[Show abstract][Hide abstract] ABSTRACT: •An improved YASSO model is proposed by considering residual spatial autocorrelation.•Model prediction errors are minimised using GIS data at the appropriate spatial scale.•Topographical factors describe 24-49% of variation in soil carbon.
Gynecologic oncology case reports. 08/2014; 9:26-8.
[Show abstract][Hide abstract] ABSTRACT: To investigate differences in genetic risk factors for rheumatoid arthritis (RA) in Han Chinese as compared with Europeans.
A genome-wide association study was conducted in China with 952 patients and 943 controls, and 32 variants were followed up in 2,132 patients and 2,553 controls. A transpopulation meta-analysis with results from a large European RA study was also performed to compare the genetic architecture across the 2 ethnic remote populations.
Three non-major histocompatibility complex (non-MHC) loci were identified at the genome-wide significance level, the effect sizes of which were larger in anti-citrullinated protein antibody (ACPA)-positive patients than in ACPA-negative patients. These included 2 novel variants, rs12617656, located in an intron of DPP4 (odds ratio [OR] 1.56, P = 1.6 × 10(-21) ), and rs12379034, located in the coding region of CDK5RAP2 (OR 1.49, P = 1.1 × 10(-16) ), as well as a variant at the known CCR6 locus, rs1854853 (OR 0.71, P = 6.5 × 10(-15) ). The analysis of ACPA-positive patients versus ACPA-negative patients revealed that rs12617656 at the DPP4 locus showed a strong interaction effect with ACPAs (P = 5.3 × 10(-18) ), and such an interaction was also observed for rs7748270 at the MHC locus (P = 5.9 × 10(-8) ). The transpopulation meta-analysis showed genome-wide overlap and enrichment in association signals across the 2 populations, as confirmed by prediction analysis.
This study has expanded the list of alleles that confer risk of RA, provided new insight into the pathogenesis of RA, and added empirical evidence to the emerging polygenic nature of complex trait variation driven by common genetic variants.
[Show abstract][Hide abstract] ABSTRACT: Background: No previous study has been done on whether systemic lupus erythematosus (SLE) disease activity is related to the hemodynamics and right ventricular (RV) function in patients with SLE-associated pulmonary artery hypertension (SLE-APAH). Methods and Results: This study prospectively recruited 54 patients (mean age, 32.8±8.4 years; 92.6% female) with SLE-APAH, including 34 patients with SLE disease activity index (SLEDAI) <5 (low score) and 20 with SLEDAI ≥5 (high score). All patients underwent right heart catheterization and iloprost inhalation, and echocardiography was performed before and immediately after iloprost inhalation. There was no difference in baseline mean pulmonary artery pressure (mPAP) between the 2 groups; pulmonary vascular resistance (PVR) was significantly higher and cardiac index was significantly lower in the low-SLEDAI group. The patients with low SLEDAI had larger RV size and worse RV systolic function on echocardiography. After iloprost inhalation, the patients with low SLEDAI had a greater decrease in mPAP and PVR than those with high SLEDAI, while significantly increased RV systolic function was found only in the low-SLEDAI group. Conclusions: SLE activity is related to hemodynamics and RV function in SLE-APAH patients, and those with low SLEDAI might have better acute response to vasodilator inhalation.
[Show abstract][Hide abstract] ABSTRACT: Behçet's disease (BD) is a rare, chronic, relapsing, systemic, immune-mediated vasculitis and the etiology remains to be defined. This study investigated single-nucleotide polymorphisms (SNP) of tyrosine-protein phosphatase non-receptor type 2 (PTPN2) and inducible T-cell co-stimulator-ligand gene (ICOSLG) in Chinese Han BD patients and healthy controls because SNPs of these two genes are associated with risk of developing other auto-inflammation diseases.
A total of 407 BD patients and 679 ethnically matched healthy controls were recruited for genotyping of PTPN2 rs1893217, rs2542151, rs2847297 and rs7234029 SNPs and ICOSLG rs2838519 and rs762421 SNPs using a Sequenom MassArray system.
PTPN2 rs1893217 was associated with risk of developing BD (χ2=10.01, pc=0.040), while the PTPN2 rs2542151 genotype had a weak association in basic genotype analysis (χ2=7.49, p=0.024), but it could not withstand the strongest Bonferroni correction (pc=0.14). In contrast, PTPN2 rs2847297 and rs7234029 and ICOSLG rs2838519 and rs762421 did not correlate with BD risk. Moreover, logistic analysis with the additive, dominant and recessive genetic models did not reveal any statistical difference between BD cases and controls (pc>0.05). In addition, associations were observed between the two SNPs (rs1893217, rs2542151) and the patients with gastrointestinal involvement (pc=0.027, pc=0.032, respectively).
PTPN2 variant rs1893217 was associated with risk of BD development in a Han Chinese population. Further study will confirm this finding and investigate the role of PTPN2 in development of BD.
Clinical and experimental rheumatology 01/2014; · 2.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study is to investigate the correlation between clinical parameter, Th17, and degree of lymphocytes infiltrating in labial salivary gland in primary Sjögren's syndrome (pSS). Minor labial gland biopsies from a cohort of 103 patients fulfilling the American-European consensus classification criteria for pSS were examined and grouped into G1 to G3 according to infiltration degree of lymphocytes in labial salivary glands and formation of germinal center. IL-17 level and Th17 proportion of peripheral blood samples in 54 patients with pSS were analyzed simultaneously. Among the 103 labial salivary glands samples, there were 10.5 % of G1, 68.4 % of G2, and 21.1 % of G3, respectively. Some clinical parameters were markedly associated with the degree of inflammatory cells infiltration in labial glands, including white blood cell counts, lymphocytes, liver enzymes, and pulmonary function diffusion rates. The average optical density of IL-17 correlated with the severity of lymphocytic infiltration in the labial glands, while the proportion of Th17 cells in the peripheral blood mononuclear cells showed no significant relationship to the degree of lymphocytic infiltration in the labial glands from the SS patients. IL-17A mRNA levels in peripheral blood mononuclear cells from pSS patients before immunosuppressant treatment were significantly higher than that in patients after immunosuppressant treatment. The degree of inflammatory cells infiltration in labial glands was related to some clinical manifestations in pSS. IL-17 may play a role in the pathogenesis of lymphocytic infiltration in the labial glands. Immunosuppressive treatment might affect Th17 cells.
[Show abstract][Hide abstract] ABSTRACT: We investigated the characteristics of Chinese SLE patients by analyzing the association between specific autoantibodies and clinical manifestations of 2104 SLE patients from registry data of CSTAR cohort. Significant (P < 0.05) associations were found between anti-Sm antibody, anti-rRNP antibody, and malar rash; between anti-RNP antibody, anti-SSA antibody, and pulmonary arterial hypertension (PAH); between anti-SSB antibody and hematologic involvement; and between anti-dsDNA antibody and nephropathy. APL antibody was associated with hematologic involvement, interstitial lung disease, and a lower prevalence of oral ulcerations (P < 0.05). Associations were also found between anti-dsDNA antibody and a lower prevalence of photosensitivity, and between anti-SSA antibody and a lower prevalence of nephropathy (P < 0.05). Most of these findings were consistent with other studies in the literature but this study is the first report on the association between anti-SSA and a lower prevalence of nephropathy. The correlations of specific autoantibodies and clinical manifestations could provide clues for physicians to predict organ damages in SLE patients. We suggest that a thorough screening of autoantibodies should be carried out when the diagnosis of SLE is established, and repeated echocardiography annually in SLE patients with anti-RNP or anti-SSA antibody should be performed.
Research Journal of Immunology 01/2014; 2014:809389.
[Show abstract][Hide abstract] ABSTRACT: •The present case is the first case report of PSTT associated with lupus nephritis.•The patient presented with lupus nephritis as paraneoplastic nephropathy before PSTT discovered, and rapidly achieved complete remission after hysterectomy.•This unusual findings must be interpreted appropriately to achieve the correct diagnosis
[Show abstract][Hide abstract] ABSTRACT: Primary Sjögren's syndrome is one of the most common autoimmune diseases. So far, genetic studies of Sjögren's syndrome have relied mostly on candidate gene approaches. To identify new genetic susceptibility loci for primary Sjögren's syndrome, we performed a three-stage genome-wide association study in Han Chinese. In the discovery stage, we analyzed 556,134 autosomal SNPs in 542 cases and 1,050 controls. We then validated promising associations in 2 replication stages comprising 1,303 cases and 2,727 controls. The combined analysis identified GTF2I at 7q11.23 (rs117026326: Pcombined = 1.31 × 10(-53), combined odds ratio (ORcombined) = 2.20) as a new susceptibility locus for primary Sjögren's syndrome. Our analysis also confirmed previously reported associations in Europeans in the regions of STAT4, TNFAIP3 and the major histocompatibility complex (MHC). Fine mapping of the region around GTF2I showed that rs117026326 in GTF2I had the most significant association, with associated SNPs extending from GTF2I to GTF2IRD1-GTF2I.
[Show abstract][Hide abstract] ABSTRACT: Different causes of mortality have been described over different decades followed by description of pathogens identified from infective episodes that led to death. A retrospective review was performed in 3,831 hospitalized systemic lupus erythematosus (SLE) patients in Peking Union Medical College Hospital from January 1986 to April 2012. The primary causes of death were identified, and the constituent ratio of specific death causes during different periods was compared. Among 3,831 hospitalized SLE patients, 268 patients died, accounting for 7.0 %. No significant difference of death rate was found between men and women, P = 0.404. The three most frequent death causes according to decade were as follows: for 1986-1995, renal involvement, lupus encephalopathy, and infections; for 1996-2005, infections, lupus encephalopathy, and renal involvement; and for 2006-2012, infections, lupus encephalopathy, and pulmonary hypertension. Certain types of deaths, primarily related to lupus activity, have decreased over time, whereas infections, often attributed to the use of corticosteroid and immunosuppressant medications, have increased gradually and changed to the most frequent death causes of SLE. Early mortality (<3 years) occurred more commonly in lupus encephalopathy, while late death (>3 years) happened more frequently in renal involvement, pulmonary artery hypertension, cardiovascular events, and cancer. In SLE death cases mainly dying from infection, mixed infections were more frequent than single pathogen infection (60.5 vs. 39.5 %), including common bacteria, fungal infection, and cytomegalovirus. Aspergillus fumigatus and Pneumocystis carinii were the two most commonly infected pathogens, and Cytomegalovirus was a frequent pathogen of mixed infection. Aggressive therapy has effectively reduced the mortality related to disease activity but also was associated with life-threatening infections. Mixed and fungal infection should be considered when SLE patients have severe infection.
[Show abstract][Hide abstract] ABSTRACT: Previous studies on gene expression profiles in primary biliary cirrhosis (PBC) have exclusively focused on liver tissue or intrahepatic cells. Since the pathological process is systemic, other complementary studies in blood cells seemed to be reasonable. In this research, we try to explore differentially expressed genes in peripheral blood mononuclear cells (PBMCs) of PBC patients. Nine PBC patients and 9 healthy controls were recruited as Cohort 1 for a microarray study of screening. Total RNA of PBMCs from each individual was isolated and screened by oligonucleotide microarray (22 K). Then, differentially expressed genes were categorized into signaling pathways. Expression levels of three important genes, tyrosine kinase binding protein (TYROBP), C-C motif chemokine 5 (CCL5) and cathepsin L (CTSL) were confirmed by quantitative real-time polymerase chain reaction (qRT-PCR) in a second Cohort 2 (30 PBC patients and 20 healthy controls). Results show that sixty-five genes differentially expressed in PBC were identified, 20 of which were up-regulated and 45 of which were down-regulated. Twenty-seven signaling pathways were identified. TYROBP and CCL5 were proved to be down-regulated in PBC, and CTSL was proved to be up-regulated (p < 0.05) in PBC, which were all consistent with the screening study. In conclusions, the analysis of gene expression in PBMCs of PBC and the comparison of gene profiles between PBMCs and the liver may provide new clues to the pathogenesis of the disease.
Clinical and Experimental Medicine 08/2013; · 2.40 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Primary Sjögren's syndrome (pSS) is an autoimmune disease with a complex genetic background. Single nucleotide polymorphisms (SNPs) in the BANK1 and FAM167A-BLK genes have been associated with multiple autoimmune diseases. In this study, we investigated whether SNPs in the BANK1 (rs4522865, rs17266594, and rs10516487) and in the FAM167A-BLK region (rs2736340, rs13277113) could be associated with pSS in Chinese Han.
Blood DNA was extracted from 540 patients with pSS and 577 healthy controls, and genotyped using the Sequenom MassArray system.
There was no significant association between the polymorphisms of BANK1 and pSS. However, the frequency of Pss patients with the T allele (rs2736340) and A allele (rs13277113) of the FAM167A-BLK region was higher than that in the controls (p=0.034; p=0.026 respectively). Genotype and haplotype frequencies of these two SNPs (rs2736340 and rs13277113) between the patients and healthy controls were also significantly different. In addition, associations were observed between the two SNPs and the patients negative for anti-LA/SSB antibodies (p=0.036 and p=0.031 respectively). There was no epistatic interaction between the SNPs in the BANK1 and FAM167A-BLK region.
Our results indicated that the SNPs (rs2736340, rs13277113) of the FAM167A-BLK region, but not the BANK1 SNPs (rs4522865, rs17266594, and rs10516487), were associated with the development of pSS in Han Chinese.
Clinical and experimental rheumatology 07/2013; · 2.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective To study the effect of resveratrol on murine CD4(+);T lymphocyte activation. Methods Splenic mononuclear cells (SMCs) from specific pathogen free (SPF) BALB/c mice (female, aged 9-10 weeks) were cultured with resveratrol (0, 10, 20, and 40 mmol/L) for 30 min in vitro, and then were activated with ConA, anti-CD3 or anti-CD3/anti-CD28. At 6 h (for CD69) and 36 h (for CD71), cells were harvested for being stained with anti-CD4-PerCP and anti-CD69-FITC, or anti-CD4-PerCP and anti-CD71-FITC, and the expressions of CD69 and CD71 were detected respectively using flow cytometry. Results Resveratrol (≥10 mmol/L) significantly decreased CD69 levels on CD4(+);T lymphocytes activated with anti-CD3 in a dose-dependent manner (P<0.01). In addition, resveratrol (≥20 mmol/L) decreased CD69 levels on CD4(+);T lymphocytes activated with ConA, and anti-CD3/anti-CD28 in a dose-dependent manner (P<0.05). When concentrations ≥10 mmol/L, resveratrol depressed CD71 expression on ConA stimulated CD4(+);T lymphocytes (P<0.05), and resveratrol (≥20 mmol/L) decreased CD71 levels on anti-CD3 and anti-CD3/anti-CD28 stimulated CD4(+);T lymphocytes (P<0.05), all in a dose-dependent manner. Conclusion Resveratrol inhibits the activation of murine CD4(+);T lymphocytes in a dosedependent manner.
Xi bao yu fen zi mian yi xue za zhi = Chinese journal of cellular and molecular immunology 07/2013; 29(7):677-80.
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVES: This study aimed to explore miRNA expression profiles in peripheral blood mononuclear cells (PBMCs) from patients with systemic lupus erythematosus (SLE) and the potential biological functions of the associated miRNA in the pathogenesis of SLE. METHODS: Fifty patients with active SLE and 26 healthy controls were enrolled. Four patients and four controls were used for miRNA microarray analysis to detect the levels of 847 miRNAs in PBMCs. The others were used for qRT-PCR confirmation and miRNA functional studies. A reporter gene assay was used to determine the biological function of miR-125b. RESULTS: Eleven miRNAs were found to be up-regulated and 26 miRNAs were down-regulated in SLE patients. Further analysis showed that the down-regulation of miR-125b, mainly in T cells, was negatively correlated with lupus nephritis. We also confirmed that ETS1 and STAT3 are target genes of miR-125b using a dual-luciferase reporter transfection assay. CONCLUSIONS: These data identified this miRNA expression profile as a possible new biomarker of SLE. Moreover, the down-regulation of miR-125b mainly in T cells may contribute to the pathogenesis of SLE by regulating ETS1 and STAT3 gene expression.
Clinical and experimental rheumatology 01/2013; · 2.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Immune imbalance between regulatory T (Treg) and Th17 cells is a characteristic of systemic sclerosis (SSc). The functional heterogeneity among Treg can be elucidated by separating Treg into different subsets based on the expression of FoxP3 and CD45RA. The aim of this study was to investigate the role of Treg subsets in the immune imbalance in naïve SSc.
Peripheral blood mononuclear cells (PBMCs) of 31 SSc patients and 33 healthy controls were analyzed for the expression of CD4, CD25, CD45RA, CTLA-4, FoxP3, and IL-17 using flow cytometry. Treg immunesuppression capacity was measured in co-culture experiments. The expression of FoxP3, CTLA-4, IL-17A, and RORC mRNA was measured by real-time PCR.
The frequency of CD4(+)CD25(+)FoxP3(+) Treg cells was significantly elevated in patients with SSc (3.62±1.14 vs 1.97±0.75, p<0.001) with diminished immunosuppression capacity. In SSc, the proportion of FoxP3(high)CD45RA(-) activated Treg cells (aTreg) was decreased, the proportion of FoxP3(low)CD45RA(-) T cells was increased, and the proportion of FoxP3(low)CD45RA(+) resting Treg cells (rTreg) was decreased. The immune suppression capacity of aTreg and rTreg was diminished, while FoxP3(low)CD45RA(-) T cells exhibited a lack of suppression capacity. The immune dysfunction of aTreg was accompanied by the abnormal expression of CTLA-4. Th17 cell numbers were elevated in SSc, FoxP3(low)CD45RA(-) T cells produced IL-17, confirming their Th17 potential, which was consistent with the elevated levels of FoxP3(+)IL-17(+) cells in SSc.
A decrease in aTreg levels, along with functional deficiency, and an increase in the proportion of FoxP3(low)CD45RA(-) T cells, was the reason for the increase in dysfunctional Treg in SSc patients, potentially causing the immune imbalance between Treg and Th17 cells.
PLoS ONE 01/2013; 8(6):e64531. · 3.73 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVES: This study aims to assess the efficacy and safety of low-dose tacrolimus therapy in patients with refractory lupus nephritis (LN) who were resistant to cyclophosphamide (CYC). METHODS: A total of 26 LN patients (4 men and 22 women) with persistent proteinuria who were resistant to CYC treatment (>8 g in less than 6 months) were enrolled. Tacrolimus was initiated at 2 mg/day (if patient weight <60 kg) or 3mg/day (if patient weight ≥60 kg), administered in two divided doses. Prospective data on daily proteinuria, serum albumin level, and serologic lupus activity were collected for 6 months. RESULTS: Mean age at baseline was 29.36±9.45 years. Mean urinary protein significantly decreased from 6.91±4.50 g at baseline to 1.11±1.10 g at 6 months (p<0.001). Mean serum album level significantly increased from 25.56±7.94 g/L at baseline to 38.12±2.42 g/L at 6 months (p<0.001). Mean systemic lupus erythematosus disease activity index (SLEDAI) score decreased from 11.42±6.74 at baseline to 3.61±2.73 at 6 months (p<0.001). Complete or partial response was observed in 88.46% of patients receiving tacrolimus therapy at 6 months. Twenty-one patients achieved partial or complete remission in two months. There was no significant difference among tacrolimus levels for patients with complete, partial, or no response. The effective dosage in this study was 2-3 mg/day for patients with complete or partial response to tacrolimus. Tacrolimus was well tolerated at the administered dose, though one patient developed severe lung infection. CONCLUSIONS: Our results suggested tacrolimus at low dosage and serum level to be potentially effective and safe for treatment in patients with LN resistant to sufficient CYC therapy. A tacrolimus dosage of 2-3 mg daily appears to be effective and safe.
Clinical and experimental rheumatology 08/2012; · 2.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Cardiac mass is a rare manifestation of Behçet's disease (BD). Intracardiac thrombosis, endomyocardiofibrosis, endocardial fibroelastosis, inflammatory mass and cystic change have been reported as different entities of cardiac mass in BD. Here we presented 6 cases of this rare manifestation of BD. The clinical and pathological features were reviewed.
Clinical and experimental rheumatology 08/2012; · 2.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To determine the significance of hepatitis B virus (HBV)-associated antigen deposition in renal tissue from patients with systemic lupus erythematosus (SLE).
The medical records of 166 inpatients with lupus nephritis and 384 controls without SLE were analyzed retrospectively. Patients with SLE were classified as positive or negative depending on whether HBV-associated antigen deposition was detected in renal biopsies.
HBV-associated antigen deposition was mainly detected in renal tissue from patients with SLE (50.6%), primary renal glomerular disease (20.8%), and allergic purpura (21.7%). It was not detected in renal tissue from patients with diabetic nephropathy, hypertensive nephrosclerosis, thin basement membrane nephropathy, or Alport syndrome. Hepatitis B surface antigen and core antigen were deposited in the mesangial region and vascular loops. The positive group had a significantly higher frequency of IgG, IgA, and IgM deposition than the negative group (53.6% vs 30.5%; p < 0.01). There was no significant difference in the types of lupus nephritis observed between the 2 groups.
There was a high prevalence of HBV-associated antigen deposition in renal tissue of patients with SLE by indirect immunofluorescence, which may result mainly from the cross-reactivity with deposited immunoglobulins.
The Journal of Rheumatology 03/2012; 39(5):974-8. · 3.26 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To study the prevalence of extraglandular manifestations in primary Sjögren's syndrome (SS) among participants enrolled in the Sjögren's International Collaborative Clinical Alliance (SICCA) Registry.
A total of 1,927 participants in the SICCA registry were studied, including 886 participants who met the 2002 American-European Consensus Group (AECG) criteria for primary SS, 830 "intermediate" cases who had some objective findings of primary SS but did not meet AECG criteria, and 211 control individuals. We studied the prevalence of immunologic and hematologic laboratory abnormalities, specific rheumatologic examination findings, and physician-confirmed thyroid, liver, and kidney disease, as well as lymphoma among SICCA participants.
Laboratory abnormalities, including hematologic abnormalities, hypergammaglobulinemia, and hypocomplementemia, frequently occurred among primary SS cases and were more common among the intermediate cases than among control participants. Cutaneous vasculitis and lymphadenopathy were also more common among primary SS cases. In contrast, the frequency of physician-confirmed diagnoses of thyroid, liver, and kidney disease and lymphoma was low and only primary biliary cirrhosis was associated with primary SS case status. Rheumatologic and neurologic symptoms were common among all SICCA participants, regardless of case status.
Data from the international SICCA registry support the systemic nature of primary SS, manifested primarily in terms of specific immunologic and hematologic abnormalities. The occurrence of other systemic disorders among this cohort is relatively uncommon. Previously reported associations may be more specific to select patient subgroups, such as those referred for evaluation of certain neurologic, rheumatologic, or other systemic manifestations.
[Show abstract][Hide abstract] ABSTRACT: To estimate the prevalence of gastroesophageal reflux (GER) and its clinical relevance with other manifestations in Chinese patients with systemic sclerosis (SSc).
A prospective cross-sectional study of 205 Chinese patients with SSc was conducted at Peking Union Medical College Hospital (PUMCH). GER was diagnosed as mild heartburn or regurgitation ≥2 days per week, or moderate/severe heartburn or regurgitation ≥1 day a week. PAH was defined as pulmonary artery systolic pressure (PASP) >45mmHg at rest as estimated by transthoracic echocardiography (TTE). Demographic, clinical, and laboratory data were calculated between GER and non-GER groups, and relative examinations including a six-minute walk test, pulmonary function test and modified Rodnan skin score (mRSS) were also performed.
The prevalence of GER was 43.90% (90/205) among 205 Chinese patients with SSc. The presence of Raynaud phenomenon (98.9% vs. 92.2%), fingertip ulcers (56.7% vs. 51.3%), pulmonary arterial hypertension (PAH) (18.89% vs. 6.96%, respectively), and all gastrointestinal tract manifestations occurred significantly more frequent in patients with GER than in patients without GER, respectively (p<0.05). There were no differences in the development of any autoantibody between GER patients and non-GER patients (p>0.05). Echocardiography showed that the left ventricular ejection fraction (LVEF) was lower (62.27±10.48 vs. 70.09±5.26, respectively) and pericarditis was more frequent (22.6% vs. 11.0%, respectively) in SSc-related GER than in SSc patients without GER, respectively. The New York Heart Association (NYHA) functional class of SSc-related GER was worse than patients without GER (p=0.015). A pulmonary function test showed that forced vital capacity FVC% (78.93±17.90 vs. 84.55±17.45, respectively, p=0.042), forced expiratory volume FEV1% (77.12±15.65 vs. 84.30±16.25, respectively, p=0.004), and diffusing capacity DLCO% (4.76±1.76 vs. 5.63±2.12, respectively, p<0.001) were lower, and the FVC%/DLCO% ratio (1.46±0.42 vs. 1.28±0.27, respectively, p=0.001)was higher in SSc-related GER than non-GER patients (p<0.05). We also found that GER was an independent risk factor of PAH in SSc patients (p=0.030, OR=7.532).
GER is common in Chinese patients with SSc, and patients with GER are susceptible to microvascular damage. Therefore, SSc patients presenting with GER should be screened for PAH.
[Show abstract][Hide abstract] ABSTRACT: Systemic sclerosis (SSc) is considered as a systemic disease which mainly affects small vessels. However, macrovascular involvement in SSc is still elusive in literature. Our study is to evaluate the macrovascular involvement in SSc patient and its association with atherosclerosis, disease activity and other factors.
Forty-eight SSc patients were studied; 46 healthy people were enrolled as control subjects. Data on traditional cardiovascular risk factors, disease duration, inflammation indices, antibodies and other vascular involvement were collected. Systolic/diastolic interarm difference (sIAD/dIAD), pulse wave velocity (PWV) and ankle brachial index (ABI) were determined using a pulse pressure analyser. Peripheral arterial disease (PAD) was defined as ABI <0.90.
A lower ABI (0.91±0.19 versus 1.09±0.08; p<0.001) and a higher sIAD (5.0 [range 0~35] mmHg versus 2.0[0~15] mmHg, p<0.001) were found in patients with SSc. ABI is negatively correlated with sIAD. Multiple regression analysis revealed that SSc itself (B=0.171, 95% confidence interval 0.090~ 0.252, p<0.001) is an independent risk factor of reduced ABI. Correlation analysis showed MRSS was negatively correlated with ABI (r=-0.419, p=0.003).
SSc patients are more likely to develop PAD, which may be a kind of macrovascular disease in SSc. MRSS, a maker of disease activity, is associated with this peripheral artery involvement.