Clinical significance of the anti-Nucleolar Organizer Region 90 antibodies (NOR90) in systemic sclerosis: Analysis of the European Scleroderma Trials and Research (EUSTAR) cohort and a systematic literature review.

BACKGROUND: The anti-Nucleolar Organizer Region 90 antibodies (NOR90) are rare antinuclear antibodies (ANA) reported in systemic sclerosis (SSc). Especially due to low prevalence, the clinical relevance of NOR90 in SSc remains uncertain. OBJECTIVES: To analyze the clinical associations of NOR90 in patients with SSc in a multicentric cohort. METHODS: Post-hoc, cross-sectional study of prospectively collected data from the European Scleroderma Trials and Research (EUSTAR) database, with additional information on NOR90. Further, we performed a systematic literature search, using the terms "systemic sclerosis" and "NOR90" across three databases: Medline via PubMed, Scopus, and Thomson Reuters' Web of Science Core Collection, from inception to November 1st, 2023. RESULTS: Overall, 1318 patients with SSc were included (mean age 58.3 ± 13.7 years, 81.3 % female), of whom 44 (3.3 %) were positive for NOR90. Of these, 32 were also positive for one of the SSc-criteria antibodies: 9/44 (20.5 %) for anti-topoisomerase I, 18/42 (42.9 %) for anti-centromere, and 5/40 (12.5 %) for anti-RNA polymerase III. NOR90-positive patients were more frequently female, had lower modified Rodnan skin score (mRSS), and lower prevalence of upper and lower gastrointestinal (GI) symptoms compared to NOR90-negative patients. In multivariable analysis, NOR90 remained significantly associated with lower mRSS and less frequent GI symptoms. The literature search identified 17 articles, including a total number of 87 NOR90-positive out of 3357 SSc patients, corresponding to an overall prevalence of 2.6 %. CONCLUSION: To our best knowledge, this is the largest SSc cohort tested for NOR90 to date, confirming the NOR90 prevalence in SSc patients is around 3 %.

[Metabolic syndrome in patients with psoriasis]. / Zespól metaboliczny w luszczycy.

Psoriasis is a chronic inflammatory disease of skin, nail plates and joints, which shares similarities with other chronic inflammatory diseases such as rheumatoid arthritis and atherosclerosis. Recent studies indicated that patients with psoriasis are at greater risk for cardiovascular co-morbidities and metabolic syndrome. Published data demonstrates that there is a correlation between the severity of skin changes, cardiovascular co-morbidities and features of metabolic syndrome. Recent research showed that psoriasis plaque shares striking histological features with atherosclerotic one. Both plaques have an elevated level of activated T helper 1 and T helper 17 cells. T helper 1 cells show an overproduction of proinflammatory cytokines such as: TNF-alpha, INF-gamma IL-6 which result in endothelial dysfunction. IL-17 produced by T helper 17 cells have been known to play an important role in the pathogenesis of psoriasis and trigger inflammation in various tissues and organs. In addition, elevated level of serum IL-17 have been observed in unstable coronary artery disease (CAD) as well as in acute myocardial infarction (MI). Physical activity was proved to play a protective role in prevalence of cardiovascular co-morbidities. Recent studies showed that increased physical activity in patients with psoriasis reduce inflammation and risk of cardiometabolic co-morbidities.