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  • Medicine  (10)
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  • 1
    In: Arthritis & Rheumatology, Wiley, Vol. 66, No. 5 ( 2014-05), p. 1121-1132
    Abstract: To investigate differences in genetic risk factors for rheumatoid arthritis (RA) in Han Chinese as compared with Europeans. Methods A genome‐wide association study was conducted in China with 952 patients and 943 controls, and 32 variants were followed up in 2,132 patients and 2,553 controls. A transpopulation meta‐analysis with results from a large European RA study was also performed to compare the genetic architecture across the 2 ethnic remote populations. Results Three non–major histocompatibility complex (non‐MHC) loci were identified at the genome‐wide significance level, the effect sizes of which were larger in anti–citrullinated protein antibody (ACPA)–positive patients than in ACPA‐negative patients. These included 2 novel variants, rs12617656, located in an intron of DPP4 (odds ratio [OR] 1.56, P = 1.6 × 10 −21 ), and rs12379034, located in the coding region of CDK5RAP2 (OR 1.49, P = 1.1 × 10 −16 ), as well as a variant at the known CCR6 locus, rs1854853 (OR 0.71, P = 6.5 × 10 −15 ). The analysis of ACPA‐positive patients versus ACPA‐negative patients revealed that rs12617656 at the DPP4 locus showed a strong interaction effect with ACPAs ( P = 5.3 × 10 −18 ), and such an interaction was also observed for rs7748270 at the MHC locus ( P = 5.9 × 10 −8 ). The transpopulation meta‐analysis showed genome‐wide overlap and enrichment in association signals across the 2 populations, as confirmed by prediction analysis. Conclusion This study has expanded the list of alleles that confer risk of RA, provided new insight into the pathogenesis of RA, and added empirical evidence to the emerging polygenic nature of complex trait variation driven by common genetic variants.
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
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    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2754614-7
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  • 2
    In: Arthritis & Rheumatology, Wiley, Vol. 66, No. 7 ( 2014-07), p. 1881-1881
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
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    Language: English
    Publisher: Wiley
    Publication Date: 2014
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  • 3
    In: Arthritis & Rheumatology, Wiley, Vol. 72, No. 12 ( 2020-12), p. 1998-2004
    Abstract: Coagulopathy is one of the characteristics observed in critically ill patients with coronavirus disease 2019 (COVID‐19). Antiphospholipid antibodies (aPLs) contribute to coagulopathy, though their role in COVID‐19 remains unclear. This study was undertaken to determine the prevalence and characteristics of aPLs in patients with COVID‐19. Methods Sera collected from 66 COVID‐19 patients who were critically ill and 13 COVID‐19 patients who were not critically ill were tested by chemiluminescence immunoassay for anticardiolipin antibodies (aCLs), anti–β 2 ‐glycoprotein I (anti‐β 2 GPI) (IgG, IgM, and IgA), and IgG anti‐β 2 GPI–domain 1 (anti‐β 2 GPI–D1) and IgM and IgG anti–phosphatidylserine/prothrombin (anti‐PS/PT) antibodies were detected in the serum by enzyme‐linked immunosorbent assay. Results Of the 66 COVID‐19 patients in critical condition, aPLs were detected in 31 (47% ). Antiphospholipid antibodies were not present among COVID‐19 patients who were not in critical condition. The IgA anti‐β 2 GPI antibody was the most commonly observed aPL in patients with COVID‐19 and was present in 28.8% (19 of 66) of the critically ill patients, followed by IgA aCLs (17 of 66, or 25.8%) and IgG anti‐β 2 GPI (12 of 66, or 18.2%). For multiple aPLs, IgA anti‐β 2 GPI + IgA aCLs was the most common antibody profile observed (15 of 66, or 22.7%), followed by IgA anti‐β 2 GPI + IgA aCL + IgG anti‐β 2 GPI (10 of 66, or 15.2%). Antiphospholipid antibodies emerge ~35–39 days after disease onset. A dynamic analysis of aPLs revealed 4 patterns based on the persistence or transient appearance of the aPLs. Patients with multiple aPLs had a significantly higher incidence of cerebral infarction compared to patients who were negative for aPLs ( P = 0.023). Conclusion Antiphospholipid antibodies were common in critically ill patients with COVID‐19. Repeated testing demonstrating medium to high titers of aPLs and the number of aPL types a patient is positive for may help in identifying patients who are at risk of developing cerebral infarction. Antiphospholipid antibodies may be transient and disappear within a few weeks, but in genetically predisposed patients, COVID‐19 may trigger the development of an autoimmune condition similar to the antiphospholipid syndrome (APS), referred to as “COVID‐19–induced APS‐like syndrome.” Long‐term follow‐up of COVID‐19 patients who are positive for aPLs would be of great importance in understanding the pathogenesis of this novel coronavirus.
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
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    Language: English
    Publisher: Wiley
    Publication Date: 2020
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  • 4
    In: Arthritis & Rheumatology, Wiley, Vol. 70, No. 2 ( 2018-02), p. 287-297
    Abstract: Recent evidence from genetic, cell biology, and animal model studies has suggested a pivotal role of autophagy in mediating systemic lupus erythematosus ( SLE ). However, the genetic basis has not yet been thoroughly examined. Therefore, the aim of the present study was to identify additional susceptibility variants in autophagy‐related genes along with their functional significance. Methods First, we performed a gene family–based genetic association analysis in SLE patients with the use of ImmunoChip arrays, and then we selected the most strongly associated polymorphisms for replication in additional cohorts. To identify regulatory clues, we analyzed publicly available blood expression quantitative trait locus data and Encyclopedia of DNA Elements data on transcription factor binding sites and cell type‐specific differential expression. Functional effects were tested by luciferase reporter assays, electrophoretic mobility shift assays, and differential gene expression assays. Results In 14,474 samples, we observed that the rare Chinese variant rs933717T was associated with susceptibility to SLE (0.11% in cases versus 0.87% in controls; P = 2.36 × 10 – 10 , odds ratio 0.13). The rs933717 risk allele C correlated with increased MAP 1 LC 3B expression; increased MAP 1 LC 3B messenger RNA was observed in SLE patients and in lupus‐prone mice. In reporter gene constructs, the risk allele increased luciferase activity up to 2.7‐3.8‐fold in both HEK 293T and Jurkat cell lines, and the binding of HEK 293T and Jurkat cell nuclear extracts to the risk allele was also increased. Conclusion We observed a likely genetic association between light chain 3B, a widely used marker for autophagy, and susceptibility to SLE .
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
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    Language: English
    Publisher: Wiley
    Publication Date: 2018
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  • 5
    In: Arthritis Care & Research, Wiley, Vol. 76, No. 5 ( 2024-05), p. 703-711
    Abstract: There is an unmet need for simpler urate‐lowering therapy (ULT) regimens that achieve the serum urate target and improve the overall quality of gout care. We report a comparative effectiveness trial of febuxostat monotherapy versus benzbromarone add‐on to low‐dose febuxostat in gout specifically with combined renal urate underexcretion and overload. Methods A prospective randomized trial was conducted on patients with combined‐type hyperuricemia and estimated glomerular filtration rate 〉 60 mL/min/1.73 m 2 1:1 randomly assigned to febuxostat and benzbromarone combination therapy (initially febuxostat at 20 mg/day, with benzbromarone at 25 mg/day added onto 20 mg/day of febuxostat if not at target) or febuxostat monotherapy (initially 20 mg/day, escalating to 40 mg/day if not at target). The primary end point at 12 weeks was the proportion achieving a serum urate (SU) level 〈 360 μmol/L. Other outcomes included altered liver and kidney function, new‐onset urolithiasis, and gout flares. Results There were 250 participants randomized; 219 completed 12‐week treatment. More patients in the febuxostat and benzbromarone combination group achieved the SU target compared to patients in the febuxostat monotherapy group (75.5% vs 47.7%; odds ratio 3.37 [95% confidence interval 1.90–5.98]). Safety profiles were comparable between the two groups. Conclusion Simply adding on low‐dose benzbromarone (25 mg/day) to low‐dose (20 mg/day) febuxostat showed superior urate lowering compared to febuxostat monotherapy in gout with a combined‐type hyperuricemia. For selected patients, expedited achievement of the SU target in more than 75% of patients using one titration step and low xanthine oxidase inhibitor and uricosuric doses is a potential alternative to standard ULT regimens.
    Type of Medium: Online Resource
    ISSN: 2151-464X , 2151-4658
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    Language: English
    Publisher: Wiley
    Publication Date: 2024
    detail.hit.zdb_id: 2016713-1
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  • 6
    In: Arthritis Care & Research, Wiley
    Abstract: To assess post‐COVID‐19 vaccination gout flare risk with differing baseline flare burden. Methods We prospectively studied gout patients with infrequent or frequent flares, defined as ≤1 flare/year, or ≥2 flares/year, respectively. COVID‐19 vaccine‐naïve patients managed with urate‐lowering therapy between February‐June 2021were included, and voluntarily decided on vaccination. Participants were followed for 12 weeks after enrollment or first vaccine dose. Gout flares and risk factors were compared between groups. Results Of 530 participants, 308 (58.1%) had infrequent flares, and 222 (41.9%) had frequent flares at baseline, with 248 (142 infrequent, 106 frequent) receiving two‐dose COVID‐19 vaccination. Vaccination increased cumulative flare incidence at 12 weeks in the infrequent but not the frequent flare group (26.1% vs. 10.8%, P =0.001, compared to 60.4% vs. 65.5%, P =0.428). Flare incidence in the final 4 weeks of observation decreased significantly only in the vaccinated infrequent flare group (4.3% vs. 12.0%, P =0.017). Multivariable analyses showed that vaccination (OR=2.82, 95%CI 1.50‐5.30, P =0.001), flare in the preceding year (OR=1.95, 95%CI 1.03‐3.71, P =0.04) and BMI (OR=1.09, 95%CI 1.01‐1.19, P =0.03) were independently associated with increased flare risk in the infrequent flare group. Baseline serum urate (mg/dL) was an independent risk factor in the frequent flare group (OR=1.23, 95%CI 1.05‐1.45, P =0.012). Conclusion COVID‐19 vaccination was associated with increased early gout flares only in patients with previously infrequent flares. image
    Type of Medium: Online Resource
    ISSN: 2151-464X , 2151-4658
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    Language: English
    Publisher: Wiley
    Publication Date: 2023
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  • 7
    In: Arthritis & Rheumatology, Wiley, Vol. 74, No. 12 ( 2022-12), p. 2015-2023
    Abstract: The predominant mechanism driving hyperuricemia in gout is renal uric acid underexcretion; however, the standard urate‐lowering therapy (ULT) recommendation is first‐line xanthine oxidase inhibitor (XOI), irrespective of the cause of hyperuricemia. This comparative effectiveness clinical trial was undertaken to compare first‐line nontitrated low‐dose benzbromarone (LDBen) uricosuric therapy to XOI ULT with low‐dose febuxostat (LDFeb) in gout patients with renal uric acid underexcretion. Methods We conducted a prospective, randomized, single‐center, open‐label trial in men with gout and renal uric acid underexcretion (defined as fractional excretion of urate 〈 5.5% and uric acid excretion ≤600 mg/day/1.73 m 2 ). A total of 196 participants were randomly assigned to receive LDBen 25 mg daily or LDFeb 20 mg daily for 12 weeks. All participants received daily urine alkalization with oral sodium bicarbonate. The primary end point was the rate of achieving the serum urate target of 〈 6 mg/dl. Results More participants in the LDBen group achieved the serum urate target than those in the LDFeb group (61% compared to 32%, P   〈  0.001). Rates of adverse events, including gout flares and urolithiasis, did not differ between groups, with the exception of greater transaminase elevation in the LDFeb group (4% for LDBen compared to 15% for LDFeb, P  = 0.008). Conclusion Compared to LDFeb, LDBen has superior urate‐lowering efficacy and similar safety in treating relatively young and healthy patients with renal uric acid underexcretion–type gout.
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
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    Language: English
    Publisher: Wiley
    Publication Date: 2022
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  • 8
    In: Arthritis & Rheumatology, Wiley, Vol. 66, No. 4 ( 2014-04), p. 822-830
    Abstract: Leukocyte immunoglobulin‐like receptor A3 belongs to a family of receptors with inhibitory or activating functions. Since Caucasian individuals lacking LILRA3 have been found to be susceptible to multiple sclerosis and Sjögren's syndrome, we undertook this study to examine whether LILRA3 deletion is a novel genetic risk factor for rheumatoid arthritis (RA) (another autoimmune disease), whether there are sex‐specific effects, and whether LILRA3 influences the subtype and severity of RA. Methods The LILRA3 deletion and its tagging single‐nucleotide polymorphism rs103294 were genotyped in a Northern Han Chinese cohort (N‐Han) (1,618 cases and 1,658 controls) and a Southern Han Chinese cohort (S‐Han) (575 cases and 549 controls). Association analyses were performed on the complete data set and subsets. The effect of the nondeleted (functional) LILRA3 allele on radiographic severity and LILRA3 expression was evaluated. Results In the N‐Han discovery cohort, we unexpectedly observed a higher frequency of the functional LILRA3 in RA patients compared with healthy individuals (10.1% versus 6.3%; P = 4.01 × 10 −5 , odds ratio [OR] 1.92). The association was replicated in the S‐Han cohort and confirmed by meta‐analysis ( P = 5.63 × 10 −6 , OR 1.83). Functional LILRA3 conferred greater risk for RA in males ( P = 1.09 × 10 −6 , OR 4.47), and was specifically associated with anti–citrullinated protein antibody (ACPA)–positive RA ( P = 3.05 × 10 −4 , OR 1.75). Furthermore, functional LILRA3 was associated with higher radiographic scores in ACPA‐positive patients with early RA ( P = 9.70 × 10 −3 ) and higher LILRA3 messenger RNA levels ( P = 3.31 × 10 −8 ). Conclusion Our study provides the first evidence that functional LILRA3 is a novel genetic risk factor for RA, especially in males. It appears to highly predispose to ACPA‐positive RA and confers an increased risk of disease severity in patients with early RA.
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
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    Language: English
    Publisher: Wiley
    Publication Date: 2014
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  • 9
    In: Arthritis & Rheumatology, Wiley, Vol. 66, No. 12 ( 2014-12), p. 3413-3423
    Abstract: To evaluate whether olfactory 1/early B cell factor–associated zinc‐finger protein (OAZ), a candidate lupus susceptibility gene involved in antinuclear antibody (ANA) production, plays a role in the regulation of B cells by mesenchymal stem cells (MSCs). Methods MSCs derived from the bone marrow of patients with systemic lupus erythematosus (SLE) and healthy control subjects were expanded and incubated with small interfering RNAs specific for OAZ or a nontargeting sequence. Knockdown of messenger RNA levels of OAZ and its downstream genes was measured using real‐time polymerase chain reaction, and protein levels of chemokine/cytokine and immunoglobulins were determined by enzyme‐linked immunosorbent assay or Western blotting. The effects of modulating the OAZ levels in MSCs, by either silencing or overexpression, on B cell proliferation and terminal differentiation were assessed by coculturing MSCs with mouse spleen cells. Results OAZ gene expression was highly enriched in MSCs compared with peripheral blood leukocytes and was increased in patients with SLE compared with control subjects. After the silencing of OAZ expression, SLE MSCs could regain the ability to inhibit B cell proliferation and terminal differentiation, as indicated by decreased percentages of bromodeoxyuridine‐positive cells and CD138+ cells as well as decreased levels of IgG, IgM, and ANAs. The level of CCL2 was increased after OAZ knockdown, while anti‐CCL2 antibodies completely counteracted the effect of OAZ silencing. Umbilical cord–derived normal MSCs that overexpressed OAZ had a diminished ability to inhibit B cell proliferation and terminal differentiation. Conclusion OAZ down‐regulation could restore the impaired function of SLE MSCs in the immune regulation of B cells, contributing to a reduction in ANA levels. OAZ might represent a new target for therapy in patients with SLE.
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
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    Language: English
    Publisher: Wiley
    Publication Date: 2014
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  • 10
    In: Arthritis & Rheumatology, Wiley, Vol. 67, No. 11 ( 2015-11), p. 2966-2977
    Abstract: Previous genome‐wide association studies (GWAS), which were mainly based on single‐variant analysis, have identified many systemic lupus erythematosus (SLE) susceptibility loci. However, the genetic architecture of this complex disease is far from being understood. The aim of this study was to investigate whether using a gene‐based analysis may help to identify novel loci, by considering global evidence of association from a gene or a genomic region rather than focusing on evidence for individual variants. Methods Based on the results of a meta‐analysis of 2 GWAS of SLE conducted in 2 Asian cohorts, we performed an in‐depth gene‐based analysis followed by replication in a total of 4,626 patients and 7,466 control subjects of Asian ancestry. Differential allelic expression was measured by pyrosequencing. Results More than one‐half of the reported SLE susceptibility loci showed evidence of independent effects, and this finding is important for understanding the mechanisms of association and explaining disease heritability. ANXA6 was detected as a novel SLE susceptibility gene, with several single‐nucleotide polymorphisms (SNPs) contributing independently to the association with disease. The risk allele of rs11960458 correlated significantly with increased expression of ANXA6 in peripheral blood mononuclear cells from heterozygous healthy control subjects. Several other associated SNPs may also regulate ANXA6 expression, according to data obtained from public databases. Higher expression of ANXA6 in patients with SLE was also reported previously. Conclusion Our study demonstrated the merit of using gene‐based analysis to identify novel susceptibility loci, especially those with independent effects, and also demonstrated the widespread presence of loci with independent effects in SLE susceptibility genes.
    Type of Medium: Online Resource
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    Language: English
    Publisher: Wiley
    Publication Date: 2015
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