Long term prognosis of children born to lupus patients

Murashima, Atsuko; Fukazawa, Toru; Hirashima, Mika; Takasaki, Yoshinari; Oonishi, Masahiko; Niijima, Shinichi; Yamashiro, Y; Yamataka, Atsuyuki; Miyano, Takeshi; Hashimoto, Hiroshi

doi:10.1136/ard.2002.001594

Cited by 20 publications

(13 citation statements)

References 15 publications

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“…These were mainly shown by studies on identical twins 6 in addition to observing a higher disease frequency in the relatives of patients with SLE 7 and children of mothers with SLE. 8 Extensive studies have linked SLE susceptibility to genes of the human leukocyte antigen (HLA) region. However, the extent of this association varies among different population.…”

mentioning

confidence: 99%

Association of HLA-DRB115 and HLA-DQB1 06 with SLE in Saudis

Al-Motwee

Jawdat

Jehani

et al. 2013

Annals of Saudi Medicine

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BACKGROUND AND OBJECTIVESSystemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by humoral autoimmunity. The etiology of SLE is thought to be multifactorial including environmental, hormonal, and genetic factors. The human leukocyte antigen (HLA) has extensively been associated with the susceptibility to SLE; however, the association is heterogeneous among different ethnic groups. The aim of this study was to determine the association of HLA-A, HLA-B, HLA-DRB1, and HLA-DQB1 with SLE susceptibility in the Saudi population.DESIGN AND SETTINGSA total of 86 consecutive SLE patients attending the rheumatology clinic at King Abdulaziz Medical City, Riyadh, were recruited for this study.METHODSHLA types were determined by the polymerase chain reaction sequence-specific oligonucleotide (PCR-SSP) method in 86 patients and 356 control subjects.RESULTSThe following HLA alleles were found to be positively associated with SLE: HLA-A*29 (OR=2.70; 95% CI=1.03–7.08; P=.0035), HLA-B*51 (OR=1.81; 95% CI=1.17–2.79; P=.0066), HLA-DRB1*15 (OR=1.45; 95% CI=0.98–2.29; P=.063), and HLA-DQB1*06 (OR=1.67; 95% CI=1.19–2.36; P=.0032), whereas HLA-DRB1*16 was negatively associated with the disease (OR=0.18; 95% CI=0.02–1.3; P=.055). HLA-DRB1*15 haplotypes were significantly associated with SLE (OR=2.01, 95% CI=1.20–3.68, P=.008); this was mainly due to the HLA-DRB1* 15-DQB1*06 association.CONCLUSIONSOur data suggest an association between MHC class I and class II (HLA-A*29, HLA-B*51, HLA-DRB1*15, and HLA-DQB1*06) and susceptibility to SLE in the Saudi population. HLA-DRB1*15-DQB1*06 haplotype showed the highest risk factor for the disease that is similar to what was seen in the African American patients, suggesting shared susceptibility genetic factors among these ethnic groups.

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mentioning

confidence: 99%

Association of HLA-DRB115 and HLA-DQB1 06 with SLE in Saudis

Al-Motwee

Jawdat

Jehani

et al. 2013

Annals of Saudi Medicine

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“…Studies including monozygotic twins and familial aggregation support the idea of genetic predisposition. The risk of developing SLE among siblings have been shown to be almost 30-fold higher than in the general population and ANA-positivity has been shown to be present in 27% of offspring to mothers with SLE compared to 7% in controls (22,23). However, in families with several affected members, the genetic component is complex and does not follow a classical Mendelian inheritance pattern, and only a few cases can be attributed to highly penetrating rare mutations (24).…”

Section: Pathogenesis and Aetiologymentioning

confidence: 99%

Antinuclear and antiphospholipid antibodies versus disease manifestations and clinical outcomes in systemic lupus erythematosus

Frodlund

2020

Linköping University Medical Dissertations

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Systemic lupus erythematosus (SLE) has an exceptionally heterogeneous clinical spectrum, ranging from mild disease limited to skin and joints to severe manifestations with renal disorder, central nervous system disease, severe cytopenias and thromboembolic events. Important clinical challenges include the prediction of disease flares and the identification of individuals that are likely to evolve severe disease with accrual of organ damage and worse prognosis. Autoantibodies, i.e. antinuclear antibodies (ANA) and antiphospholipid antibodies (aPL), and interferon alpha (IFN-α) that contribute to formation of immune complexes with nuclear antigens, are hallmarks considered to drive the disease in a vicious circle of antigen exposure, autoantibody production, inflammation and organ damage. There are few good biomarkers to predict severe SLE and organ damage. The aim of this PhD project was thus to increase the knowledge regarding ANA as well as aPL, and other potential biomarkers in relation to clinical features and disease outcomes in SLE. As expected, we found that the homogeneous ANA staining pattern was most common, and that it was associated with the occurrence of the 'immunological disorder' criterion. Speckled ANA was the second most common staining pattern, and it was inversely associated with arthritis, the 'immunological disorder' criterion and organ damage (Paper I). We also demonstrated that a considerable proportion of the patients lost ANA-positivity over time, whereas consistent staining patterns were most frequent (Paper V). Survival of patients with SLE has improved. Yet, in comparison to the general population, irreversible organ damage and increased mortality remains a critical concern. In Paper II, our cross-sectional analysis showed that more than a quarter of the patients had any aPL isotype (IgG, IgM or IgA class), and 14% were classified with antiphospholipid antibody syndrome (APS). A positive lupus anticoagulant (LA) test and/or IgG aPL tests were associated with most APS-related events and organ damage. Lupus nephritis, tobacco smoking, LA-positivity and the use of statins and/or corticosteroids were strongly associated with damage accrual, while hydroxychloroquine seemed to be protective. IgA aPL was not uncommon (16%) in Swedish cases of SLE, and analysis of IgA aPL may add information among clinically suspected APSpatients testing negative for LA and other aPL isotypes. Despite modern management and tax-funded health care with universal access, almost twothirds of the patients accrued organ damage over time, and the main causes of death were identified as malignancy, infection, and cardiovascular disease. We could confirm wellestablished risk factors for organ damage such as APS, hypertension, and/or the use of corticosteroids, but we also observed that other factors such as pericarditis, haemolytic anaemia, lymphopenia and myositis seems to be of importance in this view (Paper IV). We also demonstrated that levels of the extracellular matrix protein osteopontin (OPN) was correlated wit...

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“…Moreover, future mothers might be worried that their children may be affected by SLE, even if this risk is small. There is evidence that SLE occurrence is increased in the offspring of patients with SLE, and prevalence has been estimated at ∼4% in the children of parents with SLE (29). Other studies have shown that up to 12% of SLE patients had first‐degree relatives with SLE or other connective tissue diseases (30).…”

Section: Childbearing Decisionmentioning

confidence: 99%

“…This overestimated the number of pregnancies per woman with a diagnosis of SLE, because those who did not achieve any pregnancy were excluded. In this study, a total of 79 women with SLE and 80 healthy subjects with a mean (range) age of 33.1 (17–62) years were evaluated. There were a total of 183 pregnancies among 53 patients before the clinical diagnosis of SLE, which resulted in 42 spontaneous abortions and 141 live births.…”

Section: Fertilitymentioning

confidence: 99%