tbuckley/cabot-search huggingface dataset:
SAT0252 The number of treg cells in peripheral blood in pss patients is decreased and low dose IL-2 can promote its proliferation
Authors: M Miao, Z Hao, Y Guo, X Zhang, S Zhang, X Wu, D Xu, C Gao, X Li
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> PSS is a kind of autoimmune disease without clear pathogenesis. Treg cell plays an important role in autoimmune disease. However, opinions about change of amount of Treg cells in peripheral blood in autoimmune disease are various. Besides, the researches mainly focus on RA and SLE but not PSS. <h3>Objectives</h3> To explore the change of the number of Th17 and Treg (CD4+CD25+Foxp3+T cells) cells in peripheral blood in PSS and the effects of low dose IL-2 therapy on the balance of Treg and Th17 cells. <h3>Methods</h3> One hundred and ninety two PSS patients in our department, and 30 healthy controls were put in the research. The amount of Th17 cells and Treg cells were calculated by flow cytometry. Eighty eight in 192 were given low-dose IL-2 (50 WIU/day for 5 days) by hypodermic injection combined with standard therapy which includes glucocorticoid, immune-suppressants, biological agents or combination of them, while others (12 in 69) were given standard therapy only. The amount of these cells were calculated again after therapy. <h3>Results</h3> There was significant decrease in the absolute number of Treg cells and significant increase of the ratio of Th17/Treg cells in PSS patients when compared with healthy controls. There was no significant difference in absolute number of Th17 cells between PSS patients and healthy controls. Further, the number of Treg cells were negatively relative to ESSDAI. Traditional DMARDs had no obvious impact on Treg and Th17 cells. The amount of Treg cells significantly increased after the treatment of IL-2 by 1 week. But there was no significant improvement in clinical manifestations in the short time when comparing combinational treatment of IL-2 and classical drugs with classical therapy. No obvious adverse reactions were observed. <h3>Conclusions</h3> The number of CD4+CD25+Foxp3+T cells in peripheral blood was decreased obviously and was inversely related to ESSDAI. While there was no significant difference of Th17 cells between PSS patients and healthy controls. And there was no correlation between the number of Th17 cells and ESSDAI. So the imbalance of Th17/Treg is due to the decrease of Treg cells not increase of Th17 cell which indicates that the pathogenesis of PSS maybe mainly because of shortage of autoimmune tolerance. Low dose IL-2 therapy can effectively promote proliferation of Treg cells by which low dose IL-2 may induce and restore autoimmune tolerance to benefit disease control. <h3>References</h3> Takayoshi Morita et al. The Proportion of Regulatory T Cells in Patients with Rheumatoid Arthritis: A Meta-Analysis. PLoS One. 2016 Sep 13. Noack, M. &amp; Miossec, P. Th17 and regulatory T cell balance in autoimmune and inflammatory diseases. Autoimmun Rev. 13, 668–677 (2014). <h3>Disclosure of Interest</h3> None declared
SP0077 How to evaluate joints in juvenile idiopathic arthritis (JIA)
Authors: J Vojinovic
Journal: Annals of the Rheumatic Diseases (2017)

Ultrasound (US) has numerous advantages when used to examine joints in children compared to other imaging modalities. This include non-invasiveness, rapidity of performance, easy repeatability, high patient acceptability and lack of exposure to ionizing radiation. In addition, it does not require sedation for scanning in younger children. US is more sensitive than physical examination and may detect early disease that is not evident on physical examination. Lack of standardized precise definitions of grey scale (GS) and Power Doppler (PD) US findings in different age groups was the biggest limitation for its use. Additional difficulty is age dependent variability of normal sonoanatomy, due to maturation and ossification in children. That is why acquisition, interpretation and comparison of US images are completely different than in adults and had to be addressed specifically. All this may affect the validity of the technique, and without defined standardized examination technique, US can be a challenge in the childhood population. On the other hand, US as an imaging technique is considered to be examiner and equipment dependent. Studies resulting in good intra and inter-reader reliability and validity, based on specific definitions, are essential for its application as a diagnostic tool. Recently developed standardized image acquisition methodology, definitions of joint components in healthy children, as well as, definitions for synovitis components and its grading in GS and PD in children will be presented in details. US allow precise and thorough visualization of inflammatory and destructive joint abnormalities, including synovial hyperplasia, joint effusion, cartilage damage, bone erosion, tenosynovitis and enthesopathy. In JIA ultrasound is considered particularly useful for its ability to detect subclinical synovitis and improve classification of JIA patients into the subtypes. Current evidences about application of ultrasound in JIA can improve definition of remission necessary to optimize treatment strategies. Due to peculiarities of US examination and image acquisition in children additional educational efforts among pediatric rheumatologists are required for expanding this imaging modality in daily practice. <h3>Disclosure of Interest</h3> None declared
THU0286 Recurrence of arterial and venous thromboses in primary antiphospholipid syndrome
Authors: G Balbi, F Signorelli, RA Levy
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Antiphospholipid syndrome (APS) is the thrombophilia associated with the highest risk of recurrence of both arterial and venous thromboses. (1,2) In addition to the standard of care (lifelong oral anticoagulation), identification of other risk factors is important to provide better care and to reduce the incidence of rethrombosis. <h3>Objectives</h3> To investigate the risk factors associated with recurrence of arterial and venous thromboses in primary APS patients. <h3>Methods</h3> A cross-sectional study was performed in a group of 80 outpatients who fulfilled APS classification criteria (Sydney). The patients were regularly seen in our department, and clinical and serological features were collected during visits and by chart review. They were classified as recurrent or not, and these groups were compared. Recurrence was defined as the presence of 2 or more thrombotic events during lifetime. Patients with 1 thrombotic event were classified as "no recurrent". No history of thrombosis was the only exclusion criteria. <h3>Results</h3> Of 80 pAPS patients, thirty-five had arterial thrombosis and 54 had venous thrombosis. Of them, thirty-six had recurrent thromboses (11 arterial and 25 venous). Demographic and clinical characteristics of the arterial group are shown in Table 1. In a bivariate analysis, recurrent arterial thromboses were associated with hypertension (p=0.016) and positivity to lupus anticoagulant (LA; p=0.033), and recurrent venous thrombosis correlated to obesity (BMI≥30 kg/m<sup>2</sup>; p=0.003). In a multivariate regression analysis, the model of recurrent arterial thromboses was adjusted to age, sex, and variables with p&lt;0.10 in the bivariate analysis (age, hypertension, dyslipidemia, and positivity to lupus anticoagulant). Hypertension (OR 9.02; CI95% 1.05–77.5; p=0.045) and age (OR 1.16; CI95% 1.01–1.33; p=0.035) increased the risk of relapse of arterial thrombosis. <h3>Conclusions</h3> This data suggests that hypertension, a traditional cardiovascular risk factor, is associated with increased risk of recurrent thrombosis and, therefore, should be controlled in pAPS patients. Besides, each additional year of age is associated with the risk of 16% of a new arterial thrombotic event. <h3>References</h3> R. Cervera, M.A. Khamashta, Y. Shoenfeld, et al., Morbidity and mortality in the antiphospholipid syndrome during a 5-year period: a multicentre prospective study of 1000 patients, Ann. Rheum. Dis. 68 (2009) 1428–1432. M. Turiel, P. Sarzi-Puttini, R. Peretti, et al., Thrombotic risk factors in primary antiphospholipid syndrome: a 5-year prospective study, Stroke 36 (2005) 1490–1494. <h3>Disclosure of Interest</h3> None declared
GPs earned an average of £90 100 in 2015-16
Authors: Tom Moberly
Journal: BMJ (2017)

GPs in the UK earned £90 100 (€100 000; $120 000) on average in 2015-16, figures from NHS Digital show.1

This represents a 1.2% decrease on 2014-15, when GPs earned an average of £91 200. This figure is for the average taxable income for contractor and salaried GPs working in practices with …
SAT0441 Comparison of different remission targets in patients with psoriatic arthritis and evaluation of their prognostic value
Authors: LC Coates, L Aikman, A Szumski, A Chhabra
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Psoriatic arthritis (PsA) is a complex form of arthritis that develops in people with psoriasis. There is no agreement on the optimal criteria to identify remission in patients with PsA and some of them may miss skin lesions. <h3>Objectives</h3> To investigate the merits of different potential remission definitions using data from the PRESTA study.<sup>1</sup> <h3>Methods</h3> Remission was investigated for disease activity index for PsA for 3 definitions: very low disease activity (VLDA), Disease Activity in PsA (DAPSA), and clinical (c)DAPSA. VLDA index was defined as 7/7 met criteria of the minimal disease activity (MDA) cut-off points: tender joint count (TJC) ≤1, swollen joint count (SJC) ≤1, psoriasis activity and severity index (PASI) ≤1, patient global visual analog scale (Pt VAS) ≤20mm, Pt pain VAS ≤15mm, health assessment questionnaire (HAQ) ≤0.5, tender entheseal points ≤1. DAPSA remission was defined as DAPSA ≤4 (TJC, SJC, physician global VAS [cm], Pt VAS [cm], C-reactive protein [CRP]) and cDAPSA remission was defined as cDAPSA ≤4 (DAPSA without CRP). <h3>Results</h3> At Week 24, the proportion of patients achieving remission was 9.6%, 31.0%, and 34.7% for VLDA, DAPSA, and cDAPSA remission, respectively. Discordance between VLDA and DAPSA or cDAPSA remission was 21.7% or 25.1%, respectively. Only 0.2% of the patients that achieved VLDA did not achieve DAPSA remission and 21.5% vice versa (Kappa coefficient 0.38) and 0.0% in the case of cDAPSA remission and 25.1% vice versa (Kappa coefficient 0.33). At the end of the study, residual levels of dactylitis and enthesitis appeared to be similar among all definitions (all ≤3.0%); however, patients achieving DAPSA and cDAPSA remission had higher proportions of patients with PASI &gt;1 than patients achieving VLDA remission (PASI 2–9: VLDA 0.0% vs DAPSA 46.4% vs cDAPSA 47.2%; PASI ≥10: VLDA 0.0% vs DAPSA 5.8% vs cDAPSA 6.4%). Raised CRP values (upper limit of normal &gt;8.99) were 7.8%, 4.8%, and 7.3% for VLDA, DAPSA, and cDAPSA, respectively. <h3>Conclusions</h3> VLDA remission is a more stringent target than DAPSA and cDAPSA remission, with the advantage of including a measurement for psoriasis. Therefore, VLDA is more useful than DAPSA or cDAPSA in assessing a remission state in patients with PsA and extended skin lesions. Measurement of CRP levels does not appear to provide further information on current disease activity level in these patients and exclusion of this laboratory marker should facilitate remission assessment in clinical practice. <h3>References</h3> Sterry W, et al. BMJ 2010;340:c147. <h3>Disclosure of Interest</h3> L. Coates Grant/research support from: Abbvie, Janssen, Consultant for: Abbvie, BMS, Janssen, Lilly, MSD, Novartis, Pfizer, L. Aikman Shareholder of: Pfizer, Employee of: Pfizer, A. Szumski Employee of: InVentiv Health, A. Chhabra Shareholder of: Pfizer, Employee of: Pfizer
Comparative Effectiveness of Ultrasonography, 99mTc-Sestamibi, and 18F-Fluorocholine PET/CT in Detecting Parathyroid Adenomas in Patients With Primary Hyperparathyroidism
Authors: NTK Thanseer, Sanjay Kumar Bhadada, Ashwani Sood, Bhagwant Rai Mittal, Arunanshu Behera, Arun Kumar Reddy Gorla, Renjith R. Kalathoorakathu, Priyanka Singh, Divya Dahiya, Uma Nahar Saikia, Sudhaker D. Rao
Journal: Clinical Nuclear Medicine (2017)

Purpose Accurate preoperative localization of parathyroid lesion(s) is crucial for successful surgical management of primary hyperparathyroidism (PHPT). This study was conducted to compare the effectiveness of ultrasonography (USG) of the neck, 99m Tc-sestamibi (MIBI) imaging with or without SPECT/CT, and 18 F-fluorocholine (FCH) PET/CT imaging in the preoperative localization of parathyroid lesions in patients with PHPT. Methods Fifty-four consecutive patients with PHPT were included in this prospective study who underwent preoperative localization of the parathyroid lesion(s) using 3 diagnostic modalities followed by surgery. The sensitivity, positive predictive value, and accuracy of the 3 imaging procedures to accurately detect abnormal parathyroid glands were determined using histopathology as criterion standard with postoperative biochemical response confirmation. Results 18 F-fluorocholine PET/CT detected 52 of 54 patients and 52 of 56 lesions with histopathologically proven parathyroid adenomas on patient-based and lesion-based analysis, respectively. Preoperative USG, MIBI, and FCH PET/CT localized abnormal parathyroid gland(s) in 39 (72.2%), 43 (79.6%), and 54 (100%) patients, respectively. The sensitivity and positive predictive value were 69.3% and 87.1% for USG, 80.7% and 97.6% for MIBI, and 100% and 96.3% for FCH PET/CT. The accuracy was 62.9%, 79.6%, and 96.3% for USG, MIBI, and FCH PET/CT, respectively, in patient-wise analysis. In 6 patients with ectopic lesions, FCH PET/CT demonstrated higher sensitivity and accuracy than MIBI and USG (100% vs 66.6% and 16.7%, respectively). Conclusions Among the 3 imaging techniques tested simultaneously, FCH PET/CT was superior for accurate preoperative localization of parathyroid adenomas, especially for ectopic or small parathyroid lesions.
SAT0491 Use of histamine h1-receptor antagonists is associated with decreased prevalence of radiographic knee osteoarthritis: a cross-sectional analysis of osteoarthritis initiative data
Authors: I Shirinsky, V Shirinsky
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Mast cells are prevalent in osteoarthritis (OA) synovial tissue and their presence is associated with structural damage [1]. H1-receptor antagonists block the action of histamine, which is the major mediator of mast cells, on specific receptors. Therefore, H1 receptor blockade may represent a way to prevent and treat OA. Currently, there is a lack of data investigating the effects of H1-receptor blockade on knee OA in humans. <h3>Objectives</h3> To evaluate cross-sectional association between the use of histamine H1-receptor antagonists and radiographic knee OA. <h3>Methods</h3> For the current analysis we used data from the publically available Osteoarthritis Initiative (OAI). We compared cross-sectionally the knees of OAI participants taking H1-receptor antagonists at baseline with knees of control participants. We used logistic regression models to assess the association between radiographic knee OA (defined as KL≥2 and JSN) and the use of H1-receptor antagonists. Generalized estimating equations (GEE) were used to adjust for the correlation between knees. The models were adjusted for multiple covariates including age, race, and body mass index. <h3>Results</h3> A sample of 4377 OAI participants (8753 knees) was analyzed, 457 of them (914 knees) used histamine H1-receptors at baseline. The use of histamine H1-receptor antagonists was associated with lower prevalence of radiographic knee OA in both crude (OR 0.77, 95 CI 0.64–0.91, p&lt;0.01) and adjusted (OR 0.79, 95 CI 0.66–0.95, p=0.01) analyses. <h3>Conclusions</h3> Histamine H1-receptor antagonists are associated with decreased prevalence of knee OA. Further studies are warranted to determine whether H1-receptor blockade may be of benefit in the prevention and treatment of knee OA. <h3>References</h3> de Lange-Brokaar BJ, Kloppenburg M, Andersen SN, Dorjee AL, Yusuf E, Herb-van Toorn L, et al. Characterization of synovial mast cells in knee osteoarthritis: association with clinical parameters. Osteoarthritis and Cartilage 2016; 24: 664–671. <h3>Disclosure of Interest</h3> None declared
Origin of Cardiac Troponin T Elevations in Chronic Kidney Disease
Authors: Noreen van der Linden, Tom Cornelis, Dorien M. Kimenai, Lieke J.J. Klinkenberg, Judith M. Hilderink, Sarah Lück, Elisabeth J. R. Litjens, Frederique E.C.M. Peeters, Alexander S. Streng, Tobias Breidthardt, Luc J.C. van Loon, Otto Bekers, Jeroen P. Kooman, Pål O. Westermark, Christian Mueller, Steven J.R. Meex
Journal: Circulation (2017)
SAT0026 Signalling through insulin-like growth factor 1 receptor contributes to il-6 production and supports t cell dependent inflammation in rheumatoid arthritis
Authors: M Erlandsson, M Nadali, S Silfverswärd Töyrä, MN Svensson, I-M Jonsson, KM Andersson, MI Bokarewa
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Insulin-like growth factor (IGF) 1 receptor is essential for cell energy metabolism. It plays a key role linking glucose and lipid metabolism of active cells and may turn pathogenic in uncontrolled tissue growth in tumours. In rheumatoid arthritis (RA), the IGF-1R signalling is activated supporting expansion of the inflamed synovia. <h3>Objectives</h3> The aim of the present study was to understand the place of IGF-1R expression and signalling for development of adaptive immune responses in the setting of prospective RA cohort and in experimental arthritis. <h3>Methods</h3> Clinical associations of IGF1R expression in leukocytes of the peripheral blood were studied in 84 female RA patients with mean disease duration 8 years, all treated with methotrexate. Consequences of the IGF1R signalling inhibition for arthritis were studied in mBSA immunised Balb/c mice treated with NT157 compound promoting degradation of the insulin receptor substrates IRS-1/2. <h3>Results</h3> In RA patients, high expression of IGF1R in leukocytes was associated with systemic inflammation as verified by higher transcription factor NF-kB (p=0.033), serum levels of IL-6 (p=0.006) and erythrocyte sedimentation rate (p=0.003), and higher pain perception (VAS, p=0.019). Additionally, women with high IGF1R were often in need of combined DMARD treatment (p=0.045). Phosphorylated IGF1R and STAT3 enrich T cells infiltrate in RA synovia. Treatment with NT157 rendered no metabolic consequences to mouse body weight and serum glucose levels. NT157 inhibited the phosphorylation of IGF1R and STAT3 in synovia, and alleviated arthritis and erosions in mice. It also reduced IGF1R+ T cell population in spleen and despaired ERK and Akt signalling. This limited the ability of mBSA-specific T cells to produce IL-6 (p=0.013), IFNg (p=0.024) and IL-17 (p=0.0097). The reduction of IL-6 and IL-17 levels was associated with changed RoRgt/FoxP3 balance. <h3>Conclusions</h3> IGF1R signalling contributes to severe RA by triggering T cell dependent inflammation in arthritis. Inhibition of IGF1R on the level of insulin receptor substrates alleviates arthritis by restricting IL-6 dependent formation of Th17 cells and may open for new treatment strategies in RA. <h3>Disclosure of Interest</h3> None declared
SAT0593 Gender-specific associations between fat mass and musculoskeletal pain in community residents: a 3-year longitudinal study
Authors: KM Son, NH Cho, SH Lim, HA Kim
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Increase in fat mass is correlated with musculoskeletal pain <h3>Objectives</h3> In this study, we sought to delineate the prospective relationship between fat mass parameters and the musculoskeletal pain in Korean community residents. <h3>Methods</h3> In the Korean Health and Genome Study, 1,325 participants (mean age 60.2 years, 56.2% women) who completed pain questionnaires and underwent dual x-ray absorptiometry to calculate body composition had 3 year follow-up data on pain. Pain was categorized according to number of pain regions. After 3 years of follow-up, subjects were classified into the followings: 1) no pain both at baseline and at 3 years (no pain), 2) any pain (one, two or more, or widespread regions) at baseline and no pain at 3 years (transient pain), 3) no pain at baseline and any pain at 3 years (new pain) 4) any pain both at baseline and at 3 years (persistent pain). 1) and 2) were grouped as no/transient pain group (no pain) and 3) and 4) as new/persistent pain group (pain) <h3>Results</h3> Female gender and obesity were 2 significant factors associated with the persistence or development of pain. Total fat mass and fat:muscle mass ratio were significantly correlated with pain, and the odds ratios for pain were significantly increased in subjects in the highest quartile of fat muscle ratio after adjustment among female subjects only. Among normal weight subjects, those without metabolic syndrome were less likely to belong to the pain group, especially among women. <h3>Conclusions</h3> The association of fat mass and pain was only significant among females <h3>Disclosure of Interest</h3> None declared
SP0062 Differential scavenging of apoptotic cells and bacteria
Authors: G Krönke
Journal: Annals of the Rheumatic Diseases (2017)

During inflammation and infection, we are simultaneously confronted with both self and non-self in form of dying cells and microbes, respectively. Mechanisms that facilitate the non-immunogenic clearance of self-antigens derived from apoptotic and necrotic cells and that, in parallel, allow the initiation of an immune response against invading pathogens are incompletely understood. Recent data from our laboratory show that the immune system actively sorts apoptotic cells (ACs) and bacteria into distinct subspecies of phagocytes thereby enabling a segregated processing of self and non-self as well as a differential immune response against these two entities. During inflammation, ACs were cleared by tissue resident macrophages (resMφ) that performed a non-immunogenic disposal of self antigens, whereas bacteria were preferentially ingested by monocyte-derived inflammatory macrophages. We identified the enzyme 12/15-lipoxygenase and the nuclear receptor Nr4a1, both specifically expressed by resMφ, as key factors that control the coordinated and non-immunogenic phagocytosis of ACs by these specialized macrophage subset. Incorrect sorting and aberrant uptake of AC-derived self-antigens by pro-inflammatory and immunocompetent phagocytes, however, resulted in the break of self-tolerance and autoimmunity. Our data thus demonstrate the importance of a sorted clearance of ACs for the maintenance of immunologic self-tolerance. <h3>Disclosure of Interest</h3> None declared