TDI exposure leads to overproduction of MMP-9, which may induce airway inflammation and remodeling, and then contribute to persistent asthmatic symptoms in TDI-induced asthma.

The human interleukin 6 receptor consists of two membrane-bound glycoproteins (IL-6Rα, IL-6RA and gp130/IL-6Rβ, IL-6RB) interacting with IL-6, which is a multifunctional cytokine essential to the regulation of the immune response and acute-phase reactions. We have genotyped a single-nucleotide polymorphism (SNP) of the IL-6RA in Korean patients with systemic lupus erythematosus (SLE) (n = 300) and normal controls (NC, n = 299). Three SNPs were identified in the IL-6RA gene; -208 G ≥ A (NM_000565.3:c.-208G ≥ A, rs4845617) in the promoter region, 48841 T ≥ A (NM_000565.3:c.1067-17T ≥ A, rs4845374) in the intron 8 region and 48864 A ≥ C (NM_000565.3:c.1073A ≥ C, rs2228145) in the exon 9 region. There were no differences between the SLE and the NC in the genotype and haplotype frequencies. The 48864 A>C polymorphism was significantly associated with rash (P = 0.008). Also, the frequency of rash (P = 0.037), leucopenia (P = 0.033) and lymphopenia (P = 0.027) was significantly higher in patients with SLE having the haplotype HT2 [ATC]. These data suggest that genetic polymorphisms of IL-6RA gene may be associated with disease phenotypes of SLE in Korean.

BackgroundSystemic lupus erythematosus (SLE) is sometimes difficult to make a prompt and accurate diagnosis due to the heterogeneity of various clinical manifestations and autoantibody expression. Therefore, the development of surrogate markers specific to the diagnosis of SLE is necessary. Among biological samples, urine is non-invasive means with the advantage of being easily obtained.ObjectivesThis study aimed to evaluate the ability of Activated Leukocyte Cell Adhesion Molecule (ALCAM), Hemopexin, and Peroxiredoxin (PRDX) 6 as urine biomarkers in Korean patients with SLE.MethodsUrine samples were collected from 138 patients with SLE and 39 healthy controls (HC) with clinical data. The level of urine biomarkers were measured by enzyme-linked immunosorbent assay kits specific for ALCAM, hemopexin and PRDX 6, respectively, according to the manufacturer’s protocols. The diagnostic utility of urine biomarkers was evaluated using receiver operating characteristic (ROC) curve analysis, and Pearson’s correlation analysis was performed to assess the relationships between disease activity and urine biomarkers.ResultsUrinary ALCAM level was 6,760.5 ± 2,826.4 pg/ml and 1,192.6 ± 577 pg/ml in patients with SLE and HCs (p < 0.001). The mean levels in urinary hemopexin and PRDX6 were also significantly higher in patients with SLE compared to HCs (hemopexin, 649.8 ng/ml vs. 202 ng/ml, p < 0.001; PRDX6, 0.78 ng/ml vs. 0.17 ng/ml, p = 0.003). In patients with lupus nephritis (LN), ALCAM, hemopexin, and PRDX6 showed more significant diagnostic value, and the area under the ROC for LN was 0.850 for ALCAM (95% CI, 0.778–0.921), 0.781 for hemopexin (95% CI, 0.695–0.867), and 0.714 for salivary S100A8 (95% CI, 0.617–0.812). In addition, all urine biomarkers were significantly associated with anti-double stranded DNA (ALCAM, r = 0.350, p < 0.001; hemopexin, r = 0.346, p < 0.001; PRDX6, r = 0.191, p = 0.026) and SLEDAI (ALCAM, r = 0.526, p < 0.001; hemopexin, r = 0.479, p < 0.001; PRDX6, r = 0.262, p = 0.002) in correlation analysis.ConclusionUrinary ALCAM, hemopexin and PRDX 6 were significantly increased in patients with SLE compared to HCs. Thus, we propose that urinary ALCAM, hemopexin and PRDX 6 can be potential biomarkers for SLE, especially valuable in the diagnosis of LN.References[1]Ding H, Lin C, Cai J, Guo Q, Dai M, Mohan C et al., Urinary activated leukocyte cell adhesion molecule as a novel biomarker of lupus nephritis histology.Arthritis Res Ther(2020) 22(1):122. Doi: 10.1186/s13075-020-02209-9.[2]Soliman SA, Haque A, Vanarsa K, Zhang T, Ismail F, Lee KH et al., Urine ALCAM, PF4 and VCAM-1 surpass conventional metrics in identifying nephritis disease activity in childhood-onset systemic lupus erythematosus.Front Immunol(2022) 26;13:885307. Doi: 10.3389/fimmu.2022.885307.[3]Krata N, Foroncewicz B, Zagozdzon R, Moszczuk B, Zielenkiewicz M, Paczek L et al. Peroxiredoxins as markers of oxidative stress in IgA nephropathy, membranous nephropathy and lupus nephritis.Arch Immunol Ther Exp (Warsz) (2021) 70(1):3. Doi: 10.1007/s00005-021-00638-1.Figure 1.Urinary ALCAM, hemopexin and PRDX6 in patients with SLE and HCsAcknowledgements:NIL.Disclosure of InterestsNone Declared.

Background:Gout shows a seasonal variation that widely differs among geographic areas, and we previously reported a seasonal effect on gout in Korea. However, we had no information regarding changes in diet and had only limited laboratory data because this was a retrospective study in patients receiving a urate-lowering therapy. Therefore, we designed this prospective study to elucidate the seasonality and associated factors of gout attacks in Korea.Objectives:To evaluate the seasonality and associated factors of the incidence of gout attacks in Korea.Methods:We prospectively enrolled patients with gout attacks who were treated at nine rheumatology clinics between January 2015 and July 2018 and followed them for 1-year. Demographic data, clinical and laboratory features, and meteorological data including seasonality were collected.Results:Two hundred-five patients (males, 94.1%) were enrolled. The proportion of patients with initial gout attacks was 46.8% (n = 96). The mean age, body mass index, attack duration, and serum uric acid level at enrollment were 50.5 years, 26.1, 10.2 days, and 7.3 mg/dL, respectively. Gout attacks were most common during spring (43.4%,P< 0.001) and in March (23.4 %,P< 0.001). A similar pattern of seasonality was observed in the group with initial gout attacks. Alcohol was the most common provoking factor (39.0%), particularly during summer (50.0%). The mean diurnal temperature change on the day of the attack was highest in the spring (10.3°C), followed by winter (9.1°C), summer (8.1°C), and fall (8.0°C) (P= 0.027). The mean change in humidity between the 2 consecutive days (the day before and the day of the attack) was significantly different among the seasons (3.4%, spring; 0.2%, summer; 0.4%, fall; -3.9%, winter;P= 0.015). One hundred twenty-five (61%) patients completed 1-year follow-up (51% in the initial attack group). During the follow-up period, 51 gout flares developed (18 in the initial attack group). No significant seasonal variation in the follow-up flares was found.Conclusion:In this prospective study, the most common season and month of gout attacks in Korea were spring and March, respectively. Alcohol was the most common provoking factor, particularly during summer. Diurnal temperature changes on the day of the attack and humidity changes from the day before the attack to the day of the attack were associated with gout attack in our cohort.References:[1]Choi HJ, Lee CH, Lee JH et al. Seasonality of gout in Korea: a multicenter study. J Korean Med Sci 2015;30:240-4.Disclosure of Interests: :None declared

Background:The diagnosis for adult-onset Still’s disease (AOSD) is still based on nonspecific symptoms and laboratory data, and had necessity to rule out several infectious, autoimmune or malignant diseases.Objectives:This study aimed to elucidate the efficiency of inflammatory markers, including systemic immune-inflammation index (SII); C-reactive protein (CRP)-to-albumin ratio (CAR), albumin-to- glubulin ratio (AGR), prognostic nutritional index (PNI), and ferritin-to-ESR ratio (FER) for evaluation of diagnostic or prognostic factors in AOSD.Methods:The medical records of patients with suspected AOSD between January 1999 and June 2019 were collected and retrospectively analyzed. Among 225 patients, 61 patients received another diagnosis, such as infection and malignancy, and 164 patients were newly diagnosed to AOSD. The values of SII, CAR, AGR, PNI, and FER were compared with AOSD and non-AOSD groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic significance of inflammatory markers. Correlations between inflammatory markers and disease activity index were analyzed.Results:A total of 164 patients who diagnosed AOSD had higher values of SII, CAR, and FER as well as lower values of AGR and PNI. For AOSD diagnosis, the area under the curve (AUC) obtained from the ROC curve were 0.859 (95% CI=0.806-0.911) for SII, 0.769 (95% CI=0.702-0.837) for CAR, 0.749 (95% CI=0.615-0.782) for AGR, 0.699 (95% CI=0.675-0.823) for PNI, and 0.764 (95% CI=0.693-0.834) for FER with cut-off value of 2195.7, 1.80, 1.38, 48.8 and 17.0, respectively. The SII had the largest AUC, and FER and SII each had the highest sensitivity (70.9%) and specificity (91.5%). In correlation analysis, there were no strong correlations between inflammatory markers and disease activity indices except CAR and CRP.Table 1.Demographic and baseline characteristics of patients with adult-onset Still’s disease(AOSD)AOSD patients (N=164)Initially suspected AOSD but not diagnosed (N=61)P-valueAge, years42.6 ± 15.742.1 ± 14.40.805Fever162 (98.8)56 (91.8)0.017Sore throat93 (56.7)18 (29.5)<0.001Skin rash131 (79.9)26 (42.6)<0.001Lymphadenopathy63 (38.4)10 (16.4)0.002Hepatomegaly25 (15.2)1 (1.6)0.004Arthritis79 (48.2)22 (36.1)0.132SII4601.7 ± 6406.81105.6 ± 970.0<0.001CAR3.37 ± 2.821.22 ± 1.58<0.001AGR1.15 ± 0.351.38 ± 0.39<0.001PNI41.94 ± 6.7048.85 ± 8.43<0.001FER139.19 ± 372.1228.39 ± 70.800.006Table 2.Discriminatory ability of inflammatory markers for predicting AOSD diagnosisVariablesAUCP-valueCut-offSensitivitySpecificity+LR-LRSII0.859<0.0012195.764.6%91.5%7.600.39CAR0.769<0.0011.8065.2%74.6%2.570.47AGR0.700<0.0011.3854.1%82.3%3.060.56PNI0.752<0.00148.852.5%86.0%3.750.55FER0.7640.00617.070.9%74.6%2.760.39Figure 1.Receiver operating characteristic (ROC) curves for SII, CAR and FER in AOSD and non-AOSD patients (Initially suspected AOSD but not diagnosed).Figure 2.Receiver operating characteristic (ROC) curves for AGR and PNI in AOSD and non-AOSD patients (Initially suspected AOSD but not diagnosed).Conclusion:SII, CAR, AGR, PNI and FER were can be used as a practical tool for diagnosing AOSD. Among the inflammatory markers, SII was revealed as most powerful marker for diagnosis.References:[1]Yamaguchi M, Ohta A, Tsunematsu T, et al. Preliminary criteria for classification of adult Still’s disease. J Rheumatol 1992;19:424-30.[2]Esraa M. A. Eloseily, Francesca Minoia, Courtney B. Crayne, et al. Ferritin to Erythrocyte Sedimentation Rate Ratio: Simple Measure to Identify Macrophage Activation Syndrome in Systemic Juvenile Idiopathic Arthritis. ACR open Rheumatol 2013;6:345-349[3]Yuanyuan Li, Ying Ahzo, Limin Feng, et al. Comparison of the prognostic values of inflammation markers in patients with acute pancreatitis: a retrospective cohort study. BMJ 2017;7(3);e013206Disclosure of Interests:None declared