Publications by authors named "Guo-Cui Wu"

38 Publications

Circadian clock genes as promising therapeutic targets for autoimmune diseases.

Autoimmun Rev 2021 Aug 10;20(8):102866. Epub 2021 Jun 10.

Department of Nephrology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China. Electronic address:

Circadian rhythm is a natural, endogenous process whose physiological functions are controlled by a set of clock genes. Disturbance of the clock genes have detrimental effects on both innate and adaptive immunity, which significantly enhance pro-inflammatory responses and susceptibility to autoimmune diseases via strictly controlling the individual cellular components of the immune system that initiate and perpetuate the inflammation pathways. Autoimmune diseases, especially rheumatoid arthritis (RA), often exhibit substantial circadian oscillations, and circadian rhythm is involved in the onset and progression of autoimmune diseases. Mounting evidence indicate that the synthetic ligands of circadian clock genes have the property of reducing the susceptibility and clinical severity of subjects. This review supplies an overview of the roles of circadian clock genes in the pathology of autoimmune diseases, including BMAL1, CLOCK, PER, CRY, REV-ERBα, and ROR. Furthermore, summarized some circadian clock genes as candidate genes for autoimmune diseases and current advancement on therapy of autoimmune diseases with synthetic ligands of circadian clock genes. The existing body of knowledge demonstrates that circadian clock genes are inextricably linked to autoimmune diseases. Future research should pay attention to improve the quality of life of patients with autoimmune diseases and reduce the effects of drug preparation on the normal circadian rhythms.
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http://dx.doi.org/10.1016/j.autrev.2021.102866DOI Listing
August 2021

Psychological Status and Correlated Factors of Primary Medical Staff During the COVID-19 Outbreak in Hefei City, China.

J Multidiscip Healthc 2021 31;14:751-756. Epub 2021 Mar 31.

Lianhua Community Health Service Center, The Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People's Republic of China.

Objective: To investigate the mental illness and correlated factors of primary medical staff during the COVID-19 outbreak in Hefei city, China.

Methods: A total of 180 primary medical staff were randomly selected from seven community hospitals in Hefei Economic and Technological Development Zone as a study group. One hundred and eighty-two health people were recruited as the control group. The self-rating Anxiety Scale (SAS), self-rating Depression Scale (SDS) and Psychological questionnaire of public health emergencies were distributed to them for evaluation.

Results: The score of SAS, SDS in study group was higher than that in control group [(35.57±10.39) vs (31.31±7.98); (44.16±8.46) vs (41.47±9.47)] (=4.371, < 0.001; =2.849, =0.005). The fear subscale and total score in the psychological questionnaire of sudden public health events were negatively correlated with age (=-0.216, =0.004; =-0.154, =0.039). Marriage was negatively correlated with depression subscales in psychological questionnaires of SAS, SDS and sudden public health events (=-0.184, =0.013; =-0.298, <0.001; =-0.161, =0.031; =-0.147, =0.049). Education level was positively correlated with the total score of a psychological questionnaire for sudden public health events (=0.151, =0.043); Logistic regression analysis showed that marital status was a protective factor of psychological abnormality.

Conclusion: It is necessary to pay attention to the psychological status of primary medical staff, especially the young unmarried medical staff.
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http://dx.doi.org/10.2147/JMDH.S289336DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8020133PMC
March 2021

Association of PER2 gene single nucleotide polymorphisms with genetic susceptibility to systemic lupus erythematosus.

Lupus 2021 Apr 26;30(5):734-740. Epub 2021 Jan 26.

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui, China.

The circadian clock plays a crucial role in the progress of systemic lupus erythematosus (SLE). In this study, we performed a case-control study to explore the association between 2 (PER2) gene single nucleotide polymorphisms (SNPs) and the susceptibility of systemic lupus erythematosus (SLE). A total of 492 SLE patients and 493 healthy controls were included. The improved multiple ligase detection reaction (iMLDR) was used for genotyping. The correlations between four SNPs of PER2 (rs10929273, rs11894491, rs36124720, rs934945) and the genetic susceptibility and clinical manifestations of SLE were analyzed. Significant differences were observed in the distributions of allele frequencies and genotype under dominant model in rs11894491 between SLE patients and controls ( = 0.030,  = 022, respectively). We hypothesized that PER2 gene SNPs was related to the genetic susceptibility and clinical manifestations, implying the potential role of PER2 in the pathogenesis of SLE.
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http://dx.doi.org/10.1177/0961203321989794DOI Listing
April 2021

Mental health problems and social supports in the COVID-19 healthcare workers: a Chinese explanatory study.

BMC Psychiatry 2021 01 12;21(1):34. Epub 2021 Jan 12.

School of Nursing, Anhui Medical University, Hefei, 230032, Anhui, China.

Background: Coronavirus disease 2019 (COVID-19) has spread rapidly in China and other overseas areas, which has aroused widespread concern. The sharp increase in the number of patients has led to great psychological pressure on health care workers. The purpose of this study was to understand their mental health status and needs, so as to provide a scientific basis for alleviating the psychological pressure of health care workers.

Methods: Using a cross-sectional study design, 540 health care workers were randomly selected from two designated tuberculosis medical institutions in Anhui Province. The basic situation, perceived social support, depression level, loneliness and COVID-19 related knowledge were collected and analyzed by questionnaire.

Results: A total of 511 valid questionnaires were finally retrieved. There were 139 people in epidemic prevention and control positions (27.20%). Depression level: People in isolation ward, fever clinic and pre-check triage were at the level of mild to moderate depression. Female was higher than male; nurse was higher than doctor; middle and junior job titles were higher than senior titles; junior college degree or below were higher than bachelor's degree, master's degree and above; isolation ward, fever clinic and pre-check triage were significantly higher than those of non-prevention and control positions (p < 0.05). Loneliness scores: Doctors were higher than that of medical technicians, and isolation ward, fever clinic and pre-check triage were higher than those of other medical departments (p < 0.05). Social support: Doctors were lower than that of medical technicians, and isolation ward, fever clinic and pre-check triage were significantly lower than those of other departments (p < 0.05). The score of social support was negatively correlated with depression and loneliness (p < 0.001), while depression was positively correlated with loneliness (p < 0.001). Health care workers most want to receive one-to-one psychological counseling (29.75%), and provide crisis management (24.07%). The awareness rate of health care workers on COVID-19's knowledge was relatively high.

Conclusions: The psychological problems of health care workers, especially women, nurses with low educational background, low professional title, and staff in the epidemic prevention and control positions are relatively serious.
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http://dx.doi.org/10.1186/s12888-020-02998-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802988PMC
January 2021

Association of Gene Polymorphisms with Rheumatoid Arthritis in a Chinese Population.

Biomed Res Int 2020 6;2020:3789319. Epub 2020 Oct 6.

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.

Background: Recently, increasing studies have revealed that leptin is involved in the development of rheumatoid arthritis (RA). This study is aimed at exploring the association of gene single nucleotide polymorphisms (SNPs) with susceptibility to RA in a Chinese population.

Methods: We recruited 600 RA patients and 600 healthy controls from a Chinese population and analyzed their three SNPs (rs10244329, rs2071045, and rs2167270) using the improved Multiplex Ligase Detection Reaction (iMLDR) assays. The associations of these SNPs with clinical manifestations of RA were also analyzed. Enzyme-linked immunosorbent assay (ELISA) was performed for plasma determination.

Results: No significant difference in either allele or genotype frequencies of these three SNPs between RA patients and healthy controls was observed (all > 0.05). Association between the genotype effects of dominant, recessive models was also not found (all > 0.05). No significant difference in plasma levels was detected between RA patients and controls ( > 0.05).

Conclusion: gene (rs10244329, rs2071045, and rs2167270) polymorphisms are not associated with RA genetic susceptibility and its clinical features in the Chinese population.
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http://dx.doi.org/10.1155/2020/3789319DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559230PMC
May 2021

Decreased sleep quality in patients with systemic lupus erythematosus: a meta-analysis.

Clin Rheumatol 2021 Mar 3;40(3):913-922. Epub 2020 Aug 3.

School of Nursing, Anhui Medical University, Hefei, 230032, Anhui, China.

Objectives: To obtain a reliable estimation on the sleep quality in patients with systemic lupus erythematosus (SLE) and identify the main sleep problems, a meta-analysis was performed.

Methods: Up to March 21, 2020, PubMed, EMBASE, and Cochrane Library were searched; quality evaluation were conducted with Newcastle-Ottawa Scale; statistical analyses were performed by stata14.0 software; results were expressed by weighted mean difference or standardized mean difference (WMD/SMD) and 95% confidence interval (CI).

Results: Eighteen case-control studies were included in meta-analysis, 1086 SLE patients and 2866 controls were collected. The score of sleep quality in the case group was higher than that in the control group (SMD = 1.03, 95% CI: 0.80-1.27), and so was the Pittsburgh Sleep Quality Index (PSQI) (WMD = 3.45, 95% CI: 2.49-4.42). The first three complaints of sleep problems in PSQI were daytime dysfunction (WMD = 0.64, 95% CI: 0.36-0.92), subjective sleep quality (WMD = 0.62, 95% CI: 0.40-0.84), and habitual sleep efficiency (WMD = 0.54, 95% CI: 0.37-0.72). Subgroup analyses showed that the score of sleep quality in SLE patients were higher than controls among different regions, races, and disease duration. The sleep quality score of SLE patients with fibromyalgia (FM) was higher than that in general control, but no significant difference as compared with SLE patients without FM.

Conclusions: Our meta-analysis indicates that the sleep quality of SLE patients is worse than that of the general population; thus, more attention should be paid to the sleep status among this disease. Key Points •The sleep quality of SLE patients is worse than that of the general population. •Region, race, and disease duration are correlated with sleep quality in SLE patients.
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http://dx.doi.org/10.1007/s10067-020-05300-3DOI Listing
March 2021

Prevalence and influential factors of thrombocytopaenia in systemic lupus erythematosus patients: a retrospective analysis of 3140 cases in a Chinese population.

Lupus 2020 Jun 1;29(7):743-750. Epub 2020 May 1.

School of Nursing, Anhui Medical University, Anhui, PR China.

Introduction: The present study aimed to investigate the prevalence and influential factors of thrombocytopaenia in systemic lupus erythematosus (SLE) patients among the Chinese population in order to provide evidence for improving the treatment and nursing of SLE patients.

Methods: A retrospective analysis of 3140 SLE patients admitted to two large tertiary hospitals was conducted in Anhui, China, from 2011 to 2018. In addition, the influential factors related to SLE with thrombocytopaenia were analysed through univariate and multivariate analysis.

Results: A total of 804 SLE patients had thrombocytopaenia (25.6%). The top 5 clinical manifestations of SLE inpatients were proteinuria (51.0%), lupus nephritis (45.9%), new rash (38.4%), haematuria (36.7%) and pyuria (32.2%). The incidence of neurological manifestations, oral mucosal ulceration, pleurisy, pericarditis, hyperglycaemia, leucocytopaenia, urinary casts, haematuria, pyuria and high disease activity in the thrombocytopaenia group were higher than those in the non-thrombocytopaenia group ( < 0.05). Multivariate analysis showed age (odds ratio (OR) = 1.009,  = 0.005), neurological manifestations (OR = 1.373,  = 0.048), pericarditis (OR = 1.394,  = 0.048), hyperglycaemia (OR = 1.717,  < 0.001), leucocytopaenia (OR = 2.551,  < 0.001), haematuria (OR = 1.582,  < 0.001), serum C3 level <0.85 g/L (OR = 1.525,  = 0.001), serum C4 concentration <0.10 g/L (OR = 1.287,  = 0.020), serum CRP concentration <8 ng/L (OR = 1.314,  = 0.005), prothrombin time >15.30 seconds (OR = 1.479,  = 0.032), activated partial thromboplatin time >45 seconds (OR = 1.924,  < 0.001) and thrombin time >21 seconds (OR = 1.629,  = 0.015) were associated with thrombocytopaenia.

Conclusion: Thrombocytopaenia has a high prevalence in SLE patients and is related to some baseline, clinical and laboratory characteristics, affecting multiple organs and systems.
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http://dx.doi.org/10.1177/0961203320922301DOI Listing
June 2020

Elevated Circulating Interleukin-17 Levels in Patients with Systemic Lupus Erythematosus: A Meta-analysis.

Immunol Invest 2020 Aug 17;49(6):662-675. Epub 2019 Dec 17.

School of Nursing, Anhui Medical University , Hefei, Anhui, China.

Background: Previous studies concerning the circulating interleukin-17 (IL-17) in systemic lupus erythematosus (SLE) were contradictory.

Aims: To further precisely investigate circulating IL-17 in SLE and evaluate its influential factors by meta-analysis.

Methods: EMBASE, PubMed and Cochrane Library were comprehensively searched to obtain studies on circulating IL-17 in SLE patients by November 22, 2018. The results were illustrated by pooled standard mean difference (SMD) with corresponding 95% confidence interval (CI) using random-effects model as there was significant heterogeneity, which was estimated using Cochran and statistics. Subgroup analyses and sensitivity analyses were also conducted.

Results: Overall, 1872 articles were reviewed and 20 studies involving 1067 subjects with SLE and 721 healthy controls (HCs) were enrolled in the final analysis according to inclusion criteria. Compared with HCs, circulating IL-17 levels in SLE patients were elevated (SMD: 1.183, 95% CI: 0.763-1.603; < .001). Moreover, in comparison to HCs, European and Asian SLE patients, age <30 years, disease duration ≥5 years, NOS scores <7 and using ELISA showed increased circulating IL-17 status, whereas no significant change was observed in other subgroups. There was no significant publication bias. Sensitivity analyses demonstrated that the results of our meta-analysis were robust.

Conclusions: SLE patients have higher circulating IL-17 levels, which is influenced by ethnic, age and disease duration, literature quality and measurements.
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http://dx.doi.org/10.1080/08820139.2019.1699107DOI Listing
August 2020

TREX1 As a Potential Therapeutic Target for Autoimmune and Inflammatory Diseases.

Curr Pharm Des 2019 ;25(30):3239-3247

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.

Background And Objectives: The 3' repair exonuclease 1 (TREX1) gene is the major DNA-specific 3'-5 'exonuclease of mammalian cells which reduces single- and double-stranded DNA (ssDNA and dsDNA) to prevent undue immune activation mediated by the nucleic acid. TREX1 is also a crucial suppressor of selfrecognition that protects the host from inappropriate autoimmune activations. It has been revealed that TREX1 function is necessary to prevent host DNA accumulating after cell death which could actuate an autoimmune response. In the manuscript, we will discuss in detail the latest advancement to study the role of TREX1 in autoimmune disease.

Methods: As a pivotal cytoprotective, antioxidant, anti-apoptotic, immunosuppressive, as well as an antiinflammatory molecule, the functional mechanisms of TREX1 were multifactorial. In this review, we will briefly summarize the latest advancement in studying the role of TREX1 in autoimmune disease, and discuss its potential as a therapeutic target for these diseases.

Results: Deficiency of TREX1 in human patients and murine models is characterized by systemic inflammation and the disorder of TREX1 functions drives inflammatory responses leading to autoimmune disease. Moreover, much more studies revealed that mutations in TREX1 have been associated with a range of autoimmune disorders. But it is also unclear whether the mutations of TREX1 play a causal role in the disease progression, and whether manipulation of TREX1 has a beneficial effect in the treatment of autoimmune diseases.

Conclusion: Integration of functional TREX1 biology into autoimmune diseases may further deepen our understanding of the development and pathogenesis of autoimmune diseases and provide new clues and evidence for the treatment of autoimmune diseases.
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http://dx.doi.org/10.2174/1381612825666190902113218DOI Listing
June 2020

P2X7 receptor: A potential therapeutic target for autoimmune diseases.

Autoimmun Rev 2019 Aug 7;18(8):767-777. Epub 2019 Jun 7.

School of Nursing, Anhui Medical University, 15 Feicui Road, Hefei, Anhui, China. Electronic address:

P2X7 receptor (P2X7R), a distinct ligand-gated ion channel, is a member of purinergic type 2 receptor family with ubiquitous expression in human body. Previous studies have revealed a pivotal role of P2X7R in innate and adaptive immunity. Once activated, it will meditate some vital cascaded responses including the assembly of nucleotide-binding domain (NOD) like receptor protein 3 (NLRP3) inflammasome, non-classical secretion of IL-1β, modulation of cytokine-independent pathways in inflammation such as P2X7R- transglutaminase-2 (TG2) and P2X7R-cathepsin pathway, activation and regulation of T cells, etc. In fact, above responses have been identified to be involved in the development of autoimmunity, specifically, the NLRP3 inflammasome could promote inflammation in massive autoimmune diseases and TG2, as well as cathepsin may contribute to joint destruction and degeneration in inflammatory arthritis. Recently, numerous evidences further suggested the significance of P2X7R in the pathogenesis of autoimmune diseases, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), inflammatory bowel disease (IBD), multiple sclerosis (MS), etc. In this review, we will succinctly discuss the biological characteristics and summarize the recent progress of the involvement of P2X7R in the development and pathogenesis of autoimmune diseases, as well as its clinical implications and therapeutic potential.
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http://dx.doi.org/10.1016/j.autrev.2019.06.009DOI Listing
August 2019

Seasonal variation in systemic lupus erythematosus and rheumatoid arthritis: An ecological study based on internet searches.

Autoimmun Rev 2019 08 6;18(8):825-827. Epub 2019 Jun 6.

School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia. Electronic address:

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http://dx.doi.org/10.1016/j.autrev.2019.06.001DOI Listing
August 2019

Correction: Leveraging Google Trends to investigate the global public interest in rheumatoid arthritis.

Rheumatol Int 2019 08 6;39(8):1445. Epub 2019 Jun 6.

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China.

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http://dx.doi.org/10.1007/s00296-019-04342-4DOI Listing
August 2019

Differential Plasma Expression Profiles of Long Non-Coding RNAs Reveal Potential Biomarkers for Systemic Lupus Erythematosus.

Biomolecules 2019 05 28;9(6). Epub 2019 May 28.

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.

Identify long non-coding RNAs (lncRNAs) that might serve as biomarkers for systemic lupus erythematosus (SLE) and explore the biological functions of the identified lncRNAs. In the screening phase, we examined the lncRNA expression profile of plasma samples from 24 patients with SLE and 12 healthy controls (HCs) using lncRNA microarray with pooled samples. The candidate lncRNAs were verified in individual samples by quantitative real-time (qRT)-PCR. In the independent validation stage, the identified lncRNAs were evaluated in 240 patients with SLE and 120 HCs. The identified lncRNAs were assessed further in an external validation stage including patients with rheumatoid arthritis (RA) and primary Sjögren's syndrome (pSS). In addition, we constructed correlated expression networks including coding-non-coding co-expression and competing endogenous RNAs (ceRNAs). Plasma levels of linc0597, lnc0640, and lnc5150 were elevated in SLE patients compared with those of HCs, whereas levels of GAS5 and lnc7074 were decreased. Five lncRNAs were identified as potential SLE biomarkers with an area under the receiver operating characteristic curve (AUC) ranging from 0.604 to 0.833 in the independent validation phase. This panel of five lncRNAs had high diagnostic accuracy for SLE (AUC = 0.966) and distinguished SLE from RA and pSS (AUC = 0.683 and 0.910, respectively). Co-expression analysis showed that GAS5, lnc0640, and lnc5150 may participate in the SLE pathogenesis through the MAPK pathway. The ceRNA network indicated that GAS5, lnc0640, lnc3643, lnc6655, and lnc7074 bind competitively with microRNAs regulating the expression of target genes. Aberrant expression and related pathways suggest the important role of lncRNAs in SLE pathogenesis. In addition, the panel of five lncRNAs (GAS5, lnc7074, linc0597, lnc0640, and lnc5150) in plasma could be used as SLE biomarkers.
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http://dx.doi.org/10.3390/biom9060206DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627908PMC
May 2019

Factors influencing completion of treatment among pulmonary tuberculosis patients.

Patient Prefer Adherence 2019 10;13:491-496. Epub 2019 Apr 10.

School of Nursing, Anhui Medical University, Hefei, Anhui, People's Republic of China.

This study aimed to understand the influencing factors of treatment completion among pulmonary tuberculosis (PTB) patients in Anhui province, eastern People's Republic of China, in order to provide scientific evidence for improving the follow-up rate and treatment completion rate. A total of 262 PTB patients in six counties (districts) of Anhui province were investigated by questionnaire, and data about treatment interruption were collected. The main causes of treatment interruption were forgetting to take medicine (24.5%), drug side effects (23.3%), and symptomatic improvement (19.5%). The education background, patient type, cause of interruption, and tracking method were factors influencing completion of treatment (all <0.05). The education level was positively associated with the treatment completion rate. New smear-positive patients had a significantly higher completion rate than others. The patients interrupted by drug side effects had the highest risk of interruption. In terms of the tracking method, the completion rate of patients tracked by the rural medical staff was significantly lower. The management of PTB patients by medication supervision should be strengthened, especially for those with low education level and who had drug side effects, in order to improve their treatment completion rate.
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http://dx.doi.org/10.2147/PPA.S198007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6497847PMC
April 2019

Emerging role of air pollution in autoimmune diseases.

Autoimmun Rev 2019 Jun 5;18(6):607-614. Epub 2019 Apr 5.

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, 81 Meishan Road, Hefei, Anhui, China. Electronic address:

Autoimmune diseases (ADs) are a broad spectrum of disorders featured by the body's immune responses being directed against its own tissues, resulting in prolonged inflammation and subsequent tissue damage. Recently, the exposure to ambient air pollution has been implicated in the occurrence and development of ADs. Mechanisms linking air pollution exposures and ADs mainly include systemic inflammation, increased oxidative stress, epigenetic modifications induced by exposures and immune response caused by airway damage. The lung may be an autoimmunity initiation site in autoimmune diseases (ADs). Air pollutants can bind to the Aryl hydrocarbon receptor (AHR) to regulate Th17 and Treg cells. Oxidative stress and inducible bronchus associated lymphoid tissue caused by the pollutants can influence T, B cells, resulting in the production of proinflammatory cytokines. These cytokines stimulate B cell and dendritic cells, resulting in a lot of antibodies and self-reactive T lymphocytes. Moreover, air pollutants may induce epigenetic changes to contribute to ADs. In this review, we will concern the associations between air pollution and immune-inflammatory responses, as well as mechanisms linking air pollution exposure and autoimmunity. In addition, we focus on the potential roles of air pollution in major autoimmune diseases including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), multiple sclerosis (MS), and type 1 diabetes mellitus (T1DM).
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http://dx.doi.org/10.1016/j.autrev.2018.12.010DOI Listing
June 2019

Leveraging Google Trends to investigate the global public interest in rheumatoid arthritis.

Rheumatol Int 2019 Aug 6;39(8):1439-1444. Epub 2019 Apr 6.

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.

This study aims to investigate the global public interest in rheumatoid arthritis by evaluating search term popularity changes of the disease over a decade. Google Trends was applied to retrieve search popularity scores for the term 'rheumatoid arthritis' between January 2004 and December 2017, utilizing the category of "health". Overall, relative searches volume for rheumatoid arthritis steadily decreased from January 2004 to December 2010, and then slowly rose from January 2011 to December 2017. There were significant seasonal variations in relative searches volume for the term 'rheumatoid arthritis' (Amplitude = 3.11; Phase: Month = 4.3; Low point: Month = 10.3; p < 0.025). Relative searches volume peaked in April and reached the lowest level in October. The top 11 rising topics were scleroderma, Anna Marchesini, C-reaction protein, osteoarthritis, arthritis, joint pain, autoimmune disease, rheumatoid factor, rheumatology, methotrexate, and systemic lupus erythematosus, ranking from high to low by relative growth of topic regarding rheumatoid arthritis. In conclusion, the evidence from Google Trends analysis demonstrates a significant seasonal variation in rheumatoid arthritis, with a peak in April. In addition, the top rising search queries are beneficial for physicians to search the Internet themselves for websites that provide high-quality information to recommend to their patients.
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http://dx.doi.org/10.1007/s00296-019-04297-6DOI Listing
August 2019

Prevalence of and Factors Influencing Anti-Tuberculosis Treatment Non-Adherence Among Patients with Pulmonary Tuberculosis: A Cross-Sectional Study in Anhui Province, Eastern China.

Med Sci Monit 2019 Mar 14;25:1928-1935. Epub 2019 Mar 14.

School of Nursing, Anhui Medical University, Hefei, Anhui, China (mainland).

BACKGROUND To assess the non-adherence rate among pulmonary tuberculosis (TB) patients in Anhui Province, eastern China and to explore the influential factors, so as to identify targets for intervention. MATERIAL AND METHODS A total of 339 TB patients were recruited from TB dispensaries in 8 counties of Anhui Province, eastern China using a stratified sampling method. All study subjects were surveyed using a structured questionnaire. Differences between groups involving categorical data were analyzed using the chi-square test. RESULTS Overall, of the 339 patients, 33.63% missed medication. Divorced and widowed patients were more likely to miss medication compared with those who were married or unmarried (P<0.01). Regarding the knowledge related to topics such as transmission route, preventive measures, and suspicious symptoms, the awareness rate in the group with good medication compliance was higher than in the group with poor compliance (P<0.05). We found that compliance was not significantly associated with seeking medical treatment in professional institutions, the national free TB treatment policy, or discrimination (P>0.05). The rate of non-compliance under supervision (26.10%) was lower than that without supervision (64.18%) (P<0.001). CONCLUSIONS The anti-TB treatment non-adherence rate in TB patients is relatively high in Anhui Province, eastern China, and is associated with marital status, annual income, TB knowledge, and medical staff visits.
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http://dx.doi.org/10.12659/MSM.913510DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429981PMC
March 2019

Association of long noncoding RNAs expression levels and their gene polymorphisms with systemic lupus erythematosus.

Sci Rep 2017 11 9;7(1):15119. Epub 2017 Nov 9.

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui, P. R. China.

Increasing evidence has demonstrated the association between long noncoding RNAs (lncRNAs) and multiple autoimmune diseases. To explore four lncRNAs (GAS5, lnc-DC, linc0597 and linc0949) expression levels and gene polymorphisms in systemic lupus erythematosus (SLE), a two stage design was applied. In the first stage, 85 SLE patients and 71 healthy controls were enrolled to investigate the lncRNAs expression levels. Then, 1260 SLE patients and 1231 healthy controls were included to detect the single nucleotide polymorphisms (SNPs) in the differentially expressed lncRNAs identified in the first stage. Linc0597, lnc-DC and GAS5 expression levels were significantly lower in SLE patients than healthy controls (P < 0.001, P < 0.001, P = 0.003 respectively). Association of five SNPs (rs10515177, rs2070107, rs2632516, rs2877877, rs2067079) with SLE risk were analyzed. No significant association was observed between these gene polymorphisms and susceptibility to SLE (all P > 0.010), and we did not find significant association between any genotypes at five SNPs and their respective lncRNAs expression in SLE (all P > 0.010). In summary, the expression levels of linc0597, lnc-DC and GAS5 are decreased in SLE patients, but their gene polymorphisms are not associated with SLE risk, and do not influence their expression levels.
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http://dx.doi.org/10.1038/s41598-017-15156-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680319PMC
November 2017

Association between serum/plasma adiponectin levels and immune-mediated diseases: a meta-analysis.

Arch Dermatol Res 2017 Oct 12;309(8):625-635. Epub 2017 Jul 12.

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China.

Adiponectin plays an important role in the development of immune-mediated diseases. Currently published data regarding the relationship between serum/plasma levels of adiponectin and immune-mediated diseases are inconsistent. We therefore conducted this meta-analysis to explore the association of serum/plasma adiponectin levels with immune-mediated diseases in humans. Systematic literature search was conducted to identify all relevant studies. The study quality was assessed by the Newcastle-Ottawa scale. Pooled standard mean difference (SMD) with 95% confidence interval (CI) was calculated by random-effect model analysis. A total of 47 studies were included in our meta-analysis, including 27 studies of type 1 diabetes mellitus (T1DM), 9 studies of rheumatoid arthritis (RA), 7 studies of systemic lupus erythematosus (SLE), and 4 studies of ankylosing spondylitis (AS). The results revealed significant differences in serum/plasma levels of adiponectin between immune-mediated diseases and normal controls (SMD = 1.262, 95% CI 0.766-1.758, p < 0.001). In the subgroup analysis stratified by disease type, the serum/plasma levels of adiponectin in T1DM, RA and SLE patients were higher than those in normal control, but not in AS patients. Moreover, in the subgroup analysis stratified by gender, in both men and women group, the serum/plasma levels of adiponectin in patients with immune-mediated diseases were higher than that in the control group. Furthermore, subgroup analyses also showed that immune-mediated diseases from Asian population, Caucasian population, mean age >40 years, and BMI ≥24 kg/m had higher serum/plasma adiponectin levels when compared with normal controls. Collectively, this meta-analysis demonstrates that serum/plasma levels of adiponectin in T1DM, RA and SLE patients were higher than those in normal controls, but not in AS patients.
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http://dx.doi.org/10.1007/s00403-017-1755-yDOI Listing
October 2017

Identification of long non-coding RNAs GAS5, linc0597 and lnc-DC in plasma as novel biomarkers for systemic lupus erythematosus.

Oncotarget 2017 Apr;8(14):23650-23663

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.

Despite increasing evidence that long non-coding RNAs (lncRNAs) widely take part in human diseases, the role of lncRNAs in systemic lupus erythematosus (SLE) is largely unknown. In this study, we performed a two-stage study to explore the plasma levels of five lncRNAs (GAS5, linc0949, linc0597, HOTAIRM1 and lnc-DC) and their potential as SLE biomarkers. Compared with healthy controls, plasma levels of GAS5 and lnc-DC were significantly decreased (P < 0.001 and P = 0.002, respectively) while linc0597 were overexpressed in SLE patients (P < 0.001). When SLE patients were divided into SLE without nephritis and lupus nephritis (LN), the levels of lnc-DC were significantly higher in LN compared with SLE without nephritis (P = 0.018), but no significant difference in levels of GAS5 and linc0597 were found between LN and SLE without nephritis; plasma linc0949 level showed no significant difference in all comparisons. Further evaluation on potential biomarkers showed that GAS5, linc0597 and lnc-DC may specifically identify patients with SLE, the combination of GAS5 and linc0597 provided better diagnostic accuracy; lnc-DC may discriminate LN from SLE without nephritis. In summary, GAS5, linc0597 and lnc-DC in plasma could be potential biomarkers for SLE.
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http://dx.doi.org/10.18632/oncotarget.15569DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5410334PMC
April 2017

Elevated plasma midkine and pleiotrophin levels in patients with systemic lupus erythematosus.

Oncotarget 2017 Jun;8(25):40181-40189

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.

Emerging evidence suggests that two heparin-binding growth factor, midkine and pleiotrophin are implicated in the pathogenesis of autoimmune diseases including SLE. To investigate the plasma midkine and pleiotrophin levels in SLE patients, as well as their correlation with major clinical parameters and interleukin-17 (IL-17) level in SLE, 83 SLE patients and 123 controls including 20 rheumatoid arthritis (RA) patients, 21 Sjögren's syndrome (SS) patients and 82 healthy controls (HCs) were recruited. Plasma midkine, pleiotrophin and IL-17 levels were detected by ELISA. Midkine and pleiotrophin levels were significantly higher in SLE, RA and SS patients compared with HCs (all P < 0.05). There were significantly lower midkine and pleiotrophin levels in SLE compared to SS (P < 0.05 and P < 0.01, respectively). No significant differences in midkine and pleiotrophin levels were found between SLE and RA (P = 0.240 and P = 0.074, respectively). Both plasma midkine and pleiotrophin levels were associated with rash and anti-SSA in SLE. In addition, both midkine and pleiotrophin levels were positively associated with IL-17 level in SLE (both P < 0.001). Area under curve (AUC) of the receiver operating characteristic (ROC) curve for midkine and pleiotrophin were 0.606 (0.527-0.681) and 0.605 (0.526-0.680) respectively. In conclusion, elevated plasma midkine and pleiotrophin levels and their associations with rash, anti-SSA and IL-17 in SLE patients suggest their involvement in this disease.
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http://dx.doi.org/10.18632/oncotarget.13658DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522313PMC
June 2017

Subclinical Atherosclerosis in Patients With Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis.

Angiology 2017 May 1;68(5):447-461. Epub 2016 Jun 1.

1 Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.

We evaluated the differences in major markers of cardiovascular (CV) risk between inflammatory bowel diseases (IBDs) and controls by a systematic review and a meta-analysis. We searched PubMed, EMBASE, and Cochrane databases for literature comparing CV risk markers in IBDs and controls. The overall mean carotid intima-media thickness (CIMT), flow-mediated dilation (FMD%), and carotid-femoral pulse wave velocity (cfPWV) difference between patients with IBDs and control groups were calculated. Twenty-eight studies were included in the meta-analysis, including 16 studies with data on CIMT, 7 studies reporting FMD%, and 9 studies on cfPWV. Compared to controls, patients with IBDs showed significantly higher CIMT (standardized mean difference [ SMD]: 0.534 mm; 95% confidence interval [CI], 0.230 to 0.838; P = .001), significantly lower FMD% ( SMD, -0.721%; 95% CI, -1.020 to -0.421; P < .0001), and significantly increased cfPWV ( SMD, 0.849; 95% CI, 0.589 to 1.110; P < .0001). When analyzing subgroups with ulcerative colitis and Crohn disease (CD), all results were still significant except CIMT in CD. Our findings support the current evidence for an elevated CV burden in patients with IBD and support the clinical utility of markers of subclinical atherosclerosis in the management of these patients.
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http://dx.doi.org/10.1177/0003319716652031DOI Listing
May 2017

Association of interleukin-1 family cytokines single nucleotide polymorphisms with susceptibility to systemic sclerosis: an independent case-control study and a meta-analysis.

Immunol Res 2016 08;64(4):1041-52

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Meishan Road 81, Hefei, 230032, Anhui, China.

The aim of our study was to investigate the association of five single nucleotide polymorphisms in interleukin-1 (IL-1) gene with susceptibility to systemic sclerosis (SSc) in a Chinese population. A total of 58 SSc patients and 113 healthy controls were enrolled. TaqMan allele discrimination assay was performed to detect the genotyping of IL-1A -889C/T (rs1800587), IL-1B -511C/T (rs16944), IL-18 -607C/A (rs1946518), IL-18 -137G/C (rs187238) and IL-33 rs7044343. The association between these SNPs and SSc risk was analyzed. Furthermore, a meta-analysis of relevant studies on the association of IL-1A -889C/T (rs1800587) and IL-1B -511C/T (rs16944) with the susceptibility to SSc was performed. Through the genotyping, significant associations for SSc were found for: IL-1A -889C/T genotype frequencies (P = 0.000), dominant model (P = 0.000), recessive model (P = 0.001) and allele T frequency (P = 0.000). Among SSc patients, dyspnea was significantly associated with IL-18 -607C/A genotype frequency and IL-33 rs7044343 allele frequency (P = 0.037, P = 0.042, respectively). In addition, elevated erythrocyte sedimentation rate was significantly associated with IL-18 -137G/C (rs187238) genotype and allele frequency (P = 0.019, P = 0.006, respectively). While meta-analysis showed there was no significant association between IL-1A -889C/T polymorphism and SSc, for IL-1B -511C/T (rs16944), significant associations were found in the comparison of allele C versus T (OR 1.267, 95 % CI 1.016-1.580) by combined different outcomes. Results showed that IL-1A -889C/T (rs1800587) was associated with SSc susceptibility in the Chinese population. However, this association was not supported by a meta-analysis of all relevant studies. Further investigations are required to verify our findings.
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http://dx.doi.org/10.1007/s12026-016-8797-7DOI Listing
August 2016

Subclinical atherosclerosis in patients with systemic lupus erythematosus: A systemic review and meta-analysis.

Autoimmun Rev 2016 Jan 8;15(1):22-37. Epub 2015 Oct 8.

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032 Anhui, China; Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis, Anhui Medical University, 81 Meishan Road, Hefei, 230032 Anhui, China. Electronic address:

Objective: Systemic lupus erythematosus (SLE) is associated with increased risk of cardiovascular disease. Carotid intima media thickness (CIMT) and carotid plaques are both frequently used to identify populations at higher cardiovascular risk. A systematic literature search and meta-analysis were performed to evaluate CIMT and carotid plaques difference between SLE patients and normal controls.

Methods: The literatures comparing markers of cardiovascular risk (CIMT and prevalence of carotid plaques) in SLE and controls were systematically searched in PubMed, EMBASE and Cochrane databases. The overall mean CIMT difference and pooled odds ratio (OR) for the prevalence of carotid plaques between SLE patients and control groups were calculated by fixed-effects or random-effect model analysis. Meta-regression was performed to explore the potential influencing factors. Publication bias was examined by a funnel plot and Egger's test.

Results: A total of 80 studies (6085 SLE patients and 4794 controls) were included in the final analysis, 71 studies with data on CIMT (4814 cases and 3773 controls) and 44 studies reporting on the prevalence of carotid plaques (4417 cases and 3528 controls). As compared to controls, SLE patients showed a higher CIMT (WMD: 0.07 mm; 95%CI: 0.06, 0.09; P<0.001), and an increased prevalence of carotid plaques (OR: 2.45; 95%CI: 2.02, 2.97; P<0.001). Meta-regression models showed that traditional cardiovascular risk factors (age, HDL and triglyceride of SLE patients) and lupus related risk factors (as expressed by duration, ESR, SLEDAI and steroids) had a significant influence on CIMT, steroids and triglyceride had significant influence on the prevalence of carotid plaques.

Conclusions: Our findings support the current evidence base for an increased cardiovascular burden in SLE patients and support the use of CIMT and carotid plaques in observational studies in SLE patients. The findings are of importance to design more specific prevention and treatment strategies.
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http://dx.doi.org/10.1016/j.autrev.2015.10.002DOI Listing
January 2016

Emerging role of long noncoding RNAs in autoimmune diseases.

Autoimmun Rev 2015 Sep 16;14(9):798-805. Epub 2015 May 16.

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Laboratory of Population Health and Major Disease Screening and Diagnosis, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.

Long noncoding RNA (lncRNA), with size larger than 200 nucleotides, is a new class of noncoding RNA. Emerging evidence has revealed that lncRNAs play a key role in the regulation of immunological functions and autoimmunity. Herein, we review the recent findings of lncRNA regulation in immune functions and in the development of autoimmunity and autoimmune disease. In addition, we focus on the involvement of lncRNA regulation in innate and adaptive immune responses, immune cell development, and differential expression of lncRNAs in autoimmune diseases, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), type 1 diabetes mellitus (T1DM), multiple sclerosis (MS), autoimmune thyroid disease (AITD), psoriasis, polymyositis/dermatomyositis (PM/DM) and Crohn's disease (CD).
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http://dx.doi.org/10.1016/j.autrev.2015.05.004DOI Listing
September 2015

Omega-3: a double-edged sword for autoimmune diseases.

Rheumatol Int 2014 Feb 7;34(2):289-90. Epub 2013 Sep 7.

Department of Pharmacy, Binhu Hospital of Hefei City, the Third affiliated Hospital of Anhui Medical University, Hefei, 230001, Anhui, China,

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http://dx.doi.org/10.1007/s00296-013-2853-6DOI Listing
February 2014

Decreased serum level of IL-21 in new-onset systemic lupus erythematosus patients.

Rheumatol Int 2013 Sep 29;33(9):2337-42. Epub 2013 Mar 29.

Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, People's Republic of China.

This study aims to investigate the serum IL-21 levels in systemic lupus erythematosus (SLE) and its relations with clinical and laboratory features. Fifty-seven patients with SLE and 30 healthy volunteers were recruited in the current study. Serum IL-21 levels were detected by enzyme-linked immunosorbent assay. Statistical analyses were performed by SPSS 10.01. Results showed that IL-21 levels were significantly decreased in the serum of patients with SLE compared with controls (P = 0.026). There was no significant difference regarding serum IL-21 level between SLE patients with nephritis and those without nephritis (P = 0.066); no significant difference was found between less active SLE and more active SLE (P = 0.588). The presence of anemia was associated with low serum IL-21 levels (P = 0.030) in SLE patients. In summary, decreased serum level of IL-21 and its association with anemia indicate a possible role of IL-21 in human SLE. However, further studies are needed to confirm this preliminary results.
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http://dx.doi.org/10.1007/s00296-013-2724-1DOI Listing
September 2013

Leflunomide: friend or foe for systemic lupus erythematosus?

Rheumatol Int 2013 Feb 8;33(2):273-6. Epub 2012 Sep 8.

Department of Pharmacy, Binhu Hospital, The First People's Hospital of Hefei City, Lakeshore New District, Hefei 230001, Anhui, China.

Leflunomide is a new immunosuppressive medicine that has been effectively used in the therapy of rheumatoid arthritis and subsequently used with success in animal models and patients with systemic lupus erythematosus (SLE). However, its use has also been associated with significant and serious adverse reactions involving hematological, hepatic, immune, dermatological and respiratory systems. In the current review, we attempt to describe the two sides of this drug in the treatment of SLE.
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http://dx.doi.org/10.1007/s00296-012-2508-zDOI Listing
February 2013

[Protective effect of astragalosides on anoxia/reoxygenation injury of hippocampal neuron].

Zhongguo Zhong Xi Yi Jie He Za Zhi 2010 Nov;30(11):1173-7

Department of Pharmacology, Anhui Medical University, Hefei.

Objective: To study the effect of astragalosides (AST) on the anoxia/reoxygenation (A/R) injured neuron in rat.

Methods: Primary cultured rat's hippocampal neurons were made into A/R model cells. The cell viability was detected by MTT assay and lactate dehydrogenase releasing methods; the activity of superoxide dismutase (SOD), and contents of malondialdehyde (MDA) and nitride oxide (NO) in culture supernate were detected; the apoptosis rate of hippocampal neurons after A/R was measured by flow cytometry with double-staining of Hoechst33258 and AnnexinV-PI; and intracellular calcium ion [Ca2+]i was observed with a cofocal laser-scanning microscope and determined by fluorescent probe Fluo-3/AM.

Results: AST enhanced the cell viability of neurons after A/R injury, increased SOD activity and decreased the MDA and NO contents in supernate, reduced the A/R-induced apoptosis and decreased the calcium overload in neurons.

Conclusion: AST has the protective effects on A/R injured neurons, the mechanism is possibly related with its anti-oxidation and calcium overload reducing actions.
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November 2010

Protective effect of astragaloside on focal cerebral ischemia/reperfusion injury in rats.

Am J Chin Med 2010 ;38(3):517-27

Department of Pharmacology, Anhui Medical University, HeFei, China.

This study was to observe the neurological protective effects of astragalosides (AST) on focal cerebral ischemia-reperfusion (I/R) injury in rats and to explore its possible mechanism. Male SD rats received right middle cerebral artery occlusion for 120 min and AST (40 mg/kg) was orally administered. The rats were decapitated 1, 3, 7, and 14 days after reperfusion. The neurological deficit score, infarct volume and water content of brain were measured; the activity of superoxide dismutase (SOD), lactate dehydrogenase (LDH) and nitric oxide synthase (NOS), and the content of malondialdehyde (MDA), lactate (LD) and nitric oxide (NO) of brain tissue were detected too. The expression of inducible nitric synthase (iNOS), nerve growth factor (NGF) and tropomyosin receptor kinase A (TrkA) mRNA were measured by RT-PCR or real-time PCR. AST could significantly reduce the neurological deficit score; infract volume and water content, increase SOD and LDH activities, decrease NOS activity and MDA, LD and NO content. AST treatment could down-regulate expression of iNOS mRNA, while, NGF and TrkA mRNA were up-regulated. Our data suggest that AST have the protective effects on focal cerebral ischemia in rats at the different reperfusion time points, the mechanism may be related to the antioxidation, regulated the expressions of iNOS, NGF and TrkA mRNA.
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http://dx.doi.org/10.1142/S0192415X10008020DOI Listing
August 2010
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