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Article ; Online: Is minor salivary gland biopsy still mandatory in Sjogren's syndrome? Does seronegative Sjogren's syndrome exist?

Baldini, Chiara / Berardicurti, Onorina / Giacomelli, Roberto / Bombardieri, Michele

2023 Volume 23, Issue 1, Page(s) 103425

Abstract: Sjӧgren's disease (SjD) is a systemic autoimmune disorder characterized by the chronic inflammation and dysfunction of exocrine glands, mainly salivary glands, causing dryness of the eyes and of the mouth. The disease may affect different organs and ... ...

Abstract	Sjӧgren's disease (SjD) is a systemic autoimmune disorder characterized by the chronic inflammation and dysfunction of exocrine glands, mainly salivary glands, causing dryness of the eyes and of the mouth. The disease may affect different organs and tissues with complex and heterogeneous clinical presentation, usually with sicca symptoms, profound fatigue, chronic pain, major organ involvement, and lymphomas. SjD diagnosis is based on the combination of clinical, serological, and functional tests with histological biomarkers. Minor salivary gland biopsy (mSGB) represents the cornerstone for the diagnosis of SjD, allowing the study of the characteristic focal infiltration of B- and T lymphocytes. Besides, mSGB might also have a prognostic role, being the infiltrates more complex in patients with severe SjD. But biopsy, so far, is not mandatory for SjD and mSG ultrasound and peripheral biomarkers might replace its role in the future. Another important aspect of SjD is the presence of autoantibodies, although 20 to 30% of patients are "seronegative" for specific autoantibodies (ANA, antiRo/SSA, antiLa/SSB). The characteristics of this subset of patients are currently under evaluation and "new" autoantibodies and biomarkers might be necessary for better patient's stratification and follow-up.
MeSH term(s)	Humans ; Sjogren's Syndrome ; Salivary Glands, Minor/pathology ; Autoantibodies ; Biomarkers ; Biopsy ; Guanidines
Chemical Substances	2'-carbomethoxyphenyl 4-guanidinobenzoate (89022-11-7) ; Autoantibodies ; Biomarkers ; Guanidines
Language	English
Publishing date	2023-08-25
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2144145-5
ISSN	1873-0183 ; 1568-9972
ISSN (online)	1873-0183
ISSN	1568-9972
DOI	10.1016/j.autrev.2023.103425
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Article ; Online: The clinical heterogeneity of adult onset Still's disease may underlie different pathogenic mechanisms. Implications for a personalised therapeutic management of these patients.

Ruscitti, Piero / Berardicurti, Onorina / Giacomelli, Roberto / Cipriani, Paola

Seminars in immunology

2022 Volume 58, Page(s) 101632

Abstract: Adult-onset Still's disease (AOSD) is a rare inflammatory disease of unknown aetiology usually affecting young adults and manifesting with a clinical triad of spiking fever, arthritis, and evanescent cutaneous rash. AOSD may be considered a highly ... ...

Abstract	Adult-onset Still's disease (AOSD) is a rare inflammatory disease of unknown aetiology usually affecting young adults and manifesting with a clinical triad of spiking fever, arthritis, and evanescent cutaneous rash. AOSD may be considered a highly heterogeneous disease, despite a similar clinical presentation, the disease course may be completely different. Some patients may have a single episode of the disease whereas others may evolve toward a chronic course and experience life-threatening complications. On these bases, to dissect the clinical heterogeneity of this disease, four different subsets were identified combining the manifestations at the beginning with possible diverse outcomes over time. Each one of these derived subsets would be characterised by a prominent different clinical feature from others, thus proposing dissimilar underlying pathogenic mechanisms, at least partially. Consequently, a distinct management of AOSD may be suggested to appropriately tailor the therapeutic strategy to these patients, according to principles of the precision medicine. These findings would also provide the rationale to recognise a different genetic and molecular profile of patients with AOSD. Taking together these findings, the basis for a precision medicine approach may be suggested in AOSD, which would drive a tailored therapeutic approach in these patients. A better patient stratification may also help in arranging specific designed studies to improve the management of patients with AOSD. Behind these different clinical phenotypes, distinct endotypes of AOSD may be suggested, probably differing in pathogenesis, outcomes, and response to therapies.
Language	English
Publishing date	2022-07-01
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1018141-6
ISSN	1096-3618 ; 1044-5323
ISSN (online)	1096-3618
ISSN	1044-5323
DOI	10.1016/j.smim.2022.101632
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Article: Benefits of anakinra versus TNF inhibitors in rheumatoid arthritis and type 2 diabetes: long-term findings from participants furtherly followed-up in the TRACK study, a multicentre, open-label, randomised, controlled trial.

Ruscitti, Piero / Berardicurti, Onorina / Cipriani, Paola / Giacomelli, Roberto

Clinical and experimental rheumatology

2021 Volume 39, Issue 2, Page(s) 403–406

Abstract: Objectives: Interleukin (IL)-1β is considered a shared pathogenic mediator between rheumatoid arthritis (RA) and type 2 diabetes (T2D). In the TRACK study, participants with both diseases were randomised to an IL-1 inhibitor, anakinra, or a TNF ... ...

Abstract	Objectives: Interleukin (IL)-1β is considered a shared pathogenic mediator between rheumatoid arthritis (RA) and type 2 diabetes (T2D). In the TRACK study, participants with both diseases were randomised to an IL-1 inhibitor, anakinra, or a TNF inhibitor (TNFi). After 6 months, anakinra induced a such of improvement on metabolic and inflammatory parameters, leading to a premature stoppage of the study. Thus, we aimed to assess how long IL-1 inhibition benefits lasted. Methods: Since the TRACK was prematurely discontinued for "early benefit", we furtherly followed-up the enrolled participants to assess how long persisted the improvement of glycated haemoglobin (HbA1c%) and of RA disease activity. Results: After a mean follow-up of 18 months (15 participants in anakinra-group and 14 in TNFi-group), RA clinical response was retained in both groups (DAS28: 2.59±1.01 vs. 2.88±0.91; p=0.109). Concomitant glucocorticoids were reduced in both groups (2.01±0.71 vs. 3.01±0.87 mg/die; p=0.124), but a larger percentage of anakinra-treated participants discontinued such drugs (53.3% vs. 28.6%; p=0.004). There was no difference between anakinra and TNFi for HbA1c% (6.60±0.52 vs. 6.79±0.43; p=0.291), but a reduction of anti-diabetic drugs was observed in anakinra-treated participants (53.3% vs. 7.1%; p=0.008) whereas an increase of anti-diabetic therapies was needed in TNFi-treated ones. Significant correlations were also observed among HbA1c% with DAS28 and with C-reactive protein. Analysing the safety profile, only minor side effects were recorded. Conclusions: Data deriving from the long-term extension of participants with RA and T2D, enrolled in the TRACK study, could suggest that the benefits of IL-1 inhibition on metabolic and inflammatory parameters could last longer than first 6 months of follow-up, but further studies are needed to confirm these findings.
MeSH term(s)	Antirheumatic Agents/adverse effects ; Arthritis, Rheumatoid/diagnosis ; Arthritis, Rheumatoid/drug therapy ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/drug therapy ; Humans ; Interleukin 1 Receptor Antagonist Protein/adverse effects ; Tumor Necrosis Factor Inhibitors
Chemical Substances	Antirheumatic Agents ; Interleukin 1 Receptor Antagonist Protein ; Tumor Necrosis Factor Inhibitors
Language	English
Publishing date	2021-03-03
Publishing country	Italy
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial
ZDB-ID	605886-3
ISSN	1593-098X ; 0392-856X
ISSN (online)	1593-098X
ISSN	0392-856X
DOI	10.55563/clinexprheumatol/phsqg7
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Article ; Online: Cytokine storm syndrome in severe COVID-19.

Ruscitti, Piero / Berardicurti, Onorina / Iagnocco, Annamaria / Giacomelli, Roberto

Autoimmunity reviews

2020 Volume 19, Issue 7, Page(s) 102562

MeSH term(s)	Betacoronavirus ; COVID-19 ; Calcinosis ; Coronavirus Infections ; Cytokines ; Heart Valve Diseases ; Humans ; Hypotrichosis ; Interleukin-6 ; Macrophage Activation Syndrome ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2 ; Skin Diseases, Genetic
Chemical Substances	Cytokines ; Interleukin-6
Keywords	covid19
Language	English
Publishing date	2020-05-03
Publishing country	Netherlands
Document type	Letter ; Comment
ZDB-ID	2144145-5
ISSN	1873-0183 ; 1568-9972
ISSN (online)	1873-0183
ISSN	1568-9972
DOI	10.1016/j.autrev.2020.102562
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Article: Cytokine storm syndrome in severe COVID-19

Ruscitti, Piero / Berardicurti, Onorina / Iagnocco, Annamaria / Giacomelli, Roberto

Autoimmun Rev

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #155058
Database	COVID19

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Article ; Online: The wide spectrum of Kawasaki-like disease associated with SARS-CoV-2 infection.

Berardicurti, Onorina / Conforti, Alessandro / Ruscitti, Piero / Cipriani, Paola / Giacomelli, Roberto

Expert review of clinical immunology

2020 Volume 16, Issue 12, Page(s) 1205–1215

Abstract: ... ...

Abstract	Introduction
MeSH term(s)	COVID-19/epidemiology ; COVID-19/immunology ; COVID-19/pathology ; Child ; Humans ; Mucocutaneous Lymph Node Syndrome/epidemiology ; Mucocutaneous Lymph Node Syndrome/immunology ; Mucocutaneous Lymph Node Syndrome/pathology ; Pandemics ; SARS-CoV-2/immunology ; Systemic Inflammatory Response Syndrome/epidemiology ; Systemic Inflammatory Response Syndrome/immunology ; Systemic Inflammatory Response Syndrome/pathology
Keywords	covid19
Language	English
Publishing date	2020-11-25
Publishing country	England
Document type	Journal Article ; Systematic Review ; Video-Audio Media
ZDB-ID	2274260-8
ISSN	1744-8409 ; 1744-666X
ISSN (online)	1744-8409
ISSN	1744-666X
DOI	10.1080/1744666X.2021.1847643
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Article ; Online: Cytokine storm syndrome in severe COVID-19

Ruscitti, Piero / Berardicurti, Onorina / Iagnocco, Annamaria / Giacomelli, Roberto

Autoimmunity Reviews

2020 Volume 19, Issue 7, Page(s) 102562

Keywords	Immunology ; Immunology and Allergy ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	2144145-5
ISSN	1568-9972
ISSN	1568-9972
DOI	10.1016/j.autrev.2020.102562
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Increased Prevalence of Headaches and Migraine in Patients with Psoriatic Arthritis and Axial Spondyloarthritis: Insights from an Italian Cohort Study.

Biomedicines

2024 Volume 12, Issue 2

Abstract: Background: Psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) are inflammatory diseases with shared genetic backgrounds and clinical comorbidities. Headache, a common global health issue, affects over 50% of adults and encompasses various ... ...

Abstract	Background: Psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) are inflammatory diseases with shared genetic backgrounds and clinical comorbidities. Headache, a common global health issue, affects over 50% of adults and encompasses various types, including migraine, tension-type, and cluster headaches. Migraine, the most prevalent, recurrent, and disabling type, is often associated with other medical conditions such as depression, epilepsy, and psoriasis, but little is known about the relationship between autoimmune disease and the risk of migraine. Methods: A cross-sectional study was conducted from July to November 2022, enrolling 286 participants, including 216 with PsA, 70 with axSpA, and 87 healthy controls. Results: Headache prevalence was significantly higher in the PsA (39.81%) and axSpA (45.71%) patients compared to the healthy controls. The prevalence of migraine without aura was also significantly higher in both the PsA (18.52%) and axSpA (28.57%) groups compared to the healthy controls. Conclusions: These findings underscore the high burden of headache and migraine in PsA and axSpA participants, highlighting the need for improved management and treatment strategies for these patients.
Language	English
Publishing date	2024-02-05
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines12020371
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Article ; Online: Incidence of venous thromboembolism in rheumatoid arthritis, results from a "real-life" cohort and an appraisal of available literature.

Conforti, Alessandro / Berardicurti, Onorina / Pavlych, Viktoriya / Di Cola, Ilenia / Cipriani, Paola / Ruscitti, Piero

Medicine

2021 Volume 100, Issue 33, Page(s) e26953

Abstract: Abstract: Rheumatoid arthritis (RA) is associated with an increased risk of venous thromboembolism (VTE) occurrence. In this work, we assessed the incidence and predictive factors of VTE in our "real-life" cohort of RA patients. To contextualize our ... ...

Abstract	Abstract: Rheumatoid arthritis (RA) is associated with an increased risk of venous thromboembolism (VTE) occurrence. In this work, we assessed the incidence and predictive factors of VTE in our "real-life" cohort of RA patients. To contextualize our results, we reviewed the available literature about this topic.We performed a retrospective analysis of prospectively followed-up patients with RA attending our Rheumatologic Clinic between January 2010 and December 2020. Each patient was investigated for VTE occurrence. Incident cases were reported as incidence proportion and incidence rate per 1000 person-years at risk. Possible predictive factors were also exploited by regression analyses. Available literature about this topic was also assessed.In this evaluation, 347 consecutive patients without previous evidence of VTE, attending our Rheumatologic Clinic from 2010 to 2020, were studied. In our "real-life" cohort, the incidence proportion of VTE was 3.7% (2.7-4.7%) and considering over 1654 person-years, an incidence rate of 7.8 × 1000 (2.5-11.7). Exploratively assessing predictive factors in our cohort, older age (hazard ratio [HR] 1.07, 95% confidence interval [CI] 1.01-1.14, p = .015), higher body mass index (HR 1.37, 95% CI 1.04-1.80, P = .026), and longer disease duration (HR 1.11, 95% CI 1.03-1.20, P = .006) resulted to be significant predictors of VTE occurrence during the follow-up.In our "real-life" cohort, VTE burden has been suggested in patients with RA. Comparing our results with previous data derived from randomized controlled trials and administrative data, some different findings were retrieved about incidence of VTE. Assessing predictive factors, older age, higher body mass index, and longer disease duration resulted to be significant predictors of VTE occurrence during the follow-up. Taking together these observations, a further evaluation of this issue on specific designed studies is needed to provide more generalizable results to the daily clinical practice.
MeSH term(s)	Aged ; Arthritis, Rheumatoid/complications ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Proportional Hazards Models ; Regression Analysis ; Retrospective Studies ; Risk Factors ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/etiology
Language	English
Publishing date	2021-08-20
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000026953
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Article ; Online: The hyper-expression of NLRP4 characterizes the occurrence of macrophage activation syndrome assessing STING pathway in adult-onset Still's disease.

Ruscitti, Piero / Berardicurti, Onorina / Di Cola, Ilenia / Di Muzio, Claudia / Di Nino, Elena / Giacomelli, Roberto / Cipriani, Paola

Clinical and experimental immunology

2022 Volume 208, Issue 1, Page(s) 95–102

Abstract: To assess stimulator of interferon genes (STING) pathway in patients with adult-onset Still's disease (AOSD) who were complicated or not by macrophage activation syndrome (MAS), evaluating peripheral blood mononuclear cells (PBMCs), and synovial tissues. ...

Abstract	To assess stimulator of interferon genes (STING) pathway in patients with adult-onset Still's disease (AOSD) who were complicated or not by macrophage activation syndrome (MAS), evaluating peripheral blood mononuclear cells (PBMCs), and synovial tissues. The relative mRNA expression of key molecules of the STING pathway (i.e. CGAS, NLRP4, PKDC, STING1, XRCC5, and XRCC6) and interferon (IFN)-γ was assessed in PBMCs obtained from patients with AOSD, who were complicated or not by MAS, and healthy controls (HCs). A bulky RNA sequencing was performed in synovial tissues from two patients with AOSD. Finally, the ability of heavy ferritin subunit (FeH) to induce the expression of NLRP4 was evaluated in cultured macrophages. Twenty patients with AOSD were analysed. Out of them, seven patients were complicated by MAS. Assessing mRNA relative expression in PBMCs, STING1, NLRP4, XRCC6, and IFN-γ were significantly expressed in AOSD than HCs. The mRNA relative expression of CGAS, PKDC, and XRCC5 did not differ between patients and HCs. Furthermore, NLRP4 and IFN-γ resulted to be significantly increased in patients with AOSD complicated by MAS than others. By RNA-sequencing analysis, we observed that Nlrp4 gene was significantly up-regulated in patients with AOSD. Following the stimulation with FeH, an increased expression of NLRP4 was observed in cultured macrophages. In conclusion, an increased expression of some key molecules of STING pathway characterized patients with AOSD. In addition, our results suggested that a hyper-activity of NLRP4 may be observed in patients with MAS. Furthermore, FeH increased the expression of NLRP4 in cultured macrophages.
MeSH term(s)	Adult ; Humans ; Macrophage Activation Syndrome/genetics ; Macrophage Activation Syndrome/complications ; Still's Disease, Adult-Onset/genetics ; Leukocytes, Mononuclear/metabolism ; RNA, Messenger/genetics ; Interferons/metabolism ; Adaptor Proteins, Signal Transducing/metabolism
Chemical Substances	RNA, Messenger ; Interferons (9008-11-1) ; NLRP4 protein, human ; Adaptor Proteins, Signal Transducing
Language	English
Publishing date	2022-04-24
Publishing country	England
Document type	Journal Article
ZDB-ID	218531-3
ISSN	1365-2249 ; 0009-9104 ; 0964-2536
ISSN (online)	1365-2249
ISSN	0009-9104 ; 0964-2536
DOI	10.1093/cei/uxac014
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