Clinical, Serologic, and Genetic Profiles of Patients With Associated Sjögren’s Syndrome and Systemic Lupus Erythematosus

Szántó, Antónia; Szodoray, Péter; Kiss, Emese; Kapitány, Anikó; Szegedi, Gyula; Zeher, Margit

doi:10.1016/j.humimm.2006.06.006

Cited by 49 publications

(40 citation statements)

References 18 publications

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“…Only 2 (1.5%) of the study patients had secondary Sjogren’s syndrome. This number is lower than the 6–30% prevalence of secondary Sjogren’s previously reported among SLE patients [39–41]. However, the low prevalence of secondary Sjogren’s in our cohort is consistent with the previous report suggesting that the prevalence of clinical renal disease is significantly lower in SLE patients with Sjogren’s compared to SLE patients without Sjogren’s [42].…”

Section: Discussionsupporting

confidence: 87%

Tubulointerstitial damage predicts end stage renal disease in lupus nephritis with preserved to moderately impaired renal function: A retrospective cohort study

Broder

Mowrey

Khan

et al. 2018

Seminars in Arthritis and Rheumatism

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Objectives The presence of tubulointerstitial damage (TID) on renal biopsy is considered to be a late sequela of lupus nephritis (LN). The objective of this study was to determine if TID predicts progression to end stage renal disease (ESRD) in LN patients without advanced kidney disease. Methods All SLE patients with an index biopsy consistent with LN between January 2005 and July 2015, and eGFR≥30 mL/min/1.73m2 were included. Moderate-to-severe TID was defined as the presence of moderate to severe tubular atrophy and/or interstitial fibrosis. Time to ESRD was defined as time from the index biopsy date to incident ESRD date; non-ESRD patients were censored at time of death or the last visit before December 2015. Time-dependent analyses were conducted to evaluate whether moderate to severe TID was predictive of ESRD progression. Results Of the 131 LN patients with eGFR≥30 mL/min/1.73m2, 17 (13%) patients progressed to ESRD. Moderate-to-severe TID was present in 13% of biopsies with eGFR≥60 mL/min/1.73m2 and in 33% of biopsies with eGFR between 30 and 60 mL/min/1.73m2. Moderate-to-severe TID was associated with a higher risk of ESRD progression: adjusted hazard ratio (HR) = 4.1, 95% CI (1.4, 12.1), p=0.01 for eGFR≥30 mL/min/1.73m2; HR 6.2, 95% CI (1.7, 23.2), p=0.008 for eGFR≥60 mL/min/1.73m2. There was no association between tubulointerstitial inflammation (TII) and ESRD progression. Conclusions Moderate-to-severe TID, but not TII, was a strong predictor of ESRD progression independent of eGFR or glomerular findings, therefore, providing an important window for potential early interventions.

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Section: Discussionsupporting

confidence: 87%

Tubulointerstitial damage predicts end stage renal disease in lupus nephritis with preserved to moderately impaired renal function: A retrospective cohort study

Broder

Mowrey

Khan

et al. 2018

Seminars in Arthritis and Rheumatism

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“…SLE is deeply related to SS, and both are often diagnosed in the same patient (21). The clinical profiles of patients with both SS and SLE are more similar to those of patients with primary SS alone, than to those of patients with SLE alone (22).…”

Section: Discussionmentioning

confidence: 99%

Successful Detection of Renal Involvement in Sjögren's Syndrome Secondary to Systemic Lupus Erythematosus by Renal Biopsy

et al. 2015

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An 80-year-old man presented with a mildly decreased renal function and increased anti-double-stranded-DNA (anti-dsDNA) antibody levels, and met the diagnostic criteria of the American College of Rheumatology for systemic lupus erythematosus (SLE). However, the incremental increase in creatinine levels and the mild proteinuria were inconsistent with lupus nephritis. We performed a renal biopsy, which revealed interstitial nephritis and minor glomerular abnormalities. Further examinations determined that the renal lesion was due to Sjögren's syndrome secondary to SLE. Following treatment with oral prednisolone, the patient's renal function improved as his anti-dsDNA antibody levels decreased. This case report indicates that renal biopsy should be considered even in elderly individuals when it may assist in the diagnosis, treatment, and prognosis of the patient.

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“…Beside the pathognomonic glandular symptoms (GS), other systemic symptoms, denoted as extraglandular manifestations (EGMs), also found in approximately 9 one third of the patients. These patients frequently complain about fatigue, Raynaud's phenomenon, muscle and joint pain [41].…”

Section: Primary Sjögren's Syndromementioning

confidence: 99%

Toll-Like Receptor Pathways in Autoimmune Diseases

Chen

Szodoray

Zeher

2015

Clinic Rev Allerg Immunol

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247

177

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Autoimmune diseases are a family of chronic systemic inflammatory disorders, characterized by the dysregulation of the immune system which finally results in the break of tolerance to self-antigen.Several studies suggest that Toll-like receptors (TLRs) play an essential role in the pathogenesis of autoimmune diseases. TLRs belong to the family of pattern recognition receptors (PRRs) that recognize a wide range of pathogen-associated molecular patterns (PAMPs). TLRs are type I transmembrane proteins and located on various cellular membranes. Two main groups have been classified based on their location；the extracelluar group referred to the ones located on the plasma membrane while the intracellular group all located in endosomal compartments responsible for the recognition of nucleic acids. They are released by the host cells and trigger various intracellular pathways which results in the production of proinflammatory cytokines, chemokines, as well as the expression of co-stimulatory molecules to protect against invading microorganisms. Particular, TLR pathway-associated proteins, such as IRAK, TRAF, and SOCS are often dysregulated in this group of diseases. TLR-associated gene expression profile analysis together with single nucleotide polymorphism (SNP) assessment could be important to explain the pathomechanism driving autoimmune diseases. In this review, we summarize recent findings on TLR pathways regulation in various autoimmune diseases, including Sjögren's syndrome (SS), systemic lupus erythematosus (SLE), multiple sclerosis (MS), rheumatoid arthritis (RA), systemic sclerosis (SSc), and psoriasis. KEYWORDS:Toll-like receptors (TLRs); autoimmune disease; IL-1 receptor associated kinase (IRAK); TNF receptor associated factor (TRAF); Suppressor of cytokine signaling (SOCS) 3 Autoimmune diseases are characterized by the dysregulation of the immune system which finally results in the break of tolerance to self-antigen. Even though the accurate etiology and pathogenesis of the majority of these diseases are still not clear, complex elements, including genetic, environmental, hormonal factors may provoke the autoimmune processes leading to the development of the disease.Concerning the role of derailed immune responses in the pathogenesis, aberrant processes both in the innate and adaptive immune system have been shown to participate in the disease initiation and perpetuation [1]. Within these processes, numerous studies have been demonstrated that Toll-like receptors (TLRs) have an essential role in various autoimmune diseases, including Sjögren's syndrome (SS), systemic lupus erythematosus (SLE), multiple sclerosis (MS), rheumatoid arthritis (RA), systemic sclerosis (SSc), and psoriasis. [2,3]. Toll-like receptorsThe innate immune system is the first line of host defense mechanisms against invading microorganisms and forms the basis of the development of adaptive immunity. Host cells express diverse pattern recognition receptors (PRRs) include toll-like receptors (TLRs), C-type lectin-like receptors (CL...

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Clinical, Serologic, and Genetic Profiles of Patients With Associated Sjögren’s Syndrome and Systemic Lupus Erythematosus

Cited by 49 publications

References 18 publications

Tubulointerstitial damage predicts end stage renal disease in lupus nephritis with preserved to moderately impaired renal function: A retrospective cohort study

Tubulointerstitial damage predicts end stage renal disease in lupus nephritis with preserved to moderately impaired renal function: A retrospective cohort study

Successful Detection of Renal Involvement in Sjögren's Syndrome Secondary to Systemic Lupus Erythematosus by Renal Biopsy

Toll-Like Receptor Pathways in Autoimmune Diseases

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Clinical, Serologic, and Genetic Profiles of Patients With Associated Sjögren’s Syndrome and Systemic Lupus Erythematosus

Cited by 49 publications

References 18 publications

Tubulointerstitial damage predicts end stage renal disease in lupus nephritis with preserved to moderately impaired renal function: A retrospective cohort study

Tubulointerstitial damage predicts end stage renal disease in lupus nephritis with preserved to moderately impaired renal function: A retrospective cohort study

Successful Detection of Renal Involvement in Sj&ouml;gren's Syndrome Secondary to Systemic Lupus Erythematosus by Renal Biopsy

Toll-Like Receptor Pathways in Autoimmune Diseases

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Successful Detection of Renal Involvement in Sjögren's Syndrome Secondary to Systemic Lupus Erythematosus by Renal Biopsy