To describe changes in the 2001–2014 mortality of 6 autoimmune systemic diseases (AISDs), namely Systemic Lupus Erythematosus (SLE), Systemic Sclerosis (SSc), Idiopathic Inflammatory Myopathies ...(IIM), Sjögren's Syndrome (SS), Mixed Connective Tissue Disease (MCTD) and ANCA-associated vasculitis (AAV) at the country-, continent-, and world-levels.
Mortality data were retrieved from the World Health Organization (WHO) mortality database for each disease, based on ICD-10 codes. We computed age-standardized mortality rate (ASMR) as the estimated number of deaths per million inhabitants and its 95% confidence interval (95%CI). The association between gender, geographical areas and disease-specific mortality was analyzed using multivariate Poisson regression. The 2001–2014 temporal trends were analyzed using Jointpoint software.
In 2014, the worldwide ASMR for SLE was 2.68 (95%CI: 2.62–2.75) deaths/millions inhabitants, 1.46 (1.42–1.51) for SSc, 0.47 (0.44–0.49) for IIM, 0.17 (0.15–0.18) for SS, 0.11 (0.10–0.13) for MCTD and 0.53 (0.50–0.56) for AAV, with ASMRs generally lower in Europe than in North America, Latin America and Asia. Between 2001 and 2014, the worldwide ASMR decreased significantly for SSc (−0.71%/year), IIM (−1.65%/year) and AAV (−1.01%/year; p < .001 for all) and increased for SS (+1.53%/year, p = .01). The worldwide ASMR of SLE decreased significantly between 2001 and 2003 (−6.37%, p < .05) before increasing slightly between 2004 and 2014 (+0.58%, p < .01).
We observed a strong heterogeneity of standardized mortality rates across all countries analyzed for 6 autoimmune diseases. Those results further highlight the impact of world-wide inequities and major gaps in access to care and strategies for diagnosis and management of rare diseases, a crucial finding for world-wide physicians, patient associations and policy makers.
•The age-standardized mortality rate (ASMR) of 6 auto-immune diseases was computed using the WHO mortality database.•The ASMR were generally lower in Europe than in North America, Latin America and Asia.•Between 2001 and 2014, there was a significant worldwide decrease of the ASMR of SSc, IIM & AAVs while it increased for SLE and Sjögren's
Precise shaping of coherent electron sources allows the controlled creation of wavepackets into a one dimensional (1D) quantum conductor. Periodic trains of Lorentzian pulses have been shown to ...induce minimal excitations without creating additional electron-hole pairs in a single non-interacting 1D electron channel. The presence of electron-electron (e-e) interactions dramatically affects the non-equilibrium dynamics of a 1D system. Here, we consider the intrinsic spectral properties of a helical liquid, with a pair of counterpropagating interacting channels, in the presence of time-dependent Lorentzian voltage pulses. We show that peculiar asymmetries in the behavior of the spectral function are induced by interactions, depending on the sign of the injected charges. Moreover, we discuss the robustness of the concept of minimal excitations in the presence of interactions, where the link with excess noise is no more straightforward. Finally, we propose a scanning tunneling microscope setup to spectroscopically access and probe the non-equilibrium behavior induced by the voltage drive and e-e interactions. This allows a diagnosis of fractional charges in a correlated quantum spin Hall liquid in the presence of time-dependent drives.
Autosomal dominant gain-of-function mutations in human stimulator of interferon genes (STING) lead to a severe autoinflammatory disease called STING-associated vasculopathy with onset in infancy that ...is associated with enhanced expression of interferon-stimulated gene transcripts.
The goal of this study was to analyze the phenotype of a new mouse model of STING hyperactivation and the role of type I interferons in this system.
We generated a knock-in model carrying an amino acid substitution (V154M) in mouse STING, corresponding to a recurrent mutation seen in human patients with STING-associated vasculopathy with onset in infancy. Hematopoietic development and tissue histology were analyzed. Lymphocyte activation and proliferation were assessed in vitro. STING V154M/wild-type (WT) mice were crossed to IFN-α/β receptor (IFNAR) knockout mice to evaluate the type I interferon dependence of the mutant Sting phenotype recorded.
In STING V154M/WT mice we detected variable expression of inflammatory infiltrates in the lungs and kidneys. These mice showed a marked decrease in survival and developed a severe combined immunodeficiency disease (SCID) affecting B, T, and natural killer cells, with an almost complete lack of antibodies and a significant expansion of monocytes and granulocytes. The blockade in B- and T-cell development was present from early immature stages in bone marrow and thymus. In addition, in vitro experiments revealed an intrinsic proliferative defect of mature T cells. Although the V154M/WT mutant demonstrated increased expression of interferon-stimulated genes, the SCID phenotype was not reversed in STING V154M/WT IFNAR knockout mice. However, the antiproliferative defect in T cells was rescued partially by IFNAR deficiency.
STING gain-of-function mice developed an interferon-independent SCID phenotype with a T-cell, B-cell, and natural killer cell developmental defect and hypogammaglobulinemia that is associated with signs of inflammation in lungs and kidneys. Only the intrinsic proliferative defect of T cells was partially interferon dependent.
Studies of the impact of chirality on amorphous states are scarce. Here, we present combined dielectric relaxation spectroscopy (DRS) experiments and molecular dynamics (MD) simulation investigations ...of homochiral and racemic ibuprofen in the liquid, undercooled liquid and glassy states. The influence of chirality is particularly investigated on the syn and anti conformations of the -COOH moiety of the ibuprofen molecule and its link to the peculiar Debye-like dynamical process detected in this compound. Most of the studied properties are found to be nearly identical in the homochiral and racemic systems. But the polarity and intensity of the Debye-like process are clearly found to be more intense in the racemic mixture than in the enantiomerically pure ibuprofen. The difference is explained by the higher population of the anti conformation (with the higher dipole moment) and the lower population of hydrogen bonded cyclic dimers that can be transiently formed in the racemic mixture.
Macroautophagy was recently shown to regulate both lymphocyte biology and innate immunity. In this study we sought to determine whether a deregulation of autophagy was linked to the development of ...autoimmunity. Genome-wide association studies have pointed out nucleotide polymorphisms that can be associated with systemic lupus erythematosus, but the potential role of autophagy in the initiation and/or development of this syndrome is still unknown. Here, we provide first clues of macroautophagy deregulation in lupus. By the use of LC3 conversion assays and electron microscopy experiments, we observed that T cells from two distinct lupus-prone mouse models, i.e., MRL
lpr/lpr
and (NZB/NZW)F1, exhibit high loads of autophagic compartments compared with nonpathologic control CBA/J and BALB/c mice. Unlike normal mice, autophagy increases with age in murine lupus. In vivo lipopolysaccharide stimulation in CBA/J control mice efficiently activates T lymphocytes but fails to upregulate formation of autophagic compartments in these cells. This argues against a deregulation of autophagy in lupus T cells solely resulting from an acute inflammation injury. Autophagic vacuoles quantified by electron microscopy are also found to be significantly more frequent in T cells from lupus patients compared with healthy controls and patients with non-lupus autoimmune diseases. This elevated number of autophagic structures is not distributed homogeneously and appears to be more pronounced in certain T cells. These results suggest that autophagy could regulate the survival of autoreactive T cell during lupus, and could thus lead to design new therapeutic options for lupus.
Three randomized controlled trials in early severe systemic sclerosis demonstrated that autologous hematopoietic stem cell transplantation was superior to standard cyclophosphamide therapy. This ...European Society for Blood and Marrow Transplantation multi-center prospective non-interventional study was designed to further decipher efficacy and safety of this procedure for severe systemic sclerosis patients in real-life practice and to search for prognostic factors. All consecutive adult systemic sclerosis patients undergoing a first autologous hematopoietic stem cell transplantation between December 2012 and February 2016 were prospectively included in the study. Primary endpoint was progression free survival. Secondary endpoints were overall survival, non-relapse mortality, response and incidence of progression. Eighty systemic sclerosis patients were included. Median follow-up duration was 24 (6-57) months after stem cell transplantation using cyclophosphamide plus antithymocyte globulins conditioning for all, with CD34+ selection in 35 patients. At 2 years, progression free survival was 81.8%, overall survival was 90%, response was 88.7% and incidence of progression was 11.9%. The 100 days non-relapse mortality was 6.25% (n=5) with four deaths from cardiac event, including three due to cyclophosphamide toxicity. Modified Rodnan skin score and forced vital capacity improved with time (p< 0.001). By multivariate analysis, baseline skin score >24 and older age at transplant were associated with lower progression free survival (Hazard ration 3.32) and 1.77, respectively). CD34+-selection was associated with better response (Hazard ration: 0.46). This study confirms the efficacy of autologous stem cell transplantation in real-life practice for severe systemic sclerosis using non myeloablative conditioning. Careful cardio-pulmonary assessment to identify organ involvement at patient referral, reduced cyclophosphamide doses and CD34+ selection may improve outcomes. The study was registered at ClinicalTrials.gov: NCT02516124.
Collecting back‐scattered X‐rays from vacuum windows using a pinhole X‐ray camera provides an efficient and reliable method of measuring the beam shape and position of the white synchrotron beam. In ...this paper, measurements are presented that were conducted at ESRF beamline ID6 which uses an in‐vacuum cryogenically cooled permanent‐magnet undulator (CPMU18) and a traditional U32 undulator as its radiation sources, allowing tests to be performed at very high power density levels that were adjusted by changing the gap of the undulators. These measurements show that it is possible to record beam shape and beam position using a simple geometry without having to place any further items in the beam path. With this simple test setup it was possible to record the beam position with a root‐mean‐square noise figure of 150 nm.
White beam diagnostics through pinhole imaging of diffusely scattered radiation are presented.
The edge channels of the quantum Hall effect provide one dimensional chiral and ballistic wires along which electrons can be guided in an optics‐like setup. Electronic propagation can then be ...analyzed using concepts and tools derived from optics. After a brief review of electron optics experiments performed using stationary current sources which continuously emit electrons in the conductor, this paper focuses on triggered sources, which can generate on‐demand a single particle state. It first outlines the electron optics formalism and its analogies and differences with photon optics and then turns to the presentation of single electron emitters and their characterization through the measurements of the average electrical current and its correlations. This is followed by a discussion of electron quantum optics experiments in the Hanbury‐Brown and Twiss geometry where two‐particle interferences occur. Finally, Coulomb interactions effects and their influence on single electron states are considered.
The edge channels of the quantum Hall effect provide one dimensional chiral and ballistic wires along which electrons can be guided in optics like setup. Electronic propagation can then be analyzed using concepts and tools derived from optics. After a brief review of electron optics experiments performed using stationary current sources which continuously emit electrons in the conductor, this paper focuses on triggered sources, which can generate on‐demand a single particle state. It first outlines the electron optics formalism and its analogies and differences with photon optics and then turns to the presentation of single electron emitters and their characterization through the measurements of the average electrical current and its correlations. This is followed by a discussion of electron quantum optics experiments in the Hanbury‐Brown and Twiss geometry where two‐particle interferences occur. Finally, Coulomb interactions effects and their influence on single electron states are considered.
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