• Title/Summary/Keyword: Lupus erythematosus

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Dyslipidemia promotes germinal center reactions via IL-27

  • Ryu, Heeju;Chung, Yeonseok
    • BMB Reports
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    • v.51 no.8
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    • pp.371-372
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    • 2018
  • Cardiovascular disease such as atherosclerosis is caused by imbalanced lipid metabolism and represents a leading cause of death worldwide. Epidemiological studies show that patients with systemic autoimmune diseases exhibit a higher incidence of atherosclerosis. Conversely, hyperlipidemia has been known to accelerate the incidence of autoimmune diseases in humans and in animal models. However, there is a considerable gap in our understanding of how atherosclerosis impacts the development of the autoimmunity in humans, and vice versa. The atherosclerosis-related autoimmune diseases include psoriasis, rheumatoid arthritis, systemic lupus erythematosus (SLE) and diabetes mellitus. By using animal models of atherosclerosis and SLE, we have recently demonstrated that hyperlipidemia significantly accelerates the development of autoantibodies, by inducing autoimmune follicular helper T ($T_{FH}$) cells. Mechanistic studies have identified that hyperlipidemia induces IL-27 production in a TLR4-dependent manner, likely via downregulating LXR expression in dendritic cells. In this case, mice lacking IL-27 do not develop enhanced antibody responses. Thus it is noted that these findings propose a mechanistic insight responsible for the tight association between cardiovascular diseases and SLE in humans.

Renal Localization of Ga-67 Citrate in Noninfectious Nephritis (비세균성 신염환자에서 신장내 $^{67}Ga-Citrate$ 흡수에 관한 연구)

  • Lee, Kang-Wook;Jeong, Min-Soo;Rhee, Sunn-Kgoo;Kim, Sam-Yong;Shin, Young-Tai;Ro, Heung-Kyu
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.318-326
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    • 1992
  • Ga-67 citrate scan has been requested for detection or follow-up of inflammatory or neoplastic disease. Visualization of Ga-67 citrate in the kidneys at 48 and 72 hr post injection is usually interpreted as evidence of renal pathology. But precise mechanisms of abnormal Ga-67 uptake in kidneys were unknown. We undertook a study to determine the clinical value of Ga-67 citrate imaging of the kidneys in 68 patients with primary or secondary nephropathy confirmed by renal biopsy and 66 control patients without renal disease. Renal uptake in 48 to 72 hr images was graded as follows: Grade 0=back-ground activity:1=faint uptake greater than background;2=definite uptake, but less than lumbar vertebrae; 3=same uptake as lumbar vertebrae, but less than liver; 4=same or higher uptake than liver. The results were as follows. 1) 42 of 65 (62%) patients with noninfectious nephritis showed grade 2 or higher Ga-67 renal uptake but only 10 percent of control patients showed similar uptake. 2) In 14 patients with systemic lupus erythematosus, 8 of 9 (89%) patients with lupus nephritis exhibited marked renal uptake 3) 36 of 41 patients (88%) with combined nephrotic syndrome showed Grade 2 or higher renal uptake. 4) Renal Ga-67 uptake was correlated with clinical severity of nephrotic syndrome determined by serum albumin level, 24 hr urine protein excretion and serum lipid levels. 5) After complete remission of nephrotic syndrome, renal uptake in all 8 patients who were initially Grade 3 or 4, decreased to Grade 1 or 0. In conclusion, we think that the mechanism of renal Ga-67 uptake in nephrotic syndrome might be related to the pathogenesis of nephrotic syndrome. In systemic lupus erythematosus, Ga-67 citrate scan is useful in predicting renal involvement.

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The study on Fatigue, Pain, and Efficacy on Pain of Chronic Arthritis and Lupus (만성관절염과 루푸스의 피로, 통증, 및 통증효능감에 관한 연구)

  • Lim, Nan-Young;Lee, Eun-Young;Yang, Yong-Sook;Chung, Soon-Ae;Cha, Gyeong-Ok;Yi, Yeo-Jin
    • Journal of muscle and joint health
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    • v.7 no.1
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    • pp.53-62
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    • 2000
  • This study was designed to distinguish by the characteristic difference and the degree of symptoms such as fatigue, pain, coping to pain, and efficacy on pain, and to offer descriptive data for nursing intervention for improving coping ability to pain along each characteristics of disease in chronic arthritis and systemic lupus erythematosus. The subjects were 135 outpatients in the hospital for rheumatic disease in H-university, Seoul. The data were collected by structural questionnaire, from April 29 to June 29, 1999. The results were that the fatigue score was high in the OA patients while the RA patients and SLE patients experienced middle range of fatigue score, but which was not statistically different. Although the RA patients felt higher pain than other diseases, they have well coped with their pain than the others. In efficacy on pain the SLE patients had higher score than others but all of the disease showed lower score. No statistically significant difference among the three group was recorded in efficacy on pain. Therefore, pain management in the RA patients was primary nursing intervention because they felt severe pain and have well coped with pain while they had lower pain efficacy score than the others. It is also important that fatigue management and coping strategies on pain for the OA patients and SLE patients are specially supportive in the nursing intervention.

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A Case of Primary Antiphospholipid Antibody Syndrome Showing Vegetation on the Mitral Valve Through Echocardiography (승모판에서 증식증(vegetation)이 확인된 원발성 항인지질 항체 증후군 1례)

  • Lee, Seung-Yeop;Park, Seung-Kwon;Yun, Sung-Hwan;Jung, Yun-Seok;Kim, Hyen-Jik;Lim, Sung-Hwan;Hah, Jung-Sang;Kim, Wook-Nyeun
    • Journal of Yeungnam Medical Science
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    • v.15 no.2
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    • pp.350-358
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    • 1998
  • Antiphospholipid antibody syndrome(APS) is a well-known clinical syndrome characterized by recurrent arterial or venous thromboses, recurrent fetal loss, thrombocytopenia, together with high titers of sustained anticardiolipin antibody(aCL) or lupus anticoagulant(LA). Although systemic lupus erythematosus(SLB) and APS may coexist, a high proportion of patients manifesting the APS do not suffer from classical lupus or other connective tissue disease. The patient has been defined as having a primary antiphospholipid antibody syndrome. We experienced one case of primary APS with recurrent fetal loss, recurrent cerebral infarctions, positive anticardiolipin antibody IgG and fluttering vegetation on the mitral valve, without other connective tissue diseases including SLE. Forty-three old female had 2 out of 11 criteria for the diagnosis of SLE, such as thrombocytopenia and positive antinuclear antibody, but did not meet whole criteria. The patient was treated with ticlopidine, and anticoagulant therapy was recommended.

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Fludarabine Ameliorates Lupus Nephritis by Inhibiting T Cell Infiltration through STAT1 in R848-induced Mice Models (플루다라빈을 이용한 STAT1 신호전달 조절을 통해 R848로 유도된 루푸스 동물모델 치료 효과 검증 연구)

  • Se Gwang JANG
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.3
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    • pp.207-216
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    • 2024
  • Systemic lupus erythematosus (SLE) is a systemic autoimmune disease caused by both genetic and environmental factors. Fludarabine is a selective inhibitor of signal transducer and activator of transcription 1 (STAT1). Recently, STAT1 inhibitors have been considered potential treatments for SLE, due to the relationship between its pathogenesis and STAT1 pathway-mediated cytokines such as interferons. In the current study, we evaluated the therapeutic effects of fludarabine in an SLE animal model and explored its effects on T cell responses. 12-week-old C57BL/6 mice with topically administered R848 exhibited lupus-like phenotypes. Disease activity, such as proteinuria, autoantibody levels, immunoglobulin titers, the histological score, and C3 deposition, greatly improved with fludarabine treatment. In addition, fludarabine inhibited CD4+ T cells and T helper 1 (Th1) cells in the spleen and significantly decreased the differentiation of Th1 cells in vitro. These results indicate that Th1 cells play a critical role in the pathogenesis of lupus nephritis (LN). Thus, fludarabine exerted therapeutic effects on lupus animal models by suppressing Th1 cells via STAT1 inhibition. We propose that targeting STAT1 signaling using fludarabine could be an effective therapy for treating LN.

A 22-month-old Boy with Acute Glomerulonephritis Coexistent with Hemolytic Anemia and Idiopathic Thrombocytopenia

  • Park, Hye Won;Seo, Bo Seon;Jung, Su Jin;Lee, Jun Ho
    • Childhood Kidney Diseases
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    • v.19 no.1
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    • pp.43-47
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    • 2015
  • Hemolytic anemia and thrombocytopenia are rare clinical manifestations of acute glomerulonephritis. Initially, in all such cases, a diagnosis of hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, systemic lupus erythematosus, and amyloidosis should be ruled out. The presence of hemolytic anemia and thrombocytopenia is rare, but possible, in a case of acute poststreptococcal glomerulonephritis, and may result in delayed diagnosis or misdiagnosis. Correct and timely diagnosis would ensure adequate treatment in such patients. We report of a 22-month-old boy with acute glomerulonephritis coexistent with hemolytic anemia and idiopathic thrombocytopenia.

Role of inflammasomes in inflammatory autoimmune rheumatic diseases

  • Yi, Young-Su
    • The Korean Journal of Physiology and Pharmacology
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    • v.22 no.1
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    • pp.1-15
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    • 2018
  • Inflammasomes are intracellular multiprotein complexes that coordinate anti-pathogenic host defense during inflammatory responses in myeloid cells, especially macrophages. Inflammasome activation leads to activation of caspase-1, resulting in the induction of pyroptosis and the secretion of pro-inflammatory cytokines including interleukin $(IL)-1{\beta}$ and IL-18. Although the inflammatory response is an innate host defense mechanism, chronic inflammation is the main cause of rheumatic diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), and $Sj{\ddot{o}}gren^{\prime}s$ syndrome (SS). Since rheumatic diseases are inflammatory/autoimmune disorders, it is reasonable to hypothesize that inflammasomes activated during the inflammatory response play a pivotal role in development and progression of these diseases. Indeed, previous studies have provided important observations that inflammasomes are actively involved in the pathogenesis of inflammatory/autoimmune rheumatic diseases. In this review, we summarize the current knowledge on several types of inflammasomes during macrophage-mediated inflammatory responses and discuss recent research regarding the role of inflammasomes in the pathogenesis of inflammatory/autoimmune rheumatic diseases. This avenue of research could provide new insights for the development of promising therapeutics to treat inflammatory/autoimmune rheumatic diseases.

Hidden Hematologic Disease in Trauma Patients: A Report of Two Cases

  • Jang, Sung Woo;Jung, Pil Young
    • Journal of Trauma and Injury
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    • v.33 no.2
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    • pp.112-118
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    • 2020
  • In trauma patients, coagulopathy and abnormal increases or decreases in cell counts are frequently observed, and are associated with high mortality and morbidity in the acute phase of trauma. Because major trauma is often life-threatening, and hematologic abnormalities are multi-factorial and transient, major blood loss is usually suspected to be the primary cause of these abnormalities, and much time and cost may be spent attempting to identify a focus of hemorrhage that might or might not actually exist. Persistent abnormalities in the complete blood count, however, require clinical suspicion of other hematologic diseases to minimize improper transfusions and to improve outcomes, including mortality. Physicians at trauma centers should be familiar with the clinical characteristics of hematologic diseases and should consider these diseases in trauma patients. In this report, we present cases of two hematologic disorders found in trauma patients: autoimmune hemolytic anemia induced by systemic lupus erythematosus and myelodysplastic syndrome.

Diffuse Alveolar Hemorrhage

  • Park, Moo Suk
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.4
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    • pp.151-162
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    • 2013
  • Diffuse alveolar hemorrhage (DAH) is a life-threatening and medical emergency that can be caused by numerous disorders and presents with hemoptysis, anemia, and diffuse alveolar infiltrates. Early bronchoscopy with bronchoalveolar lavage is usually required to confirm the diagnosis and rule out infection. Most cases of DAH are caused by capillaritis associated with systemic autoimmune diseases such as anti-neutrophil cytoplasmic antibody-associated vasculitis, anti-glomerular basement membrane disease, and systemic lupus erythematosus, but DAH may also result from coagulation disorders, drugs, inhaled toxins, or transplantation. The diagnosis of DAH relies on clinical suspicion combined with laboratory, radiologic, and pathologic findings. Early recognition is crucial, because prompt diagnosis and treatment is necessary for survival. Corticosteroids and immunosuppressive agents remain the gold standard. In patients with DAH, biopsy of involved sites can help to identify the cause and to direct therapy. This article aims to provide a general review of the causes and clinical presentation of DAH and to recommend a diagnostic approach and a management plan for the most common causes.

Complement regulation: physiology and disease relevance

  • Cho, Heeyeon
    • Clinical and Experimental Pediatrics
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    • v.58 no.7
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    • pp.239-244
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    • 2015
  • The complement system is part of the innate immune response and as such defends against invading pathogens, removes immune complexes and damaged self-cells, aids organ regeneration, confers neuroprotection, and engages with the adaptive immune response via T and B cells. Complement activation can either benefit or harm the host organism; thus, the complement system must maintain a balance between activation on foreign or modified self surfaces and inhibition on intact host cells. Complement regulators are essential for maintaining this balance and are classified as soluble regulators, such as factor H, and membrane-bound regulators. Defective complement regulators can damage the host cell and result in the accumulation of immunological debris. Moreover, defective regulators are associated with several autoimmune diseases such as atypical hemolytic uremic syndrome, dense deposit disease, age-related macular degeneration, and systemic lupus erythematosus. Therefore, understanding the molecular mechanisms by which the complement system is regulated is important for the development of novel therapies for complement-associated diseases.