Spondyloarthritis is a group of immune-mediated rheumatic disorders that significantly impact patients' physical function and quality of life. Patients with spondyloarthritis experience a greater ...prevalence of cardiometabolic disorders, such as obesity, hypertension, dyslipidemia and diabetes mellitus, and these comorbidities are associated with increased spondyloarthritis disease activity and risk of cardiovascular events. This narrative review summarizes the evidence for a physiological link between inflammatory status and cardiometabolic comorbidities in spondyloarthritis, as well as the impact of interleukin (IL)-17 blockade versus other molecular mechanisms in patients with cardiometabolic conditions. The IL-23/IL-17 axis plays a pivotal role in the pathophysiology of spondyloarthritis by promoting inflammation and tissue remodeling at the affected joints and entheses. The importance of the IL-23/IL-17 signaling cascade in underlying sub-clinical inflammation in common cardiometabolic disorders suggests the existence of shared pathways between these processes and spondyloarthritis pathophysiology. Thus, a bidirectional relationship exists between the effects of biologic drugs and patients' cardiometabolic profile, which must be considered during treatment decision making. Biologic therapy may induce changes in patients' cardiometabolic status and cardiometabolic conditions may conversely impact the clinical response to biologic therapy. Available evidence regarding the impact of IL-17 blockade with secukinumab on cardiometabolic parameters suggests this drug does not interfere with traditional cardiovascular risk markers and could be associated with a decreased risk of cardiovascular events. Additionally, the efficacy and retention rates of secukinumab do not appear to be negatively affected by obesity, with some studies reporting a positive impact on clinical outcomes, contrary to that described with other approaches, such as tumor necrosis factor blockade. In this article, we also review evidence for this bidirectional association with other treatments for spondyloarthritis. Current evidence suggests that IL-17-targeted therapy with secukinumab is highly effective in spondyloarthritis patients with cardiometabolic comorbidities and may provide additional cardiometabolic benefits.
The role of the immune response in the pathogenesis of antiphospholipid syndrome (APS) remains elusive. It is possible that differences in the frequencies of Th17 cells and/or defects in the ...immunoregulatory mechanisms are involved in the pathogenesis of APS. Our aim was to determine the peripheral blood Th cells phenotype and the circulating cytokine profile in patients with primary APS (pAPS) and compare it with systemic lupus erythemathosus (SLE) as disease control group.
The frequencies of circulating regulatory T cells (Tregs) were determined in PBMCs from 36 patients with pAPS by flow cytometry. As control groups we included 21 age- and gender-matched healthy controls (HC) and 11 patients with SLE. The suppressive capacity of Tregs was evaluated
by coculture assay. On the other hand, intracellular cytokine production was assessed in Th1, Th2, and Th17 cells and circulating IL-6, IL-10, and IL-35 were measured by Cytometric Bead Array and ELISA. The quantification of Th master gene expression levels was performed by real time quantitative PCR.
pAPS patients and SLE patients did not show differences in the percentage or number of Tregs compared to HC. The suppressive capacity of Tregs was also similar in the three study group. Instead, we found higher FoxP3·mRNA expression levels in pAPS patients and HC than SLE patients. Regarding the Th17 response, patients with pAPS and HC showed a significantly lower frequency of circulating Th17 cells than SLE. However, no differences were observed in the Th1 response between patients and controls. Thus, increased Th17/Th1 and Th17/Treg ratios were found in SLE patients but not in pAPS patients. pAPS and SLE patients had higher serum IL-6 levels than HC but there was not difference between both disease groups. Besides, a significant increase in the immunosuppressive cytokine levels was observed only in pAPS as compared to HC.
Our data demonstrate an increased inflammatory profile of peripheral blood CD4
T cells from SLE as compared with pAPS mostly due to an increased Th17 response. In conclusion, there seems not to be a direct pathogenic role for Th cells in pAPS but in SLE.
Objectives:
We aimed to evaluate the drug retention rate and safety of secukinumab (SEC) in patients with axial spondyloarthritis (AxSpA) and psoriatic arthritis (PsA) in a real clinical setting.
...Methods:
This multicenter retrospective observational study included all AxSpA and PsA patients who received at least one dose of SEC. Adverse events (AE) and the drug retention rate were the main study outcomes. Drug survival was analyzed by Kaplan-Meier curves while predictive factors of discontinuation were evaluated using a Cox regression analysis. The weight of these associations was estimated by hazard ratio (HR) values.
Results:
We included 154 patients (59 PsA and 95 AxSpA). Mean disease duration was 6.5 years (IQR 2-8). Sixty-one percent of patients were treated with two or more biologics prior to SEC. The 1 and 2-year retention rates for SEC were 66 and 43%, respectively. The main causes of discontinuation were inefficacy (59%) and AE (36%). The factors associated with lower risk of discontinuation were male gender (HR 0.54, 95% CI 0.38-0.78
p
= 0.001), obesity (HR 0.53, 95% CI 0.30-0.93
p
= 0.027), hypertension (HR 0.55, 95% CI 0.30-0.93
p
= 0.008), and diabetes (HR 0.42 95% CI 0.18-0.99
p
= 0.047) while number of previous biologics and depression were predictors of discontinuation (HR 1.18, 95% CI 1.04-1.34
p
= 0.011 and HR 2.53, 95% CI 1.61-3.96
p
< 0.001).
Conclusions:
SEC showed a good retention rate in a population previously exposed to several biological therapies. As a novelty, cardiometabolic comorbidities were associated with better drug survival.
This cross-sectional observational study aims to determine isokinetic normality data at different speeds, and isometric data of ankle and knee joints, in healthy basketball players aged 15-16 years ...old. The participants were recruited through non-probabilistic convenience sampling. Sociodemographic, anthropometric, and biomechanical variables were collected. The study involved 42 participants. Right-leg dominance was higher in women (85.7%) than in men (78.6%). Men had a higher weight, height, and body mass index compared to women. Statistically significant differences were observed between sex and height (
< 0.001). Significant differences were found between sexes in knee flexor and extensor strength at different isokinetic speeds (30°, 120°, and 180°/s), except for the maximum peak strength knee flexion at 180°/s in the right leg. In the ankle, the variables inversion, eversion, and work strength values at different isokinetic speeds and full RoM, by sex, were not significantly different, except for the right (
= 0.004) and the left (
= 0.035) ankle full RoM. The study found lower knee extensor strength in women, indicating the need to improve knee flexor/extensor strength in women to match that of men, as seen in other joints. The results can guide the development of preventive and therapeutic interventions for lower limb injuries in basketball players.
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 manifestation was already present before the initiation of TCZ.
Design:
This is an observational multicenter study of patients with GCA treated with TCZ.
Methods:
Patients were divided into two subgroups according to the presence or absence of visual involvement before TCZ onset. Visual manifestations were classified into the following categories: transient visual loss (TVL), permanent visual loss (PVL), diplopia, and blurred vision.
Results:
Four hundred seventy-one GCA patients (mean age, 74 ± 9 years) were treated with TCZ. Visual manifestations were observed in 122 cases (26%), of which 81 were present at TCZ onset: PVL (n = 60; unilateral/bilateral: 48/12), TVL (n = 17; unilateral/bilateral: 11/6), diplopia (n = 2), and blurred vision (n = 2). None of the patients without previous visual involvement or with TVL had new episodes after initiation of TCZ, while only 11 out of 60 (18%) patients with PVL experienced some improvement. The two patients with diplopia and one of the two patients with blurred vision improved.
Conclusion:
TCZ may have a protective effect against the development of visual complications or new episodes of TVL in GCA. However, once PVL was established, only a few patients improved.
Souffles-Anfas: A Critical Anthology from the Moroccan Journal of Culture and Politics introduces and makes available, for the first time in English, an incandescent corpus of experimental leftist ...writing from North Africa. Founded in 1966 by Abdellatif Laâbi and a small group of avant-garde Moroccan poets and artists and banned in 1972, Souffles-Anfas was one of the most influential literary, cultural, and political reviews to emerge in postcolonial North Africa. An early forum for tricontinental postcolonial thought and writing, the journal published texts ranging from experimental poems, literary manifestos, and abstract art to political tracts, open letters, and interviews by contributors from the Maghreb, the Middle East, Africa, Europe, and the Americas. The essays, poems, and artwork included in this anthology—by the likes of Abdelkebir Khatibi, Tahar Ben Jelloun, Albert Memmi, Etel Adnan, Sembene Ousmane, René Depestre, and Mohamed Melehi—offer a unique window into the political and artistic imaginaries of writers and intellectuals from the Global South, and resonate with particular acuity in the wake of the Arab Spring. A critical introduction and section headnotes make this collection the perfect companion for courses in postcolonial theory, world literature, and poetry in translation.
Aimancipation Villa-Ignacio, Teresa
PMLA : Publications of the Modern Language Association of America,
03/2022, Letnik:
137, Številka:
2
Journal Article
Phagocyte function deregulated in age‐restricted inflammatory disorders.
This study was conducted to evaluate phagocyte function in patients with age‐related chronic inflammatory conditions. It ...included 95 patients with PMR, 17 with GCA, 40 with EORA, and 25 age‐matched HCs. Serum IL‐8 was determined with a bead array. The chemotactic capacity, phagocytic ability, and oxidative burst activity of circulating leukocytes were determined with flow cytometry kits. Patients with active chronic inflammatory diseases showed a significant increase in circulating levels of IL‐8 that remained elevated in patients with PMR or EORA, despite treatment. No correlation was found between circulating IL‐8 and the migratoty capacity of neutrophils. Neutrophils from patients with active EORA without stimulus and after fMLP stimuli showed a higher capacity to migrate than those of the HCs (P=0.033). The phagocytic activity of granulocytes in the patients with GCA was significantly higher than in the HCs and the patients with PMR or EORA (P<0.05). The percentage and MFI of phagocytes that produce ROIs when stimulated with Escherichia coli was significantly reduced in neutrophils and monocytes from the patients with age‐restricted inflammatory conditions. We concluded that the effector functions of phagocytes, determined to be chemotaxis, phagocytosis, and oxidative burst, are deregulated in age‐restricted inflammatory disorders and may have a pathogenic role.
By 2050, it is estimated that more than 2/3 of the world's populations will live in urban areas. With land management, food security, and energy production becoming increasingly challenging, ...mitigating the limiting variables has becoming progressively important. Rooftop agrivoltaics combines effective land management, food security, and energy production. This study evaluates the growth of high value leafy greens under opaque CdTe framed solar panels, opaque CdTe frameless panels, 40% semi-transparent CdTe frameless panels, and in full sun as a control treatment. A rooftop agrivoltaic system is simulated at grade in Fort Collins, Colorado, at the Foothills Campus of Colorado State University. Biomass accumulation, growth rate, stomatal conductance, and environmental conditions were evaluated through multiple growth cycles for five leafy greens. Upon preliminary analysis, leafy greens grown under semi-transparent panels accumulated the largest fresh weights comparative to the other panel types and full sun treatments. It was also found that the plants have a relatively similar stomatal conductance between the traditional opaque panel and the frameless opaque panel, and the shade from the opaque and frameless panels resulted in lower stomatal conductance across all species, except kale. There is greater biomass accumulation under solar panel treatments than in full sun. Understanding the growth characteristics and growing environment of high value crops under these treatments will increase understanding of how these crops will grow in a green roof system under solar panels. These systems can be used to ease food, energy, and land needs within urban centers and supplement the population's basic needs.
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