Presence Of SLE Research Articles

Sugar kelp Saccharina latissima extract as an innovative ingredient for chitosan films: Case study as cheese slice separators

Chitosan films enriched with aqueous extract of Sugar kelp Saccharina latissima (SLE) were developed and characterized by measuring the equilibrium moisture, moisture content, water vapor permeability, mechanical properties, antioxidant properties, optical properties, surface morphology and thermostability. The developed films were tested as separators with antioxidant properties for sliced Havarti cheese. The addition of SLE showed a decrease in mechanical properties such as tensile strength from 48.99 to 36.16 MPa and Young's Modulus from 929.49 to 743.71 MPa compared with pure chitosan films. The resulting chitosan-SLE films showed a high free-radical scavenging activity against 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS+). Moreover, the presence of SLE in the chitosan matrix significantly improved the UV-barrier of the samples. When the chitosan-SLE films were employed as separators for cheese, a significant reduction of 52.8% in cheese lipid oxidation was observed after 45 days of refrigerated storage compared to the control group using chitosan films. Hence, an environmentally sustainable alternative to synthetic and non-biodegradable slice separators has been successfully developed using chitosan, a by-product of the fishing industry, fortified with an extract from sugar kelp, a commonly found brown algae.

Impact of systemic lupus erythematosus on outcomes in patients hospitalized with acute decompensated heart failure with reduced and preserved ejection fraction: a national inpatient sample study (2016)

Abstract Background Systemic lupus erythematosus (SLE) is known to have an impact on cardiovascular outcomes, but its effect on patients with acute decompensated heart failure (ADHF) with reduced and preserved ejection fraction is not well understood. This study aims to investigate the impact of SLE on in-hospital outcomes in patients with ADHF. Methods This retrospective cohort study analyzed data from the United States National Inpatient Sample Database from 2016 to 2020. Patients hospitalized with ADHF with reduced and preserved ejection fraction were identified using ICD-10 codes and then categorized based on SLE diagnosis. Mortality and in-hospital complications were analyzed using multivariate logistic regression. Results Out of 10,700,000 ADHF hospitalizations, 0.61% (65,270) were associated with SLE. Compared to patients without SLE, those with SLE were younger (61 vs 72 years old, p<0.001), more likely to be female (85% vs 48%, p<0.001), had longer lengths of stay (coefficient: 0.23; p 0.005), and lower total hospital charges (coefficient: -$5,207; p<0.001). Patients with SLE had lower rates of cardiogenic shock, acute MI, and ischemic stroke (Figure 1). However, they had higher odds of in-hospital mortality, gastrointestinal bleeding, blood transfusion, pericardial complications, and AKI. No significant differences were found in respiratory failure and intracranial hemorrhage rates between the two cohorts. Conclusions This study suggests that the presence of SLE in patients hospitalized with ADHF is associated with worse in-hospital outcomes, including higher rates of all-cause mortality, gastrointestinal bleeding, blood transfusion, pericardial complications, and AKI. However, patients with SLE had lower rates of cardiogenic shock, acute MI, and ischemic stroke compared to those without SLE. These findings highlight the importance of early recognition and aggressive management of SLE in patients with ADHF to improve outcomes. Further research is needed to identify potential interventions that could improve the outcomes of this high-risk population.

British Association of Dermatologists guidelines for the management of people with cutaneous lupus erythematosus 2021.

The overall objective of the guideline is to provide up-to-date, evidence-based recommendations for the management of cutaneous lupus erythematosus (CLE) in the presence or absence of systemic lupus erythematosus (SLE) in adults, young people and children. The document aims to: offer an appraisal of all relevant literature up to December 2020, focusing on any key developments address important, practical clinical questions relating to the primary guideline objective. provide guideline recommendations and if appropriate research recommendations.

Prevalence of systemic lupus erythematosus in Spain: higher than previously reported in other countries?

ObjectivesPrevalence of SLE varies among studies, being influenced by study design, geographical area and ethnicity. Data about the prevalence of SLE in Spain are scarce. In the EPISER2016 study, promoted by the Spanish Society of Rheumatology, the prevalence estimate of SLE in the general adult population in Spain has been updated and its association with sociodemographic, anthropometric and lifestyle variables has been explored.MethodsPopulation-based multicentre cross-sectional study, with multistage stratified and cluster random sampling. Participants were contacted by telephone to carry out a questionnaire for the screening of SLE. Investigating rheumatologists evaluated positive results (review of medical records and/or telephone interview, with medical visit if needed) to confirm the diagnosis. To calculate the prevalence and its 95% CI, the sample design was taken into account and weighing was calculated considering age, sex and geographic origin. Multivariate logistic regression models were defined to analyse which sociodemographic, anthropometric and lifestyle variables included in the telephone questionnaire were associated with the presence of SLE.Results4916 subjects aged 20 years or over were included. 16.52% (812/4916) had a positive screening result for SLE. 12 cases of SLE were detected. The estimated prevalence was 0.21% (95% CI: 0.11, 0.40). SLE was more prevalent in the rural municipalities, with an odds ratio (OR) = 4.041 (95% CI: 1.216, 13.424).ConclusionThe estimated prevalence of SLE in Spain is higher than that described in most international epidemiological studies, but lower than that observed in ethnic minorities in the United States or the United Kingdom.

Analysis of structure, causes, and risk factors of ischemic optic neuro-pathy

to analyze the structure, risk factors, and causes of ischemic optic neuropathy (ION). A total of 239 patients (303 eyes) with ION and 98 patients (185 eyes) with optic disc drusen were examined. All ION patients underwent general clinical assessment. Those under 50 years of age were also tested for antiphospholipid markers and gene polymorphisms of the coagulation system. All patients were found to be exposed to two or more modifiable risk factors of ION. A total of 47.1% of cases were judged as being at anatomical risk of anterior ION (AION) with the cup-to-disc ratio in the second eye of less than 0.15 (of less than 0.25 in 53% of cases). Of 98 patients (185 eyes) with optic disc drusen, 5.4% of cases (10 eyes) developed AION. As many as 22% of ION patients were under 50 years of age. Of them, in 32% primary APS was diagnosed, in 3.6% - secondary (in the presence of SLE); all cases were positive for polymorphisms of the coagulation system that determine genetic predisposition to ION (indeed, the frequency of the latter was significantly higher in these patients than in the control group). Ischemic optic neuropathy is an optic nerve disorder that requires thorough medical history taking and comprehensive assessment of the patient in order to identify the causes and risk factors of this disease as well as accompanying pathologies.

Anti-heparan sulfate antibody and functional loss of glomerular heparan sulfate proteoglycans in lupus nephritis.

Background The purpose of this study was to evaluate the features of heparan sulfate proteoglycans (HSPGs) as agrins of the glomerular basement membrane (GBM) and circulating anti-heparan sulfate (HS) antibodies in lupus nephritis, comparing titers among the following groups: lupus nephritis (LN), non-renal lupus, non-lupus nephritis, and healthy controls. Methods The stage of nephritis was determined based on the kidney biopsy. Alcian blue staining and immunohistochemical (IHC) staining for agrin were performed for histological evaluation of GBM HSPGs in normal glomeruli, non-lupus membranous glomerulonephritis (MGN), and lupus MGN. The results were used for measurement of the serum anti-HS antibody titers using an enzyme-linked immunosorbent assay (ELISA) in the following groups: 38 healthy controls, 38 non-lupus nephritis, 37 non-renal lupus, and 38 LN. Results Glomerulus HSPGs were stained bluish-green along the GBM with Alcian blue. However, IHC staining against agrin was almost completely negative in the lupus MGN group compared with the normal and non-lupus MGN groups, which showed brown staining of GBM. A higher level of anti-HS IgG was detected in LN compared with other groups, respectively. Higher titers were associated with the presence of SLE and nephritis. A higher degree of proteinuria normalized to glomerular filtration rate (eGFR) was observed in association with higher anti-HS antibody titers in LN. Conclusion This study demonstrated a functional loss of GBM HSPGs and higher levels of circulating anti-HS antibodies as a characteristic feature of lupus nephritis, suggesting their involvement in the pathogenesis of lupus nephritis and proteinuria.

Comparison of breast cancer risk in women with and without systemic lupus erythematosus in a Medicare population.

Studies have suggested a decreased breast cancer risk in women with systemic lupus erythematosus. However, these studies enrolled younger patients identified primarily from lupus clinics. We compared the 5-year incidence of breast cancer among women with and without a diagnosis of SLE in a large population-based study of Medicare beneficiaries. We used a 20 % sample to create a cohort of 3,670,138 women from 2006 Medicare claims data with and without SLE at baseline. The study had 80 % power to detect whether the 5-year breast cancer incidence in the SLE cohort was 13 % higher or lower than the non-SLE cohort. Of the 18,423 women with SLE, 21 % were African American and 53 % were ≥65 years. The absolute age-adjusted risk for breast cancer in women with SLE was 2.23 (95 % CI 1.94-2.55) and 2.14 (95 % CI 1.96-2.34) in controls per 100 women. The overall absolute age and race adjusted incidence rate was 1.04 (95 % CI 0.90-1.21). Among women with SLE from "Others" (Hispanic, Native American, and/or Asian), the age-adjusted risk for breast cancer was 2.44 per 100 women (95 % CI 1.07-2.18), and age-adjusted incidence rate was 1.52 (95 % CI 1.07-2.18). In contrast to prior clinic-based studies, this population-based cohort study showed that the risk of breast cancer in women with SLE was not lower than in women without SLE. Women with SLE should follow routine breast cancer screening recommendations for their age group to avoid delay in diagnosis, because the presence of SLE may affect selection of early breast cancer therapies.

Risk factors for pregnancy failure in patients with anti-phospholipid syndrome treated with conventional therapies: a multicentre, case-control study

To identify the risk factors associated with pregnancy failure in patients with APS treated with conventional therapy. A multicentre, case-control study was conducted to compare APS patients with successful and unsuccessful pregnancy outcomes. We retrospectively considered 410 pregnancies of women diagnosed with primary APS. The study focused on 57 unsuccessful pregnancies (considered the study population) and 57 successful pregnancies (considered the control population) matched for age and therapy. All the patients had been treated with conventional protocol treatments including low-dose aspirin and/or heparin. The clinical and laboratory features of the two groups of women diagnosed with APS were compared. The independent risk factors for pregnancy failure were: (i) the presence of SLE or other autoimmune diseases [odds ratio (OR) 6.0; 95% CI 1.7, 20.8; P = 0.01]; (ii) history of both thrombosis and pregnancy morbidity (OR 12.1; 95% CI 1.3, 115.3; P = 0.03); and (iii) triple [Immunoglobulin (Ig) G/IgM aCLs plus IgG/IgM anti-β(2) glycoprotein I antibodies plus LA] aPL positivity (OR 4.1; 95% CI 1.0, 16.7; P = 0.05). APS patients diagnosed on the basis of a single positive test and/or history of pregnancy morbidity alone were generally found to have successful pregnancies. It would seem from these findings that the risk of pregnancy failure in APS women planning to conceive can be stratified on the basis of some specific clinical and laboratory features.

Antibody profiles for the diagnosis of antiphospholipid syndrome

Among the so called 'antiphospholipid antibodies', the presence of Lupus Anticoagulant (LA) is associated with thrombosis-related events and defines the antiphospholipid syndrome. The role of anti-cardiolipin (aCL) antibodies and anti-human beta2-glycoprotein I (abeta2GPI) antibodies is less striking. Since the problem of standardization for these tests is far from resolved, we evaluated whether the combination of results (antiphospholipid laboratory profiles) could help to better classify these patients. Over a 6-year period, 618 consecutive subjects (55% of whom had previous documented thrombosis-related events) were referred to our clinic for Antiphospholipid antibody detection. LA was detected according to internationally accepted recommendations. ACL and abeta2GPI antibodies were detected by Enzyme-Linked-Immunosorbent Assay (ELISA). Patients' records were reviewed for the presence of previous thromboembolic events or obstetric complications according to Sapporo's clinical criteria for the diagnosis of antiphospholipid syndrome (APS) and each patient underwent a physical examination. When individual tests were considered in a multivariate analysis which took into account age, gender, the presence of SLE or other autoimmune diseases and established risk factors for venous and arterial thromboembolism, LA (Odds Ratio 4.4, Confidence Interval 1.5-13.3) and abeta2GPI antibodies (Odds Ratio 2.9, Confidence Interval 1.1-7.5) but not aCL antibodies (Odds Ratio 1.2, Confidence Interval 0.5-2.7) were found to be independent risk factors for thrombosis-related events. When antiphospholipid antibody profiles instead of individual test positivity were analyzed in the above mentioned model, triple positivity resulted a strong independent risk factor (Odds Ratio 33.3, Confidence Interval 7.0-157.6), retaining its significance when the association with venous or arterial thromboembolism was considered. Double positivity with negative LA was close to significance for thrombosis-related events (Odds Ratio 2.2, Confidence Interval 1.0-5.2, p=0.056) and highly significant risk factor for obstetric complications (Odds Ratio 10.8, Confidence Interval 2.9-40.8). Other combinations did not reach statistical significance. The mean level of IgG abeta2GPI antibodies was statistically higher in triple positive profile and might account for positive LA. As compared to a single test, the analysis of a complete antiphospholipid antibody profile can better determine patients at risk.

Prevalence of Activated Protein C Resistance Due To Factor V Leiden Mutation among South Asians (India and Pakistan) with Venous Thromboembolism.

Objective: To study the prevalence of Activated Protein C (APC) resistance due to Factor V Leiden (FV Leiden) mutation among the first generation immigrants from India and Pakistan with venous thromboembolism (VTE).Introduction: APC resistance due to the substitution of Arginine 506 by Glutamine in coagulation Factor V is caused by G1691A mutation in exon 10 of Factor V gene. This is the commonest cause of inherited thrombophilia in Caucasians, but the frequency of this mutation is low in non-Caucasians. Among subjects in the Physician Health Study, the frequency of FV Leiden was found to be 5.27% in Caucasian Americans vs. 0.45% in Asian Americans. Another study found no mutation in 191 Asian Americans tested. In non-Caucasians with VTE, it is generally considered not cost effective to screen for this mutation. However Asians are a heterogeneous group and the Leiden gene frequency varies among different ethnic populations. While the frequency of FV Leiden gene has been documented to be low in China, Korea, Japan, Thailand, Indonesia etc, the frequency in India and Pakistan is not well studied. Two studies found a carrier frequency of 2% (Rees et al) and 4.2 % (Gou et al) among the general population from India and Pakistan. This is similar to the frequency found in Middle Eastern and European population. We did not come across any study of FV Leiden gene frequency in patients with VTE from India and Pakistan.Patients and Methods: A retrospective chart review of patients of Indian or Pakistani origin seen at Coney Island Hospital, from July 1996 to June 2003, who had a work up for inherited thrombophilia after an episode of VTE. During the chart review age, sex, first or recurrent episode and any predisposing factors such as immobilization, malignancy, hormonal therapy, surgery, pregnancy, and the presence of SLE or MPD were noted. Thrombophilia work up included functional assays for Protein C, S and Antithrombin III, Lupus anticoagulant, ACA and Homocysteine levels. APC resistance was measured by a clotting assay using Factor V depleted plasma and all patients who were borderline or resistant were tested for the presence of FV Leiden mutation by PCR.Results: A total of 18 patients were studied. All had an episode of VTE documented by a Doppler ultrasonography or a Ventilation Perfusion lung scan or a CT angiogram. 3 out of 18 patients (16.6%) had APC resistance. All the three patients were confirmed to be heterozygous for FV Leiden mutation. Two were male and one was a female with a median age of 36 yrs (27, 36 and 57 yrs). The female patient had a recurrent episode, first one occurred during pregnancy, but the second episode had no precipitating events. One male patient had trauma to the leg and was immobilized at the time of the VTE, another male patient was a cab driver by occupation. None of the patients had any other concurrent inherited thrombophilic state.Conclusions: The prevalence of the FV Leiden mutation is significantly high among South Asians with VTE in our study. If the findings are confirmed by a larger study, screening for this mutation for thrombophilia would be relevant in patients of South Asian origin and screening recommendations for family members would be identical to Caucasian population. The high prevalance as in Caucasians suggests a founder effect and possible spread of the mutation by the migration of Neolithic farmers from the Middle East towards Europe and India, ten thousand years ago. This has been confirmed by haplotype analysis.

Familial antiphospholipid antibodies and acquired circulating anticoagulants

Familial clustering of elevated antiphospholipid antibody levels has been described, but the reports are heterogeneous with regard to the characterization of the antiphospholipid syndrome (APS), coexisting autoimmune diseases and clinical implications. We report a familial occurrence of APS in two patients, in the presence of SLE in the mother and absence of autoimmune diseases in the daughter along with acquired circulating inhibitors in both cases: platelet inhibitor and factor IX inhibitor, respectively.

Characterization of N-linked oligosaccharides bearing sialyl lewis x moieties on an alternatively glycosylated form of soluble complement receptor type 1 (sCR1).

We sought to produce a complement inhibitory protein possessing oligosaccharides specifically modified to contain the sialyl Lewis x (sLe(x)) moiety. This modified glycoprotein could combine anti-complement activity with the ability to inhibit selectin-mediated interactions and concentrate this activity to sites of activated endothelium where selectins are upregulated. Soluble complement receptor type 1 (sCR1), previously shown to be effective in inhibiting the complement cascade, was produced in a cell line capable of adding fucose to N-linked oligosaccharides in the alpha1-3 linkage, which is necessary for sLe(x) glycosylation. The glycoprotein purified from these cells was designated sCR1sLe(x), and may prove to be more effective than sCR1 in some clinical applications. Detailed analysis and characterization of sCR1sLe(x) was performed to confirm that the N-linked oligosaccharides possessed sLe(x) moieties and also to determine the extent of sLe(x) glycosylation. The glycoproteins were characterized by oligosaccharide profiling, sequencing, linkage analysis and quantified by differential enzymic digestion, using fluorophore-assisted carbohydrate electrophoresis. The major glycans were identified as biantennary oligosaccharides (including sialylated and non-core fucosylated glycans). The linkages of sialic acid and the branched fucose were analysed by digestion with linkage-specific enzymes and subsequent separation by electrophoresis. All data were consistent with the presence of sLe(x) moieties on the N-linked oligosaccharides of sCR1sLe(x). sCR1sLe(x) is a prime example of a recombinant protein expressed with oligosaccharides engineered for a specific biological function, and produced using a commercially viable method.

Primary antiphospholipid antibody syndrome: neuroradiologic findings in 11 patients.

ObjectiveTo describe the neuroradiologic findings of primary antiphospholipid antibody syndrome (PAPS).Materials and MethodsDuring a recent two-year period, abnormally elevated antiphospholipid antibodies were detected in a total of 751 patients. In any cases in which risk factors for stroke were detected - hypertension, diabetes mellitus, hyperlipidemia, smoking, and the presence of SLE or other connective tissue diseases - PAPS was not diagnosed. Neuroradiologic studies were performed in 11 of 32 patients with PAPS. We retrospectively reviewed brain CT (n = 7), MR (n = 8), and cerebral angiography (n = 8) in 11 patients with special attention to the presence of brain parenchymal lesions and cerebral arterial or venous abnormalities.ResultsCT or MR findings of PAPS included nonspecific multiple hyper-intensity foci in deep white matter on T2-weighted images (5/11), a large infarct in the territory of the middle cerebral artery (4/11), diffuse cortical atrophy (2/11), focal hemorrhage (2/11), and dural sinus thrombosis (1/11). Angiographic findings were normal (5/8) or reflected either occlusion of a large cerebral artery (2/8) or dural sinus thrombosis (1/8).ConclusionNeuroradiologic findings of PAPS are nonspecific but in young or middle-aged adults who show the above mentioned CT or MR findings, and in whom risk factors for stroke are not present, the condition should be suspected.

Oral discoid lupus erythematosus. II. Skin lesions and systemic lupus erythematosus in sixty-six patients with 6-year follow-up

Sixty-six patients with oral discoid lesions and either discoid (DLE) or systemic (SLE) lupus erythematosus were followed during an average period of 6 years (range, 0.1 to 25 years). At time of initial examination, thirty-seven patients (56%) had discoid skin lesions and the remaining 29 (44%) had isolated oral discoid lesions. Among the latter, seven patients developed discoid skin lesions during the observation period. Ten of the sixty-six patients (15%) had SLE at the time of initial examination, and SLE developed in another five (8%) who had DLE initially. In six of fifteen SLE patients the oral discoid lesions were the first manifestation of SLE. Presence of ulceration of the oral discoid lesions at time of initial examination was of predictive value with regard to the presence or development of SLE. It is concluded that patients with oral discoid lesions should be seen at least yearly in order to secure an early diagnosis of eventually developing signs of cutaneous DLE and SLE. Furthermore, no connection was noted between the presence of skin lesions and the development or presence of SLE.

Lupus nephritis. Clinical and histologic survey.

Introduction Uremia has been cited as a leading cause of death in most reviews1-12of systemic erythematosus (SLE). This has been particularly true since the advent of steroid therapy which has prevented death in the acute toxic phase of the disease, permitting survival and progression to the phase of chronic renal failure.5 Interest with natural history of SLE has been heightened by the recent optimistic reports of Pollak et al.13and Holman,14both of which, contrary to previous opinions,2,3,8,9indicate favorable effects of high dosage steroid therapy. For this reason, we report our clinical and histologic experience. Methods and Material All cases of lupus nephritis from 1951 through mid-1961 at Georgetown University Hospital were reviewed clinically and histologically. The diagnosis was based on the presence of SLE and clinical and/or histologic evidence of renal involvement. After hospital charts were reviewed, the corresponding material, if