1,721,081 research outputs found
Vitamin D in Rheumatoid Arthritis: potential implications for disease control and comorbidities management
No full textBackground. Vitamin D is able to regulate the activity of immune system in vitro; whether this action has some relevance in vivo is still a matter of debate. Aim. To investigate the potential role of vitamin D in the pathogenesis and in the management of Rheumatoid Arthritis (RA) and its comorbidities, in particular insulin resistance. Methods. We investigated the expression of tha main target genes implicated in vitami D metabolism on synovial samples obtained from RA and Osteoarthritis (OA) patients; moreover, we evaluated the expression of the CYP27B1, the activating enzyme of vitamin D metabolism, by synovial fibroblasts (SF) of RA patients in vitro. We also investigated, in vivo, the relevance of visceral obesity, assessed by ultrasounds, in the prediction of cardiovascular risk and glucose metabolism in the general population. Finally, we evaluated the cross-sectional association between glucose metabolism
parameters and vitamin D plasma concentration in severely obese diabetic subjects. Results. In the present study we failed to demonstrate significant differences in vitamin D metabolism between RA and OA patients; however, we demonstrated that SF express CYP27B1 under inflammatory state, being potentially able to locally activate vitamin D. Moreover we confirmed that visceral obesity, a well known risk factor for hypovitaminosis D, is the main determinant of insulin resistance and is a strong predictor of cardiovascular risk. Finally, we demonstrated that vitamin D in severely obese type 2 diabetes mellitus patients predicts glycemic control. Conclusions. Our data support the hypothesis that the local conversion of vitamin D could be exploited for therapeutic use in RA; finally, the improvement of vitamin D status might have beneficial effects on different comorbidities related to RA, in particular insulin resistance
Long-term remission of corticosteroid- and cyclophosphamide-resistant Henoch-Schönlein purpura with rituximab
No full textCandidate Biomarkers of Liver Fibrosis: A Concise, Pathophysiology-oriented Review
Full text linkRepair of sustained liver injury results in fibrosis (i.e. the accumulation of extracellular matrix proteins), and ultimately the complete distortion of parenchymal architecture of the liver, which we call cirrhosis. Detecting and staging of fibrosis is thus a mainstay in the management of chronic liver diseases, since many clinically relevant decisions, such as starting treatment and/or monitoring for complications including hepatocellular carcinoma, may depend on it. The gold standard for fibrosis staging is liver biopsy, the role of which, however, is questioned nowadays because of cost, hazards and poor acceptance by patients. On the other hand, imaging techniques and/or measurement of direct and indirect serum markers have not proved to be completely satisfactory under all circumstances as alternatives to liver biopsy. Making progress in this field is now more crucial than ever, since treatments for established fibrosis appear on the horizon. Fine dissection of the pathways involved in the pathophysiology of liver diseases has put forward several novel candidate biomarkers of liver fibrosis, such as growth arrest-specific6, Mac-2-binding protein, osteopontin, placental growth factor, growth/differentiation factor 15 and hepatocyte growth factor. All molecules have been suggested to have potential to complement or substitute methods currently used to stage liver diseases. Here, we review the pros and cons for their use in this setting
Commenting on “Prognostic and diagnostic significance of copeptin in acute exacerbation of chronic obstructive pulmonary disease and acute heart failure: data from ACE 2 study” by Jacob A. Winther and colleagues
Full text linkAbstract We would like to comment on the article entitled “Prognostic and diagnostic significance of copeptin in acute exacerbation of chronic obstructive pulmonary disease and acute heart failure: data from ACE 2 study” by Jacob A. Winther and colleagues, in the light of the results of a multicentric study published in 2014 by Vetrone F. et al., in which 336 patients with dyspnea were enrolled in the Emergency Departments of three University Hospitals in Italy. These two studies confirm the prognostic role of copeptin in patients with dyspnea due to heart failure but, while Winther et al. performed the copeptin measurements only at admission, Vetrone et al. evaluated the time-course of copeptin plasma concentration from the admission to the hospital discharge. The results showed a better performance of copeptin measured at discharge as prognostic biomarker compared to copeptin at hospital admission; similarly, a lower reduction or an increase in copeptin concentration from admission to discharge was a strong prognostic predictor of unfavorable outcome. In our opinion this is a very important result, opening new perspectives for the use of copeptin as prognostic marker in HF patients
Unsuppressed parathyroid hormone in patients with autoimmune/inflammatory rheumatic diseases: implications for vitamin D supplementation
No full text- …
