Search

Aim: Behçet's disease (BD) can involve any gastrointestinal (GI) tract site. We analyzed the characteristics, risk factors, and treatment responses to upper GI (UGI) involvement in patients with BD. Methods: This retrospective cohort study analyzed UGI findings in 101 patients with BD who underwent endoscopy between April 2005 and December 2022 at the University of Tokyo Hospital. The patients were divided into two groups based on the presence or absence of UGI findings. Patient backgrounds, clinical symptoms, colonoscopy (CS) findings, and blood test findings were compared between the groups. Results: In total, 18.8% (19/101) of the patients had UGI lesions. The prevalence rates in the esophagus, stomach, and duodenum were 6.9%, 6.9%, and 8.9%, respectively. Of these 19 patients, BD treatment were intensified in 10 (52.6%) patients after esophagogastroduodenoscopy (EGD), and all showed improvement in symptoms or endoscopic findings. In the multivariate analysis, symptoms (OR: 37.1, P < 0.001), CRP > 1 mg/dL (OR: 11.0, P = 0.01), and CS findings (OR: 5.16, P = 0.04) were independent predictors of UGI involvement in BD patients. The prediction model for UGI involvement using these three factors was highly accurate, with an AUC of 0.899 on the ROC curve. In the subgroup analysis of intestinal BD, symptoms (OR: 12.8, P = 0.01) and ESR > 20 mm/h (OR: 11.5, P = 0.007) were independent predictors. Conclusions: EGD should be conducted in BD patients with high CRP, GI symptoms, and lower GI involvement, which leads to better management of BD in terms of improving symptoms and endoscopic findings. [ABSTRACT FROM AUTHOR]

Purpose/objectives: Tooth carvings are evaluated subjectively. However, subjective evaluations are associated with low intra‐ and inter‐evaluator reliability in providing feedback for the fabrication of better tooth carvings. Therefore, this study aimed to analyze the relationship between subjective evaluation and the morphological characteristics of tooth carvings and their morphological characteristics using the feedback method in the low‐scoring group. Methods: Between April 2013 and September 2021, 120 maxillary left first molar carvings fabricated by undergraduate students were subjectively evaluated by an experienced instructor using a five‐point scale. The tooth carvings were scanned to obtain three‐dimensional shape data and divided into two groups, the high‐ and low‐scoring groups, for principal component analysis. Homologous models with dimensions matching those of the average model were created, and principal component analysis was performed to evaluate the morphological characteristics of the tooth. Results: Principal component analysis indicated that an objective evaluation was possible using homologous model. On increasing the subjective evaluation, the occlusal inclination angle and the cervical region of the tooth became steeper, and the shape of the occlusal surface resembled a parallelogram. In addition, large morphological differences were observed in the position of the cervical region of the tooth, height of contour, and shape of the occlusal surface in the low‐scoring group, whereas no such difference was observed in the high‐scoring group. Conclusion: Objective evaluation of tooth carving was possible using homologous model. The evaluation of tooth morphological characteristics could be effective in providing feedback to undergraduate students. [ABSTRACT FROM AUTHOR]

The serum Tn-C levels were positively correlated with serum troponin I and creatine kinase (CK)-myocardial band level in high disease activity at disease onset and at relapse DM patients, but not with the serum CK, aldolase, KL-6, and C-reactive protein (CRP) level (Figure 1B). The serum tenascin-C levels of DM patients were significantly elevated in high disease activity at disease onset and at relapse, and low disease activity state DM patients, but not in IMNM patients, compared with healthy controls (Figure 1A). Keywords: biomarker; cardiomyopathy; dermatomyositis EN biomarker cardiomyopathy dermatomyositis 1635 1639 5 08/03/23 20230801 NES 230801 INTRODUCTION Idiopathic inflammatory myositis (IIM) is an autoimmune disease, which involves muscle, lung, skin, and cardiovascular organs.[1] Core set measures have been proposed to evaluate disease activity among patients with dermatomyositis (DM) or polymyositis (PM) by the International Myositis Assessment and Clinical Studies Group (IMACS), but the relationship between traditional serum biomarkers including muscle-related enzymes to disease activity of IIM is variable.[1] Because biomarkers in autoimmune diseases are required for the diagnosis, assessment of disease activity, and prediction of prognosis, a novel biomarker of IIM is needed. RESULTS Circulating tenascin-C levels in DM patients We enrolled 34 IIM patients, including 30 patients with DM and 4 patients with immune-mediated necrotizing myopathy (IMNM). [Extracted from the article]

Objective: Idiopathic inflammatory myopathies (IIM) demonstrate characteristic clinical phenotypes depending on the myositis‐specific antibody (MSAs) present. We aimed to identify common or MSA‐specific immunological pathways in different immune cell types from peripheral blood by transcriptome analysis. Methods: We recruited 33 patients with IIM who were separated into the following groups: 15 patients with active disease at onset and 18 with inactive disease under treatment. All patients were positive for MSAs: anti–melanoma differentiation‐associated gene 5 (MDA5) antibody (Ab) in 10 patients, anti‐Mi‐2 Ab in 7, and anti‐aminoacyl‐transfer RNA synthetase (ARS) Ab in 16. The patients were compared with 33 healthy controls. Twenty‐four immune cell types sorted from peripheral blood were analyzed by flow cytometry, RNA sequencing, and differentially expressed gene analysis combined with pathway analysis. Results: The frequencies of memory B cell types were significantly decreased in active patients, and the frequency of plasmablasts was prominently increased in active patients with anti‐MDA5 Ab in comparison with healthy controls. The expression of type I interferon (IFN)‐stimulated genes of all immune cell types was increased in the active, but not inactive, patients. Endoplasmic reticulum stress‐related genes in all IIM memory B cells and oxidative phosphorylation‐related genes in inactive IIM double negative B cells were also increased, suggesting prominent B cell activation in IIM. Furthermore, active patients with anti‐MDA5 Ab, anti‐Mi‐2 Ab, or anti‐ARS Ab were distinguished by IFN‐stimulated and oxidative phosphorylation‐related gene expression in plasmablasts. Conclusion: Unique gene expression patterns in patients with IIM with different disease activity levels and MSA types suggest different pathophysiologies. Especially, B cells may contribute to common and MSA‐specific immunological pathways in IIM. [ABSTRACT FROM AUTHOR]

Objective: Tofacitinib is an oral JAK inhibitor for the treatment of rheumatoid arthritis (RA), psoriatic arthritis, and ulcerative colitis, and has been previously investigated for psoriasis (PsO). This meta‐analysis of genome‐wide association studies (GWAS) was performed to identify genetic factors associated with increased risk/faster onset of herpes zoster (HZ) in subjects with RA or PsO receiving tofacitinib treatment, and to determine potential mechanisms that could be attributed to the varying rates of HZ across ethnicities. Methods: In an ethnicity/indication‐specific, trans‐ethnic, trans‐population meta‐analysis of GWAS in subjects with RA or PsO from phase II, phase III, and long‐term extension studies of tofacitinib, 8 million genetic variants were evaluated for their potential association with time to an HZ event and incidence of an HZ event (case versus control) with tofacitinib treatment, using Cox proportional hazard and logistic regression analyses, respectively. Results: In total, 5,246 subjects were included (3,168 with RA and 2,078 with PsO). After adjustment for age, baseline absolute lymphocyte count, genetically defined ethnicity, and concomitant methotrexate use (in RA subjects only), 4 loci were significantly associated with faster onset of HZ in European subjects (P < 5 × 10−8), including a single‐nucleotide polymorphism (SNP) near CD83 (frequency of risk allele ~2% in European subjects versus ~0.1% in East Asian subjects). In the trans‐ethnic, trans‐population meta‐analysis, the CD83 SNP remained significant. Four additional significant loci were identified in the meta‐analysis, among which a SNP near IL17RB was associated with faster onset of HZ (meta‐analysis hazard ratio 3.6 [95% confidence interval 2.40–5.44], P = 7.6 × 10−10; frequency of risk allele ~12% in East Asian subjects versus <0.2% in European subjects). Conclusion: Genetic analysis of tofacitinib‐treated subjects with RA or PsO identified multiple loci associated with increased HZ risk. Prevalent variants near the immune‐relevant genes CD83 and IL17RB in European and East Asian populations, respectively, may contribute to risk of HZ in tofacitinib‐treated subjects. [ABSTRACT FROM AUTHOR]