Latest advances in connective tissue disorders

Abstract

Systemic lupus erythematosus Systemic lupus erythematosus (SLE) typically affects women (circa 9:1 female:male ratio) in the 16-55 age group [Ballou et al. 1982]. It is commoner among patients of African/Afro-Caribbean, South Asian or Chinese/other Asian ethnic groups. It ranges from a mild to a lifethreatening or fatal disorder [Petri et al. 2012a]. Active disease is associated with raised anti-dsDNA antibodies and reduced levels of complement C3 and/or C4 levels. Current therapy is, in fact, very effective for most patients. In mild to moderate disease, hydroxychloroquine is now commonly used as steroid-sparing therapy for all patients. For patients with active disease, corticosteroids are at the heart of current therapy, often combined with steroid sparing agents such as azathioprine, methotrexate, leflunomide, ciclosporin or mycophenolate. In patients with severe or life-threatening renal, nervous system or pulmonary disease, oral or pulsed intravenous cyclophosphamide has been typically used over the past 20 years [Boumpas et al. 1992]. As a consequence, the survival rate for SLE has steadily increased. In a review of this topic [Urowitz et al. 2008] the authors point out that since the 1950s, SLE has changed from a disease with a 50% mortality at 5 years to one of over 90% 5-year survival. The challenge, in recent years, has been less about finding drugs with greater efficacy than corticosteroids and cyclophosphamide and more about developing drug regimes with lower toxicity. Corticosteroids, in particular, have been associated with higher rates of infection, cardiovascular and bone disease [Ruiz-Irastorza et al. 2012; Petri et al 2012b]. Cyclophosphamide is associated

The Emerging Role of Curcumin in the Modulation of TLR-4 Signaling Pathway: Focus on Neuroprotective and Anti-Rheumatic Properties

“…Musculoskeletal pain represents the main symptom of these diseases, many of which have a chronic and progressive course, often characterized by periods of both remission and exacerbation. Treatment of inflammatory/autoimmune rheumatic diseases includes conventional and biologic disease-modifying anti-rheumatic drugs, immunosuppressant drugs and corticosteroids [163], whereas the first line treatment to control pain in both degenerative and inflammatory joint diseases is represented mainly by non-steroidal anti-inflammatory drugs [164]. Some clinical and experimental data provide evidences that curcumin presents anti-oxidative capacity and it is able to decrease inflammation trough an inhibitory effect on cyclooxygenase and NF-κB pathways, as these pathways are involved in the pathogenesis of rheumatic diseases, it is rational to support the hypothesis that curcumin can have a possible therapeutic role in the treatment of symptoms of these disorders.…”

Antiphospholipid Syndrome - A Case Report of Pulmonary Thromboembolism, Followed with Acute Myocardial Infarction in Patient with Systemic Sclerosis

“…There are growing evidences about the association of APL syndrome with systemic sclerosis. It is not exclusively associated with systemic lupus or rheumatoid arthritis [ 5 ].…”

“…), but also in 13.3% of patients with mixed connective tissue disease (MCTD) and 13.3% of patients with systemic sclerosis. In conclusion they recommend that APL antibodies should be tested in all patients with connective tissue disease [ 6 ]. Balanescy and co-workers conducted a study about the association of systemic sclerosis (SSc) and APLa.…”

The value of serum Krebs von den lungen-6 as a diagnostic marker in connective tissue disease associated with interstitial lung disease

“…The efficacy of the CTX pulse therapy were determined by the following criteria [15]: [1] Invalid: dry cough or wheezing symptoms deteriorate; vital capacity (VC) or DLCo decreased more than 10% compared with baseline; progression of lung lesion range based on HRCT score [2]. Effective or stable: does not meet any of the above.…”

“…The connective tissue diseases (CTD) are a collective series of immune-mediated pathologies and systemic disorders affecting multiple connective tissues, including chronic inflammation of blood vessels [1]. The lung is rich in blood vessels, collagen and other connective tissues, and play important functions in immune, endocrine and metabolic regulations.…”