Purpose
The purpose of this study was to evaluate the utility of corneal confocal microscopy (CCM) in identifying small nerve fiber damage and immune cell activation in patients with systemic lupus erythematosus (SLE).
Methods
This cross-sectional comparative study included 39 consecutive patients with SLE and 30 healthy control participants. Central corneal sensitivity was assessed using a Cochet-Bonnet contact corneal esthesiometer and a laser scanning CCM (Heidelberg, Germany) was used to quantify corneal nerve fiber density (CNFD), nerve branch density (CNBD), nerve fiber length (CNFL), and Langerhans cell (LC) density.
Results
Age was comparable among patients with SLE (33.7 ± 12.7) and controls (35.0 ± 13.7 years,
P
= 0.670) and the median duration of disease was 3.0 years (2.0–10.0 years). CNBD (
P
= 0.003) and CNFL (
P
= 0.019) were lower and mature LC density (
P
= 0.002) was higher, but corneal sensitivity (
P
= 0.178) and CNFD (
P
= 0.198) were comparable in patients with SLE compared with controls. The SELENA-SLEDAI score correlated with CNFD (ρ = −0.319,
P
= 0.048) and CNFL (ρ = −0.373,
P
= 0.019), and the total and immature LC densities correlated with CNBD (ρ = −0.319.
P
= 0.048, and ρ = −0.328,
P
= 0.041, respectively). Immature LC density was higher (
P
= 0.025), but corneal sensitivity and nerve fiber parameters were comparable between patients with (33%) and without neuropsychiatric symptoms and SLE.
Conclusions
Corneal confocal microscopy identifies distal corneal nerve fiber loss and increased immune cell density in patients with SLE and corneal nerve loss was associated with disease activity.
Translational Relevance
Corneal confocal microscopy may enable the detection of subclinical corneal nerve loss and immune cell activation in SLE.
CT increases during H. pylori infection and returns to the normal range within 6 weeks of treatment. RNFLT does not show any change during H. pylori infection. The data related to the subfoveal CT may be useful in understanding the pathogenesis of central serous chorioretinopathy developing in H. pylori patients.
Aim: Studies have found the association of Helicobacter Pylori (Hp) seropositivity with cardiovascular diseases and it has been shown that chronic inflammation with Hp may be related to early atherosclerosis. The aim of this study is to evaluate the relationship between Hp positivity detected by endoscopic gastric biopsy and arterial stiffness. Material and Method: In this cross-sectional study, patients were divided into 2 groups as Hp positive (n=48) and Hp negative (n=61) according to endoscopic gastric biopsy findings. Augmentation index, arterial stiffness and central blood pressure were measured using Pulse wave velocity analysis/Ambulatory blood pressure monitoring in all patients. Result: Augmentation index was significantly higher in the Hp positive group (p=0.020). There was no correlation between central blood pressure and augmentation index and the intensity of Hp colonization (p=0.070, r=0.263). However, logistic regression analysis revealed that positive Hp (OR: 3.593, 95%CI: 1.341-9,629, p=0.011) was the only variable predictive for an augmentation index > 24.9 among variables including, age, BMI, systolic and diastolic blood pressure, central blood pressure, glucose, creatinine, total cholesterol, C-reactive protein, and positive Hp. Conclusion: Helicobacter Pylori positive patients with confirmed biopsy have an increased arterial stiffness. Moreover, presence of Hp infection is predictive for an increased arterial stiffness. Regarding the diversity and frequency of Hp worldwide long term follow up studies with larger sample size are needed to elaborate the mechanism of this relationship.
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