Therapeutic Advances in Chronic Disease最新文献

{"title":"Biological pathways and mechanisms linking COPD and cardiovascular disease.","authors":"Beatrice Ragnoli, Fausto Chiazza, Giovanni Tarsi, Mario Malerba","doi":"10.1177/20406223251314286","DOIUrl":"10.1177/20406223251314286","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) still poses a significant risk for morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD). For a long time, among functional parameters, only the forced expiratory volume in 1 s (FEV₁) has been considered as predictive of cardiovascular (CV) mortality especially in elderly patients in fact, there is evidence that reductions in lung function indices can increase the risk of ischaemic heart diseases and cerebrovascular diseases, independently from other risk factors. Now, there is considerable evidence suggesting that hypoxemia, systemic inflammation, oxidative stress and hyperinflation may lead to an early sub-clinical CV involvement in patients affected by COPD. Ageing in itself impacts specific aspects of the CV system, including reduced beta-adrenergic responsiveness, increased vagal tone and myocardial and vascular stiffness, endothelial dysfunction, diminished arterial baroreflex and compromised diastolic function. The complex involved interactions include ageing mechanisms as well as multiple known and unknown (e.g. genetic) risk factors. CVDs are leading causes of mortality in individuals with impaired lung function and the two entities commonly coexist with poor outcomes in patients experiencing both conditions. However, the precise mechanisms responsible for this association remain largely unknown. In this narrative review, we summarize current knowledge regarding the co-occurrence of COPD and CVD focusing on the shared biological pathways and biological mechanisms involved in these conditions.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"16 ","pages":"20406223251314286"},"PeriodicalIF":3.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of sKlotho with hemoglobin level in patients undergoing maintenance hemodialysis: a case-control study.","authors":"Qi-Feng Liu, Zhuo-Yi Sun, Xiao-Fang Tang, Li-Xia Yu, Sha-Sha Li","doi":"10.1177/20406223251318481","DOIUrl":"10.1177/20406223251318481","url":null,"abstract":"<p><strong>Background: </strong>Klotho is a kidney-derived protein that is involved in various kidney diseases. The role of serum soluble Klotho (sKlotho) in the anemia of patients undergoing hemodialysis has not been well characterized.</p><p><strong>Objective: </strong>We aimed to characterize the relationship between sKlotho and hemoglobin (Hb) levels in this group of patients.</p><p><strong>Design: </strong>A single-center cross-sectional study of 208 patients undergoing maintenance hemodialysis (MHD) and 50 healthy controls was performed between June 1 and 31, 2023.</p><p><strong>Methods: </strong>Demographic information and biomedical parameters, such as age, body mass index, medication use, and their Hb, albumin, interleukin-6, and sKlotho concentrations, were obtained. Patients undergoing MHD were allocated to a group that achieved the Hb target (⩾110 g/L) and a group that did not (<110 g/L). Correlation analysis and multivariate logistic and linear regression analyses were performed to evaluate the relationship of sKlotho with Hb concentration.</p><p><strong>Results: </strong>Participants undergoing MHD had lower Hb and sKlotho concentrations than controls. Those who had not achieved the target Hb level were given fewer erythropoiesis-stimulating agents and had lower sKlotho and albumin concentrations, but higher interleukin-6 concentrations, than those who had achieved the Hb target. The sKlotho concentration positively correlated with the Hb concentration and was inversely associated with the incidence of a lack of achievement of the target Hb level. Multivariate logistic regression models revealed that there was a close association between sKlotho and a lack of achievement of the target Hb level after adjustment for potential confounders (odds ratio: 0.335, 95% confidence interval: 0.142-0.791, <i>p</i> = 0.013). This relationship was closer on multivariate linear regression analysis when sKlotho was included as a continuous variable.</p><p><strong>Conclusion: </strong>The circulating sKlotho concentration is very low, but deficiency of this protein is independently associated with a high risk of anemia in patients undergoing MHD. Therefore, the routine monitoring of sKlotho concentration might be useful in the management of renal anemia in such patients.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"16 ","pages":"20406223251318481"},"PeriodicalIF":3.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological insights into intervention and outcomes in randomised controlled trials of herbal medicine for obesity: a scoping review.","authors":"Janice Sue Wen Chan, Mei Siu Lau, Siti Hajar Muhamad Rosli, Siti Khadijah Mustapha Kamal, Wan Nurul Nadia Wan Seman, Nurul Hidayah Ali, Terence Yew Chin Tan, Ida Farah Ahmad, Puspawathy Krishnan, Marisa Khatijah Borhan, Ami Fazlin Syed Mohamed, Xin Yi Lim","doi":"10.1177/20406223241310206","DOIUrl":"10.1177/20406223241310206","url":null,"abstract":"<p><strong>Background: </strong>With rising obesity rates worldwide, clinical trials focused on identifying effective treatments are increasing. While guidelines exist for pharmaceutical drugs targeting obesity, there are none for herbal medicine clinical trials for anti-obesity. Both industries refer to the same guidelines for clinical trials.</p><p><strong>Objectives: </strong>This scoping review aimed to gather information from herbal medicine anti-obesity randomised controlled trials (RCTs), analyse the methodologies and assess their alignment with international guidelines.</p><p><strong>Eligibility criteria: </strong>This review included RCTs of participants of all ages with obesity utilising herbal medicine with any comparators and focusing on various outcome measures.Sources of evidence: Only published journal articles were included.</p><p><strong>Charting methods: </strong>Articles were extracted from MEDLINE, CENTRAL and EMBASE using predetermined keywords. Relevant data, such as the study characteristics, types of herbal interventions and controls, treatment durations, outcome measures and safety monitoring methods were recorded in a table format for comparative analysis.</p><p><strong>Results: </strong>We included 99 RCTs that showed participant sample sizes ranging from 8 to 182, ages 18 to 80 years and body mass indexes (BMIs) between 25 and 49.9 kg/m². Herbal interventions used single herbs (<i>n</i> = 57) and mixtures (<i>n</i> = 42), given for 14 days to 56 weeks. Studies implementing diet modifications include restricted calorie diets (<i>n</i> = 35), food-portion controlled diets (<i>n</i> = 7) and fixed calorie diets (<i>n</i> = 7). Of the 28 studies implementing exercise, most were of moderate intensity (<i>n</i> = 22). All studies collected BMI and weight as primary outcomes. Body fat composition was measured in over 50% of studies using a body analyser (<i>n</i> = 57). Waist, hip and abdominal circumferences were infrequently measured. Radiological tools used include dual-energy X-ray absorptiometry (<i>n</i> = 16), computed tomography scans (<i>n</i> = 10) and ultrasound (<i>n</i> = 2). Safety monitoring methods were reported in most studies (<i>n</i> = 76).</p><p><strong>Conclusion: </strong>In conclusion, almost 50% of the studies adhered to international pharmaceutical clinical trial guidelines, addressing dietary, lifestyle, physical activity and cardiovascular risk factors. Nonetheless, more herbal anti-obesity studies need to consider the assessment of weight maintenance.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"16 ","pages":"20406223241310206"},"PeriodicalIF":3.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving diagnosis of primary aldosteronism through education: a modified Delphi study to identify key learning points.","authors":"Jocelyn Widjaja, Jun Yang, Julia Harrison","doi":"10.1177/20406223241306952","DOIUrl":"10.1177/20406223241306952","url":null,"abstract":"<p><strong>Background: </strong>Primary aldosteronism (PA) is the most common endocrine cause of secondary hypertension and can be effectively managed, or even cured, with targeted treatment. Despite this, it remains largely undiagnosed leaving a significant patient population with resistant hypertension and modifiable cardiovascular risk.</p><p><strong>Objective: </strong>To determine expert consensus on key information about PA that should ideally be taught to medical students as a step toward improving the detection of this common, underdiagnosed, and often easily treated condition.</p><p><strong>Design: </strong>The study employed a modified Delphi method which consisted of three rounds, the first of which contained an open-ended question about key areas that experts believe to be most important for inclusion in medical teaching resources and then progressing to assessment of individual versus group rankings of consensus items. Experts included both clinician-educator-researchers and patients with lived experience.</p><p><strong>Results: </strong>Nine critical knowledge areas in epidemiology, diagnostics, and pathophysiology were identified by the Delphi as consensus items, with the highest ranked being: \"PA is common but often under-diagnosed - think about it with every hypertensive patient.\"</p><p><strong>Conclusion: </strong>Experts reached a consensus, for the first time, on nine critical knowledge areas about PA that should be covered in medical education. Importantly, the consensus accounted for patients' values and decisions. The results of this study could be used to assess medical student knowledge and their learning resources to facilitate curriculum development and medical resource updates to ensure the timely and accurate diagnosis of PA in hypertensive patients.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"15 ","pages":"20406223241306952"},"PeriodicalIF":3.3,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal associations of immunophenotypes with metabolic dysfunction-associated fatty liver disease and mediating pathways: a Mendelian randomization study.","authors":"Kexin Xie, Ming Chen, Hongjin An, Jinhang Gao, Chengwei Tang, Zhiyin Huang","doi":"10.1177/20406223241303649","DOIUrl":"10.1177/20406223241303649","url":null,"abstract":"<p><strong>Background: </strong>Increasing evidence suggests that immunophenotypes play a crucial role in Metabolic dysfunction-associated fatty liver disease (MAFLD), but the specific immunophenotypes contributing to its pathogenesis remain unclear.</p><p><strong>Objectives: </strong>This study aimed to elucidate the causal associations between immunophenotypes and MAFLD and identify the underlying mediation pathways involved.</p><p><strong>Design: </strong>Mendelian randomization (MR) study.</p><p><strong>Methods: </strong>This study is a quasi-causal inference analysis using univariable and multivariable MR (UVMR and MVMR). Five MAFLD genome-wide association studies (GWASs) and the largest immunophenotype GWAS were analyzed to assess their causal associations. Two-step MR identified potential mediators and quantified their mediation proportions. Comprehensive MR methods, multiple sensitivity analyses, meta-analyses, and false discovery rate (FDR) further enhanced the robustness of our findings.</p><p><strong>Results: </strong>Pooled inverse-variance weighted (IVW) estimates in UVMR identified 47 immunophenotypes having a suggestive causal association with MAFLD. After adjusting for FDR, three lymphocyte phenotypes remained significant: CD20 on IgD^-CD24^- B cells (OR: 1.035, <i>p</i> _fdr: 0.006), terminally differentiated CD8⁺ T cells %T cells (OR: 1.052, <i>p</i> _fdr: 0.006), and CD4 on CD39⁺ secreting CD4⁺ regulatory T cells (OR: 1.036, <i>p</i> _fdr: 0.046). Meta-analysis of IVW MVMR estimates with confounders adjustment confirmed that CD20 on IgD^-CD24^- B cells and terminally differentiated CD8⁺ T cells %T cells had significant direct causal associations on MAFLD (<i>p</i> _fdr < 0.05). Additionally, two-step MR analysis identified the waist-to-hip ratio as a mediator, accounting for 42.64% of the causal association between CD20 on IgD^-CD24^- B cells and MAFLD.</p><p><strong>Conclusion: </strong>The causal associations of three lymphocyte phenotypes with increased MAFLD risk were identified in this study. CD20 on IgD^-CD24^- B cells may both directly and indirectly elevate MAFLD risk, while terminally differentiated CD8⁺ T cells have a direct causal relationship with MAFLD. These findings suggest new possibilities for targeted therapies and underscore the potential for personalized immunotherapy in managing MAFLD.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"15 ","pages":"20406223241303649"},"PeriodicalIF":3.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyclosporin A as an adjunct may enhance the therapeutic effect of interferon alpha-2a in patients with refractory Behcet's uveitis: a retrospective cohort study.","authors":"Peizeng Yang, Yang Deng, Yinan Zhang, YunYun Zhu, Ziqian Huang, Lingyu Dai, Qiuying Wu, Guannan Su, Qingfeng Cao, Yujie Lai","doi":"10.1177/20406223241304889","DOIUrl":"10.1177/20406223241304889","url":null,"abstract":"<p><strong>Background: </strong>The application of biologic agents has benefited patients with Behcet's uveitis (BU) who do not respond to conventional treatment regimens. However, there is currently no consensus on the optimal treatment regimen of interferon alpha-2a (IFN-α2a) for refractory BU.</p><p><strong>Objectives: </strong>To evaluate treatment outcomes and safety of IFN-α2a in a large series of refractory BU patients and to explore whether nonbiologic immunomodulatory agents (cyclosporin A) other than corticosteroids should be concomitantly used.</p><p><strong>Design: </strong>We conducted a retrospective cohort study, which included 153 BU patients who received IFN-α2a treatment between December 2012 and September 2023 with a minimum duration of 6 months.</p><p><strong>Methods: </strong>Best-corrected visual acuity (BCVA), the frequency of uveitis relapse, corticosteroid-sparing effect, and side effects were evaluated.</p><p><strong>Results: </strong>Of the 153 patients enrolled, 87 patients were treated with IFN-α2a plus corticosteroids (IC), and 66 patients were treated with IFN-α2a plus corticosteroids and cyclosporin A (ICC). Both IFN-α2a treatment regimens significantly improved BCVA as early as 2 months following treatment, and the improvement was maintained over at least a 2-year follow-up. At the final visit, 86.8% and 73.1% of the affected eyes in the ICC and IC groups achieved improved or stable vision, respectively. The ICC regimen was more effective at improving vision (<i>p</i> = 0.01). Overall, the frequency of uveitis relapse and the dose of oral prednisolone were significantly reduced in both groups after treatment (all <i>p</i> < 0.0001). However, there were no statistically significant differences in these parameters between the two groups. None of the included patients experienced serious side effects that led to the discontinuation of IFN-α2a therapy.</p><p><strong>Conclusion: </strong>IFN-α2a treatment is a promising option for patients with refractory BU. Our results showed that cyclosporin A as an adjunct could enhance the therapeutic effect of IFN-α2a.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"15 ","pages":"20406223241304889"},"PeriodicalIF":3.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visceral adiposity as a predictor of new-onset diabetes in patients with primary aldosteronism: a cohort study.","authors":"Wen-Kai Chu, Leay Kiaw Er, Chin-Chen Chang, Jin-Ying Lu, Wan-Chen Wu, Yao-Chou Tsai, Yen-Hung Lin, Vin-Cent Wu","doi":"10.1177/20406223241301892","DOIUrl":"https://doi.org/10.1177/20406223241301892","url":null,"abstract":"<p><strong>Background: </strong>Patients with primary aldosteronism (PA) exhibit a high prevalence of diabetes mellitus (DM). However, the relationship between visceral adipose tissue (VAT) and new-onset diabetes mellitus (NODM) in PA patients remains unclear.</p><p><strong>Objectives: </strong>To explore the association between VAT and the risk of NODM in PA patients.</p><p><strong>Design: </strong>This is a prospective cohort study spanning 10 years (2010-2020).</p><p><strong>Methods: </strong>A total of 342 PA patients were enrolled prospectively. Abdominal adiposity indexes, including VAT area, VAT ratio, subcutaneous adipose tissue (SAT) area, and SAT ratio, were measured using a computed tomography-based software at diagnosis.</p><p><strong>Results: </strong>Of 342 PA patients (46.2% male, mean age 50.8 ± 11.2 years), 35 (10.2%) developed NODM over a mean follow-up of 7.4 years. A positive nonlinear association between NODM risk and Log (VAT ratio) ⩾ -0.72 was observed (high-VAT group). High VAT (odds ratio (OR), 6.09; <i>p</i> = 0.005), older age (OR, 1.09; <i>p</i> < 0.001), higher body mass index (OR, 1.24; <i>p</i> < 0.001), higher waist-to-hip ratio (OR, 1.11, <i>p</i> < 0.001), lower baseline aldosterone (OR, 0.99, <i>p</i> = 0.011), higher diastolic blood pressure (OR, 1.05, <i>p</i> = 0.012), and lower systolic blood pressure (OR, 0.98, <i>p</i> = 0.045) as risk factors for high VAT. Adrenalectomy did not significantly associate with reduced NODM risk (OR, 0.49; <i>p</i> = 0.292).</p><p><strong>Conclusion: </strong>Our findings highlight that 10.2% of PA patients develop NODM over a mean follow-up of 7.4 years, with high VAT increasing the risk. Baseline VAT is a key determinant of NODM development in PA patients, regardless of targeted treatments.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"15 ","pages":"20406223241301892"},"PeriodicalIF":3.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between galectin-3 and hepatosteatosis in a community-based cross-sectional study.","authors":"Ming-Shyan Lin, Ya-Chi Tu, Yu-Sheng Lin, Meng-Hung Lin, Chun-Liang Lin, Ming-Horng Tsai, Yung-Yu Hsieh, Tien-Hsing Chen, Mei-Yen Chen, Chung-Sheng Shi","doi":"10.1177/20406223241302719","DOIUrl":"https://doi.org/10.1177/20406223241302719","url":null,"abstract":"<p><strong>Background: </strong>Hepatosteatosis is a common condition that can lead to cirrhosis and liver cancer. Galectin-3 (GAL-3) has been implicated in liver fibrosis and inflammation.</p><p><strong>Objectives: </strong>The purpose of this study was to investigate the association between GAL-3 and hepatosteatosis.</p><p><strong>Design: </strong>This study is a retrospective secondary analysis of data from a community health screening program.</p><p><strong>Methods: </strong>A total of 766 participants were included in the final analysis. Hepatosteatosis was diagnosed using ultrasonography, and GAL-3 levels were measured using enzyme-linked immunosorbent assay. Logistic regression analysis was used to examine the association between GAL-3 levels and the presence of hepatosteatosis, adjusting for age, sex, and other potential confounding factors.</p><p><strong>Results: </strong>The prevalence of moderate-to-severe hepatosteatosis in the study population was 31.5%. The participants with hepatosteatosis had a significantly higher mean level of GAL-3 compared to those without hepatosteatosis (16.6 ± 7.3 vs 13.5 ± 7.3 ng/ml; <i>p</i> < 0.001). After adjusting for age, sex, body mass index, and other potential confounding factors, a higher level of GAL-3 was significantly associated with an increased risk of moderate-to-severe hepatosteatosis (adjusted odds ratio (aOR) 1.24, 95% confidence interval (CI) 1.05-1.46, <i>p</i> = 0.010). The coexistence of alanine transaminase/aspartate transaminase ratio >1 and GAL-3 >14.4 ng/ml was associated with a significantly increased risk (aOR 3.37, 95% CI: 1.90-5.99, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Our findings suggest that GAL-3 level is significantly associated with the presence of moderate-to-severe hepatosteatosis, independent of other known cardiometabolic risk factors.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"15 ","pages":"20406223241302719"},"PeriodicalIF":3.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interdisciplinary approach to patients with psoriatic arthritis: a prospective, single-center cohort study.","authors":"Georg Gross, Christian Lull, Jan Alwin von Ahnen, Mara Blauth, Johanna Schwaan, Victor Olsavszky, Astrid Schmieder, Jan Leipe","doi":"10.1177/20406223241293698","DOIUrl":"https://doi.org/10.1177/20406223241293698","url":null,"abstract":"<p><strong>Background: </strong>Psoriatic arthritis (PsA) is a chronic systemic inflammatory disease that affects up to 30% of patients with psoriasis. Diagnosis and treatment could be improved by implementing an interdisciplinary dermatological-rheumatological consultation (IDRC).</p><p><strong>Objectives: </strong>This study aimed to assess the effect of a face-to-face IDRC involving both a dermatologist and a rheumatologist evaluating patients in a single visit, on disease activity and burden in patients with PsA.</p><p><strong>Design: </strong>Prospective, single-center, cohort study.</p><p><strong>Methods: </strong>202 patients with psoriasis were enrolled, among whom 115 individuals with psoriasis and musculoskeletal symptoms underwent an IDRC. Disease manifestations, comorbidities, and both objective and subjective disease activity scores were evaluated.</p><p><strong>Results: </strong>Out of the participants, 56 were diagnosed with definite PsA, while the remaining 146 had psoriasis. Nail involvement was associated with axial PsA (odds ratio 4.11; 95% CI 1.22-13.82; <i>p</i> = 0.02). Patients with PsA often experienced a prolonged time to diagnosis (mean 187 weeks) and had a significant psychosocial burden (mean Hospital Anxiety and Depression Index Scale [HADS]-Anxiety score of 7.66 and mean HADS-Depression score of 5.63). Post-IDRC, both objective and subjective disease parameters showed improvement, and patients required less time for consultations with healthcare professionals compared to before the IDRC.</p><p><strong>Conclusion: </strong>These findings suggest that an IDRC approach could effectively expedite and optimize the diagnosis and treatment of patients with psoriasis and musculoskeletal symptoms.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"15 ","pages":"20406223241293698"},"PeriodicalIF":3.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latest update on the use of recombinant growth factors for periodontal regeneration: existing evidence and clinical applications.","authors":"Anahat Khehra, Takahiko Shiba, Chia-Yu Chen, David M Kim","doi":"10.1177/20406223241302707","DOIUrl":"https://doi.org/10.1177/20406223241302707","url":null,"abstract":"<p><p>Growth factors were introduced to increase predictability in periodontal regeneration and have since been widely applied in dentistry. This narrative review article highlights histological and latest findings of recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and recombinant human fibroblast growth factor-2 (rhFGF-2) for periodontal regeneration. rhPDGF-BB enhances the proliferation and chemotaxis of periodontal ligament and alveolar bone cells. The optimal dose for rhPDGF-BB, in combination with beta-tricalcium phosphate, is 0.3 mg/ml. It is approved in the United States, Canada, and Taiwan for use in periodontal regeneration and treatment of gingival recession. rhFGF-2 promotes periodontal wound healing through mitogenic and angiogenic effects on mesenchymal cells in the periodontal ligament. It is approved in Japan at an optimal dose of 0.3% for periodontal regeneration in intrabony defects. Both recombinant growth factors show histological evidence of new bone, cementum, and periodontal ligament. Clinical studies demonstrate improved clinical attachment levels and defect resolution for treating intrabony and furcation periodontal defects. Presented clinical cases and consensus reports may serve as a reference for clinicians. rhPDGF-BB and rhFGF-2 are safe and effective biologics that can be applied to improve the outcomes of periodontal regeneration.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"15 ","pages":"20406223241302707"},"PeriodicalIF":3.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}