tbuckley/cabot-search huggingface dataset:
AB0298 Antibodies to cyclic citrullinated peptide and modified citrullinated vimentin: a role in rheumatoid arthritis associated with autoimmune thyroiditis
Authors: A Dvorovkin, V Odin, O Inamova, V Tyrenko, M Toporkov
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Specific antibodies, including antibodies to cyclic citrullinated peptide (ACCP) and modified citrullinated vimentin (AMCV) are markers of severe course of rheumatoid arthritis (RA). At the same time, rheumatoid arthritis often associated with autoimmune thyroiditis (Hashimoto9s thyroiditis (HT)). <h3>Objectives</h3> Evaluate the role of antibodies to ACCP and AMCV on the clinical and laboratory features of rheumatoid arthritis in association with autoimmune thyroiditis. <h3>Methods</h3> The study included two groups of patients. The first group of patients included 16 patients (14 men and 2 women, mean age - 62.37±2.12 years) with RA in combination with HT and detection in the blood only ACCP (group 1). The second group also included 16 patients (14 women and 2 men, mean age – 52.31±4.94 years) with RA in combination with HT and detection of ACCP and AMCV in the blood (group 2). In the first group of patients 10 patients had euthyreose, from 5 - hypothyroidism, compensated intake of L - thyroxine, 1 patient - thyrotoxicosis underway medikal euthyreose. In the second group of patients was observed in 14 patients euthyreose, from 2 - hypothyroidism, compensated reception L-thyroxine. <h3>Results</h3> Both groups of patients differed on the following parameters studied: erosion detected in 68% in group 1 and 50% in group 2 (p&lt;0,05), in the first group of patients predominated (62%) the high degree of activity of RA by DAS-28, in while in group 2 - the average (56%, p&lt;0,05). By using correlation analysis Spearman correlation relationships among the studied attracted attention significant (R =0,62, p&lt;0,05) relationship between erosions and detection in the blood of antibodies to ACCP in the second group of patients (a combination of RA and HT and identifying in blood ACCP and AMCV), which was repeatedly weakened and unreliable in group 1 (combination of RA and HT and only detect of ACCP) in the blood. <h3>Conclusions</h3> Second group patients (a combination of RA with HT and detection in blood ACCP and AMCV) are closer correlations with indicators of joint destruction than group 1 patients, that in the future may use as a prognostic marker of a more severe course of RA in combination with HT. <h3>Disclosure of Interest</h3> None declared
SP0063 The role of muscle in innate immune responses
Authors: P Rovere-Querini
Journal: Annals of the Rheumatic Diseases (2017)

The skeletal muscle represents a unique site from the immunological point of view. Leukocytes are virtually absent in healthy conditions. However they are quickly recruited upon muscle injury, persist during the regenerative phases to disappear again after tissue healing. Thus, it represents and ideal scenario to study the involvement of the innate immune system in the homeostatic response either to the conventional programmed death of multinucleated myofibers and to the parallel occurrence of "non-canonical" cell death and survival programs, including necrosis and autophagy. Recruited phagocytes are responsible of the clearance of damaged myofibers and of dying muscle stem/progenitor cells, stromal cells and leukocytes. Muscle macrophages in particular are endowed with remarkable plasticity throughout regeneration and healing, switching from activated cells that generate inflammatory cytokines to reparative assets, that play a non redundant role during the resolution phases of the damage and regulate the termination of the inflammatory responses. This dynamic transition between is increasingly felt to be the key to muscle homeostasis. Conversely defects in the process favour maladaptive remodeling with deposition of collagen and fat accumulation and in predisposed individuals autoimmunity leading to inflammatory idiopathic myopathies. A specialized population of regulatory T (Treg) cells, which control the inflammatory response by promoting the M1-to-M2 switch, and the activation of the muscle stem cells, satellite cells is receiving increasing attention for their central role in tissue homeostasis. Thus, the immunological perception of muscle cell death and regeneration – in turn influenced by environmental cues, including mitophagy and alteration of the redox balance - determines whether these events foster successful tissue healing or persisting inflammatory myopathies. The insights that are progressively become available on this original scenario hold promises to develop new approaches for disease treatment. Thus, immunologic perception of death and regeneration of muscle cells determine whether these events promote healing of tissues or persistent inflammatory myopathies. The insights that are becoming increasingly available on this original scenario hold promise for the development of new approaches to the treatment of persistent human muscle disease. <h3>Disclosure of Interest</h3> None declared
SP0067 Cytokines in juvenile idiopathic arthritis
Authors: W de Jager
Journal: Annals of the Rheumatic Diseases (2017)

The importance of cytokines in the pathogenesis of inflammatory diseases is highlighted by the success of therapeutic approaches directed against cytokines and cytokine receptors. Cytokines are characterized by their redundancy and pleyotropy: multiple cytokines can target the same receptor, while on the other hand a single cytokine can have multiple, even contradictory immunological effects. Linking a cytokine/protein biomarker signature with clinical outcome may help to identify and classify patient cohorts. Thus "intelligent" cytokine signatures can be used as biomarkers in human inflammatory diseases. There are however various risks associated with this approach; often it is impossible to obtain material from the site of inflammation and there are various often not well-known technical aspects crucial to obtain reliable and usable results. Although standardization has been prominent in day to day clinical practice, standardization of sample collection and laboratory assessments remains suboptimal. Inconsistency in sample collection can affect the results of biological assays and thus several characteristics require thorough evaluation and standardization. This standardization is not limited to assay validity and reproducibility but also pre-analytical treatment and appropriate specimen types. <h3>Disclosure of Interest</h3> None declared
AB0440 Impact of vitamin d deficiency upon disease activity and immune disorder in rheumatoid arthritis patients
Authors: Y Liu, HY Wen
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Emerging evidence suggests that vitamin D plays an important role in immune regulation. <h3>Objectives</h3> The objective of this work was to determine if patients with rheumatoid arthritis (RA) are at risk for vitamin D deficiency and whether vitamin D levels correlate with disease activity or immune disorders. <h3>Methods</h3> This study was a retrospective research. RA patients who had vitamin D levels and immune function indexes of each other were included. Patients receiving or have received vitamin D, corticosteroids, disease-modifying anti-rheumatic drugs or a tumor necrosis factor antagonist and those who had hepatic or renal insufficiency were excluded. Multivariate analysis was performed to examine correlations and control for confounding factors. <h3>Results</h3> As suggested threshold (≤25 ng/ml), the overall prevalence of vitamin D insufficiency was 265 of 280 (94.8%). Mean serum vitamin D insufficiency levels of 11.15±4.74 ng/ml for RA patients were significantly lower compared to controls (31.62±6.46) (p=0.001). Among all the subjects, 208 (72.7%) were females. Vitamin D levels in high disease activity group were lower compared to vitamin D level in patients with low and moderate disease activity (DAS-28 score &gt;5.1, 3.2–5.1, &lt;3.2, respectively, p&lt;0.001) and vitamin D levels had an inverse correlation with DAS28 score (β-coefficient-0.164, p=0.018, per 1 ng/ml). In patients with RA, the levels of vitamin D were moderately and inversely associated with Th 17 (β-coefficient-0.158, p=0.019, per 1 ng/ml). However, no significant relationship was found between vitamin D and these variables (T cell, B cell, NK cell, Treg, Th1, Th2, Th17/Treg) in patients. <h3>Conclusions</h3> Lower levels of vitamin D are associated with worse DAS28 and higher levels of Th17 with RA, especially in female patients. The levels of 1,25-dihydroxycholecalciferol (1,25(OH)<sub>2</sub>D<sub>3</sub>) could be a marker to monitor the disease activity in RA patients and vitamin D may be an alternative supplementary treatment for RA. <h3>Acknowledgements</h3> This work was supported by research grants from the National Natural Science Foundation of China (no. 81301532/H0603) and the Shanxi Science and Technology research projects of China (no. 201603D321074). <h3>Disclosure of Interest</h3> None declared
Cardioprotective Effects of HSP72 Administration on Ischemia-Reperfusion Injury
Authors: Takashi Tanimoto, Missag H. Parseghian, Takehiro Nakahara, Hideki Kawai, Navneet Narula, Dongbin Kim, Robert Nishimura, Richard H. Weisbart, Grace Chan, Richard A. Richieri, Nezam Haider, Farhan Chaudhry, Glenn T. Reynolds, John Billimek, Francis G. Blankenberg, Partho P. Sengupta, Artiom D. Petrov, Takashi Akasaka, H. William Strauss, Jagat Narula
Journal: Journal of the American College of Cardiology (2017)
OP0239 Histological features of joint and colonic inflammation in inflammatory bowel disease patients treated with anti-tnf
Authors: S Alivernini, D Pugliese, B Tolusso, L Petricca, L Bui, L Guidi, GL Rapaccini, F Federico, G Ferraccioli, A Armuzzi, E Gremese
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> New onset of joint inflammation in patients under anti-TNF-alpha for inflammatory bowel disease (IBD) has been previously described. However, histological characterization of synovial and bowel compartments has not been reported so far. <h3>Objectives</h3> Aim of the study was to evaluate the histological characteristics of paired synovial (ST) and colonic tissues in IBD patients under TNF-alpha blockers. <h3>Methods</h3> Consecutive IBD patients without history of co-existing joint involvement who developed peripheral arthritis under TNF-alpha blockers, were prospectively enrolled. Each patient underwent rheumatological evaluation and ultrasound (US) assessment (using Gray scale for synovial hyperthrophy and Power Doppler Signal) of the affected joints. Each patient underwent US guided ST biopsy of the knee, following a standardized procedure<sup>1</sup> and colonoscopy with mucosal biopsies. Each ST and colonic paired sample was stained through immunohistochemistry (IHC) for CD68, CD21, CD20, CD3 and CD117<sup>2</sup>. H&amp;E staining was performed for Paneth cells identification. Clinical and immunological parameters [Anti-citrullinated peptides antibodies (ACPA), IgM-Rheumatoid Factor (RF) and IgA-RF respectively] were collected for each patient. <h3>Results</h3> 10 patients with IBD [46.0±9.7 years old, 13.2±9.9 years of disease duration, 2.5±1.6 years of TNF-alpha blockers exposure, 6 with Crohn9s Disease and 4 with Ulcerative Colitis respectively] were studied. All patients were negative for ACPA, IgM-RF or IgA-RF and 4 patients were under Methorexate therapy. 5 (50.0%) patients showed endoscopic and histologically proven inflammation of colonic mucosa. Moreover, IHC revealed that 6 (60.0%) patients had diffuse and 4 (40.0%) had follicular synovitis, respectively. In particular, there was a direct correlation between CD68<sup>+</sup>, CD21<sup>+</sup>, CD3<sup>+</sup>, CD20<sup>+</sup> and CD117<sup>+</sup> cells distribution in paired ST and gut tissues in the whole cohort (p&lt;0.05). No significant differences in terms of disease duration (p=0.48), TNF-alpha blockers exposure time (p=0.29), ESR (p=0.26) and CRP (p=0.91) values were found comparing patients with follicular and diffuse synovitis respectively. <h3>Conclusions</h3> Our findings suggest that patients with IBD may develop histologically proven synovitis during TNF-alpha treatment, showing similar histological features in terms of CD68<sup>+</sup>, CD21<sup>+</sup>, CD20<sup>+</sup>, CD3<sup>+</sup> and CD117<sup>+</sup> cells between synovial and colonic compartments. Molecular mechanisms triggered by TNF-alpha blockers leading to joint inflammation have to be clarified. <h3>References</h3> van de Sande MJT et al. Ann Rheum Dis 2011. Alivernini S. et al. Nat Communications 2016. <h3>Disclosure of Interest</h3> None declared
AB0980 Epidemiological profile of the pulmonary diseases in mixed connective tissue disease: about 55 cases
Authors: R Amri, I Mejri, H Sahli, A Mahfoudhi, I Ben Ahmed, R Jazi
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Mixed connective tissue disease (MCTD) are a systematic autoimmune disease that the aetiopathogeny remains misunderstood. This disease is often associated with systemic involvement which sometimes is very serious, such as pulmonary diseases. <h3>Objectives</h3> To describe the characteristics of the pulmonary diseases among a sample of MCTD. <h3>Methods</h3> We conducted a retrospective study including patient9s cases diagnosed with a MCTD between the period of 10 years in the departement of internal medicine. The demographic, clinical, treated in the immunological, biological and radiological data were collected then analysed. <h3>Results</h3> In total we had 55 patients. 87% of them were female. The mean age of the sample was 50, 64±15 years. Major types of MCTD were: Rheumatoid polyarthritis (45.5%), sarcoidosis (18.2%), scleroderma (12.7%), and the lupus erythematosus (10. 9%). These causes were diagnosed after a mean delay of 686, 18 days. A lung disease was found in 50.9% of the cases. It was either present without symptoms in 52.8% of the cases or revealed by dyspnoea (22.6%), a cough (18.9%)or hemoptysie isolated or associated to thoracic pains (1.9% each).The most frequent type of respiratory diseases were adenopathies (26.9%). Pleurisy, fibrosis, and interstitial lung diseases were described among 11.5% of the cases. Bronchiectasis, Lung arterial high blood pressure, pleural nodules, bronchi dilatation were reported in 7.7%. In only 3.8% we had patients with cancer and emphysema. Chest radiographs were normal in 65.5% of the cases but we discovered interstitial lung diseases (12.7%), pleurisy (7.3%), pleural nodule and mediastinal enlargement (3.6%) and pneumopathy (1.8%). The same appearences were described in the CT scann normal in 18.5% but in different proportions: adenopathies (25.9%), interstitial lung abnormalities (14.8%), fibrosis (11.1%), bronchiectasis (7,4%) and bronchi dilatation, pleurisy, nodule and mediastinal enlargement (3.7%). Respiratory functional exploration were normal in 69.2% obstructive lung disease and restrictive pulmonary disease were found within 11.5% of the patients. <h3>Conclusions</h3> Improvement of the knowledge of these diseases will improve the care before the appearance of complications. <h3>Disclosure of Interest</h3> None declared
Real-world Data for Clinical Evidence Generation in Oncology
Authors: Sean Khozin, Gideon M Blumenthal, Richard Pazdur
Journal: JNCI Journal of the National Cancer Institute (2017)

Conventional cancer clinical trials can be slow and costly, often produce results with limited external validity, and are difficult for patients to participate in. Recent technological advances and a dynamic policy landscape in the United States have created a fertile ground for the use of real-world data (RWD) to improve current methods of clinical evidence generation. Sources of RWD include electronic health records, insurance claims, patient registries, and digital health solutions outside of conventional clinical trials. A definition focused on the original intent of data collected at the point of care can distinguish RWD from conventional clinical trial data. When the intent of data collection at the point of care is research, RWD can be generated using experimental designs similar to those employed in conventional clinical trials, but with several advantages that include gains in efficient execution of studies with an appropriate balance between internal and external validity. RWD can support active pharmacovigilance, insights into the natural history of disease, and the development of external control arms. Prospective collection of RWD can enable evidence generation based on pragmatic clinical trials (PCTs) that support randomized study designs and expand clinical research to the point of care. PCTs may help address the growing demands for access to experimental therapies while increasing patient participation in cancer clinical trials. Conducting valid real-world studies requires data quality assurance through auditable data abstraction methods and new incentives to drive electronic capture of clinically relevant data at the point of care.
SP0172 Managing volunteers- a uk perspective
Authors: CB Jacklin
Journal: Annals of the Rheumatic Diseases (2017)

Volunteers are an integral part of any charity and it would be impossible to run a charitable organisation without the support of volunteers. Like paid staff they need to be trained, nurtured and rewarded but as volunteers they need to be handled in a very different way to employees. People who volunteer do so for many differernt reasons and not always perhaps for the right reasons so managing volunteers takes great skill and diplomacy. My talk will cover how to value volunteers, lessons we have learned from managing volunteers over many years as well as how to manage issues with volunteers and the lessons I9ve learned from my mistakes! <h3>Disclosure of Interest</h3> None declared
SAT0574 Performance of immunoglobulin M and G (IGM and IGG) antibodies against chikungunya virus (CHIKV) by enzyme-linked immunosorbent (ELISA) technique
Authors: JC Rueda, J-I Angarita, AM Santos, E-L Saldarriaga, I Pelaez-Ballestas, P Lόpez-Morales, J Londono
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> CHIKV is suspected based on epidemiological and clinical criteria, however confirmation of the disease is only achieved by laboratory tests. Laboratory diagnosis is made by two approaches: the detection of viral RNA and identification of the specific immune response by serological methods. Serological tests are the most frequently used laboratory methods for the diagnosis of CHIKV. IgM is the first detected antibodies during 4 to 6 days after onset of symptoms followed by IgG. In Colombia, CHIKV9s probable cases are not mandatory to be confirmed, so there is no standardization for laboratory confirmation tests <h3>Objectives</h3> To evaluate the performance of IgM and IgG antibodies against CHIKV in a cohort of patients with CHIKV <h3>Methods</h3> IgM and IgG antibodies against CHIKV were measured by ELISA (AbcamÒ ab177835 and ab177835 anti-chikungunya virus IgM and IgG human ELISA kit, Cambridge, UK) technique in 604 patients with CHIKV suspicion. A typical case of CHIKV with high sensitivity and specificity obtained from a previous study was used as gold standard for diagnosis of CHIKV. Since CHIKV epidemic of 2014–2015 was the first to be reported in our country (Colombia), no second measurements of IgG were needed to confirmed infection. <h3>Results</h3> Cut off point for IgG was 14,3 SU and for IgM was 11,2 SU. Mean values for IgG was 36,7 SU (±22,7) in patients with CHIKV and 8,6 SU (SD± 6,3) for IgM. Statistical significance was obtained for both IgG and IgM (<i>p</i>&lt;0,0001) when comparing patients with and without CHIKV. Receiver operating characteristic (ROC) curves showed and area under the curve (AUC) of 0,81 for IgG and 0,65 for IgM (figure 1). <h3>Conclusions</h3> Our study revealed a good performance of IgG and regular performance of IgM for the diagnosis of CHIKV in a cohort of CHIKV patients from Colombia9s epidemic. Cut off points for both IgG and IgM were measured for future reference. <h3>Disclosure of Interest</h3> None declared
AB0909 Septic pseudarthrosis of the humerus treatment using orthfix external fixation
Authors: S Daas, H Sahli, MA Sbai, M Souissi, A Khorbi
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The septic pseudarthrosis of the humerus is a very difficult process that poses a towfold challenge: the infection eradication while trying to get consolidation. <h3>Objectives</h3> The aim of this study was to analyze the results of the treatment of septic pseudarthritis of the humerus with Orthofix monolateral axial external fixator. <h3>Methods</h3> This is a retrospective study which included 17 medical records of patients treated for septic pseudarthritis of the humerus debridement and stabilization by Orthofix over a period of 7 years. <h3>Results</h3> They were 13 women and 4 men with a mean age 44 years. The fracture site was most often at the distal half of the humerus. The initial treatment of the fracture was pinning or intramedullar nailing. Surgical management of pseudoarthrosis was performed 3.5 months after the first surgical procedure. All cases had a bone debridement and stabilization with a monoplane Orthofix axial external side. Fifteen cases had also a bone graft. The mean period of stabilization was 7months. Patients were evaluated clinically and radiologically each month. At the mean of three years of follow-up, we obtain osseous consolidation for all patients in the average of seven months. All patients underwent rehabilitation of the shoulder and elbow after treatment. The functional result were excellent results in 47% of cases, good results in 35,3% of cases and poor results in 17,7%. The Quick DASH score average was 28±5. The average of the elbow motion was 109 ° of flexion with an average of 30 °of deficit in extension. The useful range of motion of the elbow was preserved in 14 patients. There was a shaft angulation under 20 ° in 3 cases and over 20 ° in 3 other cases. We noted in four cases a bone shortening consolidations of 2 cm. We had a case of radial nerve neuraprexie which regressed spontaneously. <h3>Conclusions</h3> Orthofix is the method of choice for the treatment of septic pseudarthritis of the humerus. Associate eradication of the germ antibiotic and steroid intake spongy it allows the consolidation of the bone. Furthermore, the monolateral axial external fixator is tolerated well and allows movement of the shoulder and elbow throughout the period of treatment. <h3>Disclosure of Interest</h3> None declared