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nical practice.Hydroxychloroquine is an established therapy for several rheumatological disorders, and very recently it has been proposed as a possible treatment for the new coronavirus disease 2019 even if recent randomised trials did not prove any benefit. Notably, hydroxychloroquine has been associated with a heterogeneous range of cutaneous and extra-cutaneous adverse events. We carried out a narrative review of the literature up to November 1st, 2020, related to the safety of hydroxychloroquine. In particular, cutaneous and extra-cutaneous adverse events associated with hydroxychloroquine were reviewed. The following databases were consulted PubMed, Embase, Google Scholar and ResearchGate. The research of articles was conducted by using the following search terms ''hydroxychloroquine," ''adverse event/effect,'' "cutaneous", "skin", "cardiotoxicity", "retinopathy", gastrointestinal and neurological toxicity". The main indication for which hydroxychloroquine was used in the reports was an immune mediated disorder. Adverse events were described mostly in females over 50 years of age. The most common cutaneous adverse effect was maculopapular and erythematous rash occurring within 4 weeks of initiating hydroxychloroquine and disappearing within few weeks of discontinuation. Gastrointestinal symptoms and headache were the most frequent extracutaneous manifestations. Rarer cutaneous manifestations include hyperpigmentation, psoriasiform dermatitis, photodermatitis, stomatitis, melanonychia and hair loss. More severe conditions were acute generalised exanthematous pustulosis, drug rash with eosinophilia and systemic symptoms, Stevens-Johnson syndrome/toxic epidermal necrolysis, and among extra-cutaneous adverse events cardiotoxicity and retinopathy. Since hydroxychloroquine is widely prescribed in rheumatology, it is important for rheumatologists to be familiar with its safety profile.
The present study aimed at evaluating the efficacy of abatacept (ABA) compared to tocilizumab (TCZ), assumed as a gold standard biologic treatment in the management of patients with giant cell arteritis (GCA).
Thirty-three biospy-proven GCA consecutive patients were prospectively collected. Odd patients (from 1 to 33) were assigned to TCZ, given either intravenously (IV 8 mg/kg/month), #8 cases, or subcutaneously (SC 162 mg/week) #9, based on patient's preference. ABA was administered subcutaneously at the dose of 125 mg/week in 16 even patients (from 2 to 32). Biological therapies were prescribed in addition to oral prednisone.
A single biologic agent was administered in 28 patients out of 33 (85%) (8 TCZ IV, 9 TCZ SC and 16 ABA). Five patients (15%) needed a therapeutic switch (one patient from TCZ to ABA, and 4 patients from ABA to TCZ). Among the TCZ IV group, all patients experienced a response (57% complete response and 43% partial response). Among the TCZ SC group, 7 experienced a clinical response (complete in 67% and partial in 16%). Among the ABA group, 10 patients (62%) achieved either complete (5 patients) or partial (5) response, respectively. After 12 months of therapy, 100% of patients in TCZ groups, both IV and SC, and 7 (43%) of ABA group were receiving doses of oral prednisone not exceeding 7.5 mg/day as maintenance.
Both TCZ and ABA can be proposed as an effective therapeutic option in GCA with relevant inflammatory symptoms. ABA can be considered in the patient with absolute or relative or contraindications to TCZ.
Both TCZ and ABA can be proposed as an effective therapeutic option in GCA with relevant inflammatory symptoms. Selleck Panobinostat ABA can be considered in the patient with absolute or relative or contraindications to TCZ.Systemic lupus erythematosus (SLE) is a complex and challenging disorder. At present, abnormal T cells are considered to be the key point in the pathogenesis of SLE, including the losing central immune tolerance of self-reactive T cells in the thymus, breaking of regulatory T cell balances, and the overactivation of pro-inflammatory T cells. The alterations of T-cell receptor proteins are closely related to these abnormal changes. Glycosylation is one of the most ubiquitous steps of protein post-translational modification. Especially the modifications of N-glycans and O-glycans on T-cell surfaces have been found to regulate apoptosis and downstream signalling in SLE. Accordingly, this review summarises the aberrant modulate effects of T cell glycosylation in SLE and provides new insights into understanding the pathogenesis and some potential therapeutic targets of this chronic autoimmune disease.
Systemic lupus erythematosus (SLE) is a typical autoimmune disease, which is associated with many factors, such as miRNAs. The effect of miRNAs encoded by X chromosome (X-linked miRNAs) plays a crucial role in autoimmune disease. This study aims to identify X-linked miRNAs and validate the pathway influenced by miRNAs in SLE.
Differentially expressed miRNAs (DEMs) encoded by X chromosome from PBMCs of SLE patients compared to healthy controls (HCs) and differentially expressed genes (DEGs) acquired from GSE50772 were analysed. The function and pathway enrichment analysis of the overlapping genes of target genes of X-linked miRNA and DEGs were performed, followed by investigating the hub genes. The expression of the identified miRNA (miR-548m) was verified in SLE patients. The relationship between miR-548m and PTEN was detected by increasing/decreasing miR-548m expression. The target of miR-548m on PTEN was confirmed by luciferase reporter assays.
104 DEMs (9 X-linked miRNAs) and 3071 DEGs were identified. The target genes of X-linked miRNAs and DEGs were intersected to obtain 114 consensus genes. Then the top 5 hub genes (FOS, PTEN, STAT1, GRB2, ITGA6) were screened and PTEN expression might have negative correlation with X-linked miR-548m in SLE patients. Upregulation of miR-548m significantly inhibited PTEN expression, while knocking down miR-548m increased PTEN expression. There was a miR-548m target in the nt219-nt225 region of PTEN 3́UTR.
X-linked miR-548m might target PTEN and play a role in SLE, which revealed a new molecular mechanism of X-linked miRNA in the development of SLE.
X-linked miR-548m might target PTEN and play a role in SLE, which revealed a new molecular mechanism of X-linked miRNA in the development of SLE.
Homepage: https://www.selleckchem.com/products/LBH-589.html
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