{"title":"Alterations of the microbiome across body sites in systemic lupus erythematosus: A systematic review and meta-analysis.","authors":"Yiyu Wang,Hong Wu,Chengrui Yan,Ronggui Huang,Kaidi Li,Yujie Du,Xue Jin,Gaoqi Zhu,Hanjun Zeng,Baozhu Li","doi":"10.1177/09612033241281891","DOIUrl":"https://doi.org/10.1177/09612033241281891","url":null,"abstract":"BACKGROUNDSystemic lupus erythematosus (SLE) is a complex autoimmune disease with unclear etiology. Growing evidence suggests the microbiome plays a role in SLE pathogenesis. However, findings are inconsistent across studies due to factors like small sample sizes and geographical variations. A comprehensive meta-analysis is needed to elucidate microbiome alterations in SLE.OBJECTIVEThis study aimed to provide a systematic overview of microbiota dysbiosis across body sites in SLE through a meta-analysis of alpha diversity indices, beta diversity indices, and abundance taxa of microbiome.METHODSA literature search was conducted across four databases to identify relevant studies comparing SLE patients and healthy controls. Extracted data encompassed alpha and beta diversity metrics, as well as bacterial, fungal, and viral abundance across gut, oral, skin, and other microbiota. Study quality was assessed using the Newcastle-Ottawa Scale. Standardized mean differences and pooled effect sizes were calculated through meta-analytical methods.RESULTSThe analysis showed reduced alpha diversity and distinct beta diversity in SLE, particularly in the gut microbiota. Taxonomic analysis revealed compositional variations in bacteria from the gut and oral cavity. However, results for fungi, viruses, and bacteria from other sites were inconsistent due to limited studies.CONCLUSIONSThis meta-analysis offers a comprehensive perspective on microbiome dysbiosis in SLE patients across diverse body sites and taxa. The observed variations underscore the microbiome's potential role in SLE pathogenesis. Future research should address geographical variations, employ longitudinal designs, and integrate multi-omics approaches.","PeriodicalId":18044,"journal":{"name":"Lupus","volume":"2 1","pages":"9612033241281891"},"PeriodicalIF":2.6,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LupusPub Date : 2024-09-11DOI: 10.1177/09612033241283551
Guillermo J Pons-Estel,Rosana Quintana,Manuel F Ugarte-Gil,Guillermina B Harvey,Daniel Wojdyla,Rosa Serrano-Morales,José A Gómez Puerta,Mercedes A García,Luis J Catoggio,Verónica Saurit,Cristina Drenkard,Nilzio A Da Silva,Fernando Cavalcanti,Eduardo Borba,Emilia Sato,Oscar Neira,Loreto Massardo,Gloria Vásquez,Luis Alonso Gonzalez,Marlene Guibert-Toledano,Luis H Silveira,Ignacio García De La Torre,María Josefina Sauza Del Pozo,Rosa Chacón,Mario H Cardiel,Ashley Orillion,Urbano Sbarigia,Evo Alemao,Federico Zazzetti,Graciela S Alarcón,Bernardo A Pons-Estel
{"title":"Predictors of first hospitalization due to disease activity and infections in systemic lupus erythematosus patients.","authors":"Guillermo J Pons-Estel,Rosana Quintana,Manuel F Ugarte-Gil,Guillermina B Harvey,Daniel Wojdyla,Rosa Serrano-Morales,José A Gómez Puerta,Mercedes A García,Luis J Catoggio,Verónica Saurit,Cristina Drenkard,Nilzio A Da Silva,Fernando Cavalcanti,Eduardo Borba,Emilia Sato,Oscar Neira,Loreto Massardo,Gloria Vásquez,Luis Alonso Gonzalez,Marlene Guibert-Toledano,Luis H Silveira,Ignacio García De La Torre,María Josefina Sauza Del Pozo,Rosa Chacón,Mario H Cardiel,Ashley Orillion,Urbano Sbarigia,Evo Alemao,Federico Zazzetti,Graciela S Alarcón,Bernardo A Pons-Estel","doi":"10.1177/09612033241283551","DOIUrl":"https://doi.org/10.1177/09612033241283551","url":null,"abstract":"OBJECTIVESTo identify the predictive factors of first hospitalization and associated variables to the main causes of hospitalizations in lupus patients from a Latin American cohort.METHODSThe first hospitalization after entry into the cohort during these patients' follow-up due to either lupus disease activity and/or infection was examined. Clinical and therapeutic variables were those occurring prior to the first hospitalization. Descriptive statistical tests, multivariable logistic, and Cox regression models were performed.RESULTS1341 individuals were included in this analysis; 1200 (89.5%) were women. Their median and interquartile range (IQR) age at diagnosis were 27 (20-37) years and their median and IQR follow up time were 27.5 (4.7-62.2) months. A total of 456 (34.0%) patients were hospitalized; 344 (75.4%), 85 (18.6%) and 27 (5.9%) for disease activity, infections, or both, respectively. The predictors of the first hospitalization regardless of its cause were: medium (HR 2.03(1.27-3.24); p = 0.0028) and low (HR 2.42(1.55-3.79); p < 0.0001) socioeconomic status, serosal (HR 1.32(1.07-1.62); p = 0.0074) and renal (HR 1.50(1.23-1.82); p < 0.0001) involvement. Antimalarial (AM) use (HR 0.61(0.50-0.74); p < 0.0001) and achieving remission (HR 0.80(0.65-0.97); p = 0.0300) were negative predictors.CONCLUSIONSThe first hospitalization was associated with worse socioeconomic status and serosal and renal involvement. Conversely, AM use and achieving remission were associated with a lower risk of hospitalizations.","PeriodicalId":18044,"journal":{"name":"Lupus","volume":"44 1","pages":"9612033241283551"},"PeriodicalIF":2.6,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142202063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Early diagnosis of lupus: A possibilty. A multicentric study from SLE Special Interest Group (SIG) of Indian Rheumatology Association (IRA).","authors":"Vineeta Shobha,Yogesh Preet Singh,Sourabh Malviya,Arul R Ponniah Subramanian,Liza Rajasekhar,Ranjan Gupta,Subramanian Nallasivan,Vijay Kr Rao,Avinash Jain,Aradhana Singh,Shaleni V,Sumithra Selvam,Deepak Yadav,John Mathew,Amita Aggarwal","doi":"10.1177/09612033241283111","DOIUrl":"https://doi.org/10.1177/09612033241283111","url":null,"abstract":"INTRODUCTIONSystemic Lupus Erythematosus (SLE) warrants an early diagnosis and prompt management. Delay in diagnosis can result in repeated flares, permanent damage, and even death. There is a large variability in the time taken to diagnose SLE across the world. We undertook this study to determine the time taken for diagnosis of SLE in India and to identify the factors associated.METHODSPatients with SLE diagnosed within the previous 1 year as per Systemic Lupus Erythematosus International Collaborating Clinics criteria (SLICC) 2012 criteria were included in a cross-sectional multicentre questionnaire-based survey. Demographic profile, self-reported socioeconomic status as per Kuppuswamy classification of socioeconomic status (version 2022) (SES), and several healthcare related parameters including referral pattern were recorded. Median time taken for diagnosis was used to demarcate early or late diagnosis and associated factors were explored.RESULTSWe included 488 patients with SLE from 10 rheumatology centres. The median time to diagnosis was 6 months Interquartile Range (IQR 3,14.7) and within 3 months in about one third [150(30.7%)]. Very early diagnosis (<1 month) was established in 78(16.0%) patients. The mean SLE Disease Activity Index (SLEDAI) at diagnosis was 10.28+7.24. In univariate analysis, an older age, lower SES, non-southern state of residence and larger family size were significantly associated with late diagnosis. In the multivariate analysis, higher SES (AOR 0.95, 95% CI: 0.92-0.98), multiple organ system involvement at initial presentation (AOR1.75 95%CI: 1.08-2.84) and place of residence in south Indian states (AOR1.92 95%CI: 1.24-2.97) had lesser odds of being associated with late diagnosis. Distance from the closest medical centre/professional did not influence the time to diagnosis. Majority of patients had first consulted a medical graduate (42.5%) or postgraduate doctor (48.2%), and referral to rheumatologist was largely done by postgraduate (65%) doctors. More than half of our patients (61%) self-finance their treatment.CONCLUSIONMedian time to diagnosis of SLE was 6 months, 1/3rd being diagnosed within 3 months and 78(16.0%) with 1 month of symptom onset. Delay in diagnosis was noted in those belonging to lower socioeconomic strata and those with single organ disease. Distance to the health care facility did not influence time to diagnosis.","PeriodicalId":18044,"journal":{"name":"Lupus","volume":"21 1","pages":"9612033241283111"},"PeriodicalIF":2.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142202065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LupusPub Date : 2024-09-01Epub Date: 2024-08-02DOI: 10.1177/09612033241266989
Prabal Mittal, Marina Pacheco, Laura Trives-Folguera, Joana Rua, Ibrahim Tohidi-Esfahani, Hannah Cohen, Maria Efthymiou, David Isenberg
{"title":"Comparison of clinical and serological features in thrombotic antiphospholipid syndrome patients, with and without associated systemic lupus erythematosus, followed for up to 42 years: A single centre retrospective study.","authors":"Prabal Mittal, Marina Pacheco, Laura Trives-Folguera, Joana Rua, Ibrahim Tohidi-Esfahani, Hannah Cohen, Maria Efthymiou, David Isenberg","doi":"10.1177/09612033241266989","DOIUrl":"10.1177/09612033241266989","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of concomitant systemic lupus erythematosus (SLE) on the clinicopathological manifestations of thrombotic antiphospholipid syndrome (APS).</p><p><strong>Methods: </strong>This single-centre, retrospective study compared clinical and antiphospholipid antibody (aPL) data from 118 patients, 58 with SLE-associated APS (SLE-APS), and 60 with primary APS.</p><p><strong>Results: </strong>Median follow-up was 13.9 (IQR 7.7-19.3) and 8.6 years (3.5-10.6) for the SLE-APS cohort and PAPS cohort, respectively. Age at diagnosis of APS was lower in the SLE-APS cohort (mean 35.9 vs PAPS: 46.7 years; <i>p</i> < 0.05). Distribution of aPL subtypes was similar across cohorts. 198 thrombotic events were identified overall (index plus recurrent), with venous thromboembolism (VTE) and arterial thrombosis each occurring in just over half of patients in both cohorts. Microvascular thrombosis (12.1% vs 0%), and a mixed (any combination of venous, arterial and microvascular) thrombotic phenotype (19.0% vs 6.7%, <i>p</i> = 0.05) were more prevalent in SLE-APS patients. Recurrent thrombosis incidence rates (∼0.5 events/10-patient years), and Kaplan-Meier recurrence-free survival after index thrombosis, were similar. In the PAPS cohort, only: (i) triple-aPL-positivity was associated with a significantly higher recurrent thrombosis event rate (incidence rate ratio 2.22, <i>p</i> = 0.03) and lower recurrence-free survival after first thrombosis (log-rank test <i>p</i> = 0.01); (ii) lupus anticoagulant (LA)-positivity was associated with higher prevalance of arterial thrombosis (RR 2.69, <i>p</i> = 0.01), and lower prevlance of VTE (RR 0.48, <i>p</i> < 0.001), versus LA-negativity.</p><p><strong>Conclusion: </strong>Concomitant SLE does not appear to modify long-term recurrent thrombosis risk, or aPL phenotypes, in patients with APS. Triple-aPL-positivity and LA-positive status may have less influence on thrombotic outcomes in patients with SLE-APS compared to PAPS.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1082-1088"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LupusPub Date : 2024-09-01Epub Date: 2024-07-21DOI: 10.1177/09612033241266875
Liang Luo, Qingmeng Cai, Xiangjun Liu, Zelin Yun, Xuerong Li, Rui Yan, Chun Li
{"title":"Characteristics and prognosis of elderly-onset antiphospholipid syndrome: An observational cohort study.","authors":"Liang Luo, Qingmeng Cai, Xiangjun Liu, Zelin Yun, Xuerong Li, Rui Yan, Chun Li","doi":"10.1177/09612033241266875","DOIUrl":"10.1177/09612033241266875","url":null,"abstract":"<p><strong>Objective: </strong>Antiphospholipid syndrome (APS) is an autoimmune disease mainly affecting young individuals. Testing for antiphospholipid antibodies is recommended for young patients who are suspected to have APS. Yet, it is hard to differentiate APS from other acquired thrombophilia disorders in elderly-onset APS patients. This study aim to investigate the characteristics and prognosis of elderly-onset APS.</p><p><strong>Methods: </strong>This is an observational cohort study. Thrombotic APS patients who underwent follow-ups between 2009 and 2022 were included. Elderly-onset APS patients (onset age ≥60 years) were compared to non-elderly-onset APS patients (onset age <60 years) and matched cases of elderly non-APS patients (age ≥60 years with thrombosis).</p><p><strong>Results: </strong>A total of 161 APS patients were included in this study, 45 (28.0%) were elderly-onset APS. Stroke (35.6% vs. 18.1%, <i>p</i> = .018) was more common at disease onset in elderly-onset APS patients. Compared to non-elderly-onset patients, elderly-onset APS patients were associated with a higher number of cardiovascular risk factors. Elderly-onset APS patients showed significantly lower positive rate (51.1% vs. 71.6%, <i>p</i> = .014) and ratios [1.24 (1.01-1.38) vs. 1.37 (1.16-1.77), <i>p</i> = .004] of lupus anticoagulant. Elderly-onset APS patients had a significantly higher 10-years cumulative all-cause mortality (<i>p</i> < .001) and APS-related mortality than non-elderly-onset patients (<i>p</i> = .002) and elderly non-APS patients (<i>p</i> = .040).</p><p><strong>Conclusions: </strong>Elderly-onset APS patients have unique disease characteristics with higher 10-years cumulative all-cause mortality and APS-related mortality. Early recognition and control of comorbidities may reduce the recurrence of thrombosis and mortality in elderly-onset APS patients.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1034-1042"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LupusPub Date : 2024-09-01Epub Date: 2024-07-25DOI: 10.1177/09612033241266083
Li-Ping Lai, Liang-Qin Wang, Shui-Ping Li
{"title":"Predictive value of Doppler echocardiography parameters for cardiovascular events in patients with systemic lupus erythematosus.","authors":"Li-Ping Lai, Liang-Qin Wang, Shui-Ping Li","doi":"10.1177/09612033241266083","DOIUrl":"10.1177/09612033241266083","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study aimed to assess the utility of Doppler echocardiography in evaluating left ventricular diastolic function, and prognosis in patients with systemic lupus erythematosus (SLE).</p><p><strong>Patients and methods: </strong>A total of 286 SLE patients were selected along with 100 age- and gender-matched healthy individuals who underwent physical examinations. Clinical baseline characteristics were collected. Various Doppler echocardiographic parameters were measured and analyzed, including left ventricular posterior wall thickness (LVPWT), interventricular septal diameter (IVSD), left ventricular mass (LVM), LVM index (LVMI), and others.</p><p><strong>Results: </strong>Compared to the control group, SLE patients exhibited significantly higher levels of C-reactive protein and lower levels of complement (C) 3 and C4 (<i>p</i> < .001). Doppler echocardiographic parameters showed significant differences between SLE patients and healthy controls, including increased LVPWT, IVSD, LVM, LVMI, peak A, PWI + Tei, E/e', TDI-Tei, and decreased e' and E/A (<i>p</i> < .001). Subgroup analyses indicated more severe ventricular diastolic dysfunction in patients with higher SLE activity and those who experienced cardiovascular events. Correlation analysis revealed positive associations of PWI + Tei, TDI-Tei, and GLS with SLE activity and cardiovascular events (<i>p</i> < .01). Multivariate logistic regression analysis identified LVMI, PWI + Tei, TDI-Tei, and GLS as significant predictors of cardiovascular events (<i>p</i> < .05).</p><p><strong>Conclusion: </strong>Doppler echocardiography is a valuable tool for the early diagnosis of left ventricular diastolic dysfunction in SLE patients. Key echocardiographic parameters, including LVMI, PWI + Tei, TDI-Tei, and GLS, are effective in predicting cardiovascular events, underscoring the importance of comprehensive cardiac function assessments in these patients.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1059-1068"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tofacitinib versus thalidomide for mucocutaneous lesions of systemic lupus erythematosus: A real-world CSTAR cohort study XXVII.","authors":"Man Zhao, Leyao Ma, Xinwang Duan, Yuehong Huo, Shengyun Liu, Cheng Zhao, Zhaohui Zheng, Qian Wang, Xinping Tian, Yunzhuan Chen, Mengtao Li","doi":"10.1177/09612033241272953","DOIUrl":"10.1177/09612033241272953","url":null,"abstract":"<p><strong>Objective: </strong>Thalidomide is an effective medication for refractory mucocutaneous lesions of systemic lupus erythematosus (SLE) and can treat arthritis in some autoimmune diseases, but it has some adverse reactions. Recently, the effectiveness of tofacitinib in treating mucocutaneous lesions of SLE has been reported. We aimed to compare the efficacy and safety of tofacitinib with thalidomide in treating mucocutaneous and musculoskeletal lesions in patients with SLE.</p><p><strong>Methods: </strong>This study was a real-world cohort study based on the Chinese SLE Treatment and Research group (CSTAR) registry. SLE patients who manifested mucocutaneous and/or musculoskeletal symptoms and were prescribed tofacitinib or thalidomide were included. We retrospectively conducted comparisons between the tofacitinib and thalidomide groups regarding clinical improvements, SLE disease activity, serological indicators, glucocorticoid doses, and adverse events at the 1, 3, and 6-months time points.</p><p><strong>Results: </strong>At 3 and 6 months, the tofacitinib group exhibited a higher proportion of patients with improvement in mucocutaneous and musculoskeletal issues. Additionally, a greater percentage of patients in the tofacitinib group achieved remission or a low disease activity state (LLDAS) at these time points. No significant serological improvements were observed in either the tofacitinib or thalidomide groups. Fewer adverse events were observed in the tofacitinib group than in the thalidomide group.</p><p><strong>Conclusions: </strong>Tofacitinib might be superior to thalidomide in the improvement of mucocutaneous and musculoskeletal lesions in SLE, and had a good safety profile.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1109-1115"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LupusPub Date : 2024-09-01Epub Date: 2024-07-20DOI: 10.1177/09612033241266779
Sree Nethra Bulusu, Christina Mary Mariaselvam, Sanket Shah, Vallayyachari Kommoju, Chengappa Kavadichanda, Kotten Thazhath Harichandrakumar, Molly Thabah, Vir Singh Negi
{"title":"Type I interferon gene expression signature as a marker to predict response to cyclophosphamide based treatment in proliferative lupus nephritis.","authors":"Sree Nethra Bulusu, Christina Mary Mariaselvam, Sanket Shah, Vallayyachari Kommoju, Chengappa Kavadichanda, Kotten Thazhath Harichandrakumar, Molly Thabah, Vir Singh Negi","doi":"10.1177/09612033241266779","DOIUrl":"10.1177/09612033241266779","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the longitudinal effect of cyclophosphamide (CYC) treatment on type-I interferon (IFN) signature in proliferative lupus nephritis (LN) and its role in predicting treatment response.</p><p><strong>Methods: </strong>Fifty-four biopsy proven proliferative LN patients scheduled to receive high-dose (HD) or low-dose (LD) CYC were recruited and followed up for six months. At six months, patients were classified as clinical responders (CR) or non-responders (NR) to treatment, using the EULAR/EDTA criteria. An IFN-gene based score (IGS) was developed from the mean log-transformed gene expression of <i>MX1, OAS1, IFIT1, OASL, IFIT4, LY6E, IRF7</i> at baseline, three and six months. Longitudinal changes of IGS within and between groups were assessed and ΔIGS, which is the difference in IGS between baseline and three months was calculated. Independent predictors of non-response were identified and an ROC analysis was performed to evaluate their utility to predict NR.</p><p><strong>Results: </strong>There was a dynamic change in IGS within the HD, LD, CR, and NR groups. Compared to baseline, there was a significant decrease in IGS at three months in HD and LD groups (HD group: 2.01 to 1.14, <i>p</i> = .001; LD group = 2.01 to 0.81, <i>p</i> < .001), followed by a significant increase from three to six months in LD group (LD: 0.81 to 1.51, <i>p</i> = .03; HD: 1.14 to 1.54, <i>p</i> = .300). A decrease in IGS from baseline to three months was seen in both CR (2.13 to 0.79, <i>p</i> < .001) and NR groups (1.83 to 1.27, <i>p</i> = .046), and a significant increase from three to six months was observed only in the CR group (CR: 0.79 to 1.57, <i>p</i> = .006; NR: 1.27 to 1.46, <i>p</i> = 1). ΔIGS (baseline to three months) was higher in CR compared to NR group (-1.339 vs -0.563, <i>p</i> = .017). ROC analysis showed that the model comprising of 0.81 fold decrease in IGS from baseline to three months, endocapillary hypercellularity and interstitial inflammation on renal histopathology predicted non-response with a sensitivity of 83.3% and specificity of 71.4%.</p><p><strong>Conclusion: </strong>In proliferative LN, treated with HD or LD-CYC, combined model comprising of decrease in IGS score by 0.81 fold from baseline to three months, along with important histopathological features such as endocapillary hypercellularity and interstitial inflammation had better predictive capability for non-response.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1069-1081"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LupusPub Date : 2024-09-01Epub Date: 2024-08-16DOI: 10.1177/09612033241272961
Ryan Kammeyer, Kimberly Chapman, Anna Furniss, Elena Hsieh, Robert Fuhlbrigge, Ekemini A Ogbu, Susan Boackle, JoAnn Zell, Kavita V Nair, Tyler L Borko, Jennifer C Cooper, Jeffrey L Bennett, Amanda L Piquet
{"title":"Blood-based biomarkers of neuronal and glial injury in active major neuropsychiatric systemic lupus erythematosus.","authors":"Ryan Kammeyer, Kimberly Chapman, Anna Furniss, Elena Hsieh, Robert Fuhlbrigge, Ekemini A Ogbu, Susan Boackle, JoAnn Zell, Kavita V Nair, Tyler L Borko, Jennifer C Cooper, Jeffrey L Bennett, Amanda L Piquet","doi":"10.1177/09612033241272961","DOIUrl":"10.1177/09612033241272961","url":null,"abstract":"<p><strong>Background: </strong>Neuropsychiatric systemic lupus erythematosus (NPSLE) is a poorly understood and heterogeneous manifestation of SLE. Common major NPSLE syndromes include strokes, seizures, myelitis, and aseptic meningitis. Easily obtainable biomarkers are needed to assist in early diagnosis and improve outcomes for NPSLE. A frequent end-result of major syndromes is neuronal or glial injury. Blood-based neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) have been utilized as markers for monitoring disease activity and/or severity in other neurodegenerative and neuroinflammatory diseases; however, they have not been evaluated in active major NPSLE.</p><p><strong>Methods: </strong>This was a case-control study. We enrolled patients aged 12-60 years with active major NPSLE, SLE without active major NPSLE, and healthy controls. Active NPSLE was defined as being <6 months from last new or worsening neuropsychiatric symptom. Demographics, clinical data, and serum or plasma biosamples were collected.</p><p><strong>Results: </strong>Thirteen patients with active major NPSLE, 13 age/sex/kidney function matched SLE controls without active major NPSLE, and 13 age/sex matched healthy controls (mean ages 26.8, 27.3, 26.6 years) were included. 92% of each group were female. Major syndromes included stroke (5), autonomic disorder (3), demyelinating disease (2), aseptic meningitis (2), sensorimotor polyneuropathy (2), cranial neuropathy (1), seizures (1), and myelopathy (2). Mean (standard deviation) blood NfL and GFAP were 3.6 pg/ml (2.0) and 50.4 pg/ml (15.0), respectively, for the healthy controls. Compared to healthy controls, SLE without active major NPSLE had mean blood NfL and GFAP levels 1.3 pg/ml (<i>p</i> = .42) and 1.2 pg/ml higher (<i>p</i> = .53), respectively. Blood NfL was on average 17.9 pg/ml higher (95% CI: 9.2, 34.5; <i>p</i> < .001) and blood GFAP was on average 3.2 pg/ml higher (95% CI: 1.9, 5.5; <i>p</i> < .001) for cases of active major NPSLE compared to SLE without active major NPSLE. In a subset of 6 patients sampled at multiple time points, blood NfL and GFAP decreased after immunotherapy.</p><p><strong>Conclusions: </strong>Blood NfL and GFAP levels are elevated in persons with SLE with active major NPSLE compared to disease matched controls and may lower after immunotherapy initiation. Larger and longitudinal studies are needed to ascertain their utility in a clinical setting.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1116-1129"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11405133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LupusPub Date : 2024-09-01Epub Date: 2024-07-22DOI: 10.1177/09612033241266988
Cuicui Wang, Shiwen Yuan, Yanting Zeng, Weinian Li, Jinghua Ye, Fangfei Li, Zhixiang He, Yi Chen, Xiaojun Lin, Liuqin Liang, Hanshi Xu, Xiaoyan Cai
{"title":"A novel long noncoding RNA ENST00000597482 serves as a potential biomarker for disease activity and diagnosis of systemic lupus erythematosus.","authors":"Cuicui Wang, Shiwen Yuan, Yanting Zeng, Weinian Li, Jinghua Ye, Fangfei Li, Zhixiang He, Yi Chen, Xiaojun Lin, Liuqin Liang, Hanshi Xu, Xiaoyan Cai","doi":"10.1177/09612033241266988","DOIUrl":"10.1177/09612033241266988","url":null,"abstract":"<p><strong>Objectives: </strong>Emerging evidence indicate that long noncoding RNAs (lncRNAs) may play an important role in the pathogenesis of systemic lupus erythematosus (SLE) however, the contribution of lncRNAs to SLE remains largely unclear. Our study aimed to explore the lncRNA expression profiles in peripheral blood mononuclear cells (PBMCs) from SLE patients.</p><p><strong>Methods: </strong>LncRNA sequencing was used to detect differentially expressed genes in PBMCs from 5 SLE-MIX samples and 3 healthy controls (HC)-MIX samples, and the expression of selected lncRNAs was further verified by real-time quantitative polymerase chain reaction (RT‒qPCR). The correlation of lncRNA expression with laboratory indicators as well the SLE disease activity index 2000 (SLEDAI‒2K) score from 72 SLE patients was assessed by Spearman's test. The association between lncRNA ENST00000597482 and organ involvement in SLE patients was determined by the Mann‒Whitney U test. Moreover, lymphocyte subsets in peripheral blood from SLE patients were measured by flow cytometry. In addition, the diagnostic value of lncRNAs in predicting SLE was evaluated by receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>The lncRNA expression profiles demonstrated 218 differentially expressed lncRNAs, including 121 upregulated genes and 97 downregulated genes, in PBMCs from SLE patients compared to HCs. Among the 10 candidate genes selected, only lncRNA ENST00000597482, which was lower in SLE PBMCs than in HCs, was consistent with the sequencing results. LncRNA ENST00000597482 expression was negatively correlated with SLEDAI-2K score and the titres of ANA antibodies and anti-double-stranded DNA (anti-dsDNA) antibodies. Of note, SLE patients with lower expression of lncRNA ENST00000597482 were prone to develop organ involvement. Furthermore, lncRNA ENST00000597482 exhibited potential diagnostic value in differentiating SLE patients from HCs.</p><p><strong>Conclusions: </strong>LncRNA ENST00000597482 expression was lower in PBMCs from SLE patients than HCs and was negatively correlated with the SLEDAI-2K score and autoantibody titres. In addition, lncRNA ENST00000597482 could act as a novel biomarker for disease activity and diagnosis of SLE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1089-1099"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}