ABSTRACT
Background: Certain associated and specific myositis antibodies are related to certain clinical phenotypes of dermatomyositis (DM), disease severity and the presence of cancer. Aim: To describe the clinical profile of Chilean patients with DM and their associated and specific myositis antibodies. Material and Methods: Review of medical records of 15 patients with DM aged 31 to 72 years. Their clinical characteristics, laboratory tests and complementary tests were reviewed. In serum samples from each patient the presence of 16 specific antibodies was analyzed by immunoblot technique (Myositis Profile Euroline Blot test kit). Results: Fourteen (93.3%) patients had skin manifestations, five (33.3%) had pulmonary involvement, two (13.3%) had an associated cancer and nine (60%) had specific antibodies associated with myositis. Conclusions: These patients with DM had a clinical profile similar to what has been described elsewhere. The profile of myositis specific antibodies was different from reports in other populations.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Autoantibodies/blood , Dermatomyositis/diagnosis , Skin/immunology , Skin/pathology , Autoantibodies/immunology , Dermatomyositis/etiology , Dermatomyositis/bloodABSTRACT
ABSTRACT Background: The dual potential to promote tolerance or inflammation when facing self-antigens makes dendritic cells (DCs) fundamental players in autoimmunity. There is an association between smoking and DCs maturation in patients with rheumatoid arthritis (RA). However, ethnicity is a key factor in autoimmune disorders. Aim: To evaluate phenotypic and functional alterations of DCs obtained from Chilean patients with RA as compared to healthy controls (HC). In second term, to compare the inflammatory behaviour of DCs between smoker and non-smoker patients. Material and Methods: Monocyte-derived DCs and T-cells were obtained from blood samples isolated from 30 HC and 32 RA-patients, 14 of which were currently smokers and 18 non-smokers. Several maturation surface markers were evaluated in DCs, including HLA-DR, CD40, CD80, CD83 and CD86. Furthermore, autologous co-cultures of DCs and T-cells were carried out and then T-cell proliferation, and expansion of Th1, Th17 and Tregs were analysed. Results: Compared with HC, RA-patients displayed increased HLA-DR expression in DCs, which was manifested mainly in patients with moderate-to- high disease activity scores (DAS28). Furthermore, RA-patients presented a stronger Th17-expansion and a correlation between DAS28 and Th1-expansion. Both effects were mainly observed in patients in remission or with a low DAS28. Moreover, smoker RA-patients displayed enhanced HLA-DR and CD83 expression in DCs as well as an exacerbated Th17-expansion and a correlation between DAS28 and Th1-expansion. Conclusions: These findings suggest that smoking enhances the inflammatory behaviour of DCs and the consequent Th1 and Th17-mediated response in patients with RA
Introducción: El potencial dual que poseen para promover tolerancia o inflamación ante antígenos propios, hace de las células dendríticas (CDs) actores fundamentales en el desarrollo de autoinmunidad. Existe una asociación entre fumar y la maduración de las CDs en pacientes con artritis reumatoide (AR). No obstante, la etnicidad es un factor clave a considerar en desórdenes autoinmunes. Objetivos: Comparar las alteraciones fenotípicas y funcionales de las CDs obtenidas desde pacientes Chilenos con AR y controles sanos (CS). Además, analizamos las diferencias en el comportamiento inflamatorio que existe entre las CDs obtenidas de pacientes fumadores y CS. Materiales y Métodos: Se obtuvieron CDs derivadas de monocitos y células T desde muestras de sangre aisladas de 30 CS y 32 pacientes con AR, 14 de los cuales eran fumadores y 18 no fumadores. Se evaluaron marcadores de maduración en la superficie de las CDs: HLA-DR, CD40, CD80, CD83 y CD86. Además, se realizaron co-cultivos autólogos de células T y CDs, analizando la proliferación de células T, y la expansión de células Th1, Th17 y Tregs. Resultados: En comparación con los CS, los pacientes AR mostraron un aumento de la expresión de HLA-DR en las CDs, principalmente en los individuos con DAS28 moderado-alto. Los pacientes con AR presentaron una mayor expansión de células Th17 y una correlación entre el DAS28 y la expansión de células Th1, ambos efectos manifestados principalmente en los individuos con un DAS28 bajo o en remisión. Además, los pacientes con AR fumadores mostraron un aumento en la expresión de HLA-DR y CD83 en las CDs y una expansión de células Th17 exacerbada así como una correlación entre el DAS28 y la expansión de células Th1. Conclusiones: Nuestros resultados sugieren que fumar favorece el comportamiento inflamatorio de las CDs y en consecuencia la inducción de respuestas mediadas por células Th1 y Th17 en los pacientes Chilenos con AR.
Subject(s)
Humans , Female , Middle Aged , Arthritis, Rheumatoid/metabolism , Dendritic Cells/immunology , Smoking/adverse effects , Cell Proliferation/physiology , Phenotype , Arthritis, Rheumatoid/physiopathology , Arthritis, Rheumatoid/immunology , Smoking/physiopathology , Antigens, Differentiation, B-Lymphocyte/immunology , HLA-DR Antigens/immunology , Case-Control Studies , Chile , T-Lymphocyte Subsets/immunology , Disease Progression , Flow Cytometry , Inflammation/physiopathology , Inflammation/drug therapyABSTRACT
Objetivo: Examinar el posible rol de medicaciones en el desarrollo de daño Neuropsiquiátrico en pacientes con lupus eritematoso sistémico (LES). Materiales y métodos: Se incluyeron pacientes con LES (Criterio del ACR, mayor e igual 16 años al momento de ser enrolados en el estudio, menor e igual 5 años de duración de la enfermedad) de la cohorte LUMINA (Lupus in Minorities: Nature vs. Nurture). El tiempo a desarrollar daño Neuropsiquiátrico (psicosis o impedimento neurocognitivo, convulsiones, neuropatía perférica o craneal, accidente cerebro vascular, mielitis transversal) fue examinando mediante regresiones univariables y multivariables de Cox. Además se realizaron análisis de propensidad para determinar el posible rol protector de la hidroxiclorquina en el desarrollo de daño Neuropsiquiátrico en estos pacientes. Resultados: Se estudiaron 632 pacientes con LES. La edad, etnia caucásica, actividad de enfermedad a lo largo de la misma, diabetes, y conductas anormales relacionadas con la enfermedad estuvieron asociadas con un tiempo más corto para el desarrollo de daño Neuropsiquiátrico. Por otro lado la foto sensibilidad, la anemia, el fenómeno de Raynaud, y el uso de hidroxiclorquina y dosis medias de prednisona estuvieron asociados con un tiempo más prolongado. La dirección de la asociación fue la misma cuando se realizó el análisis de propensidad pero la hidroxicloroquina y de dosis media de prednisona en el desarrollo de daño Neuropsiquiátrico en paciente con LES.
Objective: To examine the possible role of medication in the occurrence of neuropsychiatric damage in patients with systemic lupus erythematosus (SLE). Material and methods: SLE patients from the LUMINA (Lupus in Minorities: Nature) cohort (ACR criteria, major and equal 16 years of age at enrollment and minor and equal 5 years of disease duration) were studied. Time to neuropsychiatric damage (defined according with the Systemic Lupus Collaborating Clinics (SCLICC) Damage Index (SDI): neurocognitive impairment or psychosis, seizures, cranial or peripheral neuropathy, stroke or surgical resection not due to malignancies and transverse myelitis) was examined by univariables and multivariable Cox regression analyses. Propensity score analyses were done to further determine the possible protective role of hydroxychloroquine in neuropsychiatric damage occurrence. Results: Six-hundred and thirty-behaviors were associated with a shorter time to the occurrence of neuropsychiatric damage whereas photosensitivity, anemia, Reynaud's phenomenon, hydroxychloroquine and a medium a medium dose of prednisone were associated with a longer time. Although the direction of the association remained the same by propensity score analyses (hydroxychloroquine), significance was no longer evident. Conclusion: Our data suggest a possible protective role of hydroxychloroquine and moderate doses of prednisone in the occurrence of neuropsychiatric damage in patients with SLE.