Update on classification, diagnosis, and management of immunoglobulin G4-related disease / 中华医学杂志(英文版)

Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized chronic fibro-inflammatory autoimmune disease, and its recognition has been constantly increasing worldwide over the last few years. A correct and timely recognition, as well as appropriate intervention, is crucial for the treatment of IgG4-RD. For certain subtypes of IgG4-RD, organ-specific criteria are formulated to make the diagnosis more accurate. New biomarkers have emerged in the recent years to aid the disease diagnosis, its prognosis prediction, as well as therapy response monitoring. Although recurrence is very common in IgG4-RD, glucocorticoid is still the first-line treatment for the majority of patients. The factors that affect the likelihood of disease relapse are multifaceted. The selection strategy of various steroid-sparing agents is still being explored. Besides, when patients have special sites involvement leading to severe clinical conditions, surgical operation or interventional therapy should also be considered. An update on classification, diagnosis, and management of IgG4-RD is provided in the current study to fully elucidate the recommended clinical practice of this mysterious disease.

Study on the plasma level of pentraxin 3 and fibroblast growth factors 2 and its association with disease activity in systemic lupus erythematosus patients / 中华风湿病学杂志

Objective:To elucidate the correlation between peripheral blood levels of pentraxin 3 (PTX3) and fibroblast growth factors 2 (FGF2) and clinical manifestations, immunological indexes and disease activity of systemic lupus erythematosus (SLE) patients.Methods:The correlation between peripheral blood levels of PTX3 and FGF2 and clinical manifestations, immunological indexes and disease activity of SLE pa-tients was determined. T test, Mann-Whitney U test and Spearman's rank correlation coefficient were analyzed statistically. Results:Plasma PTX3 levels were significantly higher in SLE patients than in healthy controls (3 191±2 423) pg/ml vs (755±432) pg/ml, t=5.595, P<0.01) . The titer of PTX3 in patients with hematologic in-volvement was higher than that in the patients without [(3 810±2 840) pg/ml vs (2 493±1 830) pg/ml, t=2.008, P=0.049). Plasma PTX3 concentration in SLE patients was positively correlated not only with the level of 24 h urine protein ( r=0.498 6, P=0.005 9), but also with ESR ( r= 0.376, P=0.007) and systemic lupus erythematosus disease activity index (SLEDAI) scores ( r=0.405, P=0.003). On the contrast, plasma PTX3 concentration in SLE patients was negatively correlated with complement 3 ( r=-0.405, P=0.005). Increased serum PTX3 levels accompanied by increased serum FGF2 levels was observed. Plasma FGF2 concentration in SLE patients was positively correlated with SLEDAI scores ( r=0.326, P=0.019), but negatively correlated with level of comple-ment 3 ( r=-0.414, P=0.004) and complement 4 ( r=-0.451, P=0.007). Levels of FGF2 were higher in patients with positive anti-NuA antibody [(138±91) pg/ml vs (59±68) pg/ml, t=2.996, P=0.004 2), anti-dsDNA antibody [(120±96) pg/ml vs (56±58) pg/ml, t=3.583, P=0.000 7] and anti-rRNP antibody (151±109) pg/ml vs (63±61) pg/ml, t=3.757, P=0.000 4) than in patients with negative of these antibodies. Conclusion:The levels of PTX3 and FGF2 in peripheral blood may play a role in determining the disease activity and clinical phenotype of SLE, and can help doctors to make diagnosis and treatment decisions.

Effect of basic amino acid on acid accumulation during poly(D,L-lactide-co-glycol ide)degradation in vitro○ / 中国组织工程研究

BACKGROUND:Poly(D,L-lactide-co-glycolide)(PLGA)may produce lactic acid and glycolic acid when PLGA degrades,thus leading to the acid accumulation and inducing the inflammatory reaction locally.OBJECTIVE:To investigate the effect of lysine,histidine and arginine on regulating the acid accumulation of PLGA copolymer during the degradation.DESIGN:Repeated measurement and experiment.TIME AND SETTING:The experiments were performed in the College of Bioengineering.Chongqing University from July 2006 to August 2007.MATERIALS:PILGA(80:20)was produced by Sigma(USA);Lysine,histidine and arginine(purlty>99%)were purchased from Sigma(USA);Chitosan(deacetylation degree:85%)was purchased from Chengdu Kelong Chemical Reagent Factory;Algin(viscosity:1.05-1.15)was purchased from Tianiin Damao Chemical Reagent Factory.METHODS:Lysine,histidine and arginine were added into PLGA with the proportion of 5%(w/v)and 10%(w/v)respectively.The resultant film sample was put into a bottle with tri-distilled-water for 2-month degradation at 37℃.The pH value of degradation solution was detected by pH meter;Each film sample was taken out and lyophilized 12 hours to get its dry weight and calculate mass loss ratio.Each variety of the solution was sampled three specimens,the average pH value,average initial weight and average finial weight of these three specimens were taken as the indices at each sampling time point,respectively.Accordingly,the regulation effect of basic amino acid was comparexl with that of algin,chitosan and NaHCO3.MAIN OUTCOME MEASURES:The changes of pH value of degradation solution;the mass loss ratio of the composite.RESULTS:Each basic additive could relieve the acid accumulation,among them,NaHCO3 was the strongest,while algin and chitosan showed a lowest capacity,basic amino acid was moderate;The suitable regulation effect could be achieved at a level of 5%lysine.CONCLUSION:Basic amino acid can effectively regulate the acid accumulation after PLGA degrades,and the optimal concentration of lysine is 5%.