[Clinical features and prognosis analysis of myelin oligodendrocyte glycoprotein antibody-positive optic neuritis].

Objective: To investigate the clinical characteristics and prognosis of myelin oligodendrocyte glycoprotein (MOG) antibody-positive optic neuritis (ON). Methods: The data of 39 patients with MOG antibody-positive ON in the Department of Neurology of Beijing Tongren Hospital, Capital Medical University from January 1, 2017 to October 31, 2019 were retrospectively collected. There were 25 males and 14 females, aged from 15 to 80 (40±16) years. According to the recurrence, the patients were divided into two groups: the recurrence group (n=12) and the non-recurrence group (n=27). The clinical manifestations, relapse-related factors, magnetic resonance imaging (MRI) manifestations, treatment and prognosis of the two groups were analyzed. Results: A total of 63 eyes were involved, including 30 cases of optic perineuritis (OPN), accounting for 47.6% (30/63). The number of attacks ranged from 1 to 9, among which 12 patients had more than 2 attacks. There were 37 eyes [58.7% (37/63)] with severe visual loss (SVL) at the time of onset, and 7 eyes [11.1% (7/63)] with SVL at the final follow-up. Forty-eight eyes [76.2% (48/63)] had optic disc edema. Forty seven eyes [74.6% (47/63)] showed long-segment disease on optic nerve MRI. One case was complicated with aseptic meningitis and encephalitis. The recurrence group was younger than the non-recurrence group [(28.5±9.8) years vs (43.3±16.4) years, P=0.001]. There were no statistically significant differences between the two groups in gender, bilateral onset, initial visual acuity, final visual acuity, optic disc edema, head and spinal cord lesions, and immunosuppressant (all P>0.05). All patients were treated with methylprednisolone (MP) pulse therapy during the acute attack, and 16 of them were additively treated with immunosuppressive agents; the pain was alleviated or relieved significantly after the application of glucocorticoids. Conclusions: MOG antibody-positive ON often occurred in both eyes at the same time, often manifesting as OPN, often accompanied by optic disc edema, and SVL at the beginning of the disease, but most of the visual recovery was good, might be associated with meningitis and encephalitis. MRI of the optic nerve showed that the lesions often manifested as long-segment lesions. Glucocorticoids could alleviate pain and promote the recovery of visual function.

Plasma melatonin levels do not differ in SLE patients.

OBJECTIVE: This study aims to investigate the plasma melatonin levels in systemic lupus erythematosus (SLE) patients and its relationship with clinical and laboratory features. PATIENTS AND METHODS: A total of 90 patients with SLE (82 females, 8 males; mean age 37.86 ± 13.98 years, range 19-77 years) and 90 healthy controls (82 females, 8 male; mean age 36.54 ± 10.89 years, range 22-60 years) were recruited for the current study. Plasma melatonin levels were detected by enzyme-linked immunosorbent assay. RESULTS: Melatonin levels were not significantly different in the plasma of patients with SLE compared with controls (P = 0.026). There was no significant difference regarding plasma melatonin level between SLE patients with nephritis and those without nephritis (P = 0.714); no significant difference was found between less active SLE and more active SLE (P = 0.791). The presence of IgM was associated with melatonin levels (P = 0.031) in SLE patients. CONCLUSIONS: There is no significant difference in plasma melatonin levels between SLE patients and controls. Further studies are needed to elucidate the role of melatonin in SLE.

Elevated serum levels of interleukin-1ß and interleukin-33 in patients with systemic sclerosis in Chinese population.

PURPOSE OF THE STUDY: Systemic sclerosis (SSc) is a multisystem autoimmune disease. Although the pathogenesis of the disease remains incompletely understood, some cytokines or growth factors which regulate SSc induction may be involved in the injury of endothelial cells and the modulation of leukocyte function. We aimed to perform this case-control study to determine serum levels of interleukin (IL)-1α, IL-1ß, IL-18 and IL-33 and their associations with clinical manifestations in SSc patients. MATERIALS AND METHODS: There were 56 patients with SSc and 56 healthy individuals who were recruited from local hospital between 2012 and 2014. Serum IL-1α, IL-1ß, IL-18 and IL-33 levels were measured with specific enzyme-linked immunosorbent assay kits. RESULTS: Univariate analysis revealed that serum IL-1ß, IL-18 and IL-33 levels in SSc patients were significantly higher than that in healthy controls. After adjusting possible confounding factors (sex, age, smoking and drinking) by multivariable analyses, serum IL-1ß levels (OR = 1.082; 95 % CI: 1.013-1.155) and serum IL-33 levels (OR = 1.100; 95 %CI: 1.022-1.185) were still related factors. There were interrelationships among the serum levels of IL-1α, IL-1ß, IL-18 and IL-33 and these associations were not consistent in SSc patients and controls. No associations of serum IL-1α, IL-1ß, IL-18 and IL-33 levels with clinical parameters were found. CONCLUSION: IL-1ß and IL-33 may contribute to the development of SSc. While there were no direct associations between these cytokines and disease manifestations, they still could be considered as serum markers of development of SSc. Further studies are required to validate this incipient data.

[The effect of long-term low dose prednisone on bone mineral density in patients with systemic lupus erythematosus].

Objective: To investigate the effect of long-term low dose prednisone administration on bone mineral density (BMD) in patients with inactive systemic lupus erythematosus (SLE). Methods: A total of 118 inactive female SLE patients with long-term administration of low dose prednisone were recruited from the Department of Rheumatology and Immunology at An hui Provincial Hospital.All patients were given low dose prednisone for long-term (≤10 mg/d, more than half a year). According to prednisone doses, subjects were divided into two groups, namely group A (≤7.5 mg/d) and group B (7.5-10 mg/d). In addition, patients were also divided into four groups based on the duration of administration, including groupⅠ≤3 years, Ⅱfrom 4-5 years, Ⅲ 6-10 years and Ⅳ>10 years.Twenty-nine healthy people were recruitedas normal controls.The BMD was measured by dual energy X-ray absorptiometry.The association of BMD with prednisone dose and duration was compared between different groups. Results: The incidence of osteopenia in all patients with SLE was 42.4%(50/118), and the incidence of osteoporosis was 14.4%(17/118). BMD of all bone sites in both group A and B were significantly lower than that in normal control group (P<0.05). Similarly, the BMD of all bone sites in groupⅠ, Ⅱ, Ⅲ and Ⅳ were significantly decreased (P<0.05). What needed to be stressed was the BMD in group Ⅳ was lower than those in other three groups (P<0.05). Multiple logistic regression analysis showed that the cumulative prednisone dose was the risk factor for osteopenia, while taking calcium and alfacalcidol were protective factors. Conclusion: Long-term use of low dose prednisone result in the decrease of BMD in patients with inactive SLE.The lumbar spine and femoral neck had more severe osteopenia. Long-term administration of prednisone, even less than 7.5 mg/d, can also cause osteopenia.Calcium and alfacalcidol were protective factors of BMD.

The correlation between miR-200c and the severity of interstitial lung disease associated with different connective tissue diseases.

OBJECTIVES: To explore the correlation between microRNA (miR)-200c and the severity of interstitial lung disease (ILD) associated with connective tissue diseases (CTDs). METHOD: We recruited 218 patients with CTDs who were evaluated with high-resolution computed tomography (HRCT) and the pulmonary function test (PFT). Peripheral blood mononuclear cells (PBMCs) were acquired from 23 patients with systemic sclerosis (SSc), 29 with dermatomyositis/polymyositis (DM/PM), 30 with primary Sjögren's syndrome (pSS), 47 with rheumatoid arthritis (RA), and 23 normal controls to detect the expression level of miR-200c by quantitative reverse transcription polymerase chain reaction (QRT-PCR). miR-200c levels were compared among the different disease groups, between the group with ILD (CTD+ILD) and the group without ILD (CTD-ILD), and between mild and severe ILD groups. Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were compared among the different CTD groups and the different CTD+ILD groups. RESULTS: The miR-200c level in the SSc group was significantly higher than in the DM/PM, pSS, and RA groups, and the levels in the DM/PM and pSS groups were significantly higher than in the RA group. The level of miR-200c in the CTD+ILD group was significantly higher than in the CTD-ILD group, and the level in the severe ILD group was significantly higher than in the mild ILD group. FVC and FEV1 were significantly different among the different CTD groups, and among the different CTD+ILD groups. There was a negative correlation between the level of miR-200c and FVC and FEV1. CONCLUSIONS: The level of miR-200c was positively correlated with the severity of ILD, and miR-200c in PBMCs could be a biomarker of the severity of ILD in CTDs.

[Epidemiological features of heatstroke in Shaoxing, China in 2008-2014].

OBJECTIVE: To investigate the epidemiological features of heatstroke in Shaoxing, China in 2008-2014, and to provide a reference for developing prevention and control measures for heatstroke. METHODS: The reports on heatstroke in Shaoxing in 2008-2014 were collected from the China Information System for Disease Control and Prevention, and the data were summarized and analyzed. RESULTS: A total of 1 676 heatstroke cases were reported in Shaoxing in 2008-2014, among which 1 485 cases(88.6%) were mild heatstroke and 191 cases(11.4%) were severe heatstroke. Nine persons died of severe heatstroke, and the fatality rate was 0.5%(9/1 676). Among these persons, 4(44.4%, 4/9) were the elderly living at home, 4 (44.4%, 4/9) were farmers (working outdoors), and 1(11.2%, 1/9) was unemployed. The male patients with heatstroke accounted for 66.3%(1 111/1 676), and those with severe heatstroke accounted for 13.1%(146/1 111); the female patients with heatstroke accounted for 33.7%(565/1 676), and those with severe heatstroke accounted for 8.0%(45/565); there were significant differences between male and female patients(χ(2)=9.94, P=0.002). The mean age of patients with heatstroke was 48.7±18.8 years; the mean age of male patients was 49.8±17.9 years, and that of female patients was 46.6±20.3 years, with a significant difference between the male and female patients(t=3.19, P<0.001). Most of the patients experiencing heatstroke were in their forties or fifties, each accounting for 19.2%(321/1 676); in male patients who experienced heatstroke, those in their fifties accounted for the highest percentage(21.5%, 239/1 111), and in female patients who experienced heatstroke, those in their twenties accounted for the highest percentage (18.9%, 107/565). Based on stratification by age, the severity of heatstroke differed significantly between male and female patients in their forties, fifties, sixties, seventies, and eighties(P<0.05). Most of the cases of heatstroke occurred in June to September, accounting for 98.9%(1 657/1 676), particularly in July and August, accounting for 87.1%(1 460/1 676). CONCLUSION: In Shaoxing, heatstroke usually occurs in summer, and most cases are mild. Middle-aged and elderly men and farmers(working outdoors) are susceptible to heatstroke, and warnings on heatstroke and emergency treatment of severe heatstroke should be enhanced.

Clinical and laboratory profiles of 136 systemic sclerosis patients with and without echocardiographically detected pulmonary hypertension.

AIM: This study aims to review the clinical and laboratory profiles of systemic sclerosis (SSc) patients with and without echocardiographically detected pulmonary hypertension (PH) in China. PATIENTS AND METHODS: The study included 136 consecutive patients treated from 1992 to 2012. Diagnosis of SSc was made according to the 1980 revision of the American College of Rheumatology SSc criteria. PH was defined as systolic pulmonary artery pressure ≥ 40 mmHg detected by Doppler echocardiography. The clinical and laboratory parameters of SSc patients with pulmonary hypertension (SSc-PH) were compared to those of SSc patients without pulmonary hypertension (SSc-no PH). RESULTS: Of the 136 SSc patients, 28 (20.6 %) were diagnosed as having PH by echocardiography. Upon comparison with the SSc-no PH patients, SSc-PH patients were observed to have a significantly higher frequency of subjective dyspnea (P = 0.010) and a higher rate of anti-nuclear RNP (anti-nRNP) antibody positivity (P = 0.028). We also observed that the percentage of SSc-PH patients with increased urea nitrogen is significantly higher than that of SSc-no PH patients after correction for multiple testing (P = 0.006, compared to patients with normal values). CONCLUSION: This study demonstrates that SSc patients with PH detected by echocardiography had characteristic clinical and laboratory features. More specific treatment addressing these aspects should be offered to improve the curative effect of therapy in SSc-PH patients.

Ets-1: a new player in the pathogenesis of systemic lupus erythematosus?

v-ets erythroblastosis virus E26 oncogene homolog 1 (avian) (Ets-1) is a member of the Ets family of transcription factors that share a unique Ets DNA binding domain. They control a wide variety of cellular processes including cell proliferation and differentiation. Recently, two genome-wide association studies in systemic lupus erythematosus (SLE) independently identified genetic variants in Ets-1 associated with SLE. Interestingly, previous studies have found that Ets-1-deficient mice develop lupus-like disease characterized by high titers of IgM and IgG autoantibodies, immune complex-mediated glomerulonephritis, and local activation of complement. In addition, Ets-1 is also involved in many cellular abnormalities that are known to participate in SLE pathogenesis, such as its role in negative regulation of Th17 cell and B cell differentiation. All these findings suggest that Ets-1 may play an important role in the pathogenesis of SLE. This article will focus on current understanding of the role of Ets-1 in the physiological and pathological functions associated with SLE. It is the intention of the article to provide insights which may assist in the development of Ets-1 based approaches for the treatment of SLE.

The association between BANK1 and TNFAIP3 gene polymorphisms and systemic lupus erythematosus: a meta-analysis.

The past decade has witnessed hundreds of reports declaring or not being able to replicable genetic association with systemic lupus erythematosus (SLE) susceptibility. BANK1 is a gene that encodes a B-cell-specific scaffold protein and its activation can affect B-cell-receptor-induced calcium mobilization from intracellular calcium stores. TNFAIP3 encodes the ubiquitin-modifying enzyme, also known as A20, which is a cytoplasmic zinc finger protein that inhibits nuclear factor kappa-B (NFKB) activity and tumour necrosis factor (TNF)-mediated programmed cell death. The association of BANK1 and TNFAIP3 polymorphism with SLE has been reported in several studies. The aim of this study was to assess whether combined evidence shows the association between BANK1 and TNFAIP3 polymorphism and SLE. We report the results of a meta-analysis of genome-wide association scans and replication in independent sets for BANK1 and TNFAIP3 polymorphism and SLE that includes 12,416 subjects with SLE and 19,113 control subjects. Meta-odds ratios (ORs) and 95% confidence intervals (CIs) based on random effects models. Both of BANK1 and TNFAIP3 harbour several controversial single nucleotide polymorphisms (SNPs). We selected and identified three SNPs of BANK1 associated with SLE (rs17266594, P = 1.949e-10; OR = 1.380; 95% CI: 1.250-1.525; rs10516487, P = 2.642e-13; OR = 1.317; 95% CI: 1.223-1.417; rs3733197, P = 3.452e-06; OR = 1.193; 95% CI: 1.107-1.286); one SNP of TNFAIP3 associated with SLE (rs2230926, P = 1.502e-12; OR = 1.826; 95% CI: 1.545-2.157). This meta-analysis demonstrates a significant association between BANK1 and TNFAIP3 gene polymorphism and SLE in multiple ethnic populations. These findings reinforce the value of large sample series for discovery and follow-up of genetic variants contributing to the aetiology of SLE.

Association of NFKB1 -94ins/delATTG promoter polymorphism with susceptibility to autoimmune and inflammatory diseases: a meta-analysis.

The aim of our study is to assess the association of NFKB1 -94ins/delATTG promoter polymorphism with autoimmune and inflammatory diseases using a meta-analysis. We surveyed the studies on the association of NFKB1 -94ins/delATTG promoter polymorphism with autoimmune and inflammatory diseases. Meta-analysis was performed for genotypes DD vs WW, WD vs WW, DD vs WW + WD, WD + DD vs WW, and D allele vs W allele in a fixed/random effect model. Seventeen studies (7312 cases and 6193 controls) were identified. When all groups were pooled, we found no association between NFKB1 -94ins/delATTG promoter polymorphism and autoimmune and inflammatory diseases. In ethnic subgroup analyses, we found no association between NFKB1 -94ins/delATTG promoter polymorphism and autoimmune and inflammatory diseases in the Caucasian population. However, an association of NFKB1 -94ins/delATTG promoter polymorphism with autoimmune and inflammatory diseases was found in the Asian population [D vs W: odds ratio (OR) = 0.87, 95% confidence interval (CI) = 0.77-0.99, P = 0.03; WD + DD vs WW: OR = 0.79, 95% CI = 0.65-0.95, P = 0.01; DD vs WW + WD: OR = 0.92, 95% CI = 0.73-1.16, P = 0.11; DD vs WW: OR = 0.80, 95% CI = 0.62-1.03, P = 0.09; WD vs WW: OR = 0.78, 95% CI = 0.65-0.95, P = 0.01]. In disease subgroup analyses, we found no association between NFKB1 -94ins/delATTG promoter polymorphism and inflammatory bowel disease, ankylosing spondylitis and Graves' disease. This meta-analysis suggests a possible association between NFKB1 -94ins/delATTG promoter polymorphism and certain autoimmune and inflammatory diseases in the Asian population, but not in the Caucasian population. This finding demands further investigation.

Association of ITGAM polymorphism with systemic lupus erythematosus: a meta-analysis.

BACKGROUND: ITGAM is one of the major non-human leucocyte antigen that has been implicated in the pathogenesis of systemic lupus erythematosus (SLE). The association of ITGAM polymorphism with SLE has been reported in several studies, but with inconclusive results. OBJECTIVES: The aim of this study was to assess whether combined evidence shows the association between ITGAM polymorphism and SLE. METHODS: A meta-analysis was performed to survey studies on the ITGAM polymorphism and SLE using comprehensive Medline search and review of the references. A total of five published studies including 12,123 patients with SLE and 17,016 controls were involved. Meta-odds ratios (ORs) and 95% confidence intervals (CIs) based on fixed effects models or random effects models were depended on Cochran's Q-statistic and I(2) values. RESULTS: The overall ORs for the minor A-allele (OR 1.795; 95%CI 1.676-1.921), AA vs. GG (OR 3.540; 95%CI 2.771-4.522), AG vs. GG (OR 1.750; 95%CI 1.617-1.895), dominant model (OR 1.857;95%CI 1.719-2.005), recessive model (OR 3.041; 95%CI 2.384-3.878) of ITGAM rs1143679 were significantly increased in SLE and fixed effects models were conducted. All controls were in Hardy-Weinberg (HW) proportion. Although this meta-analysis showed significant association of rs1143683 (A vs. G, OR 1.534;95%CI 1.312-1.792), rs9888739 (T vs. C,OR 1.627;95%CI 1.380-1.918), rs1143678 (T vs. C, OR 1.543; 95%CI 1.330-1.790), rs9937837 (A vs. G, OR 0.466; 95%CI 0.227-0.957) with SLE; all of these were conducted in random effects model as heterogeneity was detected. No significant association was detected in the analysis between rs11574637 and SLE. No publication bias was presented. CONCLUSIONS: This meta-analysis demonstrates a significant association between ITGAM gene polymorphism and SLE in multiple ethnic populations.

Association of SUMO4 M55V polymorphism with susceptibility to autoimmune and inflammatory diseases: a meta-analysis.

The purpose of this study was to generate large-scale evidence on whether SUMO4 M55V polymorphism is associated with autoimmune and inflammatory diseases using a meta-analysis. We surveyed studies on the association of SUMO4 M55V polymorphism with autoimmune and inflammatory diseases in PubMed. Meta-analysis was performed for genotypes AG versus AA, GG versus AA, GG versus AA + AG, AG + GG versus AA and G allele versus A allele in a fixed/random effect model. We identified 16 studies (11, 407 cases and 10, 679 controls) using PubMed search. When all groups were pooled, we detected the association of SUMO4 M55V polymorphism with autoimmune and inflammatory diseases (G versus A: OR = 1.11, 95%CI = 1.03-1.19, P = 0.005; AG +GG versus AA: OR=1.17, 95%CI=1.06-1.28, P=0.001; GG versus AA+AG: OR=1.07, 95%CI=0.94-1.21, P=0.29; GG versus AA: OR=1.15, 95%CI=1.00-1.34, P=0.06; AG versus AA: OR=1.15, 95%CI=1.08-1.23, P<0.0001). In subgroup analyses, we detected the association of SUMO4 M55V polymorphism with autoimmune and inflammatory diseases in Asian population (G versus A: OR=1.18, 95%CI=1.08-1.28, P=0.0001; AG+GG versus AA: OR=1.30, 95%CI=1.16-1.45, P<0.00001; GG versus AA+AG: OR=1.04, 95%CI=0.78-1.37, P=0.80; GG versus AA: OR=1.20, 95%CI=0.99-1.45, P=0.07; AG versus AA: OR=1.32, 95%CI=1.18-1.49, P<0.00001). But the association was not found in Caucasian population. Meanwhile, an association of SUMO4 M55V polymorphism with autoimmune diabetes was found (G versus A: OR=1.18, 95%CI=1.08-1.30, P=0.0005; AG+GG versus AA: OR=1.22, 95%CI=1.13-1.32, P<0.00001; GG versus AA+AG: OR=1.15, 95%CI=0.96-1.38, P=0.13; GG versus AA: OR=1.32, 95%CI=1.08-1.60, P=0.006; AG versus AA: OR=1.23, 95%CI=1.13-1.33, P<0.00001). This meta-analysis demonstrates the association of SUMO4 M55V polymorphism with autoimmune and inflammatory diseases, especially in Asian population.