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  1. Fulltext Antiphospholipid syndrome in lupus retinopathy
    Ng HK, Chong MF, Azhany Y, Zunaina E
    Clin Ophthalmol, 2014;8:2359-63.
    PMID: 25473262 DOI: 10.2147/OPTH.S71712
    Systemic lupus erythematosus (SLE) is a chronic, multisystem, autoimmune disease that can affect any part of the human body including the eyes. Common blinding ocular manifestations include central retinal artery occlusion (CRAO), central retinal vein occlusion (CRVO), severe vaso-occlusive retinopathy, and optic nerve involvement. Antiphospholipid syndrome (APS) in lupus is usually associated with large vessel occlusions and needs prompt treatment with anticoagulant. We are reporting two cases of APS in SLE patients that presented with CRVO (case 1) and vaso-occlusive lupus retinopathy (case 2). Both cases were positive for antiphospholipid antibody (APA) and were treated with immunosuppression, anticoagulant, and laser treatment. Thus, screening for APA is vital in SLE patients with lupus retinopathy, as prompt treatment with anticoagulants is important to prevent further vascular thrombosis, which worsens the visual prognosis.
    Study site: Ophthalmology clinic, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia
    Matched MeSH terms: Lupus Erythematosus, Systemic
  2. Fulltext New Benefits of Hydroxychloroquine in Pregnant Women with Systemic Lupus Erythematosus: A Retrospective Study in a Tertiary Centre
    Abd Rahman R, Min Tun K, Kamisan Atan I, Mohamed Said MS, Mustafar R, Zainuddin AA
    Rev Bras Ginecol Obstet, 2020 Nov;42(11):705-711.
    PMID: 33254264 DOI: 10.1055/s-0040-1715140
    OBJECTIVE:  To determine pregnancy outcomes in women with systemic lupus erythematosus (SLE) who were treated with hydroxychloroquine in a tertiary center.

    METHODS:  A retrospective study involving pregnant women with SLE who had antenatal follow-up and delivery in between 1 January 2007 and 1 January 2017. All participants were retrospectively enrolled and categorized into two groups based on hydroxychloroquine treatment during pregnancy.

    RESULTS:  There were 82 pregnancies included with 47 (57.3%) in the hydroxychloroquine group and 35 (42.7%) in the non-hydroxychloroquine group. Amongst hydroxychloroquine users, there were significantly more pregnancies with musculoskeletal involvement (p = 0.03), heavier mean neonatal birthweight (p = 0.02), and prolonged duration of pregnancy (p = 0.001). In non-hydroxychloroquine patients, there were significantly more recurrent miscarriages (p = 0.003), incidence of hypertension (p = 0.01) and gestational diabetes mellitus (p = 0.01) and concurrent medical illness (p = 0.005). Hydroxychloroquine use during pregnancy was protective against hypertension (p = 0.001), and the gestational age at delivery had significant effect on the neonatal birthweight (p = 0.001). However, duration of the disease had a significant negative effect on the neonatal birthweight (p = 0.016).

    CONCLUSION:  Hydroxychloroquine enhanced better neonatal outcomes and reduced adverse pregnancy outcomes and antenatal complications such as hypertension and diabetes.

    Matched MeSH terms: Lupus Erythematosus, Systemic/drug therapy*
  3. Fulltext Prevalence and risk factors for menstrual disorders among systemic lupus erythematosus patients
    Fatnoon NN, Azarisman SM, Zainal D
    Singapore Med J, 2008 May;49(5):413-8.
    PMID: 18465054
    INTRODUCTION: This study aims to determine the prevalence and the types of menstrual disorders among patients with systemic lupus erythematosus (SLE) and to identify factors that influence their development.
    METHODS: 61 patients with SLE were enrolled into a cross-sectional, observational study at the medical outpatient clinic, Hospital Universiti Sains Malaysia. A total of 120 healthy women were selected randomly to act as the control group. A questionnaire was administered, vital signs were recorded, and blood was evaluated for routine investigations. A review of past medical records was also undertaken.
    RESULTS: The mean age and standard deviation for the study group was 33.23 +/- 10.96 years, the majority being ethnic Malays. 75 percent had a severe SLE disease activity index score on initial presentation, and 59 percent were on cyclophosphamide. 49 percent of the study population had menstrual irregularities, of which 60 percent had sustained amenorrhoea. Nine patients with sustained amenorrhoea had hormonal assays, which confirmed the diagnosis of premature menopause.
    CONCLUSION: This study showed that SLE patients had a higher risk of developing menstrual irregularities compared to the normal/healthy population. The risk was higher in the older age group (greater than 30 years old) and those on cyclophosphamide therapy, especially those with a cumulative dose of more than 10 g. Sustained amenorrhoea was the commonest irregularity and a majority of them had confirmed premature menopause.
    Study site: medical outpatient clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Lupus Erythematosus, Systemic/complications*
  4. Fulltext Steroid-induced osteoporosis--a cause for concern?
    Tan TT, Lau IS, Kong NC, Zainal AG
    Malays J Pathol, 1997 Jun;19(1):27-33.
    PMID: 10879239
    Matched MeSH terms: Lupus Erythematosus, Systemic/drug therapy; Lupus Erythematosus, Systemic/metabolism
  5. The spectrum of nasal involvement in systemic lupus erythematosus and its association with the disease activity
    Kusyairi KA, Gendeh BS, Sakthiswary R, Shaharir SS, Haizlene AH, Yusof KH
    Lupus, 2016 Apr;25(5):520-4.
    PMID: 26657735 DOI: 10.1177/0961203315622279
    The purpose of this study was to determine the spectrum of nasal involvement in systemic lupus erythematosus (SLE) and its association with the disease activity of SLE based on the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). This was a cross-sectional and observational study involving 73 stable SLE patients. All subjects were evaluated for the SLEDAI scores and had nasal endoscopic examination. The most commonly reported symptom was nasal congestion (31.5%) followed by nasal itchiness (26.0%), runny nose (20.5%) and nasal dryness (19.2%). Almost half (42.9%) of the subjects had nasal mucosal abnormalities, which included mucositis, crusting, ulceration, bifid middle turbinate, septal spur, Jacobson's organ, deviated nasal septum, bilateral inferior turbinate hypertrophy, everted uncinate process, nasopharynx cleft and torus palatinus. The median SLEDAI score for subjects with nasal symptoms was significantly higher than subjects without nasal symptoms (p 
    Matched MeSH terms: Lupus Erythematosus, Systemic*
  6. Fulltext Retinal vasculitis in systemic lupus erythematosus: an indication of active disease
    Md Noh UK, Zahidin AZ, Yong TK
    Clin Pract, 2012 Mar 30;2(2):e54.
    PMID: 24765453 DOI: 10.4081/cp.2012.e54
    A 26-year-old woman with a recent flare-up of systemic lupus erythematosus presented with peripheral retinal hemorrhages at a routine check-up. She is on a tapering dose of immunosuppressive agents. Her visual acuity was good. Fluorescein angiogram revealed vasculitic changes with capillary non-perfusion areas. A few weeks later, she developed cerebral lupus with advanced lupus nephritis. Immunosuppressive therapy was restarted and panretinal photocoagulation was delivered. Her visual acuity remained stable, despite development of a cataract from prednisolone therapy.
    Matched MeSH terms: Lupus Erythematosus, Systemic
  7. Fulltext Dietary calcium and bone mineral density in premenopausal women with systemic lupus erythematosus
    Chong HC, Chee SS, Goh EM, Chow SK, Yeap SS
    Clin Rheumatol, 2007 Feb;26(2):182-5.
    PMID: 16565892 DOI: 10.1007/s10067-006-0258-6
    The primary objective of this study was to determine the relationship between dietary calcium intake and bone mineral density (BMD) in premenopausal women with systemic lupus erythematosus (SLE) on corticosteroids (CS). The secondary aim was to identify other risk factors for osteoporosis in these patients. A cross-sectional sample of patients attending the SLE Clinic at a teaching hospital was recruited. BMD was measured using dual-energy X-ray absorptiometry. Daily dietary calcium intake was assessed using a structured validated food frequency questionnaire, in which patients were asked to estimate their food intake based on their recent 2-month dietary habits. Sixty subjects were recruited with a mean age of 33.70+/-8.46 years. The median duration of CS use was 5.5 years (range 0.08-24). The median cumulative dose of steroids was 17.21 g (range 0.16-91.37). The median daily dietary calcium intake was 483 mg (range 78-2101). There was no significant correlation between calcium intake and BMD, even after correcting for CS use. There were also no correlations between BMD and the duration of SLE, cumulative CS use, duration of CS use, smoking, alcohol intake, and SLE disease activity index score. Twenty-eight (46.7%) patients had normal BMD, 28 (46.7%) had osteopenia, and four (6.6%) had osteoporosis. Duration of SLE significantly correlated with cumulative CS dosage. In conclusion, 6.7% of these Asian premenopausal SLE women had osteoporosis and only 46.7% had normal BMD. Daily dietary calcium intake did not correlate with BMD.
    Study site: SLE clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Lupus Erythematosus, Systemic/complications; Lupus Erythematosus, Systemic/metabolism*; Lupus Erythematosus, Systemic/physiopathology
  8. IgG anti-beta(2) glycoprotein I antibodies in Malaysian patients with antiphospholipid syndrome and systemic lupus erythematosus: prevalence and clinical correlations
    Ong SG, Cheng HM, Soon SC, Goh E, Chow SK, Yeap SS
    Clin Rheumatol, 2002 Sep;21(5):382-5.
    PMID: 12223986 DOI: 10.1007/s100670200102
    The aim of this study was to investigate the incidence of IgG anticardiolipin antibody (ACL) and IgG anti-beta(2) glycoprotein I antibody (anti-beta2GPI) positivity in patients with primary or secondary antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE), to assess the association between IgG ACL and anti-beta2GPI, and the relationship between the presence of ACL and anti-beta2GPI with the clinical manifestations of APS. IgG ACL and IgG anti-beta2GPI levels were measured in 51 SLE patients, 20 patients with SLE and APS (secondary APS) and 11 primary APS patients using commercially available ELISA kits. Relationships between laboratory data and clinical manifestations of the patients were examined. The incidence of IgG ACL positivity was significantly higher in primary (36.4%) and secondary (40%) APS than in SLE (13.7%) patients (P = 0.02). The incidence of IgG anti-beta2GPI positivity was significantly higher in primary (54.5%) and secondary (35%) APS than in SLE (7.8%) patients (P = 0.0006). Mean levels of IgG ACL and anti-beta2GPI were significantly higher in the primary and secondary APS than in the SLE patients (P = 0.002 for both). A significant relationship was found between IgG ACL and IgG anti-beta2GPI (P = 0.01, R(2) = 0.56). There was a significant correlation between the presence of IgG ACL and a history of thrombosis in the combined primary and secondary APS group, but not in SLE patients. In conclusion, in this study IgG ACL and IgG anti-beta2GPI are closely related and mean levels of IgG ACL and IgG anti-beta2GPI are higher in patients with either primary or secondary APS than in SLE patients.
    Study site: Rheumatology Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Lupus Erythematosus, Systemic/diagnosis; Lupus Erythematosus, Systemic/immunology*; Lupus Erythematosus, Systemic/epidemiology
  9. Fulltext Tuberculosis or systemic lupus erythematosus? A diagnostic and therapeutic dilemma
    Mohd A, Goh EM, Chow SK, Looi LM, Yeap SS
    Southeast Asian J. Trop. Med. Public Health, 2003 Jun;34(2):361-4.
    PMID: 12971563
    The diagnosis of patients with fever of unknown origin (FUO) is often problematic because the range of possible differential diagnoses is broad. We report on a case in which a patient presented with FUO and was subsequently found to have both a collagen vascular disease and an intercurrent infection. Treatment for the collagen vascular disease with corticosteroids exacerbated the intercurrent infection. The problems in the diagnosis and management of such cases are discussed.
    Matched MeSH terms: Lupus Erythematosus, Systemic/diagnosis*; Lupus Erythematosus, Systemic/drug therapy*
  10. Fulltext Cerebral infarction and cerebral salt wasting syndrome in a patient with tuberculous meningoencephalitis
    Loo KL, Ramachandran R, Abdullah BJ, Chow SK, Goh EM, Yeap SS
    Southeast Asian J. Trop. Med. Public Health, 2003 Sep;34(3):636-40.
    PMID: 15115143
    A 38-year old female with underlying systemic lupus erythematosus was admitted with tuberculous meningoencephalitis. After an initial good response to anti-tuberculous treatment, she developed cerebral infarction and profound hyponatremia. This was due to cerebral salt wasting syndrome, which has only previously been described in 2 cases. The difficulties in diagnosis and management of this case are discussed.
    Matched MeSH terms: Lupus Erythematosus, Systemic/complications; Lupus Erythematosus, Systemic/diagnosis
  11. Use of complementary medicine in systemic lupus erythematosus patients in Malaysia
    Goh EML, Tan LC, Chow SK, Teh LK, Yeap SS
    APLAR Journal of Rheumatology, 2003;6(1):21-25.
    DOI: 10.1046/j.0219-0494.2003.00021.x
    Aim: To determine the prevalence of the use of complementary medicine in patients with systemic lupus erythematosus (SLE)., Method: A prospective survey was conducted of 132 patients using a standard questionnaire., Results: Of the 132 patients, 15.2% were on alternative therapy and 56.7% were taking food supplements. The common types of alternative therapy taken were oral traditional herbs (50%) and noni juice (20%). Vitamin C, calcium, vitamin E, vitamin B, Spirulina, evening primrose oil, fish oil and multivitamins were the commonest food supplements. There was no significant relationships between taking alternative treatment and educational level (P = 0.16), income (P = 0.05) or race (P = 0.42) of the patients. The majority of these patients took these therapies or supplements for up to 1 year. Up to 70% of the patients had not consulted a doctor before taking these therapies, with immediate family members and friends being the main sources of recommendation. The majority of patients spent RM50-RM500 (US$13-US$132) for 2 months' supply of medications. In conclusion, 15.2% of SLE patients in our study were on alternative therapy and 57.6% on food supplements., Conclusion: Physicians should be aware of these practices which should be taken into account during the history-taking and subsequent management of the patients.
    Matched MeSH terms: Lupus Erythematosus, Systemic*
  12. HLA-A*11 and novel associations in Malays and Chinese with systemic lupus erythematosus
    Mohd-Yusuf Y, Phipps ME, Chow SK, Yeap SS
    Immunol Lett, 2011 Sep 30;139(1-2):68-72.
    PMID: 21658414 DOI: 10.1016/j.imlet.2011.05.001
    We investigated the association of the HLA genes in Malaysian patients with systemic lupus erythematosus (SLE) and their associations with the clinical manifestations in 160 SLE patients (99 Chinese and 61 Malays) and 107 healthy control individuals (58 Chinese and 49 Malays) were studied. Sequence specific primer amplification (PCR-SSP) phototyping techniques were used to analyse 25 HLA-A allele groups, 31 HLA-DR allele groups and 9 HLA-DQ allele groups. Appreciable increases in allele frequencies of HLA-A*11, DRB1*0701, DRB1*1601-1606, DRB5*01-02 and DQB1*05, and decrease in HLA-DRB1*1101-1121, 1411, DRB1*1201-3, DRB1*1301-22, DRB3*0101, 0201, 0202, 0203, 0301 and DQB1*0301, 1304 in SLE patients compared with healthy control individuals. However, after Bonferroni correction (p(c)<0.05) only HLA-A*1101, 1102, DRB5*01-02, DQB1*05, DRB1*1201-3, DRB3*0101, 0201, 0202, 0203, 0301 and DQB1*0301, 0304 remained significant. Allele frequencies of DRB1*0701 and DRB4*0101101, 0102, 0103, DQB1*05, DRB1*1301-22, DRB3*0101, 0201, 0202, 0203, 0301 and DQB1*0301, 0304 were significantly increased in Malay SLE patients compared with healthy control individuals. In contrast, Chinese SLE patients had increased allele frequencies of DRB1*1601-1606, DQB1*05, DRB1*1201-3, DRB3*0101, 0201, 0202, 0203, 0301, DRB3*0101, 0201, 0202, 0203, 0301 and DQB1*0301, 0304 compared with healthy control individuals. HLA-A*6801-02 and DRB1*1601-1606 frequencies appeared elevated in a subset of patients with serositis and DRB1* 0401-1122 frequency was elevated in those displaying neurologic disorder. However, unequivocal evidence of these associations would require investigation of substantially larger cohorts. On the whole, our findings suggest that HLA allele associations with SLE are race specific in Malays and Chinese.
    Study site: SLE clinic, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Lupus Erythematosus, Systemic/ethnology; Lupus Erythematosus, Systemic/genetics*; Lupus Erythematosus, Systemic/immunology
  13. Lack of correlation between Apo-1/Fas promoter polymorphism and susceptibility to systemic lupus erythematosus
    Radzi AM, Hun KS, Kong N, Yahaya N
    International Medical Journal (Tokyo), 2008;15(4):257-259.
    Background: Systemic lupus erythematosus (SLE) is a complex autoimmune disease exhibiting extensive clinical heterogeneity. Genetic factors and immune dysregulation play important roles in its development. Apoptosis is a physiologic process that regulates normal homeostasis. It is likely to contribute to the pathogenesis of autoimmune diseases by impairing elimination of autoreactive T and B cells. Apo-1/Fas which is a transmembrane protein mediates apoptosis and is a member of the tumour necrosis factor/nerve growth factor receptor family. It transduces the apoptotic signal into susceptible target cells. Recent studies have focused on the apoptosis mediated by these proteins in the causation of several autoimmune disorders including SLE. Aim: To determine the frequency of Apo-1/Fas promoter gene polymorphism in patients with systemic lupus erythematosus and healthy controls and to investigate its role in the susceptibility of SLE in a cohort of Malaysian Chinese SLE patients Materials and methods: 107 Chinese patients and 60 matched controls were genotyped using polymerase chain reaction (PCR) amplification followed by MvaI restriction enzyme digestion. The MvaI RFLP is located at the -670 position from the transcription starting site and results from an A→G substitution which alters the MvaI restriction site. Results: G/G genotype was found in 25% of patients and controls while the A/A genotype in 23% and 31.6% of patients and controls respectively. Heterozygous form was noted in 43% of the normal population compared to 51% in SLE patients. There was also no significant difference in the allele frequencies of G and A in both groups studied. Conclusion: We suggest that polymorphism of the Apo-1/Fas promoter gene does not play a role in disease susceptibility in Chinese patients with SLE. © 2008 Japan International Cultural Exchange Foundation.
    Matched MeSH terms: Lupus Erythematosus, Systemic*
  14. A case of minimal change disease complicated by acute kidney injury in systemic lupus erythematosus
    Wong KW
    Saudi J Kidney Dis Transpl, 2014 Nov;25(6):1308-11.
    PMID: 25394457
    Matched MeSH terms: Lupus Erythematosus, Systemic/complications*; Lupus Erythematosus, Systemic/diagnosis; Lupus Erythematosus, Systemic/drug therapy
  15. Fulltext Cutaneous tuberculosis mimicking cellulitis in an immunosuppressed patient
    Chin PW, Koh CK, Wong KT
    Singapore Med J, 1999 Jan;40(1):44-5.
    PMID: 10361486
    A 28-year-old lady suffering from systemic lupus erythomatosus (SLE) with diffuse proliferative glomerulonephritis (DPGN) and who was on oral cyclophosphamide and prednisolone presented with left lower limb 'cellulitis'. The 'cellulitis' of the left lower limb failed to respond to usual antibiotics which prompted evaluation of the clinical diagnosis. The diagnosis is made based on the presence of granulomas, multinucleated giant cells and acid fast bacilli on the skin biopsy.
    Matched MeSH terms: Lupus Erythematosus, Systemic/complications
  16. Fulltext Slicc damage index score in systemic lupus erythematosus patients and its associated factors
    Ghazali WSW, Daud SMM, Mohammad N, Wong KK
    Medicine (Baltimore), 2018 Oct;97(42):e12787.
    PMID: 30334968 DOI: 10.1097/MD.0000000000012787
    The aims of this study were to determine damage index in systemic lupus erythematosus (SLE) patients based on Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (SDI) and to determine the laboratory and clinico-demographic factors affecting SDI.This is a retrospective cohort study of 94 SLE patients attending rheumatology clinics in 2 local hospitals in Kelantan, Malaysia. The patients were divided into 2 groups based on SDI score assigned by the attending physician, 0 (without damage) or ≥1 (with damage). Newly diagnosed SLE patients with disease duration less than 6 months were excluded.A total of 45 (47.9%) SLE patients showed damage by SDI score. Majority of the subjects had neuropsychiatric damages (21/94; 22.3%) followed by skin (12/94; 12.8%) and musculoskeletal (6/94; 6.4%) damage. SDI score was significantly associated with higher disease duration (6.2 ± 6.57 years vs 4.5 ± 3.7 years; P = .018), lower prednisolone dose (8.74 ± 10.89 mg vs 4.89 ± 3.81 mg; P 
    Matched MeSH terms: Lupus Erythematosus, Systemic/complications; Lupus Erythematosus, Systemic/drug therapy; Lupus Erythematosus, Systemic/pathology*
  17. Fulltext CD3+CD4+gp130+ T Cells Are Associated With Worse Disease Activity in Systemic Lupus Erythematosus Patients
    Mohd Shukri ND, Farah Izati A, Wan Ghazali WS, Che Hussin CM, Wong KK
    Front Immunol, 2021;12:675250.
    PMID: 34149710 DOI: 10.3389/fimmu.2021.675250
    The receptors for IL-35, IL-12Rβ2 and gp130, have been implicated in the inflammatory pathophysiology of autoimmune diseases. In this study, we set out to investigate the serum IL-35 levels and the surface levels of IL-12Rβ2 and gp130 in CD3+CD4+, CD3+CD4─ and CD3─CD4─ lymphocyte subpopulations in systemic lupus erythematosus (SLE) patients (n=50) versus healthy controls (n=50). The potential T cell subsets associated with gp130 transcript (i.e. IL6ST) expression in CD4+ T cells of SLE patients was also examined in publicly-available gene expression profiling (GEP) datasets. Here, we report that serum IL-35 levels were significantly higher in SLE patients than healthy controls (p=0.038) but it was not associated with SLEDAI-2K scores. The proportions of IL-12Rβ2+ and gp130+ cells in SLE patients did not differ significantly with those of healthy controls in all lymphocyte subpopulations investigated. Essentially, higher SLEDAI-2K scores were positively correlated with increased proportion of gp130+ cells, but not IL-12Rβ2+ cells, on CD3+CD4+ T cells (r=0.425, p=0.002, q=0.016). Gene Set Enrichment Analysis (GSEA) of a GEP dataset of CD4+ T cells isolated from SLE patients (n=8; GSE4588) showed that IL6ST expression was positively associated with genes upregulated in CD4+ T cells vs myeloid or B cells (q<0.001). In an independent GEP dataset of CD4+ T cells isolated from SLE patients (n=9; GSE1057), IL6ST expression was induced upon anti-CD3 stimulation, and that Treg, TCM and CCR7+ T cells gene sets were significantly enriched (q<0.05) by genes highly correlated with IL6ST expression (n=92 genes; r>0.75 with IL6ST expression) upon anti-CD3 stimulation in these SLE patients. In conclusion, gp130 signaling in CD3+CD4+ T cell subsets may contribute to increased disease activity in SLE patients, and it represents a promising therapeutic target for inhibition in the disease.
    Matched MeSH terms: Lupus Erythematosus, Systemic/immunology*
  18. Fulltext Increased IL-23R+ Th Cells Population Exhibits Higher SLEDAI-2K Scores in Systemic Lupus Erythematosus Patients
    Izati AF, Mohd Shukri ND, Wan Ghazali WS, Che Hussin CM, Wong KK
    Front Immunol, 2021;12:690908.
    PMID: 34484186 DOI: 10.3389/fimmu.2021.690908
    The IL-23/IL-17 axis plays causative roles in the development and progression of systemic lupus erythematosus (SLE). However, it remains unclear if the IL-17RA+ and IL-23R+ T helper (Th) cells populations are associated with the serum IL-17 and IL-23 levels, or with the immunological parameters and disease activities in SLE patients. Herein, we examined the proportion of IL-17RA+ and IL-23R+ Th cells and serum levels of IL-17 and IL-23 in established SLE patients (n = 50) compared with healthy controls (n = 50). The associations of these interleukins and their receptors with immunological parameters [anti-nuclear antibody (ANA), anti-dsDNA antibody, and C-reactive protein (CRP)] and SLE disease activity (SLEDAI-2K scores) in SLE patients were assessed. CD3+CD4+ Th cells of SLE patients demonstrated significantly elevated IL-17RA+ (p = 1.12 x 10-4) or IL-23R+ (p = 1.98 x 10-29) populations compared with the healthy controls. Serum IL-17 levels were significantly lower in SLE patients compared with the healthy controls (p = 8.32 x 10-5), while no significant difference was observed for the IL-23 serum levels between both groups. IL-23R+ Th cells population was significantly associated with higher SLEDAI-2K scores (p = 0.017). In multivariate analysis, the proportion of IL-23R+ Th cells remained significantly associated with higher SLEDAI-2K scores independent of prednisolone intake (p = 0.027). No associations were observed between the interleukin parameters (i.e., IL-17, IL-23, IL-17RA+ Th cells, and IL-23R+ Th cells) with ANA, anti-dsDNA, and CRP status, suggesting that the IL-17/IL-23 axis acts independently of these immunological parameters. In conclusion, our results support that therapeutic inhibition of the IL-23/IL-17 axis receptors on Th cells, particularly IL-23R, is potentially relevant in SLE patients.
    Matched MeSH terms: Lupus Erythematosus, Systemic/blood; Lupus Erythematosus, Systemic/immunology*
  19. Coexistence of antiphospholipid antibodies and cephalalgia
    Islam MA, Alam F, Gan SH, Cavestro C, Wong KK
    Cephalalgia, 2018 03;38(3):568-580.
    PMID: 28952322 DOI: 10.1177/0333102417694881
    Background The occurrence of antiphospholipid antibodies (aPLs) and headache comorbidity in the presence or absence of underlying autoimmune diseases remains unclear. Aim The aim of this review was to summarize the relationship between headache and aPLs based on evidences from cohort studies and case reports, in addition to examining the treatment strategies that resolved headache in aPLs-positive individuals.
    Methods A comprehensive literature search was conducted through PubMed, ISI Web of Science and Google Scholar. A total of 559 articles were screened and the appropriate articles were selected based on quality and level of evidence.
    Results Cohort studies (n = 27) from Europe, North America and Asia demonstrated comorbidity of aPLs and headache in antiphospholipid syndrome, systemic lupus erythematosus (SLE) and neuropsychiatric SLE patients. Significantly higher association between migraine and aPLs was observed (n = 170/779; p 
    Matched MeSH terms: Lupus Erythematosus, Systemic/epidemiology
  20. Anti-phospholipid antibody isotypes in normal human sera
    Cheng HM, Wong KK
    Immunol Lett, 1990 Jan;23(3):183-6.
    PMID: 2307490
    Heat-sensitive serum masking cofactor(s) of antiphospholipid antibody (aPL) in normal human sera (NHS) are specifically inactivated at 56 degrees C. The degree of binding in ELISA by unmasked aPL in NHS was equivalent to that in non-heated, aPL-reactive autoimmune SLE sera. Previously "negative" SLE sera also reacted equally strongly in the aPL ELISA when similarly heat-inactivated. Isotype studies by ELISA of the heat-potentiated aPL in 36 NHS revealed the presence of specific IgG (34/36), IgM (11/36) and IgA (24/36) aPL antibodies. 11/36 (31%) NHS had all three aPL isotypes while 13/36 (36%) had both IgG and IgA antibodies to phospholipid.
    Matched MeSH terms: Lupus Erythematosus, Systemic/immunology
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