Findings: Education, marital status may affect symptoms by Margarida Maia, PhD Having a higher level of education or being married may mean fewer symptoms of depression for people with systemic sclerosis (SSc), according to a systematic review of multiple studies.
Researchers also observed that lung involvement, breathing problems, and tender joints were linked to more symptoms of depression, but not anxiety. Because there was not much evidence available, “future studies should examine prevalence of mood and anxiety disorders in SSc in large, representative samples,” the researchers wrote. The systematic review, “Results from a living systematic review of the prevalence of mood and anxiety disorders and factors associated with symptoms in systemic sclerosis,” was published in the journal Scientific Reports. People with SSc experience a wide range of symptoms caused by a buildup of scar tissue in the skin and possibly internal organs such as the heart, lungs, kidneys, and intestinal tract. “Disease presentation is extremely heterogeneous, and its course is unpredictable,” the researchers wrote. Because they are unsure of how their disease will progress, many people with SSc experience changes in mood or begin to feel anxious. Also contributing to mood and anxiety disorders are “high levels of chronic pain, fatigue, body-image distress, overall disability, increased risk of mortality, and limited treatment options,” the scientists added. Patients positive for Scl-70 antibodies at more risk of major organ involvement by Steve Bryson, PhD People with systemic sclerosis (SSc) who test positive for Scl-70 self-reactive antibodies are at a higher risk of major organ involvement, particularly the lungs, than those with other types of autoantibodies, a study suggested.
Digestive tract involvement was associated with the presence of anti-nuclear (ANA) autoantibodies. SSc patients with Scl-70 autoantibodies should be monitored for lung disease, regardless of whether their disease is limited to the skin or occurs in both skin and internal organs, the researchers recommended. “Understanding these risk factors might help with earlier diagnosis and better disease management for people with SSc,” they noted in the autoantibody study, “Clinical phenotype in scleroderma patients based on autoantibodies,” which was published in Rheumatology Advances in Practice. SSc, also called scleroderma, is an autoimmune disease that features the buildup of scar tissue in the skin and several other organs, potentially. It’s usually classified into two subtypes, based on the extent of skin symptoms. Limited cutaneous SSc (lcSSc) is indicated by skin symptoms confined to the face and arms below the elbows. Diffuse cutaneous SSc (dcSSc) involves widespread skin scarring that’s accompanied by internal organ damage. “However, dividing SSc according to skin involvement might be too simplistic, meaning that we could overlook a wider spectrum of the disease,” the researchers wrote. People with SSc have self-reactive autoantibodies that mistakenly target cellular components in their own tissues, including Scl-70, ANA, and anti-centromere (ACA) autoantibodies. While lcSSc has been associated with anti-ACA autoantibodies and dcSSc with anti-Scl-70 autoantibodies, some people with lcSSc are positive for Scl-70 autoantibodies and some with dsSSc are positive for ACA autoantibodies. SPIN was founded by McGill University researcher Dr. Brett Thombs as a partnership of researchers, scleroderma clinicians, patient organizations, and patients, who work together to develop and test online programs to help people cope with important problems related to scleroderma. SPIN was launched in 2011 with seed funding from the Scleroderma Society of Ontario and Scleroderma Canada.
SPIN maintains a large cohort of over 1,800 scleroderma patients, recruited by scleroderma clinicians from around the world. These patients complete regular online questionnaires to help researchers understand their challenges and support needs. SPIN’s mission is to work with people with scleroderma to identify their needs and prioritize research in areas most important to them and to develop, test, and disseminate accessible patient programs that improve quality of life and empower people with scleroderma and their loved ones. See their letter of thanks in this link. Autoantibodies called ATAs appear to speed disease progression, study finds by Margarida Maia, PhD from Scleroderma News About half of the people with suspected very early systemic sclerosis (SSc) may go on to develop definite disease, and those who test positive for anti-topoisomerase antibodies (ATAs) are more likely to experience faster disease progression. That’s according to a study from the Netherlands where the proportion of people who tested positive for ATA, autoantibodies associated with SSc, was very low among those with suspected very early disease. “The low ATA prevalence among patients with suspected very early SSc suggests swift disease progression in ATA-positive SSc and consequently a different approach to identify this subgroup before development of irreversible organ damage,” the researchers wrote. The study, “Progression from suspected to definite systemic sclerosis and the role of anti-topoisomerase I antibodies,” was published in the journal RMD Open. Diagnostic workup includes extensive testing SSc, also known as scleroderma, is characterized by self-reactive autoantibodies in the immune system attacking healthy tissues and causing them to become scarred. Scar tissue can build up in the skin and in internal organs such as the heart, kidneys, lungs, and digestive tract. As part of the workup toward diagnosis, patients usually undergo examination for medical history, physical assessments, and various other tests, including blood tests to check for the presence of autoantibodies. Because not all patients meet the criteria for diagnosis, doctors came up with criteria for suspected very early SSc. The criteria consist of Raynaud’s phenomenon (fingers and toes that feel numb, prickly, and frigid in response to cold temperatures or stress), the presence of SSc-specific autoantibodies, puffy fingers, and changes in the small blood vessels under the fingernails. “Specific autoantibodies are important risk factors for progression from suspected very early SSc to definite SSc,” the researchers wrote. In earlier work, however, they found that only a small proportion of patients with suspected very early SSc tested positive for ATA. To know more about ATA and how these autoantibodies contribute to disease progression to definite SSc, the researchers carried out a review of the literature. Percentage of hypochromic red blood cells higher than 2%, DLCO of 65% or lower seen as factors by Marisa Wexler, MS Analyzing the color of red blood cells could help predict survival outcomes among people with systemic sclerosis (SSc), a study shows.
The study, “Hypochromic red cells as a prognostic indicator of survival among patients with systemic sclerosis screened for pulmonary hypertension,” was published in Arthritis Research & Therapy. Red blood cells carry oxygen through the bloodstream out to all the tissues. To ferry it, they use an iron-containing protein called hemoglobin. When iron-rich hemoglobin binds to oxygen, it turns red, which is how blood gets its distinctive “blood red” color. When iron levels are too low, red blood cells can become hypochromic, meaning they’re not as bright. Chronic inflammatory conditions like SSc may cause fluctuations in iron levels, but the clinical consequences are incompletely understood. In this study, researchers led by scientists in Germany assesed whether the percentage of hypochromic red blood cells — referred to as % HRC — was associated with differences in survival among people with SSc. The analysis included data for 171 patients who underwent screening for pulmonary hypertension (abnormally high pressure in the lung’s blood vessels). Among them, 81.3% were female, the mean age was 60, and nearly two-thirds had elevated pulmonary blood pressure. The patients were followed for a median of more than two years, during which time 18 died, mainly from complications related to lung disease. Probiotic therapy may need to be more personalized for autoimmune disorders by Marisa Wexler, MS People with systemic sclerosis (SSc) who have more severe digestive problems tend to have less diversity in the makeup of bacteria living in their gut, a new study reports.
Certain bacterial species, including Lactobacillus — present in commercially available probiotics — are more abundant in SSc patients with more digestive complaints, results show, which suggests that probiotic therapy may need to be more personalized for people with autoimmune disorders like SSc. The study, “Gastrointestinal tract involvement in systemic sclerosis: The roles of diet and the microbiome,” was published in the journal Seminars in Arthritis and Rheumatism. Other risk factors include pneumonia, pulmonary hypertension by Patricia Inácio, PhD from Scleroderma News Systemic sclerosis (SSc) patients with interstitial lung disease (ILD), where the lungs become scarred, are more than three times more likely to be hospitalized due to respiratory failure, according to real-world data collected in the U.S.
Other strong risk factors for respiratory failure among hospitalized SSc patients included pneumonia and pulmonary hypertension, or high blood pressure in the vessels that supply the lungs. “Outpatient optimization and inpatient recognition of these risk factors can lead to improved hospitalization outcomes for SSc patients,” the researchers wrote. The study, “Risk Factors for Respiratory Failure in Patients Hospitalized With Systemic Sclerosis: An Analysis of the National Inpatient Sample,” was published in the journal Cureus. Patients in racial minority groups found to be more dissatisfied with their lives by Patricia Inácio, PhD of Scleroderma News More than 30% of people with systemic sclerosis (SSc) are dissatisfied with their lives, and higher levels of dissatisfaction are reported by racial minority groups, a U.S.-based study has found.
The spiritual well-being of patients was the strongest contributor to life satisfaction scores. These scores were found to be significantly lower for Black, Asian, American Indian, and Alaska Native patients. “Spiritual well-being is particularly important in understanding life satisfaction in people with systemic sclerosis,” researchers wrote, adding that this should prompt further research to “assess and examine spiritual well-being and its impact on life satisfaction in a larger and more diverse systemic sclerosis sample.” The study, “Factors associated with life satisfaction in systemic sclerosis: Examining the moderating roles of social support and spiritual well-being,” was published in the Journal of Scleroderma and Related Disorders. Life satisfaction often reflects mental health status SSc, also known as scleroderma, is a chronic autoimmune condition that causes inflammation and fibrosis (scarring) of the skin, but it can also affect internal organs. Symptoms can include joint pain, fatigue, and gastrointestinal problems — all of which increase functional limitations and affect quality of life. Life satisfaction, a parameter that reflects how people evaluate their lives as a whole, is one of the tools for assessing quality of life. Life satisfaction often reflects mental health status and has been associated with mortality risk. However, few studies have addressed life satisfaction of SSc patients. Prior research has indicated that social support is important to help people with SSc cope with disease-related challenges, and that spiritual well-being has a positive impact on their perception of well-being. To understand the effects of spiritual well-being, integrated with social support and functional limitations, a team of researchers in the U.S. analyzed data from the University of California Los Angeles Scleroderma Quality of Life Study. SSc patients, 18 and older, completed questionnaires about their demographics, symptoms of depression, functional limitations, social support, and spiritual well-being. Functional limitations, social support, and especially spiritual well-being are all associated with subjective well-being in people with SSc. Researchers analyzed OxyHem levels in 267 patients screened for pulmonary hypertension by Andrea Lobo, PhD (Scleroderma News) Oxygenated hemoglobin may be a new prognosis biomarker for systemic sclerosis (SSc) patients screened for pulmonary hypertension (PH), a study in Germany shows.
Low levels of oxygenated hemoglobin (OxyHem), the protein that carries oxygen to body tissues, were significantly associated with worse survival among SSc patients. Also, the combination of a low predicted diffusion capacity for carbon monoxide (DLCO) — a standard lung function assessment — with low OxyHem may predict developing PH. “This study provides important insights into prognostic predictors and stratification models in SSc patients screened for PH,” the researchers wrote in “Oxygenated hemoglobin as prognostic marker among patients with systemic sclerosis screened for pulmonary hypertension,” which was published in Scientific Reports. A feature of SSc is the accumulation of scar tissue in the skin, which can affect internal organs. The level of organ involvement predicts the disease’s outcome. Pulmonary complications, including pulmonary arterial hypertension, are the leading cause of death among people with SSc. Screening and early diagnosis are essential to the disease’s prognosis. Previous studies identified oxygen saturation (blood oxygen levels) and anemia, or reduced levels of red blood cells in the blood, as prognostic predictors of SSc. Proteins are related to hypoxia, blood vessel disease, and collagen turnover by Patricia Inácio, PhD The levels of three blood proteins — endostatin, basic fibroblast growth factor (bFGF), and platelet-activating factor acetylhydrolase (PAF-AH) beta subunit — may help predict the risk of progression from early to definite systemic sclerosis (SSc), according to a new study.
“In particular, endostatin was the protein most strongly associated with disease progression, and it is worthwhile to further investigate its mechanistic roles for its possible pathogenetic [disease] role in SSc development and its therapeutic potential,” the researchers wrote in the study, “Proteomic aptamer analysis reveals serum markers that characterize preclinical systemic sclerosis (SSc) patients at risk for progression toward definite SSc,” which was published in Arthritis Research & Therapy. In SSc, or scleroderma, the immune system wrongly recognizes the body’s own proteins as foreign and mounts an immune attack by producing antibodies against them. The hallmark of SSc is thick and hardened skin, but other organs can be damaged. At early (preclinical) stages, symptoms are typically limited to Raynaud’s phenomenon, a condition wherein the fingers and toes become numb and cold in response to low temperatures or stress, along with SSc-specific autoantibodies, and abnormalities in the small blood vessels of the nail folds. About 50% of patients with preclinical SSc progress into definite SSc within five years of being diagnosed. Understanding what promotes that progression may help uncover potential therapeutic targets. |
AuthorScleroderma Queensland Support Group Archives
May 2024
Categories
All
|