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Publications (58)
Objective
To investigate whether T-bet+ B cells, as well as age-associated B cells/ABCs (CD19+CD21-CD11c+T-bet+) and double-negative B cells/DN (CD19+IgD-CD27- CXCR5-Tbet+), serve as prognostic and/or therapeutic tools for systemic lupus erythematosus (SLE) in humans.
Methods
Flow cytometry was used for enumerating T-bet+ B cells and ABCs/DN
su...
To view the published abstract, follow the link below: https://acrabstracts.org/abstract/t-bet-expressing-b-cells-as-a-putative-prognostic-and-therapeutic-biomarker-for-human-sle/
Despite advances in the management of systemic lupus erythematosus (SLE), it remains a chronic disease with frequent flares, requiring constant medical care, laboratory exams, hospitalisations, and the use of immunosuppressive drugs and corticosteroids, increasing the morbidity and mortality of these patients. The past decade of research has brough...
Background
Organ damage is a key determinant of unfavorable long-term prognosis and increased mortality, thus being reflective of disease severity in SLE patients.
Objectives
To develop a clinical, machine learning based model for the prediction of early organ damage in SLE towards disease severity stratification.
Methods
Using a cohort of 914 ad...
Objectives
To discern predictive factors for incident kidney involvement in patients with systemic lupus erythematosus (SLE).
Methods
Patients with SLE from the ‘Attikon’ Lupus cohort were monitored for lupus nephritis (LN), defined by kidney histology and/or classification criteria. Demographic and clinical characteristics at baseline were compar...
Objective
This study aims to clarify whether T-bet⁺ B cells, as well as the sub-populations of age-associated B cells/ABCs (CD19⁺CD21⁻CD11c⁺T-bet⁺) and double-negative B cells/DN (CD19⁺IgD⁻CD27⁻CXCR5⁻T-bet⁺), serve as prognostic and/or therapeutic tools for systemic lupus erythematosus (SLE) in humans.
Methods
Flow cytometry was used to enumerate...
Janus kinases (JAK)/Signal Transducer and Activator of Transcription (STAT) pathway is involved in pathophysiologic cascade of a notable number of rheumatic diseases. The development of JAK inhibitors has expanded treatment choices in rheumatoid arthritis (RA) with a sustained class-effect efficacy. Filgotinib is a novel selective inhibitor of JAK1...
Dear Editor, Ibrutinib, an irreversible inhibitor of Bruton tyrosine kinase (BTKi) is an orally bioavailable established therapy for chronic lymphocytic leukaemia (CLL). Acalabrutinib, a second-generation BTKi has the same properties and efficacy, and is believed to have less overall adverse event burden than ibrutinib [1]. Here, we describe the ca...
Background: Age-associated B cells (ABCs) constitute a B cell subset, defined as CD19+CD21-CD11c+, that expands continuously with age and accumulates strongly in individuals with autoimmune and/or infectious diseases. In humans, ABCs are principally IgD-CD27- double-negative (DN) B cells. Data from murine models of autoimmunity, implicate ABCs/DN i...
Background
Early or pre-clinical forms of lupus encompass a broad range of presentations, spanning from asymptomatic individuals with immunological abnormalities to individuals with autoantibodies and some features suggestive of SLE who do not yet meet the classification criteria. Research on this topic could reveal predictive and diagnostic biomar...
Partners play a crucial role in patients’ adaptation to a chronic illness, yet very little is known about the impact of partners’ representations on rheumatic patients’ coping behaviors. The aim of the present cross-sectional study was to examine the relation of partners’ representations of control/cure, consequences and emotional representations t...
Background
Cognitive impairment (CI) is one of the most frequent neuropsychiatric manifestations of systemic lupus erythematosus (SLE). Given that extensive neuropsychological testing is not always feasible in routine clinical practice, brief cognitive screening tools are desirable. The aim of this study was to evaluate the Montreal Cognitive Asses...
Comorbidities and multimorbidity, often complicating the disease course of patients with chronic inflammatory rheumatic diseases, may be influenced by disease-intrinsic and extrinsic determinants including regional and social factors. We analyzed the frequency and co-segregation of self-reported comorbid diseases in a community-based Mediterranean...
Objectives
Diagnostic reasoning in systemic lupus erythematosus (SLE) is a complex process reflecting the probability of disease at a given timepoint against competing diagnoses. We applied machine learning in well-characterised patient data sets to develop an algorithm that can aid SLE diagnosis.
Methods
From a discovery cohort of randomly select...
Objectives:
Evidence on comorbidity prevalence in antiphospholipid syndrome (APS) and its difference from high comorbidity burden rheumatic diseases is limited. Herein, we compare multiple comorbidities between APS and RA.
Methods:
A total of 326 patients from the Greek APS registry [237 women, mean age 48.7 (13.4) years, 161 primary APS (PAPS),...
Background: The ACR-1997, SLICC-2012 and EULAR/ACR-2019 classification
criteria have high sensitivity and specificity for SLE, yet they classify non-overlapping
groups of patients suggesting that they can be supplemented with additional
features to improve their diagnostic performance.
Objectives: To identify criteria and non-criteria manifestation...
Background
SLE onset is preceded by a preclinical phase evidenced by the presence of anti-nuclear and other autoantibodies (autoAbs), which however, have low predictive value for development of clinical SLE.
Objectives
To define the subgroup of autoAbs-positive individuals who are at high risk for progression into SLE by integrating environmental,...
Purpose of review:
Update on the diagnosis, treatment, and monitoring of lupus nephritis.
Recent findings:
The recent criteria enable the earlier classification of lupus nephritis based on kidney biopsy and compatible serology. Treatment of active nephritis includes low-dose intravenous cyclophosphamide or mycophenolate, followed by maintenance...
Background
In patients with lupus nephritis (LN), clinical response to treatment and renal histopathology have been shown to be discordant. No clinical or laboratory markers have to date been shown to reliably portend renal prognosis, in particular renal function impairment.
Objectives
To investigate whether per-protocol repeat renal biopsies are...
Background
Comorbidities in rheumatic diseases (RDs) have been associated with increased morbidity and mortality. Evidence on prevalence of comorbidities in antiphospholipid syndrome (APS) and its difference from high comorbidity burden RDs is limited.
Objectives
To compare the prevalence of common comorbidities between APS [primary (PAPS) and Sys...
Objectives:
In patients with LN, clinical and histological responses to treatment have been shown to be discordant. We investigated whether per-protocol repeat kidney biopsies are predictive of LN relapses and long-term renal function impairment.
Methods:
Forty-two patients with incident biopsy-proven active proliferative (class III/IV±V) LN fro...
Objective
: Detailed analysis of hematological manifestations (HM) in systemic lupus erythematosus (SLE) are limited and their clinical impact on disease remain obscure. Here, we aimed to decipher factors associated with different hematological abnormalities in SLE patients and to assess their impact on disease related outcomes.
Methods
: A datase...
Background
In patients with Lupus Nephritis (LN), clinical response to treatment and renal histopathology have been shown to be discordant. We investigated whether per-protocol repeat renal biopsies are predictive of LN relapses and long-term impairment of renal function.
Methods
Forty-two patients with an incident biopsy-proven active proliferati...
Immune cells have unique metabolic requirements to support the energetic and biosynthetic burden during their activation. Delineation of the metabolic tuning of immune cells could lead to novel strategies in treating metabolically-demanding processes including autoimmune diseases. Among innate effectors, monocytes have a distinct role in systemic l...
Objectives
Classification criteria are biased towards classifying long-standing disease. We compared the European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR)-2019, Systemic Lupus International Collaborating Clinics (SLICC)-2012 and ACR-1997 criteria in an early (median 48 months) systemic lupus erythematosus (SLE) cohor...
Cytopenias may herald or concur with the onset of various systemic rheumatic diseases. Accordingly, patients with reduced blood cell counts are often referred for possible underlying autoimmune disease. Initial evaluation aims to exclude nonrheumatic causes such as drug toxicity, infections, or hematological/myelopoiesis disorders. Patient intervie...
Background
Data regarding effectiveness and persistence to therapy with anti-IL17 agent secukinumab (SEC) in spondyloarthritis (SpA) patients of real world clinical practice are very limited.
Objectives
To assess characteristics of SpA patients starting therapy with SEC versus tumor necrosis factor inhibitors (TNFis) in routine clinical care and c...
Background
A joined EULAR/ACR initiative has proposed a new set of classification criteria for SLE based on weighted items and the use of ANA as an entry criterion.
Objectives
To compare the diagnostic performance of the old and new classification criteria against physician diagnosis in an early SLE cohort and examine phenotypic and prognostic dif...
Background
Detailed analysis of hematological manifestations are limited and their clinical impact on disease remain obscure.
Objectives
To scrutinize factors associated with different hematological abnormalities (HA) in SLE patients and their impact on infections, bleeding and damage accrual.
Methods
A dataset (GIPTSLE) originated from SLE patie...
The therapeutic armamentarium in Systemic Lupus Erythematosus (SLE) is expanding with the introduction of novel biologic and small-molecule agents. Complementary to randomized controlled trials, registry-based studies are advantageous due to the inclusion of a wider range of patients from daily practice and the potential for long-term monitoring of...
Background
Examining urban–rural differences can provide insights into susceptibility or modifying factors of complex diseases, yet limited data exist on systemic lupus erythematosus (SLE).
Objective
To study SLE risk, manifestations and severity in relation to urban versus rural residence.
Methodology
Cross-sectional analysis of the Crete Lupus...
Εισαγωγή: Η EULAR και το ACR έχουν πρόσφατα θεσπίσει κριτήρια (ACR/EULAR 2017) με στόχο την ακριβέστερη και πρωιμότερη ταξινόμηση/διάγνωση του ΣΕΛ.
Σκοπός της μελέτης: Η σύγκριση της ευαισθησίας και ειδικότητας των νέων κριτήριων (2017) ταξινόμησης με τα προγενέστερα SLICC 2012 και ACR 1997.
Μέθοδοι: Εφαρμόστηκαν τα 3 σύνολα κριτηρίων (ACR, SLICC...
Mediterr J Rheumatol 2018;29(4):232-5
BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by significant clinical heterogeneity with early diagnosis being a major challenge, complicated by the absence of formal diagnostic criteria. Instead, classification criteria have been developed to enable the homogenou...
Background/Purpose: SLE diagnosis can be challenging especially at the early stages, and existing classification criteria are biased towards classifying patients with long-standing disease. A joined ACR/EULAR initiative has introduced a new set of criteria (herein referred to as 2017 criteria), using positive ANA test as an entry criterion coupled...
Despite advancements in the care of lupus nephritis, a considerable proportion of patients may respond poorly or flare while on conventional immunosuppressive agents. Studies in murine and human lupus have illustrated a pathogenic role for several cytokines by enhancing T- and B-cell activation, autoantibodies production and affecting the function...
Background
Low disease activity is a validated target of systemic lupus erythematosus (SLE) therapy.
Objectives
τo assess the ability of belimumab to induce low disease activity states in real-life setting.
Methods
Multicentre prospective observational study of SLE patients receiving belimumab due to active disease, refractory to at least one con...
Results. A significantly lower age of SLE diagnosis was found in patients who had lived exclusively in urban [median (IQR), 39 (19) years] versus rural areas [46 (24) years], p<0.001]. Likewise, patients whose upbringing was exclusively at urban place (n=193) had about five years earlier age of diagnosis as compared to those who had grown up in vil...
Purpose
To provide an updated, comprehensive assessment of the burden and severity of SLE manifestations at the community level.
Methods
Data were retrieved from the Cretan Lupus Registry, which includes adult patients with SLE who are regularly followed in Crete. SLE is defined as mild, moderate or severe, based on the BILAG glossary of the sever...
Multimorbidity burden in SLE: Preliminary data from the community-based lupus registry of Crete
Introduction
Interleukin (IL)−33 is a cell necrosis-derived alarmin with immunostimulatory properties which depends on the context of immune cells and the inflammatory milieu.1,2 In Systemic Lupus Erythematosus (SLE), extracellular DNA (as in extracellular chromatin traps [NETs] or immune complexes [ICs]) combined with alarmins stimulate innate imm...
Purpose
To examine the prevalence of comorbidities in SLE patients at the community as well as their impact on disease outcomes.¹
Methods
We utilised data from the Cretan Lupus Registry.² Comorbidities were defined based on self-reported condition(s) and/or use of relevant treatments, and were accessed through face interviews upon enrollment (peri...
Background:
Low disease activity is a validated target of current systemic lupus erythematosus (SLE) therapy. The aim of this study was to assess the ability of belimumab to achieve low disease activity states in real-life settings.
Methods:
Multicentre prospective observational study of consecutive SLE patients receiving belimumab for at least...
Objectives
Several population-based studies on systemic lupus erythematosus (SLE) have been reported, yet community-based, individual-case validated, comprehensive reports are missing. We studied the SLE epidemiology and burden on the island of Crete during 1999–2013.
Methods
Multisource case-finding included patients ≥15 years old. Cases were asc...
Background
Although existing data support the effectiveness of the low dose regimen (LDR, 1gr every 6 months) of rituximab as initial treatment for active rheumatoid arthritis (RA) (2), it is unknown whether this regimen may be used to maintain the therapeutic effect in patients achieved clinical remission or low disease activity (LDA) upon treatme...
Background
SLE originates from the complex interplay between genetic, epigenetic and environmental factors but the effects of the latter remain elusive. Very few studies have examined the impact of the place of residence (urban/rural) on SLE clinical profile and outcomes.
Objectives
To evaluate the effect of rural versus urban place of residency w...
Background
Data on the efficacy of belimumab in SLE mainly originate from large randomized clinical trials, whereas reports from real-life clinical practice are lacking.
Objectives
To describe the clinical experience from the use of belimumab in Greece since the approval of the drug.
Methods
Multicentre observational study of patients receiving b...
Background
Systemic Lupus Erythematosus (SLE) often poses challenges to diagnosis in clinical practice and classification in research. The 2012 SLICC criteria have been recently introduced, with validation studies suggesting greater sensitivity yet equal or lower specificity compared to the 1997 ACR criteria. However, the prognostic significance of...
Η προκαλούμενη από τη νόσο βλάβη φαίνεται να επηρεάζει την εκδήλωση συμπτωμάτων άγχους και κατάθλιψης μέσω της αίσθησης προσωπικού ελέγχου που αναπτύσσει ο ασθενής, επίδραση που διατηρείται στην πάροδο του χρόνου. Το εύρημα αυτό σε νεο διαγνωσμένους ασθενείς με ΣΕΛ μπορεί να αποτελέσει τη βάση για την σχεδίαση ειδικών ψυχολογικών παρεμβάσεων με στό...
Despite advances in the treatment, patients with systemic lupus erythematosus (SLE) often experience disease exacerbations (flares) of varying severity. Their diagnosis is primarily made on clinical grounds after exclusion of other diseases or disturbances, primarily infections, and can be assisted by the use of validated clinical indices. Serologi...
