Publications (6)19.09 Total impact
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Article: Induced sputum as a method for detection of systemic sclerosis-related interstitial lung disease.
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ABSTRACT: Inducted sputum (IS) is a non-invasive procedure that can be used for collection of airway secretions. The aim of our study is to evaluate the clinical usefulness of IS for detection of airway inflammation in systemic sclerosis (SSc). Bronchoalveolar lavage and IS were performed to 20 patients with SSc. Eighteen patients who were referred to pulmonary medicine for bronchoalveolar lavage due to other reasons were also recruited for cell counts comparisons. Spirometry, echocardiography and thorax CT (HRCT) imaging were also performed to all patients. Mean macrophage and lymphocyte counts were found to be increased in IS of SSc patients compared with that of control (58.4 ± 14.5% vs. 31.3 ± 16.3%, 30.2 ± 15.4% vs. 15.0 ± 11.5% P < 0.001), whereas mean neutrophil count was lower in the SSc patients (4.1 ± 4.5% vs. 17.2 ± 13.1%, P < 0.05). Significant correlations were noted between BAL and IS findings for macrophage (r = 0.55, P = 0.02) lymphocyte (r = 0.65, P < 0.01) and total cell counts (r = 0.45, P = 0.06). IS is an easy and reliable method for the detection of alveolitis and can be used for early detection of lung involvement in scleroderma.Rheumatology International 03/2011; 32(7):1921-5. · 1.88 Impact Factor -
Article: Assessment of disease activity and progression in Takayasu's arteritis with Disease Extent Index-Takayasu.
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ABSTRACT: Disease Extent Index-Takayasu (DEI.Tak) is a new index developed for the follow-up of Takayasu's arteritis (TA), assessing only clinical findings without the requirement of imaging. We investigated the effectiveness of DEI.Tak in assessing disease activity and progression by comparing with physician's global assessment (PGA) and active disease criteria defined by Kerr et al. The initial DEI.Tak forms were filled in for 145 TA patients cross-sectionally to detect the baseline damage and after 29.8 (31) months (n = 105, 144 visits) only by including the new/worsening symptoms within the past 6 months. At baseline, all patients had a DEI.Tak >0 [mean (s.d.): 7.6 (4.2)]. At this evaluation, 62% of the patients had active, 16.2% had persistent and 21.8% had inactive disease according to the PGA. At follow-up, in 69% of the patients the DEI.Tak score was 0. However, 14% of them were accepted as having active and 17% persistent disease according to PGA. In contrast, 18% with a DEI.Tak ≥ 1 were inactive according to PGA. Patients with active or persistent disease with PGA had higher DEI.Tak compared with inactives [1.3 (1.9), 1 (1.3) vs 0.2 (0.6), respectively; P < 0.001]. According to Kerr's criteria 27% were active. The total agreement between DEI.Tak and Kerr's criteria was 94% (κ = 0.85). Compared with PGA, Kerr's criteria had a total agreement of 74% and DEI.Tak 68%. During follow-up, most TA patients showed no clinical activity with DEI-Tak. Although the agreement between Kerr's criteria and DEI.Tak seemed very good, using Kerr's criteria instead of DEI.Tak increased the consistency with PGA, which could be explained by the influence of imaging data and acute-phase reactant levels on the physician's decisions.Rheumatology (Oxford, England) 10/2010; 49(10):1889-93. · 4.24 Impact Factor -
Article: Hydroxychloroquine improves dry eye symptoms of patients with primary Sjogren's syndrome.
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ABSTRACT: The objective of the study is to investigate the effect of hydroxychloroquine (HCQ) on subjective and objective parameters of dry eye in patients with primary Sjogren's disease and to evaluate the association of tear fluid B-cell activating factor (BAFF) level with the response. Thirty-two patients with primary Sjogren's disease were enrolled in this prospective study. All patients included in the study completed at least a 48-month run-in period of using hydroxychloroquine. Patients were then instructed to drop the treatment for 3 months. Baseline and post cessation of treatment (baseline and 3 months) evaluations included, subjective symptom scoring, fluorescein and lissamine green staining, Schirmer's test, tear break-up time (BUT) and tear fluid BAFF assessments. Significant worsening was observed in, tear break up-time (TBUT) (7.9 ± 3.4 vs. 5.9 ± 2.9, P < 0.001) lissamine green of staining of the ocular surface (1.3 ± 0.9 vs. 1.8 ± 0.8, P < 0.01) and corneal fluorescein staining scores (2.2 ± 2.1 vs. 4.6 ± 3.3, P < 0.003) between on and off HCQ treatment, respectively. Similarly, gritty sensation and burning sensation were significantly changed at week 12 compared to baseline evaluation (1.18 ± 1.02 vs. 1.7 ± 1.05, P < 0.007 and 1.1 ± 1.0 vs. 1.6 ± 1.2, P < 0.0, respectively). Disease duration significantly correlated with baseline OSDI (r = 0.38, P < 0.04) and the average daily use of artificial tears (r = 0.36, P < 0.04). The mean BAFF levels were 0.8 ± 0.5 and 4.0 ± 0.7 ng/ml for baseline and week 12 evaluation, respectively (P < 0.0001). The results of this study suggest that HCQ may alleviate symptoms and signs of dry eye in pSS and decreases tear fluid BAFF levels.Rheumatology International 03/2010; 31(8):1045-9. · 1.88 Impact Factor -
Article: Comparative performance analysis of 4 different anti-citrullinated protein assays in the diagnosis of rheumatoid arthritis.
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ABSTRACT: To evaluate the diagnostic performances of 2 recently developed assays, third-generation anti-cyclic citrullinated peptide (anti-CCP3) and anti-mutated citrullinated vimentin (anti-MCV), in comparison to conventional second-generation anti-cyclic citrullinated peptide (anti-CCP2) assay; and to assess a novel fully automated, random-access AxSYM anti-CCP assay for early diagnosis of rheumatoid arthritis (RA). A cohort of 176 patients was enrolled in our study; 93 were diagnosed as having RA. The non-RA group consisted of 83 patients including 38 with systemic lupus erythematosus, 17 with primary Sjögren's syndrome, 11 with osteoarthritis, and 17 healthy controls. All were tested for presence of anti-CCP2, anti-CCP3, AxSYM anti-CCP, anti-MCV, and rheumatoid factor (RF)-IgM according to the manufacturers' instructions. Diagnostic performance of the assays revealed the highest area under the curve for the novel AxSYM anti-CCP [89.1; 95% confidence interval (CI) 84.3-93.8], followed by anti-CCP3 (86.7; 95% CI 81.6-91.9), anti-CCP2 (82; 95% CI 75.8-88.3), and anti-MCV (71.9; 95% CI 64.4-79.5). The sensitivities and specificities were 60.2% and 98.8% for anti-CCP2, 61.3% and 97.6% for anti-CCP3, 80.6% and 84.3% for AxSYM anti-CCP, 49.8% and 91.6% for anti-MCV, and 67.8% and 91.6% for RF-IgM, respectively. At cutoff of 5 U/ml, AxSYM anti-CCP emerged as a highly sensitive first-line early diagnostic tool for RA, with the greatest discrimination power, above 16 U/ml, in case of positive result. Using a single easily performed automated assay at 2 determined decision limits we were able to diagnose 81% of cases of RA and missing only 1.2%.The Journal of Rheumatology 03/2009; 36(3):491-500. · 3.69 Impact Factor -
Article: Mannose binding lectin levels in spondyloarthropathies.
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ABSTRACT: Mannose binding lectin (MBL), a member of the collectin family proteins, is a major molecule of the innate immune system; MBL deficiency is associated with increased susceptibility to infections. As gastrointestinal and genitourinary infections are suggested to be among the etiological factors of spondyloarthropathies (SpA), we investigated MBL deficiency in ankylosing spondylitis (AS) and undifferentiated SpA (uSpA). One hundred seven patients with AS, 43 patients with uSpA, and 74 healthy controls were studied. Disease activity, radiological scores, and demographic features were recorded. MBL levels were measured with standard ELISA kits. Median MBL levels in AS, uSpA, and controls were 2705 (range 0-5861) ng/ml, 2897 (36-7586) ng/ml, and 3468 (0-7950) ng/ml, respectively. No significant differences were observed in median MBL levels and the prevalence of MBL deficiency between the groups. Bath AS Radiological Index scores were not affected by MBL levels. However, although statistically not significant, radiographic damage quantified by modified Stoke AS Spine Score (mSASSS) was 3 times higher in AS patients with MBL deficiency. Disease activity, clinical picture, and therapies were not associated with MBL levels. In AS patients with MBL deficiency, there was a tendency towards a more severe radiographic progression detected by mSASSS.The Journal of Rheumatology 11/2007; 34(10):2075-7. · 3.69 Impact Factor -
Article: Comparative analysis of autoantibodies against a-fodrin in serum, tear fluid, and saliva from patients with Sjögren's syndrome.
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ABSTRACT: To evaluate levels of IgA and IgG antibodies against a-fodrin in serum, tear fluid, and saliva and compare them with anti-Ro and anti-La antibody levels in the same samples of patients with Sjögren's syndrome (SS). Samples from 25 patients with SS (17 primary and 8 secondary), 8 patients with systemic lupus erythematosus (SLE), and 7 patients with rheumatoid arthritis (RA) as well as 20 healthy blood donor controls were collected. Antibodies were measured using ELISA. Although 40% of patients with primary SS had IgG anti-a-fodrin in their sera, it was also found in 36% and 32% of samples of their tear fluid and saliva, respectively. IgA a-fodrin antibodies were detected in 32% of SS sera, 20% of tear fluid samples, and 32% of saliva samples. Although the level of IgG anti-a-fodrin was significantly greater in serum, tear fluid, and saliva of SS patients compared to controls (p < 0.001), a significant difference was observed only in serum and saliva. While anti-Ro was detected in 48%, 56%, and 24% of serum, tear fluid, and saliva samples, respectively, anti-La was found in 40%, 44%, and 28%. Significant association was observed between serum IgG antibodies against a-fodrin and dry eye symptom score and rose bengal staining score. A negative association was also noted between tear IgA antibodies against a-fodrin and Schirmer I test. Correlation of IgG and IgA antibodies against a-fodrin with the severity of eye involvement suggests that these autoantibodies may be considered activation markers of SS.The Journal of Rheumatology 08/2006; 33(7):1289-92. · 3.69 Impact Factor
