Rita Rugiene

Expression of IL-17, IL-23 and Their Receptors in Minor Salivary Glands of Patients with Primary Sjögren's Syndrome

The main purpose of this study was to determine the expression of interleukins-17/-23 (ILs-17/-23) and receptors of interleukins-17/-23 (IL-17R, IL-23R) in minor salivary glands (MSGs) of patients with primary Sjögrens syndrome (pSS). Expression of IL-17, IL-23 and receptors of IL-17/-23 was analyzed in MSGs from 25 patients with pSS, 25 patients with probable preclinical pSS, and 25 patients with nonautoimmune sicca syndrome by immunohistochemistry. Comparison of the expression of IL-17, IL-23 and receptors of IL-17, IL-23 in MSG of patients with pSS with probable preclinical pSS, and with nonautoimmune sicca syndrome showed significant differences between three groups. However, the expression of IL-17, IL-23 and receptors of IL-17/-23 in MSG was comparable in pSS and probable preclinical pSS patients. We did not find correlation between the expression of IL-17 and IL-23 and of IL-17R and IL-23R in patients with pSS. These results demonstrate an involvement of IL-17/-23 system in the early pSS pathogenesis.

Arterial wall dysfunction in systemic lupus erythematosus

Carotid-radial pulse wave velocity (PWV), aortic augmentation index (AIx) and endothelium-dependent flow-mediated dilatation (FMD) have been repeatedly showed to be related to premature atherosclerosis and cardiovascular diseases in different settings of population. The increased arterial stiffness and endothelium dysfunction may add to premature aging of the arteries in systemic lupus erythematosus (SLE) patients. Still data about arterial stiffness and endothelium function in inflammatory rheumatic diseases are not well described. The aim of this study was to determine the PWV, its derivate marker AIx and FMD and factors possibly influencing them in young SLE women without significant organ damage. Thirty women between 23 and 55 years with an established SLE diagnosis and 66 healthy women were consequently included in the study and both groups were comparable according to age, body mass index (BMI), serum lipid profile and creatinine. PWV was determined by measuring carotid-radial pulse wave transit time with the help of applanation tonometry and AIx, its derivate marker, was calculated as a difference between two waveform peaks expressed as a percentage of the pulse pressure. The FMD was performed by obtaining the repeated scans of the brachial artery at rest and during reactive hyperemia. In SLE women, PWV and AIx were significantly higher and FMD was not different from controls. In linear multiple stepwise regression analysis if patients and controls were both considered, PWV was weakly related to mean blood pressure (MBP), AIx was mostly predicted by age and MBP and FMD was predicted by the diameter of blood vessel, BMI, high density lipoproteins. If the sole SLE setting was analyzed, PWV was not related to any of the pending parameters, AIx turned out to be related to organ damage measured by Systemic Lupus International collaborative Clinics (SLICC) index and age, and FMD obtained strong and significant relation with vessel diameter, and BMI, and disease duration. Regardless of the small number of study group patients, we can state that controlling for MBP and taking measures towards organ damage prevention can partially slow down the process of early atherosclerosis in SLE patients.

The Prevalence of Systemic Lupus Erythematosus in Lithuania: The Lowest Rate in Northern Europe

The aim of this study was to explore the prevalence of systemic lupus erythematosus (SLE) in Lithuania (Vilnius). Two different studies were designed for SLE cases identification: registry-based SLE study and population-based SLE study. For the registry-based study patients were enrolled during the period of 1999-2004 and from two sources, including out-patient clinics of Vilnius and tertiary rheumatology center with interview during the year 2004. Only Vilnius residents who fulfilled the ACR 1982 revised criteria for the classification of SLE were counted in this study. Seventy-six living adult patients with SLE were interviewed and accounted for the prevalence of 16.2/100 000 (0.016%) using the Vilnius adult population in January 2004 (a population of 470 451). The population study of randomly selected 10 000 Vilnius inhabitants with beforehand validation of the survey was performed in the same year. The population-based study revealed two cases for 4017 respondents, but the low response rate may be important. Extrapolating the results to population of 10 000 inhabitants, the point prevalence of SLE in the entire sample was at least 0.02%. Therefore, the prevalence of SLE in Lithuania is the lowest if compared to Northern European countries.

Parvovirus B19 infection modulates the levels of cytokines in the plasma of rheumatoid arthritis patients

Background Parvovirus B19 (B19V) infection is associated with various autoimmune diseases. We investigated the levels of pro‐inflammatory (IFN&ggr;, TNF&agr;, IL‐2, IL‐12) and anti‐inflammatory (IL‐4, IL‐10) cytokines in the plasma of B19V DNA positive (B19+) and negative (B19−) rheumatoid arthritis (RA) patients in comparison with the control group (healthy persons). Methods Blood samples were collected from 118 patients with RA and 49 healthy voluntaries. B19V sequence was determined in whole blood and cell‐free plasma DNA by nested PCR. The levels of cytokines in the plasma and cell culture medium from Concanavalin A (ConA) or B19V VP1 protein stimulated PBMC were determined by ELISA. Results The levels of IL‐4, IL‐10, IL‐12, IL‐2 and TNF&agr; were higher in plasma of RA patients in comparison with control persons. B19+ controls and RA patients had lower levels of IFN&ggr; in comparison with B19− controls and RA patients. Within RA patients the plasma levels of IFN&ggr; were lower in patients with low RA disease activity or remission. Plasma level of IL‐4 was increased and IL‐10 level was decreased in B19+ RA patients in comparison with B19− RA patients and did not differ between B19+ and B19− controls. B19V infection did not affect plasma levels of IL‐12, IL‐2, and TNF&agr;. ConA and B19 VP1 protein stimulated PBMC from RA patients produced less IFN&ggr; than stimulated PBMC from the healthy controls. Conclusions B19V infection could differently modulate the amount of cytokines in the plasma of healthy persons and RA patients. Decreased production of IFN&ggr; and raised level of plasma IL‐4 in RA patients could lower antiviral clearance. HighlightsCytokine levels in parvovirus B19 DNA positive and negative individuals were investigated.Parvovirus B19 reduces INF&ggr; plasma levels in rheumatoid arthritis patients.Parvovirus B19 elevates IL‐4 plasma levels in rheumatoid arthritis patients.Parvovirus B19 reduces IL‐10 plasma levels in rheumatoid arthritis patients.B19V infection did not affect plasma levels of IL‐12, IL‐2, and TNF&agr;.

Frequency and significance of parvovirus B19 infection in patients with rheumatoid arthritis

The present study aims to clarify the possible involvement of parvovirus B19 (B19V) infection in rheumatoid arthritis (RA) pathogenesis by investigating the presence of B19V infection markers (genomic sequences and virus-specific antibodies) in association with the level of cytokines and RA clinical activity and aggressiveness. A total of 118 RA patients and 49 age- and sex-matched healthy volunteers were enrolled in the study. Nested PCR was used to detect B19V sequences in whole blood and cell-free plasma DNA, ELISA to detect virus-specific antibodies and cytokine levels in plasma and recomLine dot blot assay for antibodies to separate B19V antigens. The detection frequency of B19V DNA was higher in patients with RA (25.4 %) in comparison with healthy persons (18.4 %). B19V DNA in cell-free plasma (B19+p) was detected significantly often in RA patients in comparison with healthy controls (13.6 vs 2 %; P=0.0002). RA B19+p patients had higher disease activity and aggressiveness, decreased haemoglobin and increased erythrocyte sedimentation rates. IL-6 plasma levels were significantly higher in RA patients than in controls. Within the RA patients’ group the IL-6 level was significantly increased in B19+p patients with disease activity scores of DAS28>5.2, high C-reactive protein and low haemoglobin. Contrary to the healthy controls, the majority of RA B19+p patients did not have antibodies to VP-1S (VP1u) and VP-N (N-terminal half of structural proteins VP1 and VP2), which correspond to the epitopes of neutralizing antibodies. These results indicate that B19V infection at least in some patients is involved in RA pathogenesis.

Anti‐TIF1‐gamma antibodies are not associated with other paraneoplastic rheumatic syndromes than dermatomyositis

An association between cancer and dermatomyositis (DM) is well recognized. The high frequency of malignancies detected close to DM diagnosis suggest that DM can be a paraneoplastic syndrome. Recently, anti–transcription intermediary factor 1γ (anti‐TIF1γ) has been discovered to be associated with cancer and with DM. A meta‐analysis reported the pooled sensitivity of anti‐p155 for diagnosing cancer‐associated DM to be 78% and the specificity to be 89%. Thus, anti‐TIF1γ has shown promising results as a marker for cancer‐associated DM. However, none of the studies evaluated the association of anti‐TIF1γ with cancer with or without rheumatic diseases other than DM. To clarify the specificity of anti‐TIF1γ antibodies as a biomarker for cancer‐associated DM, we analyzed the frequency of anti‐TIF1γ antibodies in other cancer‐associated rheumatic syndromes, as well as in cancer patients and healthy controls.