Galectins, a family of animal lectins, play central roles in immune system regulation, shaping both innate and adaptive responses in physiological and pathological processes. These include rheumatoid arthritis (RA), a chronic multifactorial autoimmune disease characterized by inflammatory responses that affects both articular and extra-articular tissues. Galectins have been reported to play central roles in RA and its experimental animal models. In this perspective article we present new data highlighting the regulated expression of galectin-1 (Gal-1) and galectin-3 (Gal-3) in sera from RA patients under disease-modifying anti-rheumatic drugs (DMARDs) and/or corticoid treatment in the context of a more comprehensive discussion that summarizes the roles of galectins in joint inflammation. We found that Gal-1 levels markedly increase in sera from RA patients and positively correlate with erythrocyte sedimentation rate (ERS) and disease activity score 28 (DAS-28) parameters. On the other hand, Gal-3 is downregulated in RA patients, but positively correlates with health assessment questionnaire parameter (HAQ). Finally, by generating receiver-operator characteristic (ROC) curves, we found that Gal-1 and Gal-3 serum levels constitute good parameters to discriminate patients with RA from healthy individuals. Our findings uncover a differential regulation of Gal-1 and Gal-3 which might contribute to the anti-inflammatory effects elicited by DMARDs and corticoid treatment in RA patients.
Background:
Sudden sensorineural hearing loss (SSNHL) is defined as a sudden loss of
hearing, usually unilateral, of more than 30 dB in 3 contiguous frequencies of the tonal audiometry.
SSNHL estimates an incidence ranging from 5 to 20 per 100.000 people per year. In approximately
75% of cases, a cause cannot be identified. However, it could be a clinical manifestation of Systemic
lupus erythematosus (SLE) and Antiphospholipid Syndrome (APS).
Objective:
This review will focus on the clinical presentation, diagnosis, and management of the
SLE and APS associated SSNHL.
Methods:
We searched in PubMed, Scopus, Lilacs, and Cochrane reviewing reports of Sudden sensorineural
hearing loss in SLE and/or APS. Articles written in English and Spanish, and were available
in full text, were included.
Results:
In patients with SLE, bilateral involvement was frequent. Antiphospholipid antibodies
were positive in the majority of the patients. Corticosteroids were the mainstay of the treatment.
The auditory prognosis was poor with total hearing loss recovery reached in only 22% of patients.
On the other hand, most of the patients with SSNHL and APS were males and presented associated
symptoms such as vertigo, tinnitus and/or headache, 75% had bilateral disease. Lupus anticoagulant
and aCL were found in equal proportions, all patients were anticoagulated, and aspirin was associated
in 25% of the cases. Complete resolution or improvement of symptoms was observed in
25% of the patients.
Conclusion:
Sudden sensorineural hearing loss, can be a clinical feature of SLE and APS. Treating
physicians should be aware of this devastating complication, especially when bilateral involvement
occurs.
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