Publications by authors named "Anastasiya Muntyanu"

15 Publications

  • Page 1 of 1

Malignancy in psoriatic disease: Results from prospective longitudinal cohorts.

Semin Arthritis Rheum 2021 Feb 24;51(1):144-149. Epub 2020 Dec 24.

Center for Prognostic Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network, Toronto, ON Canada; Department of Medicine, University of Toronto, Toronto, ON Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada. Electronic address:

Objectives: To estimate the prevalence and incidence of malignancy and its types in psoriatic arthritis (PsA) and psoriasis without arthritis (PsC) patients, in comparison to the general population, and to identify the predictive factors for developing cancer in psoriatic disease (PsD).

Methods: PsA patients followed prospectively since 1978 and PsC patients followed since 2006 at 6-to-12 month intervals according to a standard protocol were included. Malignancies were recorded prospectively and linkages with Cancer Care Ontario and the Death Registry were carried out to confirm the presence and type of malignancy up to December 2016. Standardized incidence ratios (SIR) were calculated for overall cancers and by age and sex. Cox regression analysis was conducted to identify risk factors associated with the development of malignancy after the diagnosis of PsD.

Results: 2051 patients (PsD) were included of whom 228 (11%) developed cancer. 168 patients developed cancer after first clinic visit and are included in this report. Overall SIR for malignancy was 0.83 (0.68, 1.00), SIR for females was 1.06 (0.80, 1.37), and for males was 0.67 (0.50, 0.88). The most common malignancies were skin, breast, and hematological. Skin cancer was the only specific cancer that had a higher incidence than the general population with SIR = 3.37 (1.84, 5.66). There was insufficient evidence to suggest an increased risk of malignancy associated with biologics use.

Conclusions: In this long-term prospective follow-up of patients with PsA and PsC the overall malignancy risk was not found to be higher than the general population, while skin cancer increased.
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http://dx.doi.org/10.1016/j.semarthrit.2020.12.008DOI Listing
February 2021

Non-Melanoma Skin Cancer Distribution in the Russian Federation.

Dermatology 2020 Dec 23:1-9. Epub 2020 Dec 23.

Division of Dermatology, McGill University, Montreal, Québec, Canada,

Background: Non-melanoma skin cancer (NMSC) incidence has been increasing steadily around the world. The aim of the study is to describe geographic trends in incidence and mortality of NMSC in Russia between 2007 and 2017 and compare findings to other European countries.

Methods: We used geospatial analysis to map the incident cases and descriptive statistical analysis to analyze trends. Additionally, we assessed the relationship between ethnicity, geographic latitude/longitude, and NMSC incidence/mortality rates. We retrospectively analyzed the data from the Moscow Oncology Research Institute, Ministry of Health of the Russian Federation, for 2007-2017. Routine methods of descriptive epidemiology were used to study incidence and mortality rates by age groups, years, and jurisdictions (i.e., Federal Districts and Federal Subjects).

Results: In total, 733,723 patients were diagnosed with NMSC in Russia over the period 2007-2017, of whom 63% were women. The overall age-standardized incidence and mortality rates were 29.64/100,000 and 0.70/100,000, respectively. There was a consistent increase in age-standardized incidence rates over the study period, with a decreasing mortality rate. Geographic mapping revealed north-to-south and east-to-west gradients for NMSC.

Conclusions: This study demonstrated longitudinal trends for NMSC incidence in Russia documenting that skin phototype, latitude/longitude, climate zones, and cultural practices remain dominant risk factors defining the epidemiology of NMSC. Moreover, this work identified several regions in the country (i.e., Republic of Adygea, Samara, Krasnodar Krai, etc.), where patient education/sun awareness campaigns will be useful to help reduce the risk of this malignancy.
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http://dx.doi.org/10.1159/000512454DOI Listing
December 2020

Inhibition of IL-13: A New Pathway for Atopic Dermatitis.

J Cutan Med Surg 2020 Dec 22:1203475420982553. Epub 2020 Dec 22.

54473 Division of Dermatology, McGill University Health Centre, Montreal, QC, Canada.

Dupilumab, a monoclonal antibody against the common receptor of interleukin (IL)-4 and IL-13, was the first biologic therapy approved in Canada for treatment of moderate-to-severe atopic dermatitis (AD). While it is considered safe and effective, dupilumab is not universally effective and 8%-38% of patients develop conjunctivitis, while some patients develop head and neck dermatitis. Thus, new therapeutic options are warranted. While both IL-4 and IL-13 play important roles in the pathogenesis of AD, it has been recently demonstrated that IL-13 is the primary upregulated cytokine in AD skin biopsy samples. A placebo-controlled phase 2b clinical trial evaluating the efficacy and safety of lebrikizumab, an IL-13 inhibitor, in AD demonstrated that, at 16 weeks, Eczema Area and Severity Index (EASI) 75 and Investigator's Global Assessment (IGA) 0/1 were achieved by 60.6% and 44.6% of patients taking lebrikizumab at its highest dose (vs 24.3% and 15.3% of patients taking placebo, respectively). Moreover, treatment with lebrikizumab was associated with rapid improvement of pruritus and low rates of conjunctivitis (1.4%-3.8%). Another IL-13 monoclonal antibody, tralokinumab, was evaluated for safety and efficacy in moderate-to-severe AD. By week 12, among adults receiving 300 mg tralokinumab, 42.5% achieved EASI-75 and 26.7% achieved IGA 0/1 score (vs 15.5% and 11.8% in the placebo group, respectively). Both lebrikizumab and tralokinumab demonstrated acceptable safety profiles in AD (and non-AD) trials with adverse events often being comparable between treatment and control groups. Thus, IL-13 inhibitors may provide a safe and effective treatment alternative for patients with moderate-to-severe AD.
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http://dx.doi.org/10.1177/1203475420982553DOI Listing
December 2020

Reply to Reader Comment on "Rituximab Lymphoma-Protocol May Be Superior for Inducing Remission in Pemphigus Vulgaris".

J Cutan Med Surg 2021 Jan-Feb;25(1):113-114. Epub 2020 Nov 10.

54473 Division of Dermatology, McGill University Health Centre, Montreal General Hospital, QC, Canada.

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http://dx.doi.org/10.1177/1203475420972360DOI Listing
February 2021

Toward Understanding of Environmental Risk Factors in Systemic Sclerosis.

J Cutan Med Surg 2020 Sep 28:1203475420957950. Epub 2020 Sep 28.

54473 Division of Dermatology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada.

Importance: Systemic sclerosis (SSc) is a severe, chronic, and incurable autoimmune fibrotic skin disease with significant extracutaneous involvement. Low concordance rate in twin studies and unequal geographic distribution of SSc argues for importance of environment in disease initiation and progression.

Objective: In this manuscript we provide a summary of all investigated potential external risk factors for SSc.

Data Sources: A literature search in PubMed and EMBASE database was performed for studies published until January 1, 2020 by 2 reviewers (EN and LO) independently.

Findings: Occupational and/or environmental exposures to silica and organic solvents are associated with increased incidence and severity of SSc. Exposure to epoxy resins, asbestos, and particulate air pollution favors increased risk of SSc, but data are based on limited number of observational studies. There is insufficient evidence to conclude an association between SSc development and other occupational (eg, welding fumes) or personal exposures (eg, smoking, vitamin D deficiency). Association of SSc with silicone breast implants has been disproven. Infectious pathogens (eg, and angiotropic viruses) and dysbiosis seem to play a role in SSc development and severity, but their role remains to be clarified.

Conclusions And Relevance: It may be prudent to counsel our patients with SSc (or those at risk of SSc) to avoid occupations with exposure to silica, organic solvents, asbestos and epoxy resins; restraint from smoking, using cocaine or drugs with pro-fibrotic potential. While the association between low vitamin D and SSc remains to be confirmed, we believe that SSc patients should be encouraged to maintain healthy vitamin D levels as benefits outweigh the risks.
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http://dx.doi.org/10.1177/1203475420957950DOI Listing
September 2020

Cutaneous Immune-Related Adverse Events (irAEs) to Immune Checkpoint Inhibitors: A Dermatology Perspective on Management [Formula: see text].

J Cutan Med Surg 2021 Jan-Feb;25(1):59-76. Epub 2020 Aug 3.

54473507266 Division of Dermatology, McGill University, Montreal, QC, Canada.

Immune checkpoint inhibitors have proven to be efficacious for a broad spectrum of solid organ malignancies. These monoclonal antibodies lead to cytotoxic T-cell activation and subsequent elimination of cancer cells. However, they can also lead to immune intolerance and immune-related adverse event (irAEs) that are new and specific to these therapies. Cutaneous irAEs are the most common, arising in up to 34% of patients on PD-1 inhibitors and 43% to 45% on CTLA-4 inhibitors. The most common skin manifestations include maculopapular eruption, pruritus, and vitiligo-like lesions. A grading system has been proposed, which guides management of cutaneous manifestations based on the percent body surface area (BSA) involved. Cutaneous irAEs may prompt clinicians to reduce drug doses, add systemic steroids to the regiment, and/or discontinue lifesaving immunotherapy. Thus, the goal is for early identification and concurrent management to minimize treatment interruptions. We emphasize here that the severity of the reaction should not be graded based on BSA involvement alone, but rather on the nature of the primary cutaneous pathology. For instance, maculopapular eruptions rarely affect <30% BSA and can often be managed conservatively with skin-directed therapies, while Stevens-Johnson syndrome (SJS) affecting even 5% BSA should be managed aggressively and the immunotherapy should be discontinued at once. There is limited literature available on the management of the cutaneous irAEs and most studies present anecdotal evidence. We review the management strategies and provide recommendations for psoriatic, immunobullous, maculopapular, lichenoid, acantholytic eruptions, vitiligo, alopecias, vasculitides, SJS/toxic epidermal necrolysis, and other related skin toxicities.
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http://dx.doi.org/10.1177/1203475420943260DOI Listing
August 2020

Geographic Variations in Cutaneous Melanoma Distribution in the Russian Federation.

Dermatology 2020 5;236(6):500-507. Epub 2020 Jun 5.

Division of Dermatology, McGill University, Montreal, Québec, Canada,

Background: Cutaneous melanoma (CM) incidence has been increasing around the world. The goal of this study is to describe geographic trends in incidence and mortality of CM in Russia between 2001 and 2017.

Methods: To achieve this we used geo-informatic technique (mapping) and descriptive statistical analysis. Additionally, we studied the associations between ethnicity, geographic latitude/longitude, and CM incidence/mortality rates. We retrospectively analyzed the data from the Moscow Oncology Research Institute, Ministry of Health of the Russian Federation, for the period of the study. Routine methods of descriptive epidemiology were used to study incidence and mortality rates by age groups, years, and jurisdictions (i.e., Federal Districts and Federal Subjects of Russia).

Results: In total, 141,597 patients were diagnosed with melanoma in Russia over the period 2001-2017, of whom 62% were women. The overall age-standardized incidence and mortality rates were 4.27/100,000 and 1.62/100,000, respectively. Geographic mapping revealed north-to-south and east-to-west gradients. As the study was fully descriptive, retrospective, and based on official statistical reports, detailed characteristics of clinical forms, anatomic sites, Breslow depth, and treatments could not be analyzed.

Conclusions: This study outlined the burden of melanoma in the Russian Federation, and the trends were similar to those observed in countries with similar latitudes and skin phenotype. The importance of the skin color gradient and recreational/cultural practices were some of the most important risk factors highlighted in this study for the development of melanoma in Russia.
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http://dx.doi.org/10.1159/000507617DOI Listing
June 2020

Mortality in psoriatic arthritis: Risk, causes of death, predictors for death.

Semin Arthritis Rheum 2020 08 23;50(4):571-575. Epub 2020 May 23.

Centre for Prognostic Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto, Toronto, ON Canada; Institute of Medical Science, University of Toronto, Toronto, ON Canada. Electronic address:

Background/objectives: Mortality studies in psoriatic arthritis (PsA) have provided inconsistent results. This study aimed to: 1) Estimate trends in mortality rates among PsA patients over calendar time; 2) Evaluate cause-specific mortality rates in patients with PsA compared to the general population; 3) Identify predictors for mortality in PsA.

Methods: The study was carried out at the University of Toronto Psoriatic Arthritis Clinic where patients are followed prospectively according to a standard protocol at 6- to 12- month intervals. Standardized mortality ratios (SMRs) were calculated overall, by age, and by sex with reference to the Ontario population. Causes of death were recorded by ICD9 and ICD10 codes and cause-specific SMRs were computed. Cox regression models were used to identify predictors for mortality among PsA patients.

Results: Among 1490 patients followed over 15062.8 patient-years, 225 (15%) confirmed deaths were recorded (111 females, 114 males). The overall SMR was 0.92 (95% CI: 0.81-1.05), the sex-specific SMRs were 1.08 (95% CI: 0.89-1.30) for females and 0.81 (95% CI: 0.66-0.97) for males. The age-specific SMRs were 3.36 (95% CI: 1.61-6.18), 0.97 (95% CI: 0.68-1.34), 0.88 (95% CI: 0.73-1.06) and 0.86 (95% CI: 0.66-1.11) for 20-39, 40-59, 60-79 and above 80 years of age, respectively. Major causes of death included malignant neoplasms (n=61; SMR=0.97, 95% CI: 0.72-1.28), acute myocardial infarction (n=32; SMR=1.11, 95% CI: 0.74-1.58), and pneumonia (n=14; SMR=2.46, 95% CI: 1.27-4.31). Factors found to be associated with increased mortality include elevated acute phase reactants, presence of comorbidities such as heart disease and cancer, and lower education level.

Conclusion: Young patients with PsA are at increased mortality risk. Better control of comorbidities may reduce this risk.
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http://dx.doi.org/10.1016/j.semarthrit.2020.04.001DOI Listing
August 2020

Ultraviolet Radiation Seeking Behavior, Mediated by Endogenous β-Endorphin, Has Addictive Features.

J Cutan Med Surg 2020 Jul/Aug;24(4):414-415. Epub 2020 May 15.

1236754473 Division of Dermatology, Department of Medicine, McGill University Health Centre, Montreal General Hospital, QC, Canada.

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http://dx.doi.org/10.1177/1203475420926990DOI Listing
May 2020

Rituximab Lymphoma-Protocol May Be Superior for Inducing Remission in Pemphigus Vulgaris.

J Cutan Med Surg 2020 Sep/Oct;24(5):523-524. Epub 2020 May 13.

54473507266 Division of Dermatology, McGill University Health Centre, Montreal General Hospital, QC, Canada.

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http://dx.doi.org/10.1177/1203475420926983DOI Listing
May 2020

IncRNAs and circRNAs provide insight into discoid lupus pathogenesis and progression.

Ann Transl Med 2020 Mar;8(6):260

Division of Dermatology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada.

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http://dx.doi.org/10.21037/atm.2020.03.56DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186711PMC
March 2020

Ligelizumab Is Superior to Omalizumab for Chronic Spontaneous Urticaria.

J Cutan Med Surg 2020 Mar/Apr;24(2):201-202

54473 Division of Dermatology, McGill University Health Centre, Montreal General Hospital, QC, Canada.

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http://dx.doi.org/10.1177/1203475419888873DOI Listing
February 2021

Idiopathic Atrophoderma of Pasini and Pierini: Case report and literature review.

Clin Case Rep 2019 Feb 18;7(2):258-263. Epub 2018 Dec 18.

Division of Dermatology McGill University Health Centre Montreal Québec Canada.

Idiopathic Atrophoderma of Pasini and Pierini should be considered on the differential in a patient presenting with an asymptomatic atrophic plaque on the skin. Differentiation from Linear Atrophoderma of Moulin and morphea remains a challenge; however, features of the presentation and tissue biopsy can help establish the diagnosis.
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http://dx.doi.org/10.1002/ccr3.1958DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389486PMC
February 2019

Differential gene and protein expression of chemokines and cytokines in synovial fluid of patients with arthritis.

Arthritis Res Ther 2016 12 13;18(1):296. Epub 2016 Dec 13.

Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University of Toronto, University Health Network, 399 Bathurst Street 1E-410B, Toronto, ON, M5T 2S8, Canada.

Background: Psoriatic arthritis (PsA), an inflammatory musculoskeletal disease, develops in approximately 30% of patients with psoriasis. Previously, chemokine (C-X-C motif) ligand 10 (CXCL10) was identified as a predictive biomarker of PsA in patients with psoriasis and was reduced after development of PsA. The purpose of the present study was to explore messenger RNA (mRNA) and protein expression of CXCL10 and its receptor, chemokine (C-X-C motif) receptor 3 (CXCR3), in the joints of patients with PsA to gain insight into their role in the pathogenesis of the disease.

Methods: Sera from 47 patients with PsA and 33 healthy control subjects were compared for expression of CXCL10 by Luminex assay. Synovial fluid (SF) was obtained from patients with PsA (n = 40), osteoarthritis (OA; n = 14), gout (n = 8), and rheumatoid arthritis (RA; n = 11) during clinical care. SF mRNA and protein expression of CXCL10, interleukin-17A (IL-17A), CXCR3, TBX21, RORC and/or interferon γ (IFNγ) were compared among the above-mentioned disease groups, as well as in paired SF and serum samples from patients with PsA using real-time polymerase chain reaction and Luminex assays, respectively.

Results: Serum CXCL10 was significantly higher in patients with PsA than in control subjects (p = 0.0007). CXCL10, IL-17A, and TBX21 expression were elevated in SF cells of patients with PsA compared with those of patients with OA and gout, but not those of patients with RA. CXCR3 and RORC were elevated in PsA SF cells compared with all other patient groups. Concordant results were obtained for CXCL10 and IL-17A protein expression. IFNγ was elevated in PsA SF compared with OA SF (p = 0.015). CXCL10 protein expression was substantially increased in SF (median 7283.9 pg/ml, interquartile range [IQR] 1330-10,362 pg/ml) compared with paired serum samples (median 282.06, IQR 180.7-395.8 pg/ml; p = 0.001), whereas IFNγ was significantly reduced (SF median 6.03 pg/ml, IQR 4.47-8.94 pg/ml; versus serum median 23.70 pg/ml, IQR 3.2-104.6 pg/ml; p = 0.001).

Conclusions: CXCL10 may have an important etiological role in PsA that is analogous to that in RA, and it is a candidate biomarker to distinguish PsA from healthy individuals and from patients with OA and gout.
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http://dx.doi.org/10.1186/s13075-016-1196-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5154157PMC
December 2016

Structural and optical properties of self-assembled chains of plasmonic nanocubes.

Nano Lett 2014 Nov 10;14(11):6314-21. Epub 2014 Oct 10.

Department of Chemistry, University of Toronto , 80 Saint George Street, Toronto, Ontario M5S 3H6, Canada.

Solution-based linear self-assembly of metal nanoparticles offers a powerful strategy for creating plasmonic polymers, which, so far, have been formed from spherical nanoparticles and cylindrical nanorods. Here we report linear solution-based self-assembly of metal nanocubes (NCs), examine the structural characteristics of the NC chains, and demonstrate their advanced optical characteristics. In comparison with chains of nanospheres with similar dimensions, composition, and surface chemistry, predominant face-to-face assembly of large NCs coated with short polymer ligands led to a larger volume of hot spots in the chains, a nearly uniform E-field enhancement in the gaps between colinear NCs, and a new coupling mode for NC chains due to the formation of a Fabry-Perot resonator structure formed by face-to-face bonded NCs. The NC chains exhibited stronger surface-enhanced Raman scattering in comparison with linear assemblies of nanospheres. The experimental results were in agreement with finite difference time domain simulations.
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http://dx.doi.org/10.1021/nl502746hDOI Listing
November 2014