-Background -Crohn's disease accompanied by nonspecific or idiopathic ulcerative proctocolitis corresponds to a condition called intestinal inflammatory disease. The immunoexpression of cyclooxygenase 2 (COX-2) in Crohn's disease becomes more marked with progression of the disease and the presence of wild-type p53 suppresses the transcription of COX-2. Aims -To investigate the immunoexpression of cyclooxygenase 1 (COX-1), COX-2 and p53 in Crohn's ileocolitis and to correlated this expression with clinical and histopathological parameters. Methods -Forty-five cases of Crohn's disease, 16 cases of actinic colitis (diseased-control group) and 11 cases without a history of intestinal disease (normal control group) were studied. Hematoxylin-eosin-stained sections were submitted to histopathological analysis and the immunohistochemical expression of COX-1, COX-2 and p53 was evaluated by the streptavidin-biotin-peroxidase method. Results -Sixty percent of the Crohn's disease patients were women and 40% were men, with 75.5% whites and 25.5% non-whites. The disease involved the terminal ileum in 44.5% of cases, ileum in 33.3%, colon in 20% and duodenum-ileum in 2.2%. A significant association was observed between COX-2 immunoreactivity and age ≤40 years. Histopathological analysis of Crohn's disease samples showed mild or moderate crypt distortion (57.8% and 35.6% of cases), atrophy (6.6%), mild, moderate and marked chronic inflammation (46.7%, 26.7% and 20%), acute inflammatory activity (93.3%), ulceration (24.4%), mucin depletion (37.8%), Paneth's cells (24.4%), intraepithelial lymphocytes (93.3%), and subepithelial collagen (6.7%). In the CD group, COX-1 immunoreactivity in epithelial and inflammatory cells was observed in 26.7% and 22.2% of cases, respectively.
Background Rheumatoid arthritis (RA) is an inflammatory autoimmune disease of unknown etiology, affecting the joint and also other tissues [Altindag, 2007]. RA patients usually present weakness and muscle atrophy, non-articular manifestation of the disease [Mirό, 1996]. Although causing great impact, the development of muscle atrophy and mechanisms involved is still very limited. Objectives To evaluate the development of muscle atrophy in skeletal muscle of murine model of arthritis. Methods We used the experimental murine model of collagen induced arthritis (CIA) conform Brand et al [2007]. Experimental animals were randomly divided into three groups (n=79): control (CO), sham arthritis (SA) and arthritis (CIA), analyzed in different time-points: 25, 35 and 45 days after induction of the arthritis. The arthritis development was followed by clinical scores three times a week and weight was evaluated weekly. Cytokine analysis was evaluated by CBA in serum collected before the death of the animals. Cross-sectional area of the myofiberof skeletal muscle (tibialis anterior - TA, gastrocnemius - GA) was measured. Significance was considered p<0.05. Results Disease scores of arthritis groups were always different from their controls in all times, also in 45 days CIA group was different from other times and SA was different from CO (Table 1). There were no differences in myofiber cross-sectional area among groups in 25 and 35 days, however in 45 days CIA had reduced myofiber area (Table 1). Myofiber area did not differed among times on all experimental groups. There was no correlation between myofiber area and disease score when analyzing paws separately (left and right), however using a paw mean, this correlation was significant and inverse in 45 days (TA: -0.68 p=0.029 and GA: -0.71 p=0.021). CBA analysis showed IL-6 significantly inhanced in CIA. Conclusions Disease score is inversely correlated with myofiber area in 45 days, demonstrating that muscle atrophy was clearly presented when arthritis is established. Furthermore, this correlation is not symmetric. These observations are relevant to understand the development of muscle loss, as well as for the design of future studies trying to understand the mechanisms involved. As far as we concern, this is the first study to evaluate the relation between disease score and muscle atrophy in a model of arthritis. Disclosure of Interest None Declared
Background Sarcopenia refers to age-related loss of muscle mass and function. However, autoimmune sarcopenia refers to excessive weight loss usually with disproportionate muscle wasting due to cytokine excess. Previous studies have found a frequency of autoimmune sarcopenia of about 15 to 20%. The progressive loss of muscle mass lead to decrease in physical activity and a rise in cardiovascular and metabolic disorders. There is currently no widely accepted definition of sarcopenia in autoimmune diseases. Objectives The purpose of this study was to determine the frequency of muscle wasting in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Methods In a cross-sectional study, we screened the patients from outpatient clinic in the rheumatology service and were excluded patients with chronic disorders of heart, kidney and liver, also the patients that were on HMG-CoA reductase inhibitors treatment; we performed medical history and physical examination, specialist in clinical nutrition made the anthropometric measures, blood samples were taken for clinical laboratory analysis. Activity scales for each disease were made, DAS-28 in RA and MEX-SLEDAI in SLE patients. We determined the whole body lean mass using Dual-emission X-ray Absorptiometry (DEXA). Statistical analysis was performed using arithmetic mean, standard deviation, Student T test; chi-square and Fisher exact test when appropriate and Spearman rank correlation test all using SPSS program (v 12.0). Results Forty-six patients with autoimmune disease (AID), twenty six patients with RA and 20 with SLE according to the 1987 ACR criteria and 25 healthy subjects were analyzed; mean age of AID was 40±13.4 vs. 39±18 years in control group. Ninety-four percent were women. 90% of the AID group was taking hydroxychloroquine and 80% was on mild doses of corticosteroids. The anthropometric measures revealed obesity in 28% of the patients vs 16% in control group. The frequency of sarcopenia in AID group was 26% (12 pts) vs 20% (5 pts) in control group, p=0.000; There was no difference in the cases of sarcopenic-obesity. The risk of sarcopenia in sedentary patients was OR 1.93 (IC 95% 0.385 to 9.7). There was no correlation between activity scales of AID and sarcopenia rho =0.121 for SLE and rho=0.170 in RA patients. The use of hydroxychloroquine is not protection for muscle wasting OR 1.4 (IC 95% 0.147 to 14.59). Finally the risk of sarcopenia in patients with AID was OR 1.4 (IC 95% 0.434 to 4.596). Conclusions Our work demonstrated that patients with AID have a slightly risk of sarcopenia when are compared to control group. This finding may affect the quality of life and promote the increasing of morbidity in such patients. References Santos MJ, Vinagre F, Canas Da silva J, Gil V, Fonseca JE. Body composition phenotypes in systemic lupus erythematosus and rheumatoid arthritis: a comparative of caucasian female patients. Clin Exp Rheum; 2011 29: 470-476 Disclosure of Interest None Declared
BackgroundSome cardiovascular risk factors (CVRF) have been related to poorer responses to biological therapy1. We aimed to evaluate the potential link between the MDA response and the presence of CVRF in patients treated with traditional and/or biological DMARDs.ObjectivesThe objective has been to evaluate the potential association beetween classic CVRF and the probability of reaching an MDA response in PsA patients.MethodsCross-sectional study carried out at 25 rheumatology outpatient clinics in patients who fulfilled the Classification for Psoriatic Arthritis (CASPAR) criteria with at least one year disease duration, and treated with biological or conventional synthetic (cs) DMARDs according to routine clinical practice in Spain. Patients were considered in MDA if they met at least 5/7 of the MDA criteria2. The relationship between MDA and CVRF was evaluated by uni and multivariate analyses.Results227 patients were included, 133 (58.6%) were in MDA state (52% on anti-TNFα monotherapy, 24% on csDMARD monotherapy, 24% on anti-TNFα in combination with csDMARD). Among the classic CVRF, tobacco (crude OR: 0.54), sedentary lifestyle (crude OR: 1.95), hyperuricemia (crude OR: 2.01) and obesity (crude OR: 1.54) were related to the likelihood of MDA in the univariate model (p<0.25). The only CVRF related to the MDA response in the multivariate analysis was a sedentary lifestyle (OR 3.13, 95% CI: 1.50–6.53; p=0.002). We did not find any association between the number of CVRF and the MDA response.ConclusionsContrary to what has been found in other studies, in this cross-sectional multicenter study we could not find any relationship between traditional CVRF (except for sedentary lifestyle) and MDA. In any case, patients with psoriatic disease should be encouraged to maintain healthy lifestyle habits.References Ogdie A, Eder L. Improving cardiovascular health and metabolic comorbidities in patients with psoriatic arthritis. Int J Clin Rheumatol 2015; 10(6):451–459.Coates LC, Fransen J, Helliwell PS. Defining minimal disease activity in psoriatic arthritis: a proposed objective target for treatment. Ann Rheum Dis 2010; 69(1):48–53. AcknowledgementsThis study was funded by Pfizer.Disclosure of InterestNone declared
El derecho a la salud, entendida como un estado de bienestar y no simplemente como la ausencia de enfermedad, se ha venido generalizando, desde las orientaciones generales de las organizaciones internacionales, como en las políticas y legislaciones específicas de cada país. En Ecuador, la misma Constitución Nacional garantiza este derecho para toda la población, incluida la de los pueblos indígenas. En el presente texto, se plantea una revisión crítica de la situación en uno de los aspectos de la salud mental de la población: el de los niños, niñas y adolescentes pertenecientes a los pueblos indígenas. Para ello, se revisarán documentos oficiales de organizaciones nacionales e internacionales, datos censales, así como investigaciones académicas y publicaciones científicas relativas al tema.
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