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Article ; Online: Monogénesen öröklődő és szerzett autoinflammatoricus betegségek.

Szekanecz, Zoltán / Szamosi, Szilvia / Benkő, Szilvia / Szűcs, Gabriella

2024 Volume 165, Issue 18, Page(s) 683–697

Title translation	Monogenic and acquired autoinflammatory diseases.
MeSH term(s)	Humans ; Autoimmune Diseases/immunology ; Hereditary Autoinflammatory Diseases/immunology ; Inflammation/immunology ; Mutation
Language	Hungarian
Publishing date	2024-05-05
Publishing country	Hungary
Document type	Journal Article ; Review
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2024.33038
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Article ; Online: Can we define difficult-to-treat systemic sclerosis?

Szűcs, Gabriella / Szekanecz, Zoltán / Szamosi, Szilvia

Expert review of clinical immunology

2024 , Page(s) 1–17

Abstract: Introduction: Systemic sclerosis (SSc) is a chronic autoimmune rheumatic disease characterized by microvascular alterations, immunopathology, and widespread fibrosis involving various organs. It is considered difficult to treat due to several reasons: ... ...

Abstract	Introduction: Systemic sclerosis (SSc) is a chronic autoimmune rheumatic disease characterized by microvascular alterations, immunopathology, and widespread fibrosis involving various organs. It is considered difficult to treat due to several reasons: complex pathogenesis, heterogeneity, late diagnosis, limited treatment options for certain organ manifestations, lack of personalized medicine. Areas covered: This review presents the heterogeneity, survival and organ manifestations with their risk factors of systemic sclerosis and their current treatment options, while drawing attention to difficult-to-treat forms of the disease, based on literature indexed in PubMed. Expert opinion: Despite recent advances in the management of SSc over the last decades, the disease presents significant morbidity and mortality. Although available treatment protocols brought significant advancements in terms of survival in SSc-associated interstitial lung disease and pulmonary arterial hypertension, less success has been achieved in the treatment of Raynaud's phenomenon and digital ulcers and the results are modest in case of heart, gastrointestinal, and renal manifestations. There are patients who do not respond to treatment and deteriorate even with adequate therapy. They can be considered difficult-to treat (D2T) cases. We have created a possible score system based on the individual organ manifestations and highlighted treatment options for the D2T SSc category.
Language	English
Publishing date	2024-05-14
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2274260-8
ISSN	1744-8409 ; 1744-666X
ISSN (online)	1744-8409
ISSN	1744-666X
DOI	10.1080/1744666X.2024.2352450
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Article ; Online: Should we use nintedanib as early therapy in patients with SSc-ILD?

Zanatta, Elisabetta / Moccaldi, Beatrice / Szucs, Gabriella / Spagnolo, Paolo

Autoimmunity reviews

2023 Volume 23, Issue 1, Page(s) 103463

Abstract: Systemic sclerosis (SSc) is a heterogeneous autoimmune disease, where a significant proportion of patients develop interstitial lung disease (ILD), which is the major cause of mortality. In recent years, the diagnosis of SSc-ILD has improved a lot, and ... ...

Abstract	Systemic sclerosis (SSc) is a heterogeneous autoimmune disease, where a significant proportion of patients develop interstitial lung disease (ILD), which is the major cause of mortality. In recent years, the diagnosis of SSc-ILD has improved a lot, and caring rheumatologists, together with pulmonologists, regularly screen and follow the development and course of ILD. Considerable progress has also been made in the treatment of SSc-ILD based on several clinical trials. The recommendations for immunosuppressive treatment have been modified and supplemented with targeted agents (tocilizumab, rituximab), and antifibrotic drugs such as nintedanib registered as a new treatment for SSc-ILD. However, there are no clear recommendations regarding the start and timing of nintedanib treatment. A debate on the early introduction of nintenadib or not took place on the 7th edition of the International Congress on Controversies in Rheumatology and Autoimmunity (CORA) in March/2023, and this review summarizes the main arguments that were discussed in this session.
MeSH term(s)	Humans ; Secondary Prevention ; Immunosuppressive Agents/therapeutic use ; Lung Diseases, Interstitial/drug therapy ; Lung Diseases, Interstitial/etiology ; Indoles/therapeutic use ; Scleroderma, Systemic/complications ; Scleroderma, Systemic/drug therapy ; Lung
Chemical Substances	nintedanib (G6HRD2P839) ; Immunosuppressive Agents ; Indoles
Language	English
Publishing date	2023-10-14
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.2023.103463
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Article ; Online: Granulomatosis with polyangiitis or its mimic? A case report.

Major, Tamás / Nagy, Gábor / Szabó, Judit / Mózes, Huba / Szűcs, Gabriella / Szekanecz, Zoltán / Szamosi, Szilvia

The Journal of international medical research

2024 Volume 52, Issue 4, Page(s) 3000605241237876

Abstract: Differentiation between granulomatosis with polyangiitis (GPA) limited to the upper airways and cocaine-induced midline destructive lesion (CIMDL) may be particularly difficult because of their common histopathologic features and antineutrophil ... ...

Abstract	Differentiation between granulomatosis with polyangiitis (GPA) limited to the upper airways and cocaine-induced midline destructive lesion (CIMDL) may be particularly difficult because of their common histopathologic features and antineutrophil cytoplasmic antibody (ANCA) profiles. We herein present a case involving a young woman with an initial diagnosis of GPA based on upper and lower airway manifestations and constitutional symptoms, histopathologic evidence of granulomas, a positive cytoplasmic ANCA indirect immunofluorescent test result, and proteinase 3 positivity by enzyme-linked immunosorbent assay (ELISA). CIMDL was confirmed based on the appearance of a hard palate perforation, positivity for methylecgonine on urine toxicology, a positive perinuclear ANCA indirect immunofluorescent test result, and subsequent human neutrophil elastase (HNE) ANCA positivity by ELISA. Finally, based on the coexistence of CIMDL, constitutional symptoms, and lower airway manifestations, the diagnosis was modified to cocaine-induced GPA mimic. Urine toxicology for cocaine and HNE ELISA are indicated in young patients with GPA who develop limited airway disease to check for the presence of CIMDL and cocaine-/levamisole-induced ANCA-associated vasculitis. Continued abstinence from cocaine is the first-choice therapy for both CIMDL and cocaine-induced GPA mimic.
MeSH term(s)	Female ; Humans ; Antibodies, Antineutrophil Cytoplasmic ; Granulomatosis with Polyangiitis/diagnosis ; Granulomatosis with Polyangiitis/complications ; Cocaine-Related Disorders/complications ; Cocaine-Related Disorders/diagnosis ; Cocaine ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complications
Chemical Substances	Antibodies, Antineutrophil Cytoplasmic ; Cocaine (I5Y540LHVR)
Language	English
Publishing date	2024-04-12
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	184023-x
ISSN	1473-2300 ; 0300-0605 ; 0142-2596
ISSN (online)	1473-2300
ISSN	0300-0605 ; 0142-2596
DOI	10.1177/03000605241237876
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Article: Evaluation of the Efficacy of BBIBP-CorV Inactivated Vaccine Combined with BNT62b2 mRNA Booster Vaccine.

Rákóczi, Éva / Magócs, Gusztáv / Kovács, Sára / Nagy, Béla / Szűcs, Gabriella / Szekanecz, Zoltán

Diagnostics (Basel, Switzerland)

2023 Volume 13, Issue 3

Abstract: Objectives: In this prospective study, SARS-CoV-2 spike protein specific total immunoglobulin (Ig) levels were analyzed before and after BNT162 b2 mRNA booster vaccination in individuals previously administered with two doses of BBIBP-CorV vaccine in ... ...

Abstract	Objectives: In this prospective study, SARS-CoV-2 spike protein specific total immunoglobulin (Ig) levels were analyzed before and after BNT162 b2 mRNA booster vaccination in individuals previously administered with two doses of BBIBP-CorV vaccine in comparison to immunized participants with three doses of BNT162 b2 vaccination. Methods: Sixty-one Caucasian volunteers (39 females, 22 males) vaccinated by BBIBP-CorV were included (mean age: 63.9 years). Sixty-one patients (41 females, 20 males) as controls were vaccinated with BNT162b2 (mean age: 59.9 years). Both groups received the third booster BNT162b2 vaccine. Total anti-SARS-CoV-2 S1-RBD Ig levels were measured by an immunoassay (Roche Diagnostics) and their calculated ratios after/before booster dose were compared between the two groups. Results: At baseline, significantly lower anti-SARS-CoV-2 S1-RBD total antibody levels were determined after initial immunization by two doses of inactivated BBIBP-CorV compared to BNT62b2 mRNA vaccine (p < 0.001). After BNT162b2 boosters, similarly high total Ig levels were detected in both the heterologous (27,195 [15,604-42,754] BAU/mL, Conclusion: To address the concept that basic BBIBP-CorV vaccination is not as effective as BNT162b, we analyzed the effect of heterologous vaccination with BNT162b2. Our results suggest that BNT162b2 can successfully boost the effects of two-dose BBIBP-CorV vaccination.
Language	English
Publishing date	2023-02-02
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics13030556
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Article ; Online: Parry–Romberg syndrome

Tamás, Tímea / Iszlai, Zoltán / Szűcs, Gabriella / Karosi, Tamás

Orvosi hetilap

2020 Volume 161, Issue 28, Page(s) 1181–1185

Abstract: Parry-Romberg syndrome is a rare, slowly progressive, autolimitated disease, characterized by unilateral facial atrophy. It is usually manifested in childhood and young adulthood. Because of the degree of atrophy and the variety of symptoms, the ... ...

Title translation	Parry-Romberg-szindróma
Abstract	Parry-Romberg syndrome is a rare, slowly progressive, autolimitated disease, characterized by unilateral facial atrophy. It is usually manifested in childhood and young adulthood. Because of the degree of atrophy and the variety of symptoms, the diagnosis, prognosis, and treatment of Parry-Romberg syndrome are a major challenge. The purpose of this case presentation is to highlight the difficulty of establishing the diagnosis, furthermore, to present the steps of examining the patient and to draw attention to the importance of proper timing of the surgery. Moreover, it wants to emphasize the importance of looking for diseases that often occur with the mentioned syndrome. Orv Hetil. 2020; 161(28): 1181-1185.
MeSH term(s)	Adult ; Child ; Face ; Facial Hemiatrophy/diagnosis ; Facial Hemiatrophy/surgery ; Humans ; Syndrome ; Young Adult
Language	Hungarian
Publishing date	2020-07-01
Publishing country	Hungary
Document type	Case Reports ; Journal Article
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2020.31755
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Article ; Online: Balneotherapy, a Complementary Non-pharmacological Approach for Non-Inflammatory Complaints in Systemic Lupus Erythematosus: A Pilot Study.

Fritsch, Kinga / Nagy, Gyorgy / Szekanecz, Zoltan / Szűcs, Gabriella / Kovacs, Laszlo / Bender, Tamas

In vivo (Athens, Greece)

2022 Volume 36, Issue 6, Page(s) 3010–3017

Abstract: Background/aim: Despite remission or low disease activity non-inflammatory complaints like exhaustion, fatigue, and pain persist in a significant proportion of patients with systemic lupus erythematosus (SLE) and have a considerable impact on health- ... ...

Abstract	Background/aim: Despite remission or low disease activity non-inflammatory complaints like exhaustion, fatigue, and pain persist in a significant proportion of patients with systemic lupus erythematosus (SLE) and have a considerable impact on health-related quality of life. This study evaluated the effects of balneotherapy on non-inflammatory complaints, quality of life, and work productivity of patients with SLE. Patients and methods: SLE patients in remission/low disease activity in three rheumatology centers were included in this randomized, controlled, follow-up study. In addition to the standard of care (SOC), sixteen out of the thirty patients with SLE received balneotherapy (3-week period, 15 times, for 30 min) and fourteen patients received the SOC only. Pre-validated survey instruments including Lupus Quality of Life (LupusQoL), Short-Form Health Survey (SF-36), Work Productivity, and Activity Impairment-Lupus (WPAI-Lupus) questionnaires were used. Results: Based on the SF-36 questionnaires, several subdomains of physical condition improved significantly after the course; the improvement remained durable (p=0.019). General health improved significantly by the end of the course (p=0.001). According to the LupusQoL questionnaire, physical health and pain showed a tendency of improvement shortly after the spa treatment. Changes in the WPAI-lupus questionnaire indicated a short-term improvement of the daily activity by the end of the observation period. No adverse reactions were observed. Conclusion: Thermal water therapy may be an effective, well-tolerated, complementary non-pharmacological approach for non-inflammatory complaints of patients with SLE. Physical condition improved in the short-term, whereas fatigue worsened despite treatment.
MeSH term(s)	Humans ; Quality of Life ; Pilot Projects ; Follow-Up Studies ; Surveys and Questionnaires ; Lupus Erythematosus, Systemic/therapy ; Fatigue/etiology ; Fatigue/therapy ; Pain ; Balneology ; Severity of Illness Index
Language	English
Publishing date	2022-10-29
Publishing country	Greece
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	807031-3
ISSN	1791-7549 ; 0258-851X
ISSN (online)	1791-7549
ISSN	0258-851X
DOI	10.21873/invivo.13046
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Article ; Online: Effectiveness and waning of protection with the BNT162b2 vaccine against the SARS-CoV-2 Delta variant in immunocompromised individuals.

Szekanecz, Zoltán / Vokó, Zoltán / Surján, Orsolya / Rákóczi, Éva / Szamosi, Szilvia / Szűcs, Gabriella / Szekanecz, Éva / Müller, Cecília / Kiss, Zoltán

Frontiers in immunology

2023 Volume 14, Page(s) 1247129

Abstract: Introduction: In Hungary, the HUN-VE 3 study determined the comparative effectiveness of various primary and booster vaccination strategies during the Delta COVID-19 wave. That study included more than 8 million 18-100-year-old individuals from the ... ...

Abstract	Introduction: In Hungary, the HUN-VE 3 study determined the comparative effectiveness of various primary and booster vaccination strategies during the Delta COVID-19 wave. That study included more than 8 million 18-100-year-old individuals from the beginning of the pandemic. Immunocompromised (IC) individuals have increased risk for COVID-19 and disease course might be more severe in them. In this study, we wished to estimate the risk of SARS-CoV-2 infection and COVID-19 related death in IC individuals compared to healthy ones and the effectiveness of the BNT162b2 vaccine by reassessing HUN-VE 3 data. Patients and methods: Among the 8,087,988 individuals undergoing follow-up from the onset of the pandemic in the HUN-VE 3 cohort, we selected all the 263,116 patients with a diagnosis corresponding with IC and 6,128,518 controls from the second wave, before vaccinations started. The IC state was defined as two occurrences of corresponding ICD-10 codes in outpatient or inpatient claims data since 1 January, 2013. The control group included patients without chronic diseases. The data about vaccination, SARS-CoV-2 infection and COVID-19 related death were obtained from the National Public Health Center (NPHC) during the Delta wave. Cases of SARS-CoV-2 infection were reported on a daily basis using a centralized system via the National Public Health Center (NPHC). Results: Out of the 263,116 IC patients 12,055 patients (4.58%) and out of the 6,128,518 healthy controls 202,163 (3.30%) acquired SARS-CoV-2 infection. Altogether 436 IC patients and 2141 healthy controls died in relation to COVID-19. The crude incidence rate ratio (IRR) of SARS-CoV-2 infection was 1.40 (95%CI: 1.37-1.42) comparing IC patients to healthy controls. The crude mortality rate ratio was 4.75 (95%CI: 4.28-5.27). With respect to SARS-CoV-2 infection, interestingly, the BNT162b2 vaccine was more effective in IC patients compared to controls. Primary vaccine effectiveness (VE) was higher in IC patients compared to controls and the booster restored VE after waning. VE regarding COVID-19 related death was less in IC patients compared to healthy individuals. Booster vaccination increased VE against COVID-19-related death in both IC patients and healthy controls. Conclusion: There is increased risk of SARS-CoV-2 infection and COVID-19 related mortality in IC patient. Moreover, booster vaccination using BNT162b2 might restore impaired VE in these individuals.
MeSH term(s)	Humans ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; SARS-CoV-2 ; COVID-19/epidemiology ; COVID-19/prevention & control ; BNT162 Vaccine ; Vaccines
Chemical Substances	BNT162 Vaccine ; Vaccines
Language	English
Publishing date	2023-11-02
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2023.1247129
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Article ; Online: Novel aspects of muscle involvement in immune-mediated inflammatory arthropathies and connective tissue diseases.

Mogyoróssy, Sándor / Nagy-Vincze, Melinda / Griger, Zoltán / Dankó, Katalin / Szabó, Nóra Anna / Szekanecz, Zoltán / Szűcs, Gabriella / Szántó, Antónia / Bodoki, Levente

Autoimmunity reviews

2023 Volume 22, Issue 5, Page(s) 103311

Abstract: Myalgia, myopathy and myositis are the most important types of muscle impairment in immune-mediated inflammatory arthropathies and connective tissue diseases. Multiple pathogenetic and histological changes occur in the striated muscles of these patients. ...

Abstract	Myalgia, myopathy and myositis are the most important types of muscle impairment in immune-mediated inflammatory arthropathies and connective tissue diseases. Multiple pathogenetic and histological changes occur in the striated muscles of these patients. Clinically, the most important muscle involvement is the one that causes complaints to the patients. In everyday practice, insidious symptoms present a serious problem for the clinician; in many cases, it is difficult to decide when and how to treat the muscle symptoms that are often present only subclinically. In this work, authors review the international literature on the types of muscle problems in autoimmune diseases. In scleroderma histopathological picture of muscle shows a very heterogeneous picture, necrosis and atrophy are common. In rheumatoid arthritis and systemic lupus erythematosus, myopathy is a much less defined concept, further studies are needed to describe it. According to our view, overlap myositis should be recognized as a separate entity, preferably with distinct histological and serological characteristics. More studies are needed to describe muscle impairment in autoimmune diseases which may help to explore this topic more in depth and be of clinical use.
MeSH term(s)	Humans ; Connective Tissue Diseases/complications ; Myositis ; Autoimmune Diseases/complications ; Muscular Diseases/etiology ; Lupus Erythematosus, Systemic/complications ; Arthritis, Rheumatoid/complications ; Muscle, Skeletal/pathology ; Scleroderma, Systemic/complications
Language	English
Publishing date	2023-03-07
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.2023.103311
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Article ; Online: Psoriatic arthritis and its special features predispose not only for osteoporosis but also for fractures and falls.

Halasi, Andrea / Szegedi, Andrea / Törőcsik, Dániel / Varga, József / Farmasi, Nikolett / Szűcs, Gabriella / Tarr, Tünde / Gaál, János

The Journal of dermatology

2023 Volume 50, Issue 5, Page(s) 608–614

Abstract: Limited data are available on the predisposing factors to fractures and falls of patients with psoriatic arthritis (PsA). Our study intended to explore the differences between PsA patients and controls, concerning bone mineral density (BMD), the 10-year ... ...

Abstract	Limited data are available on the predisposing factors to fractures and falls of patients with psoriatic arthritis (PsA). Our study intended to explore the differences between PsA patients and controls, concerning bone mineral density (BMD), the 10-year fracture risk, the number of prevalent fractures, the frequency of falls and to investigate the association of the same factors with PsA disease characteristics within the PsA group. Medical reports of 61 PsA patients and 69 consecutive, age-matched controls were analyzed, physical examination and bone mineral density (BMD, and T-score) were performed, and the 10-year fracture risk was calculated. The results were subjected to statistical analysis. Femoral neck BMD, as well as vertebral and femoral neck T-scores were lower, the odds ratio (OR) for low BMD and the 10-year risk of hip fracture was higher (p = 0.0029; 0.0002, p < 0.0001, OR = 21,9, p = 0.014) in the PsA group. The PsA patients were more predisposed to prevalent fractures, including peripheral fractures, and vertebral fractures as well as falls (OR 3.42; 2.26; 13.33; 3.95, respectively), compared to controls. Within the PsA group (beyond the age) scalp psoriasis and late-onset psoriasis, were significantly associated with a greater number of prevalent fractures (p = 0.0049; 0.029), while the number of falls per year correlated with late-onset psoriasis and the flexural psoriasis (p = 0.007; 0.023). Our results suggest that PsA is an independent risk factor for reduced bone density and falls hence to related bone fractures. Patients with late-onset psoriasis are more likely to suffer falls and related fractures, especially if their disease is characterized by the involvement of the hairy scalp and body folds.
MeSH term(s)	Humans ; Arthritis, Psoriatic/complications ; Arthritis, Psoriatic/epidemiology ; Osteoporosis/epidemiology ; Osteoporosis/complications ; Fractures, Bone/epidemiology ; Fractures, Bone/etiology ; Bone Density ; Psoriasis/complications ; Risk Factors
Language	English
Publishing date	2023-01-17
Publishing country	England
Document type	Journal Article
ZDB-ID	800103-0
ISSN	1346-8138 ; 0385-2407
ISSN (online)	1346-8138
ISSN	0385-2407
DOI	10.1111/1346-8138.16710
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