scholarly journals Proinflammatory and autoimmunogenic gut microbiome in systemic lupus erythematosus

2019 ◽  
Author(s):  
Bei-di Chen ◽  
Xin-miao Jia ◽  
Jia-yue Xu ◽  
Li-dan Zhao ◽  
Jun-yi Ji ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Small Sample Size ◽  
Bacterial Species ◽  
Organ Damage ◽  
Small Sample ◽  
Oral Microbiome ◽  
Systemic Lupus ◽  
Microbial Composition

AbstractSystemic lupus erythematosus (SLE), characterized by chronic inflammation and multi-organ damage, has been suggested to associate with gut dysbiosis, but knowledge is limited from small sample size and 16s rRNA-based studies. To shed new light on the role of microbiota in SLE development, we analyzed the fecal metagenome of 117 treatment-naïve SLE patients and 115 sex- and age-matched healthy controls (HC) by deep-sequencing; in addition, 52 of the aforementioned patients have post-treatment fecal metagenome for comparison. We found significant differences in microbial composition and function between SLE and HC, revealing multiple plausible contributing bacterial species and metabolic pathways in SLE. In-depth SNP-based analysis revealed an oral-microbiome origin for two marker species, strengthening the importance of bacterial translocation in disease development. Lastly, we confirmed experimentally that peptides of SLE-enriched species mimicking autoantigens such as Sm and Fas could trigger autoimmune responses, suggesting a potential causal role of gut microbiota in SLE.

scholarly journals A modified regimen of low-dose rituximab therapy for patients with refractory immune thrombocytopenia associated with systemic lupus erythematosus

2021 ◽  
Vol 12 ◽  
pp. 204062232110486
Author(s):  
Shuo Zhang ◽  
Nan Jiang ◽  
Li Wang ◽  
Li Zhang ◽  
Hua Chen ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Immune Thrombocytopenia ◽  
Low Dose ◽  
Intervention Study ◽  
Response Rate ◽  
Small Sample Size ◽  
Small Sample ◽  
Systemic Lupus ◽  
Refractory Itp

Background: Severe and refractory immune thrombocytopenia (ITP) affects the life expectancy of patients with systemic lupus erythematosus (SLE) and poses a challenge in their clinical management. This intervention study employed a small sample size to evaluate the efficacy and safety of a modified low-dose rituximab (RTX) regimen in patients with SLE-associated refractory ITP. Methods: Eight patients with severe SLE-associated refractory ITP were enrolled in this intervention study. They received an infusion of intravenous RTX (200 mg) on days 1 and 15. The dose of corticosteroids (prescribed previously) was gradually tapered, and immunosuppressants were withdrawn. Patients were followed up at 1, 3, 6, and 12 months; platelet counts, other laboratory indicators, and side effects were recorded. We used intention-to-treat analysis to calculate the response rate. Results: Seven participants (87.5%) completed the study. At 1 month, two patients (25.0%) achieved partial response (PR); the PR rate increased to 87.5% at 3 months. At 6 months, three patients (37.5%) achieved complete response (CR). However, the CR rate dropped to 25.0% at 12 months. The overall responses (ORs) were 25.0% (2/8), 87.5% (7/8), 75.0%(6/8), and 75.0%(6/8) at 1, 3, 6, and 12 months, respectively. Two patients developed a mild infusion reaction and one discontinued the study due to herpes zoster virus infection and an allergic reaction 2 weeks after the first dose of RTX. Conclusion: Modified low-dose RTX therapy (two infusions of 200 mg every 2 weeks) could be a promising new option for patients with SLE-associated refractory ITP with a satisfactory response rate.

scholarly journals Resolution of the Expert Council «The role of type I interferon inhibitor in the treatment of patients with systemic lupus erythematosus»

2021 ◽  
Vol 15 (4) ◽  
pp. 126-128
Author(s):  
A. M. Lila ◽  
S. K. Soloviev ◽  
T. V. Popkova
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Organ Damage ◽  
Immunosuppressive Drugs ◽  
Type I ◽  
Type I Ifn ◽  
Systemic Lupus ◽  
Key Points

On April 28, 2021, a meeting of the Council of Experts was held with the participation of the leading experts in the field of rheumatic diseases, approaches to the treatment of patients with systemic lupus erythematosus (SLE) were discussed. The issues of medical care for patients with SLE and their routing, key points of Russian and international clinical guidelines for the management of patients with SLE, as well as the role of interferon (IFN) type I in the pathogenesis of the disease were discussed. It is noted that the management of patients with SLE requires a multidisciplinary approach. The basis of therapy is the use of glucocorticoids (GC), immunosuppressive drugs and their combinations. But long-term use of GC in patients with SLE leads to severe complications. Early prescription of biological disease-modifying antirheumatic drugs (bDMARDs) allows to achieve the greatest effect and prevent the development of irreversible organ damage associated with SLE. Currently data from three clinical trials on the efficacy and safety of the type I IFN inhibitor anifrolumab are available. During the discussion, experts defined the clinical profile of a patient with SLE, for whom administration of bDMARD therapy is indicated. According to experts, the use of a type I IFN inhibitor in routine clinical practice can improve disease outcomes in both short and long term.

scholarly journals Soluble erythropoietin receptor levels associate with inflammatory mediators but not with disease activity or cumulative organ damage in patients with systemic lupus erythematosus

2018 ◽  
Vol 16 ◽  
pp. 205873921881103 ◽  
Author(s):  
Heather Jones ◽  
Warren Raymond ◽  
Gro Eilertsen ◽  
Johannes Nossent
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Organ Damage ◽  
Erythropoietin Receptor ◽  
Inflammatory Back Pain ◽  
Enzyme Linked Immunosorbent Assay ◽  
Systemic Lupus ◽  
Significant Difference

The erythropoietin receptor (EpoR) stimulates erythrocyte proliferation after erythropoietin binding. EpoR belongs to the cytokine receptor superfamily and can be found on macrophages and endothelial cells. As there are no data on the role of EpoR systemic autoimmune diseases, we investigated the role of soluble EpoR (sEpoR) in patients with systemic lupus erythematosus (SLE). In a cross-sectional study we recorded clinical characteristics, disease activity (SLEDAI-2K) and organ damage (SDI). sEpoR, autoantibodies and cytokines were measured by enzyme-linked immunosorbent assay (ELISA) in SLE patients (n = 100) and compared with a rheumatoid arthritis (RA) cohort (n = 57) and a cohort with non-inflammatory back pain (NIBP; n = 89). Data were analysed with non-parametric techniques. We found no significant difference in sEpoR levels across the SLE, RA and NIBP groups and sEpoR levels were similar in patients with (6% of SLE and 31% of RA) or without anaemia. sEpoR levels were unrelated to haemoglobin levels, SLEDAI-2K or SDI scores, but in both cohorts correlated with levels for C-reactive protein (CRP), interleukin-6 (IL-6), tumour necrosis factor (TNF) and IL-1 (all P < 0.001). sEpoR levels are not involved in anaemia or erythropoietin resistance in SLE and RA patients, but closely mirror the underlying inflammatory process. This suggests that increased shedding of sEpoR during inflammation occurs at other sites than bone marrow.

scholarly journals Propensity Score Methods in Rare Disease: A Demonstration Using Observational Data in Systemic Lupus Erythematosus

2020 ◽  
pp. jrheum.200254
Author(s):  
Ibrahim Almaghlouth ◽  
Eleanor Pullenayegum ◽  
Dafna D. Gladman ◽  
Murray B. Urowitz ◽  
Sindhu R. Johnson
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Propensity Score ◽  
Rare Disease ◽  
Lupus Erythematosus ◽  
Small Sample Size ◽  
Study Groups ◽  
Small Sample ◽  
Observational Research ◽  
Systemic Lupus ◽  
Real World Data

Observational studies allow researchers to understand the natural history of rheumatic conditions, risk factors for disease development, and factors affecting important disease-related outcomes, and to estimate treatment effect from real-world data. However, this design carries a risk of confounding bias. A propensity score (PS) is a balancing score that aims to minimize the difference between study groups and consequently potential confounding effects. The score can be applied in 1 of 4 methods in observational research: matching, stratification, adjustment, and inverse probability weighting. Systemic lupus erythematosus (SLE) is a rare disease characterized by a relatively small sample size and/or low event rates. In this article, we review the PS methods. We demonstrate application of the PS methods to achieve study group balance in a rare disease using an example of risk of infection in SLE patients with hypogammaglobulinemia.

GATA3 rs3824662 gene polymorphism as possible risk factor for systemic lupus erythematosus

Lupus ◽  
2018 ◽  
Vol 27 (13) ◽  
pp. 2112-2119 ◽  
Author(s):  
Y M Mosaad ◽  
A Hammad ◽  
A A Elghzaly ◽  
Z M E Tawhid ◽  
E M Hammad ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Risk Factor ◽  
Lupus Erythematosus ◽  
Small Sample Size ◽  
Positive Association ◽  
Small Sample ◽  
Limiting Factor ◽  
Healthy Controls ◽  
Systemic Lupus ◽  
Genotype Frequencies

Background There is no report about the association between GATA3 rs3824662 polymorphism and systemic lupus erythematosus (SLE). Objective To investigate the possible role of GATA3 rs3824662 polymorphism as a susceptibility risk factor for either adult SLE (aSLE) or pediatric SLE (pSLE) and to evaluate its role in the development of lupus nephritis (LN) in pSLE. Methods Typing of GATA3 rs3824662 polymorphism was done using real-time polymerase chain reaction for three groups; 104 pSLE patients, 140 aSLE patients and 436 age- and sex-matched healthy controls. Results Non-significant differences were found between SLE patients and healthy controls for the allele and genotype frequencies of GATA3 rs3824662 ( p > 0.05). In pSLE; the AC genotype was associated with LN ( p = 0.04); the A allele and AC genotype were associated with persistent proteinuria ( p = 0.036 and 0.01, respectively) and both the A allele and AA genotype were associated with higher chronicity index ( p = 0.031 and 0.04, respectively). In aSLE; the C allele was associated with cellular cast ( p = 0.03) and thrombocytopenia ( p = 0.01). Logistic regression analysis revealed significant association between the AC+AA genotypes and the prediction of LN and renal active disease in pSLE ( p = 0.04 and 0.01, respectively). Conclusion GATA3 rs3824662 is not associated with susceptibility to SLE either in adult or in pediatric patients; however, in pSLE patients, the heterozygous AC genotype could be considered a risk factor for LN. At the same time, the AC and AA genotypes could be considered as predictors for LN and active renal disease. However, the small sample size is a limiting factor of the present study when interpreting the positive association.

The role of microRNAs (MiR-125a and MiR-146a), RANTES, and IFN-γin systemic lupus erythematosus

2020 ◽  
Vol 23 (13) ◽  
Author(s):  
Ikram khazal Qasim Al- hasso ◽  
Aida Rashid Al- Derzi ◽  
Ahmed Abdul-hassan Abbas ◽  
Faiq I. Gorial ◽  
Ahmed Sameer Alnuimi
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus

scholarly journals Acute interstitial nephritis and drug-induced systemic lupus erythematosus due to chlorthalidone and amiodarone: A case report

2020 ◽  
Vol 8 ◽  
pp. 2050313X2091002 ◽  
Author(s):  
Umut Selamet ◽  
Ramy M Hanna ◽  
Anthony Sisk ◽  
Lama Abdelnour ◽  
Lena Ghobry ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Interstitial Nephritis ◽  
Lupus Erythematosus ◽  
Kidney Biopsy ◽  
Kidney Injury ◽  
Acute Interstitial Nephritis ◽  
Systemic Lupus ◽  
Drug Induced ◽  
Systemic Manifestations

Drug-induced lupus erythematosus has features distinct from primary systemic lupus erythematosus. It can occur with a wide variety of agents that result in the generation of anti-histone or other types of antibodies. Systemic manifestations of drug-induced systemic lupus erythematosus may include renal dysfunction due to circulating immune complexes or due to other immune reactions to the culprit medication(s). Acute interstitial nephritis occurs due to DNA–drug or protein–drug complexes that trigger an allergic immune response. We report a patient who developed acute kidney injury, rash, and drug-induced systemic lupus diagnosed by serologies after starting chlorthalidone and amiodarone. A renal biopsy showed acute interstitial nephritis and not lupus-induced glomerulonephritis. It is important to note that systemic lupus erythematosus and acute interstitial nephritis can occur together, and this report highlights the role of the kidney biopsy in ascertaining the pathological diagnosis and outlining therapy in drug-induced lupus erythematosus.

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