Miguel Ángel Gonzalez-Gay

Miguel Ángel Gonzalez-Gay
Universidad de Cantabria | UNICAN · Department of Medicine and Psychiatry

MD, PhD

About

1,547
Publications
118,122
Reads
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41,216
Citations
Citations since 2017
609 Research Items
19800 Citations
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Introduction
Epidemiology and genetics of giant cell arteritis, polymyalgia rheumatica, IgA vasculitis, connective -tissue diseases, anti-synthetase syndrome, interstitial lug disease
Additional affiliations
April 2017 - present
Hospital Universitario Marques de Valdecilla
Position
  • Head, Rheumatology Division
February 2016 - present
Universidad de Cantabria
Position
  • Professor (Associate)
Description
  • Accredited as a Full Professor by ANECA, Spain's National Agency for Quality Assessment and Accreditation in 2018
April 2014 - present
Faculty of Health Sciences, University of the Witwatersrand, South Africa
Position
  • Professor

Publications

Publications (1,547)
Poster
Full-text available
Introducción Paciente de 84 años con sucesivos ingresos en dermatología con el diagnóstico de eccema (2012-2018). En el 2007 y en el 2015 de acuerdo con Alergología: Pustulosis Exantemática Aguda. Epicutáneas positivas a una serie de corticoides..y más En la Actualidad: Presenta misma repetición de clínica con una pustulosis de pliegues, troncal y...
Poster
Full-text available
Tenemos una personalidad consciente y múltiples inconscientes. Una vida entera no basta para conocernos totalmente: Apremilast Discusión: La aplasia /hipoplasia medular en aproximadamente el 75% de los pacientes no es posible determinar una etiología, si bien cada vez es más evidente que el mecanismo subyacente es un fenómeno autoinmune. 25% son me...
Article
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Background/purpose The manifestations of uveitis are well established in axial spondyloarthritis (ax-SpA), but not in psoriatic arthritis (PsA). We aimed to assess, in a large unselected series of PsA: (A) the frequency and clinical features of uveitis; (B) its association with PsA activity, the impact of disease and functional disability, and (C)...
Article
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The aim of this study was to determine the role of endothelin-1 (ET-1), a molecule involved in multiple vascular and fibrosing abnormalities, as a biomarker of interstitial lung disease (ILD), as well as its use for the differential diagnosis between idiopathic pulmonary fibrosis (IPF) and ILD associated with autoimmune diseases (AD-ILD), using a l...
Article
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Adipose tissue malfunction leads to altered adipokine secretion which might consequently contribute to an array of metabolic diseases spectrum including obesity, diabetes mellitus, and cardiovascular disorders. Asprosin is a novel diabetogenic adipokine classified as a caudamin hormone protein. This adipokine is released from white adipose tissue d...
Article
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Transforming growth factor beta (TGF-β) is a highly pleiotropic cytokine that has broad anti-inflammatory and immunosuppressive effects. In patients with systemic lupus erythematosus (SLE), the immunosuppressive effect of TGF-β1 is thought to be dysfunctional. In the present work, we aimed to study the relationship between the serum levels of TGF-β...
Article
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Interleukin-1 receptor antagonist (IL-1ra) concentration reflects and is proportional to IL-1 production. Both IL-1 and IL-6 are involved in the pathogenesis of rheumatoid arthritis (RA). However, the relationship of serum levels of these two cytokines to each other in RA patients is not well-understood. In this study, our objective was to analyze...
Article
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Vascular endothelial growth factor (VEGF) is a major regulator of physiological and pathological angiogenesis. Its soluble receptor (sVEGFR) is a potent VEGF antagonist. Systemic lupus erythematosus (SLE) is an autoimmune disease with a diverse array of clinical manifestations that affect virtually any organ. We aimed to analyze the relationship of...
Article
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Progranulin (PGRN) is a glycoprotein formed by 593 amino acids encoded by the GRN gene. It has an important role in immunity and inflammatory response, as well as in tissue recovery. Its role in musculoskeletal inflammatory diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and intervertebral disc degeneration disease (I...
Article
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Objective The main study objective was to determine how giant cell arteritis (GCA) is diagnosed in our clinical practice and whether the EULAR recommendations have influenced the diagnostic procedures used. Methods ARTEritis of the Rheumatology Spanish Society -Sociedad Española de Reumatología (ARTESER) is a multicentre observational retrospectiv...
Article
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Background COVID-19 may present different degrees of severity. Viral infections in patients with rheumatic inflammatory diseases (R-IMID) trend to present more severe disease. However, data comparing the severity of the disease between R-IMID and the general population are scarce. Objectives To compare predisposing factors, clinical, serological f...
Article
Full-text available
Introduction: Early diagnosis of interstitial lung disease (ILD) associated with rheumatoid arthritis (RA) constitutes a challenge for the clinicians. Pulmonary vasculopathy is relevant in the development of interstitial lung disease. Accordingly, we aimed to explore the role of vascular cell adhesion molecule-1 (VCAM-1), monocyte chemoattractant p...
Article
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Antisynthetase syndrome (ASSD) is an autoimmune disease characterized by the positivity of autoantibodies against different aminoacyl transfer RNA (tRNA) synthetases. Morbidity and mortality of this disease are highly affected by interstitial lung disease (ILD) which is present in about 80% of patients. In this study, we investigated possible diffe...
Article
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Ocular disease, such as scleritis and peripheral ulcerative keratitis (PUK), may be a serious ocular complication. We present a patient with severe and refractory PUK treated with baricitinib. A review of the literature on Janus kinase inhibitors (JAKINIB) in refractory ocular surface pathology was also performed. For the literature review, the sea...
Article
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Objective The aim of this study was to evaluate the frequency of systemic treatment in a cohort of sarcoidosis patients and identify presenting clinical features as predictive factors of the need for systemic immunosuppressive therapy. Methods Retrospective study of 342 patients diagnosed and followed-up from January 1999 to December 2019 in a Uni...
Article
Background/Introduction Hydroxychloroquine (HCQ) is a widely used drug in Systemic Lupus Erythematosus (SLE). It may cause cardiac alterations which includes short term arrhythmic events (via QT interval prolongation) and medium-late term dose dependent cardiomyopathy1. The few research articles published on the medium-late term effects of HCQ in c...
Article
Full-text available
Copy number (CN) polymorphisms of complement C4 play distinct roles in many conditions, including immune-mediated diseases. We investigated the association of C4 CN with systemic sclerosis (SSc) risk. Imputed total C4, C4A, C4B, and HERV-K CN were analyzed in 26,633 individuals and validated in an independent cohort. Our results showed that higher...
Article
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CD40, BLK and BANK1 genes involved in the development and signaling of B-cells are identified as susceptibility loci for numerous inflammatory diseases. Accordingly, we assessed the potential influence of CD40, BLK and BANK1 on the pathogenesis of immunoglobulin-A vasculitis (IgAV), predominantly a B-lymphocyte inflammatory condition. Three genetic...
Article
Objectives To determine the potential impact of extra-articular manifestations (EAMs) on disease characteristics and cardiovascular (CV) risk in patients with axial spondylarthritis (axSpA). Methods This is a cross-sectional study from the AtheSpAin cohort, a Spanish multicenter cohort to study atherosclerosis in axSpA. Data on the history of CV e...
Preprint
Full-text available
Background: COVID19 may present different degrees of severity. Viral infections in patients with rheumatic inflammatory diseases (R-IMID) tend to present more severe disease. However, data comparing the severity of the disease between R-IMID and the general population are scarce. Objectives: To compare predisposing factors, clinical, serological fe...
Article
Objectives: Two main different clinical phenotypes of giant cell arteritis (GCA) have been described, the classic cranial pattern and the extracranial large-vessel (LV) pattern. Since interferon gamma (IFNG) has shown to be a pivotal cytokine in the pathophysiology of GCA, our aim was to evaluate for the first time the influence of IFNG and IFNG r...
Article
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Interleukin (IL) 1, and its family member, IL-1 receptor antagonist (IL-1ra), are involved in the pathogenesis and inflammation perpetuation of patients with rheumatoid arthritis (RA). Besides, IL-1 has been linked to an increased risk and greater severity of cardiovascular (CV) disease. We aimed to study if IL-1ra is related to the CV manifestatio...
Article
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Background Visual involvement is the most feared complication of giant cell arteritis (GCA). Information on the efficacy of tocilizumab (TCZ) for this complication is scarce and controversial. Objective We assessed a wide series of GCA treated with TCZ, to evaluate its role in the prevention of new visual complications and its efficacy when this m...
Article
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Introduction Patients with axial spondyloarthritis (axSpA) have a high disease burden mainly due to the rheumatic disease itself, and also exhibit accelerated atherosclerosis, that leads to a higher incidence of cardiovascular (CV) disease. Accordingly, the identification of biomarkers of CV risk and inflammation in axSpA patients is clinically rel...
Article
External auditory canal psoriasis (PsEAC) is often underrecognized. To assess the prevalence of PsEAC, study the association with a particular psoriasis subtype and its impact on quality of life. A prospective study was carried out in two Spanish University hospitals. Consecutive patients who attended consultation for psoriasis were included. Clini...
Article
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Cardiovascular diseases, including ischemic heart disease and stroke, reportedly comprise the top two causes of global mortality [...]
Article
Objectives: Tocilizumab (TCZ) is the only biologic therapy approved for giant cell arteritis (GCA). There is general agreement on the initial/maintenance dose, duration of TCZ therapy is not well established. In GiACTA trial, after one year on TCZ, most patients had GCA relapse after withdrawal. The aim of this study is to assess the effectiveness...
Article
Background and purpose: Interstitial lung disease (ILD) is the main cause of mortality in systemic sclerosis (SSc) and current therapies available are of low efficacy or high toxicity. Thus, the identification of innovative less toxic and high efficacy therapeutic approaches to ILD treatment is a crucial point. P-selectin Glycoprotein Ligand-1 (PS...
Article
Background IgA vasculitis (IgAV) and IgA nephropathy (IgAN) are inflammatory conditions [1, 2], that share pathogenic mechanisms [1], in which B-lymphocytes are described as key cells implicated in these processes. BAFF, APRIL and BAFF-R are cytokines implicated in the development of B-lymphocytes [3, 4] and in autoimmune processes [5, 6]. In this...
Article
Background IgA vasculitis (IgAV) and IgA nephropathy (IgAN) are inflammatory conditions that share pathogenic and molecular mechanisms [1] and may represent different outcomes of a continuous spectrum of the disease [2]. Interleukin (IL)-33 is a cytokine that exerts its biological functions by binding to its receptor, IL-1 receptor like 1 (IL-1RL1)...
Article
Background Janus Kinases (JAK) can promote cytokine production in immune and hematopoietic cells. The JAK-2 (V617F) mutation is the most frequently detected mutation in myeloproliferative neoplasms (MPN) which include essential thrombocythemia (ET), polycythemia vera (PV), primary myelofibrosis (PMF) and undifferenciated MPN. JAK-2 (V617F) mutation...
Article
Background Patients with Rheumatoid Arthritis (RA) present an increased risk of mortality. In the last decades, mortality rates tended to decrease but cardiovascular (CV) events remained as the leading cause of death in most series (1). Objectives To assess mortality rates and leading causes of death, as well as predictors of mortality related to...
Article
Background Rheumatoid Arthritis (RA) and Gout are associated with an increase of cardiovascular (CV) disease (1,2) Carotid plaques and increased carotid intima-media thickness (cIMT) are surrogate markers of CV mortality (3 ). The association of serum uric acid (SUA) levels as an independent factor of subclinical Atherosclerosis and mortality in...
Article
Background Tocilizumab (TCZ) has shown to be effective for large vessel vasculitis including giant cell arteritis (GCA) and Takayasu arteritis (TAK) (1-5 ). However, LVV-GCA and TAK show different demographic and clinical features that may influence on TCZ therapeutic response. Objectives To compare the effectiveness of TCZ in patients with LVV-G...
Article
Background Upadacitinib (UPA) is an inhibitor of JAK kinases recently approved by EMA for the treatment of psoriatic arthritis (PsA) in Europe (January 2021) 1. UPA has shown efficacy in refractory patients to anti-TNF 2. Objectives A ) to assess efficacy and safety of UPA in the first cases in Spain in clinical practice. B ) to compare the prof...
Article
Background Neurosarcoidosis (NS) is a severe complication of sarcoidosis [1,2]. NS may be classified according to several subtypes [1]. Data on therapy, including biological therapy (BT) is scarce. Objectives To assess efficacy and safety of BT in refractory NS subtypes. Methods Study of NS from a large cohort (n=234) of all consecutive patients...
Article
Background Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) includes granulomatosis with polyangiitis (GPA), eosinophilic granulomatosis with polyangiitis (EGPA) or microscopic polyarteritis (MPA). Standard treatment is often accompained by significant adverse events. Intravenous immunoglobulins (IVIG) may constitute a ther...
Article
Background Positron emission tomography (PET) is one of the tools available for the diagnosis of extracranial large-vessel vasculitis (1-5 ). Tocilizumab (TCZ) has shown efficacy in large-vessel vasculitis (LVV) including GCA. However, the improvement objectified by imaging techniques after TCZ therapy in extracranial GCA patients is controversial....
Article
Background Inflammatory ocular pathology (IOP) includes internal and external involvement. IOP may be severe ocular conditions refractory to conventional immunosuppressants and even biological therapy. Janus Kinase inhibitors (JAKINIB) had shown efficacy in refractory cases of different immune-mediated inflammatory diseases (IMID). Objectives In p...
Article
Background Ocular and Neurobehçet’s Disease (NBD) are the most severe manifestations of Behcet’s disease (1-4 ). NBD can be classified as A ) primary neural parenchymal lesions, also known as parenchymal NBD (p-NBD) or B ) secondary to vascular involvement or non-parenchymal NBD (np-NBD) (4 ). Response to biologic therapy (BT) in these two refr...
Article
Background Hydroxychloroquine (HCQ) is a widely used drug in Systemic Lupus Erythematosus (SLE). It may cause cardiac alterations which includes short term arrhythmic events (via QT interval prolongation) and medium-late term dose dependent cardiomyopathy¹. The few research articles published on the medium-late term effects of HCQ in cardiac conduc...
Article
Background Behçet’s disease (BD) may present with different clinical phenotypes. Ocular and Neurobehçet’s Disease (NBD) are severe complications [1-4] Data on NBD epidemiology, clinical phenotype and therapy are scarce and controversial. Objectives In a wide unselected single-center series of BD our aims were to assess A ) NBD prevalence, B ) a...
Article
Background Nuclear factor of activated T cells (NFAT) is a transcription factor family that plays a crucial role in physiological and immune processes, modulating intracellular and extracellular signaling pathways related with several diseases 1,2 . In this regard, it has been involved in the pathogenesis of rheumatoid arthritis (RA) and in the dev...
Article
Background Phase 2 studies have shown that Filgotinib (FIL), a JAK-inhibitor (JAKi), significantly improves signs and symptoms of psoriatic arthritis (PsA) in patients with active disease. PENGUIN 1 and 2 were two phase III trials of FIL in PsA that were stopped. We considered Tofacitinib (TOFA) the best alternative drug for these patients because...
Article
Background Visual involvement is the most feared complication of Giant Cell Arteritis (GCA) (1-5 ). Permanent visual loss (PVL) may be preceded by transient visual loss. Once blindness is established, the prognosis is poor. Most of the series of predictive factors of visual involvement in GCA are old and with a small number of patients. Objective...
Article
Background Uveitis is a frequent extraarticular manifestation of spondyloarthritis (SpAs). It has been classically reported that whereas uveitis in axial spondyloarthritis (ax-SpA) is predominantly anterior, unilateral, acute, and non-recurrent; in psoriatic arthritis (PsA) and in inflammatory bowel disease (IBD) it has been described as posterior,...
Article
Background Patients with Rheumatoid Arthritis (RA) have an increased risk of infections. This may belinked to disease-related, the immunosuppressive therapy and the co-morbidities. Objectives in an unselected group of RA patients, our aim was to assess the A )incidence B )features of disease and C )predictive factors of serious infections-relat...
Article
Background Rheumatoid arthritis (RA) that is a chronic systemic and disabling disease affecting 0.5–1% of the general population, have been strongly linked to accelerated aterosclerosis and increased incidence of cardiovascular events and mortality. Klotho is a membrane-bound or soluble antiaging protein, whose protective activity is essential for...
Article
Background Ocular manifestations of Behçet’s disease (BD) are globally recognized and widely studied [1] . Vascular lesions are also frequent but less explored [2] . Microvascular involvement may be clinical (as Raynaud’s phenomenon) or subclinical. Vascular microcirculation is studied with Nailfold Capillaroscopy (NFC) that may show capillary abno...
Article
Background Axial spondyloarthritis (axSpA) is an inflammatory disease with detrimental effects on the health status of the individuals affected by this condition [1]. axSpA patients also exhibit high cardiovascular (CV) risk, mainly due to accelerated atherosclerosis [2]. Interestingly, the adipomyokine irisin was described to play a beneficial rol...
Article
Background Tocilizumab (TCZ) has shown efficacy in large-vessel vasculitis, including Giant Cell Arteritis (GCA) (1-3 ). Clinical trials with TCZ in GCA was performed with intravenous (iv) TCZ in a phase 2 trial (3 ), and with subcutaneous (sc) TCZ in the phase 3 GiACTA (4 ). However, in GCA there are no studies comparing IV vs SC TCZ. Objectives...
Article
Background Interstitial lung disease (ILD) is a common and life-threatening complication in patients with autoimmune diseases (AD), mainly in those with systemic sclerosis (SSc) and rheumatoid arthritis (RA). Growing evidence indicate that vascular abnormalities constitute the early phase in the pathogenesis of these inflammatory diseases [1]. We r...
Article
Background COVID-19 has become a common disease in patients with rheumatic immune-mediated diseases (R-IMID). A risk stratification of the patients at COVID-19 onset is important to predict possible unfavorable results. Objectives To identify predictive severity factors in patients with COVID-19 with R-IMID. Methods Cross-sectional study in a sin...
Article
Full-text available
Background Insulin resistance and beta-cell dysfunction are manifestations of rheumatoid arthritis (RA). Apolipoprotein C-III (ApoC3) has been associated with such insulin resistance and beta-cell dysfunction in the general population. Our purpose was to study whether ApoC3 is also related to the insulin resistance and beta-cell dysfunction that ar...
Article
Background Anti-SSA/Ro autoantibodies are among the most frequently detected extractable nuclear antigen autoantibodies and have mainly been associated with primary Sjögren’s syndrome (pSS), systemic lupus erythematosus (SLE) and undifferentiated connective tissue disease (UCTD). Objectives Is there a common signature to all patients expressing an...
Article
Background COVID19 may present different degrees of severity. It is generally thought that viral infections in patients with rheumatic inflammatory diseases (R-IMID) or receiving immunosuppressive treatment tend to present more severe disease. However, data comparing the severity of the disease between R-IMID and the general population are scarce....
Article
Background Large-vessel vasculitis are characterized by the wall inflammation of the involved vessels, which can be detected by imaging tools (1-3 ). Ultrasound (US) is one of the most commonly used tools for the diagnosis of giant cell arteritis (GCA), especially in patients with a cranial phenotype. Tocilizumab (TCZ) has shown efficacy in large-v...
Article
Background Patients with Rheumatoid arthritis (RA) have an increased risk of infections due to the disease itself, and/or immunosuppressive therapy. The risk of herpes zoster (HZ) including disseminated HZ is also increased (1 ) Objectives In an unselected series of RA patientswe assess A )prevalence, B )general features and C ) predictive fac...
Article
Background Tocilizumab (TCZ) has shown to be useful in the treatment of large-vessel vasculitis, including giant cell arteritis (GCA) (1-4 ). There is general agreement on the initial and the standard maintenance dose of TCZ. However, information on duration and optimization of TCZ in GCA is really scarce. Objectives Our aim was to assess the eff...
Article
Background Epidemiological information on Giant Cell Arteritis (GCA) comes mainly from the Scandinavian countries of northern Europe, which show a higher incidence than the countries of southern Europe. GCA clinical manifestations can be divided into cranial, extracranial, and general syndrome. Objectives In a large series of GCA from Spain, we st...
Article
Background Treatment of inflammatory idiopathic myopathies (IIM) is not well-stablished. Although the mechanism of action of intravenous immunoglobulins (IVIG) is not completely understood, they may be useful in rheumatic diseases, including IIM. Objectives To assess the efficacy and safety of IVIG in IIM. Methods Observational Single University...
Article
Background Large vessel involvement in Giant Cell Arteritis (GCA), especially the aorta and/or its main branches, is frequent. Tocilizumab (TCZ) has shown efficacy and safety in GCA and other large-vessel vasculitis (1-4 ). Objectives To assess the efficacy and safety of TCZ in GCA patients with involvement of the aorta and/or its main branches....
Article
Background Glucocorticoids (GC) are the mainstay therapy in Giant Cell Arteritis (GCA), initially at high doses (40-60 mg/day) followed by gradual glucocorticoid tapering. This treatment, especially in older patients, is associated with numerous adverse effects (AE). In addition, there are frequent relapses. Therefore, conventional synthetic immuno...
Article
Background Tocilizumab (TCZ) is the only biologic drug approved in giant cell arteritis (GCA), based in two clinical trials (CT) (1,2 ). CT included selected patients who may differ from those of clinical practice (CP). A high proportion of GCA patients treated with TCZ in CT had a newly diagnosed GCA, whereas in CP, most of them are refractory/rec...
Article
Background Intercellular adhesion molecule-1 (ICAM-1) and E-Selectin are adhesion molecules considered as markers of underlying endothelial activity and damage. These molecules are known to play an important role in autoimmune disease (AD) [1]. Accordingly, they may contribute to the development of interstitial lung disease (ILD), one of the main c...
Article
Background Isoniazid (INH) is used to treat latent tuberculosis infection (LTBI), and hepatotoxicity is one of the most frequent adverse effect. Several Disease-modifying drugs (DMARDs) can also cause hepatotoxicity. Many patients with rheumatic immune mediated diseases (R-IMID) receive INH prior to DMARDs for prophylaxis of LTBI. This risk of hepa...
Article
Background Autoinflammatory syndromes are characterized by dysregulation of innate immunity and recurrent episodes of fever, cutaneous and other. Janus Kinase inhibitors (JAKINIB) may inhibit innate and acquired immunity. They have been approved in several immune mediated diseases, but not in autoinflammatory syndromes. Objectives To assess the ef...
Article
Background Vascular manifestations are frequent in Behçet’s disease (BD). However, they have been less studied than other manifestations, such as uveitis [1]. Increased venous wall thickness assessed with ultrasound (US) has been reported in BD [2]. However, it remains unclear if US findings correlate with vascular involvement in BD. Objectives To...
Article
Background Anti-3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) immune-mediated necrotizing myopathy (IMNM) is an entity of growing interest. However, data on epidemiology and clinical spectrum are still scarce and there is a need for the identification of its potential risk factors. Objectives To characterize the demographic, genetic, clinical,...
Article
Introduction: Inflammatory bowel disease (IBD) has been associated with an abnormal lipid profile. Apolipoprotein C-III (ApoC3) is a key molecule of triglycerides metabolism that is known to be related to inflammation and cardiovascular (CV) disease. In the present study, we aim to study if ApoC3 serum levels differ between patients with IBD and c...
Article
Full-text available
Background Systemic lupus erythematosus (SLE) has been associated with atherosclerotic cardiovascular disease (CV) and an altered lipid profile. High levels of apolipoprotein C-III (ApoC3) are associated with elevated triglyceride levels and an increased risk of CV. In the present study, we aimed to study circulating ApoC3 in patients with SLE and...
Article
Introduction: : In the few last years, a new family of drugs, anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs), has been developed for migraine therapy. Anti-CGRP mAbs are highly effective, but the current limited experience with their use and their high-cost warrant establishing certain rules of use. Areas covered: The p...
Article
Full-text available
Background Elevated triglycerides or triglyceride-rich lipoproteins are an additional cause of cardiovascular (CV) disease. Given that patients with systemic lupus erythematosus (SLE) have a high prevalence of premature CV disease and show an altered lipid profile, our objective was to study whether three molecules that play a central role in the t...