replicated. Other genes associated with Wegener's granulomatosis in replicated candidate gene studies are also associated with other autoimmune diseases. Consistent with this finding, epidemiologic data suggest a familial link between risk of Wegener's granulomatosis and rheumatoid arthritis. Among the most interesting genes clearly associated with vasculitis, however, are uncommon alleles that also cause monogenic recessive diseases: MEFV in Behçet's disease and Henoch-Schönlein purpura, and A1AT in Wegener's granulomatosis. SUMMARY: At the same time as candidate gene studies in vasculitis are identifying both common polymorphisms associated with other autoimmune diseases and rare alleles associated with recessive inherited diseases, early GWAS results are identifying completely different associations. The tools are available to more comprehensively delineate the genetic component of risk for these rare diseases.
20051003 Canine sterile nodular panniculitis: a retrospective study of 14 cases. 2010 Mar BACKGROUND: Sterile nodular panniculitis (SNP) is an uncommon inflammatory condition of subcutaneous fat that can be idiopathic, but has also been associated with underlying conditions such as pancreatic disease or systemic lupus erythematosus (SLE). The pathogenesis and clinical course of the condition are not well understood. OBJECTIVES: To retrospectively review cases of SNP associated with systemic signs, concurrent disease, or both and characterize the clinical, laboratory, imaging, and histopathologic findings, treatment, and response to treatment. ANIMALS: Fourteen dogs with histologically confirmed SNP diagnosed between 1996 and 2008. METHODS: Retrospective study. RESULTS: Skin lesions were ulcerated or draining nodules in 9 dogs and nonulcerative subcutaneous nodules in 5. Most dogs had systemic signs, such as fever, inappetence, lethargy, and multiple lesions. Common clinicopathologic findings included neutrophilia with or without left shift, increased alkaline phosphatase activity, mild hypoglycemia, hypoalbuminemia, and proteinuria. Concurrent diseases included pancreatic disease, SLE, rheumatoid arthritis, polyarthritis, lymphoplasmacytic colitis, and hepatic disease. Dogs responded to immunosuppressive doses of corticosteroids when administered. Prognosis for recovery was related to the underlying disease process. CONCLUSIONS AND CLINICAL IMPORTANCE: SNP is not a single disease. Rather, it is a cutaneous marker of systemic disease in many cases. After thorough evaluation for concurrent disease and infectious causes, immunosuppressive treatment is often effective.
20021284 Novel TACE inhibitors in drug discovery: a review of patented compounds. 2010 Jan TNF-alpha converting enzyme (TACE), a pro-inflammatory cytokine, catalyzes the formation of TNF-alpha from membrane bound TNF-alpha precursor protein. TNF-alpha is believed to play pathophysiological roles in inflammation, anorexia, cachexia, septic shock, viral replication and so on. TNF-alpha is a key player in inflammation and joint damage in rheumatoid arthritis. While a variety of TACE inhibitors have been reported in the literature, a vast majority of these compounds are peptidic and peptide-like compounds that are expected to have bioavailability and pharmacokinetic problems, common to such compounds, limiting their clinical effectiveness. Low molecular mass, long acting, orally bioavailable inhibitors of TACE are, therefore, highly desirable for the treatment of potential chronic diseases mentioned above. A review of patented compounds as TACE inhibitors in drug discovery is given. A selection of interesting patents recorded from 2001 to 2009 is presented. Various novel TACE inhibitors developed by different companies have been discussed.
19836826 Peptidyl arginine deiminase: A novel immunohistochemical marker for liver fibrosis in pati 2010 Nov Peptidylarginine deiminase (PAD) is an enzyme known to be involved in the pathogenesis of rheumatoid arthritis (RA). Since many of the molecular events present in the joints in RA also take place in the injured liver, we postulated in this study that PAD may be involved in liver fibrosis. The objectives of this study therefore were to find out if PAD could be demonstrated immunohistochemically in liver biopsies of patients with chronic hepatitis and if it is associated with METAVIR activity and fibrosis scores. Liver biopsies were obtained from 100 patients with chronic liver diseases between September 2006 and 2007. The biopsies were scored by two histopathologists according to the METAVIR activity and fibrosis scores after histological preparation. Immunohistochemistry for PAD was performed on the biopsies using a monoclonal antibody against PAD. PAD could not be demonstrated in normal liver biopsies but was found in the hepatocytes of patients with chronic hepatitis. PAD labeling could distinguish patients with no fibrosis from either F1 or F2 or F3 or F4 fibrosis. Similarly, PAD labeling could separate patients with no inflammatory activity from those with mild or moderate or severe activity. We concluded that PAD could be demonstrated immunohistochemically in liver biopsies of patients with chronic hepatitis and that its immunodetection was significantly associated with Metavir activity and fibrosis scores.
19775068 Role of different cytokines and seizure susceptibility: a new dimension towards epilepsy r 2009 Aug Epilepsy is a common health problem. Although variety of factors influence the incidence and prevalence of seizures, cytokines are considered to play an important role in seizures. Cytokines are also known to be involved in other neurodegenerative disorders. Proinflammatory cytokines like IL-1, IL-6, TNF-alpha and growth factor vascular endothelial growth factor (VEGF) as well as anti-inflammatory cytokine IL-10 and related molecules have been described in CNS and plasma of experimental models of seizures and clinical cases of epilepsy. There are reports suggesting more predispositions to seizures during inflammatory conditions like colitis, pneumonia and rheumatoid arthritis. These inflammatory cytokines and growth factors are also known to have dual roles in affecting seizure susceptibility. It remains to be seen if cytokine modulators can be therapeutically exploited for patients with inflammatory disorder and suffering from epilepsy.
19727441 Freezing of enkephalinergic functions by multiple noxious foci: a source of pain sensitiza 2009 Sep 3 BACKGROUND: The functional significance of proenkephalin systems in processing pain remains an open question and indeed is puzzling. For example, a noxious mechanical stimulus does not alter the release of Met-enkephalin-like material (MELM) from segments of the spinal cord related to the stimulated area of the body, but does increase its release from other segments. METHODOLOGY/PRINCIPAL FINDINGS: Here we show that, in the rat, a noxious mechanical stimulus applied to either the right or the left hind paw elicits a marked increase of MELM release during perifusion of either the whole spinal cord or the cervico-trigeminal area. However, these stimulatory effects were not additive and indeed, disappeared completely when the right and left paws were stimulated simultaneously. CONCLUSION/SIGNIFICANCE: We have concluded that in addition to the concept of a diffuse control of the transmission of nociceptive signals through the dorsal horn, there is a diffuse control of the modulation of this transmission. The "freezing" of Met-enkephalinergic functions represents a potential source of central sensitization in the spinal cord, notably in clinical situations involving multiple painful foci, e.g. cancer with metastases, poly-traumatism or rheumatoid arthritis.
19660660 Estrogen and testosterone therapies in multiple sclerosis. 2009 It has been known for decades that females are more susceptible than men to inflammatory autoimmune diseases, including multiple sclerosis (MS), rheumatoid arthritis, and psoriasis. In addition, female patients with these diseases experience clinical improvements during pregnancy with a temporary "rebound" exacerbation postpartum. These clinical observations indicate an effect of sex hormones on disease and suggest the potential use of the male hormone testosterone and the pregnancy hormone estriol, respectively, for the treatment of MS. A growing number of studies using the MS animal model experimental autoimmune encephalomyelitis (EAE) support a therapeutic effect of these hormones. Both testosterone and estriol have been found to induce anti-inflammatory as well as neuroprotective effects. Findings from two recent pilot studies of transdermal testosterone in male MS patients and oral estriol in female MS patients are encouraging. In this paper, we review the preclinical and clinical evidence for sex hormone treatments in MS and discuss potential mechanisms of action.
19634082 Pulmonary arterial hypertension complicating connective tissue diseases. 2009 Aug Pulmonary arterial hypertension (PAH) may complicate diverse connective tissue diseases (CTDs) such as systemic sclerosis (SSc), systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and mixed CTD (MCTD) and is an important cause of morbidity and mortality in this context. From a histological standpoint, the pulmonary vascular lesions in PAH complicating CTD are similar to those observed in idiopathic PAH (IPAH). However, prognosis and responsiveness to therapy are distinctly worse in PAH associated with CTD. PAH is most common in SSc (affecting up to 20% of patients with SSc), and most of the data regarding incidence, clinical features, and therapy of CTD-associated PAH are derived from patients with SSc (scleroderma). Although PAH may involve other CTDs, data are more limited (primarily small, uncontrolled series and case reports). Treatment strategies for PAH associated with CTD are similar to but are distinctly less effective than those for IPAH. Lung transplantation may be offered for a subset of patients with CTD-associated PAH, but results are less favorable than for IPAH due to comorbidities and specific complications associated with CTD (e.g., esophageal involvement, aspiration with SSc).
19621421 The molecular mechanism of human group IIA phospholipase A2 inactivation by bolinaquinone. 2009 Nov The molecular basis of the human group IIA secretory phospholipase A(2) inactivation by bolinaquinone (BLQ), a hydroxyquinone marine terpenoid, has been investigated for the comprehension of its relevant antiinflammatory properties, through the combination of spectroscopic techniques, biosensors analysis, mass spectrometry (MS) and molecular docking. Indeed, sPLA(2)s are well known to be implicated in the pathogenesis of inflammation such as rheumatoid arthritis, septic shock, psoriasis and asthma. Our results suggest a mechanism of competitive inhibition guided by a non-covalent molecular recognition event, disclosing the key role of the BLQ hydroxyl-quinone moiety in the chelation of the catalytic Ca(2+) ion inside the enzyme active site.The understanding of the sPLA(2)-IIA inactivation mechanism by BLQ could be useful for the development of a new chemical class of PLA(2) inhibitors, able to specifically target the enzyme active site.
19512928 Leflunomide use in renal transplantation. 2009 Aug PURPOSE OF REVIEW: Leflunomide has been used off-label in renal transplantation because of the attractive combination of antiviral and immunosuppressive effects. This study intends to review the clinical applications of leflunomide with interest to transplantation. RECENT FINDINGS: In renal transplantation, particularly in BK nephropathy, the use of leflunomide has attempted to model the in-vitro antiviral experimental data, leading to the use of higher dosages than those studied in the approved use in rheumatoid arthritis. Concerns of toxicity with this approach have been raised, and a newer association with hemolysis and thrombotic microangiopathy has been reported. By attempting to target levels, the use of leflunomide in transplantation has been difficult because of the long half-life of the drug and the high interpatient variability. Higher leflunomide levels may lead to disproportionate immunosuppressive effects and decrease the antiviral properties. Newer data suggest that the correlation between leflunomide levels and BK nephropathy outcome is unclear. SUMMARY: The available clinical data with leflunomide in renal transplantation are limited; however, it suggests positive outcomes and shows that the correlation between the drug exposure and its effects has not been well delineated. Further research is needed to refine the safety and efficacy of leflunomide in relation to its potential effects in a multitude of pathological entities in renal transplantation.
19151119 Acute Chlamydia pneumoniae infection in the pathogenesis of autoimmune diseases. 2009 Feb Autoimmune diseases have several etiologies. Acute Chlamydia pneumoniae (C. pneumoniae) infection may be involved in the pathogenesis of several autoimmune diseases. In this study, 82 patients with several autoimmune diseases and 70 controls were enrolled, and acute C. pneumoniae infection has been evaluated by monitoring the levels of IgM antibody. Chlamydia pneumoniae IgM positive results were observed in 29% (P < 0.05) of the patients with several autoimmune diseases and in 10% of the controls. Chlamydia pneumoniae IgM positive cases were more frequent among the patients with rheumatoid arthritis (RA; 30%, P < 0.05), systemic lupus erythematosus (SLE; 28.0%, P < 0.05), dermatomyositis/polymyositis (23%, NS), myeloperoxidase-antineutrophil cytoplasmic autoantibody (MPO-ANCA)-associated vasculitis (33%, NS), adult onset of Still's disease (29%, NS) and giant cell arteritis/Takayasu arteritis (50%, NS) than among the controls. This positive frequency was statistically significant in RA and SLE. These results suggest that acute C. pneumoniae infection is probably involved in the pathogenesis of autoimmune diseases.
21217940 A case of chloroquine-induced cardiomyopathy that presented as sick sinus syndrome. 2010 Nov A 52-year-old woman with rheumatoid arthritis who had been treated with prednisone and hydroxychloroquine for >12 years presented with chest discomfort and a seizure. She was diagnosed with restrictive cardiomyopathy combined with sick sinus syndrome. A myocardial muscle biopsy was performed to identify the underlying cardiomyopathy, which showed marked muscle fiber hypertrophy, fiber dropout, slightly increased interstitial fibrous connective tissue, and extensive cytoplasmic vacuolization of the myocytes under light microscopy. Electron microscopy of the myocytes demonstrated dense, myeloid, and curvilinear bodies. The diagnosis of hydroxychloroquine-induced cardiomyopathy was made based on the clinical, hemodynamic, and pathologic findings. This is the first case report describing chloroquine-induced cardiomyopathy involving the heart conduction system.
21794688 [Oxidative stress biomarkers as indicator of chronic inflammatory joint diseases stage]. 2010 Mar OBJECTIVE: To evaluate the participation of oxidative stress (OS) on chronic inflammatory joint disease (CIJD), as well as its possible use as a diagnostic biomarker. PATIENTS AND METHODS: The study population comprised 29 patients with CIJD: 18 with rheumatoid arthritis (RA: 13 active/5 inactive); 11 with ankylosing spondylitis (AS: 7 active/4 inactive) and 13 healthy subjects. Activity of the disease was assessed by: RA patients, Disease Activity Score (DAS 28) and AS patients by means of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Oxidative stress biomarkers were determined in plasma using spectrophotometrical techniques. The statistical analysis was carried out using the SSPS statistical package. RESULTS: Active CIJD showed a high oxidative stress characterized by increases in oxidative damage markers and a reduction in antioxidative systems, together with a higher myeloperoxidase (MPO) concentration. Inactive CIJD only showed changes in oxidized glutathione (GSSG) and reduced glutathione (GSH)/GSSG ratio levels, without changes in oxidative damage parameters or in antioxidative systems. CONCLUSIONS: Our data revealed that: i) CIJD presents with a high oxidative stress; ii) inactive CIJD shows a production of reactive species without triggering oxidative damage and maintaining red-ox homeostasis, and iii) the combination of oxidative stress biomarkers may be used as markers of active-inactive stages of CIJD.
21794674 [Update of the Consensus Statement of the Spanish Society of Rheumatology on the managemen 2010 Jan OBJECTIVE: To provide a reference to rheumatologists and to those involved in the treatment of RA who are using, or about to use biologic therapy. METHODS: Recommendations were developed following a nominal group methodology and based on systematic reviews. The level of evidence and grade of recommendation were classified according to the model proposed by the Center for Evidence Based Medicine at Oxford. The level of agreement was established through Delphi technique. RESULTS: We have produced recommendations on the use of the seven biologic agents available for RA in our country. The objective of treatment is to achieve the remission of the disease as quickly as possible. Indications and nuances regarding the use of biologic therapy were reviewed as well as the evaluation that should be performed prior to administration and the follow up of patients undergoing this therapy. CONCLUSIONS: We present an update on the SER recommendations for the use of biologic therapy in patients with RA.
20488911 Unintended effects of statins in men and women in England and Wales: population based coho 2010 May 20 OBJECTIVE: To quantify the unintended effects of statins according to type, dose, and duration of use. DESIGN: Prospective open cohort study using routinely collected data. SETTING: 368 general practices in England and Wales supplying data to the QResearch database. PARTICIPANTS: 2 004 692 patients aged 30-84 years of whom 225 922 (10.7%) were new users of statins: 159 790 (70.7%) were prescribed simvastatin, 50 328 (22.3%) atorvastatin, 8103 (3.6%) pravastatin, 4497 (1.9%) rosuvastatin, and 3204 (1.4%) fluvastatin. METHODS: Cox proportional hazards models were used to estimate effects of statin type, dose, and duration of use. The number needed to treat (NNT) or number needed to harm (NNH) was calculated and numbers of additional or fewer cases estimated for 10 000 treated patients. MAIN OUTCOME MEASURE: First recorded occurrence of cardiovascular disease, moderate or serious myopathic events, moderate or serious liver dysfunction, acute renal failure, venous thromboembolism, Parkinson's disease, dementia, rheumatoid arthritis, cataract, osteoporotic fracture, gastric cancer, oesophageal cancer, colon cancer, lung cancer, melanoma, renal cancer, breast cancer, or prostate cancer. RESULTS: Individual statins were not significantly associated with risk of Parkinson's disease, rheumatoid arthritis, venous thromboembolism, dementia, osteoporotic fracture, gastric cancer, colon cancer, lung cancer, melanoma, renal cancer, breast cancer, or prostate cancer. Statin use was associated with decreased risks of oesophageal cancer but increased risks of moderate or serious liver dysfunction, acute renal failure, moderate or serious myopathy, and cataract. Adverse effects were similar across statin types for each outcome except liver dysfunction where risks were highest for fluvastatin. A dose-response effect was apparent for acute renal failure and liver dysfunction. All increased risks persisted during treatment and were highest in the first year. After stopping treatment the risk of cataract returned to normal within a year in men and women. Risk of oesophageal cancer returned to normal within a year in women and within 1-3 years in men. Risk of acute renal failure returned to normal within 1-3 years in men and women, and liver dysfunction within 1-3 years in women and from three years in men. Based on the 20% threshold for cardiovascular risk, for women the NNT with any statin to prevent one case of cardiovascular disease over five years was 37 (95% confidence interval 27 to 64) and for oesophageal cancer was 1266 (850 to 3460) and for men the respective values were 33 (24 to 57) and 1082 (711 to 2807). In women the NNH for an additional case of acute renal failure over five years was 434 (284 to 783), of moderate or severe myopathy was 259 (186 to 375), of moderate or severe liver dysfunction was 136 (109 to 175), and of cataract was 33 (28 to 38). Overall, the NNHs and NNTs for men were similar to those for women, except for myopathy where the NNH was 91 (74 to 112). CONCLUSIONS: Claims of unintended benefits of statins, except for oesophageal cancer, remain unsubstantiated, although potential adverse effects at population level were confirmed and quantified. Further studies are needed to develop utilities to individualise the risks so that patients at highest risk of adverse events can be monitored closely.
20364286 Preliminary studies for the development of a second generation granulocytapheresis (G-CAP) 2010 Jul The preliminary studies for developing a second generation granulocytapheresis (G-CAP) column were made. In the past, the G-CAP column has been used for the treatment of ulcerative colitis and rheumatoid arthritis. However, recent clinical studies have revealed that the therapeutic effects of the G-CAP column are not significant compared with those of the sham column. These results were considered to be due to insufficient reduction of granulocytes. Thus, development of a better granulocyte removal column was attempted. Realizing that white cells adhered on small-diameter synthetic fibers of 1-2 microm, small diameter cotton fibers were subjected to the studies of their granulocyte-removing capabilities. Three types of cotton, Pakistani, Australian and Egyptian cottons, were evaluated using normal human blood in vitro. Miniature columns were made of each fiber, and CBC and WBC differentiation was compared between pre- and post-filtered blood. The Egyptian cotton removed leukocytes, especially granulocytes, the most efficiently of the three types of cotton. The Egyptian cotton's granulocyte adhesion properties were not altered after different chemical treatments. A 4-ml column of packaged Egyptian cotton with a density of more than 0.125 g/ml could remove granulocytes effectively up to 80 ml of blood passages. Based upon these studies, second generation G-CAP could be carried out with Egyptian cotton fibers as a scaled-up clinical module.
20201920 CD20-depleting therapy in autoimmune diseases: from basic research to the clinic. 2010 Mar The B lymphocyte-associated antigen CD20 is becoming an important immunotherapy target for autoimmune diseases, although its biological function has not been defined. Besides rheumatoid arthritis, growing experience with B cell-depleting therapy indicates that it may be effective in Sjögren's syndrome, dermatomyositis-polymyositis, systemic lupus erythematosus and some types of vasculitides. However, controlled clinical trials are still lacking for some of these indications. Infection has not been seen as a major limitation to this therapy, but reports of progressive multifocal leukoencephalopathy in an extremely small number of patients are of concern. Here, we review the therapeutic actions of anti-CD20 antibodies, and the recent and ongoing clinical trials with CD20-depleting therapy in autoimmune diseases.
20101879 Top-down therapy for Crohn's disease: rationale and evidence. 2009 Nov Several trials have shown that early treatment of Crohn's disease with immunomodulators and anti-TNF agents leads to superior clinical outcome including healing of the mucosa. Evidence is mounting that this endpoint is associated with a reduced risk of complications and a reduced need for surgeries and hospitalizations. In the SONIC trial, treatment with the combination of azathioprine and infliximab was the most potent anti-inflammatory therapy in Crohn's disease patients with evidence of active inflammation who had never been exposed to immunomodulators or biologics. These findings have introduced a trend towards earlier initiation of immunomodulator therapy, comparable to what is being done in rheumatoid arthritis. Given the fact that subsets of patients have a favorable disease course without immunomodulator therapy and given the significant potential toxicity of these medications, however, it is becoming a challenge to the gastroenterologists to try and identify patients with an unfavorable disease prognosis and treat these early and aggressively. The key to successful management of Crohn's disease appears to lie in careful timing and selection of the appropriate interventions.