1,721,016 research outputs found
Antioxidant effect of Iloprost: current knowledge and therapeutic implications for systemic sclerosis
No full textMany lines of independent research have pointed out the role of oxidative stress as a fascinating pathogenic link between the three main hallmarks of systemic sclerosis (SSc), viz. humoral and cellular immunity activation, microvascular damage and widespread tissue fibrosis. Therefore counteracting oxidative stress may have a favourable impact on clinical features and progression of disease. It is becoming clearer that Iloprost, a synthetic stable analogue of prostacycline, currently employed in the treatment of SSc vascular features, also possess anti-oxidative properties beside its prostaglandin-like vasodilatory and antiaggregant effects. This brief review is aimed to discuss available clinical evidences supporting Iloprost antioxidant action and focus on putative molecular pathways underlying it
Repurposing available anti-inflammatory and immunomodulating agents for cardiovascular risk management: A call for submissions to current clinical pharmacology
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Antimalarial use and arrhythmias in COVID-19 and rheumatic patients: a matter of dose and inflammation?
No full textPlacebo response in psoriatic arthritis clinical trials: a systematic review and meta-analysis
No full textObjective: To determine the placebo response rate in PsA randomized clinical trials (RCTs), its contributing factors and impact on the effect size of active treatments. Methods: We searched multiple databases, from inception to 20 December 2020, for placebo-controlled RCTs in PsA. We used a random-effects meta-analysis to pool the response rates for the ACR20 criteria in the placebo arm, determined the risk difference for treatment vs placebo, and used meta-regression to determine the factors associated with placebo response rates. The risk of bias was assessed in duplicate. The study protocol was registered with PROSPERO: CRD42021226000. Results: We included 42 RCTs (5050 patients receiving placebo) published between 2000 and 2020. The risk of bias was low in 28 trials, high in four, and with some concerns in 10. The pooled placebo response rate was 20.3% (95% CI: 18.6%, 22.1%; predicted intervals, 11.7-29.0%), with significant between-trial heterogeneity (I2 = 56.8%, P < 0.005). The pooled risk difference for treatment vs placebo was 27% (95% CI: 24%, 31%). In the multivariable meta-regression, there was a 15% (95% CI: 2.9%, 29.8%) increase in the odds of achieving the placebo response for each 5-year increment in publication year (P = 0.016). In addition, the active treatment risk difference decreased for every 5-year increment in publication year (β = -0.053, 95% CI: -0.099, -0.007; P = 0.024) but was not associated with the placebo response. Conclusion: Despite increasing over time, the placebo response for ACR20 in PsA RCTs was not associated with the active treatment effect size
Role of infections in the pathogenesis of rheumatoid arthritis: Focus on mycobacteria
No full textRheumatoid arthritis (RA) is a systemic inflammatory autoimmune disease characterized by chronic erosive polyarthritis. A complex interaction between a favorable genetic background, and the presence of a specific immune response against a broad-spectrum of environmental factors seems to play a role in determining susceptibility to RA. Among different pathogens, mycobacteria (including Mycobacterium avium subspecies paratuberculosis, MAP), and Epstein–Barr virus (EBV), have extensively been proposed to promote specific cellular and humoral response in susceptible individuals, by activating pathways linked to RA development. In this review, we discuss the available experimental and clinical evidence on the interplay between mycobacterial and EBV infections, and the development of the immune dysregulation in RA
Humoral response to microbial biomarkers in rheumatoid arthritis patients
No full textBackground/Objective: Chronic humoral immune response against multiple microbial antigens may play a crucial role in the etiopathogenesis of rheumatoid arthritis (RA). We aimed to assess the prevalence and magnitude of antibody response against various bacterial and viral immunogen peptides in the sera of RA patients compared with the general population. Methods: Polyclonal IgG antibodies (Abs) specific for peptides derived from Porphyromonas gingivalis (RgpA, Kpg), Aggregatibacter actinomycetemcomitans (LtxA1, LtxA2), Mycobacterium avium subsp. paratuberculosis (MAP4027), Epstein–Barr virus (EBNA1, EBVBOLF), and human endogenous retrovirus (HERV-W env-su) were detected by ELISA in serum samples from 148 consecutive RA patients and 148 sex and age-matched healthy controls (HCs). In addition, the presence of a relationship between the positivity and the titer of antibodies and RA descriptors was explored by bivariate correlation analysis. Results: RA patients exhibit a higher prevalence of humoral immune response against all tested peptides compared to HCs with a statically significant difference for MAP4027 (30.4% vs. 10.1%), BOLF (25.7% vs. 8.1%), RgpA (24.3% vs. 9.4%), HERV W-env (20.3% vs. 9.4%), and EBNA1 (18.9% vs. 9.4%) peptides. Fifty-three (35.8%) out of 148 RA serum and 93 (62.8%) out of 148 HCs were negative for all pathogen-derived peptides. There was a significant correlation between OD values obtained by ELISA test against all peptides (p < 0.0001). We also found an increased titer and prevalence of Abs against LtxA1 and LtxA2 in seropositive vs. seronegative RF (p = 0.019, p = 0.018). Conclusion: This study demonstrates a significantly increased humoral response against multiple pathogens in patients with RA and implies that they could be an important factor in the pathogenesis of the disease. Therefore, the role of each individual pathogen in RA needs to be further investigated
Association between lipoprotein levels and humoral reactivity to mycobacterium avium subsp. Paratuberculosis in multiple sclerosis, type 1 diabetes mellitus and rheumatoid arthritis
No full textEnvironmental factors such as bacterial infections may play an important role in the development of autoimmune diseases. Mycobacterium avium subsp. paratuberculosis (MAP) is an obligate pathogen of ruminants able to use the host’s cholesterol for survival into macrophages and has been associated with multiple sclerosis (MS), type 1 diabetes (T1DM) and rheumatoid arthritis (RA) through a molecular mimicry mechanism. Here, we aimed at investigating the correlation between humoral reactivity against MAP and serum lipoprotein levels in subjects at T1DM risk (rT1DM) grouped by geographical background and in patients affected by MS or RA. Our results showed significant differences in HDL, LDL/VLDL and Total Cholesterol (TC) levels between patients and healthy controls (p < 0.0001). Patients positive to anti-MAP Abs (MAP+) had lower HDL levels in comparison with Abs negative (MAP-) subjects, while opposite trends were found for LDL/VLDL concentrations (p < 0.05). TC levels varied between MAP+ and MAP-patients in all three assessed diseases. These findings suggest the implication of anti-MAP Abs in fluctuations of lipoprotein levels highlighting a possible link with cardiovascular disease. Further studies will be needed to confirm these results in larger groups
Association of Rheumatoid Arthritis with Glucose-6-Phosphate Dehydrogenase Deficiency: Results from a Case-Control Study
No full textDiagnostic value of antifilaggrine antibodies (antibodies to cyclic citrullinated peptide and anti-keratin antibodies) for rheumatoid arthritis
No full textObjective: The aim of the study is to verify the diagnostic value of antibodies to cyclic citrullinated peptide (anti-CCP) and anti-keratin antibodies (AKA), alone and in combination, in patients with rheumatoid arthritis (RA) and early rheumatoid arthritis (ERA). Methods: A retrospective study was performed in 100 patients with established RA and 100 controls to validate sensitivity, specificity and positive predictive value (PPV) for RA of the Anti-CCP and AKA assays in our Unit. Results: Anti-CCP demonstrated high sensitivity (70%) and specificity (97%) for the diagnosis of RA and similar accuracy for the diagnosis of ERA. The sensitivity and the specificity of AKA were respectively 52% and 99%. Conclusion: We concluded that anti-CCP is a very valuable tool for the diagnosis of RA and ERA. © 2006 Pharma Project Group srl
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