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. Body betrayal is a common experience among people with chronic illness by Amy Gietzen from Scleroderma News After I was diagnosed with scleroderma in 2001, I found myself having some strange thoughts, such as, “What’s wrong with me? My body hates me. I hate my body. What did I do to deserve this? Why can’t I just be normal again?”
While many of the feelings I experienced are hard to describe and identify, I vividly remember the feeling of betrayal coursing through my veins for months after my diagnosis. Because scleroderma can affect people in so many different ways, and because symptoms can ebb and flow and change over time, it can be easy to think that your body is out to get you. For me, it felt like my body was betraying my trust in it. I can’t recall a time since my diagnosis that I wasn’t in pain or, at the very least, uncomfortable with the changes I was experiencing. In my first few years with scleroderma, I felt like I had no control over what was happening to me. At any given time, my hands would cramp, my muscles would stiffen and tense, and my skin would itch so intensely that I needed to ice it with cold packs. HSI technology seen as novel way to quantify disease activity by Andrea Lobo, PhD from Scleroderma News Hyperspectral imaging (HSI) — technology used in medicine to obtain a three-dimensional dataset — may be a feasible, non-invasive technique to quantify the severity of Raynaud’s phenomenon associated with systemic sclerosis (SSc-RP), according to a new study.
This “technology may present a novel, fast, and effective method to quantify and monitor disease activity in SSc-RP,” the researchers wrote. HSI technology also may provide needed outcome measures for clinical trials of potential treatments for the condition. “There is an unmet medical need to enhance the SSc-RP clinical trial design to enable valid testing of therapy,” the team wrote. The study, “Hyperspectral imaging in systemic sclerosis-associated Raynaud phenomenon,” was published in the journal Arthritis Research & Therapy. Findings in Phase 2 trial of prednisolone seen as inconclusive due to pandemic by Patricia Inácio, PhD from Scleroderma News Moderate doses of oral prednisolone, a corticosteroid, given for a short period may help to ease symptoms in people with early diffuse cutaneous scleroderma (dcSSc), a Phase 2 trial suggests. The study, intended to assess whether moderate dose of corticosteroids are safe and effective for early dcSSc, was affected by the COVID-19 pandemic starting in March 2020 and failed to provide conclusive results, its researchers noted. Given the disease’s “inflammatory basis,” however, its findings may provide “support for the view of many clinicians that it is not unreasonable to prescribe short-term moderate dose prednisolone for symptom control, always remembering the importance of careful monitoring of blood pressure and renal function,” the team wrote. The study, “A Phase II randomised controlled trial of oral prednisolone in early diffuse cutaneous systemic sclerosis (PRedSS)” was published in the journal Rheumatology. Prednisolone use ‘contentious’ due to risk of renal crisis with dcSSc Scleroderma, also known as systemic sclerosis (SSc), is marked by progressive scarring in the skin and, possibly, internal organs that include the kidneys. The disease is caused by a wrongful immune response against the body’s own proteins. Organ damage is a particular risk for people with dcSSc, and one that develops early in the disease’s course and can worsen quickly. Currently, no effective disease modifying treatments are available for these patients. Although the inflammatory basis of dcSSC supports the use of corticosteroids, their use poses of risk of a renal, or kidney, crisis. “Whether or not they should be prescribed is therefore highly contentious,” the researchers wrote. Scientists in the U.K. designed the Phase 2 PRednisolone in early diffuse SSc (PRedSS) trial (NCT03708718) to assess the safety and effectiveness of prednisolone at a moderate dose compared to a placebo in adults with early dcSSc. The study was funded by Versus Arthritis. Finding reinforces research that viral infections increase likelihood of autoimmune disorders by Patricia Inácio, PhD People who were infected with SARS-CoV-2, the virus that causes COVID-19, are at greater risk for developing autoimmune diseases, including scleroderma (SSc), according to a large study.
The findings support recent evidence that viral infections may increase the likelihood of autoimmune conditions, although the mechanisms remain unknown. “It is crucial for physicians to have relevant notions and to recognize these autoimmune manifestations in order to respond appropriately in the ongoing pandemic and long-term post-pandemic phase,” the researchers wrote. The study, “Risk of autoimmune diseases in patients with COVID-19: A retrospective cohort study,” was published in the journal eClinical Medicine. Viral infections, such as those triggered by SARS-CoV-2, are believed to serve as potential triggers of autoimmune disorders in people who have genetic predisposition for such conditions. In fact, a number of cases of autoimmune diseases — such as Guillain-Barré syndrome and systemic lupus erythematosus — after SARS-CoV-2 infection have been reported. “However, obtaining conclusive evidence of a connection between viral infection and subsequent autoimmune diseases is challenging, not only because it is frequently impossible to extract the virus from diseased tissues, but also because the collection of sufficient amounts of epidemiological evidence is constrained by lengthy process and geographic distances,” the scientists wrote. Since the COVID-19 pandemic began, millions of people experienced this acute infection around the same time, which enabled the collection of large amounts of data to better establish the link between SARS-CoV-2 and autoimmune diseases. Researchers in Taiwan conducted a retrospective analysis of data from the U.S. Collaborative Network, from 48 global healthcare organizations part of the TriNetX Research Network. TriNetX holds the largest global COVID-19 dataset. In total, the analysis included 3,814,479 participants from January 2020 to December 2021. They were divided into two groups after matching for age, sex, race, socioeconomic status, lifestyle-related variables, and coexisting diseases. After matching, participants with a positive test for the SARS-CoV-2 virus were part of the COVID-19 group (mean age 45.2 years) and those with a negative test were included in the control group (45.1 years). Each group had 887,455 participants. Women represented 57.4% of the COVID-19 group, and the majority were White (64.4%). Patients who had received COVID-19 vaccinations were excluded from the study. |
AuthorScleroderma Queensland Support Group Archives
May 2024
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