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  1. Article ; Online: Versorgungssituation des Systemischen Lupus Erythematodes in Rheinland-Pfalz und dem Saarland.

    Alberti, Ciaran / Dreher, Matthias / Triantafyllias, Konstantinos / Schwarting, Andreas

    Zeitschrift fur Rheumatologie

    2024  

    Abstract: Background: Systemic lupus erythematosus (SLE) is a clinically heterogeneous autoimmune disease that is associated with great suffering for those affected, as well as high socioeconomic costs. Early diagnosis and adequate medical care are essential for ... ...

    Title translation Current patient care of systematic lupus erythematosus in Rhineland-Palatinate and Saarland.
    Abstract Background: Systemic lupus erythematosus (SLE) is a clinically heterogeneous autoimmune disease that is associated with great suffering for those affected, as well as high socioeconomic costs. Early diagnosis and adequate medical care are essential for a mild course of the disease. However, there is a lack of current figures and data on the care situation of patients in the area.
    Methodology: A total of 1546 general practitioners, rheumatologists, neurologists, nephrologists and dermatologists in Rhineland-Palatinate and Saarland were interviewed by fax or mail using a questionnaire regarding epidemiology, symptoms, therapy and therapy success. In addition, there was the possibility of making suggestions for improvement.
    Results: Five out of six of the 635 reported SLE patients were female. The most common main symptoms were arthralgia, fatigue, myalgia, and skin changes. Of the patients, 68% received antimalarials (AMs), whereas 46% were treated with glucocorticoids (GCs) and 50% with an immunosuppressant (IS), mainly methotrexate. In terms of comorbidities, patients suffered mainly from cardiovascular disease, fibromyalgia syndrome and depression. Rheumatologists also frequently described anaemia, diabetes mellitus and osteoporosis.
    Discussion: Compared with guideline recommendations, the low rate of AMs in therapy was particularly striking in patients not treated by rheumatologists (35% on average compared with 81% for rheumatologists). Additionally, (sustained) high doses of GCs are not in line with literature recommendations. In the free text field, the main requests were for more rheumatologists in private practice and faster appointment scheduling, as well as better communication and networking. In addition, the desire for more training and education was frequently expressed..
    Language German
    Publishing date 2024-03-20
    Publishing country Germany
    Document type English Abstract ; Journal Article
    ZDB-ID 124985-x
    ISSN 1435-1250 ; 0340-1855 ; 0301-6382
    ISSN (online) 1435-1250
    ISSN 0340-1855 ; 0301-6382
    DOI 10.1007/s00393-024-01491-1
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  2. Article: Ausdauersport bei systemischem Lupus erythematodes?

    Schwarting, Andreas

    B&G Bewegungstherapie und Gesundheitssport

    2020  Volume 36, Issue 01, Page(s) 12–14

    Language German
    Publishing date 2020-02-01
    Publisher © Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2141948-6
    ISSN 1613-3269 ; 1613-0863
    ISSN (online) 1613-3269
    ISSN 1613-0863
    DOI 10.1055/a-0976-4052
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  3. Article ; Online: Transcriptome analysis of renal ischemia/reperfusion (I/R) injury in BAFF and BAFF-R deficient mice.

    Möckel, Tamara / Boegel, Sebastian / Schwarting, Andreas

    PloS one

    2023  Volume 18, Issue 9, Page(s) e0291619

    Abstract: Acute kidney injury (AKI) accompanies with high morbidity and mortality. Incomplete renal recovery can lead to chronic and finally end-stage kidney disease, which results in the requirement of lifelong dialysis or kidney transplantation. Consequently, ... ...

    Abstract Acute kidney injury (AKI) accompanies with high morbidity and mortality. Incomplete renal recovery can lead to chronic and finally end-stage kidney disease, which results in the requirement of lifelong dialysis or kidney transplantation. Consequently, finding predictive biomarker and therefore developing preventive therapeutic approaches is an urgent need. For this purpose, a better understanding of the mechanism underlying AKI is necessary. The cytokine BAFF (B cell activating factor) is related to AKI by supporting B cells, which in turn play an important role in inflammatory processes and the production of antibodies. In our study, we investigated the role of BAFF and its receptor BAFF-R in the early phase of AKI. Therefore, we performed the well-established ischemia/reperfusion (I/R) model in BAFF (B6.129S2-Tnfsf13btm1Msc/J) and BAFF-R (B6(Cg)-Tnfrsf13ctm1Mass/J) deficient mice. Transcriptome of ischemic and contralateral control kidneys was analyzed and compared to wildtype littermates. We detected the upregulation of Lcn2, Lyz2, Cd44, Fn1 and Il1rn in ischemic kidneys as well as the downregulation of Kl. Furthermore, we revealed different expression patterns in BAFF and BAFF-R knockout mice. Compared to wildtype littermates, up- and downregulation of each investigated gene were higher in BAFF-R knockout and lower in BAFF knockout. Our findings indicate a positive impact of BAFF knockout in early phase of AKI, while BAFF-R knockout seems to worsen I/R injury. In addition, our study shows for the first time a remarkable renal upregulation of Lyz2 in a murine I/R model. Therefore, we consider Lyz2 as conceivable predictive or early biomarker in case of I/R and AKI.
    MeSH term(s) Mice ; Animals ; B-Cell Activating Factor/genetics ; Renal Dialysis ; Kidney ; Reperfusion Injury/genetics ; Acute Kidney Injury/genetics ; Gene Expression Profiling ; Reperfusion ; Craniocerebral Trauma
    Chemical Substances B-Cell Activating Factor
    Language English
    Publishing date 2023-09-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0291619
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  4. Article: Diagnostic Value of Labial Minor Salivary Gland Biopsy: Histological Findings of a Large Sicca Cohort and Clinical Associations.

    Triantafyllias, Konstantinos / Bach, Mirjam / Otto, Mike / Schwarting, Andreas

    Diagnostics (Basel, Switzerland)

    2023  Volume 13, Issue 19

    Abstract: 1) Background: The aim of this study was to analyze labial minor salivary gland biopsy (MSGB) findings of a large sicca cohort and to examine their associations with Sjogren's syndrome (SS)-associated laboratory markers, phenotypic characteristics and ... ...

    Abstract (1) Background: The aim of this study was to analyze labial minor salivary gland biopsy (MSGB) findings of a large sicca cohort and to examine their associations with Sjogren's syndrome (SS)-associated laboratory markers, phenotypic characteristics and systemic manifestations. Moreover, we sought to explore the ability of MSGB to identify SS patients among subjects with pre-diagnosed fibromyalgia (FM). (2) Methods: Included were all patients of three rheumatology departments having undergone a diagnostic MSGB within 9 years. Next to the examination of histological and immunohistochemical findings, we focused on activity and chronicity parameters of the underlying disease, autoantibodies, presence of systemic and hematologic involvement, as well as chronic pain and SS comorbidities. (3) Results: Among the 678 included patients, 306 (45.1%) had a positive focus score (FS). The remaining patients (
    Language English
    Publishing date 2023-10-03
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics13193117
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  5. Article: Performance of a novel high-resolution infrared thermography marker in detecting and assessing joint inflammation: a comparison with joint ultrasound.

    Triantafyllias, Konstantinos / Clasen, Marina / De Blasi, Michele / Berres, Manfred / Nikolodimos, Eleftherios / Schwarting, Andreas

    Clinical and experimental rheumatology

    2024  

    Abstract: Objectives: To examine the value of a novel high-resolution thermographic marker in the detection of joint inflammation compared to joint ultrasound (US) and to suggest thermographic cut-off values of joint inflammatory activity.: Methods: Infrared ... ...

    Abstract Objectives: To examine the value of a novel high-resolution thermographic marker in the detection of joint inflammation compared to joint ultrasound (US) and to suggest thermographic cut-off values of joint inflammatory activity.
    Methods: Infrared thermographies were performed in patients with inflammatory arthritides and healthy controls. Patients were moreover examined clinically and by joint-US [Power-Doppler-(PDUS), Greyscale-US (GSUS)]. Regions of interest (ROIs) were defined for every joint and absolute temperature values within the ROIs were documented. The hottest areas ("hotspots") were identified by a clustering algorithm and the Hotspot/ROI-Ratio (HRR)-values were calculated. Subsequently, the HRR of patient-joints with different grades of hypervascularity (PDUS I°-III°) were compared among each other and with PDUS 0° control-joints. Diagnostic HRR-performance was tested by receiver-operating-characteristics.
    Results: 360 joints of 75 arthritis-patients and 1,808 joints of 70 controls were thermographically examined. HRR-values were statistically different between PDUS I-III vs. PDUS 0 and vs. healthy subjects for all four joint groups as well as in the majority of cases between patient-joints with different grades of hypervascularity (PDUS I°-III°; p<0.05). Taking joint-US as a reference, the best performance of HRR was found at the level of the wrist-joints by an area under the curve (AUC) of 0.91 (95%CI 0.84-0.98) with a sensitivity of 0.83 and specificity of 0.88.
    Conclusions: HRR showed an excellent performance in the differentiation of joints with US inflammatory activity from non-inflamed joints. Moreover, HRR was able to differentiate between joints with different grades of hypervascularity, making HRR a promising tool to assist disease activity monitoring.
    Language English
    Publishing date 2024-05-01
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 605886-3
    ISSN 1593-098X ; 0392-856X
    ISSN (online) 1593-098X
    ISSN 0392-856X
    DOI 10.55563/clinexprheumatol/ne4k8y
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  6. Article: Von ADAPTHERA zu Rheuma-VOR: Konzept der koordinierten Kooperation zur Verbesserung der rheumatologischen Versorgungsqualität

    Schwarting, Andreas

    Aktuelle Rheumatologie

    2018  Volume 43, Issue 05, Page(s) 406–409

    Abstract: Rheumatologische Erkrankungsbilder nehmen in Ihrer Relevanz immer weiter zu. Die Kombination aus einem optimalen Behandlungsbeginn innerhalb von 12 Wochen nach Beschwerdebeginn und dem Mangel an Rheumatologen stellt eine große Herausforderung für alle ... ...

    Abstract Rheumatologische Erkrankungsbilder nehmen in Ihrer Relevanz immer weiter zu. Die Kombination aus einem optimalen Behandlungsbeginn innerhalb von 12 Wochen nach Beschwerdebeginn und dem Mangel an Rheumatologen stellt eine große Herausforderung für alle Beteiligten dar. Ein möglicher Ansatzpunkt ist die koordinierte Kooperation von Patienten, Primärversorgern (Internisten, Orthopäden, Dermatologen) und den niedergelassenen Rheumatologen mithilfe einer zentralen Koordinationsstelle. Das erfolgreich etablierte rheinland-pfalzweite Netzwerk ADAPTHERA konnte zeigen, dass durch Risikostratifizierung eine zeitnahe Diagnose der Rheumatoiden Arthritis möglich ist und dabei die Ressource „Rheumatologe“ geschont wird. Die durch den Innovationsfonds des Gemeinsamen Bundesausschusses geförderte Proof-of-Concept Folgestudie Rheuma-VOR fußt auf dem gleichen Prinzip, jedoch stehen nun 3 entzündlich-rheumatische Erkrankungen (Rheumatoide Arthritis, Psoriasis Arthritis und Spondylarthritis) im Fokus. Zudem wurde das Projekt auf die Bundesländer Rheinland-Pfalz, Niedersachsen und dem Saarland ausgeweitet. Das Ziel ist die Steigerung der Versorgungsqualität in den 3 Bundesländern bei gleichzeitiger Reduktion der Wartezeiten.
    Keywords Früh-Diagnose ; Rheumatoide Arthritis ; Psoriasis Arthritis ; Spondyloarthritis ; Rheuma-VOR ; ADAPTHERA ; Early diagnosis ; Rheumatoid Arthritis ; Psoriatic arthritis ; Spondyloarthritis ; Rheuma VOR ; ADAPTHERA
    Language German
    Publishing date 2018-10-01
    Publisher © Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 131267-4
    ISSN 1438-9940 ; 0341-051X
    ISSN (online) 1438-9940
    ISSN 0341-051X
    DOI 10.1055/a-0658-1031
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  7. Book ; Thesis: Untersuchungen des Methioninstoffwechsels bei cerebrovasculären Erkrankungen im jugendlichen Alter

    Schwarting, Andreas

    1992  

    Author's details vorgelegt von: Andreas Schwarting
    Keywords Cerebrovascular Disorders / metabolism ; Methionine / metabolism
    Size 113 S. : Ill., graph. Darst.
    Document type Book ; Thesis
    Thesis / German Habilitation thesis Bonn, Univ., Diss., 1992
    HBZ-ID HT004264809
    Database Catalogue ZB MED Medicine, Health

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    Shelf markLoan statusLocation
    92 D 3251 order for loan Magazin

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  8. Article ; Online: Fehlendes Therapieansprechen: Ist es wirklich eine rheumatoide Arthritis?

    Marinoska, Tatjana / Lauf, Carla / Schorn, Corinna / Schwarting, Andreas

    Deutsche medizinische Wochenschrift (1946)

    2022  Volume 147, Issue 17, Page(s) 1153–1157

    Abstract: Anamnesis: A 78-year-old female patient was referred to our hospital with treatment-resistant seronegative anti-citrullinated protein antibodies (ACPA)-negative rheumatoid arthritis. The course was characterized by high inflammatory activity and rapid ... ...

    Title translation Lack of therapeutic response: Is it really a rheumatoid Arthritis?
    Abstract Anamnesis: A 78-year-old female patient was referred to our hospital with treatment-resistant seronegative anti-citrullinated protein antibodies (ACPA)-negative rheumatoid arthritis. The course was characterized by high inflammatory activity and rapid progression of the erosive changes. Under the required high-dose prednisolone therapy, osteoporosis and a deep venous thrombosis (DVT) with pulmonary embolism developed.
    Physical examination: A physical examination revealed symmetrical, painful, synovial swelling of the metacarpophalangeal, proximal-interphalangeal and distal-interphalangeal (MCP, PIP, and DIP) joints, finger joint-related violaceous erythema, contractures of the long fingers, and advanced deformities bilaterally. Pain and weakness in the muscles of her proximal extremities led to difficulties in raising her arms and climbing stairs.
    Diagnosis: The results of laboratory tests showed negative RF (rheumatoid factor) and ACPAs, positive ANA (anti-nuclear antibodies) with titer 1:5120, a nuclear fluorescence pattern and a positive anti-Mi-2 Antibodies in the myositis blot. Conventional x-ray showed erosive and advanced mutilating joint changes in both hands. A magnetic resonance imaging (MRI) of the proximal extremities showed a pronounced muscle atrophy without sights of active myositis.This clinical constellation leads to the diagnosis of an amyopathic dermatomyositis.
    Therapy and progress: The patient was started on intravenous prednisone 100 mg daily, 4 days, followed by rapid dose tapering in the setting of accompanying risk factors such as Osteoporosis, arterial Hypertension and blurred vision. This treatment leads to improvement of symptoms. The basic therapy was switched to Rituximab. An extended tumor search was recommended on an outpatient basis.
    Conclusions: A seronegative, ACPA negative, therapy-resistant RA with a rapidly progressive erosive course requires a diagnostic re-evaluation. An erosive, rapidly progressing polyarthritis is commonly seen as manifestation of the subtype inflammatory myopathies associated with anti-Jo 1 antibodies, known as anti-synthetase syndrome. However, associations with the presence of other myositis specific antibodies (MSA) have been also described. The anti-Mi-2 Antibodies are highly specific for dermatomyositis (DM).Amyopathic DM is not common, but the disease course and prognosis do not differ significantly from myopathic DM.As a sudden presentation of DM may be of paraneoplastic origin a further examination in order to exclude malignancy are indicated.
    MeSH term(s) Aged ; Arthritis, Rheumatoid ; Autoantibodies ; Dermatomyositis ; Female ; Humans ; Myositis ; Osteoporosis
    Chemical Substances Autoantibodies
    Language German
    Publishing date 2022-08-28
    Publishing country Germany
    Document type Case Reports ; Journal Article
    ZDB-ID 200446-x
    ISSN 1439-4413 ; 0012-0472
    ISSN (online) 1439-4413
    ISSN 0012-0472
    DOI 10.1055/a-1887-3463
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  9. Article: Novel Surrogate Markers of Cardiovascular Risk in the Setting of Autoimmune Rheumatic Diseases: Current Data and Implications for the Future.

    Mandel, Anna / Schwarting, Andreas / Cavagna, Lorenzo / Triantafyllias, Konstantinos

    Frontiers in medicine

    2022  Volume 9, Page(s) 820263

    Abstract: Patients suffering from rheumatologic diseases are known to have an increased risk for cardiovascular disease (CVD). Although the pathological mechanisms behind this excess risk have been increasingly better understood, there still seems to be a general ... ...

    Abstract Patients suffering from rheumatologic diseases are known to have an increased risk for cardiovascular disease (CVD). Although the pathological mechanisms behind this excess risk have been increasingly better understood, there still seems to be a general lack of consensus in early detection and treatment of endothelial dysfunction and CVD risk in patients suffering from rheumatologic diseases and in particular in those who haven't yet shown symptoms of CVD. Traditional CVD prediction scores, such as Systematic Coronary Risk Evaluation (SCORE), Framingham, or PROCAM Score have been proposed as valid assessment tools of CVD risk in the general population. However, these risk calculators developed for the general population do not factor in the effect of the inflammatory burden, as well as other factors that can increase CVD risk in patients with rheumatic diseases, such as glucocorticoid therapy, abnormal lipoprotein function, endothelial dysfunction or accelerated atherosclerosis. Thus, their sole use could lead to underestimation of CVD risk in patients with rheumatic diseases. Therefore, there is a need for new biomarkers which will allow a valid and early assessment of CVD risk. In recent years, different research groups, including ours, have examined the value of different CVD risk factors such as carotid sonography, carotid-femoral pulse wave velocity, flow-mediated arterial dilation and others in the assessment of CVD risk. Moreover, various novel CVD laboratory markers have been examined in the setting of autoimmune diseases, such as Paraoxonase activity, Endocan and Osteoprotegerin. Dyslipidemia in rheumatoid arthritis (RA) is for instance better quantified by lipoproteins and apolipoproteins than by cholesterol levels; screening as well as pre-emptive carotid sonography hold promise to identify patients earlier, when prophylaxis is more likely to be effective. The early detection of subtle changes indicating CVD in asymptomatic patients has been facilitated through improved imaging methods; the inclusion of artificial intelligence (AI) shows promising results in more recent studies. Even though the pathophysiology of coronary artery disease in patients with autoimmune rheumatic diseases has been examined in multiple studies, as we continuously gain an increased understanding of this comorbidity, particularly in subclinical cases we still seem to fail in the stratification of who really is at risk-and who is not. A the time being, a multipronged and personalized approach of screening patients for traditional CVD risk factors, integrating modern imaging and further CV diagnostic tools and optimizing treatment seems to be a solid approach. There is promising research on novel biomarkers, likewise, methods using artificial intelligence in imaging provide encouraging data indicating possibilities of risk stratification that might become gold standard in the near future. The present review concentrates on showcasing the newest findings concerning CVD risk in patients with rheumatologic diseases and aims to evaluate screening methods in order to optimize CVD risk evaluation and thus avoiding underdiagnosis and undertreatment, as well as highlighting which patient groups are most at risk.
    Language English
    Publishing date 2022-06-30
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2775999-4
    ISSN 2296-858X
    ISSN 2296-858X
    DOI 10.3389/fmed.2022.820263
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  10. Article ; Online: Infektgetriggerte Arthralgien und Arthritiden: wie behandeln?

    Klonowski, Anna / Schwarting, Andreas

    MMW Fortschritte der Medizin

    2020  Volume 162, Issue 2, Page(s) 39–42

    Title translation Infection-triggered arthralgia and arthritis.
    MeSH term(s) Arthralgia ; Arthritis ; Arthritis, Reactive ; Humans ; Infections
    Language German
    Publishing date 2020-02-04
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 1478211-x
    ISSN 1613-3560 ; 1438-3276
    ISSN (online) 1613-3560
    ISSN 1438-3276
    DOI 10.1007/s15006-020-0104-9
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