tbuckley/cabot-search huggingface dataset:
THU0136 NESFATIN-1 expression is associated with reduced atherosclerotic disease risk in patients with rheumatoid arthritis
Authors: C Robinson, L Tsang, A Solomon, A Woodiwiss, S Gunter, H-C Hsu, G Norton, A Millen, P Dessein
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Nesfatin-1 comprises a peptide that is involved in appetite suppression, energy homeostasis and fluid regulation, and was recently documented to participate in a range of cardiometabolic pathways (1,2). There is currently a need for the identification of novel biomarkers in the elucidation of CVD risk and its stratification in persons with rheumatoid arthritis (RA). The role of nesfatin-1 in cardiovascular disease risk among RA patients is uncertain. <h3>Objectives</h3> We investigated the potential impact of nesfatin-1 on subclinical cardiovascular disease manifestations in patients with RA by determining the associations of nesfatin-1 concentrations with atherosclerosis and circulating levels of matrix metalloproteinase (MMP)-2 that mediates plaque stability and those of MMP-3 and MMP-9 that cause plaque vulnerability. <h3>Methods</h3> Nesfatin-1 concentrations were measured in 236 (114 black; 122 white) RA patients. Relationships of nesfatin-1 concentrations with ultrasound determined carotid intima-media thickness (cIMT) and plaque and MMP levels were identified in confounder adjusted multivariate regression models. <h3>Results</h3> Nesfatin-1 concentrations were inversely associated with c-IMT (β (SE) = -0.022 (0.008), p=0.00) and directly with MMP-2 levels (β (SE) =0.117 (0.031), p=0.00). After adjustment for conventional risk factors and RA characteristics, these associations persisted (c-IMT: β (SE) = -0.017 (0.008), p=0.04; MMP-2: β (SE) =0.116 (0.033), p=0.00). Patient characteristics did not influence the nesfatin-1-to-cIMT relation (interaction p≥0.7). By contrast, the Disease Activity Score in 28 joints (DAS28) and Clinical Disease Activity Index impacted the nesfatin-1-to-cIMT association (interaction p=0.04 and 0.02, respectively). Nevertheless, in stratified analysis, nesfatin-1 concentrations were related to those of MMP-2 in patients with no or mild (β (SE) =0.148 (0.054), p=0.00) and moderate or high disease activity (β (SE) =0.086 (0.041), p=0.04) as determined by DAS28 (cut-off value 3.6) as well as by CDAI (cut-off value =10) (β (SE) =0.130 (0.048), p=0.00 and 0.107 (0.046), p=0.02), respectively). <h3>Conclusions</h3> Nesfatin-1 concentrations are consistently associated with a reduced atherosclerosis burden and increased MMP-2 levels in patients with RA. <h3>References</h3> Oh-I S, Shimizu H. Identification of nesfatin-1 as a satiety molecule in the hypothalamus. Nature. 2006;443:709–712. Dore R, Levata L, Lehnert H, Schulz C. Nesfatin-1: functions and physiology of a novel regulatory peptide. Journal of Endocrinology. 2016; e-pub ahead of print: doi: 10.1530/JOE-16–0361. <h3>Disclosure of Interest</h3> None declared
SAT0034 Analysis of the t-cell subset composition in ankylosing spondylitis patients with long-standing anti-tnf therapy
Authors: S Dulic, Z Vásárhelyi, A Bajnok, B Szalay, G Toldi, L Kovács, A Balog
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Ankylosing spondylitis (AS) is a chronic, progressive, immune-mediated inflammatory disease, driven primarily by Th1 and Th17 cells. Anti-TNF therapies are successfully used in AS to achieve and maintain remission. However, their influence on the composition of the T-cell repertoire is not clear, and, in particular, the few published studies involve mostly patients with anti-TNF treatment of short duration. <h3>Objectives</h3> We aimed to characterize the changes in several T cell subsets after long-term anti-TNF treatment in AS patients. <h3>Methods</h3> Twenty-two AS patients on long-term anti-TNF therapy were evaluated (15 anti-TNF-responders and 7 non-responders). A wide range of cell subtypes were analysed with flow cytometry and compared with therapy-naïve and short-term data. <h3>Results</h3> Key findings include decreased proportions of naive CD4 and CD8 cells, increased frequencies of Th1 and Th17 cells and higher Th1/Th2 and Th17/Treg ratios in the long-term anti-TNF-treated patients (responders, non-responders and total), which was found to be significant not only when compared with healthy controls, but also with therapy-naive and short-term anti-TNF-treated AS patients. We have found several alterations within the various activated T-cell subsets – increase in CD4HLADR cells in responders, in CD8HLADR cells in the whole AS group and in responders, and in CD4CD25 cells in responders, and decrease in CD4CD69 cell percentages in long-term treated patients – becoming evident only after long-term anti-TNF-therapy. <h3>Conclusions</h3> This study provides a comprehensive assessment of the impact of anti-TNF therapy on the T cell repertoire in AS, and indicate that these therapies induce profound changes within T-cells. Changes in T cell phenotype seem to develop progressively during therapy, even in inactive disease, and reflect an ongoing effector T-cell differentiation and activation, and a normalization of Treg development. <h3>Disclosure of Interest</h3> None declared
AB1133 High consumption of seafoods or vegetables negatively correlates with disease activity of rheumatoid arthritis
Authors: I Murakami, K Murakami, M Hashimoto, M Torii, K Ikeda, A Kuwabara, K Tanaka, A Yoshida, T Usui, N Kuramoto, R Nakashima, Y Imura, H Yoshifuji, M Tanaka, K Ohmura, T Mimori
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Food intake is one of the important environmental factors of various diseases, and possibly influences the pathogenesis of RA. However, we have little knowledge about the impact of food intake on the pathogenesis of RA. Because each country has its own food culture, the study focused on the dietary habit in Japan is essential in order to clarify the clinical impact of food intake in Japanese RA patients. <h3>Objectives</h3> The aim of this study is to clarify the relationship between the dietary habit of RA patients and their disease status. <h3>Methods</h3> We took the questionnaire survey about dietary habit in 2015, in KURAMA (Kyoto University Rheumatoid Arthritis Management Alliance) cohort as single institute. Disease activity was also examined in this cohort. These data were combined and statistically analyzed. <h3>Results</h3> 563 RA patients were enrolled from KURAMA cohort; female: male 4:1, age 63 years old, disease duration 15.5 years, DAS28-ESR 2.8 on average. Multivariate analysis showed that the intake frequency of vegetables had statistically significant negative correlation with DAS28-ESR (β=−0.17, p&lt;0.01), SDAI (β=−0.15, p&lt;0.01), HAQ (β=−0.15, p&lt;0.01) and MMP-3 (β=−0.13, p&lt;0.01). The intake frequency of frozen foods had positive correlation with MMP-3 (β=0.12,p&lt;0.01). The intake frequency of juice had positive correlation with DAS28-ESR (β=0.11,p&lt;0.01) and SDAI (β=0.11,p&lt;0.01). Factor analysis revealed five dietary patterns, which were labeled "seafoods", "meat and fried foods", "vegetables and fruits", "snacks" and "processed foods". The "seafoods" had statistically significant negative correlation with DAS28-ESR (β=−0.10, p=0.027), SDAI (β=−0.11, p=0.015), HAQ (β=−0.11, p=0.015) and MMP-3 (β=−0.11, p=0.013). The "vegetables and fruits" had also statistically significant negative correlation with DAS28-ESR (β=−0.13, p&lt;0.01), SDAI (β=−0.14, p=0.015), HAQ (β=−0.17, p&lt;0.001) and MMP-3 (β=−0.14, p&lt;0.01). <h3>Conclusions</h3> This study implicates that the disease activity of RA may be alleviated by high consumption of vegetables and fruits, or seafoods. <h3>Disclosure of Interest</h3> None declared
Early antenatal care visit: a systematic analysis of regional and global levels and trends of coverage from 1990 to 2013
Authors: Ann-Beth Moller, Max Petzold, Doris Chou, Lale Say
Journal: The Lancet Global Health (2017)

The timing of the first antenatal care visit is paramount for ensuring optimal health outcomes for women and children, and it is recommended that all pregnant women initiate antenatal care in the first trimester of pregnancy (early antenatal care visit). Systematic global analysis of early antenatal care visits has not been done previously. This study reports on regional and global estimates of the coverage of early antenatal care visits from 1990 to 2013.Data were obtained from nationally representative surveys and national health information systems. Estimates of coverage of early antenatal care visits were generated with linear regression analysis and based on 516 logit-transformed observations from 132 countries. The model accounted for differences by data sources in reporting the cutoff for the early antenatal care visit.The estimated worldwide coverage of early antenatal care visits increased from 40·9% (95% uncertainty interval [UI] 34·6-46·7) in 1990 to 58·6% (52·1-64·3) in 2013, corresponding to a 43·3% increase. Overall coverage in the developing regions was 48·1% (95% UI 43·4-52·4) in 2013 compared with 84·8% (81·6-87·7) in the developed regions. In 2013, the estimated coverage of early antenatal care visits was 24·0% (95% UI 21·7-26·5) in low-income countries compared with 81·9% (76·5-87·1) in high-income countries.Progress in the coverage of early antenatal care visits has been achieved but coverage is still far from universal. Substantial inequity exists in coverage both within regions and between income groups. The absence of data in many countries is of concern and efforts should be made to collect and report coverage of early antenatal care visits to enable better monitoring and evaluation.Department of Reproductive Health and Research, WHO and UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction.
Erratum: KLHL3 mutations cause familial hyperkalemic hypertension by impairing ion transport in the distal nephron
Authors: Hélène Louis-Dit-Picard, Julien Barc, Daniel Trujillano, Stéphanie Miserey-Lenkei, Nabila Bouatia-Naji, Olena Pylypenko, Geneviève Beaurain, Amélie Bonnefond, Olivier Sand, Christophe Simian, Emmanuelle Vidal-Petiot, Christelle Soukaseum, Chantal Mandet, Françoise Broux, Olivier Chabre, Michel Delahousse, Vincent Esnault, Béatrice Fiquet, Pascal Houillier, Corinne Isnard Bagnis, Jens Koenig, Martin Konrad, Paul Landais, Chebel Mourani, Patrick Niaudet, Vincent Probst, Christel Thauvin, Robert J Unwin, Steven D Soroka, Georg Ehret, Stephan Ossowski, Mark Caulfield, Patrick Bruneval, Xavier Estivill, Philippe Froguel, Juliette Hadchouel, Jean-Jacques Schott, Xavier Jeunemaitre
Journal: Nature Genetics (2012)
AB0025 Pregnancy results in the selective modulation of platelet tissue factor expression independently of the presence of antiphospholipid antibodies or of other autoimmune features
Authors: V Canti, MT Castiglioni, M Angelo A, P Rovere-Querini, N Maugeri
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Neutrophils and platelets are key innate immune cells that productively interact upon activation, generating/releasing moieties that can damage the bystander tissue and prompt vasculogenesis. Successful pregnancy critically depends on a tight regulation of the latter events. Conversely pregnancy complications are associated with alteration/damage of the vasculature associated to the placenta. Blood-born tissue factor (TF) due to the expression of the moiety by platelets and leukocytes has been involved in the pro-thrombotic diathesis associated with sustained human autoimmunity, including that associated with anti-phospholipid syndrome (APS). <h3>Objectives</h3> To test the modulation of parameters related to blood-born TF during normal and pathological pregnancy <h3>Methods</h3> The expression of TF by platelets, monocytes and neutrophils has been studied in 40 women at the 12th week of gestation (wg) including twelve healthy women, 14 patients with insulin-dependent diabetes mellitus (IDDM) and 14 patients with a previous history of pregnancy complications, six of them with APS. 30 healthy age-matched non-pregnant women served as controls. When possible, patients were studied again at least one year after the pregnancy completion. Blood samples were collected and processed as described<sup>1,2</sup>. Other features reflecting cell activation were assessed in parallel<sup>1,2</sup>. <h3>Results</h3> The expression of platelet TF was significantly higher in pregnant women compared with age-matched controls. Platelet P-selectin was as well significantly up-regulated. Neutrophils circulating in all pregnant women were mildly degranulated. The content of the neutrophil secondary granules was depleted in particular in subiects with previous pregnancy complications <i>sine causa</i>. <h3>Conclusions</h3> Our data support the contention that the activation of the innate immune system is a key feature of pregnancy, regardless of the presence of features of systemic or organ-specific autoimmunity. This implies an important modulation of the machinery involved in the reciprocal activation of platelets and neutrophils and in the pro-thrombotic phenotype of circulating cells. The analysis of the potential modulation of these parameters by ongoing treatment is currently being carried out. <h3>References</h3> Manfredi A &amp; al. Ann Rheum Dis. 2016;75(8):1511–20. doi: 10.1136/annrheumdis-2015-208442. Maugeri N et al. Blood. 2011 Sep 22;118(12):3359–66. doi: 10.1182/blood-2011-02-337337. <h3>Disclosure of Interest</h3> None declared
THU0296 The role of ultrasound in the management of giant cell arteritis (GCA) in routine clinical practice
Authors: S Monti, A Floris, C Ponte, S Vaggers, WA Schmidt, AP Diamantopoulos, C Pereira, R Luqmani
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Colour Doppler sonography (CDS) is an emerging diagnostic tool for giant cell arteritis (GCA), however, its use in routine practice is still not widespread. <h3>Objectives</h3> To develop a protocol using CDS and explore its value in the routine care of patients with GCA. <h3>Methods</h3> We developed a structured scanning protocol for CDS of temporal and axillary arteries (total of 8 anatomical sites scanned per patient) based on previously published methods. We tested the protocol on consecutive patients referred to a single rheumatology centre, with suspected or established GCA, between July 2014 and September 2016. We defined a positive scan by the presence of halo in at least one branch of a temporal artery (TA) or one axillary artery (AX). We report data from the first 293 consecutively scanned cases. <h3>Results</h3> We assessed 293 patients (mean age 72±10, female/male 196/97), of whom 118 had clinically confirmed GCA. Amongst new referrals with confirmed diagnosis of GCA, 44% had a positive scan; two patients with a positive scan did not have GCA. 82% of new referrals patients showed exclusive TA involvement, 25% concomitant AX, and 4% exclusive AX involvement. High-dose glucocorticoid therapy had already been started in 78% of these patients for an average of 17±33 days. Amongst this group, the sensitivity of CDS was 46% (95% IC 37%&gt;55%), specificity 98% (95% CI 93%&gt;99.8%), positive predictive value 96% (88%&gt;99.6%), and negative predictive value 60% (95% IC 52%&gt;68%). During the period of observation, the rate of temporal artery biopsies (TAB) decreased significantly from 42% to 25% (p=0.002). During follow up, CDS was positive in 21% of 89 routine scans in asymptomatic individuals, compared to 58% in patients with confirmed clinical flares (45% of whom had negative inflammatory markers). Over time, the number of halos per patient reduced; only new or flaring patients showed a halo in &gt;4 sites. Halo size at the TA did not change significantly (average thickness 0.6±0.1 mm), however, the size of AX artery halos significantly reduced from first referral (1.6±0.4 mm) to follow up (1.4±0.2, p=0.01) or during subsequent flares (1.4±0.2, p=0.02). <h3>Conclusions</h3> We have developed and tested a standardised methodology for CDS evaluation of GCA. CDS provides a high positive predictive value for a diagnosis of GCA in unselected patients from routine clinical practice, although prior high dose glucocorticoid therapy is likely to reduce its sensitivity. CDS allows for a significant reduction of TAB. We explored the role of CDS to detect disease flares and demonstrated a significant reduction in the extent of abnormalities, and of the size of halo of the AX arteries during follow up or flares. These findings could have a significant impact on the management of patients with suspected and confirmed GCA. <h3>Disclosure of Interest</h3> None declared
Infantile-Onset Fever and Urticaria
Authors: Sukesh Sukumaran, Vini Vijayan
Journal: JAMA Pediatrics (2017)

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SAT0629 Electrodiagnostic vs ultrasonography: which one is better to confirm diagnosis of ulnar neuropathy at elbow?
Authors: SM Rayegani, E Loni, SA Raeissadat, E Kargozar, S Rahimi Dehgolan
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Ulnar neuropathy at the elbow is the second most common compression neuropathy preceded by carpal tunnel syndrome. Although this diagnosis has been traditionally confirmed by electrodiagnosis (EDX), ultrasonography (US) is a re-emerging alternative method which can also evaluate the cubital zone anatomy. This study determines the maximum amount of US sensitivity and specificity by assessing different sonographic parameters and evaluates consistency and diagnostic value of the best US method in compare with EDX. <h3>Methods</h3> We included 66 participants (32 elbows of patient and 34 normal elbows) and performed physical exam, US and EDX for both groups. Patients were classified into four severity grades using EDX criteria. The parameters of US were cross sectional area (CSA) of ulnar nerve at three levels: medial epicondyle (CSA med), 2cm distal (CSA dist) and 2cm proximal (CSA prox) to medial epicondyle. Then we would be able to evaluate consistency between two tests using area under receiver operating curve (AU-ROC) method and also to determine the optimum CSA cut-off point to better diagnosis of ulnar neuropathy by US. <h3>Results</h3> Our findings showed that CSA med and CSA dist had significantly larger size in patients compared to normal participants (P-value =0.01 and 0.05, respectively). This increase in nerve size was more prominent among those who had axonal lesion rather than patients with demyelinated lesion (p-value &lt;0.01). Moreover those who had longer duration of symptoms had significantly higher CSA med. and CSA dist. (p-value=0.015 and 0.001 respectively). The other promising findings were two important points; First a strong correlation between CSA med. and severity grade (p-value=0.034) and the second correlation was between CSA med and CSA dist. with a cross-elbow nerve conduction velocity (NCV) (p-value=0.01 and 0.02, respectively). Finally we assessed US diagnostic value as it showed AU-ROC =0.871, that means a very good coverage for an alternative diagnostic method. Also our results showed specificity of 80% and sensitivity of 84% for US in the CSA med cut-off point =9mm<sup>2</sup> for diagnosis of ulnar nerve entrapment at elbow. <h3>Conclusions</h3> Based on these results we can conclude that US is a highly sensitive and specific method to diagnose ulnar neuropathy at elbow and can be used as an alternative and complementary method in diagnosis of ulnar neuropathy at elbow in particular when EDX is not available. However it could not be still a definitive and substitute mutually exclusive method to EDX in diagnosis of ulnar neuropathy <h3>Acknowledgements</h3> <h3>Disclosure of Interest</h3> None declared
AB0608 Predictive factors for long-term survival and disease progression of systemic sclerosis – a longitudinal analysis
Authors: AM Gheorghiu, A Radu, R Oneata, A Soare, R Dobrota, S Magda, T Constantinescu, R Jurcut, R Sfrenţ-Cornăţeanu, M Bojincă, V Stoica, C Mihai
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Systemic sclerosis (ScS) has unpredictable course and high mortality. Generalised Estimating Equations (GEE) is a technique useful for longitudinal data analysis, using data from all time points and adjusting for within-patient correlation,i.e. correlation between time points within the same patient. GEE does not require a normal distribution of dependent variables, making it attractive for analyzing SSc data. <h3>Objectives</h3> To identify predictive factors for death and unfavorable outcomes. <h3>Methods</h3> Data of SSc patients with ≥2 visits in our EUSTAR centre in 2004–2016 were analyzed. GEE investigated the relationship over time between outcomes (death, digital ulcers (DUs), forced vital capacity (FVC), modified Rodnan skin score (mRSS)) and potential predictors (age, gender, disease duration, cutaneous subset, mRSS at baseline, DUs history, DLCO, left ventricle ejection fraction (LVEF), proteinuria), separately for each predictor and in combined models. <h3>Results</h3> 89 patients (12.4%males, mean±SD age 49.2±12.2years, disease duration 4.1±7.5years) were included, with a follow-up of up to 13years. There were 14deaths, most due to lung involvement (7/14). In multivariable GEE analysis (Table 1), predictors of death were a shorter disease duration, DUs history, and a lower LVEF. Predictors for FVC decrease over time were difuse cutaneous subset (dcSSc), younger age and lower DLCO. Younger age, shorter disease duration and higher baseline mRSS were the most important predictors for higher mRSS at follow-up. The only predictor for the development of new DUs was a history of DUs. <h3>Conclusions</h3> Patients with shorter disease duration, dcSSc, higher mRSS, lower DLCO and LVEF and a history of DUs had a more unfavorable course. GEE is a robust technique for longitudinal data analysis, excellent for identifying prediction factors in SSc. <h3>Acknowledgements</h3> <i>This abstract is part of the QUANTICAP project, UEFIS-CDI PN-II- PT-PCCA-2013–4-1589 grant.</i> <h3>Disclosure of Interest</h3> None declared