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ID PMID Title PublicationDate abstract
24555106 The expression profile of miR-23b is not altered in peripheral blood mononuclear cells of 2013 Idiopathic inflammatory myopathies (IIM) belong to a group of autoimmune disorders, primarily characterized by chronic inflammation of human skeletal muscle tissue. The etiology of these diseases is unknown, however, genetic predisposition plays a significant role in disease onset. Beside the known genetic risk located in the MHC complex, the epigenetic modifications including changes in miRNAs expression profiles have been recently implicated recently in many autoimmune diseases. Micro RNA molecules are involved in many physiological processes, including the regulation of the immune response. In our study we have focused on the miR-23b, as it represents a novel promising autoimmunity regulator molecule. Downregulation of miR-23b was recently described in patients with rheumatoid arthritis and systemic lupus erythematosus. We have measured the expression miR-23b peripheral blood mononuclear cells of patients with dermatomyositis and polymyositis. No meaningful difference was found in comparison with healthy controls.
24498769 [Two patients with CICV (cannot intubate cannot ventilate) rescued by cricothyrotomy]. 2013 Dec The first case was a 69-year-old woman with rheumatoid arthritis undergoing posterior occipito-cervical fusion. Although the operation was successfully performed, airway obstruction developed immediately after extubation. Her upper airway obstruction probably came from pharyngolaryngeal edema. The second case was a 59-year-old man with diabetes mellitus undergoing anterior cervical fusion. The day of surgery, he complained of dyspnea and his neck was swollen with hematoma. We used cricothyrotomy tubes (Mini-Trach II) in these two patients with postoperative upper airway obstruction and performed assist-ventilation via the tube. After starting ventilation through Mini-Trach II, we succeeded in intubation. We belive that cricothyrotomy in well-trained hands can be used safely for the management of the patient with a difficult airway.
24399181 Pulmonary infarction complicating thoracoscopic removal of congenital foregut cyst. 2014 Aug A 42-year old woman presented with rheumatoid arthritis, dyspnoea and a congenital foregut cyst referred by a rheumatologist for thoracic surgery. The cyst was removed by video-assisted thoracoscopic surgery. The patient developed acute haemoptysis in the immediate postoperative period, which necessitated pulmonary resection due to infracted right lower lobe. This case report highlights the complication related to an unusual anatomy of a congenital foregut cyst.
24164387 Advances in understanding the pathogenesis of autoimmune disorders: focus on chemokines an 2014 Feb Lymphocyte trafficking is a key step in the pathogenesis of various autoimmune diseases. Recruitment of autoreactive lymphocytes to inflamed tissues is a defining feature of numerous persistent organ-specific autoimmune conditions and various therapies are now used in several of these diseases which appear to specifically block lymphocyte migration. Thus, better understanding of the molecular events involved in homing of autoreactive pathogenic lymphocytes may present novel opportunities for pharmacological intervention in autoimmune diseases, such as multiple sclerosis, rheumatoid arthritis, type-1 diabetes and psoriasis. This review describes recent progress in understanding lymphocyte trafficking in autoimmunity, focusing on the involvement of the chemokine and chemokine receptor superfamily. Possible strategies to improve therapeutics for autoimmune diseases arising from these studies are discussed.
25135825 Postoperative pyoderma gangrenosum in association with renal cell carcinoma and chronic ly 2013 Jun INTRODUCTION: Pyoderma gangrenosum (PG) is a rare sterile neutrophilic dermatosis characterized by painful recurrent ulcerations. It is frequently associated with inflammatory bowel disease, rheumatoid arthritis, or malignancies. PG is a diagnosis of exclusion, and it is based on clinical presentation, histology, history of an underlying disease, and exclusion of other causes of ulceration. CASE REPORT: The authors report a 62-year-old male who developed a nonhealing ulcer at the site of incision following nephrectomy for renal cell carcinoma. Past medical history included chronic lymphocytic leukemia treated with rituximab. Histology of the skin lesion showed a phlegmonous nonspecific inflammation without being able to differentiate between a necrotizing wound infection and PG. The patient's condition was initially diagnosed as an infectious process and treated accordingly. After unsuccessful results with systemic antibiotics, high-dose corticosteroids induced prompt healing of the wound. On these bases, the diagnosis of postoperative PG within chronic lymphocytic leukemia and renal cell carcinoma was made. CONCLUSION: Faced with postoperative necrotizing ulceration resistant to correctly administered antibiotics, PG must be considered. In such condition, the diagnosis must not be guided primarily by histology and early advice of a dermatologist is recommended.
25229498 Nanoparticle-based diagnostic imaging of inflammation in rheumatic disease. 2014 A variety of imaging modalities assists in the diagnosis and assessment of rheumatoid arthritis and of other rheumatic disorders; however, the definitive diagnosis of inflammatory arthritides can be challenging, especially in the early stages of disease. Consequently, there is significant research underway in expanding imaging sensitivity and specificity to aid in diagnostics of early stage inflammation and management of subclinical disease activity. Nanotechnology, the manipulation of materials in the nanoscale range (1 to 1000nm), is increasingly utilized in the biomedical field to meet this need, particularly as novel contrast agents in imaging. In this review, the use of superparamagnetic iron oxide (SPIO), gold, and chitosan glyco-nanoparticles will be discussed in their imaging capabilities pertaining to rheumatic diseases as well as emerging multimodal nanomaterials that could have future biomedical applications in the imaging of inflammation.
25088887 Three cases of concurrent infection with Mycobacterium tuberculosis and Cryptococcus neofo 2014 Impaired cellular-mediated immunity is a known risk factor for both tuberculosis and cryptococcosis. However, pulmonary cryptococcosis associated with pulmonary tuberculosis is rare. We herein describe three cases of concurrent infection with Mycobacterium tuberculosis and Cryptococcus neoformans. All patients had underlying diseases; all three had uncontrolled diabetes mellitus, and other underlying diseases were liver cirrhosis, malignancy, and rheumatoid arthritis requiring long-term steroid use. We also review other relevant reports.
29147400 Does Aromatase Inhibitors Cause Sjogren's Syndrome and Polyneuropathy? 2014 Aug Aromatase inhibitors (AIs) are the indispensible part of hormone-responsive breast cancer treatment. A potential relation between autoimmunity and AIs has been described before. Herein, we report a case of Sjogren's syndrome (SjS) and polyneuropathy which developed during treatment with anastrozole. A 70 years old female patient having a history of breast cancer was referred to our clinic with numbness in both legs for 1 year. She was receiving anastrazole since 2006. She was having sicca symptoms for 3 years. After laboratory evaluation, salivary gland biopsy and electroneuromyography, the patient was evaluated as SjS and polyneuropathy. Intravenous immunoglobulin treatment (400 mg/kg/day, 5 days, 6 months) was initiated. A potential pathogenic linkage between AI therapy and autoimmunity is mentioned. Only few cases of rheumatoid arthritis and SjS related with AIs have been reported. But, our case is the first in the literature having definite SjS and neuropathy in this setting.
23858311 The contribution of cortical and trabecular tissues to bone strength: insights from denosu 2013 Jan All materials undergo an aging process which is characterized essentially by changes of the rigidity (stiffness), of the ability to absorb the stresses (toughness) and then ultimately in the mechanical resistance (strength). Both cortical and trabecular bone undergo a continuous process of structural remodeling with the main aim to preserve their biomechanical properties. An imbalance in this process, which promotes bone resorption, results in a quantitative loss of bone tissue and in a qualitative alteration of the skeletal microarchitecture, as you can see in osteoporosis, rheumatoid arthritis or bone metastases. Cortical component has a prominent role on strength therefore loss of cortical bone that is prevalent in elderly may explain the higher frequency of fractures of bones composed mainly of cortical bone such as the proximal femur. Remodeling inhibition with denosumab improved structural strength without altering material properties, that can be primarily explained by the combined effects of increased trabecular and cortical bone mass, and reductions in trabecular eroded surfaces and particularly cortical porosity. Denosumab for its mechanism of action and pharmacokinetics results in a significant, early and continued increase in BMD with enhanced bone strength improving both cortical and trabecular bone.
23769426 [Impact of chronic constipation on quality of life: Much more important than it seems]. 2013 Aug Chronic constipation is highly frequent in the general population (a prevalence of 14%). An underlying organic cause is usually absent, this type of constipation being known as chronic idiopathic constipation (CIC). Although usually considered banal, this disorder has a substantial personal, social and healthcare impact. Several studies have associated CIC with high rates of absenteeism in the workplace and disruption of routine activities. All these factors lead to high direct and indirect healthcare expenditure. Physically, the impact on patients with CIC, who require specialized care, is higher than that of ulcerative colitis or stable Crohn's disease. The psychological impact exceeds that caused by rheumatoid arthritis or hemodialysis. Appropriate treatment can improve HRQL in affected individuals. Recently, prucalopride, a highly selective 5-HT4 receptor agonist has been shown to improve the symptoms of CIC and to have a beneficial effect on HRQL.
23555050 Amino Acid derivatives as new zinc binding groups for the design of selective matrix metal 2013 A number of matrix metalloproteinases (MMPs) are important medicinal targets for conditions ranging from rheumatoid arthritis to cardiomyopathy, periodontal disease, liver cirrhosis, multiple sclerosis, and cancer invasion and metastasis, where they showed to have a dual role, inhibiting or promoting important processes involved in the pathology. MMPs contain a zinc (II) ion in the protein active site. Small-molecule inhibitors of these metalloproteins are designed to bind directly to the active site metal ions. In an effort to devise new approaches to selective inhibitors, in this paper, we describe the synthesis and preliminary biological evaluation of amino acid derivatives as new zinc binding groups (ZBGs). The incorporation of selected metal-binding functions in more complex biphenyl sulfonamide moieties allowed the identification of one compound able to interact selectively with different MMP enzymatic isoforms.
23463460 [Granulomatous lung and systemic diseases]. 2013 Apr Granuloma formation occurs in the human body if there is a particle which persists in phagocytes and which the immune system cannot eliminate. The immune reaction of granuloma formation evolved in order to combat mycobacteria with the aim of localizing mycobacteria and to avoid spreading of mycobacteria throughout the body. Granulomatous lung diseases are often accompanied by severe, systemic inflammation. However, acute phase proteins may be only slightly elevated. The spectrum of granulomatous lung diseases is broad. Sarcoidosis is the most common granulomatous lung disease. To diagnose sarcoidosis, other infectious granulomatous lung diseases such as tuberculosis, atypical mycobacterial and fungal infection have to be ruled out. Pulmonary granuloma also evolve in the context of autoimmune diseases such as rheumatoid arthritis, granulomatosis with polyangiitis (GBA, Wegener's) and eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss syndrome). Furthermore, immunodeficiencies such as common variable immunodeficiency (CVID) and immune reconstitution syndrome in HIV can be associated with systemic granulomatous inflammation. Finally, occupational lung disease, particularly hypersensitivity pneumonitis, silicosis, hard metal lung, and chronic berylliosis are associated with pulmonary granuloma formation.
22423182 Role of notch signaling in osteoimmunology--from the standpoint of osteoclast differentiat 2013 Apr The Notch signaling pathway is a highly conserved cell signaling system present in most multicellular organisms. Osteoimmunology comprises the interplay between the immune system and bone metabolism. Osteoclasts, cells that resorb bone, play a crucial role in bone metabolism. In this review, we discuss the role of Notch signaling in osteoimmunology that is crucial for physiological bone remodeling (such as in orthodontic tooth movement, where bone remodeling is in balance) and undue non-physiological Notch signaling which results in pathological bone remodeling (such as in rheumatoid arthritis and periodontitis, where bone remodeling is out of balance) from the point view of osteoclast differentiation. A proposal is made that Notch signaling not only controls immune system reaction but also interferes with osteoclast differentiation involved in the bone remodeling process. Therefore, Notch signaling could be a promising therapeutic target at conditions that cross link the immune system with the skeletal system.
25478383 Rheumatologic manifestations in Iranian patients with autoimmune thyroid diseases. 2014 Oct BACKGROUND: Autoimmune thyroid diseases (ATDs) are the most common endocrine diseases which result in rheumatologic manifestations. Some studies have shown association between rheumatologic disorders and ATDs. Thus, the aim of this study was to assess the frequency of rheumatologic manifestations in patients with ATDs. MATERIALS AND METHODS: In this cross-sectional descriptive study during 2010 to 2011, 65 patients with ATDs referred to the Rheumatology clinic of 5 Azar Hospital in Gorgan (North of Iran) were studied via systematic random sampling and patients with positive antithyroid peroxides (anti-TPO) were included in the study. These patients were examined by a rheumatologist for diagnosis of rheumatologic manifestations and tested for serum levels of TSH, Free T3 and T4, Anti-Nuclear Antibodies (ANAs) and Rheumatoid Factor (RF). SPSS software (version 16) and descriptive statistics were used for data analysis. RESULTS: Nine males (14.8%) and 56 females (86.2%) with mean age of 38.81±1.44 years were studied. Overall, Rheumatologic manifestations were seen in 86.2 % (n=56). In this study, the most frequent rheumatologic manifestations were Carpal Tunnel Syndrome (36.1%) and Osteoarthritis (23%). Reynaud's phenomenon (RP) (10.7%), Discopathy (8.9%), Fibromyalgia (5.3%), Myopathy (3.6%), Rheumatoid arthritis (3.6%) and trigger finger (3.6%) were other manifestations, respectively. CONCLUSION: In this region, there is a high frequency of rheumatologic manifestations in patients with ATDs. Thus, initial evaluation and regular checkings are recommended.
23871505 Perceptions, attitudes and experiences of family caregivers of patients with musculoskelet 2013 Nov OBJECTIVE: To determine the perceptions, attitudes and experiences among family caregivers of patients with musculoskeletal diseases (MSD). METHODS: Descriptive, exploratory, qualitative study. Two discussion groups were organized with family caregivers of MSD patients, representing the caregiver profile: gender (men/women) and age (31-45 years/46-65 years); and patient profiles: MSD type (rheumatoid arthritis/ankylosing spondylitis), work status (yes or no for the variables housewife, at least 3 episodes of sick leave, patients who abandoned their work, and patients with permanent work disability). A content analysis based on the Grounded Theory was done to detect and explore emerging categories. RESULTS: The emerging dimensions were: alterations in daily life activities, need for caregiver support, physical and psychological impact on the caregiver, characteristics of the patient, and several aspects of care. Relevant experiences mentioned were: the diagnosis of a MSD changes the patient and their family members' life affecting work, financial, social, psychological and physical spheres, making it necessary help for basic activities of daily living. Early age at onset or severe MSDs require dedication and effort on the part of caregivers which increases with time. This leads to a great emotional overload on the caregivers, which may be modulated by the support they receive when providing care. CONCLUSION: The primary consequences for caregivers are loss of purchasing power, work problems, social isolation and emotional stress. Programs for effective at-home support need to be developed with streamlined administrative processes to quickly classify the level of disability and provide official assistance.
22907627 Is every joint symptom related to acromegaly? 2013 Apr Acromegaly is a chronic endocrinopathy characterized by the hypersecretion of growth hormone and insulin-like growth factor-1. Musculoskeletal pain is a frequent problem encountered in acromegaly and is associated with a reduction in the quality of life. In this study, the presence of inflammatory and degenerative rheumatologic diseases in acromegaly has been retrospectively evaluated. Forty patients with acromegaly who were in remission according to laboratory findings, but still having joint and back pain problems, were referred to rheumatology outpatient clinic and all the patients were examined by clinical, radiological, and laboratory data. Mean age was 47.1 years (22-75). When the radiological data were evaluated, erosions of the left sacroiliac joint were found by means of magnetic resonance imaging in 1 patient and degenerative joint changes were observed in 24 patients by X-ray imaging. However, there was no pathology in the radiological data of 15 patients. Laboratory data revealed antinuclear antibody positivity (3 nucleolar and 1 homogeneous) in 4 patients, rheumatoid factor positivity in 4, and cyclic citrullinated peptide positivity only in 1 patient. The diagnosis of an inflammatory rheumatologic disease, including rheumatoid arthritis, ankylosing spondylitis, or undifferentiated connective tissue disease was made in 3 patients. Besides, the diagnosis of diffuse idiopathic skeletal hyperostosis was also established in 6 patients. While degenerative joint diseases were frequently observed in our group similar to the literature, inflammatory rheumatologic diseases were also found in three patients. Distinguishing these two diseases is important because response to medical treatment is dramatically better in inflammatory diseases than in degenerative pathologies. A multidisciplinary approach is imperative for appropriate management of these patients.
25484062 Versatile characterization of glycosylation modification in CTLA4-Ig fusion proteins by li 2014 CTLA4-Ig is a highly glycosylated therapeutic fusion protein that contains multiple N- and O-glycosylation sites. Glycosylation plays a vital role in protein solubility, stability, serum half-life, activity, and immunogenicity. For a CTLA4-Ig biosimilar development program, comparative analytical data, especially the glycosylation data, can influence decisions about the type and amount of animal and clinical data needed to establish biosimilarity. Because of the limited clinical experience with biosimilars before approval, a comprehensive level of knowledge about the biosimilar candidates is needed to achieve subsequent development. Liquid chromatography-mass spectrometry (LC-MS) is a versatile technique for characterizing N- and O-glycosylation modification of recombinant therapeutic proteins, including 3 levels: intact protein analysis, peptide mapping analysis, and released glycans analysis. In this report, an in-depth characterization of glycosylation of a candidate biosimilar was carried out using a systematic approach: N- and O-linked glycans were identified and electron-transfer dissociation was then used to pinpoint the 4 occupied O-glycosylation sites for the first time. As the results show, the approach provides a set of routine tools that combine accurate intact mass measurement, peptide mapping, and released glycan profiling. This approach can be used to comprehensively research a candidate biosimilar Fc-fusion protein and provides a basis for future studies addressing the similarity of CTLA4-Ig biosimilars.
23831512 The association between Interleukin (IL)-4 gene intron 3 VNTR polymorphism and alopecia ar 2013 Sep 25 OBJECTIVE: Alopecia areata (AA) is hypothesized to be an organ-specific autoimmune disease of hair follicles mediated by T cells. As immunological and genetic factors have been implicated in the pathogenesis of AA, the purpose of the present study was to investigate possible associations between the functional Interleukin (IL)-4 gene intron 3 VNTR polymorphism and AA susceptibility and disease progression in Turkish population. METHODS: The study group consisted of 116 unrelated patients with AA and 125 unrelated healthy controls. Genomic DNA was isolated and IL-4 gene 70 bp VNTR polymorphism determined by using polymerase chain reaction (PCR) with specific primers. RESULTS: No association was observed between AA patients and controls according to genotype distribution (p=0.051). The allele distribution of IL-4 gene intron 3 VNTR polymorphism was statistically different between AA patients and control group (p=0.026). The frequency of P1 allele in patients was significantly higher than that in the control group. When the P2P2 genotype was compared with P1P2+P1P1 genotypes, a statistically significant difference was observed between patients and controls (p=0.036). Intron 3 VNTR polymorphism in the IL-4 gene was found to be associated with AA susceptibility in Turkish population. CONCLUSION: The results suggest that IL-4 VNTR polymorphism in the intron 3 region may be a risk factor for the development of AA among Turkish population. This is the first to report that intron 3 VNTR polymorphism in the IL-4 gene is associated with AA susceptibility.
23747735 A closer look to botulinum neurotoxin type A-induced analgesia. 2013 Sep Chronic pain indicates a type of pain that lasts over time and is accompanied by diagnostic and therapeutic difficulties. It follows that treatment failures are common and patients roam from doctor to doctor in search of an effective care program. So there is an urgent need for long-acting and effective therapeutics to alleviate symptoms of the varied forms of chronic pain. During the past few years, a good success has been achieved with a derivative of a neurotoxin. It has been shown that administration of this toxin can block the release of neurotransmitters and pain mediators. Botulinum neurotoxin type A (BoNT/A) is well known as a treatment for neuromuscular conditions such as dystonia and spasticity. However, the clinical application for BoNT/A has continued to expand. Its analgesic effect has been used in clinical practice with satisfactory results. This review provides an introduction of a hypothesis for the mechanism by which BoNT/A eases chronic pain. It also summarizes the clinical therapeutic effects of BoNT/A in different types of chronic pain and its potential prospects.
25434553 [Thymoma with extensive coagulative necrosis and high serum level of CYFRA 21-1; report of 2014 Dec A 73-year-old woman complained of right chest discomfort. Chest X-ray during the follow-up for rheumatoid arthritis showed a mediastinal tumor. Chest computed tomography (CT) and magnetic resonance imaging (MRI) showed a 65-mm tumor in the right anterior mediastinum. A blood test showed high serum levels of CYFRA 21-1(29.8 ng/ml), white blood cells( WBC 10,800/µl), and C-reactive protein(CRP 16.1 mg/dl). Subsequently, inflammatory reactions improved, and the thymic tumor was resected. Histopathologically, the tumor was a type B2 thymoma with extensive coagulative necrosis. After resection, the serum CYFRA 21-1 level returned to the normal range.