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ABSTRACT: Peripheral blood lymphocyte subsets were determined by flow cytometry in 89 Chinese patients with polymyositis (PM) and dermatomyositis (DM). We aimed to investigate the clinical significance of peripheral blood lymphocyte subsets in PM/DM. Patients with active DM showed significant decreases in numbers of CD3(+) cells, CD3(+)CD4(+) cells, and CD3(+)CD8(+) cells, as compared to patients with inactive DM and healthy controls (P < 0.05). CD3(+) and CD3(+)CD4(+) cell counts were significantly lower in DM before treatment, compared with after treatment (t = -5.714 and -3.665, P < 0.05). Counts of CD3(+) cells, CD3(+)CD4(+) cells, CD3(+)CD8(+) cells, and CD19(+)CD5(-) cells were all correlated with the total disease activity score as determined by the Myositis Disease Activity Assessment Visual Analogue Scale (P < 0.05). The decreased number of CD3(+) cells and the decreased percentage of CD3(+)CD4(+) cells were additionally correlated with the presence of interstitial lung disease in PM/DM (P < 0.05). The presence of levels of CD3(+)CD8(+) cells was risk factor for death (b = -0.011, OR = 0.989, P < 0.05). The identification of peripheral blood T lymphocyte subsets in PM/DM appears to be useful as a reference marker in the evaluation of clinical disease activity, and be useful in the comprehensive assessment of clinical lung involvement. A decrease in CD8(+) T cells may predict a poor outcome in patients with PM/DM.
Clinical Rheumatology 08/2012; · 2.00 Impact Factor
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ABSTRACT: To explore the possible diagnostic values of serum surfactant protein-A (SP-A) and surfactant protein-D (SP-D) for interstitial lung diseases (ILD) in patients with polymyositis or dermatomyositis (PM/DM).
Serum MCP-1 concentrations were measured by enzyme-linked immunosorbent assay (ELISA) in 100 adult PM/DM patients, 20 patients with pulmonary infection and 42 healthy controls. And the association with their clinical features and serum levels of SP-A and SP-D was analyzed.
The serum levels of SP-A and SP-D in the PM/DM patients with ILD were both significantly higher than those without ILD and healthy controls (all P < 0.01) while there were no significance differences with those with infectious lung diseases (P > 0.05). The sensitivity of serum abnormal levels of SP-A, SP-D and combination of SP-A and SP-D for ILD in PM/DM patients were 66.1%, 64.3% and 80.0% and the specificity 72.7%, 72.7% and 70.2% respectively. The serum levels of SP-A were positively correlated with serum ferritin and C-reactive protein (CRP) and negatively with percent carbon monoxide diffusing capacity (DLCO%) (r = -0.474, P < 0.05), VC% (r = -0.404, P < 0.05) while the serum levels of SP-D were negatively correlated with circulating CD3+T cells (r = -0.244, P < 0.05) and CD4+T cells (r = -0.277, P < 0.05) in PM/DM patients. Furthermore, SP-A was an independent risk factor for death of ILD in PM/DM (OR 1.032, 95%CI 1.006 - 1.059, P < 0.05).
SP-A and SP-D may be potential useful serum markers for the diagnosis of ILD in PM/DM patients. And the combined detection of SP-A and SP-D offers a higher sensitivity than either marker alone. As a risk factor, serum SP-A can predict the prognosis of PM/DM patients with ILD.
Zhonghua yi xue za zhi 08/2012; 92(31):2182-5.
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ABSTRACT: To analyze the correlated clinical significance by testing the serum monocyte chemoattractant protein-1 (MCP-1) levels of patients with polymyositis/dermatomyositis (PM/DM).
The sera from 100 adult PM/DM patients, 20 patients with pulmonary infection and 42 healthy controls were selected. The serum MCP-1 concentrations were detected by enzyme-linked immunosorbent assay (ELISA). The correlations between serum MCP-1 levels and clinical features or laboratory examinations of PM/DM patients were investigated.
The serum levels of MCP-1 were (1 869 ±1 590) ng/L, (1 349±1 303) ng/L, (493±255) ng/L and (256±144) ng/L in PM/DM patients with interstitial lung disease (ILD) and without ILD, patients with infectious lung disease and healthy controls, respectively. Serum MCP-1 levels in the PM/DM patients with ILD were significantly higher than those of the PM/DM patients without ILD, patients with infectious lung disease and healthy controls (all P values<0.01). Significant correlations were found between the elevated levels of serum MCP-1 and the presence of ILD in the patients with PM/DM (χ2=9.6, P<0.01). The sensitivity and specificity of serum abnormal MCP-1 levels for ILD in the patients with PM/DM were 60.7% and 68.2%, respectively. The incidence of fever, arthritis, decreased %DL(CO) , erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum ferritin were significantly higher in the MCP-1 raised group than in the MCP-1 normal group (all P values<0.005). Additionally, Spearman rank correlation analysis showed that serum MCP-1 levels were positively correlated with serum ferritin in peripheral blood in the patients with PM/DM.
The levels of serum MCP-1 are significantly elevated in PM/DM and it is significantly associated with ILD complication, and may contribute to the early differentiation of ILD from lung infectious disease.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 04/2012; 44(2):204-8.
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ABSTRACT: To investigate serum levels of B cell activating factor (BAFF) in Chinese patients with polymyositis (PM) or dermatomyositis (DM), and analyze the correlation of BAFF with autoantibodies and clinical phenotypes.
Serum BAFF levels of 28 PM patients and 30 DM patients (study group), and 25 matched healthy controls (control group) were measured by ELISA. Serum anti-Jo-1 antibody levels were also measured by ELISA in all the subjects. The results of the two groups were compared by unpaired t test and the relevance was analyzed by Pearson's correlation analysis.
Serum levels of BAFF in PM/DM patients were significantly higher compared to healthy controls (P = 0.000), but there was no statistically significant difference between the PM and DM patients (P > 0.05). Patients with interstitial lung disease (ILD) had significantly higher serum BAFF level than the patients without ILD (P = 0.000) or the controls (P = 0.000). Serum BAFF levels of patients with positive anti-nuclear antibody (ANA) were significantly higher than those with negative ANA (P = 0.003). For patients with anti-Jo-1 antibodies, the serum BAFF levels were correlated with the serum concentration of anti-Jo-1 antibodies (r = 0.799, P = 0.006).
Serum levels of BAFF are increased in Chinese PM/DM patients. These findings indicate that BAFF may be possibly enrolled in the pathogenesis of PM/DM. Detecting serum BAFF levels could have some implication for the diagnosis and treatment of PM/DM.
Zhonghua nei ke za zhi [Chinese journal of internal medicine] 03/2012; 51(3):210-3.
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ABSTRACT: The objectives of this study are to review and summarize published information on the use, effectiveness, and adverse effects of intravenous immunoglobulin (IVIG) in patients with polymyositis (PM) or dermatomyositis (DM) and to search MEDLINE and CNKI (Chinese) databases from 1985 to 2011 to retrieve clinical research articles concerning IVIG in adult patients with PM/DM. Of the 14 articles selected, two were randomized controlled trials, nine prospective open studies, and three retrospective studies with a total of 308 adult patients. IVIG has been used successfully in the treatment of PM/DM. The standard dose is 2 g/kg, given in two to five individual daily doses. The course of IVIG treatment is usually 3~6 months. IVIG therapy seemed rarely employed as first-line therapy in PM/DM. In a double-blind study conducted in patients with refractory DM, IVIG combined with corticosteroid significantly improved muscle strength and decreased serum creatine kinase level, compared with placebo. The beneficial effect of IVIG in refractory, flare-up, rapidly progressive, or severe PM/DM has been documented in many open-label trials. IVIG was shown to be effective in most of PM/DM patients with lung involvement and esophageal involvement. In some patients, IVIG can lower the corticosteroid dose required for maintenance, demonstrating the most effective steroid-sparing effect. Adverse effects were generally tolerable. IVIG is effective in the treatment of adult patients with PM/DM and appears to be relatively well tolerated and safe. IVIG may be a good choice especially in patients with refractory, flare-up, rapidly progressive, or severe PM/DM, and can be tried in patients with a contraindication for corticosteroid.
Clinical Rheumatology 01/2012; 31(5):801-6. · 2.00 Impact Factor
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ABSTRACT: Little is known about the clinical features and true survival risk factors in Chinese Han population. We conducted the current study to investigate the clinical features, long-term outcome and true potential indicators associated with mortality of idiopathic inflammatory myopathies (IIM) in China.
We restrospectvely investigated 188 patients diagnosed with IIM at our hospital from January 1986 to April 2009. The primary outcome was determined with mortality. The secondary outcomes for survival patients were organ damage and disease activity, health status, and disability, which were assessed with Myositis Damage Index, Myositis Disease Activity Assessment Visual Analogue Scales, Health Assessment Questionnaire Disability Index, and the Modified Rankin Scale, respectively. Potential prognostic factors for mortality were analyzed with the multivariate Cox regression model.
Mean age at disease onset was 43.8 ± 15.8 years and male to female ratio was 1:2.1 in this cohort. The 1-, 5-, 10-, 15- and 20-year survival rates were 93.6%, 88.7%, 81%, 73.6% and 65.6%. The independent predicators for mortality were age at disease onset [hazard ratio (HR):1.05, 95% CI 1.02 - 1.08], presence of cancer (HR:3.68, 95%CI 1.39 - 9.74), and elevated IgA level at diagnosis (HR:2.80, 95% CI 1.16-6.74). At the end of the follow-up, 29 patients manifested drug withdrawal within an average 4.1 years (range 0.5-15.2 year), most patients (85.9%) had no disease activity and 130 patients (83.4%) had no disability.
The long-term outcomes of IIM patients in our cohort have improved dramatically. Those patients most likely to survive had a high chance of reaching stable disease status, and obtained long-term or possibly permanent remission to a large extent.
BMC Neurology 11/2011; 11:143. · 2.17 Impact Factor
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ABSTRACT: To test the reliability, discriminating validity and clinical value of myositis disease activity tool in Chinese patients with polymyositis/dermatomyositis (PM/DM).
Fifty-four PM/DM patients (PM, n = 18; DM, n = 36) at our hospital between January 2009 and June 2010 were enrolled into this prospective study. The disease activity was assessed by the MDAAT (myositis disease activity assessment tool). The reliability and discriminating validity were assessed with test-retest reliability, interrater reliability and t-test analysis.
The reliability analysis of MDAAT indicated 8 items (constitutional, cutaneous, skeletal, gastrointestinal, pulmonary, cardiovascular, muscular & global) had excellent reliability, the ICC (intraclass correlation coefficient) was 0.72 (95%CI: 0.57, 0.83), 0.88 (95%CI: 0.79, 0.93), 0.83 (95%CI: 0.72, 0.90), 0.62 (95%CI: 0.42, 0.76), 0.81 (95%CI: 0.70, 0.89), 0.59 (95%CI: 0.38, 0.74), 0.85 (95%CI: 0.75, 0.91) and 0.84 (95%CI: 0.73, 0.90) respectively. MDAAT had excellent discrimination validity in all items except for cardiovascular ones.
With excellent reliability and discriminating validity, MDAAT may be used to assess the disease activity and therapeutic effects of Chinese PM/DM patients.
Zhonghua yi xue za zhi 05/2011; 91(19):1328-30.
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Bu-Shan Xie,
Hong-Chuan Zhao,
Shu-Kun Yao,
De-Xiang Zhuo,
Bo Jin,
Dui-Cai Lv,
Cheng-Lin Wu,
Dai-Long Ma,
Chun Gao, Xiao-Ming Shu,
Zheng-Lin Ai
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ABSTRACT: Induction of autophagy usually acts as a survival mechanism of cancer cells in response to chemotherapy. However, the function and molecular mechanism of autophagy in human hepatoma cells under drug treatment is still not clear. To address this issue, we established an experimental model in which HepG2 cells were treated with etoposide, a widely used anticancer agent. We demonstrate the etoposide-induced accumulation of GFP-LC3 dots by fluorescent microscopy, the up-regulation of LC3-II protein expression by Western blotting and the increased number of autophagic vacuoles by electron microscopy, confirming the activation of autophagy by etoposide in HepG2 cells. Inhibition of autophagy by either 3-methyladenine (3MA) or beclin-1 small interfering RNA enhanced etoposide-induced cell death. Furthermore, activation of p53 and AMPK was detected in etoposide-treated cells and inhibition of AMPK triggered apoptosis through suppression of autophagy. On the other hand, inactivation of p53 promoted cell survival through augmentation of autophagy. Collectively, these findings indicate that etoposide-induced autophagy promotes hepatoma cell adaptation and survival, and that autophagy inhibition improves the chemotherapeutic effect of etoposide. Moreover, AMPK activation is clearly associated with etoposide-induced autophagy. We conclude that manipulation of AMPK may be a promising approach of adjuvant chemotherapy for hepatocellular carcinoma.
International Journal of Molecular Medicine 01/2011; 27(4):599-606. · 1.98 Impact Factor
