Objective Changes in gut microbiota have been linked to systemic lupus erythematosus (SLE), but knowledge is limited. Our study aimed to provide an in‐depth understanding of the contribution of gut microbiota to the immunopathogenesis of SLE. Methods Fecal metagenomes from 117 patients with untreated SLE and 52 SLE patients posttreatment were aligned with 115 matched healthy controls and analyzed by whole‐genome profiling. For comparison, we assessed the fecal metagenome of MRL/lpr mice. The oral microbiota origin of the gut species that existed in SLE patients was documented by single‐nucleotide polymorphism–based strain‐level analyses. Functional validation assays were performed to demonstrate the molecular mimicry of newly found microbial peptides. Results Gut microbiota from individuals with SLE displayed significant differences in microbial composition and function compared to healthy controls. Certain species, including the Clostridium species ATCC BAA‐442 as well as Atopobium rimae, Shuttleworthia satelles, Actinomyces massiliensis, Bacteroides fragilis, and Clostridium leptum, were enriched in SLE gut microbiota and reduced after treatment. Enhanced lipopolysaccharide biosynthesis aligned with reduced branched chain amino acid biosynthesis was observed in the gut of SLE patients. The findings in mice were consistent with our findings in human subjects. Interestingly, some species with an oral microbiota origin were enriched in the gut of SLE patients. Functional validation assays demonstrated the proinflammatory capacities of some microbial peptides derived from SLE‐enriched species. Conclusion This study provides detailed information on the microbiota of untreated patients with SLE, including their functional signatures, similarities with murine counterparts, oral origin, and the definition of autoantigen‐mimicking peptides. Our data demonstrate that microbiome‐altering approaches may offer valuable adjuvant therapies in SLE.

OBJECT The aims of this study were 1) to establish the standard parameters of alignment and total and segmental range of motion (ROM) of the cervical spine in the asymptomatic population, and 2) to identify factors that influence cervical ROM and alignment. METHODS The authors measured 636 standard cervical lateral, flexion, and extension plain radiographs of 212 asymptomatic volunteers. The relationship between cervical alignment and total ROM was assessed with simple linear regression. Multivariate linear regression was used to determine the effect of the influential factors on cervical alignment and total and segmental ROM. RESULTS The mean value for C2–7 cervical alignment was 21.40° ± 12.15°, and the mean value for total ROM was 63.59° ± 15.37°. Sex was a significant factor in cervical alignment, total ROM, and segmental ROM for C2–3 and C5–6 (p < 0.05). Age had a significant negative association with both the total ROM and all of the segmental ROM measurements (p < 0.05). Cervical disc degeneration at the level of interest had a significant negative association with C4–5, C5–6, and C6–7 ROM (p < 0.05). CONCLUSIONS Cervical alignment in female subjects was 2.47° lower than that in male subjects. Total ROM was 3.86° greater in female than in male subjects and decreased 6.46° for each decade of aging. Segmental ROM decreased 1.28° for each decade of aging and 2.26° for each category increase in disc degeneration at the level of interest.

No abstract

Study Design. A case control study. Objective. The aim of this study was to identify the potential impact of cervical spine malalignment on muscle parameters. Summary of Background Data. Muscular factors are associated with cervical alignment. Nevertheless, only muscle dimensions or imaging changes have been evaluated, function of cervical muscles has scarcely been investigated. Methods. Thirty-four patients diagnosed as cervical spine degeneration associated with cervical malalignment and 32 control subjects were included in this case control study. Visual analogue scale (VAS) and the neck disability index (NDI) were used. The sagittal alignment parameters and cervical range of motion (ROM) were measured on cervical spine lateral radiographs, included C2-C7 lordosis, C2-C7 sagittal vertical axis (C2-C7 SVA), cervical gravity-sagittal vertical axis (CG-SVA), T1-Slope, and spinal canal angle (SCA). Surface electromyography (SEMG)-based flexion-relaxation ratio (FRR) was measured. Results. The result showed VAS score of the neck significantly lower in controls (P<0.05), C2-C7 lordosis, C2-C7 SVA, CG-SVA, T1-Slope and ROM showed significantly different (P<0.001) between malalignment group and control group, FRR of splenius capitis (FRRSpl) and upper trapezius (FRRUTr) of the malalignment group were lower than in the control group, which correlated well with NDI (rSpl = −0.181 rUTr = −0.275), FRRSpl correlated well with VAS (rSpl = −0.177). FRRSpl correlated strongly with C2-C7 SVA (r = 0.30), CG-SVA (r = 0.32), T1-Slope (r = 0.17), ROM (r = 0.19), FRRUTr correlated with C2-C7 lordosis (r = −0.23), CG-SVA (r = 0.19), T1-Slope (r = 0.28), ROM (r = 0.23). Conclusion. Cervical malalignment patients had more tensional posterior cervical muscle and poor muscle functions. CG-SVA showed advantages in evaluating cervical malalignment. Level of Evidence: 3

BackgroundMulti-level cervical degeneration of the spine is a common clinical pathology that is often repaired by anterior cervical discectomy and fusion (ACDF).The aim of this study was to investigate the kinematics of the cervical spine after hybrid surgery compared with 2-level ACDF.Material/MethodsFive freshly frozen, unembalmed whole human cadavers were used including 3 males and 2 females with a mean age of 51±8 years. After evaluating the intact spine for range of motion (ROM), sagittal alignment and instantaneous center of rotation (ICR), each cadaver underwent 4 consecutive surgeries: 2-level artificial disc replacement (ADR) from C4 to C6 (ADR surgery); 2-level ACDF from C4 to C6 (ACDF surgery); hybrid C4–5 ACDF and C5–6 ADR (ACDF+ADR surgery); and hybrid C4–5 ADR and C5–6 ACDF (ADR+ACDF surgery). The ROM and ICR of adjacent intact segments (C3–4; C6–7), and whole sagittal alignment were revaluated.ResultsTwo-level ACDF resulted in increased ROM at C3–4 and C6–7 compared with intact spine. ROM was significantly different to intact spine using ACDF surgery at C3–C4 and C6–C7 and ROM was increased with ACDF+ADR surgery at C6–C7 (all P<0.05). No improvement in sagittal alignment was observed with any approach. The localization of the ICR shifted upwards and anteriorly at C3–C4 after reconstruction. ICR changes at C3–C4 were greatest for ADR+ACDF surgery and were significantly different to ACDF surgery (P<0.05), but not between ADR surgery and ACDF+ADR surgery. At C6–C7, the ICR was more posterior and superior than in the intact condition. The greatest change in ICR was observed in ACDF surgery at the C6–C7 level, significantly different from the other groups (P<0.05).ConclusionsFor 2-level reconstruction, hybrid surgery and ADR did not alter ROM and minimally changed ICR at the adjacent-level. The type of surgery had a significant impact on the ICR location. This suggests that hybrid surgery may be a viable option for 2-level cervical surgery.

No abstract

No abstract

No abstract