Interstitial Lung Disease in Rheumatoid Arthritis Remains a Challenge for Clinicians

Bendstrup, Elisabeth; Møller, Janne; Kronborg-White, Sissel; Prior, Thomas Skovhus; Hyldgaard, Charlotte

doi:10.3390/jcm8122038

Cited by 63 publications

(53 citation statements)

References 106 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

Section: Introductionmentioning

confidence: 99%

“…Interstitial lung disease (ILD) is one of the most feared complications in patients with rheumatoid arthritis (RA), increasing their morbidity and mortality [ 1 , 2 ]. Although ILD frequently develops in patients with established RA, it may also be presented as the initial or single manifestation of an unidentified RA [ 1 , 2 , 3 ]. In this regard, the identification of an underlying RA in ILD patients remains a challenge, considering that RA-ILD + shares clinical, pathological, and epidemiological similarities with idiopathic pulmonary fibrosis (IPF), the most common and severe ILD [ 2 , 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Endothelial Progenitor Cells as a Potential Biomarker in Interstitial Lung Disease Associated with Rheumatoid Arthritis

Pulito‐Cueto

Remuzgo‐Martínez

Genre

et al. 2020

JCM

View full text Add to dashboard Cite

Interstitial lung disease (ILD) increases morbidity and mortality in patients with rheumatoid arthritis (RA). Although the pathogenesis of ILD associated with RA (RA-ILD+) remains poorly defined, vascular tissue is crucial in lung physiology. In this context, endothelial progenitor cells (EPC) are involved in endothelial tissue repair. However, little is known about their implication in RA-ILD+. Accordingly, we aimed to investigate the potential role of EPC related to endothelial damage in RA-ILD+. EPC quantification in peripheral blood from 80 individuals (20 RA-ILD+ patients, 25 RA-ILD− patients, 21 idiopathic pulmonary fibrosis (IPF) patients, and 14 healthy controls) was performed by flow cytometry. EPC were considered as CD34+, CD45low, CD309+ and CD133+. A significant increase in EPC frequency in RA-ILD+ patients, as well as in RA-ILD− and IPF patients, was found when compared with controls (p < 0.001, p = 0.02 and p < 0.001, respectively). RA-ILD+ patients exhibited a higher EPC frequency than the RA-ILD− ones (p = 0.003), but lower than IPF patients (p < 0.001). Our results suggest that EPC increase may represent a reparative compensatory mechanism in patients with RA-ILD+. The degree of EPC frequency may help to identify the presence of ILD in RA patients and to discriminate RA-ILD+ from IPF.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endothelial Progenitor Cells as a Potential Biomarker in Interstitial Lung Disease Associated with Rheumatoid Arthritis

Pulito‐Cueto

Remuzgo‐Martínez

Genre

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…Smoking was reported by about 61% of patients with RA. Several studies have shown that smoking is a risk factor for the occurrence and the progression of RA [ 23 - 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…A few hazard factors for improvement of ILD in patients with RA have been recognized [ 23 ]. The most reliably revealed hazard factors incorporate more established age and male gender [ 24 ], cigarette smoking [ 25 ], positive anti- cyclic citrullinated peptide antibodies (against CCP) or IgM rheumatoid factor [ 26 ], and, in certain investigations, RA disease progression [ 22 ]. Smoking is the main preventable hazard factor [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Rheumatoid Arthritis Interstitial Lung Disease: Measuring and Predictive Factors Among Patients Treated in Rehabilitation Clinics at Royal Medical Services

et al. 2020

View full text Add to dashboard Cite

Introduction: Autoimmune diseases have increasing importance in modern medicine and cover increasing areas of medicine including rheumatoid arthritis interstitial lung disease. Aim: The main aims of this study are to evaluate the association of some autoimmune variables in patients with rheumatoid arthritis interstitial lung disease. Methods: A retrospective study was conducted from files of patients with rheumatoid arthritis interstitial lung disease. A total of 210 files of intended patients were included in this study. The study was conducted in rehabilitation clinics at Royal Medical Services. Study variables include some demographic variables such as age, and gender; clinical variables such as disease related factors such as duration, diagnostic criteria; predictive factors such as rheumatoid factors, smoking, and MTX treatment. Data were collected and entered into excel spreadsheet to create raw data. The analysis of data was carried out using the software SPSS version 21. Descriptive statistical parameters were used to describe data including means and standard deviations for continuous variables. Frequency and percentages were used to describe categorized variables such as gender. The relationships between study variables were computed using independent T test, and One Way ANOVA test. Significance was determined if α≤ 0.05. Results: The prevalence of RA-ILD was 3.70%. The study participants were subdivided into two groups according to MTX treatment, non-exposed group and exposed group. There were significant relationships between MTX treatment and study variables including gender, age of (rheumatoid arthritis) RA onset, smoking, and rheumatoid factor (RF). The progression of RA-ILD was impacted by gender, age of (rheumatoid arthritis) RA onset, smoking, rheumatoid factor (RF), and MTX treatment. Conclusion: Patients with RA and RA-ILD follow similar clinical characteristics in other studies except MTX treatment, but this can’t be generalized because of small number of RA-ILD patients.

show abstract

“…ILD is a frequent extra-articular involvement, which can deteriorate rather rapidly [18], and imposes a severe burden on affected patients. The therapeutic armamentarium for treating this condition is fortunately becoming richer, although to date there are no specific recommendations on how to treat RA-ILD [19]. Different are the attempts to diagnose RA-ILD without the use of methods that use ionizing radiation, including the use of algorithms that elaborate velcro sounds at chest auscultation [20].…”

Section: Discussionmentioning

confidence: 99%

Lung ultrasound in patients with rheumatoid arthritis and the definition of significant interstitial lung disease

Carlo

Tardella

Filippucci

et al. 2020

Preprint

View full text Add to dashboard Cite

Background In recent years, a growing interest has grown around interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA). While high resolution computed tomography (HRCT) of the chest remains the diagnostic method of choice, increasing attention has been directed towards lung ultrasound (LUS) in the diagnosis of ILD in connective tissue diseases. However, it is not yet well defined how to interpret the LUS findings under suspicion of RA-ILD. The aim of this study was to determine the cut-off number of LUS B-lines that identifies a significant RA-ILD. Methods A cross sectional study was conducted on consecutive RA patients with suspected RA-ILD. The inclusion criteria were clinical (dyspnea, velcro sounds), instrumental (suggestive anomalies on conventional radiography, DLco reduction), or in presence of at least two of the following risk factors for RA-ILD: smoking habit, male sex, advanced age, and ACPA presence. Patients underwent LUS (carried out in 14 defined intercostal spaces), chest HRCT, pulmonary function tests, and clinical evaluation. The diagnosis of RA-ILD was based on a semi-quantitative evaluation of chest HRCT using a computer-aided method (CaM). The discriminative validity of the LUS versus HRCT has been studied by using the receiver operating characteristic (ROC) curve analysis. Results 72 consecutive RA patients (21 male, 51 female) were evaluated, with a mean age of 63.0 (SD 11.5 years). The mean estimate of pulmonary fibrosis using the CaM was 11.20% (SD 7.48) at chest HRCT, while at LUS the mean number of B-lines was 10.65 (SD 15.11). A significant RA-ILD, as measured by the CaM at HRCT, was detected in 25 patients (34.7%). The presence of 9 B-lines was found to be the optimal cut-off at ROC curve analysis. This LUS cut-off defines the presence of significant RA-ILD with a sensitivity of 70.0%, a specificity of 97.62%, and a positive likelihood ratio of 29.4. Conclusion The present study provided data to determine the number of B-lines to identify a significant RA-ILD. LUS may represent a useful technique to select RA patients to be assessed by chest HRCT.

show abstract

Interstitial Lung Disease in Rheumatoid Arthritis Remains a Challenge for Clinicians

Cited by 63 publications

References 106 publications

Endothelial Progenitor Cells as a Potential Biomarker in Interstitial Lung Disease Associated with Rheumatoid Arthritis

Endothelial Progenitor Cells as a Potential Biomarker in Interstitial Lung Disease Associated with Rheumatoid Arthritis

Rheumatoid Arthritis Interstitial Lung Disease: Measuring and Predictive Factors Among Patients Treated in Rehabilitation Clinics at Royal Medical Services

Lung ultrasound in patients with rheumatoid arthritis and the definition of significant interstitial lung disease

Contact Info

Product

Resources

About