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Systemic Lupus Erythematosus

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161. Glucocorticoids pharmacology and their application in the treatment of childhood-onset systemic lupus erythematosus. (Abstract)

Glucocorticoids pharmacology and their application in the treatment of childhood-onset systemic lupus erythematosus. Glucocorticoids are potent anti-inflammatory and immunosuppressant medications and remain the mainstay of systemic lupus erythematosus (SLE) therapy. The potency of a specific glucocorticoid, i.e., the dose of glucocorticoid that is required to produce a specific effect, is dependent on its pharmacokinetic (PK) and pharmacodynamic (PD) properties. In this review, we summarize

2019 Seminars in arthritis and rheumatism

162. Metabolism as a key regulator in the pathogenesis of systemic lupus erythematosus. (Abstract)

Metabolism as a key regulator in the pathogenesis of systemic lupus erythematosus. In the middle of the 20th century, biologists focused on investigating the mechanism of gene regulation and signal transduction in cells, which led to the concept that metabolites were products of gene expression and signal transduction pathways. In the 1920s, the importance of cellular metabolism was shown in the Warburg effect, in which cancer cells are characterized by a mitochondrial defect that shifts (...) (OXPHOS) and fatty acid oxidation (FAO), whereas activated lymphocytes rapidly shift to the glycolytic pathway. A detailed understanding of metabolic regulation has progressed rapidly, especially in T cells during their differentiation from naïve to effector T cells. Metabolism is now considered to play a key role in autoimmune diseases. Metabolic changes in autoimmune diseases might be due to inflammation as well as being involved in autoimmune pathogenesis. Systemic lupus erythematosus (SLE

2019 Seminars in arthritis and rheumatism

163. The burden of chronic kidney disease in systemic lupus erythematosus: A nationwide epidemiologic study. (Abstract)

The burden of chronic kidney disease in systemic lupus erythematosus: A nationwide epidemiologic study. To analyze the impact of chronic kidney disease (CKD) on major clinical outcome in SLE by using a nationwide database.Characteristics of all admitted SLE patients experiencing CKD (eGFR <60 mL/min/1.73 m2) in France from 2009 to 2015 were analyzed through the French medico- administrative database. Factors associated with CKD and major clinical outcomes such as end-stage renal disease (ESRD (...) ), cardiovascular event (CVE), septic shock and death were assessed. We used a multivariate Cox proportional hazard model and subdistribution hazard models to analyze survival without major clinical events according to the presence of CKD.From 2009 to 2015, 26,320 SLE patients were hospitalized in France. Among them, 6439 (86.5% women; mean age 45.7 [16.5] years old) had a baseline stay in 2009 during which CKD was reported in 428 (6.7%) cases. Multivariate analysis showed that lupus nephritis (OR 6.6 [5.2-8.4

2019 Autoimmunity reviews

164. Echocardiographic Assessment of Diastolic Function in Children with Incident Systemic Lupus Erythematosus. (Abstract)

Echocardiographic Assessment of Diastolic Function in Children with Incident Systemic Lupus Erythematosus. The timing and etiology of diastolic impairment in pediatric-onset systemic lupus erythematosus (SLE) are poorly understood. We compared echocardiographic metrics of left ventricular diastolic function in children at SLE diagnosis to controls and identified factors associated with diastolic indices. Echocardiograms of children aged 5-18 years within 1 year of SLE diagnosis and age-/sex

2019 Pediatric Cardiology

165. Bacteremia in systemic lupus erythematosus patients from RELESSER: risk factors, clinical and microbiological characteristics and outcomes. (Abstract)

Bacteremia in systemic lupus erythematosus patients from RELESSER: risk factors, clinical and microbiological characteristics and outcomes. To describe the incidence of bacteremia in a large multicentric cohort of SLE patients and their clinical characteristics and to identify risk factors.All bacteremic episodes from the RELESSER registry were included. Clinical and laboratory characteristics concerning bacteremia and SLE status, as well as comorbidities at the time of infection, were

2019 Journal of Rheumatology

166. Construction of a frailty index as a novel health measure in systemic lupus erythematosus. (Abstract)

Construction of a frailty index as a novel health measure in systemic lupus erythematosus. To construct a frailty index (FI) as a measure of vulnerability to adverse outcomes among patients with SLE, using data from the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort.The SLICC inception cohort consists of recently diagnosed SLE patients followed annually with clinical and laboratory assessments. For this analysis, the baseline visit was defined as the first study

2019 Journal of Rheumatology

167. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Full Text available with Trip Pro

2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Our objective was to update the EULAR recommendations for the management of systemic lupus erythematosus (SLE), based on emerging new evidence. We performed a systematic literature review (01/2007-12/2017), followed by modified Delphi method, to form questions, elicit expert opinions and reach consensus. Treatment in SLE aims at remission or low disease activity and prevention of flares (...) . Hydroxychloroquine is recommended in all patients with lupus, at a dose not exceeding 5 mg/kg real body weight. During chronic maintenance treatment, glucocorticoids (GC) should be minimised to less than 7.5 mg/day (prednisone equivalent) and, when possible, withdrawn. Appropriate initiation of immunomodulatory agents (methotrexate, azathioprine, mycophenolate) can expedite the tapering/discontinuation of GC. In persistently active or flaring extrarenal disease, add-on belimumab should be considered; rituximab

2019 Annals of the Rheumatic Diseases

168. Risk of severe herpes simplex virus infection in systemic lupus erythematosus: analysis of epidemiology and risk factors analysis in Taiwan. (Abstract)

Risk of severe herpes simplex virus infection in systemic lupus erythematosus: analysis of epidemiology and risk factors analysis in Taiwan. Patients with systemic lupus erythematosus (SLE) are susceptible to herpes simplex virus (HSV) infection, which occasionally leads to severe complications including meningoencephalitis and keratitis. However, few attempts to analyse the associated incidence and risk factors have been made.We enrolled patients with SLE recorded between 1997 and 2012

2019 Annals of the Rheumatic Diseases

169. Altered cognitive function in systemic lupus erythematosus and associations with inflammation and functional and structural brain changes. Full Text available with Trip Pro

Altered cognitive function in systemic lupus erythematosus and associations with inflammation and functional and structural brain changes. Cognitive dysfunction (CD) is common in systemic lupus erythematosus (SLE) but the cause remains unclear and treatment options are limited. We aimed to compare cognitive function in SLE and healthy controls (HCs) using both behavioural and neuroimaging techniques.Patients with SLE with stable disease and HCs were recruited. Clinical and psychological data

2019 Annals of the Rheumatic Diseases

170. Familial aggregation of childhood and adulthood-onset Systemic Lupus Erythematosus. (Abstract)

Familial aggregation of childhood and adulthood-onset Systemic Lupus Erythematosus. To assess the familial occurrence of systemic lupus erythematosus (SLE) in a large Brazilian cohort.Consecutive SLE patients were recruited, and stratified according to age at disease-onset into childhood (cSLE) or adult (aSLE). Each patient was personally interviewed regarding history of SLE across three generations (first-, second-, and third-degree relatives). Recurrence rates were analyzed for each degree

2019 Arthritis care & research

171. Low Disease Activity State/Remission Predicts a Better Health-Related Quality of Life in Systemic Lupus Erythematosus Patients. (Abstract)

Low Disease Activity State/Remission Predicts a Better Health-Related Quality of Life in Systemic Lupus Erythematosus Patients. To determine if low disease activity state (LDAS)/Remission predicts a better health-related quality of life (HRQoL).Systemic lupus erythematosus (SLE) patients from a single center with at least two visits were included. Visits were performed every six months. HRQoL was measured with the LupusQoL. Remission: a SLEDAI-2K=0, prednisone daily dose≤5mg/d

2019 Arthritis care & research

172. Relationships Between Adverse Childhood Experiences and Health Status in Systemic Lupus Erythematosus. (Abstract)

Relationships Between Adverse Childhood Experiences and Health Status in Systemic Lupus Erythematosus. Adverse childhood experiences (ACEs) are associated with poor adult health and immune dysregulation. The impact of ACEs on patients with autoimmune disease is unknown. We compared the prevalence of ACEs in Systemic Lupus Erythematosus (SLE) patients to population-based survey estimate and investigated relationships between ACEs and SLE outcomes.Data derive from the California Lupus (...) Epidemiology Study (CLUES), a sample of adult SLE patients. Participants completed a 10-item ACE questionnaire covering 3 domains (abuse, neglect, household challenges). We estimated ACEs prevalence in 269 CLUES participants compared to 2015 California Behavioral Risk Factor Surveillance System (BRFSS) geographically matched respondents, standardized (age, sex, race/ethnicity) to CLUES participant characteristics. We examined associations for patient-reported and physician-assessed health status measures

2019 Arthritis care & research

173. An emerging role of neutrophils and NETosis in chronic inflammation and fibrosis in systemic lupus erythematosus (SLE) and ANCA-associated vasculitides (AAV): Implications for the pathogenesis and treatment. (Abstract)

An emerging role of neutrophils and NETosis in chronic inflammation and fibrosis in systemic lupus erythematosus (SLE) and ANCA-associated vasculitides (AAV): Implications for the pathogenesis and treatment. Neutrophils derive from hematopoietic stem cells (HSCs) with systemic inflammation driving their activation and differentiation to myeloid progenitors to ensure enhanced myelopoiesis. Epigenetic reprograming and re-education of these HSCs produces neutrophils primed towards elimination (...) may not be present in chronic inflammatory lesions, their remnants may amplify the inflammatory response beyond their short life-span in the tissues. Herein, we review current evidence supporting a role of neutrophils and NETosis in tissue injury and dysfunction in systemic autoimmunity using as disease paradigms Systemic Lupus Erythematosus (SLE) and the ANCA-associated vasculitides (AAV). We also discuss the mechanisms involved and their potential as targets for novel therapy and drug

2019 Autoimmunity reviews

174. New therapies for systemic lupus erythematosus - past imperfect, future tense. Full Text available with Trip Pro

New therapies for systemic lupus erythematosus - past imperfect, future tense. The failure of many new, mostly biologic, drugs to meet their primary end points in double-blind clinical trials in patients with systemic lupus erythematosus (SLE) has caused a profound sense of disappointment among both physicians and patients. Arguably, the success of B cell depletion with rituximab in open-label clinical trials, the approval of belimumab (which blocks B cell-activating factor (BAFF)) for use (...) in patients with lupus nephritis in the USA and in difficult-to-treat patients with SLE in the UK and the recognition that clinical trial design can be improved have given some cause for hope. However, changes to therapies in current use and the development of new approaches are urgently needed. The results of the latest studies investigating the use of several new approaches to treating SLE are discussed in this Review, including: fully humanized anti-CD20 and anti-CD19 monoclonal antibodies; inhibition

2019 Nature reviews. Rheumatology

175. A retrospective study of patients with systemic lupus erythematosus combined with Pneumocystis jiroveci pneumonia treated with caspofungin and trimethoprim/sulfamethoxazole. Full Text available with Trip Pro

A retrospective study of patients with systemic lupus erythematosus combined with Pneumocystis jiroveci pneumonia treated with caspofungin and trimethoprim/sulfamethoxazole. Systemic lupus erythematosus (SLE) complicated with Pneumocystis jiroveci pneumonia (PCP) is a clinical complex with unsatisfying treatment efficacy and poor prognosis which is difficult to be diagnosed at early stage. The present study aimed to investigate the clinical features of SLE with PCP, recognize the early onset

2019 Medicine

176. Lack of patient education is risk factor of disease flare in patients with systemic lupus erythematosus in China. Full Text available with Trip Pro

Lack of patient education is risk factor of disease flare in patients with systemic lupus erythematosus in China. To explore the inadequacies of health service and its impact on clinical outcomes of patients with systemic lupus erythematosus (SLE) in China.A total of 210 SLE patients were randomly recruited between January 2017 and January 2018. Each patient received self-report questionnaires to assess medication adherence [Compliance Questionnaire for Rheumatology (CQR)], beliefs about (...) with SIMS, EuroQol five-dimensions [EQ5D], Systemic Lupus International Collaborating Clinics (SLICC), depression, use of NSAID (P ≤ 0.05). Remission of disease was positively correlated with SIMS (OR = 0.16, 95% CI: [0.06, 0.40]), and BMQ (OR = 0.64, 95%CI: [0.43, 0.94]).In this study, the scores of BMQ and SIMS were low, implying defects in the patient education of health service system, which led to disease flare in Chinese SLE patients.ClinicalTrials.gov ID: NCT03024307 . Registered January 18, 2017.

2019 BMC health services research

177. Abnormal Cardiac Biomarkers in Patients with Systemic Lupus Erythematosus and No Prior Heart Disease: The Role of Endomyocardial Biopsy. Full Text available with Trip Pro

Abnormal Cardiac Biomarkers in Patients with Systemic Lupus Erythematosus and No Prior Heart Disease: The Role of Endomyocardial Biopsy. Tselios, et al reported in their recent study that patients with systemic lupus erythematosus (SLE) who receive prolonged antimalarial (AM) treatment are at increased risk for elevated cardiac biomarkers [brain natriuretic peptide (BNP) and high-sensitivity cardiac troponin I (HS-cTnI)], particularly when persistently elevated creatine phosphokinase (CPK

2019 Journal of Rheumatology

178. T cell receptor β repertoires as novel diagnostic markers for systemic lupus erythematosus and rheumatoid arthritis. (Abstract)

T cell receptor β repertoires as novel diagnostic markers for systemic lupus erythematosus and rheumatoid arthritis. T cell receptor (TCR) diversity determines the autoimmune responses in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and is closely associated with autoimmune diseases prognosis and prevention. However, the characteristics of variations in TCR diversity and their clinical significance is still unknown. Large series of patients must be studied in order

2019 Annals of the Rheumatic Diseases

179. Association of Epstein-Barr virus serological reactivation with transitioning to systemic lupus erythematosus in at-risk individuals. Full Text available with Trip Pro

Association of Epstein-Barr virus serological reactivation with transitioning to systemic lupus erythematosus in at-risk individuals. Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with unknown aetiology. Epstein-Barr virus (EBV) is an environmental factor associated with SLE. EBV maintains latency in B cells with frequent reactivation measured by antibodies against viral capsid antigen (VCA) and early antigen (EA). In this study, we determined whether EBV reactivation

2019 Annals of the Rheumatic Diseases

180. Libman-Sacks Endocarditis Involving a Bioprosthesis in the Aortic Valve Position in Systemic Lupus Erythematosus. (Abstract)

Libman-Sacks Endocarditis Involving a Bioprosthesis in the Aortic Valve Position in Systemic Lupus Erythematosus. Described herein is a 39-year-old man with systemic lupus erythematosus not receiving corticosteroid therapy who developed Libman-Sacks endocarditis causing stenosis of a bioprosthesis in the aortic valve position.Copyright © 2019 Elsevier Inc. All rights reserved.

2019 American Journal of Cardiology

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