Efficacy and safety of gut microbiota-based therapies in autoimmune and rheumatic diseases: a systematic review and meta-analysis of 80 randomized controlled trials

BMC Medicine, Journal Year: 2024, Volume and Issue: 22(1)

Published: March 13, 2024

Abstract Background Previous randomized controlled trials (RCTs) suggested that gut microbiota-based therapies may be effective in treating autoimmune diseases, but a systematic summary is lacking. Methods Pubmed, EMbase, Sinomed, and other databases were searched for RCTs related to the treatment of diseases with probiotics from inception June 2022. RevMan 5.4 software was used meta-analysis after 2 investigators independently screened literature, extracted data, assessed risk bias included studies. Results A total 80 14 types disease [celiac sprue, SLE, lupus nephritis (LN), RA, juvenile idiopathic arthritis (JIA), spondyloarthritis, psoriasis, fibromyalgia syndrome, MS, systemic sclerosis, type 1 diabetes mellitus (T1DM), oral lichen planus (OLP), Crohn’s disease, ulcerative colitis] included. The results showed improve symptoms and/or inflammatory factor celiac SLE LN, JIA, PSS, colitis. However, not spondyloarthritis RA. Gut relieve pain effect on impact questionnaire score significant. HbA1c T1DM, its insulin requirement does seem These did increase incidence adverse events. Conclusions several (celiac colitis).

Language: Английский

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Management of systemic sclerosis: the first five years

Current Opinion in Rheumatology, Journal Year: 2020, Volume and Issue: 32(3), P. 228 - 237

Published: March 24, 2020

Purpose of review This provides a risk-stratified and evidence-based management for subsets systemic sclerosis (SSc) patients in the first five years from disease onset. Recent findings Cardiopulmonary remains primary cause mortality SSc patients. Morbidity SSc-associated pulmonary arterial hypertension have improved with combination treatment, either an upfront or sequential treatment pattern. Traditional therapies interstitial lung (SSc-ILD) targeted those clinically significant progressive ILD immunosuppression. New data suggest possible paradigm shift, introducing immunosuppressive therapy to before they develop ILD. The year 2019 saw approval FDA-approved disease, using antifibrotic agent previously approved idiopathic fibrosis. To date, only autologous hematopoietic stem cell transplant has demonstrated benefit SSc-ILD, albeit narrow spectrum SSc-ILD Summary is highly heterogeneous autoimmune typified by varying clinical trajectories. Its may be stratified within subclassifying based on factors that important prognostic significance: skin distribution autoantibody status.

Language: Английский

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Pulmonary hypertension phenotypes in patients with systemic sclerosis

European Respiratory Review, Journal Year: 2021, Volume and Issue: 30(161), P. 210053 - 210053

Published: Aug. 17, 2021

Pulmonary hypertension (PH) commonly affects patients with systemic sclerosis (SSc) and is associated significant morbidity increased mortality. PH a heterogenous condition several different forms can be SSc, including pulmonary arterial (PAH) resulting from vasculopathy, due to left heart disease interstitial lung disease. The incidence of veno-occlusive also increased. Accurate early diagnosis allow optimal treatment is, therefore, essential. Recent changes diagnostic haemodynamic criteria at the 6th World Symposium on Hypertension have resulted in therapeutic uncertainty regarding borderline haemodynamics. Furthermore, vascular resistance threshold for diagnosing PAH role exercise identifying require further elucidation. In this article we review epidemiology, diagnosis, outcomes spectrum phenotypes SSc.

Language: Английский

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Renal Involvement in Systemic Sclerosis: An Update

Kidney & Blood Pressure Research, Journal Year: 2020, Volume and Issue: 45(4), P. 532 - 548

Published: Jan. 1, 2020

<b><i>Background:</i></b> Systemic sclerosis is an immune-mediated rheumatic disease characterized by vascular abnormalities, tissue fibrosis and autoimmune phenomena. <b><i>Summary:</i></b> Renal occurring in patients with systemic may have a variable clinicopathological picture. The most specific renal condition associated scleroderma crisis, acute onset of failure severe hypertension. Although the management crisis was revolutionized introduction angiotensin-converting enzyme inhibitors, there still significant proportion poor outcomes. Therefore, research on establishing markers (clinical, ultrasonographical serological) clear diagnostic criteria, which could limit risk developing facilitate diagnosis this complication, ongoing. Other forms involvement include vasculitis, isolated reduced glomerular filtration rate sclerosis, antiphospholipid-associated nephropathy, high intrarenal arterial stiffness proteinuria. <b><i>Key Messages:</i></b> Scleroderma life-threatening presentation albeit declining prevalence. In it mandatory to control blood pressure early increasing doses along other antihypertensive drugs if necessary. There strong association between patients’ outcomes sclerosis; consequently, becomes find that be used identify especially crisis.

Language: Английский

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Mesenchymal stromal cells for systemic sclerosis treatment

Autoimmunity Reviews, Journal Year: 2021, Volume and Issue: 20(3), P. 102755 - 102755

Published: Jan. 19, 2021

Language: Английский

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Role of B-Cell in the Pathogenesis of Systemic Sclerosis

Frontiers in Immunology, Journal Year: 2022, Volume and Issue: 13

Published: July 12, 2022

Systemic sclerosis (SSc) is a rare multisystem autoimmune disease, characterized by fibrosis, vasculopathy, and autoimmunity. Recent advances have highlighted the significant implications of B-cells in SSc. are present affected organs, their subpopulations disrupted, they display an activated phenotype, regulatory capacities impaired, as illustrated decrease IL-10+ producing B-cell subpopulation or inhibitory membrane co-receptor density. multi-omics evidence highlights role mainly early stage SSc preferentially during severe organ involvement. This dysregulated homeostasis partly explains synthesis anti-endothelial cell autoantibodies (AECAs) anti-fibroblast (AFAs), proinflammatory profibrotic cytokines (interleukin-6 transforming growth factor-β) produced B plasma cells. That associated with cell-to-cell interactions endothelial cells, fibroblasts, vascular smooth muscle other immune altogether leading to activation proliferation, resistance apoptosis, impairment mechanisms, causing fibrosis several organs encountered Finally, alongside these exploratory data, treatments targeting B-cells, through depletion cytotoxicity (anti-CD20 monoclonal antibody), B-cell, costimulation molecules, seem interesting, probably certain profiles patients organic damage.

Language: Английский

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Janus kinase inhibitors for treatment of morphea and systemic sclerosis: A literature review

Dermatologic Therapy, Journal Year: 2022, Volume and Issue: 35(6)

Published: March 12, 2022

Morphea and systemic sclerosis (SSc) are rare disorders of connective tissue characterized by increased skin thickness fibrosis, with current treatment options having variable efficacies, many limited therapeutic benefit. Janus kinase (JAK) inhibitors have been shown in preclinical studies to inhibit the fibrotic pathway murine models sclerosis, blocking TGF-beta mediated STAT protein activation. Additionally, case reports morphea SSc tofacitinib, a JAK 1/3 inhibitor, improvement sclerosis. Several developed utilized dermatologic rheumatologic diseases. To date, tofacitinib has far most commonly trialed inhibitor patients morphea. Herein we review reported literature supporting use efficacy for cutaneous manifestations SSc, as well discuss clinical cases published date illustrating benefits disease management. The pathogenesis mechanism action will be reviewed it relates process fibrosis along disease. Based on available data consideration there is promising evidence support further study management SSc.

Language: Английский

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The Past, Present, and Future in Antinuclear Antibodies (ANA)

Diagnostics, Journal Year: 2022, Volume and Issue: 12(3), P. 647 - 647

Published: March 7, 2022

Autoantibodies are a hallmark of autoimmunity and, specifically, antinuclear antibodies (ANAs) the most relevant autoantibodies present in systemic autoimmune rheumatic diseases (SARDs). Over years, different methods from LE cell to HEp-2 indirect immunofluorescence (IIF), solid-phase assays (SPAs), and finally multianalyte technologies have been developed study ANA-associated SARDs. All them provide complementary information that is important clinically valuable information. The identification new biomarkers together with platforms will help close so-called “seronegative gap” correctly classify diagnose patients Finally, artificial intelligence machine learning an area still be exploited but next future extract patterns within patient data, exploit these predict outcomes for improved clinical management.

Language: Английский

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Can Antinuclear Antibodies Have a Pathogenic Role in Systemic Sclerosis?

Frontiers in Immunology, Journal Year: 2022, Volume and Issue: 13

Published: June 28, 2022

Systemic sclerosis (SSc) is a connective tissue disease characterized by extensive fibrosis of the skin and internal organs, associated with vasculopathy autoimmune features. Antinuclear antibodies (ANA) are found in almost all SSc patients constitute strong diagnosis prognosis biomarkers. However, it remains unclear whether ANA simple bystanders or if they can have role pathophysiology disease. One might think that nuclear nature their targets prevents any accessibility to autoantibodies. Nevertheless, recent data suggest could be pathogenic at least contribute perennation We review here first indirect clues contribution SSc: subtypes, may precede onset, titer correlates activity severity, there an association between molecular subsets, some respond B-cell targeting therapy. Then, we describe second part mechanisms production from individual genetic background post-transcriptional modifications neoantigens. Finally, elaborate on potential pathogenicity: through immune-complex-mediated mechanisms; other processes potentially involve mimicry penetration into target cell, focus anti-topoisomerase-I antibodies, which most probable candidate play SSc. outline technical conceptual ways improve our understanding this field.

Language: Английский

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Systemic Scleroderma—Definition, Clinical Picture and Laboratory Diagnostics

Journal of Clinical Medicine, Journal Year: 2022, Volume and Issue: 11(9), P. 2299 - 2299

Published: April 20, 2022

(1) Background: Scleroderma (Sc) is a rare connective tissue disease classified as an autoimmune disorder. The pathogenesis of this not fully understood. (2) Methods: This article reviews the literature on systemic scleroderma (SSc). A review available scientific articles was conducted using PubMed database with time range January 1985 to December 2021. (3) Results and Conclusions: information epidemiology, criteria for diagnosis, pathogenesis, variety clinical pictures possibility laboratory diagnostic in diagnosis monitoring scleroderma.

Language: Английский

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