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Ther Umsch 2022 Jun;79(5):260-268

Klinik Rheumatologie & Schmerzmedizin, Bethesda Spital Basel.

IgA vasculitis - similarities and differences to IgA nephropathy IgA vasculitis (IgAV), formerly called Henoch-Schönlein Purpura (HSP) is an immune complex-mediated vasculitis of small vessels typically affecting the skin, gastrointestinal tract, and the kidneys. Based on distinct histopathological and pathophysiological commonalities of IgAV and IgA nephropathy (IgAN) they are viewed as part of a spectrum of IgA-mediated inflammatory syndromes. While the disease course in children is most often benign, IgAV has a high risk of renal and gastrointestinal complications when first appearing in adulthood. Read More

J Ayub Med Coll Abbottabad 2022 Apr-Jun;34(2):336-340

Department of Paediatrics Aga Khan University Hospital Karachi, Pakistan.

Background: Henoch-Schönlein Purpura (HSP) is the most common vasculitis among children and adolescent characterized by skin, joints, renal and gastrointestinal involvement. There is different presenting feature of Henoch-Schönlein Purpura (HSP) and systemic involvement may vary at a certain age group.

Methods: This was a ten-year retrospective cohort study done at a tertiary care hospital of Pakistan conducted from 2011-2020. Read More

Oncology (Williston Park) 2022 May;36(5):316-320

A Mexican woman, aged 60 years, presented with fevers and abdominal pain. She had initially presented to an outside emergency department with weakness, malaise, nausea, vomiting, tachycardia to 110s, and fever to 102 °F. Her medical history was relevant for hypertension, prediabetes, and tobacco use (4-5 cigarettes/day for 12 years). Read More

Lancet 2022 May;399(10338):1902

Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.

Nat Microbiol 2022 May 28;7(5):680-694. Epub 2022 Apr 28.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

Intestinal proteases mediate digestion and immune signalling, while increased gut proteolytic activity disrupts the intestinal barrier and generates visceral hypersensitivity, which is common in irritable bowel syndrome (IBS). However, the mechanisms controlling protease function are unclear. Here we show that members of the gut microbiota suppress intestinal proteolytic activity through production of unconjugated bilirubin. Read More

BMC Health Serv Res 2022 Apr 9;22(1):468. Epub 2022 Apr 9.

Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA.

Background: Non-Hispanic (NH) Black older adults experience substantially higher rates of potentially avoidable hospitalization compared to NH White older adults. This study explores the top three chronic conditions preceding hospitalization and potentially avoidable hospitalization among NH White and NH Black Medicare beneficiaries in the United States.

Methods: Data on 4993 individuals (4,420 NH White and 573 NH Black individuals) aged ≥ 65 years from 2014 Medicare claims were linked with sociodemographic data from previous rounds of the Health and Retirement Study. Read More

Kidney360 2021 Aug 30;2(8):1240-1250. Epub 2021 Jun 30.

Cardiovascular, Metabolic, Endocrine and Renal, Labcorp Drug Development, Inc., Princeton, New Jersey.

Background: Diabetic kidney disease (DKD) is characterized by albuminuria and reduced renal function. Whether xanthine oxidoreductase inhibitors (XORIs) have a renoprotective effect in DKD patients with type 2 diabetes remains controversial. We conducted a proof-of-concept study to investigate the renal effects of a novel XORI, TMX-049, in patients with DKD and type 2 diabetes. Read More

Front Immunol 2022 14;13:762390. Epub 2022 Mar 14.

Thomas E. Starzl Transplantation Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.

B cells can be polarized to express various cytokines. The roles of IFNγ and IL-10, expressed respectively by B effector 1 (Be1) and Bregs, have been established in pathogen clearance, tumor growth, autoimmunity and allograft rejection. However, the role of B cell IL-4, produced by Be2 cells, remains to be established. Read More

Sheng Wu Gong Cheng Xue Bao 2022 Mar;38(3):1149-1158

College of Bioscience and Biotechnology, Hunan Agricultural University, Changsha 410128, Hunan, China.

The α2δ-1 protein coded by is dramatically up-regulated in dorsal root ganglion (DRG) neurons and spinal dorsal horn following sensory nerve injury in various animal models of neuropathic pain. overexpression potentiates presynaptic and postsynaptic NMDAR activity of spinal dorsal horn neurons to cause pain hypersensitivity. The α2δ-1-NMDAR interaction promotes surface trafficking and synaptic targeting of NMDARs in neuropathic pain caused by chemotherapeutic agents and peripheral nerve injury, as well as in other pathological conditions such as in the paraventricular nucleus (PVN) with neurogenic hypertension and in the brain with ischemic stroke. Read More

Med Sci Monit 2022 Mar 19;28:e934703. Epub 2022 Mar 19.

Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Bejing, China (mainland).

BACKGROUND This retrospective study aimed to compare the effects of methylprednisolone and dexamethasone in 35 patients with anaphylactic shock due to iodinated contrast media (ICM) during cardiac catheterization. MATERIAL AND METHODS Thirty-five patients diagnosed with ICM-related anaphylactic shock were enrolled. Nineteen patients received methylprednisolone, while 16 patients received dexamethasone. Read More

Z Rheumatol 2022 May 18;81(4):305-312. Epub 2022 Mar 18.

Klinik für Rheumatologie, Kantonsspital St. Gallen, Rorschacher Str. 95, 9007, St. Gallen, Schweiz.

Immunoglobulin A vasculitis (IgAV) is a systemic vasculitis of the small vessels with formation of IgA immune complexes and a broad spectrum of clinical constellations. Typical manifestations include purpura, arthralgia or arthritis, enteritis and glomerulonephritis. The IgAV is the most common vasculitis in childhood with a mostly uncomplicated and self-limiting course. Read More

Pediatr Int 2022 Jan;64(1):e15025

Division of Nephrology, Saitama Children's Medical Center, Saitama-City, Saitama, Japan.

Curr Med Res Opin 2022 May 29;38(5):811-825. Epub 2022 Mar 29.

Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Acute pain is among the most common reasons that people consult primary care physicians, who must weigh benefits versus risks of analgesics use for each patient. Paracetamol (acetaminophen) is a first-choice analgesic for many adults with mild to moderate acute pain, is generally well tolerated at recommended doses (≤4 g/day) in healthy adults and may be preferable to non-steroidal anti-inflammatory drugs that are associated with undesirable gastrointestinal, renal, and cardiovascular effects. Although paracetamol is widely used, many patients and physicians still have questions about its suitability and dosing, especially for older people or adults with underlying comorbidities, for whom there are limited clinical data or evidence-based guidelines. Read More

Lupus 2022 Apr 4;31(4):495-499. Epub 2022 Mar 4.

Faculty of Medicine, 27964Pontificia Universidad Javeriana, Bogotá, DC, Colombia.

The coexistence of systemic lupus erythematosus (SLE) and ANCA-associated vasculitis (AAV) as an overlapping syndrome is not common. Here, we report a case of a 33-year-old woman, with recent SLE diagnosis due to skin, kidney, articular, and immunologic compromise, in whom a chest CT scan showed bilateral nodules, consolidations, and tree-in-bud pattern; thoracoscopic lung biopsy revealed diffuse non-caseating granulomas, without other features of sarcoid, organizing pneumonia, or hypersensitivity pneumonitis with high positive p-ANCA titers. Overlap between SLE and AAV was a possible explanation for lupus granulomatous pneumonitis, and for this reason, a multidisciplinary meeting was held to evaluate complex patients with interstitial lung diseases patients. Read More

J Dermatol 2022 May 28;49(5):560-563. Epub 2022 Feb 28.

Department of Dermatology, Iwata City Hospital, Iwata, Japan.

Immunoglobulin (Ig)A vasculitis/nephropathy is a systemic immune complex-mediated vasculitis. Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is widely recommended in individuals without specific allergy to the vaccine components, it is arguable whether vaccination is advisable for patients with IgA vasculitis or for predisposed individuals. We and others have presented cases of IgA vasculitis occurring after SARS-CoV-2 vaccination. Read More

Drug Metab Dispos 2022 Feb 27. Epub 2022 Feb 27.

Pharmaceutical Sciences, University of Connecticut, United States

The market for large molecule biological drugs has grown rapidly, including antisense oligonucleotide (ASO) drugs. ASO drugs work as single-stranded synthetic oligonucleotides that reduce production or alter functions of disease-causing proteins through various mechanisms, such as mRNA degradation, exon skipping, and ASO-protein interactions. After the first ASO drug Fomivirsen was approved in 1998, the US Food and Drug Administration has approved 10 ASO drugs to date. Read More

BMC Nephrol 2022 02 16;23(1):67. Epub 2022 Feb 16.

Department of Nephrology, Aix-Marseille Univ, Hôpital de la Conception, AP-HM, 147 Bd Baille, 13005, Marseille, France.

Background: Hypocomplementemic urticarial vasculitis (HUV) is a rare systemic vasculitis. We aimed to describe the kidney involvement of HUV in a multicenter national cohort with an extended follow-up.

Methods: All patients with HUV (international Schwartz criteria) with a biopsy-proven kidney involvement, identified through a survey of the French Vasculitis Study Group (FVSG), were included. Read More

Int J Mol Sci 2022 Jan 28;23(3). Epub 2022 Jan 28.

Institute of Physiology, University of Zurich, 8057 Zurich, Switzerland.

Dysregulated energy metabolism is a major contributor to a multitude of pathologies, including obesity and diabetes. Understanding the regulation of metabolic homeostasis is of utmost importance for the identification of therapeutic targets for the treatment of metabolically driven diseases. We previously identified the deubiquitinase OTUB1 as substrate for the cellular oxygen sensor factor-inhibiting HIF (FIH) with regulatory effects on cellular energy metabolism, but the physiological relevance of OTUB1 is unclear. Read More

Diagn Pathol 2022 Feb 11;17(1):28. Epub 2022 Feb 11.

Institute of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China.

Background And Objectives: The underlying mechanism of IgA vasculitis (IgAV) and IgA vasculitis with nephritis (IgAVN) remains unclear. Therefore, there are no accurate diagnostic methods. Lipid metabolism is related to many immune related diseases, so this study set out to explore the relationship of lipids and IgAV and IgAVN. Read More

Clin Respir J 2022 Apr 11;16(4):293-300. Epub 2022 Feb 11.

Department of Medicine, The University of Hong Kong, Hong Kong.

Background: Chronic illnesses were reported to be poor prognostic factors associated with severe illness and mortality in Coronavirus disease 2019 (COVID-19) infection. The association with asthma, however, is limited and controversial, especially for mild asthma.

Methods: A territory wide retrospective study was conducted to investigate the association between asthma and the prognosis of COVID-19. Read More

Liver Int 2022 Feb 7. Epub 2022 Feb 7.

Section on Gastroenterology & Hepatology, Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.

Background: Leflunomide, a disease-modifying anti-rheumatic drug, has been associated with elevations of serum aminotransferases. Herein, we describe the clinical, laboratory features and outcomes of 17 patients with leflunomide/teriflunomide hepatotoxicity from two large drug-induced liver injury (DILI) registries.

Methods: Consecutive, adjudicated cases of leflunomide (n = 16)-or teriflunomide (n = 1)-related DILI from a single centre in Bangalore, India and the multicentre US Drug-Induced Liver Injury Network (DILIN) were reviewed. Read More

Curr Opin Pediatr 2022 04;34(2):209-216

Pediatric Nephrology, Children's and Adolescents' Hospital, University Hospital of Cologne, Faculty of Medicine, University of Cologne, Köln, Germany.

Purpose Of Review: The purpose of this update is to summarize current knowledge on the pathophysiology of immunglobulin A (IgA) vasculitis nephritis (IgAVN) as well as to critically review evidence for established therapeutic regimes and available biomarkers. An additional purpose is to raise the discussion what could be done to further improve our understanding of IgAVN, identify patients at risk for adverse outcome and increase the evidence for therapy recommendations.

Recent Findings: Clinical and experimental studies have established the concept of a multilevel pathogenesis. Read More

Mol Immunol 2022 03 1;143:114-121. Epub 2022 Feb 1.

Department of Dermatology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands; Centre for Human Drug Research, Leiden, The Netherlands.

IgA-vasculitis is a systemic small-vessel leucocytoclastic vasculitis and is associated with a high morbidity. The disease can progress to IgA-vasculitis with nephritis (IgAVN) which can result in chronic renal failure. Complement activation is involved in the pathogenesis of IgA-vasculitis. Read More

J Immunol Res 2022 20;2022:1737419. Epub 2022 Jan 20.

Department of Medicine, University at Buffalo, Buffalo, NY 14203, USA.

Complement factor H (FH) is a key regulator of the alternative pathway of complement, in man and mouse. Earlier, our studies revealed that the absence of FH causes the C57BL6 mouse to become susceptible to chronic serum sickness (CSS) along with an increase in the renal infiltration of macrophages compared to controls. To understand if the increased recruitment of macrophages (Ms) to the kidney was driving inflammation and propagating injury, we examined the effect of M depletion with clodronate in FH knockout mice with CSS. Read More

Am J Physiol Renal Physiol 2022 03 24;322(3):F268-F279. Epub 2022 Jan 24.

Department of Pharmacology and Toxicology, Michigan State University, East Lansing, Michigan.

Histamine has been implicated in urinary bladder dysfunction as an inflammatory mediator driving sensory nerve hypersensitivity. However, the direct influence of histamine on smooth muscle has not been thoroughly investigated. We hypothesized that histamine directly contracts urinary bladder smooth muscle (UBSM) independent of effects on nerves. Read More

Pediatr Nephrol 2022 04 19;37(4):915. Epub 2022 Jan 19.

Nephrology, GOSH, Great Ormond Street Hospital, London, UK.

Pediatr Nephrol 2022 04 10;37(4):913-914. Epub 2022 Jan 10.

Paediatric Nephrology Centre, Hong Kong Children's Hospital, Kowloon, Hong Kong.

Clin Rheumatol 2022 Mar 7;41(3):803-810. Epub 2022 Jan 7.

Clinical Laboratory, Hunan Children's Hospital, Changsha, 410007, China.

Objectives: Henoch-Schonlein purpura (HSP) is the most common childhood vasculitis, infection is the most essential inducement. We hypothesized that infection could impact the blood routine characteristics and/or outcome of vasculitis. Thus, we aim to find the most common infectious agent in HSP patients and identify convenient indicators to predict renal involvement in HSP patients with infection. Read More

Pediatr Pulmonol 2022 04 17;57(4):919-925. Epub 2022 Jan 17.

Department of Pharmacy, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, USA.

Objective: Pediatric cystic fibrosis (CF) patients possess unique pharmacokinetics and may benefit from prolonged beta-lactam infusions to optimize pharmacodynamics. This study compared adverse drug event (ADE) rates with cefepime prolonged (PI) and standard infusions (SI).

Methods: This retrospective study included pediatric patients treated with cefepime for CF exacerbations between 2009 and 2019. Read More

BMC Nephrol 2022 01 3;23(1):13. Epub 2022 Jan 3.

Department of Internal Medicine, Division of Nephrology, Veterans Health Service Medical Center, 53 Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul, 05368, South Korea.

Background: Immunoglobulin A vasculitis (IgA vasculitis) is one of the most common forms of vasculitis in children. It rarely occurs in adults. It is a systemic vasculitis with IgA deposition and is characterized by the classical tetrad of purpura, arthritis/arthralgia, gastrointestinal and renal involvement. Read More