tbuckley/cabot-search huggingface dataset:
SP0192 UPDATE OF THE EULAR RECOMMENDATIONS LAGE VESSEL VASCULITIS MANAGEMENT
Authors: Bernhard Hellmich
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Since the publication of the European League Against Rheumatism (EULAR) recommendations for the management of large vessel vasculitis (LVV) in 2009, several relevant randomized clinical trials and cohort analyses have been published, which have the potential to change clinical care and therefore supporting the need to update the original recommendations. <h3>Objectives:</h3> To update the 2009 EULAR recommendations for the management of LVV. <h3>Methods:</h3> Using EULAR standardized operating procedures for EULAR-endorsed recommendations, the EULAR task force undertook a systematic literature review and sought opinion from 20 experts from 13 countries. We modified existing recommendations and created new recommendations. <h3>Results:</h3> Three overarching principles and 10 recommendations were formulated. We recommend that a suspected diagnosis of LVV should be confirmed by imaging or histology. High dose glucocorticoid therapy (40-60 mg/day prednisone-equivalent) should be initiated immediately for induction of remission in active giant cell arteritis (GCA) or Takayasu arteritis (TAK). We recommend adjunctive therapy in selected patients with GCA (refractory or relapsing disease, presence of an increased risk for glucocorticoid-related adverse events or complications) using tocilizumab. Methotrexate may be used as an alternative. Non-biologic glucocorticoid-sparing agents should be given in combination with glucocorticoids in all patients with TAK and biologic agents may be used in refractory or relapsing patients. We no longer recommend the routine use of antiplatelet or anticoagulant therapy for treatment of LVV unless it is indicated for other reasons. <h3>Conclusion:</h3> We have updated the recommendations for the management of LVV to facilitate the translation of current scientific evidence and expert opinion into better management and improved outcome of patients in clinical practice. <h3>Disclosure of Interests:</h3> Bernhard Hellmich Consultant for: Roche, Speakers bureau: Abbvie, MSD, Roche, Novartis, Pfizer
SAT0080 COMPARISON OF INFLAMMATORY CYTOKINES LEVELS IN RHEUMATOID ARTHRITIS WITH CAROTID PLAQUE; CASE-CONTROL STUDY
Authors: Karla Paola Cuéllar-Calderón, Dionicio Ángel Galarza-Delgado, José Ramón Azpiri-López, Iris Jazmin Colunga-Pedraza, Ileana Cecilia Reynosa-Silva, Marielva Castro-González, Carolina Marlene Martínez-Flores, Raymundo Pineda, Gisela García-Arellano, Rosa Arivizú Rivera
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> There is a 50% increase in cardiovascular mortality in RA compared to controls. Chronic inflammation causes endothelial dysfunction and accelerated atherosclerosis. Key molecular pathways in this process are dependent on cytokines like TNF-α, IL-1, IL-6, among others, which are shared with RA. Increased disease activity could contribute to atherosclerosis. Carotid ultrasound (US) has recently been recommended as a screening tool for early detection of subclinical atherosclerosis. <h3>Objectives:</h3> To compare different cytokines between Mexican-mestizo RA-subjects with/without carotid plaque (CP). <h3>Methods:</h3> An observational cross-sectional trial was designed. Inclusion criteria: age between 40-75 years old, fulfillment of the 2010 ACR/EULAR classification criteria, and detection of a CP during a carotid US. Subjects with a prior diagnosis of cardiovascular disease or a poor US window were excluded. RA subjects were matched to controls (RA patients without CP) by age and cardiovascular (CV) comorbidities. Every subject had a carotid US performed; reviewed by two board-certified radiologists. Cytokines measured were IL-1, IL-6, TNF-α, VCAM-1, ICAM-1 and MMP-9, using an ELISA reader (Glomax E9032). Descriptive analysis was done with frequencies (%), median (q25-q75), and comparisons between groups with Chi square test and Mann U Whitney's test. <h3>Results:</h3> 71 subjects were included, 95.8% were females, with a median age of 58 years (54-65). Levels of cytokines in Table 1. Comparisons between groups are in Table 2. Groups were well balanced, with no differences in CV comorbidities (p&gt;0.05). No significant differences among cytokine levels regarding CP were found. Subjects in remission (n=12, 33%) had a lower prevalence of CP (p&lt;0.05, OR: 0.3; 95% CI: 0.1-0.9) and a lower median IL-1 level than those with higher disease activity (p&lt;0.05). No significant differences were found among any other of the compared cytokines. <h3>Conclusion:</h3> In our cohort subjects in remission had a lower prevalence of CP (OR= 0.3, 0.1-0.9). No difference was found between cytokines regarding CP. Subjects with active disease had a higher level of IL-1 than subjects in remission. To our best knowledge, this is the first study to evaluate levels of cytokines in Mexican RA-subjects. <h3>References</h3> [1] López R, et al. Cardiovascular risk assessment in patients with rheumatoid arthritis. Autoimmun Rev2016. [2] Pasceri V, et al. A tale of two diseases: Atherosclerosis and rheumatoid arthritis Circulation1999. <h3>Disclosure of Interests:</h3> None declared
AB0315 EVALUATION OF SLEEP QUALITY, FATIGUE AND SEXUAL PROFILE IN ELDERLY PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: Mohamed Amine EL Achek, Amel Farhat, Saoussen Zrour, Ismail Bejia, Mongi Touzi, Mahbouba Jguirim, Naceur Bergaoui
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> People over the age of 60 with rheumatoid arthritis (RA) often complain of fatigue, which is considered an extra-articular symptom. This problem has a multidimensional character and sounds on the quality of sleep and on the sexual profile. <h3>Objectives</h3> Our study consists in assessing the prevalence of fatigue and studying the quality of sleep and the sexual profile of patients over 60 years of age with RA compared to subjects suffering from the same illness of younger age. <h3>Methods</h3> This is a prospective study involving 100 patients at the Rheumatology department of Fattouma Bourguiba university hospital in Monastir over a period of 6 months: 40 patients more than 60 years of age with RA compared with 60 patients with RA of younger age. Data collection was based on scales and specific questionnaires (Visual Analogue Fatigue Scale (VAS-F), Multidimensional Fatigue Inventory (MFI-20), Pittsburgh Sleep Quality Index (PSQI), Female sexual Function Index (FSFI), Sexual Health Inventory for Men (SHIM). <h3>Results</h3> The average age was 55.8 years [25-84]. The most represented age group was over 60 (40%). The sex ratio was 5.6. 73% of our patients were married and 81% had children with an average number of 3 children in charge and extremes between 1 and 9. Fatigue, sleep quality and sexual profile were analyzed comparatively and respectively between the 2 groups (1st group≥60 and second &lt;60 years). The average of the VAS-F was 60.25 compared to 53.5. Fatigue (via MFI-20) was present in all its domains in our patients. General fatigue and physical fatigue were the highest, averaging 13.98 vs. 13.07 and 12.98 vs. 12.33 respectively. Sleeping insomnia (PSQI&gt; 5) was found with the same proportion of 65% in both groups. Low sleep quality was found in 90% versus 93%. A sleep latency&gt; 31 minutes was found in 37.5% against 30%. Sleep duration &lt;6 hours per night was found in 52.5% versus 50%. Sleep efficiency &lt;85% was found at an equal percentage of 75%. Sleep disorders&gt; 10 times in the last 4 weeks were found at an equal percentage of 15%. Regular female sexual activity was found in 42.5% versus 71% and dysfunction (FSFI≤26.55) was noted in 35% against 63.3%. Regular male sexual activity was found in 54.5% against 75% and mild erectile dysfunction (SHIM≤21) was noted in 83.3% against 20%. <h3>Conclusion</h3> A multidimensional approach is needed to explore the different components of fatigue, sleep quality and sexual profile in patients with RA and its very diverse consequences. This should lead to an improvement in the quality of life in the current medical practice. <h3>Disclosure of Interests</h3> None declared
A study of the endocytosis mechanism and transendothelial activity of lung-targeted GALA-modified liposomes
Authors: Sarochin Santiwarangkool, Hidetaka Akita, Ikramy A. Khalil, Mahmoud M. Abd Elwakil, Yusuke Sato, Kenji Kusumoto, Hideyoshi Harashima
Journal: Journal of Controlled Release (2019)
PB2032 BASELINE PREDICTORS INFLUENCING THE PROGNOSIS OF INVASIVE ASPERGILLOSIS IN ADULTS
Authors: P. Köhler, J. Salmanton Garcia, S. Gräfe, F. Koehler, S. Mellinghoff, D. Seidel, A. Steinbach, O. Cornely
Journal: HemaSphere (2019)

Please indicate where the abstract has been published before: Journal of Infection. Background: Invasive aspergillosis (IA) is a serious hazard to hematological and critical care patients. Aims: To understand prognostic variables we analyzed original articles identifying baseline factors that predict treatment outcome in patients with IA. Methods: PubMed database was searched for publications since database inception until May 2018. Inclusion criteria were published baseline prognostic factors present at the diagnosis of IA. Results: In total, 58 studies from 267 centers reported 7,320 patients with IA, and 40 different predictors. Unfavorable predictors in medical history were kidney (7.4%, 10/136) and liver failure (3.7%, 5/136), ICU admission (3.7%, 5/136), and uncontrolled underlying disease (3.7%, 5/136). Regarding state of immunosuppression, negative outcome predictors were prolonged neutropenia (12.5%, 17/136), corticosteroid treatment (8.1%, 11/136), and graft‐versus‐host disease (3.7%, 5/136). On the pathogen side, relevant predictors were galactomannan positivity (8.1%, 11/136), Aspergillus terreus infection (2.2%, 3/136), and lack of amphotericin B susceptibility (1.5%, 2/136). IA‐specific predictors were disseminated disease (5.1%, 7/136) and CNS involvement (2.9%, 4/136). Imaging results associated with negative outcome were multiple consolidations (2.9%, 4/136), bipulmonary lesions (2.2%, 3/136), and pleural effusion (2.2%, 3/136). Summary/Conclusion: At diagnosis of IA, most frequently identified predictors of outcome were neutropenia, corticosteroid use, elevated galactomannan, renal failure, and disseminated disease.
A cellular census of human lungs identifies novel cell states in health and in asthma
Authors: Felipe A. Vieira Braga, Gozde Kar, Marijn Berg, Orestes A. Carpaij, Krzysztof Polanski, Lukas M. Simon, Sharon Brouwer, Tomás Gomes, Laura Hesse, Jian Jiang, Eirini S. Fasouli, Mirjana Efremova, Roser Vento-Tormo, Carlos Talavera-López, Marnix R. Jonker, Karen Affleck, Subarna Palit, Paulina M. Strzelecka, Helen V. Firth, Krishnaa T. Mahbubani, Ana Cvejic, Kerstin B. Meyer, Kourosh Saeb-Parsy, Marjan Luinge, Corry-Anke Brandsma, Wim Timens, Ilias Angelidis, Maximilian Strunz, Gerard H. Koppelman, Antoon J. van Oosterhout, Herbert B. Schiller, Fabian J. Theis, Maarten van den Berge, Martijn C. Nawijn, Sarah A. Teichmann
Journal: Nature Medicine (2019)
SP0084 POST-ACTIVATED B CELLS IN AUTOIMMUNITY
Authors: Andreia Lino
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> B cells are key players in autoimmune diseases such as systemic lupus erythematosus (SLE), primary Sjögren"s syndrome (pSS) and rheumatoid arthritis (RA). In the past, it was believed that B cells from these patients were hyperresponsive to B cell receptor (BCR) and Toll-like receptor (TLR) signaling. New insights suggest that B cells from these patients present a post-activated <i>functiotype</i>. <h3>Objectives:</h3> We aim at characterizing B cells and B cell responses of SLE, pSS and RA patients to understand which venues can be taken towards new therapies for these diseases. <h3>Methods:</h3> B cells and B cell subsets from peripheral blood samples from SLE, pSS and RA patients and healthy donors (HD), as well as few autoimmune tissues, were analyzed for: phosphotyrosine kinase (PTK) phosphorylation kinetics, protein phosphatase activity, expression of phosphatases or of checkpoint molecules, such as <i>e.g.</i>PD-1, before and after BCR engagement, alone or together with TLR9 and CD40 stimulation, differentiation and proliferation. Expression of transcription factors, such as <i>e.g.</i>STAT1, and the effect of interferons in their expression in B cells from patients were also evaluated. <h3>Results:</h3> B cell responses upon BCR engagement in SLE, pSS, RA patients were abnormal with diminished BCR downstream PTK phosphorylation. TLR9, but not CD40 responses were also abnormal. Part of the abnormality related to diffuse up-regulation of phosphatases that apparently counteracted PTK signaling. The abnormality was partially mimicked by repeated signaling through the BCR of HD B cells and could be overcome by CD40 engagement. Check-point molecules, such as <i>e.g.</i>PD-1, was differentially expressed in SLE naive and memory B cells. SLE naive and memory B cells expressed higher amounts of STAT1 compared to those of pSS, RA and HD. <h3>Conclusion:</h3> Post-activated B cells are characterized by a phenotype of dysregulated expression of certain check-point molecules, such as PD-1, some transcription factors, like STAT1 and certain phosphatases (figure 1). Our data suggest that CD40 activation is involved in modulating BCR responses in post-activated B cells. This has implications for innovative therapies since blocking BCR signaling pathways and CD40 activation as well as targeting certain phosphatases may have synergistic value for treating systemic autoimmunity. <h3>Disclosure of Interests:</h3> None declared
Avatrombopag, a Novel Oral Thrombopoietin Receptor Agonist, Demonstrates Superiority to Placebo for the Treatment of Chronic Immune Thrombocytopenic Purpura in a Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Wojciech Jurczak, Krzysztof Chojnowski, Jiri Mayer, Katarzyna Krawczyk, Francesco Bibbiani
Journal: Blood (2017)
Ancient Recombination Events between Human Herpes Simplex Viruses
Authors: Sonia Burrel, David Boutolleau, Diane Ryu, Henri Agut, Kevin Merkel, Fabian H. Leendertz, Sébastien Calvignac-Spencer
Journal: Molecular Biology and Evolution (2017)

Herpes simplex viruses 1 and 2 (HSV-1 and HSV-2) are seen as close relatives but also unambiguously considered as evolutionary independent units. Here, we sequenced the genomes of 18 HSV-2 isolates characterized by divergent UL30 gene sequences to further elucidate the evolutionary history of this virus. Surprisingly, genome-wide recombination analyses showed that all HSV-2 genomes sequenced to date contain HSV-1 fragments. Using phylogenomic analyses, we could also show that two main HSV-2 lineages exist. One lineage is mostly restricted to subSaharan Africa whereas the other has reached a global distribution. Interestingly, only the worldwide lineage is characterized by ancient recombination events with HSV-1. Our findings highlight the complexity of HSV-2 evolution, a virus of putative zoonotic origin which later recombined with its human-adapted relative. They also suggest that coinfections with HSV-1 and 2 may have genomic and potentially functional consequences and should therefore be monitored more closely.
SAT0022 THE SUBPOPULATION FEATURES OF DENDRITIC CELLS AS A POTENTIAL BIOMARKER OF EARLY RHEUMATOID ARTHRITIS
Authors: Maxim Korolev, Yuliya Kurochkina, Nadezda Banshhikova, Vitaly Omelchenko, Anna Akimova, Elena Letyagina, Mariya Surovtseva, Alexander Lykov, Olga Poveschenko
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Dendritic cells (DCs) are professional antigen-presenting cells (APCs), which play important role in immune responses. DCs are a heterogeneous population and can be divided into groups: myeloid (mDCs) and plasmacytoid (pDCs). Furthemore, DCs are important in rheumatoid arthritis (RA) pathogenesis through antigen presentation and activation autoreactive T-lymphocytes. As established the different subpopulation DCs can promote different immune reactions. That's why, it may be possible to consider them as a potential target for the development of new target of the immunopathological disorders therapy. <h3>Objectives:</h3> To investigate the subpopulations of peripheral blood DCs (myeloid and plasmacytoid) in patients with early RA as a predictor of responsibility to disease-modifying antirheumatic drugs (DMARDs) treatment. <h3>Methods:</h3> Forty nine patients with early RA (duration of the disease up to 12 months) were included in the study. All patients fullfield ACR/EULAR criteria (2010) and received methotrexate, leflunomide, sulfasalazine or their combination. Forty three patients with osteoarthritis (OA) used as a control group. Analysis of the content of the B-lymphocytes, myeloid and plasmacytoid DCs, labeled by antibodies against surface markers, was carried out by flow cytometry. B-lymphocytes, subtypes of peripheral blood DCs were characterized by the following phenotypes: myeloid DCs (CD3-CD14-CD19-HLA-DR + CD11c + CD123-), plasmacytoid DCs (CD3-CD14-CD19-HLA-DR + CD11c-CD123 +), B-lymphocytes (CD19 +). Analysis were performed before treatment and after 3 and 6 months. <h3>Results:</h3> Patients with early RA are characterized by significant evaluation of the population of plasmacytoid DCs in comparison of patients with moderate stages of rheumatoid arthritis and osteoarthritis (3.8 vs2.1 vs 1, p=0.0042). Furthermore, the difference was found in the number of cells with the phenotype B-lymphocytes: 7.95 * 106/l vs. 3.6* 106/l, respectively (p = 0.014). No significant differences were observed in the number of myeloid DCs. After 6 month of observation we detected reducing amount of plasmacytoid DCs (3.8 before treatment and 2.1 in 6 month, p=0.002) and B-cells that correlated with activity of disease. <h3>Conclusion:</h3> The data obtained indicated that plasmacytoid DCs are predominant in patients with inflammatory arthritis especially in early RA and correlate with activity of disease that can use as a predictor of good response on DMARDs treatment. <h3>Disclosure of Interests:</h3> None declared
Bryon Edward Roberts
Authors: Derek Norfolk, Graeme Smith, David Roberts
Journal: BMJ (2019)

Bryon Edward Roberts founded the department of haematology at the General Infirmary at Leeds and was a major figure in the development of modern haematology practice in Yorkshire and the UK. His father, Albert Roberts, was a coal miner and trades unionist who became the Labour MP for Normanton in west Yorkshire. In his youth, Bryon was an excellent cricketer, close to county level—an attritional batsman, “more Geoffrey Boycott than Viv Richards,” as he put it.

Bryon entered Leeds Medical School in 1951. In his professional autobiography, Blood on my Hands (2016), he described postwar Leeds as “a dirty, smoky city” that contrasted sharply with “the gleam and glitter of the Rolls Royces and Bentleys of the hospital’s consultant staff.” After qualifying in 1957 he married Audrey, a school teacher, later in the same year. He worked at the Leeds General Infirmary as house surgeon to Digby Chamberlain and Michael Oldfield, proteges of the legendary surgeon Berkley Moynihan, and was then …
Mycophenolate mofetil: a step forward in the induction treatment of ANCA-associated vasculitis? Comment on the article by Jones<i>et al</i>
Authors: Frédéric Alain Vandergheynst, Christophe Lelubre
Journal: Annals of the Rheumatic Diseases (2019)

We have read with interest the results of the MYCYC trial showing that mycophenolate mofetil (MMF) is not inferior to intravenous cyclophosphamide (CYC) in achieving a primary remission in the treatment of ANCA-associated vasculitides (AAV).1 We would like to address several comments.

First, in a previous report of the MYCYC trial in 2013, the authors could not establish a non-inferiority of MMF compared with CYC because the lower bound of the 90% CI of the absolute risk difference (RD) crossed the prespecified non-inferiority margin of −12% (MMF: n=46/70 (66%) vs CYC: n=48/70 (69%), RD=−3%, 90% CI −16% to 10%, p=0.06).2 In the current publication, the reported primary remission rates at 6 months are slightly different compared …
AB0631 INTERSTITIAL LUNG DISEASE – A RARE MANIFESTATION OF MICROSCOPIC POLYANGIITIS
Authors: Ekaterina Vinogradova, Nikolai Bulanov, Elena Shchegoleva, Larisa Akulkina, Anastasiia Zykova, Pavel Novikov, Sergey Moiseev
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Interstitial lung diseases (ILD) are a group of diffuse inflammatory and/or fibrotic lung disorders with similar clinical, radiologic and histopathologic features. The coexistence of ILD and aNCA-associated vasculitis has been reported in case reports and small case series. <h3>Objectives:</h3> The aim of this study was to assess the prevalence, clinical and radiological characteristics of ILD in MPA patients admitted to the Rheumatology Department of our hospital. <h3>Methods:</h3> This retrospective single center cohort study included 102 patients diagnosed with MPA according to CHCC 2012 and EMA algorithm. We assessed Birmingham Vasculitis activity Score (BVAS) at disease onset and VDI (Vasculitis Damage index) at the end of the follow up in each patient. ANCA type and titer were assessed by enzyme-linked immunosorbent assay (ELISA). The results of repeated high resolution computed tomography (HRCT) of the chest were analyzed and interstitial changes (focal ground-glass opacity, reticular changes, honeycombing, traction bronchiectasis) were classified in four patterns: non-specific interstitial pneumonia (NSIP), typical interstitial pneumonia, possible interstitial pneumonia, and "inconsistent" usual interstitial pneumonia (UIP). <h3>Results:</h3> ILD-features on HRCT was found in 11 (11.8%) of 102 patients with MPA. Their median age was 55 [53; 63] years. All of them were aNCA-positive (Table 1). In 5 cases interstitial pneumonia was the first and the sole manifestation that preceded for the occurrence of overt systemic vasculitis for a median of 3 years. The radiologic patterns included non-specific interstitial pneumonia in 5 cases, usual interstitial pneumonia in 3 cases and unclassifiable interstitial pneumonia in 3 cases. The most common clinical manifestations were non-productive cough (82%), progressive dyspnea (82%) and crepitation (27%). The most common extrathoracic manifestations of MPA in patients with ILD were glomerulonephritis with decreased renal function (91%), fever (100%) and arthritis (91%). All patients received induction therapy with glucocorticosteroids combined with cyclophosphamide, rituximab, azathioprine or methotrexate. <h3>Conclusion:</h3> ILD is a rare manifestation of MPA, which can precede systemic manifestations. ANCA-associated vasculitis should be included in the spectrum of differential diagnosis in patients with ILD. <h3>Disclosure of interests:</h3> None declared