tbuckley/cabot-search huggingface dataset:
AB0564 Dry syndrome in ra patients. comparison with sjÖgren’s syndrome patients
Authors: D. Peiteado, G. Bonilla, R. Montejano, A. Boto, A. Del Hierro, I. Monjo, C. Plasencia, A. Balsa
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Objectives</h3> The aim of the study is to analyse the clinical characteristics of Rheumatoid Arthritis (RA) patients and dry syndrome, and to compare with primary Sjögren's syndrome (PSS) patients. <h3>Methods</h3> Patients with RA and dry syndrome derived from Rheumatology Clinic to Cornea Unit were evaluated. According to symptoms and ophthalmological examination, patients were classified as high or low probability of Sjögren Syndrome (SS). Clinical and laboratory assessments included sex, age and smoking habit, DAS28, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-citrullinated peptide antibodies (ACPA), antinuclear antibodies (ANA), anti Ro, anti La and presence of other extraarticular symptoms. In addition, the ophthalmological examination data (Ocular Staining Score [OSS] and Schirmer test), salivary gland scintigraphy (SGS) and salivary gland biopsy (biopsy) were analysed. The percentage of patients who would be classified according to the criteria of the Revised American-European Consensus Group (AECG) 2002, NIH-funded Sjögren's International Collaborative Clinical Alliance (SICCA) 2012 criteria and ACR/EULAR 2016 criteria is evaluated. RA patients with high probability of SS are compared with SSP patients. Statistics analysis was made by mean ±SD, and comparison was made by t- Student test (quantitative parameters) and non parametric test (qualitative) (p&lt;0.05). <h3>Results</h3> 24 RA with dry syndrome were included. 71% were women and the mean age was 64±14 years. The disease duration was 17±12 years. All patients had ocular manifestations, 2/3 oral manifestations, and 17% other extra-articular manifestations. According to DAS28, 33% of the patients were in clinical remission, 33% in high activity, and the others in low-moderate activity. 17 patients (71%), 19 (86%) and 5 (21%) were positive (+) for RF, ACPA and ANA, respectively. One patient had Anti Ro +and another anti La +. The mean OSS was 4.2 (±3.1) and the average of Schirmer was 10 (±11). In relation to other tests: 7 patients had a biopsy performed (2 positive [29%]), 5 patients had GGS (2 positive [40%]). 17 of the 24 RA patients (71%) were considered "high probability Sjögren's Syndrome" (SS and AR). These patients were compared with the PSS group (see table 1), showing differences in immunological parameters, sex, age and in the% that fulfilled the classification criteria. No significant differences were found in the ophthalmological examinations or the acute phase reactants. <h3>Conclusions</h3> Most of this RA patients cohort with dry syndrome were considered as "high probability SS", however only a small percentage (12%–23%) fulfilled the classification criteria. This can be explained by the low rate of specific antibodies (6%), and by the poor performance of some tests included in the criteria. <h3>Disclosure of Interest</h3> None declared
Neutrophil-induced genomic instability impedes resolution of inflammation and wound healing
Authors: Veronika Butin-Israeli, Triet M. Bui, Hannah L. Wiesolek, Lorraine Mascarenhas, Joseph J. Lee, Lindsey C. Mehl, Kaitlyn R. Knutson, Stephen A. Adam, Robert D. Goldman, Arthur Beyder, Lisa Wiesmuller, Stephen B. Hanauer, Ronen Sumagin
Journal: Journal of Clinical Investigation (2019)

Neutrophil (PMN) infiltration of the intestinal mucosa is a hallmark of tissue injury associated with inflammatory bowel diseases (IBDs). The pathological effects of PMNs are largely attributed to the release of soluble mediators and reactive oxygen species (ROS). We identified what we believe is a new, ROS-independent mechanism whereby activated tissue-infiltrating PMNs release microparticles armed with proinflammatory microRNAs (miR-23a and miR-155). Using IBD clinical samples, and in vitro and in vivo injury models, we show that PMN-derived miR-23a and miR-155 promote accumulation of double-strand breaks (DSBs) by inducing lamin B1–dependent replication fork collapse and inhibition of homologous recombination (HR) by targeting HR-regulator RAD51. DSB accumulation in injured epithelium led to impaired colonic healing and genomic instability. Targeted inhibition of miR-23a and miR-155 in cultured intestinal epithelial cells and in acutely injured mucosa decreased the detrimental effects of PMNs and enhanced tissue healing responses, suggesting that this approach can be used in therapies aimed at resolution of inflammation, in wound healing, and potentially to prevent neoplasia.
FRI0467 The relationship between 99mtc-pertechnetate hand perfusion scintigraphy and naifolid capilloscopy in systemic sclerosis patients: a pilot study
Authors: S.R. Pavlov-Dolijanovic, N. Petrovic, N. Vujasinovic Stupar, N. Damjanov, G. Radunovic, V. Zugic, D. Babic, D. Sobic-Saranovic, V. Artiko
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The aim of this study was to assess possible relationship between the altered blood perfusion at hands analysed by <sup>99m</sup>Tc-pertechnetate hand perfusion scintigraphy (<sup>99m</sup>TcPHPS) and, morphological microvascular abnormalities detected by nailfold capillaroscopy (NC) in SSc patients. <h3>Methods</h3> The study group consisted of 25 patients with SSc (14 with diffuse SSc, and 11 with limited SSc) and 28 control subjects (18 patients with primary RP, and10 healthy individuals). NC and <sup>99m</sup>TcPHPS was performed in all the groups examined. The capillaroscopic pattern was classsified as normal or scleroderma ("early", "active", or "late") pattern. Gamma-camera dynamic first-pass study during the first 60 s and a static scintigraphy after 5 min were recorded following a bolus injection of <b><sup>99m</sup></b> Tc-pertechnetate via a cubital vein. Regions of interest were drawn on the summed images around the fingers and the palmar region. The fingers-to-palm ratios were then calculated. <h3>Results</h3> SSc patients showed a significantly lower blood flow (BF) and blood pool (BP), (0.43±0.21 vs 0.36±0.07, respectively), than PRP patients (0.45±0.18 vs 0.42±0.06, respectively) and healthy subjects (0.58±0.19 vs 0.44±0.06, respectively), (p-value 0.039 vs 0.004, respectively). A gradual decrease of BF and BP was found in SSc patients with progressive severity of NVC patterns of microangiopathy ["early" (0.49±0.03 vs 0.39±0.04, respectively), "active" (0.43±0.11 vs 0.38±0.06, respectively) or "late" (0.40±0.28 vs 0.36±0.08, respectively), (p- value 0.462 vs 0.728 respectively], but these differences were not statistically significant. Patients with diffuse SSc showed lower BF, and higher BP (0.42±0.26 vs 0.37±0.07, respectively) than those with limited SSc, (0.44±0.14 vs 0.35±0.064, respectively), but this differences is not statistical significantly (p=0.76 vs p=0.53, respectively). There was no significant correlation between BF and BP values and type of SSc (limited or diffuse) (r=−0.06, p=0.77; r=0.13, p=0.54, respectively) as well as three microangiopathy patterns (r=−0.253, p=0.22; r=– 0.13, p=0.54, respectively). <h3>Conclusions</h3> NC represents the best method to analyse microvascular damage in rheumatic diseases, especially SSc. 99m TcPHPS improves the evaluation of vascular damage in SSc patients. There is no direct relationship between these two methods, but one method complements another in the study of vascular damage in SSc patients. <h3>Disclosure of Interest</h3> None declared
THU0483 Bone mineral density and prevalence of osteoporosis in hiv-infected patients in comparison with a reference spanish population: the importance of local normative ranges
Authors: C. Sobrino, J. Loarce, F. López, J. Gallego, M.J. Vivancos, M. Pérez Elías, J.L. Casado, M. Vazquez
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> HIV-infected patients have less bone mineral density (BMD) than non-HIV population. According to current guidelines, the normal BMD reference range is that derived from the US NHANES III (National Health and Nutrition Examination Survey) and from BMDCS-Hologic. However, local variations of BMD could change the interpretation of bone loss and the prevalence of osteoporosis (OP) in this population. <h3>Objectives</h3> To compare the BMD in HIVinfected Spanish patients with values from healthy Spanish population and to estimate the prevalence of OP in this patients, based on the local data. <h3>Methods</h3> This was a cross-sectional study in a homogenous cohort of HIV-infected patients (RyC cohort, EC 009/17). Data of femoral neck and spine BMD were obtained by DXA (Dual-Energy X-ray Absorptiometry) from 949 patients (241 women, 25%) and compared with the results of a nationally representative Spanish cohort (14 centres) including 2442 subjects (1305 women, 53%) aged 20–80 years. <h3>Results</h3> Overall, mean age was 45.4 years (women, 46.5 years). The Spanish reference cohort showed a reduced BMD (−7%, 3%–12%) in comparison with NHANES, especially in middle aged women. HIVinfected patients had a lower BMD than Spanish cohort in both spine and femoral neck localizations for the different age strata (p&lt;0.001), not significant in femoral neck for males aged 30–39 (n=152 patients, 0.848 vs 0.869 gr/cm2; p=0.07). Using NHANES data, the prevalence of OP was 26% in women in the Spanish cohort and 41% in our HIV population. By contrast, if the Spanish data are used as normative range, the prevalence of OP decreased in HIV females, significant between 40–60 years (from 26.5% to 23.5% in spine, p&lt;0.01). Although OP in spine was less frequent in males by using Spanish data (p&lt;0.01, OP decrease from 17.8% to 6.5%), there was more OP in femoral neck in males older than 40 years (from 13.5% to 21% in 60–69; p&lt;0.01). <h3>Conclusions</h3> Our data demonstrate that HIV-infected patients had a significantly reduced BMD in comparison with both US and Spanish reference data for all the age strata. However, the prevalence of osteoporosis could change if local representative cohorts are used as normative data, with almost 30% of patients being reclassified. <h3>Disclosure of Interest</h3> None declared
FRI0486 Potential predictors of visceral involvement in adult iga vasculitis
Authors: A. Hocevar, Ž. Rotar, V. Jurčić, M. Tomšič
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Predictors of severity of visceral involvement in acute adult IgA vasculitis (IgAV) are poorly recognised. <h3>Objectives</h3> The aim of our study was to evaluate the role of smoking and extension of skin lesions on the visceral manifestations of acute adult IgA vasculitis. <h3>Methods</h3> We analysed medical records of adult, histologically proven IgAV cases, diagnosed at our secondary/tertiary rheumatology centre between 1 January 2010 and 31 December 2017. Purpura was defined as generalised when skin lesions extended above the waistline. Gastrointestinal (GI) disease was considered severe in case of bloody diarrhoea, ileus or bowel perforation. Renal disease was defined as severe when nephritic syndrome with acute renal failure or nephrotic syndrome developed. <h3>Results</h3> During the study period we identified 230 incident IgAV cases (57.8% males, median (IQR) age 64.8 (45.6–77.3) years). Ninety-eight (42.6%) patients were smokers (56 past and 42 current). Skin, joint, GI, renal and involvement were present in 230 (generalised purpura in 114 (49.6%), necrotizing in 108 (47.0%)), 93 (40.4%), 70 (30.4%; severe in 17) and 102 (44.3%; severe in 27) patients, respectively. Smoking was associated with renal disease (RR 1.3 (95%CI 1.0–1.8)) and its severity (RR 3.2 (95%CI 1.5–7.0)), but not with GI involvement or its severity. Generalised purpura was associated with GI involvement (RR 2.9 (95%CI 1.8–4.7) and its severity (RR 3.3 (95%CI 1.1–9.8)), as well as with renal involvement (RR 1.4 (95%CI 1.0–1.9)). Data of combined influence of smoking and purpura extension on visceral involvement are presented in table 1. The risk of severe renal involvement in IgAV was the highest in ever-smoker with generalised purpura (RR 8.1 (95%CI 1.9–34.7) in comparison to IgAV non-smoker with localised purpura). Table 1 The influence of smoking and purpura extension on visceral involvement in IgAV <h3>Conclusions</h3> Smoking and generalised purpura were associated with visceral involvement in adult IgAV. <h3>Disclosure of Interest</h3> None declared
SAT0100 The determinants of refractory rheumatoid arthritis
Authors: M. Bécède, J. Smolen, D. Aletaha
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> It is an ongoing matter of research, whether the course of rheumatoid arthritis (RA) can be altered by an early intervention, a concept historically referred to as the "window of opportunity".<sup>1</sup> With the inherent challenge of underlying self-limiting disease in early patients, it remains unclear, whether the ultimate disease course of definite RA is really affected by the timing of initial treatment. <h3>Objectives</h3> To explore whether the long-term course of RA is different according to the delay of initial treatment. <h3>Methods</h3> Patients were identified from a longitudinal clinical database, and patients with refractory RA ("reRA") were compared with patients with treatment amenable RA ("taRA"). reRA was defined as ≥3 treatment courses (≥1 biological) over ≥18 months since diagnosis without reaching low disease activity (LDA) or remission (REM) defined by a Clinical Disease Activity Index (CDAI,≥10); taRA patients reached at least LDA within their first 2 treatment courses. We performed both matched and adjusted logistic regression analysis to compare differences in timing of first treatment between these two groups. <h3>Results</h3> We enrolled 412 patients, of whom 70 were reRA and 102 taRA; 240 patients fulfilled neither definition. As can be seen in table 1, reRA patients were more frequently female (92.9 vs. 70.6%, p&lt;0.001), younger (44.37 vs. 51.14 years, p=0.002), and had higher CDAI levels at first presentation (26.06 vs. 15.39, p&lt;0.001); time to first DMARD treatment was significantly longer for reRA than taRA (3.17 vs. 1.45 years, p=0.001). In a multivariate analysis, treatment delay also showed statistical significance (p=0.007). After matching reRA with taRA patients for the date of their initial presentation at our clinic, treatment delay was significantly longer univariately (p=0.013) and adjusted for other significant predictors (p=0.027). As our matching allowance for calendar year was +/–1 year, we could only use 50 (of 70) identified reRA patients from the cohort study approach. Based on the significant predictors, a discriminative matrix model could be constructed (figure 1). *Colour scheme: blue: 0%–5%; green: 5.1%–15%; orange: 15.1%–25%; red:&gt;25% predicted probability of reRA; <b>results are estimated for patient presenting in the year 2010</b> <h3>Conclusions</h3> Our data suggest that delay to initial treatment affects the long-term course of RA. Earlier treatment initiation thus may change the severity of RA. <h3>Reference</h3> [1] Van Nies JAB, et al. What is the evidence for the presence of a therapeutic window of opportunity in rheumatoid arthritis? A systematic literature review. Ann Rheum Dis2014;73(5):861–70. <h3>Disclosure of Interest</h3> None declared
Abstract 20420: Pulmonary Vascular Resistance (PVR) Does Not Affect One-Year Mortality After Heart Transplantation (HTx) Both in LVAD and Non-LVAD Cohorts: Should There Be Any Cut-Off Value in the Current Era?
Authors: Masahiko Ando, Hiroo Takayama, Paul Kurlansky, Matthew Wright, Jiho Han, ChiaLing Lee, Arthur Garan, Melana Yuzefpolskaya, Paolo Colombo, Veli Topkara, Maryjane Farr, Yoshifumi Naka, Koji Takeda
Journal: Circulation (2017)

Introduction: Though PVR 6). Demographic data were compared and odds ratios (ORs) for one-year mortality after HTx in intermediate and high PVR groups were calculated making low PVR group as baseline. Results: In a LVAD cohort, 3490 patients (2772 in low PVR, 647 in intermediate PVR, and 71 in high PVR group) were included, while in a non-LVAD cohort 5920 patients (4264 in low P...
Low transmission risk of<i>Pseudomonas aeruginosa</i>in a bronchiectasis clinic based on the knowledge of bacterial population biology
Authors: Nina Cramer, Ludwig Sedlacek, Burkhard Tümmler, Tobias Welte
Journal: European Respiratory Journal (2019)

The nosocomial acquisition of opportunistic pathogens, particularly Pseudomonas aeruginosa , has been repeatedly documented in individuals with cystic fibrosis (CF) [1]. Cross-infection is also a concern in bronchiectasis not due to CF [2]. This issue was not addressed by the European Respiratory Society 2017 guidelines for the management of adult bronchiectasis [3] but the European Bronchiectasis Network (EMBARC), the EMBARC Patient Advisory Group and the European Reference Network (ERN-Lung) Bronchiectasis Network released a position statement in the European Respiratory Journal in 2018 [4]. Based on the available evidence, the risk of cross-infection with P. aeruginosa was judged to be small. This study suggests that the risk of cross-infection with P. aeruginosa in bronchiectasis is small <http://ow.ly/itUa30nrgET>
Manipulation of Nephron-Patterning Signals Enables Selective Induction of Podocytes from Human Pluripotent Stem Cells
Authors: Yasuhiro Yoshimura, Atsuhiro Taguchi, Shunsuke Tanigawa, Junji Yatsuda, Tomomi Kamba, Satoru Takahashi, Hidetake Kurihara, Masashi Mukoyama, Ryuichi Nishinakamura
Journal: Journal of the American Society of Nephrology (2019)

Previous research has elucidated the signals required to induce nephron progenitor cells (NPCs) from pluripotent stem cells (PSCs), enabling the generation of kidney organoids. However, selectively controlling differentiation of NPCs to podocytes has been a challenge.We investigated the effects of various growth factors in cultured mouse embryonic NPCs during three distinct steps of nephron patterning: from NPC to pretubular aggregate, from the latter to epithelial renal vesicle (RV), and from RV to podocyte. We then applied the findings to human PSC-derived NPCs to establish a method for selective induction of human podocytes.Mouse NPC differentiation experiments revealed that phase-specific manipulation of Wnt and Tgf-β signaling is critical for podocyte differentiation. First, optimal timing and intensity of Wnt signaling were essential for mesenchymal-to-epithelial transition and podocyte differentiation. Then, inhibition of Tgf-β signaling supported domination of the RV proximal domain. Inhibition of Tgf-β signaling in the third phase enriched the podocyte fraction by suppressing development of other nephron lineages. The resultant protocol enabled successful induction of human podocytes from PSCs with >90% purity. The induced podocytes exhibited global gene expression signatures comparable to those of adult human podocytes, had podocyte morphologic features (including foot process-like and slit diaphragm-like structures), and showed functional responsiveness to drug-induced injury.Elucidation of signals that induce podocytes during the nephron-patterning process enabled us to establish a highly efficient method for selective induction of human podocytes from PSCs. These PSC-derived podocytes show molecular, morphologic, and functional characteristics of podocytes, and offer a new resource for disease modeling and nephrotoxicity testing.
SP0148 Pain: the role of psychology
Authors: L. Knudsen
Journal: Annals of the Rheumatic Diseases (2018)

<h3></h3> Pain is a multidimensional experience, and chronic ongoing pain may have wide-ranging social and psychological implications. A biopsychosocial model of understanding is generally considered to be the best pain model, and it is well-established that interdisciplinary pain management is the most effective treatment approach. Psychological management plays an important role in such treatment. This lecture will cover the link between psychological factors and pain as well as psychological pain management. <h3>Disclosure of Interest</h3> None declared
AB0489 Tofacitinib improves left ventricular mass and cardiac output in rheumatoid arthritis patients with chronic heart failure
Authors: K. Kume, K. Amano, S. Yamada, T. Kanazawa, K. Hatta, N. Kuwaba
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Rheumatologists need to develop primary and secondary prevention strategies for cardiovascular disease (CVD) in rheumatoid arthritis (RA) patients. We reported tofacitinib (Tofa) improved left ventricular mass index (LVMI) in patients with rheumatoid arthritis<sup>1)</sup>. We have experienced RA patient with chronic heart failure (CHF). We couldn't use some TNF blockers in RA patients with CHF<sup>2)</sup>. There is no evidence that Tofa effects on left ventricular (LV) morphology and function in RA patients with CHF. <h3>Objectives</h3> To study the effect of Tofa on LV morphology and function in conventional synthetic (cs) DMARDs resistant active RA patients with CHF, in a cohort study design. <h3>Methods</h3> RA patients with CHF were eligible if they had active disease despite treatment with cs DMARDs. Consecutive 24 patients with moderate to severe active RA patients (DAS28 &gt;3.2) despite cs DMARDs were received Tofa plus cs DMARDs. LV morphology and function was assessed with cardio-MRI at baseline and 24 weeks follow-up. Cardiovascular risk factors and clinical data were collected at regular visits. <h3>Results</h3> 21 patients completed 24 weeks. New York heart association functional classification (NYHA) class 1 is 12 cases, class 2 is 7 cases, and class 3 is 2 cases respectively. Left ventricular mass index (LVMI) was attenuated significantly by Tofa (week 0 week24, −9.02±5.8 g/m<sup>2</sup>; p=0.02). Cardiac output (CO) was attenuated significantly by Tofa (week 0 week24,−0.42±1.2 l/min). DAS28 and CRP improved significantly by Tofa (week 0 week24; DAS28: −2.16±0.95; CRP: 15.1±5.7 mg/L) (p&lt;0.05). Surprisingly, the change of disease activity (DAS 28 and CRP) is no correlation with the change of LVMI or CO in this study. Observationally, 2 cases significantly improved right ventricular mass as well as left ventricular mass (10% improved right ventricular mass index from baseline). <h3>Conclusions</h3> Tofa improved LVMI and CO in active RA despite cs DMARDs with CHF. Tofa improves LVMI and CO independently of its effects on disease activity. Tofa might be improved right ventricular mass. JAK-STAT pathway might be an important role of LV hypertrophy. Tofa, JAK-STAT pathway blocking, may prevent cardiovascular morbidity and mortality in RA with CHF. <h3>References</h3> [1] Kume K, et al. Tofacitinib improves left ventricular mass and cardiac output in patients with rheumatoid arthritis. Presentation at Annual Meeting of EULAR 2017. [2] Hochenberg MC, et al. The benefit/risk profile of TNF-blocking agents: findings of a consensus panel. Semin Arthritis Rheum2005Jun;34(6):819–36. <h3>Disclosure of Interest</h3> None declared