A prospective study of survival and prognostic indicators of systemic lupus erythematosus in a southern Chinese population

Mok, Chi Chiu; Lee, K. W.; Ho, Carmen Tze Kwan; Lau, Chak Sing; Wong, Rebecca

doi:10.1093/rheumatology/39.4.399

Cited by 183 publications

(163 citation statements)

References 30 publications

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“…A PubMed search revealed 6 studies of SMRs in SLE patients, 12 in RA patients, 3 in PsA patients, 3 in SSc patients, and 3 in SV patients (9,. There was only one study on SMR in AS patients, published in 1993 (39).…”

Section: Life Expectancy Smrs and Causes Of Death In Rheumatic Disementioning

confidence: 99%

Life expectancy, standardized mortality ratios, and causes of death in six rheumatic diseases in Hong Kong, China

Mok¹,

Kwok²,

Ho³

et al. 2011

Arthritis & Rheumatism

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196

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Objective. To examine the life expectancy, standardized mortality ratios (SMRs), and causes of death in 6 groups of patients from Hong Kong with different rheumatic diseases.Methods 7 years). In male patients, the loss in life expectancy was highest for SV (28.3 years), SLE (27 years), and SSc (16 years). There were 2,486 deaths during the study period (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008), and the principal causes were infections (28%), cardiovascular complications (18%), cancer (16%), and disease activity (7%). Infection was the leading cause of death in SLE, RA, AS, and PsA, whereas deaths from disease-related activity and cardiovascular complications were most frequent in SSc. Cancer was the most common cause of death in SV. Conclusion.Our findings indicate that patients with SLE, RA, AS, PsA, SV, and SSc have increased mortality rates and reduced life expectancy. SLE has the highest adjusted SMR, and female SSc patients have the greatest loss in life expectancy. Infection is the leading cause of death, followed by cardiovascular complications and malignancies.

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Section: Life Expectancy Smrs and Causes Of Death In Rheumatic Disementioning

confidence: 99%

Life expectancy, standardized mortality ratios, and causes of death in six rheumatic diseases in Hong Kong, China

Mok¹,

Kwok²,

Ho³

et al. 2011

Arthritis & Rheumatism

Self Cite

196

161

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show abstract

“…Among many organs affected in SLE, the kidney may be most frequent and severely injured. The incidence of lupus nephritis (LN) is 40%~80%, and LN remains a major cause of morbidity and mortality in patients with SLE (1). Treatment of SLE is difficult as it is hard to balance the efficacy and safety of drugs.…”

Section: Introductionmentioning

confidence: 99%

A Pilot Study of the Therapeutic Efficacy and Mechanism of Artesunate in the MRL/lpr Murine Model of Systemic Lupus Erythematosus

Ouyang

Zhang

et al. 2009

Cell Mol Immunol

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Recent evidence indicates that artesunate has immunomodulatory properties that might be useful for treating autoimmune disease. In this study, we conducted a pilot study and explored the effect and mechanism of artesunate on the treatment of systemic lupus erythematosus using an MRL/lpr murine model. MRL/lpr mice were divided into control, cyclophosphamide (CTX) and artesunate treatment groups. Blood was collected to measure serum levels of creatinine, antinuclear antibody (ANA) and anti-double-stranded DNA (anti-dsDNA) antibody. Twenty-four-hour urine was collected to measure levels of proteinuria. The concentration of monocyte chemotactic protein-1 (MCP-1) in serum and urine was measured. The expression of MCP-1 in kidney was detected by Western blot and immunohistochemistry assay, respectively. The expression of B cell activating factor (BAFF) in spleen was determined by real time-PCR and immunoblotting. We found that artesunate significantly increased the survival rate, body weight and blood leukocyte counts, and reduced the serum levels of ANA and anti-dsDNA antibody titer, 24 h urinary protein, and serum creatinine. Our results indicated that artesunate could decrease MCP-1, major pro-inflammation cytokine, in serum, urine and kidney. We also found that the level of BAFF, the major B cell activation factor, was decreased in artesunate treated MRL/lpr mice. Its efficacy was comparable with that of CTX in this study. Taken

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“…[13][14][15] Familial subphenotypes of SLE may be the result of fewer genes compared with overall disease susceptibility, and stratifying by subphenotypes may reduce heterogeneity and facilitate the identification of gene polymorphisms associated with SLE. One such subphenotype, thrombocytopenia, is an independent marker for severe and deadly SLE, [16][17][18][19] and stratification for thrombocytopenia found evidence for linkage to 1q23, a region involving the FasL gene, as well as suggestive linkage to a region on 10q24 in close proximity to FAS. 20 The Fas and FasL genes are considered possible candidate genes in human SLE, since evidence from animal models of lupus with defective Fas and FasL expression point to a role for FasL-mediated apoptosis in the pathogenesis of SLE.…”

Section: Introductionmentioning

confidence: 99%

Functional promoter haplotypes of the human FAS gene are associated with the phenotype of SLE characterized by thrombocytopenia

et al. 2005

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Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by production of autoantibodies against intracellular antigens and tissue injury. Defective apoptosis of activated immune cells leads to the development of autoantibodies in SLE. FasL initiated apoptosis is central for peripheral tolerance. Fas deficiencies in humans and mice predispose toward systemic autoimmunity. SLE is conferred by many genes. The genetic effects may be concentrated by familial clustering or by stratifying of subphenotypes. We have tested polymorphisms and haplotypes in FAS and FASL for association to SLE or subphenotypes in 126 multiplex American SLE pedigrees and found association of the FAS codon214 AC C/T as well as the FASÀ670G4A 0 -codon214 AC C/T 0 haplotype to thrombocytopenia in SLE. Furthermore we have functionally characterized the FAS/FASL promoter polymorphisms associated with SLE in other populations and demonstrate that the activity depends on the allelic variants as well as on the haplotype. The presence of FASÀ670G, which affects STAT1 binding, leads to the highest activity. FASLÀ844C activity is modified by the cis acting À478A and, hence, the haplotype and not the individual variant, determines the promoter activity. We conclude that the FAS/FASL promoter haplotypes are functional and that polymorphisms in FAS may contribute to thrombocytopenia in SLE.

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A prospective study of survival and prognostic indicators of systemic lupus erythematosus in a southern Chinese population

Cited by 183 publications

References 30 publications

Life expectancy, standardized mortality ratios, and causes of death in six rheumatic diseases in Hong Kong, China

Life expectancy, standardized mortality ratios, and causes of death in six rheumatic diseases in Hong Kong, China

A Pilot Study of the Therapeutic Efficacy and Mechanism of Artesunate in the MRL/lpr Murine Model of Systemic Lupus Erythematosus

Functional promoter haplotypes of the human FAS gene are associated with the phenotype of SLE characterized by thrombocytopenia

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