The famous musician Seal is known for his numerous international hits, and for living with an autoimmune disease: the scars on his face are the result of discoid lupus erythematosus. Picture: C. Grube for Access2music.de, wikimedia
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease with manifold manifestations. SLE belongs to the family of autoimmune disorders, diseases that occur, when a mislead immune system attacks the body’s own structures. SLE can affect almost any organ system, thus its presentation and course are highly variable, and diagnosis and therapy may be challenging.
With the intention to classify SLE patients for research and surveillance studies and to support clinicians in confirming a diagnosis, a set of clinical and laboratory classification criteria has been developed and released by the American College of Rheumatology (ACR). The first classification criteria for SLE were originally published in 1971 [1,2]. They have been updated 1982  and 1997  to incorporate new immunologic knowledge and improve patient classification. In contrast to the 1987 criteria, the 1997 criteria have not been validated.
The most recent addendum to the classification criteria for SLE dates from 2012, when the Systemic Lupus International Collaborating Clinics (SLICC) group published a revision and validation of the ACR criteria .
The long Arm of the Dendritic Cells: The Link between Atherosclerosis and Autoimmune Diseases
Inflammation has been closely linked to autoimmunogenic processes in atherosclerosis. In fact, patients who are suffering from an autoimmune disease have an increased incidence of “hardening of the arteries”, concretely atherosclerosis (the spelling “arteriosclerosis” is also common). In the case of rheumatoid arthritis (RA) the patients have a 30 to 60% higher risk of suffering a heart attack or stroke!
It is an accepted fact: Rheumatoid arthritis patients have a higher risk of suffering a heart attack or stroke. But where is the connection between the two types of disease?
pDCs: the link between atherosclerosis and autoimmunity
Now clinical researchers at Munich Ludwig-Maximilians-University (LMU) have uncovered a mechanism which establishes a causal link between the two types of disease. The immunological process may help to explain the link between autoimmunity and atherosclerosis.
The mechanism described is provided by a specific class of immune cells called plasmacytoid dendritic cells (pDCs). The pDCs respond to DNA released from damaged and dying cells by secreting interferon proteins. The research, which is done in collaboration with scientists from Rudolf Virchow Center at Wuerzburg University, shows that stimulation of pDCs by a specific DNA-protein complex contributes to the progression of atherosclerosis. These findings may have implications for new strategies for the treatment of a whole spectrum of conditions that are associated with chronic inflammatory reactions. (more…)
Celiac disease diagnostics revised
Anti-endomysial antibodies on monkey esophagus
The diagnostic criteria for celiac disease (CD) have remained unchanged for more than 20 years, after the 1990 revision of the guidelines originally formulated in 1969. During this period the disease has been intensively studied and scientific findings have unveiled the genetic background of celiac disease, linked to the human leukocyte antigen (HLA)-DQ2 and HLA-DQ8 haplotypes. The key autoantigen tissue transglutaminase (tTG) has been identified and reliable laboratory tests for disease specific autoantibodies now contribute to diagnostics and complement the methodological repertoire of clinical observations and histologic findings in duodenal biopsy samples. Finally, the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) has now published New Guidelines for the Diagnosis of Celiac Disease.
No matter if it’s rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or multiple sclerosis (MS): most autoimmune diseases affect women significantly more often than men. It is possible that this could be at least partially explained by the occurrence of age-associated B cells (ABCs), as described in an article recently published in Blood, the journal of the American Society of Hematology. (more…)
Found last Week on the Internet, part 1: Up-to-date Articles on Autoimmunity and Autoimmune Diseases
Duroux-Richard I, Jorgensen C, Apparailly F. miRNAs and rheumatoid arthritis – promising novel biomarkers. Swiss Med Wkly. 2011 Mar 18;141:w13175 – doi: 10.4414/smw.2011.13175 – Free full text available! – Today, the most challenging issue in the field of rheumatoid arthritis is the identification of biomarkers for early disease diagnosis and for prediction drug response. micro(mi)-RNAs certainly represent an realistic option for optimal diagnosis an disease treatment.
Roux CH, Breuil V, Valerio L, Amoretti N, Brocq O, Albert C, Grisot C, Allam Y, Chevalier P, Pradier C, Euller-Ziegler L. Etanercept Compared to Intraarticular Corticosteroid Injection in Rheumatoid Arthritis: Double-blind, Randomized Pilot Study. J Rheumatol. 2011 Mar 16. [Epub ahead of print]. – Patients with rheumatoid arthritis who had persistent (more…)
Our Point-of-Care-Test rheumachec for Diagnosing Rheumatoid Arthritis – a Highly Accessed Research Article in Arthritis Research & Therapy!
Several days ago, a colleague pointed out to me a publication in the journal Arthritis Research & Therapy that came about largely through collaboration with scientists at ORGENTEC Diagnostika. Needless to say that this article was already familiar to me – already before its initial online publication in the summer of this year, I had read excerpts from it and extensively discussed the work and the results of this evaluation study with co-workers and clients. (more…)
Rheumatism affects more than just the joints: the heart and circulatory system are also at risk!The knowledge gradually sinks in, even for patients: inflammatory rheumatic diseases like rheumatoid arthritis (RA) not only damage the joints, but also the blood vessels. Patients with rheumatism thus have an increased risk of suffering a heart attack or stroke.
Why is this the case? Rheumatoid arthritis (RA) not only causes inflammation of the musculoskeletal system; it also affects the walls of blood vessels. In addition, RA patients have an increased incidence of hardening of the arteries, arteriosclerosis. “These patients have a 30 to 60 % higher risk of suffering a heart attack or stroke.”
These figures are given by Professor Dr. med. Jürgen Braun, Medical Director of the Ruhr Centre for Rheumatism in Herne, Germany (Rheumazentrum Ruhrgebiet). (These figures and excerpts, and those that follow, were published by the German Society of Rheumatology- Deutsche Gesellschaft für Rheumatologie, DGRh, in the run-up to the 38th Congress of the DGRh (38. Kongress der Deutschen Gesellschaft für Rheumatologie e.V.), which is currently underway in Hamburg.) Prof. Jürgen Braun adds, “The danger increases further when patients have elevated lipid levels, high blood pressure or diabetes, or are overweight.” (more…)
Is the Incidence of Rheumatoid Arthritis Rising?
Is rheumatoid arthritis (RA) actually on the rise? Researchers from the Mayo Clinic in Minnesota say “yes”, and they presented data from a study, published in the June issue of the Arthritis & Rheumatism magazine – even though the authors themselves can only speculate about the reasons why.
Rheumatoid arthritis is on the rise, they found – is increased use of some lower dose birth control pills a factor?
In that recently published Rheumatoid Arthritis Clinical Study Elena Myasoedova, Cynthia S. Crowson, Hilal Maradit Kremers, Terry M. Therneau, and Sherine E. Gabriel from the Mayo Clinic College of Medicine, Rochester, Minnesota, expanded a previous research from 1955 to 1994, looking at the years 1995 to 2007. To augment the pre-existing study they now focused on the medical records of more than 1,700 residents of Olmstedt County, Minnesota, aged 18 years or older, who had received at least one diagnosis of rheumatoid arthritis (RA).
Yes, RA is on the rise!
What did they find out? – From 1955 to 1994, the incidence of rheumatoid arthritis had continually been on the decline. That apparently changed beginning in the mid-1990s. When the researchers analyzed patient data from early 1995 to the start of 2005, they found that both the incidence and the prevalence of the condition were rising. (more…)
How Bones and the Immune System Do Communicate
The term osteoimmunology was first used about 10 years ago by Joseph R. Arron and Yongwon Choi in their article Osteoimmunology: Bone Versus Immune System in Nature. Since then, a number of articles have appeared in the scientific literature with this term in their title. A Wikipedia article on the subject has also been available since July 2007, though it is only in English and is not (yet) very comprehensive.
There have also been occasional conferences that explicitly included osteoimmunology, for example the 3rd International Conference on Osteoimmunology: Interactions of Immune and Skeletal Systems coming up end of this month in Greece (20-25 June, 2010). In addition, the Deutsche Forschungsgemeinschaft (DFG) has initiated a new area of concentration called Immunobone, in order to promote this area of research and to facilitate networking between the various research groups and numerous different studies. (more…)