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ID PMID Title PublicationDate abstract
30581616 Risk of serious infection among patients receiving biologics for chronic inflammatory dise 2019 Jan Risk of hospitalized infections under biologics among patients suffering from chronic inflammatory autoimmune diseases such as rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PSA), or psoriasis was investigated using administrative data. The hospital discharge records database, the medical prescription database, and the database of exemptions from medical charges were linked at the individual patient level. A cohort of patients diagnosed with RA, SA, PSA, and severe psoriasis from 2006 to 2017 was identified and followed-up to either the end of 2017 or hospitalization with the main discharge diagnosis of infection, death, or they moved out of the region. Multiple Cox regression was used to estimate the hazard ratio (HR) of hospitalization associated with bDMARDs and adjusting for age, sex, Charlson's Comorbidity Index, calendar year, prescription of steroids, and use of csDMARDs. Use of bDMARDs was treated as a time-dependent variable. A total of 5596 patients diagnosed with RA, AS, or PSA/severe psoriasis were included in the cohort. Overall, 289 (4.2%) were hospitalized due to infection. Time to first use of biological drugs was significantly associated with a 55% increased risk of hospitalization for infections. Thus, large cohorts from administrative databases are useful to support observations from registries and clinical trials. Patients with chronic autoimmune inflammatory diseases are at risk of serious infections when starting biologics. This risk is higher in the elderly or those with comorbidities. Upper and lower respiratory tract infections are the most common infections. Our findings support prevention policies such as vaccination.
31485214 Corrigendum: Signal Transducer and Activator of Transcription 3 Hyperactivation Associates 2019 [This corrects the article DOI: 10.3389/fimmu.2018.01226.].
31068560 [Sarcoidosis-lymphoma syndrome showing abnormal FDG uptake in lymph nodes and muscles upon 2019 A 65-year-old woman was diagnosed with rheumatoid arthritis in 2010 and was treated with methotrexate (MTX). In 2012, she was diagnosed with sarcoidosis and underwent a follow-up therapy for mild peripheral neuropathy due to neurosarcoidosis. In 2018, she experienced primary splenic diffuse large B-cell lymphoma (DLBCL) and was diagnosed with sarcoidosis-lymphoma syndrome (SLS). MTX was discontinued, and six cycles of rituximab were administered combined with chemotherapy. Positron emission tomography combined with computed tomography performed 18 weeks after the last cycle of chemotherapy showed new abnormal fluoro-2-deoxy-D-glucose (FDG) uptake in the mediastinal and hilar lymph nodes and skeletal muscles. Sarcoidosis was suspected because of increased serum angiotensin-converting enzyme levels and magnetic resonance imaging findings in the lower limb muscles. However, pathological findings of DLBCL and sarcoidosis were not confirmed in the hilar lymph node biopsy. Therefore, malignant lymphoma can be distinguished from sarcoidosis using abnormal FDG uptake after chemotherapy for SLS.
32232102 Neuroimmunomodulation of tissue injury and disease: an expanding view of the inflammatory 2019 Neuroimmunomodulation through peripheral nerve activation is an important therapeutic approach to various disorders. Central to this approach is the inflammatory reflex pathway in which the cholinergic anti-inflammatory pathway represents the efferent limb. Recent studies provide a framework for understanding this control pathway, however our understanding remains incomplete. Genetically modified mice, using optogenetics and pharmacogenomics, have been invaluable resources that will allow investigators to disentangle neural pathways that provide a unifying mechanism by which vagal nerve stimulation (and other means of stimulating the pathway) leads to an anti-inflammatory and tissue protective effect. In this review we describe disease models that contribute to our understanding of how vagal nerve stimulation attenuates inflammation and organ injury: acute kidney injury, rheumatoid arthritis, and inflammatory gastrointestinal disease. The gut microbiota contributes to health and disease and the potential role of the vagus nerve in affecting the relationship between gut microbiota and the immune system and modifying diseases remains an intriguing opportunity to attenuate local and systemic inflammation that undergird disease processes.
31185450 Dulaglutide mitigates inflammatory response in fibroblast-like synoviocytes. 2019 Sep Rheumatoid arthritis is a common autoimmune disease primarily characterized by chronic inflammation, the formation of an invasive pannus, and destruction of the joints. In the present study, we employed real-time PCR and western blot analysis to investigate the role of dulaglutide in human fibroblast-like synoviocytes (FLS). The results of our study show that dulaglutide exerted a powerful protective effect by rescuing mitochondrial membrane potential, inhibiting the production of NOX-4, and abrogating TNF-α-induced downregulation of the antioxidant GSH. Our findings demonstrate that dulaglutide significantly ameliorated the expression of proinflammatory cytokines and chemokines including IL-1β, IL-6, MCP-1, and HMGB-1. Matrix metalloproteinases mediate cartilage destruction, thereby aiding in pannus formation. Our findings indicate that dulaglutide treatment significantly downregulated the expression of MMP-3 and MMP-13, two crucial degradative enzymes. Importantly, the results of our study demonstrate that the beneficial effects of dulaglutide are mediated through the JNK/NF-κB signaling pathway, which has been suggested as a potential treatment target against RA. Taken together, the results of this study show that dulaglutide may exert significant protective effects against the progression of RA induced by TNF-α.
31750337 Methotrexate-related lymphoproliferative disorders in the liver: Case presentation and min 2019 Nov 6 BACKGROUND: Immunosuppression is effective in treating a number of diseases, but adverse effects such as bone marrow suppression, infection, and oncogenesis are of concern. Methotrexate is a key immunosuppressant used to treat rheumatoid arthritis. Although it is effective for many patients, various side effects have been reported, one of the most serious being methotrexate-related lymphoproliferative disorder. While this may occur in various organs, liver involvement is rare. Information on these liver lesions, including clinical characteristics, course, and imaging studies, has not been summarized to date. CASE SUMMARY: We present a case of 70-year-old woman presented with a 2-wk history of fever and abdominal pain. She had had rheumatoid arthritis for 5 years and was being treated with medication including methotrexate. Contrast-enhanced computed tomography revealed multiple low density tumors in the liver and the histological analyses showed significant proliferation of lymphocytes in masses that were positive on immunohistochemical staining for CD3, CD4, CD8, and CD79a but negative for CD20 and CD56. Staining for Epstein-Barr virus-encoded RNA was negative. And based on these findings, the liver tumors were diagnosed as Methotrexate-related lymphoproliferative disorders. A time-dependent disappearance of the liver tumors after stopping methotrexate supported the diagnoses. CONCLUSION: The information obtained from our case and a review of 9 additional cases reported thus far assist physicians who may face the challenge of diagnosing and managing this disorder.
30827153 Dioscin, a Steroidal Saponin Isolated from Dioscorea nipponica, Attenuates Collagen-Induce 2019 Dioscin, a steroidal saponin isolated from Dioscorea nipponica Makino, has previously been shown to possess antiarthritic effects. However, the underlying mechanism is still elusive. Herein, we investigated the therapeutic effects of dioscin on collagen-induced arthritis (CIA) in DBA/1 mice and related mechanism. Cytokine production in CII-specific immune responses were measured by enzyme-linked immunosorbent assay (ELISA); Th17 cell-related gene expression, including IL-17A, ROR γτ and IL-23p19, were detected by qPCR analysis; Surface marker, T regulatory (Treg) cells and intracellular cytokines (IL-17A and IFN- γ ) were evaluated by flow cytometry. We performed Th17 cell differentiation assay in vitro. Results showed that, in vivo, dioscin treatment significantly reduced the severity of CIA, which was accompanied by decreased Th17 response, but not Th1 and Treg response; dioscin-treated mice also showed lower percentage of CD11b + Gr-1 + neutrophils; In vitro, dioscin treatment suppressed the differentiation of naive CD4 + T cells into Th17 cell and decreased IL-17A production. Collectively, our results indicate that dioscin exerts antiarthritic effects by inhibiting Th17 cell immune response.
30838157 Osteoclasts in the Inflammatory Arthritis: Implications for Pathologic Osteolysis. 2019 Feb The enhanced differentiation and activation of osteoclasts (OCs) in the inflammatory arthritis such as rheumatoid arthritis (RA) and gout causes not only local bone erosion, but also systemic osteoporosis, leading to functional disabilities and morbidity. The induction and amplification of NFATc1, a master regulator of OC differentiation, is mainly regulated by receptor activator of NF-κB (RANK) ligand-RANK and calcium signaling which are amplified in the inflammatory milieu, as well as by inflammatory cytokines such as TNFα, IL-1β and IL-6. Moreover, the predominance of CD4(+) T cell subsets, which varies depending on the condition of inflammatory diseases, can determine the fate of OC differentiation. Anti-citrullinated peptide antibodies which are critical in the pathogenesis of RA can bind to the citrullinated vimentin on the surface of OC precursors, and in turn promote OC differentiation and function via IL-8. In addition to adaptive immunity, the activation of innate immune system including the nucleotide oligomerization domain leucine rich repeat with a pyrin domain 3 inflammasome and TLRs can regulate OC maturation. The emerging perspectives about the diverse and close interactions between the immune cells and OCs in inflammatory milieu can have a significant impact on the future direction of drug development.
32016833 Astaxanthin attenuates oxidative stress and inflammatory responses in complete Freund-adju 2020 Feb BACKGROUND: Astaxanthin (ATX), a natural xanthophyll carotenoid, has shown to exert significant protective effects against various diseases via its antioxidant and anti-inflammatory properties. However, its potential role in arthritis is still not reported. Therefore, the aim of the present study was to investigate the potential anti-arthritic properties of ATX against complete Freund's adjuvant (CFA)-induced arthritis rats. METHODS: Adjuvant arthritis was induced by single intraplantar injection of complete Freund's adjuvant (CFA) in the left hind paw of adult female Wistar rats. ATX (25, 50 and 100 mg/kg) and indomethacin (5 mg/kg) were given orally from days 14 to 28. The anti-arthritic activity was evaluated through various nociceptive behavioral tests (mechanical allodynia, mechanical hyperalgesia, cold allodynia, and thermal hyperalgesia), paw edema assessment, and arthritis scores. Serum tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and cyclic citrullinated peptide (CCP) antibody levels were assessed. Moreover, malondialdehyde (MDA), nitrite, glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) levels were also evaluated. RESULTS: Oral administration of ATX (50 and 100 mg/kg) exhibited significant anti-arthritic activity via enhancing the nociceptive threshold, reducing paw edema and improving arthritis scores. Moreover, ATX treatment also markedly suppressed inflammatory and oxidative mediators in adjuvant-administered rats. CONCLUSIONS: Our findings suggest that ATX possesses potential anti-arthritic activity, which could be attributed to its anti-inflammatory and antioxidant properties.
31262506 Adherence to Current Vaccination Recommendations for Patients With Rheumatoid Arthritis in 2021 Mar BACKGROUND: Patients with RA have a two to four-fold increased risk of developing infections compared to the general population. For this reason, the administration of influenza, pneumococcal and shingles vaccines is recommended for all patients with RA, preferably prior to initiating treatment, Previous studies have demonstrated the low prevalence of vaccination as well as adherence to current recommendations by rheumatologists in other regions. OBJECTIVE: To determine the knowledge and adherence to the current vaccination recommendations for patients with RA by rheumatology members of the Mexican College of Rheumatology (MCR), and to identify barriers to their application in this population. METHODS: A cross-sectional study was conducted through a survey sent to 577 rheumatologists from Mexico in January 2017. RESULTS: We received completed surveys from 122 individuals, representing 21.14% of the 577 rheumatologists in our registry. Fifty percent responded that they recommended immunization against influenza to 76%-100% of their patients, 36.07% recommended immunization against pneumococcus to 76%-100% of their patients, and 69.67% of the survey responders did not recommend shingles immunization routinely to their patients. CONCLUSIONS: The data collected in this study show there is poor adherence to immunization schedules recommended for the RA population. This data suggests there is misinformation about the effectiveness, safety and optimal timing of immunization in patients with RA in Mexico.
31081771 Protective effects of vitamin D and losartan in complete Freund's adjuvant-induced arthrit 2019 Mar The current study was designed to explore the protecting effects of vitamin D and losartan in treatment of rheumatoid arthritis (RA). Animals were allotted to five groups: Group I received vehicles only (vehicle control). Group II was administered complete Freund's adjuvant (CFA) and did not receive any medication. The remaining three groups (III, IV, V) were given CFA followed by treatment with leflunomide, vitamin D or losartan, respectively for two weeks. Compelling increment in tumor necrosis factor (TNF-α), interleukin 6 (IL-6), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), malondialdehyde (MDA) level, white blood cells (WBCs), total cholesterol (TC) and triglycerides (TGs) was revealed in arthritic rats. This was associated with marked decline in glutathione (GSH) level, red blood cells (RBCs), hemoglobin (Hb), Platelets (Plts), hematocrit (Hct) and high density lipoprotein cholesterol (HDL). vitamin D or losartan significantly decreased TNF α, IL-6, RF, ESR, MDA, TC, TGs, WBCs and significantly increased RBCs, Hb, Hct, Plts and HDL. It could be concluded that vitamin D and losartan are able to repress the alterations associated with adjuvant-induced arthritis (AIA). This preserving effect might be partially attributed to antiarithritic, hypolipidemic and antianemic properties.
31236746 Elevated serum levels of interleukin-10 in adult-onset Still's disease are associated with 2019 Nov To evaluate the serum levels of the anti-inflammatory cytokine interleukin-10 (IL-10) in patients with adult-onset Still's disease (AOSD), a rare, systemic, and multigenic inflammatory disease. The serum levels of IL-10, IL-1β, IL-6, IL-18, and TNF-α were examined by electrochemiluminescence assay. The serum levels of IL-10 were higher in AOSD patients than in healthy controls and positively correlated with systemic score, erythrocyte sedimentation rate (ESR), C-reactive protein level (CRP), ferritin, and inflammatory cytokine (IL-1β, IL-6, IL-18, and TNF-α) levels. Moreover, the levels of IL-10 were significantly higher in AOSD patients who had fever, sore throat, rash, lymphadenopathy, splenomegaly, pneumonia, and arthralgia than in patients who did not. IL-10 was increased in AOSD patients and correlated with disease activity. KEY POINTS: • In this manuscript, we confirmed the elevated serum levels of the anti-inflammatory cytokine IL-10 in AOSD patients, which was previously poorly defined. • We revealed for the first time that the levels of IL-10 were correlated with disease activity and inflammatory cytokine levels in AOSD.
31534486 Clinical outcomes and complications following primary total elbow arthroplasty using the L 2019 Oct BACKGROUND: The Latitude total elbow arthroplasty (TEA) is an implant with limited published data on its performance and outcomes. The aim of this study was to report the short-term outcomes of the Latitude TEA as well as to describe the radiographic outcomes and complications. METHODS: The Latitude was implanted in 20 patients (23 elbows) in a linked configuration. Patients were recalled to clinic for the assessment of their range-of-motion and compared to preoperative values. Administration of functional outcome measures was also performed. RESULTS: Mean follow-up was 4.7 years (range, 1 to 7.5 years) with four elbows requiring revision. The flexion-extension arc improved from 86.6 to 101.3 (range, 76 to 126) postoperatively (p = 0.04). The average Disabilities of the Arm, Shoulder, and Hand score was 28.1 (range, 5.8 to 50.4) and the average Mayo Elbow Performance Score was 89.6 (range, 76 to 100), with 83% of elbows scoring in the good or excellent range. Radiolucencies were detected in 60% of patients and 31% of these lucencies progressed in size at the time of follow-up. CONCLUSIONS: The Latitude prosthesis provides patients with favorable clinical outcomes with improvements in their range-of-motion and a complication rate comparable to other elbow arthroplasty implants.
33086972 Vasculitis in a patient with mixed cryoglobulinemia treated with rituximab biosimilar CT-P 2020 Jan Rituximab represents a milestone in the treatment of mixed cryoglobulinemic vasculitis. Despite usually well-tolerated, rituximab may induce different types of adverse drug reactions, including exacerbation of vasculitis. Rituximab biosimilar have been recently approved in Europe in the treatment of rheumatoid arthritis, but no data are available about effectiveness and safety of rituximab biosimilar in the treatment of mixed cryoglobulinemic vasculitis. We describe a severe skin vasculitis reactivation in a patient affected by rheumatoid arthritis and mixed cryoglobulinemic vasculitis treated with rituximab biosimilar. After 7 days from the first infusion, a severe purpuric rash at lower limbs appeared, that resolved in about 2 weeks with high dose-corticosteroid. Rituximab-induced vasculitis has also been described since 2001, but its pathophysiology is still controversial due to the anecdotical descriptions in literature and the variability of the time between the rituximab infusion and the onset of skin lesions. Up to date, this is the first report describing a vasculitic flare in a patient affected by mixed cryoglobulinemic vasculitis treated with rituximab biosimilar.
31703067 Quantitative assessment of interstitial lung disease in Sjögren's syndrome. 2019 BACKGROUND: Interstitial lung disease (ILD) is a frequent manifestation of Sjögren's syndrome (SS), an autoimmune disease of salivary and lacrimal glands, and affects approximately 20% of patients. No clinical or serological features appear to be useful to predict its presence, severity or progression, and chest high-resolution computed tomography (CT) remains the gold standard for diagnosis. Semiquantitative CT (SQCT) based on visual assessment (Goh and Taouli scoring) can estimate ILD extent, although it is burdened by relevant intra- and interobserver variability. Quantitative chest CT (QCT) is a promising alternative modality to assess ILD severity. AIM: To determine whether QCT assessment can identify extensive or limited lung disease in patients with SS and ILD. METHODS: This multi-center, cross-sectional and retrospective study enrolled patients with SS and a chest CT scan. SQCT assessment was carried out in a blinded and centralized manner to calculate both Goh and Taouli scores. An operator-independent analysis of all CT scans with the open-source software platform Horos was used to evaluate the QCT indices. Patients were classified according to the extent of ILD and differences in QCT index distribution were investigated with non-parametric tests. RESULTS: From a total of 102 consecutive patients with SS, the prevalence of ILD was 35.3% (36/102). There was a statistically significant difference in QCT index distribution between the SS with ILD and SS without ILD groups (p<0.001). Moreover, SS-ILD patients with ILD >20% (by Goh score) had a QCT index statistically different from those with limited ILD extent (p<0.001). Finally, QCT indices showed a moderate-to-good correlation with the Goh and Taouli scores (from 0.44 to 0.65; p<0.001). CONCLUSIONS: QCT indices can identify patients with SS and ILD and discriminate those with lesser or greater lung disease.
31594442 A case report of Sjögren's syndrome associated with protein-losing gastroenteropathy succ 2020 Feb Protein-losing gastroenteropathy (PLGE) is a rare manifestation of primary Sjögren's syndrome that is most commonly reported in Japan. Herein, the case of a 71-year-old Chinese male patient, diagnosed with PLGE and Sjögren's syndrome, is reported. The patient presented with peripheral oedema, and PLGE was diagnosed based on the result of technetium-99m ((99m)Tc)-labelled albumin scintigraphy. In addition to a positive Schirmer's test, the patient had atrophy of the salivary gland with lymphocyte infiltration, impaired parotid-gland secretory and excretory function, and an increased level of anti-SSA antibodies, fulfilling the criteria for Sjögren's syndrome. He was successfully treated with methylprednisolone. Follow-up (99m)Tc-labelled albumin scintigraphy results correlated well with clinical improvement and increased serum albumin levels. The present case study highlights the necessity of considering a diagnosis of protein loss enteropathy associated with primary Sjögren's syndrome when patients have unexplained hypoproteinaemia.
31464664 Systemic manifestations of primary Sjögren's syndrome out of the ESSDAI classification: p 2019 May OBJECTIVES: To analyse the frequency and characterise the systemic presentation of primary Sjögren's syndrome (SS) out of the ESSDAI classification in a large international, multi-ethnic cohort of patients. METHODS: The Big Data Sjögren Project Consortium is an international, multicentre registry based on world-wide data-sharing and cooperative merging of pre-existing clinical SS databases from leading centres in clinical research in SS from the five continents. A list of 26 organ-by-organ systemic features not currently included in the ESSDAI classification was defined according to previous studies; these features were retrospectively recorded. RESULTS: Information about non-ESSDAI features was available in 6331 patients [5,917 female, mean age at diagnosis 52 years, mainly White (86.3%)]. A total of 1641 (26%) patients had at least one of the ESSDAI systemic features. Cardiovascular manifestations were the most frequent organ-specific group of non-ESSDAI features reported in our patients (17% of the total cohort), with Raynaud's phenomenon being reported in 15%. Patients with systemic disease due to non-ESSDAI features had a lower frequency of dry mouth (90.7% vs. 94.1%, p<0.001) and positive minor salivary gland biopsy (86.7% vs. 89%, p=0.033), a higher frequency of anti-Ro/SSA (74.7% vs. 68.7%, p<0.001), anti-La/SSB antibodies (44.5% vs. 40.4%, p=0.004), ANA (82.7% vs. 79.5%, p=0.006), low C3 levels (17.4% vs. 9.7%, p<0.001), low C4 levels (14.4% vs. 9.6%, p<0.001), and positive serum cryoglobulins (8.6% vs. 5.5%, p=0.001). Systemic activity measured by the ESSDAI, clinESSDAI and DAS was higher in patients with systemic disease out of the ESSDAI in comparison with those without these features (p<0.001 for all comparisons). CONCLUSIONS: More than a quarter of patients with primary SS may have systemic manifestations not currently included in the ESSDAI classification, with a wide variety of cardiovascular, digestive, pulmonary, neurological, ocular, ENT (ear, nose, and throat), cutaneous and urological features that increase the scope of the systemic phenotype of the disease. However, the individual frequency of each of these non-ESSDAI features was very low, except for Raynaud's phenomenon.
30572138 Novel autoantibodies in Sjögren's syndrome: A comprehensive review. 2019 Feb Sjögren's syndrome is a systemic autoimmune disease characterized by immune- mediated injury of exocrine glands, as well as a diverse array of extraglandular manifestations. B cell over-activation is a key feature of the disease, attested by the wide spectrum of autoantibodies detected in these patients. Up to date, anti- Ro/SSA and anti-La/SSB antibodies are traditional biomarkers for disease classification and diagnosis. On the other hand, the detection of novel autoantibodies in SS has increased in the last years, opening a window of opportunity to denote particular stages of the disease, to establish clinical phenotypes, and to predict long-term complications such as lymphoma. For instance, anti-SP-1, anti-CA6 and anti-PSP antibodies occur in an earlier stage than anti-Ro/La antibodies, and may identify a subset of primary Sjögren's syndrome patients with mild or incomplete disease, whereas anti-cofilin-1, anti- alpha-enolase and anti-RGI2 antibodies are potential biomarkers of MALT lymphoma. Antibody detection is also important to elucidate new aspects of SS pathophysiology, and in the future to permit a phenotype-specific patient approach. Herein we review the literature regarding new autoantibodies in SS and attempt to dissect their usefulness as diagnostic tools, pathogenic role, identification of clinical phenotypes and as predictors of an overlap syndrome.
31344425 Triamcinolone acetonide-loaded PLA/PEG-PDL microparticles for effective intra-articular de 2019 Sep 10 Nowadays the use of sustainable polymers as poly-lactic acid (PLA) and poly-δ-decalactone (PDL) in drug delivery is advantageous compared to polymers derived from fossil fuels. The present work aimed to produce microparticles (MPs) derived from novel sustainable polymers, loaded with triamcinolone acetonide (TA) for treatment of rheumatoid arthritis via intra-articular (IA) delivery. PDL was synthesized from green δ-decalactone monomers and co-polymerized with methoxy-polyethylene glycol (mPEG) forming PEG-PDL with different molecular weights. The Hansen's solubility parameters were applied to select the most compatible polymer with the drug. An o/w emulsion/solvent evaporation technique was used for MPs fabrication, using 3 [3] full factorial design. Selection of the optimized MPs was performed using Expert Design® software's desirability function. The optimized formulations were characterized using scanning electron microscope, powder X-ray diffraction, differential scanning calorimetry, infrared spectroscopy and in vitro release studies. The inhibition percents of inflammation and histopathological studies were assessed in complete Freund's adjuvant-induced rats' knee joints evaluating the effect of IA injections of selected MPs compared to the free drug suspension. Solubility studies revealed high compatibility and miscibility between TA and PEG-PDL(1700), which was blended with PLA for convenient MPs formation. The in vitro characterization studies confirmed the formation of drug-copolymer co-crystals. The in vivo studies ensured the superiority of the newly designed composite MPs in inflammation suppression, compared to the free drug suspension and PLA MPs as well. The present study proved the advantage of using sustainable polymers in a novel combination for effective drug delivery and suggesting its usefulness in designing versatile platforms for therapeutic applications.
31946330 Predicting lymphoma outcomes and risk factors in patients with primary Sjögren's Syndrome 2019 Jul Primary Sjogren's Syndrome (pSS) is a chronic autoimmune disease followed by exocrine gland dysfunction, where it has been long stated that 5% of pSS patients are prone to lymphoma development. In this work, we use clinical data from 449 pSS patients to develop a first, rule-based, supervised learning model that can be used to predict lymphoma outcomes, as well as, identify prominent features for lymphoma prediction in pSS patients. Towards this direction, the gradient boosting method combined with regression tree ensembles is used to derive a rule-based, decision model for lymphoma prediction. Our results reveal an average accuracy 87.1% and area under the curve score 88%, highlighting the importance of the C4 value, the rheumatoid factor and the lymphadenopathy factor as prominent lymphoma predictors, among others.