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  1. Article ; Online: Persistence on subcutaneous tocilizumab as monotherapy or in combination with synthetic disease-modifying anti-rheumatic drugs in rheumatoid arthritis patients in Greece (EMBRACE study): a multicenter, post-marketing, non-interventional, observational trial.

    Athanassiou, Panagiotis / Katsimbri, Pelagia / Bounas, Andreas / Gazi, Sοusana / Sarikoudis, Theodosios / Syrigou, Victoria / Boumpas, Dimitrios

    Clinical rheumatology

    2024  Volume 43, Issue 5, Page(s) 1469–1478

    Abstract: Introduction: Rheumatoid arthritis (RA) is a systemic, inflammatory disease affecting multiple organs and causing physical disability over time.: Objective: The primary objective was to evaluate treatment persistence to subcutaneous tocilizumab (TCZ- ... ...

    Abstract Introduction: Rheumatoid arthritis (RA) is a systemic, inflammatory disease affecting multiple organs and causing physical disability over time.
    Objective: The primary objective was to evaluate treatment persistence to subcutaneous tocilizumab (TCZ-SC). Additionally, treatment effects on persistence and their associations with clinical and patient-reported outcomes were assessed.
    Method: We performed a multicenter, non-interventional, 52-week observational study on 222 patients with moderate or severe RA. Clinical outcomes were evaluated by using disease activity score for 28 joints (DAS28) and European League Against Rheumatism (EULAR) response, and patients' perceptions were evaluated by using Health Assessment Questionnaire (HAQ), Visual Analog Scale (VAS) for pain, and patient global assessment (PtGA) of disease activity. Safety was assessed throughout the study.
    Results: The mean age of the overall cohort was 62.2 ± 12.3 years, and 83.8% were females. Persistence to TCZ-SC was 89.6% at week 24 and 85.1% at week 52 in the overall cohort with slightly increased persistence in the combination group. At week 52, changes from the baseline were - 2.68 in DAS28, - 0.76 in HAQ, - 43.21 in VAS pain, and - 41.66 in PtGA (p < 0.0001 for all). Moderate and good EULAR response was achieved in 83.2% of patients. Non-serious and serious adverse events occurred in 18.5% and 3.2% of the participants, respectively.
    Conclusions: The current study confirms the favorable safety and effectiveness of TCZ-SC as well as its acceptability by RA patients in Greece, with sustained high persistence rates up to 52 weeks. TCZ-SC offers a sustainable treatment response in RA. Key Points • Based upon clinical and patient-reported outcomes, TCZ-SC is a highly effective and safe treatment modality in patients with moderate-to-severe RA. • Persistence to TCZ-SC was high throughout the study, both as monotherapy and in combination with csDMARDs. • TCZ-SC is effective both as monotherapy and when used in combination with other csDMARDs regardless of the line of treatment.
    MeSH term(s) Female ; Humans ; Middle Aged ; Aged ; Male ; Greece ; Injections, Subcutaneous ; Arthritis, Rheumatoid/drug therapy ; Arthritis, Rheumatoid/chemically induced ; Antirheumatic Agents/adverse effects ; Pain/drug therapy ; Treatment Outcome ; Antibodies, Monoclonal, Humanized
    Chemical Substances tocilizumab (I031V2H011) ; Antirheumatic Agents ; Antibodies, Monoclonal, Humanized
    Language English
    Publishing date 2024-03-12
    Publishing country Germany
    Document type Observational Study ; Multicenter Study ; Journal Article
    ZDB-ID 604755-5
    ISSN 1434-9949 ; 0770-3198
    ISSN (online) 1434-9949
    ISSN 0770-3198
    DOI 10.1007/s10067-024-06916-5
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  2. Article ; Online: Impaired serotonin synthesis in hippocampus of murine lupus represents an early neuropsychiatric event.

    Nikolopoulos, Dionysis / Nakos-Bimpos, Modestos / Manolakou, Theodora / Polissidis, Alexia / Boumpas, Dimitrios T

    Lupus

    2023  Volume 33, Issue 2, Page(s) 166–171

    Abstract: Background: Despite significant progress in understanding the mechanisms underlying hippocampal involvement in neuropsychiatric systemic lupus erythematosus (NPSLE), our understanding of how neuroinflammation affects the brain neurotransmitter systems ... ...

    Abstract Background: Despite significant progress in understanding the mechanisms underlying hippocampal involvement in neuropsychiatric systemic lupus erythematosus (NPSLE), our understanding of how neuroinflammation affects the brain neurotransmitter systems is limited. To date, few studies have investigated the role of neurotransmitters in pathogenesis of NPSLE with contradictory results.
    Methods: Hippocampal tissue from NZB/W-F1 lupus-prone mice and age-matched control strains were dissected in both pre-nephritic (3-month-old) and nephritic (6-month-old) stages. High-Performance Liquid Chromatography (HPLC) was used to evaluate the level of serotonin (5-HT), dopamine (DA), and their metabolites 5-HIAA and DOPAC, respectively, in mouse hippocampi.
    Results: Lupus mice exhibit decreased levels of serotonin at the early stages of the disease, along with intact levels of its metabolite 5-HIAA. The 5-HT turnover ratio (5-HIAA/5-HT ratio) was increased in the hippocampus of lupus mice at pre-nephritic stage suggesting that low hippocampal serotonin levels in lupus are attributed to decreased serotonin synthesis. Both DA and DOPAC levels remained unaffected in lupus hippocampus at both early and late stages.
    Conclusion: Impaired hippocampal serotonin synthesis in the hippocampus of lupus-prone mice represents an early neuropsychiatric event. These findings may have important implications for the use of symptomatic therapy in diffuse NPSLE.
    MeSH term(s) Mice ; Animals ; Serotonin/metabolism ; 3,4-Dihydroxyphenylacetic Acid/metabolism ; Hydroxyindoleacetic Acid/metabolism ; Lupus Erythematosus, Systemic/metabolism ; Dopamine/metabolism ; Hippocampus ; Lupus Vasculitis, Central Nervous System/metabolism
    Chemical Substances Serotonin (333DO1RDJY) ; 3,4-Dihydroxyphenylacetic Acid (102-32-9) ; Hydroxyindoleacetic Acid (54-16-0) ; Dopamine (VTD58H1Z2X)
    Language English
    Publishing date 2023-12-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 1154407-7
    ISSN 1477-0962 ; 0961-2033
    ISSN (online) 1477-0962
    ISSN 0961-2033
    DOI 10.1177/09612033231221651
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  3. Article ; Online: Update on the pathogenesis of central nervous system lupus.

    Nikolopoulos, Dionysis / Fanouriakis, Antonis / Boumpas, Dimitrios T

    Current opinion in rheumatology

    2019  Volume 31, Issue 6, Page(s) 669–677

    Abstract: ... methyl-D-aspartate receptors, antiribosomal P and antiphospholipid antibodies may cause injury in subsets ...

    Abstract Propose of review: Neuropsychiatric systemic lupus erythematosus (NPSLE) is an emerging frontier in lupus care encompassing a wide spectrum of clinical manifestations. Its pathogenesis remains poorly understood because of the complexity of pathophysiologic mechanisms involved and limited access to tissue. We highlight recent advances in the pathophysiology of neuropsychiatric lupus.
    Recent findings: Disruption of blood-brain barrier (BBB) facilitating entrance of neurotoxic antibodies into the central nervous system (CNS), neuroinflammation and cerebral ischemia are the key mechanisms. Disruption of the BBB may occur not only at the traditional BBB, but also at the blood-cerebrospinal fluid barrier. Certain autoantibodies, such as anti-N-methyl-D-aspartate receptors, antiribosomal P and antiphospholipid antibodies may cause injury in subsets of patients with diffuse neuropsychiatric disease. Activation of microglia via autoantibodies, interferon-a or other immune reactants, may amplify the inflammatory response and promote neuronal damage. New inflammatory pathways, such as TWEAK/Fn14, Bruton's tyrosine kinase, Nogo-a and ACE may represent additional potential targets of therapy. Novel neuroimaging techniques suggest alterations in brain perfusion and metabolism, increased concentration of neurometabolites, indicative of glial activation, vasculopathy and neuronal impairment.
    Summary: NPSLE encompasses a diverse phenotype with distinct pathogenic mechanisms, which could be targeted by novel therapies or repositioning of existing drugs.
    MeSH term(s) Autoantibodies/immunology ; Autoimmunity ; Blood-Brain Barrier/physiology ; Humans ; Lupus Vasculitis, Central Nervous System/diagnosis ; Lupus Vasculitis, Central Nervous System/immunology ; Lupus Vasculitis, Central Nervous System/metabolism ; Magnetic Resonance Imaging/methods ; Microglia/physiology ; Signal Transduction
    Chemical Substances Autoantibodies
    Language English
    Publishing date 2019-08-15
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1045317-9
    ISSN 1531-6963 ; 1040-8711
    ISSN (online) 1531-6963
    ISSN 1040-8711
    DOI 10.1097/BOR.0000000000000655
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Relapses are common in severe hematologic systemic lupus erythematosus and may be prevented by early institution of immunosuppressive agents: Α real-life single-center study.

    Moysidou, Georgia-Savina / Garantziotis, Panagiotis / Nikolopoulos, Dionysis / Katsimbri, Pelagia / Fanouriakis, Antonis / Boumpas, Dimitrios T

    Lupus

    2022  Volume 32, Issue 2, Page(s) 225–230

    Abstract: Background: Hematologic manifestations are common in systemic lupus erythematosus (SLE), either at initial presentation or during the course of the disease, but data regarding their natural history are scarce.: Objective: To describe the ... ...

    Abstract Background: Hematologic manifestations are common in systemic lupus erythematosus (SLE), either at initial presentation or during the course of the disease, but data regarding their natural history are scarce.
    Objective: To describe the characteristics, treatments, and outcomes of severe hematological manifestations in a large cohort of lupus patients.
    Methods: Retrospective cohort study of patients in the "Attikon" lupus cohort who had a history of a severe hematologic manifestation, defined as autoimmune hemolytic anemia (AIHA) with hemoglobin < 8 g/dL, thrombocytopenia with platelet count < 30,000/mm
    Results: From over 300 patients with hematologic manifestations, 41 qualified as severe (70.7% women, mean [SD] age at SLE diagnosis 42.6 [18.0] years). Hematologic manifestations preceded SLE diagnosis in 13 patients (31.7%), was concomitant to SLE diagnosis in 16 patients (39%), and occurred during the course of the disease in 12 (29.3%) patients, with a mean (SD) disease duration of 8.7 (5.5) years. Thrombocytopenia was the most common severe hematological manifestation (56.1%), followed by AIHA (17.1%) and TTP-like syndrome (12.2%). For initial treatment, all patients were treated with glucocorticoids (GC), while rituximab and cyclophosphamide were the most frequently used immunosuppressive agents. Following initial treatment, relapse occurred in 22 patients (53.7%). Compared to patients that did not relapse, those that relapsed had less often received concomitant immunosuppressive agents following treatment of initial episode (
    Conclusion: Severe hematologic disease in SLE has a high risk of relapse, which may be mitigated by the early institution of GC-sparing agents.
    MeSH term(s) Humans ; Female ; Adolescent ; Male ; Immunosuppressive Agents/therapeutic use ; Lupus Erythematosus, Systemic/complications ; Lupus Erythematosus, Systemic/drug therapy ; Retrospective Studies ; Thrombocytopenia/drug therapy ; Thrombocytopenia/epidemiology ; Thrombocytopenia/etiology ; Anemia, Hemolytic, Autoimmune/diagnosis ; Leukopenia
    Chemical Substances Immunosuppressive Agents
    Language English
    Publishing date 2022-12-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 1154407-7
    ISSN 1477-0962 ; 0961-2033
    ISSN (online) 1477-0962
    ISSN 0961-2033
    DOI 10.1177/09612033221144425
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  5. Article ; Online: Microglia activation in the presence of intact blood-brain barrier and disruption of hippocampal neurogenesis via IL-6 and IL-18 mediate early diffuse neuropsychiatric lupus.

    Nikolopoulos, Dionysis / Manolakou, Theodora / Polissidis, Alexia / Filia, Anastasia / Bertsias, George / Koutmani, Yassemi / Boumpas, Dimitrios T

    Annals of the rheumatic diseases

    2023  Volume 82, Issue 5, Page(s) 646–657

    Abstract: Introduction: Inflammatory mediators are detected in the cerebrospinal fluid of systemic lupus erythematosus patients with central nervous system involvement (NPSLE), yet the underlying cellular and molecular mechanisms leading to neuropsychiatric ... ...

    Abstract Introduction: Inflammatory mediators are detected in the cerebrospinal fluid of systemic lupus erythematosus patients with central nervous system involvement (NPSLE), yet the underlying cellular and molecular mechanisms leading to neuropsychiatric disease remain elusive.
    Methods: We performed a comprehensive phenotyping of NZB/W-F1 lupus-prone mice including tests for depression, anxiety and cognition. Immunofluorescence, flow cytometry, RNA-sequencing, qPCR, cytokine quantification and blood-brain barrier (BBB) permeability assays were applied in hippocampal tissue obtained in both prenephritic (3-month-old) and nephritic (6-month-old) lupus mice and matched control strains. Healthy adult hippocampal neural stem cells (hiNSCs) were exposed
    Results: At the prenephritic stage, BBB is intact yet mice exhibit hippocampus-related behavioural deficits recapitulating the human diffuse neuropsychiatric disease. This phenotype is accounted by disrupted hippocampal neurogenesis with hiNSCs exhibiting increased proliferation combined with decreased differentiation and increased apoptosis in combination with microglia activation and increased secretion of proinflammatory cytokines and chemokines. Among these cytokines, IL-6 and IL-18 directly induce apoptosis of adult hiNSCs ex vivo. During the nephritic stage, BBB becomes disrupted which facilitates immune components of peripheral blood, particularly B-cells, to penetrate into the hippocampus further augmenting inflammation with locally increased levels of IL-6, IL-12, IL-18 and IL-23. Of note, an interferon gene signature was observed only at nephritic-stage.
    Conclusion: An intact BBB with microglial activation disrupting the formation of new neurons within the hippocampus represent early events in NPSLE. Disturbances of the BBB and interferon signature are evident later in the course of the disease.
    MeSH term(s) Adult ; Humans ; Mice ; Animals ; Infant ; Blood-Brain Barrier ; Lupus Vasculitis, Central Nervous System ; Interleukin-6 ; Interleukin-18 ; Microglia ; Lupus Erythematosus, Systemic ; Cytokines ; Neurogenesis ; Interferons ; Hippocampus
    Chemical Substances Interleukin-6 ; Interleukin-18 ; Cytokines ; Interferons (9008-11-1)
    Language English
    Publishing date 2023-03-10
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 7090-7
    ISSN 1468-2060 ; 0003-4967
    ISSN (online) 1468-2060
    ISSN 0003-4967
    DOI 10.1136/ard-2022-223506
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  6. Article ; Online: Restoration of aberrant gene expression of monocytes in systemic lupus erythematosus via a combined transcriptome-reversal and network-based drug repurposing strategy.

    Nikolakis, Dimitrios / Garantziotis, Panagiotis / Sentis, George / Fanouriakis, Antonis / Bertsias, George / Frangou, Eleni / Nikolopoulos, Dionysis / Banos, Aggelos / Boumpas, Dimitrios T

    BMC genomics

    2023  Volume 24, Issue 1, Page(s) 207

    Abstract: Background: Monocytes -key regulators of the innate immune response- are actively involved in the pathogenesis of systemic lupus erythematosus (SLE). We sought to identify novel compounds that might serve as monocyte-directed targeted therapies in SLE.!# ...

    Abstract Background: Monocytes -key regulators of the innate immune response- are actively involved in the pathogenesis of systemic lupus erythematosus (SLE). We sought to identify novel compounds that might serve as monocyte-directed targeted therapies in SLE.
    Results: We performed mRNA sequencing in monocytes from 15 patients with active SLE and 10 healthy individuals. Disease activity was assessed with the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K). Leveraging the drug repurposing platforms iLINCS, CLUE and L1000CDS
    Conclusions: Application of two independent - a transcriptome-reversal and a network-based -drug repurposing strategies uncovered novel agents that might remedy transcriptional disturbances of monocytes in SLE.
    MeSH term(s) Humans ; Monocytes/metabolism ; Transcriptome ; NF-kappa B/metabolism ; Drug Repositioning ; CD8-Positive T-Lymphocytes/metabolism ; MicroRNAs/metabolism ; Lupus Erythematosus, Systemic/drug therapy ; Lupus Erythematosus, Systemic/genetics
    Chemical Substances NF-kappa B ; MicroRNAs
    Language English
    Publishing date 2023-04-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041499-7
    ISSN 1471-2164 ; 1471-2164
    ISSN (online) 1471-2164
    ISSN 1471-2164
    DOI 10.1186/s12864-023-09275-8
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  7. Article ; Online: Disentangling the riddle of systemic lupus erythematosus with antiphospholipid syndrome: blood transcriptome analysis reveals a less-pronounced IFN-signature and distinct molecular profiles in venous versus arterial events.

    Nikolopoulos, Dionysis / Loukogiannaki, Catherine / Sentis, George / Garantziotis, Panagiotis / Manolakou, Theodora / Kapsala, Noemin / Nikoloudaki, Myrto / Pieta, Antigone / Flouda, Sofia / Parodis, Ioannis / Bertsias, George / Fanouriakis, Antonis / Filia, Anastasia / Boumpas, Dimitrios T

    Annals of the rheumatic diseases

    2024  

    Abstract: Introduction: Systemic lupus erythematosus with antiphospholipid syndrome (SLE-APS) represents a challenging SLE endotype whose molecular basis remains unknown.: Methods: We analysed whole-blood RNA-sequencing data from 299 patients with SLE (108 SLE- ...

    Abstract Introduction: Systemic lupus erythematosus with antiphospholipid syndrome (SLE-APS) represents a challenging SLE endotype whose molecular basis remains unknown.
    Methods: We analysed whole-blood RNA-sequencing data from 299 patients with SLE (108 SLE-antiphospholipid antibodies (aPL)-positive, including 67 SLE-APS; 191 SLE-aPL-negative) and 72 matched healthy controls (HC). Pathway enrichment analysis, unsupervised weighted gene coexpression network analysis and machine learning were applied to distinguish disease endotypes.
    Results: Patients with SLE-APS demonstrated upregulated type I and II interferon (IFN) pathways compared with HC. Using a 100-gene random forests model, we achieved a cross-validated accuracy of 75.6% in distinguishing these two states. Additionally, the comparison between SLE-APS and SLE-aPL-negative revealed 227 differentially expressed genes, indicating downregulation of IFN-α and IFN-γ signatures, coupled with dysregulation of the complement cascade, B-cell activation and neutrophil degranulation. Unsupervised analysis of SLE transcriptome identified 21 gene modules, with SLE-APS strongly linked to upregulation of the 'neutrophilic/myeloid' module. Within SLE-APS, venous thromboses positively correlated with 'neutrophilic/myeloid' and 'B cell' modules, while arterial thromboses were associated with dysregulation of 'DNA damage response (DDR)' and 'metabolism' modules. Anticardiolipin and anti-β2GPI positivity-irrespective of APS status-were associated with the 'neutrophilic/myeloid' and 'protein-binding' module, respectively.
    Conclusions: There is a hierarchical upregulation and-likely-dependence on IFN in SLE with the highest IFN signature observed in SLE-aPL-negative patients. Venous thrombotic events are associated with neutrophils and B cells while arterial events with DDR and impaired metabolism. This may account for their differential requirements for anticoagulation and provide rationale for the potential use of mTOR inhibitors such as sirolimus and the direct fIIa inhibitor dabigatran in SLE-APS.
    Language English
    Publishing date 2024-04-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 7090-7
    ISSN 1468-2060 ; 0003-4967
    ISSN (online) 1468-2060
    ISSN 0003-4967
    DOI 10.1136/ard-2024-225664
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  8. Article ; Online: Cerebrovascular Events in Systemic Lupus Erythematosus: Diagnosis and Management.

    Nikolopoulos, Dionysis / Fanouriakis, Antonis / Boumpas, Dimitrios T

    Mediterranean journal of rheumatology

    2019  Volume 30, Issue 1, Page(s) 7–15

    Abstract: Stroke is a major cause of morbidity, mortality and disability in systemic lupus erythematosus (SLE). Patients with SLE have a two-fold increase in the risk of stroke with younger patients (ie, less than 50 years of age) having an ever-higher risk (up to ...

    Abstract Stroke is a major cause of morbidity, mortality and disability in systemic lupus erythematosus (SLE). Patients with SLE have a two-fold increase in the risk of stroke with younger patients (ie, less than 50 years of age) having an ever-higher risk (up to 10-fold). Although the prognosis of SLE has improved, mortality due to cerebrovascular events (CVE) remains unchanged. Cerebrovascular disease may be directly attributed to the disease per se, as a manifestation of neuropsychiatric SLE, or be the result of traditional cardiovascular risk factors accompanying the disease. Elucidation of the underlying mechanism(s) of CVE is essential as it may guide the type of therapy (ie, antithrombotic or anticoagulant therapy versus immunosuppressive). Strokes attributed to lupus usually occur early in the course of the disease and are often accompanied by evidence of activity in other organs; those related to antiphospholipid antibodies can occur at any time, in patients with either active or inactive SLE. In this review, we discuss the epidemiology, work-up, management and primary prevention of CVE in patients with lupus. In view of the effectiveness of thrombolysis, physicians need to educate lupus patients and their families for the early recognition of the signs of stroke and the need to seek prompt attention. To this end acronyms, such as FAST (Facial drooping, Arm weakness, Speech difficulties and Time to call emergency service) can be used as a mnemonic to help detect and enhance responsiveness to the needs of a person having a stroke.
    Language English
    Publishing date 2019-03-28
    Publishing country Greece
    Document type Journal Article ; Review
    ZDB-ID 3019943-8
    ISSN 2529-198X ; 2459-3516
    ISSN (online) 2529-198X
    ISSN 2459-3516
    DOI 10.31138/mjr.30.1.7
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  9. Article: Enhanced medullary and extramedullary granulopoiesis sustain the inflammatory response in lupus nephritis.

    Zervopoulou, Eleni / Grigoriou, Maria / Doumas, Stavros A / Yiannakou, Danae / Pavlidis, Pavlos / Gasparoni, Gilles / Walter, Jörn / Filia, Anastasia / Gakiopoulou, Harikleia / Banos, Aggelos / Mitroulis, Ioannis / Boumpas, Dimitrios T

    Lupus science & medicine

    2024  Volume 11, Issue 1

    Abstract: Objectives: In SLE, deregulation of haematopoiesis is characterised by inflammatory priming and myeloid skewing of haematopoietic stem and progenitor cells (HSPCs). We sought to investigate the role of extramedullary haematopoiesis (EMH) as a key player ...

    Abstract Objectives: In SLE, deregulation of haematopoiesis is characterised by inflammatory priming and myeloid skewing of haematopoietic stem and progenitor cells (HSPCs). We sought to investigate the role of extramedullary haematopoiesis (EMH) as a key player for tissue injury in systemic autoimmune disorders.
    Methods: Transcriptomic analysis of bone marrow (BM)-derived HSPCs from patients with SLE and NZBW/F1 lupus-prone mice was performed in combination with DNA methylation profile. Trained immunity (TI) was induced through β-glucan administration to the NZBW/F1 lupus-prone model. Disease activity was assessed through lupus nephritis (LN) histological grading. Colony-forming unit assay and adoptive cell transfer were used to assess HSPCs functionalities.
    Results: Transcriptomic analysis shows that splenic HSPCs carry a higher inflammatory potential compared with their BM counterparts. Further induction of TI, through β-glucan administration, exacerbates splenic EMH, accentuates myeloid skewing and worsens LN. Methylomic analysis of BM-derived HSPCs demonstrates myeloid skewing which is in part driven by epigenetic tinkering. Importantly, transcriptomic analysis of human SLE BM-derived HSPCs demonstrates similar findings to those observed in diseased mice.
    Conclusions: These data support a key role of granulocytes derived from primed HSPCs both at medullary and extramedullary sites in the pathogenesis of LN. EMH and TI contribute to SLE by sustaining the systemic inflammatory response and increasing the risk for flare.
    MeSH term(s) Humans ; Animals ; Mice ; Lupus Nephritis ; Lupus Erythematosus, Systemic ; Hematopoiesis ; Hematopoietic Stem Cells ; beta-Glucans
    Chemical Substances beta-Glucans
    Language English
    Publishing date 2024-03-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 2779620-6
    ISSN 2053-8790
    ISSN 2053-8790
    DOI 10.1136/lupus-2023-001110
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  10. Article ; Online: NF-kappa-B essential modulator (NEMO) gene polymorphism in an adult woman with systemic lupus erythematosus and recurrent non-tuberculous mycobacterial disseminated infections.

    Thomas, Konstantinos / Tsioulos, Georgios / Kotsogianni, Christina / Banos, Agellos / Niemela, Julie E / Cheng, Aristine / DiMaggio, Tom / Holland, Steven / Rosenzweig, Sergio D / Tziolos, Nikolaos / Papadopoulos, Antonios / Lionakis, Michail S / Boumpas, Dimitrios T

    RMD open

    2023  Volume 9, Issue 2

    Abstract: Infections are among the most serious complications in patients with systemic lupus erythematosus (SLE), with bacterial and viral infections being the most common. Non-tuberculous mycobacterial (NTM) infections are quite rare and are typically seen in ... ...

    Abstract Infections are among the most serious complications in patients with systemic lupus erythematosus (SLE), with bacterial and viral infections being the most common. Non-tuberculous mycobacterial (NTM) infections are quite rare and are typically seen in older patients with SLE with longstanding disease duration treated with corticosteroids. Here, we describe a 39-year-old woman with SLE and an unusual pattern of recurrent NTM disseminated infections. After excluding the presence of autoantibodies against interferon-γ, whole exome sequencing revealed a homozygous polymorphism in the NF-kappa-B essential modulator (NEMO) gene. Primary immunodeficiencies should be included in the differential diagnosis of patients with recurrent opportunistic infections, even in those with iatrogenic immunosuppression.
    MeSH term(s) Adult ; Female ; Humans ; Autoantibodies ; Immunosuppression Therapy ; Lupus Erythematosus, Systemic/complications ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/drug therapy ; Nontuberculous Mycobacteria ; Polymorphism, Genetic
    Chemical Substances Autoantibodies
    Language English
    Publishing date 2023-06-25
    Publishing country England
    Document type Case Reports ; Journal Article ; Research Support, N.I.H., Intramural
    ZDB-ID 2812592-7
    ISSN 2056-5933 ; 2056-5933
    ISSN (online) 2056-5933
    ISSN 2056-5933
    DOI 10.1136/rmdopen-2023-003149
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