Insulin resistance in non-diabetes patients with spondyloarthritis.

Objectives: Insulin resistance (IR) constitutes a major underlying abnormality driving cardiovascular disease in the general population and has been linked to inflammatory diseases. In this study, we aimed to determine the prevalence of IR in patients with spondyloarthritis (SpA) and whether IR can be explained by disease-related features in such cases. Method: The study included 577 subjects: 306 patients diagnosed with SpA according to Assessment of SpondyloArthritis international Society criteria and 271 controls. Insulin and C-peptide serum levels, IR and ß-cell function (%B) indices by homoeostatic model assessment (HOMA2), and lipid profiles were assessed in patients and controls. A multivariable regression analysis was performed to evaluate the differences in IR indices between patients and controls and to determine how IR is associated with disease-related characteristics in SpA patients. Results: HOMA2-%B and HOMA2-IR scores, both calculated with insulin or C-peptide, had significantly higher values in SpA patients compared to controls in multivariable analysis adjusted for age, gender, traditional IR-related factors, and glucocorticoid intake. Disease activity, functional status, and metrological SpA indices were positively related to IR, but only in univariable analysis. Disease duration and positivity for human leucocyte antigen-B27 were independently associated with a higher HOMA2-%B after multivariable analysis. Conclusion: Patients with SpA have an increased IR compared to controls. SpA disease-related data are independently associated with ß-cell dysfunction.

Systemic blockade of TNF-α does not improve insulin resistance in humans.

The purpose of this study was to determine whether long-term modulation of inflammatory activity by tumor necrosis factor (TNF)-α inhibitors has some influence on insulin resistance (IR). 16 active rheumatoid arthritis (RA) patients without CV risk factors treated with anti-TNF-α agents were included in this study. RA activity by disease activity score 28, IR by HOMA2-IR, body composition by impedance analysis, physical activity by accelerometry, abdominal fat distribution by magnetic resonance imaging, and serum level of key adipokines by ELISA were measured at baseline and during a 1-year follow-up period. Patient body mass index increased significantly (26.94 ± 3.88 vs. 28.06 ± 4.57 kg/m2, p=0.02) after 1 year of treatment. Body composition, in terms of fat and fat-free mass, remained unchanged except for a significant elevation in body cell mass (25.50 ± 4.60 vs. 26.60 ± 3.17 kg, p=0.02). Basal levels of IR in the RA patients included in this study were significantly higher than healthy controls (1.6 ± 0.8 vs. 1.11 ± 0.56, p=0.011) but did not change during the follow-up. Nor did basal concentrations of adiponectin, visfatin, leptin, ghrelin, resistin, and apelin in response to anti-TNF-α treatment; only retinol-binding protein 4, showed a significant increase (51.7 ± 32.7 vs. 64.9 ± 28.4 µg/ml, p=0.03) at the end of the study. IR, adiposity distribution, and serum levels of most adipokines are not significantly affected by long-term inhibition of TNF-α in RA patients. Our data suggest that although systemic blockade of TNF-α exerts an anticachectic effect in RA patients, it does not seem to play a major role in IR.

Búsqueda de nuevos autoantígenos en el síndrome de Sjögren / The search for new autoantigens in Sjögren’s syndrome

Objetivo: Determinar la existencia de nuevos autoantígenos en el síndrome de Sjögren (SS) así como estudiar la prevalencia de éstos en pacientes y población sana. Material y métodos: Se procedió a realizar un muestreo con el suero de una enferma afectada de SS mediante la utilización de una genoteca de cerebro humano (técnica SEREX). Se determinó que este suero expresaba autoantígenos ya conocidos y proteínas no descritas previamente, y también se confirmó la presencia de una proteína desconocida hasta ahora. De entre ellas, se seleccionó a esta última (hIscA) y a la proteína Tau (hallada en el muestreo) para ser transformadas en sendos plásmidos de expresión para conseguir su síntesis recombinante. Resultados: Mediante técnica de inmunotransferencia se testó la existencia de anticuerpos anti-Tau y anti-hIscA en 19 pacientes y 20 sujetos sanos. No se encontró diferencia estadísticamente significativa entre pacientes y controles en la expresión de anticuerpos anti-Tau y se halló que los pacientes expresaban, de forma significativa, valores inferiores de anticuerpos anti-hIscA. Conclusión: Se ha identificado a las proteínas Tau y hIscA como nuevos autoantígenos en el SS. Se ha hallado que los pacientes con SS expresan valores inferiores de anticuerpos anti-hIscA en comparación con controles y, aunque no se ha encontrado ninguna diferencia entre sanos y enfermos en relación con la presencia de anticuerpos anti-Tau, ésta es la primera vez en que anticuerpos contra esta proteína se han detectado en el SS(AU)

Objective: To identify new autoantigens related to Sjögren’s syndrome and to determine their prevalence in patients and healthy individuals. Material and methods: Serological sampling was performed in a patient with Sjögren’s syndrome through the use of a human brain expression genotec (SEREX technique) to determine expression of known autoantigens and previously undescribed proteins. The presence of a previously unknown protein was found. Several proteins were obtained and two were selected to be studied (a human protein called Tau and an unknown protein described by our group and named hlscA). Both Tau and hIscA cDNA were transformed into an expression plasmid to obtain their recombinant proteins. Results: Using a Western-blot technique we investigated the presence of anti-Tau and anti-hlscA autoantibodies in the sera of 19 patients with Sjögren’s syndrome and in the sera of 20 controls. No statistically significant differences were found in the expression of anti-Tau antibodies between patients with Sjögren’s syndrome and controls but values of anti-hlscA autoantibodies were significantly lower in patients with Sjögren’s syndrome. Conclusion: We identified Tau and hIscA proteins as new autoantigens in Sjögren’s syndrome. Anti-hlscA antibody values were significantly lower in patients with Sjögren’s syndrome than in healthy controls. Although no statistically significant differences in values of anti-Tau antibodies were found between Sjögren’s syndrome patients and controls, this is the first time antibodies against this protein have been detected in Sjögren’s síndrome(AU)

[The search for new autoantigens in Sjögren's syndrome]. / Búsqueda de nuevos autoantígenos en el síndrome de Sjögren.

OBJECTIVE: To identify new autoantigens related to Sjögren's syndrome and to determine their prevalence in patients and healthy individuals. MATERIAL AND METHODS: Serological sampling was performed in a patient with Sjögren's syndrome through the use of a human brain expression genotec (SEREX technique) to determine expression of known autoantigens and previously undescribed proteins. The presence of a previously unknown protein was found. Several proteins were obtained and two were selected to be studied (a human protein called Tau and an unknown protein described by our group and named hlscA). Both Tau and hIscA cDNA were transformed into an expression plasmid to obtain their recombinant proteins. RESULTS: Using a Western-blot technique we investigated the presence of anti-Tau and anti-hlscA autoantibodies in the sera of 19 patients with Sjögren's syndrome and in the sera of 20 controls. No statistically significant differences were found in the expression of anti-Tau antibodies between patients with Sjögren's syndrome and controls but values of anti-hlscA autoantibodies were significantly lower in patients with Sjögren's syndrome. CONCLUSION: We identified Tau and hIscA proteins as new autoantigens in Sjögren's syndrome. Anti-hlscA antibody values were significantly lower in patients with Sjögren's syndrome than in healthy controls. Although no statistically significant differences in values of anti-Tau antibodies were found between Sjögren's syndrome patients and controls, this is the first time antibodies against this protein have been detected in Sjögren's syndrome.

Dual positivity for cytoplasmic and perinuclear anti-neutrophil antibodies in a patient with Henoch-Schönlein purpura.

We herein describe the case of a 60-year-old man who presented clinical and histopathological evidence of Henoch-Schönlein purpura. Antineutrophil antibodies (ANCA) showed positive results on an enzyme-linked immunosorbent assay and immunofluorescence for anti-myeloperoxidase and anti-proteinase 3 antibodies. Dual positivity for both cytoplasmatic (C-ANCA) and perinuclear (P-ANCA) antineutrophil antibodies has been found previously in a small number of reports, but to our knowledge this is the first time the simultaneous presence of C-ANCA and P-ANCA has been observed in Henoch-Schönlein purpura.

Conferencia clinicopatológica: dolor lumbar en un varón de 55 años con pancreatitis crónica / Clinicopathologic conference: lumbar pain in a -year-old man with chronic pancreatitis

No disponible