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  • 901.
    Sundström, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Rantapää-Dahlqvist, Solbritt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Diet and alcohol as risk factors for rheumatoid arthritis: a nested case-control study2015Ingår i: Rheumatology International, ISSN 0172-8172, E-ISSN 1437-160X, Vol. 35, nr 3, s. 533-539Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to investigate whether alcohol and diet, assessed as both macronutrients and dietary patterns, increased the risk of development of rheumatoid arthritis (RA) through a nested case-control design in the Vasterbotten Intervention Program (VIP) cohort. Individuals in the VIP who had developed RA after the dietary survey were identified from medical records at the department of rheumatology at the University Hospital, UmeAyen (n = 386), and matched to 1,886 controls from the same database. Diet was assessed as food groups, as macronutrients and as scores of dietary patterns, namely the carbohydrate-restricted diet score, the Mediterranean diet score and the healthy diet indicator score. When analysing the dietary patterns, consumption of food groups and different macronutrients, a significant association was found in the highest tertile of carbohydrate-restricted diet among the cases with a subsequent anti-CCP-positive disease 1.40 (1.02-1.92), as well as in the highest tertile of protein consumption among smokers (OR = 1.80, 95 % CI 1.09-2.95). However, after additional adjustment for sodium intake, these associations were no longer statistically significant. No association was observed between alcohol consumption and the risk of RA. To summarize, there were no significant associations between diet, or alcohol consumption, and the risk of development of RA within this cohort. The lack of any significant associations of alcohol consumption may be explained by a low consumption in the studied population overall or alternatively by methodological issues raised recently.

  • 902.
    Sundström, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Rantapää-Dahlqvist, Solbritt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Dietary patterns, macronutrients and alcohol as risk factors for rheumatoid arthritis2014Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 73, s. 1144-1145Artikel i tidskrift (Övrigt vetenskapligt)
  • 903.
    Sundström, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi.
    Rantapää-Dahlqvist, Solbritt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Dietary Sodium Increases The Risk For Rheumatoid Arthritis Among Smokers – Results From a Nested Case-Control Study.2013Ingår i: Arthritis and Rheumatism, ISSN 0004-3591, E-ISSN 1529-0131, Vol. 65, nr Special Issue, Supplement 10, s. S966-S966, Meeting Abstract: 2271Artikel i tidskrift (Övrigt vetenskapligt)
  • 904.
    Sundström, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Kvist, Lillemor
    Malmbergets vårdcentral.
    Grupprehabilitering vid Fibromyalgi: effekter på vårdkonsumtion, välbefinnande och symtom.2009Ingår i: Abstrakt Sjukgymnastdagarna, Stockholm, 2009, 2009Konferensbidrag (Refereegranskat)
  • 905.
    Sundström, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Ljung, Lotta
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi. Karolinska Institutet, Clinical Epidemiology Division, Dept. Medicine Solna, Stockholm, Sweden.
    Di Giuseppe, Daniela
    Consumption of dairy products and risk of rheumatoid arthritis among women: a population-based prospective cohort study2019Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, s. 1047-1048Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Background: Conflicting results have been reported regarding the association between consumption of milk and dairy products and the risk for development of rheumatoid arthritis (RA).

    Objectives: The aim of this study was to investigate the association between consumption of milk and dairy products and the development of RA in a large population-based cohort of women.

    Methods: In a prospective cohort study 35,600 women aged 48-83 years, from the Swedish Mammography Cohort (SMC), were followed between 2003 and 2015. Consumption of dairy products was assessed in 1997 at a mean age of mean age of 61.5 years (SD 9.1 years) with a 96-item self-administered questionnaire. The risk (hazard ratio; HR) of RA development associated with consumption of dairy products was estimated using Cox proportional hazard regression models with adjustment for age, alcohol intake, smoking, energy intake, meat and fish consumption.

    Results: During the follow-up of 12 years, 368 individuals were identified with a new diagnosis of RA. Comparing high consumption with low consumption of dairy products, no association between consumption of dairy products and the development of RA was observed: HR for the fully adjusted model=1.12 (95% CI: 0.78-1.59 (Table 1). Also when evaluating milk and cheese consumption separately, no association with the risk of RA was observed: HR for the highest milk consumption=1.10 (95% CI: 0.82-1.44) and highest cheese consumption HR=1.20 (95% CI: 0.81-1.79), compared with low consumption (fully adjusted models, table 1).

    Conclusion: In this large population-based cohort study, consumption of dairy products was not associated with risk to develop RA.

  • 906.
    Sundström, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Ljung, Lotta
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi. Clinical Epidemiology Section, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
    Wallberg-Jonsson, Solveig
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Exercise habits and C-reactive protein may predict development of spinal immobility in patients with ankylosing spondylitis2018Ingår i: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 37, nr 10, s. 2881-2885Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To assess predictors for spinal immobility in a long-term clinical study of patients with AS, data from annual clinical measurements of spinal mobility in 54 patients (41 men, mean of age at end of follow-up 54.7 years) with ankylosing spondylitis were co-analysed with data regarding lifestyle factors as well as laboratory measurements from a previous cross-sectional study. Spinal immobility was graded on the basis of recently published age-, sex- and length-specific reference intervals. Exercise habits and high-sensitivity C-reactive protein (hsCRP) were independently associated with the development of subnormal spinal immobility (p = 0.019 and p = 0.021). In multiple regression models, approximately 25% of the spinal immobility could be attributed to disease duration (p ae 0.011), levels of hsCRP (p ae0.004) and exercise in leisure time (p ae 0.019). The mean concentration of hsCRP was 4.2 mg/L (range 0.2-8.4 mg/L) in the study cohort. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR) and physical activity at work were not associated with spinal immobility. The results indicate that exercise habits may have an impact in preventing the development of spinal immobility in AS independently of disease duration and inflammation. This corresponds well with the accumulated knowledge from long-term clinical experience among rheumatologists, health professionals and patients. Consequently, exercise should remain an important part of the non-pharmacological treatment and self-care for patients with AS. Furthermore, modest inflammatory activity, measured as a slightly elevated hsCRP concentration, appears to affect subsequent spinal immobility in AS.

  • 907.
    Sundström, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Ljung, Lotta
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Wållberg Jonsson, Solveig
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Exercise habits and C-reactive protein are associated with long term spinal immobility in ankylosing spondylitis2017Konferensbidrag (Refereegranskat)
  • 908.
    Sundström, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Ljung, Lotta
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Wållberg-Jonsson, Solveig
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Spinal mobility in long standing ankylosing spondylitis: application of newly developed reference intervals on clinical data2016Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 75, s. 1290-1290Artikel i tidskrift (Refereegranskat)
  • 909.
    Sundström, Björn
    et al.
    Department of Medical Rehabilitation, Gällivare Hospital.
    Stålnacke, K
    Department of Medicine/Rehabilitation, Kiruna Hospital.
    Hagfors, Linda
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för kostvetenskap.
    Johansson, Gunnar
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för kostvetenskap.
    Supplementation of Omega-3 fatty acids in patients with ankylosing spondylitis2006Ingår i: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 35, s. 359-362Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To study the effect of supplementation with omega‐3 fatty acids on disease variables and drug consumption in patients with ankylosing spondylitis (AS).

    Methods: Twenty‐four patients were randomized to either a low‐dose (1.95 g omega‐3/day) or a high‐dose (4.55 g omega‐3/day) supplement. Disease activity, functional impairment, erythrocyte sedimentation rate (ESR), and drug consumption were assessed during visits at baseline and at weeks 7, 14, and 21.

    Results: Eighteen patients completed the study, nine patients from each group. The patients in the high‐dose group exhibited a significant decrease in disease activity according to the Bath Ankylosing Disease Activity Index (BASDAI; p = 0.038), which was not seen in the low‐dose group. Significant differences were not found on drug consumption or in functional capacity in either of the groups. No significant differences were found when comparing the results between the high‐ and low‐dose groups.

    Conclusion: Omega‐3 fatty acids in adequate doses may have the capacity to decrease the disease activity of AS. However, larger and better controlled studies are needed before any further conclusions can be made on the extent of this capacity.

    Read More: http://informahealthcare.com/doi/abs/10.1080/03009740600844357

  • 910.
    Sundström, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Wållberg Jonsson, Solveig
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Cederholm, Tommy
    Uppsala University.
    Johansson, Gunnar
    Högskolan i Halmstad, Sektionen för hälsa och samhälle .
    Long-chain polyunsaturated fatty acid composition in diet, plasma and adipose tissue among patients with ankylosing spondylitis2010Ingår i: Clinical and experimental rheumatology, Pacini Editore SpA , 2010, Vol. 28, s. 625-625Konferensbidrag (Övrigt vetenskapligt)
  • 911.
    Sundström, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Wållberg Jonsson, Solveig
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Cederholm, Tommy
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala.
    Johansson, Gunnar
    Högskolan i Halmstad, Sektionen för hälsa och samhälle .
    Plasma phospholipids are related to disease activity in ankylosing spondylitis2011Ingår i: Annals of the Rheumatic Diseases 2011;70(Suppl3):739, 2011, s. 739-Konferensbidrag (Refereegranskat)
  • 912.
    Sundström, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Wållberg Jonsson, Solveig
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Johansson, Gunnar
    Högskolan i Halmstad, Sektionen för hälsa och samhälle .
    Fat composition in diet, plasma and adipose tissue among patients with ankylosing spondylitis2010Ingår i: Ann Rheum Dis 2010;69 (Suppl3):698, 2010Konferensbidrag (Refereegranskat)
  • 913.
    Sundström, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Wållberg Jonsson, Solveig
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Johansson, Gunnar
    Högskolan i Halmstad, Sektionen för hälsa och samhälle .
    Gastric complaints in Ankylosing Spondylitis: is the silent gut inflammation really silent?2009Ingår i: Ann Rheum Dis 2009; 68: 636, Ann Rheum Dis, 2009Konferensbidrag (Refereegranskat)
  • 914.
    Sundström, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Wållberg-Jonsson, Solveig
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Johansson, Gunnar
    School of Social and Health Sciences, Halmstad University, Halmstad, Sweden.
    Diet, disease activity, and gastrointestinal symptoms in patients with ankylosing spondylitis2011Ingår i: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 30, nr 1, s. 71-76Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aims of this study were to investigate, firstly, the relationship between diet and disease activity and, secondly, the presence of gastrointestinal symptoms and their relationship to diet among patients with ankylosing spondylitis (AS) using a cross-sectional design. One hundred sixty-five individuals diagnosed with AS were invited to complete a self-administered postal questionnaire regarding demographic data, diet, medication, and gastrointestinal symptoms in addition to two established disease assessment questionnaires, i.e., the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI). No significant correlation between diet and disease activity was found. Overall, 27% of the patients reported aggravating gastrointestinal problems when consuming certain foodstuff(s). The 30% of patients who reported suffering from gastrointestinal pain had significantly greater disease activity and poorer functional status according to their BASDAI and BASFI scores (p < 0.01 and p = 0.01, respectively). Patients who reported gastrointestinal pain had a significantly higher consumption of vegetables (p < 0.01) and lower consumption of milk and soured milk (p = 0.04). No significant correlation was found between the use of non-steroidal anti-inflammatory drugs (NSAID) and gastrointestinal symptoms. In multiple regression models, BASDAI and the consumption of vegetables were independent and statistically significant predictors of gastrointestinal pain. To conclude, in a group of Swedish AS patients, no correlation between diet and disease activity could be detected. There were, however, correlations between diet and gastrointestinal pain. Gastrointestinal problems were also found to be prevalent in AS, independent of NSAID usage.

  • 915.
    Surowiec, Izabella
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Gjesdal, Clara Gram
    Jonsson, Grete
    Norheim, Katrine Braekke
    Lundstedt, Torbjorn
    Trygg, Johan
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Omdal, Roald
    Metabolomics study of fatigue in patients with rheumatoid arthritis na < ve to biological treatment2016Ingår i: Rheumatology International, ISSN 0172-8172, E-ISSN 1437-160X, Vol. 36, nr 5, s. 703-711Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Fatigue occurs in all chronic inflammatory diseases, in cancer, and in some neurological conditions. Patients often regard fatigue as one of their most debilitating problems, but currently there is no established treatment and the mechanisms that lead to and regulate fatigue are incompletely understood. Our objective was to more completely understand the physiology of this phenomenon. Twenty-four patients with rheumatoid arthritis (RA) na < ve to treatment with biological drugs were enrolled for the study. Fatigue was measured with a fatigue visual analogue scale (fVAS). Ethylenediaminetetraacetic acid (EDTA) plasma samples were subjected to gas chromatography-time-of-flight mass spectrometry (GC/MS-TOF)-based metabolite profiling. Obtained metabolite data were evaluated by multivariate data analysis with orthogonal projections to latent structures (OPLS) method to pinpoint metabolic changes related to fatigue severity. A significant multivariate OPLS model was obtained between the fVAS scores and the measured metabolic levels. Increasing fatigue scores were associated with a metabolic pattern characterized by down-regulation of metabolites from the urea cycle, fatty acids, tocopherols, aromatic amino acids, and hypoxanthine. Uric acid levels were increased. Apart from fatigue, we found no other disease-related variables that might be responsible for these changes. Our MS-based metabolomic approach demonstrated strong associations between fatigue and several biochemical patterns related to oxidative stress.

  • 916.
    Surowiec, Izabella
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Johansson, Erik
    Stenlund, Hans
    Rantapää-Dahlqvist, Solbritt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Bergström, Sven
    Umeå universitet, Medicinska fakulteten, Institutionen för molekylärbiologi (Medicinska fakulteten). Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi.
    Normark, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för molekylärbiologi (Medicinska fakulteten). Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi.
    Trygg, Johan
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen. Sartorius Stedim Data Analytics, Umeå, Sweden.
    Quantification of run order effect on chromatography: mass spectrometry profiling data2018Ingår i: Journal of Chromatography A, ISSN 0021-9673, E-ISSN 1873-3778, Vol. 1568, s. 229-234Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Chromatographic systems coupled with mass spectrometry detection are widely used in biological studies investigating how levels of biomolecules respond to different internal and external stimuli. Such changes are normally expected to be of low magnitude and therefore all experimental factors that can influence the analysis need to be understood and minimized. Run order effect is commonly observed and constitutes a major challenge in chromatography-mass spectrometry based profiling studies that needs to be addressed before the biological evaluation of measured data is made. So far there is no established consensus, metric or method that quickly estimates the size of this effect. In this paper we demonstrate how orthogonal projections to latent structures (OPLS®) can be used for objective quantification of the run order effect in profiling studies. The quantification metric is expressed as the amount of variation in the experimental data that is correlated to the run order. One of the primary advantages with this approach is that it provides a fast way of quantifying run-order effect for all detected features, not only internal standards. Results obtained from quantification of run order effect as provided by the OPLS can be used in the evaluation of data normalization, support the optimization of analytical protocols and identification of compounds highly influenced by instrumental drift. The application of OPLS for quantification of run order is demonstrated on experimental data from plasma profiling performed on three analytical platforms: GCMS metabolomics, LCMS metabolomics and LCMS lipidomics.

  • 917.
    Surowiec, Izabella
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Ärlestig, Lisbeth
    Rantapää-Dahlqvist, Solbritt
    Trygg, Johan
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Metabolite and Lipid Profiling of Biobank Plasma Samples Collected Prior to Onset of Rheumatoid Arthritis2016Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, nr 10, artikel-id e0164196Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The early diagnosis of rheumatoid arthritis (RA) is desirable to install treatment to prevent disease progression and joint destruction. Autoantibodies and immunological markers pre-date the onset of symptoms by years albeit not all patients will present these factors, even at disease onset. Additional biomarkers would be of high value to improve early diagnosis and understanding of the process, leading to disease development. Methods: Plasma samples donated before the onset of RA were identified in the Biobank of Northern Sweden, a collection within national health survey programs. Thirty samples from pre-symptomatic individuals and nineteen from controls were subjected to liquid chromatography-mass spectrometry (LCMS) metabolite and lipid profiling. Lipid and metabolite profiles discriminating samples from pre-symptomatic individuals from controls were identified after univariate and multivariate OPLS-DA based analyses. Results: The OPLS-DA models including pre-symptomatic individuals and controls identified profiles differentiating between the groups that was characterized by lower levels of acyl-carnitines and fatty acids, with higher levels of lysophospatidylcholines (LPCs) and metabolites from tryptophan metabolism in pre-symptomatic individuals compared with controls. Lipid profiling showed that the majority of phospholipids and sphingomyelins were at higher levels in pre-symptomatic individuals in comparison with controls. Conclusions: Our LCMS based approach demonstrated that there are changes in small molecule and lipid profiles detectable in plasma samples collected from the pre-symptomatic individuals who subsequently developed RA, which point to an up-regulation of levels of lysophospatidylcholines, and of tryptophan metabolism, perturbation of fatty acid beta-oxidation and increased oxidative stress in pre-symptomatic individuals' years before onset of symptoms.

  • 918. Svard, Anna
    et al.
    Ljungberg, Karin Roos
    Brink, Mikael
    Kastbom, Alf
    Rantapää-Dahlqvist, Solbritt
    Secretory antibodies to citrullinated peptides in plasma and saliva from rheumatoid arthritis patients and their unaffected family members2019Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, s. 1097-1097Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Background Mucosal involvement in early phases of rheumatoid arthritis (RA) pathophysiology has emerged as an attractive hypothesis, supported by several findings. Elevated levels of antibodies against citrullinated peptides/proteins (ACPA) can be found during a long pre-symptomatic period, preceding manifest arthritis. Secretory antibodies are produced at mucosal surfaces, but can also be detected in the circulation. Secretory ACPA in plasma has been demonstrated in patients with RA (1). First-degree relatives (FDRs) of patients with RA can be regarded as potential pre-RA patients or at-risk individuals. In a previous study, a higher prevalence of ACPA was found in FDRs than in healthy controls (2), with IgA-ACPA being more common than IgG-ACPA.

    We hypothesized that formation of secretory ACPA is an early step in RA development, preceding the occurrence of regular non-secretory ACPA, and consequently secretory ACPA would be prevalent in a large proportion of FDRs.

    Objectives To evaluate secretory ACPA in plasma and saliva from patients with RA and FDRs.

    Methods We analyzed secretory antibodies to 2nd generation cyclic citrullinated peptides (anti-CCP) in plasma from 194 patients with RA and 191 FDRs unaffected by RA and salivary samples from 25 RA patients, 21 first-degree relatives and 11 controls.

    In plasma, cutoff for secretory ACPA was set at the 99th percentile of healthy blood donors. In saliva, a positive test was defined as a difference between optical density values for IgA anti-CCP and IgA anti-cyclic arginine peptide (delta OD value) >2 SD above the mean delta OD value of the controls.

    Mann-Whitney U test was used for continuous variables and Pearson Chi-square for categorical variables.

    Results Secretory ACPA occurred in 37 (19.1%) of RA patients but only in 2 (1%) of FDRs (table 1). Salivary IgA ACPA was found in 3/25 (12%) of patients with RA, but not in any of the 21 FDRs. 27% of FDRs were positive for regular non-secretory IgA ACPA in plasma, and out of them, only 2 individuals (5%) were positive for secretory ACPA in plasma. Among FDRs negative for regular ACPAs, no one was positive for secretory ACPA. Secretory ACPA had the highest PPV for identifying patients, while IgG ACPA had the highest negative predictive value (table 2).

  • 919.
    Svenungsson, E.
    et al.
    Karolinska Inst, Karolinska Univ Hosp, Dept Med Solna, Rheumatol Unit, Stockholm, Sweden..
    Gustafsson, J.
    Karolinska Inst, Karolinska Univ Hosp, Dept Med Solna, Rheumatol Unit, Stockholm, Sweden..
    Lindberg, M. Herlitz
    Karolinska Inst, Sodersjukhuset, Dept Clin Physiol, Stockholm, Sweden..
    Gunnarsson, I.
    Karolinska Inst, Karolinska Univ Hosp, Dept Med Solna, Rheumatol Unit, Stockholm, Sweden..
    Pettersson, S.
    Karolinska Inst, Karolinska Univ Hosp, Dept Med Solna, Rheumatol Unit, Stockholm, Sweden..
    Elvin, K.
    Karolinska Inst, Dept Clin Immunol & Transfus Med, Unit Clin Immunol, Stockholm, Sweden..
    Öhrvik, J.
    Karolinska Inst, Karolinska Univ Hosp, Dept Med Solna, Stockholm, Sweden..
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Jensen-Urstad, K.
    Karolinska Inst, Sodersjukhuset, Dept Clin Physiol, Stockholm, Sweden..
    Accelerated Atherosclerosis In Systemic Lupus Erythematosus, - A Matter Of Renal Involvement2016Ingår i: Clinical and Experimental Rheumatology, ISSN 0392-856X, E-ISSN 1593-098X, Vol. 34, nr 4, s. S19-S19Artikel i tidskrift (Refereegranskat)
  • 920. Svenungsson, Elisabet
    et al.
    Lundström, Emeli
    Gustafsson, Johanna
    Jonsen, Andreas
    Leonard, Dag
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Zickert, Agneta
    Elvin, Kerstin
    Sturfelt, Gunnar
    Nordmark, Gunnel
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Bengtsson, Anders
    Klareskog, Lars
    Gunnarsson, Iva
    Ronnblom, Lars
    Padyukov, Leonid
    Ischemic vascular disease and antiphospholipid antibodies are associated with HLA-DRB1 *04/*13 alleles in systemic lupus erythematosus2012Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 71, s. A57-A58Artikel i tidskrift (Övrigt vetenskapligt)
  • 921. Sverdrup, Berit M
    et al.
    Källberg, Henrik
    Klareskog, Lars
    Alfredsson, Lars
    Baecklund, Eva (Medarbetare/bidragsgivare)
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi.
    Usage of skin care products and risk of rheumatoid arthritis: results from the Swedish EIRA study.2012Ingår i: Arthritis Research & Therapy, ISSN 1478-6354, E-ISSN 1478-6362, Vol. 14, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: The aim of this study was to investigate the association between exposure to cosmetics, often containing mineral oil, and the risk of developing rheumatoid arthritis (RA). The study was performed against the background that occupational exposure to mineral oil has recently been shown to be associated with an increased risk for RA in man, and that injection of or percutaneous exposure to mineral-oil-containing cosmetics can induce arthritis in certain rat strains.

    METHODS: A population-based case-control study of incident cases of RA was performed among the population aged 18 to 70 years in a defined area of Sweden during May 1996 to December 2003. A case was defined as an individual from the study base, who received for the first time a diagnosis of RA according to the 1987 American College of Rheumatology criteria. Controls were randomly selected from the study base with consideration taken for age, gender and residential area. Cases (n = 1,419) and controls (n = 1,674) answered an extensive questionnaire regarding environmental and lifestyle factors including habits of cosmetic usage. The relative risk of developing RA was calculated for subjects with different cosmetic usage compared with subjects with low or no usage. Analysis was also performed stratifying the cases for presence/absence of rheumatoid factor and antibodies to citrulline-containing peptides.

    RESULTS: The relative risks of developing RA associated with use of cosmetics were all close to one, both for women and men, for different exposure categories, and in relation to different subgroups of RA.

    CONCLUSION: This study does not support the hypothesis that ordinary usage of common cosmetics as body lotions, skin creams, and ointments, often containing mineral oil, increase the risk for RA in the population in general. We cannot exclude, however, that these cosmetics can contribute to arthritis in individuals carrying certain genotypes or simultaneously being exposed to other arthritis-inducing environmental agents.

  • 922. Sveälv, B G
    et al.
    Täng, M S
    Klingberg, E
    Forsblad-d'Elia, Helena
    Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg.
    Bergfeldt, L
    Prevalence of diastolic dysfunction in patients with ankylosing spondylitis: a cross-sectional study2015Ingår i: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 44, nr 2, s. 111-117Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To determine the prevalence of diastolic dysfunction (DD) in patients with ankylosing spondylitis (AS) by following recommended criteria from the American Society of Echocardiography (ASE) and using single variables reflecting DD.

    METHOD: A total of 187 patients with AS (105 men; mean age 51 ± 13 years; mean duration of disease 15 ± 11 years) fulfilled the inclusion criteria and underwent pulsed-wave and tissue Doppler imaging.

    RESULTS: By following ASE recommended criteria, we observed that 12% of patients with AS had mild DD. We also compared single standard Doppler values with normal age-stratified reference values and showed a wide variation in the number of patients with AS outside the 95% confidence interval (CI) of normal values depending on the variable chosen (ranging from 1.1% to 30.5%).

    CONCLUSIONS: By following recommended criteria, our cross-sectional study shows that DD was infrequent and mild in patients with AS.

  • 923.
    Svärd, Anna
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
    Skogh, Thomas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Ilar, Anna
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Klareskog, Lars
    Rheumatology Unit, Department of Medicine, Karolinska Institutet/Karolinska University Hospital, Solna, Stockholm, Sweden.
    Bengtsson, Camilla
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Kastbom, Alf
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Associations to smoking and shared epitope differ between IgA and IgG class antibodies to cyclic citrullinated peptides in early rheumatoid arthritis2015Ingår i: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 67, nr 8, s. 2032-2037Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Smoking and HLA-DRB1/shared epitope (SE) are well-known interacting risk factors for developing rheumatoid arthritis (RA) with IgG anticitrullinated protein/peptide antibodies (ACPA). It remains unknown to what extent SE-genes and smoking associate with mucosal immune responses.

    Objectives This study was done to explore relations between cigarette smoking habits and SE versus circulating IgA and IgG anti-cyclic citrullinated peptide antibodies (anti-CCP) among early RA patients.

    Methods Patients from two early-RA cohorts were analysed, EIRA-1 (n=1663) and TIRA-2 (n=199). The patients were grouped into four subsets based on anti-CCP: IgG-/IgA-, IgG-/IgA+, IgG+/IgA- and IgG+/IgA+. Interaction between smoking and SE was calculated by the attributable proportion due to deviation from additivity. Analyzed controls (n=1100) were randomly selected from the EIRA-1 study base.

    Results Anti-CCP occurrence was similar in the two cohorts. Only in EIRA was IgA anti-CCP detected alone in a minority of cases (3%). Smoking was significantly overrepresented among IgA anti-CCP+ patients with or without IgG-class anti-CCP, but not with IgG anti-CCP alone. Presence of SE genes was overrepresented among IgG anti-CCP+ patients with or without IgA-class anti-CCP, but not with IgA anti-CCP alone. Smoking and SE interacted regarding the risk of IgG+/IgA+ RA (AP=0.5, 95 % CI=0.4-0.6), whereas no significant interaction was observed regarding IgG-/IgA+ or IgG+/IgA- RA.

    Conclusions Association between cigarette smoking and anti-CCP is limited to cases with IgA-class antibodies in addition to IgG anti-CCP. This suggests a causal relation between chronic mucosal irritation/inflammation, induction of a systemic IgA anti-CCP response and subsequent development of RA.

  • 924.
    Söderberg, Daniel
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten.
    Segelmark, Mårten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Njurmedicinska kliniken US.
    Neutrophil extracellular traps in vasculitis, friend or foe?2018Ingår i: Current Opinion in Rheumatology, ISSN 1040-8711, E-ISSN 1531-6963, Vol. 30, nr 1, s. 16-23Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Purpose of review Neutrophil extracellular traps (NETs) can be found at the sites of vascular lesions and in the circulation of patients with active small vessel vasculitis. Neutrophils from vasculitis patients release more NETs in vitro, and NETs have properties that can harm the vasculature both directly and indirectly. There are several ways to interfere with NET formation, which open for new therapeutic options. However, there are several types of NETs and different mechanisms of NET formation, and these might have different effects on inflammation. Here we review recent findings regarding the pathogenesis and therapeutic potentials of NETs in vasculitis. Recent findings Experimental mouse models support a role for NETs in promoting vascular damage, where histones and mitochondrial DNA appear to be driving forces. Impaired formation of NETs, however, in an SLE-like mouse model leads to more severe disease, suggesting that NETs can be important in limiting inflammation. Studies on drug-induced vasculitis reveal that levamisole can induce NETosis via muscarinic receptors, predisposing for the generation of autoantibodies, including antineutrophil cytoplasmic autoantibodies (ANCA). This supports the notion that NETs can bridge the innate and adaptive immune systems. Summary NETs can participate in the pathogenesis of vasculitis, but in some models there also seem to be protective effects of NETs. This complexity needs further evaluation with experimental models that are as specific as possible for human primary vasculitis.

  • 925.
    Södergren, Anna
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Askling, J.
    Bengtsson, K.
    Forsblad-d'Elia, Helena
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Jernberg, T.
    Lindström, U.
    Ljung, Lotta
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi. Clinical Epidemiology Section, Department of Medicine Solna, Karolinska Institutet, Stockholm.
    Mantel, A.
    Jacobsson, L. T.
    Case fatality over 365 days after first acute coronary syndrome in patients with ankylosing spondylitis2018Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, s. 341-341Artikel i tidskrift (Övrigt vetenskapligt)
  • 926.
    Södergren, Anna
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Karp, Kjell
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Bengtsson, Christine
    Moller, Bozena
    Rantapää-Dahlqvist, Solbritt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Wållberg-Jonsson, Solveig
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    The Extent of Subclinical Atherosclerosis Is Partially Predicted by the Inflammatory Load: A Prospective Study over 5 Years in Patients with Rheumatoid Arthritis and Matched Controls2015Ingår i: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 42, nr 6, s. 935-942Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. This prospective followup study investigated subclinical atherosclerosis in relation to traditional cardiovascular disease (CVD) risk factors and inflammation in patients with rheumatoid arthritis (RA) recruited at diagnosis compared with controls. Methods. Patients diagnosed with early RA were consecutively recruited into a prospective study. From these, a subgroup aged <= 60 years (n = 71) was consecutively included for ultrasound measurement of intima-media thickness (IMT) and flow-mediated dilation (FMD) at inclusion (T0) and after 5 years (T5). Age-and sex-matched controls (n = 40) were also included. Results. In the Wilcoxon signed-rank test, both IMT and FMD were significantly aggravated at T5 compared to baseline in patients with RA, whereas only IMT was significantly increased in controls. In univariate linear regression analyses among patients with RA, the IMT at T5 was significantly associated with age, systolic blood pressure (BP), cholesterol, triglycerides, Systematic Coronary Risk Evaluation (SCORE), and Reynolds Risk Score at baseline (p < 0.05). Similarly, FMD at T5 was significantly inversely associated with age, smoking, systolic BP, SCORE, and Reynolds Risk Score (p < 0.05). A model with standardized predictive value from multiple linear regression models including age, smoking, BP, and blood lipids at baseline significantly predicted the observed value of IMT after 5 years. When also including the area under the curve for the 28-joint Disease Activity Score over 5 years, the observed value of IMT was predicted to a large extent. Conclusion. This prospective study identified an increased subclinical atherosclerosis in patients with RA. In the patients with RA, several traditional CVD risk factors at baseline significantly predicted the extent of subclinical atherosclerosis 5 years later. The inflammatory load over time augmented this prediction.

  • 927.
    Södergren, Anna
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Karp, Kjell
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Bengtsson, Christine
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Möller, Bozena
    Department of Rheumatology, Sunderby Hospital, Luleå, Sweden.
    Rantapää-Dahlqvist, Solbritt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Wållberg-Jonsson, Solveig
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Is Lipoprotein-Associated Phospholipase A2a Link between Inflammation and Subclinical Atherosclerosis inRheumatoid Arthritis?2015Ingår i: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, artikel-id 673018Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. Lipoprotein-associated phospholipase A2 (Lp-PLA2), a marker of vascular inflammation, is associated with cardiovascular disease. This prospective study of an inception cohort aimed to investigate whether the level of Lp-PLA2 is associated with subclinical atherosclerosis in patients with rheumatoid arthritis (RA). Methods. Patients from northern Sweden diagnosed with early RA were consecutively recruited into an ongoing prospective study. From these, all patients <= 60 years (n = 71) were included for measurements of subclinical atherosclerosis at inclusion (T0) and five years later (T5). Forty age-and sex-matched controls were included. The patients were clinically assessed, SCORE, Reynolds Risk Score, and Larsen score were calculated, and blood samples were drawn from all individuals at T0 and T5. Results. There was no significant difference in the level of Lp-PLA2 between patients with RA and controls (p > 0.05). In simple linear regression models among patients with RA, Lp-PLA2 at T0 was significantly associated with intima media thickness (IMT) at T0 and T5, flow mediated dilation (FMD) at T0 and T5, ever smoking, male sex, HDL-cholesterol (inversely), non-HDL-cholesterol, SCORE, Reynolds Risk Score, and Larsen score (p < 0.05). Conclusion. In this cohort of patients with early RA, the concentration of Lp-PLA2 was associated with both subclinical atherosclerosis and disease severity.

  • 928.
    Söderlin, M. K.
    et al.
    Research and Development Centre, Spenshult Rheumatology Hospital, Oskarström, Sweden.
    Petersson, I. F.
    Department of Orthopaedics, Lund University, Skåne University Hospital, Lund, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Rheumatology Hospital, Oskarström, Sweden.
    Svensson, B.
    Department of Rheumatology, Lund University, Skåne University Hospital, Lund, Sweden.
    Smoking at onset of rheumatoid arthritis (RA) and its effect on disease activity and functional status: Experiences from BARFOT, a long-term observational study on early RA2011Ingår i: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 40, nr 4, s. 249-255Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To assess the effects of smoking on disease outcome in a large cohort of patients with early rheumatoid arthritis (RA).

    METHODS: Between 1996 and 2004, 1787 adult patients (disease duration ≤ 1 year) were included in the BARFOT early RA study in Sweden. Smoking status was recorded at inclusion in the study. Disease Activity Score using 28 joint counts (DAS28), C-reactive protein (CRP), Health Assessment Questionnaire (HAQ) score, rheumatoid factor (RF), antibodies to cyclic citrullinated peptide (anti-CCP), general health (GH) and pain visual analogue scales (VAS), and drug treatment were registered at inclusion and at follow-up at 3, 6, and 12 months. European League Against Rheumatism (EULAR) response and remission criteria were applied at 3, 6, and 12 months.

    RESULTS: The proportion of patients who smoked at inclusion in the study fell from 29% in 1996 to 20% in 2004. There were no significant differences in disease activity at inclusion stratified according to smoking status. At 12 months of follow-up, 18% of current smokers at inclusion, 12% of previous smokers, and 11% of never smokers had high disease activity (DAS28 > 5.1, p = 0.005). Significantly fewer current smokers were in remission at 12 months (33%) compared to never smokers (36%) and previous smokers (42%) (p = 0.013). Current smoking at inclusion independently predicted poor EULAR response up to 12 months of follow-up.

    CONCLUSION: The present study gives some support to earlier data indicating that RA patients who smoke have a more active disease but further studies are needed to confirm this.

  • 929.
    Söderlin, Maria K.
    et al.
    R and D Center, Spenshult Rheumatology Hospital, Oskarström, Sweden.
    Bergman, Stefan
    R and D Center, Spenshult Rheumatology Hospital, Oskarström, Sweden.
    Absent "Window of Opportunity" in smokers with short disease duration. Data from BARFOT, a multicenter study of early rheumatoid arthritis2011Ingår i: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 38, nr 10, s. 2160-2168Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To study the effect of disease duration and smoking on outcome in early rheumatoid arthritis (RA).

    METHODS: Between 1996 and 2004, 1587 patients were included in the BARFOT early RA (disease duration ≤ 1 year) study in Sweden. European League Against Rheumatism (EULAR) response, Health Assessment Questionnaire (HAQ), rheumatoid factor (RF), and antibodies to cyclic citrullinated peptide (anti-CCP) were recorded at study start and at 3, 6, and 12 months.

    RESULTS: In total, 180 RA patients (11%) had disease duration ≤ 12 weeks. These patients achieved good EULAR response significantly more often at 3 and 12 months than patients with a longer disease duration despite having more aggressive disease [EULAR good response was achieved by 35% and 35% at 3 and 12 months, respectively, among the patients with disease duration ≤ 12 weeks, by 35% and 41% of patients with disease duration of 13-24 weeks, and by 28% and 33% of patients with disease duration of 25-52 weeks (p = 0.02 for 3 months; p = 0.02 for 12 months)]. There was a significant correlation between improvement in Disease Activity Score-28 (DAS28), its individual variables, and Health Assessment Questionnaire (HAQ) and disease duration up to 12 months after study start. For smokers, no such trend was seen.

    CONCLUSION: Up to 12 months after inclusion in the study, there was a significant correlation between improvement in DAS28, its individual components, and HAQ and disease duration, with patients who had a shorter disease duration improving most. Smokers had poorer EULAR response and showed no improvement with regard to disease duration. The Journal of Rheumatology Copyright © 2011. All rights reserved.

  • 930.
    Tarn, Jessica R.
    et al.
    Newcastle Univ, Inst Cellular Med, Newcastle Upon Tyne, Tyne & Wear, England.
    Nordmark, Gunnel
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Gillespie, Colin
    Newcastle Univ, Sch Math & Stat, Newcastle Upon Tyne, Tyne & Wear, England.
    Al-Ali, Shereen
    Newcastle Univ, Inst Cellular Med, Newcastle Upon Tyne, Tyne & Wear, England;Univ Basrah, Coll Sci, Dept Biol, Basrah, Iraq.
    James, Katherine
    Newcastle Univ, Inst Cell & Mol Biosci, Newcastle Upon Tyne, Tyne & Wear, England;Newcastle Univ, Complex BioSyst Res Grp, Newcastle Upon Tyne, Tyne & Wear, England.
    Mitchell, Sheryl
    Newcastle Upon Tyn Hosp NHS Fdn Trust, Newcastle Upon Tyne, Tyne & Wear, England.
    Bowman, Simon
    Univ Hosp Birmingham, Birmingham, W Midlands, England.
    Griffiths, Bridget
    Newcastle Upon Tyn Hosp NHS Fdn Trust, Newcastle Upon Tyne, Tyne & Wear, England.
    Johnsen, Svein Joar Auglaend
    Stavanger Univ Hosp, Stavanger, Norway.
    Norheim, Katrine
    Stavanger Univ Hosp, Stavanger, Norway.
    Backlin, Carin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Rönnblom, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Eloranta, Maija-Leena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Omdal, Roald
    Stavanger Univ Hosp, Stavanger, Norway.
    Young, David Alan
    Newcastle Univ, Inst Cellular Med, Newcastle Upon Tyne, Tyne & Wear, England.
    Ng, Wan-Fai
    Newcastle Univ, Inst Cellular Med, Newcastle Upon Tyne, Tyne & Wear, England;Newcastle Upon Tyn Hosp NHS Fdn Trust, Newcastle Upon Tyne, Tyne & Wear, England;Newcastle Univ, NIHR Newcastle Biomed Res Ctr, Newcastle Upon Tyne, Tyne & Wear, England.
    Interleukin-22 and associated genes are targets of microRNAs dysregulated2018Ingår i: Clinical and Experimental Rheumatology, ISSN 0392-856X, E-ISSN 1593-098X, Vol. 36, nr 3, s. S327-S327Artikel i tidskrift (Övrigt vetenskapligt)
  • 931.
    Teruel, Maria
    et al.
    Univ Granada, Andalusian Reg Govt, Ctr Genom & Oncol Res Pfizer, GENYO, Granada, Spain..
    Coit, Patrick
    Univ Michigan, Div Rheumatol, Ann Arbor, MI 48109 USA..
    Dozmorov, Mikhail
    Virginia Commonwealth Univ, Dept Biostat, Richmond, VA USA..
    Cardiel, Mario
    Ctr Invest Clin Morelia SC, Morelia, Michoacan, Mexico..
    Garcia-De La Torre, Ignacio
    Ctr Est Invest Bas & Clin SC, Immunol & Rheumatol, Guadalajara, Jalisco, Mexico..
    Maradiaga-Cecena, Marco A.
    Hosp Gen Culiacan, Culiacan, Mexico..
    Moctezuma, Jose Francisco
    Hosp Gen Mexico City, Serv Reumatol, Mexico City, DF, Mexico..
    Tusie-Luna, Maria Teresa
    Univ Nacl Autonoma Mexico, Med Genom & Toxicol Ambiental, Mexico City, DF, Mexico..
    Alarcón-Riquelme, Marta E.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi. Univ Granada, Junta Andalucia, Pfizer, Ctr Genom & Invest Oncol, Granada, Spain..
    Sawalha, Amr H.
    Univ Michigan, Div Rheumatol, Ann Arbor, MI 48109 USA..
    Genome-Wide DNA Methylation Study in Lupus in an Admixed Mexican Population2017Ingår i: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 69, nr S10, artikel-id 178Artikel i tidskrift (Övrigt vetenskapligt)
  • 932.
    Tessier-Cloutier, Basile
    et al.
    Univ British Columbia, Dept Pathol & Lab Med, Vancouver, BC, Canada.
    Twa, David
    Univ British Columbia, Dept Med, Vancouver, BC, Canada.
    Baecklund, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi.
    Gascoyne, Randy
    British Columbia Canc Agcy, Dept Pathol, Vancouver, BC, Canada.
    Johnson, Nathalie A.
    McGill Univ, Dept Oncol, Montreal, PQ, Canada.
    Backlin, Carin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi.
    Kamen, Diane L.
    Med Univ South Carolina, Med Rheumatol & Immunol, Charleston, SC 29425 USA.
    Clarke, Ann E.
    Univ Calgary, Cumming Sch Med, Dept Med, Calgary, AB, Canada.
    Ramsey-Goldman, Rosalind
    Northwestern Univ, FSM, Chicago, IL 60611 USA.
    Lee, Jennifer L. F.
    McGill Univ, Ctr Hlth, Res Inst, Med, Montreal, PQ, Canada.
    Farinha, Pedro
    British Columbia Canc Agcy, Dept Pathol, Vancouver, BC, Canada.
    Bernatsky, Sasha
    McGill Univ, Ctr Hlth, Res Inst, Div Rheumatol, Montreal, PQ, Canada;McGill Univ, Ctr Hlth, Res Inst, Div Clin Epidemiol, Montreal, PQ, Canada.
    An Analysis of Cell-of-Origin in Diffuse Large B-Cell Lymphoma in Systemic Lupus Erythematosus, Including Molecular and Clinical Factors Associated with Survival2018Ingår i: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 70Artikel i tidskrift (Övrigt vetenskapligt)
  • 933.
    Tessier-Cloutier, Basile
    et al.
    Univ British Columbia, Anat Pathol & Lab Med, Vancouver, BC, Canada.
    Twa, David D. W.
    Univ British Columbia, Fac Med, Vancouver, BC, Canada.
    Baecklund, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi.
    Gascoyne, Randy
    Univ British Columbia, Dept Pathol & Lab Med, Vancouver, BC, Canada;British Columbia Canc Agcy, Pathol Dept, Vancouver, BC, Canada;British Columbia Canc Agcy, Ctr Lymphoid Canc, Vancouver, BC, Canada.
    Johnson, Nathalie A.
    Sir Mortimer B Davis Jewish Hosp, Dept Med, Montreal, PQ, Canada.
    Backlin, Carin
    Med Univ South Carolina, Dept Rheumatol & Immunol, Charleston, SC 29425 USA.
    Kamen, Diane L.
    Med Univ South Carolina, Med, Charleston, SC 29425 USA.
    Clarke, Ann E.
    Univ Calgary, Calgary, AB, Canada.
    Ramsey-Goldman, Rosalind
    Northwestern Univ, Med Rheumatol, Chicago, IL 60611 USA.
    Lee, Jennifer L. F.
    McGill Univ, Hlth Ctr, Div Clin Epidemiol, Montreal, PQ, Canada.
    Farinha, Pedro
    Univ British Columbia, Dept Pathol & Lab Med, Vancouver, BC, Canada;British Columbia Canc Agcy, Pathol Dept, Vancouver, BC, Canada;British Columbia Canc Agcy, Ctr Lymphoid Canc, Vancouver, BC, Canada.
    Bernatsky, Sasha
    McGill Univ, Hlth Ctr, Div Clin Epidemiol, Montreal, PQ, Canada;McGill Univ, Dept Med, Montreal, PQ, Canada.
    Cell of origin in diffuse large B-cell lymphoma in systemic lupus erythematosus: molecular and clinical factors associated with survival2019Ingår i: Lupus Science and Medicine, ISSN 2053-8790, E-ISSN 1625-9823, Vol. 6, nr 1, artikel-id e000324Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background SLE is associated with increased risk of diffuse large B-cell lymphoma (DLBCL). DLBCL is routinely classified by cell of origin (COO), with germinal centre B-cell (GCB) being more common and indicating better prognosis in the general population. We studied COO subtyping in patients with SLE diagnosed with DLBCL and their survival. Patients and methods We evaluated 20 cases of SLE with DLBCL. Immunohistochemistry analysis was performed (BCL2, MYC, BCL6, CD10, CD20, FOXP1, GCET1, MUM1) in tissue microarrays. We examined associations between molecular and clinical features, including overall survival. Results Of the 20 DLBCL SLE cases, 12/20 cases (60%) were classified as non-GCB using Hans or Choi algorithms. MYC and BCL2 protein expression was positive in 6/20 (30%) and 8/20 (40%) SLE cases, respectively, with 2/20 (10%) co-expressing both markers. Seven (7/20) had only extranodal involvement at DLBCL diagnosis. As expected, non-GCB cases had worse survival. Cases presenting exclusively with extranodal disease were associated with shorter SLE duration and better survival despite higher BCL2 protein expression. Conclusions We present novel data characterising DLBCL in SLE. Sixty per cent of the DLBCL in patients with SLE were non-GCB. The nodal and extranodal distribution in SLE was similar to what is known in the general population, but extranodal disease occurred more often with short SLE duration and was associated with longer overall survival. More research on cancer in SLE is the key to further understanding the complex interplay between cancer and the immune system.

  • 934. Theander, Elke
    et al.
    Husmark, Tomas
    Alenius, Gerd-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Larsson, Per T
    Teleman, Annika
    Geijer, Mats
    Lindqvist, Ulla RC
    Early psoriatic arthritis: short symptom duration, male gender and preserved physical functioning at presentation predict favourable outcome at 5-year follow-up. Results from the Swedish Early Psoriatic Arthritis Register (SwePsA)2014Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 73, nr 2, s. 407-413Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective The Swedish Early Psoriatic Arthritis Register describes the course of early psoriatic arthritis (PsA) in a real life clinical setting in Sweden. The aim of this study was to obtain information on predictors of clinical outcomes over a 5-year period with special focus on effects of gender, joint patterns, diagnostic delay and initial disease activity.

    Methods In six centres, patients with signs suggestive of PsA were included in the Swedish Early Psoriatic Arthritis Register within 2 years of symptom onset. CASPAR (classification for psoriatic arthritis) criteria were fulfilled by 197 patients who had passed the 5-year follow-up. Disease activity was measured by the Disease Activity Score including 28 joints (DAS28) and the Disease Activity Index for Psoriatic Arthritis (DAPSA). Remission and minimal disease activity (MDA) were used as outcome measures.

    Results Mean age at inclusion was 46 years, younger in male than female patients (43 vs 48 years). Mean DAS28 was 3.7 and 3.0 at inclusion and 2.8 and 2.1 at follow-up for women and men, respectively-significantly higher in women at both visits. Likewise, DAPSA scores were significantly higher in women. The degree of improvement (change in DAS28 and DAPSA) was similar. Men achieved MDA or remission (50% vs 33%, 25% vs 13%, respectively) more often, and women had significantly more polyarthritis at inclusion (49% vs 27%) and after 5 years (25% vs 15%). Axial or mono/oligoarticular disease was predominant in men. Independent predictors of MDA at the 5-year follow-up were: shorter symptom duration; greater general wellbeing (global visual analogue scale); and low Health Assessment Questionnaire at inclusion.

    Conclusions In early PsA, short delay between onset of symptoms and diagnosis, preserved function, and male gender are the most important predictors of favourable clinical outcome at the 5-year follow-up. Early recognition of PsA and active treatment may be important, particularly in women with polyarticular disease.

  • 935. Theander, Elke
    et al.
    Husmark, Tomas
    Alenius, Gerd-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Larsson, Per
    Teleman, Annika
    Geijer, Mats
    Lindqvist, Ulla R. C.
    The Swedish Early Psoriatic Arthritis (SwePsA) Registry. 5-Year Follow-up: Higher Disease Activity, Greater Functional Impairment and Worse Outcome for Women Compared to Men2011Ingår i: Arthritis and Rheumatism, ISSN 0004-3591, E-ISSN 1529-0131, Vol. 63, nr 10, s. S193-S193Artikel i tidskrift (Refereegranskat)
  • 936. Theander, Elke
    et al.
    Husmark, Tomas
    Lindqvist, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi.
    Larsson, Per T.
    Teleman, Annika
    Alenius, Gerd-Marie
    Geijer, Mats
    The Swedish Early Psoriatic Arhtritis (SWEPSA) Registry 5-Yeear Follow-up: Slow Radiographic Progression with Highest Scores in Male Feet and in Patients with Baseline X-Ray Abnormalities2014Ingår i: Arthritis & Rheumatology, ISSN 2326-5191, Vol. 66, nr S10, s. S682-S683, artikel-id 1549Artikel i tidskrift (Övrigt vetenskapligt)
  • 937.
    Thorlacius, Gudny Ella
    et al.
    Karolinska Inst, Dept Med, Stockholm, Sweden.
    Hultin-Rosenberg, Lina
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi.
    Sandling, Johanna K.
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi.
    Imgenberg-Kreuz, Juliana
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi.
    Theander, Elke
    Skane Univ Hosp, Dept Rheumatol, Malmo, Sweden.
    Kvarnstrom, Marika
    Karolinska Inst, Dept Med, Stockholm, Sweden.
    Forsblad-d'Elia, Helena
    Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden.
    Bucher, Sara Magnusson
    Orebro Univ, Fac Med & Hlth, Dept Rheumatol, Orebro, Sweden.
    Norheim, Katrine Braekke
    Stavanger Univ Hosp, Dept Internal Med, Stavanger, Norway.
    Johnsen, Svein Joar
    Stavanger Univ Hosp, Dept Internal Med, Stavanger, Norway.
    Hammenfors, Daniel
    Haukeland Hosp, Dept Rheumatol, Bergen, Norway.
    Skarstein, Kathrine
    Haukeland Hosp, Dept Pathol, Bergen, Norway.
    Jonsson, Malin V.
    Univ Bergen, Dept Clin Dent, Bergen, Norway.
    Baecklund, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Mandl, Thomas
    Skane Univ Hosp, Dept Rheumatol, Malmo, Sweden.
    Eriksson, Per
    Linkoping Univ, Dept Clin Expt Med, Linkoping, Sweden.
    Omdal, Roald
    Stavanger Univ Hosp, Dept Internal Med, Stavanger, Norway.
    Jonsson, Roland
    Univ Bergen, Broegelmann Res Lab, Bergen, Norway.
    Lindblad-Toh, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab. Broad Inst MIT & Harvard, Cambridge, MA USA.
    Rönnblom, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Wahren-Herlenius, Marie
    Karolinska Inst, Dept Med, Stockholm, Sweden.
    Nordmark, Gunnel
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Genetic basis and clinical evidence for two variants of primary Sjögren's syndrome with distinct outcomes2018Ingår i: Clinical and Experimental Rheumatology, ISSN 0392-856X, E-ISSN 1593-098X, Vol. 36, nr 3, s. S246-S247Artikel i tidskrift (Övrigt vetenskapligt)
  • 938. Thorlacius, Gudny Ella
    et al.
    Hultin-Rosenberg, Lina
    Sandling, Johanna K.
    Imgenberg-Kreuz, Juliana
    Theander, Elke
    Kvarnström, Marika
    Forsblad-d'Elia, Helena
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Bucher, Sara Magnusson
    Norheim, Katrine Braekke
    Johnsen, Svein Joar
    Hammenfors, Daniel
    Skarstein, Kathrine
    Jonsson, Malin V.
    Baecklund, Eva
    Mandl, Thomas
    Eriksson, Per
    Omdal, Roald
    Jonsson, Roland
    Lindbladh-Toh, Kerstin
    Ronnblom, Lars
    Wahren-Herlenius, Marie
    Nordmark, Gunnel
    Genetic basis and clinical evidence for two variants of primary Sjögren's syndrome with distinct outcomes2018Ingår i: Clinical and Experimental Rheumatology, ISSN 0392-856X, E-ISSN 1593-098X, Vol. 36, nr 3, s. S246-S247Artikel i tidskrift (Övrigt vetenskapligt)
  • 939.
    Thorlacius, Gudny Ella
    et al.
    Karolinska Inst, Dept Med, Rheumatol Unit, Stockholm, Sweden.
    Wahren-Herlenius, Marie
    Karolinska Inst, Dept Med, Rheumatol Unit, Stockholm, Sweden.
    Rönnblom, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    An update on the role of type I interferons in systemic lupus erythematosus and Sjogren's syndrome2018Ingår i: Current Opinion in Rheumatology, ISSN 1040-8711, E-ISSN 1531-6963, Vol. 30, nr 5, s. 471-481Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Purpose of review Systemic lupus erythematosus (SLE) and primary Sjogren's syndrome (pSS) share several clinical and laboratory features, including an overexpression of type I interferon (IFN) regulated genes. The genetic background to this IFN signature and the role of the type I IFN system in the disease process have been partly clarified. Here, we summarize the latest information concerning the type I IFN system in both diseases. Recent findings A number of gene variants in the type I IFN signalling pathways associate with an increased risk for both SLE and pSS in several ethnicities. The function of some risk gene variants has been elucidated, as well as the importance of epigenetic changes in type I IFN regulated genes. MicroRNA-451 and miR-302d have been shown to target IFN regulatory factor 8 and 9, suggesting that noncoding RNAs can control the IFN system. A prominent type I IFN activation is related to several disease manifestations, and in SLE to a more severe disease phenotype. Phase II studies in SLE suggest beneficial effects of blocking the type I IFN receptor. Summary The activated type I IFN system in SLE and pSS has a strong genetic component, is important in the disease etiopathogenesis and can be targeted.

  • 940.
    Thorstensson, Carina A.
    et al.
    Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden & Lund University, Lund, Sweden.
    Henriksson, M.
    Karolinska Institutet, Stockholm, Sweden.
    von Porat, A.
    Lund University, Lund, Sweden.
    Roos, E. M.
    Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden & Lund University, Lund, Sweden.
    Eight weeks of exercise reduced knee adduction moment during one-leg rise in patients with early knee osteoarthritisManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Background

    Reduced functional performance is a risk factor for development of knee osteoarthritis, and peak knee adduction moment is associated with radiographic progression. Knee adduction moment can be reduced by high tibial osteotomy. The effect of dynamic stabilization through increased muscle performance is not known.

    Aims

    To study the effect from exercise on external peak knee adduction moment during one-leg rise, and the relationship between peak knee adduction moment during one-leg rise and maximum number of one-leg rise.

    Methods

    13 patients, aged 48–63, with mild to moderate knee osteoarthritis underwent 8 weeks of supervised exercise, aiming at increasing neuromuscular control and lower extremity strength. The maximum number of one-leg rise from a stool (48 cm), 3-dimensional gait analysis and self-estimated knee symptoms were assessed before and after exercise intervention. Peak external knee adduction moment during one-leg rise and gait was calculated using a Vicon system. The Knee injury and Osteoarthritis Outcome Score (KOOS) was used as assessment of knee symptoms. Patients defined their most symptomatic knee as index knee.

    Results

    Peak knee adduction moment during one-leg rise was reduced for the index knee from 0.57 Nm/kg at baseline to 0.51 after 8 weeks of exercise (p=0.04). The change for the opposite knee was not significant (from 0.58 to 0.56 Nm/kg, p=0.23). No significant changes were seen for index or opposite knees in peak adduction moment during gait (p>0.40). A higher maximum number of one-leg rise was correlated to a lower peak adduction moment for the index knee at baseline (rs =-0.35, p=0.24) and follow up (rs = -0.65, p=0.03). For the opposite knee the correlation was similar at baseline (rs= -0.47, p=0.10), and no correlation was seen at follow up (rs = 0.13, p=0.70). Correlations for change over time were poor (-0.43 to -0.03) and not significant (p>0.20). Patients with symptomatic knee osteoarthritis had higher peak adduction moment in their opposite knee, than patients without symptoms at baseline (0.72 (0.09) vs. 0.50 (0.11), p=0.01) and follow-up (0.66 (0.14) vs. 0.51 (0.07), p=0.04). The differences for the index knee pointed in the same direction, however not significant (p>0.28).

    Conclusion

    Peak knee adduction moment in the most symptomatic knee of middle-aged patients with early signs of knee osteoarthritis can be reduced by exercise. Improved muscular performance might reduce the risk of radiographic progression of knee osteoarthritis. It seem of importance to reduce pain prior to starting exercising. A lower maximum number of one-leg rise is associated with higher peak knee adduction moment and has the potential to serve as a surrogate in studies where 3-dimensional analysis is not feasible.

  • 941.
    Thorstensson, Carina A.
    et al.
    Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Petersson, I. F.
    Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Jacobsson, L. T. H.
    Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden & Department of Rheumatology, Malmö University Hospital, Malmö, Sweden.
    Boegård, T. L.
    Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden & Department of Radiology, County Hospital, Helsingborg, Sweden.
    Roos, E. M.
    Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden & Department of Orthopaedics, Lund University Hospital, Lund, Sweden.
    Reduced functional performance in the lower extremity predicted radiographic knee osteoarthritis five years later2004Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 63, nr 4, s. 402-407Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Reduced quadriceps strength is an early finding in subjects with knee osteoarthritis, but it is not clear whether it is a cause or a consequence of knee osteoarthritis.

    Objective: To determine whether reduced functional performance in the lower extremity predicts the incidence or progression of radiographic knee osteoarthritis.

    Design: Prospective, epidemiological, population based cohort study.

    Patients: 148 subjects (62 women), aged 35–54 (mean 44.8), with chronic knee pain from a population based cohort.

    Measurements: Predictors analysed were age, sex, body mass index, baseline knee pain, and three tests of lower extremity functional performance: maximum number of one-leg rises from sitting, time spent walking 300 m, and timed standing on one leg. Weightbearing tibiofemoral knee radiographs were obtained at baseline and after 5 years (median 5.1, range 4.2–6.1), and classified according to Kellgren and Lawrence as no osteoarthritis (Kellgren and Lawrence = 0, n = 94) or prevalent osteoarthritis (Kellgren and Lawrence ⩾1, n = 54).

    Results: Fewer one-leg rises (median 17 v 25) predicted incident radiographic osteoarthritis five years later (OR 2.6, 95% CI 1.1 to 6.0). The association remained significant after controlling for age, sex, body mass index, and pain. No significant predictor of radiographic progression in the group with prevalent osteoarthritis was found.

    Conclusion: Reduced functional performance in the lower extremity predicted development of radiographic knee osteoarthritis 5 years later among people aged 35–55 with chronic knee pain and normal radiographs at baseline. These findings suggest that a test of one-leg rises may be useful, and interventions aimed at improving functional performance may be protective against development of knee osteoarthritis.

  • 942.
    Thyberg, Ingrid
    et al.
    Linköping university.
    Dahlström, Örjan
    Linköping university.
    Björk, Mathilda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Arvidsson, Patrik
    Linköping university.
    Thyberg, Mikael
    Linköping University.
    HAQ scores related to persistent disabilities 8 years efter diagnosis of RA despite reduction of DAS-28.: The Swedish TIRA study2011Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background: Early instituted disease modifying anti rheumatic drugs (DMARD:s) leads to reduced disease activity. Critical levels of disease activity measured with Disease Activity Score 28 joint count (DAS-28) are widely used to identify needs and evaluate outcomes of DMARD:s. Early instituted DMARD:s also reduce disability, but some patients still have disabilities and there is a need to establish clinically useful routines to identify patients with different disabilities, and thereby possible unmet needs for rehabilitation as a complement to their medication.Objectives: To discriminate sub-groups of patients due to HAQ levels and relate these sub-groups to disease activity and more comprehensive aspects of disability.Methods: 132 patients (68% women) with recent-onset (≤1 year) RA who fulfilled ≥4/7 RA classification criteria or at least: morning stiffness ≥60 minutes, symmetrical arthritis, and arthritis of small joints, and included in the Swedish TIRA-1 cohort during 1996-1998, constituted the study group. All patients had access to rehabilitation and regular contact with a multi-professional team, but there were no standardized criteria for further assessments or interventions. Anti-CCP antibodies were analysed. Disease activity (DAS-28), Health Assessment Questionnaire (HAQ), Short Form 36 (SF-36) and ongoing DMARD:s were registered at inclusion and thereafter yearly. In the presented analysis, the study group was divided into a high-HAQ group (score≥1) and a low-HAQ group (score<1) based on the HAQ score at the 8 year follow-up (1).Results: The sub-group of 48 patients (36%) with a HAQ score ≥1 at the 8 year follow-up had a higher mean HAQ score already at inclusion and further on at all visits compared to the low-HAQ group. 32 patients (24%) had high HAQ-score both at inclusion and at Year 8. Also, more comprehensive aspects of disability reported with the 8 dimensions of SF-36 differed significantly between these sub-groups at the majority of the visits. Age and Anti-CCP did not differ between sub-groups while the high-HAQ group had a higher DAS-28 at most visits except at inclusion. In accordance with known sex differences, the majority of the patients in the high-HAQ group were women. Despite higher frequencies of DMARD:s, the HAQ-score in the high-HAQ group showed a persistent divergence in contrast to the improvement in the low-HAQ group, and in contrast to the DAS-28 that showed improvement over time in both groups. Thus, a HAQ score ≥1 at the 8 year follow-up indicated persistent and comprehensive disabilities, and supposed needs for more effective or more specific rehabilitation as a complement to the medication in 36% of the study group.Conclusions: The HAQ-score is clinically useful as a complement to DAS-28, especially to identify patients with unmet needs for further rehabilitation assessments.

  • 943.
    Thyberg, Ingrid
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Dahlström, Örjan
    Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Björk, Mathilda
    Avd. för rehabilitering, HHJ, Hälsohögskolan, Högskolan i Jönköping.
    Arvidsson, Patrik
    Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Thyberg, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    HAQ scores related to persistent disabilities 8 years efter diagnosis of RA despite reduction of DAS-28.: The Swedish TIRA study2011Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Background: Early instituted disease modifying anti rheumatic drugs (DMARD:s) leads to reduced disease activity. Critical levels of disease activity measured with Disease Activity Score 28 joint count (DAS-28) are widely used to identify needs and evaluate outcomes of DMARD:s. Early instituted DMARD:s also reduce disability, but some patients still have disabilities and there is a need to establish clinically useful routines to identify patients with different disabilities, and thereby possible unmet needs for rehabilitation as a complement to their medication.Objectives: To discriminate sub-groups of patients due to HAQ levels and relate these sub-groups to disease activity and more comprehensive aspects of disability.Methods: 132 patients (68% women) with recent-onset (≤1 year) RA who fulfilled ≥4/7 RA classification criteria or at least: morning stiffness ≥60 minutes, symmetrical arthritis, and arthritis of small joints, and included in the Swedish TIRA-1 cohort during 1996-1998, constituted the study group. All patients had access to rehabilitation and regular contact with a multi-professional team, but there were no standardized criteria for further assessments or interventions. Anti-CCP antibodies were analysed. Disease activity (DAS-28), Health Assessment Questionnaire (HAQ), Short Form 36 (SF-36) and ongoing DMARD:s were registered at inclusion and thereafter yearly. In the presented analysis, the study group was divided into a high-HAQ group (score≥1) and a low-HAQ group (score<1) based on the HAQ score at the 8 year follow-up (1).Results: The sub-group of 48 patients (36%) with a HAQ score ≥1 at the 8 year follow-up had a higher mean HAQ score already at inclusion and further on at all visits compared to the low-HAQ group. 32 patients (24%) had high HAQ-score both at inclusion and at Year 8. Also, more comprehensive aspects of disability reported with the 8 dimensions of SF-36 differed significantly between these sub-groups at the majority of the visits. Age and Anti-CCP did not differ between sub-groups while the high-HAQ group had a higher DAS-28 at most visits except at inclusion. In accordance with known sex differences, the majority of the patients in the high-HAQ group were women. Despite higher frequencies of DMARD:s, the HAQ-score in the high-HAQ group showed a persistent divergence in contrast to the improvement in the low-HAQ group, and in contrast to the DAS-28 that showed improvement over time in both groups. Thus, a HAQ score ≥1 at the 8 year follow-up indicated persistent and comprehensive disabilities, and supposed needs for more effective or more specific rehabilitation as a complement to the medication in 36% of the study group.Conclusions: The HAQ-score is clinically useful as a complement to DAS-28, especially to identify patients with unmet needs for further rehabilitation assessments.

  • 944.
    Thyberg, Ingrid
    et al.
    Linköping University.
    Dahlström, Örjan
    Linköping University.
    Björk, Mathilda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Arvidsson, Patrik
    Linköping University.
    Thyberg, Mikael
    Linköping University.
    Potential of the HAQ score as clinical indicator suggesting comprehensive multidisciplinary assessments: the Swedish TIRA cohort 8 years after diagnosis of RA2012Ingår i: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 31, nr 5, s. 775-783Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study explores the potential of the health assessment questionnaire (HAQ) score as a clinical indicator that can be used to suggest comprehensive multidisciplinary assessments, by relating it to more general aspects of disability. In a cohort of 132 patients with early RA (mean age 55, 68% women), 28 joint count Disease Activity Scores (DAS-28), HAQ, and Short Form 36 (SF-36) scores were registered at annual follow-up visits 8 years after diagnosis. The patients were tentatively sub-grouped into a high-HAQ group (HAQ ≥1 at the 8-year follow-up) and a low-HAQ group. The high-HAQ group, comprising 36% of the cohort, had a higher mean HAQ score at inclusion and beyond at all visits compared to the low-HAQ group, and 24% of all individual patients in the high-HAQ group had a HAQ score ≥1 at inclusion. Although the DAS-28 improved in both groups, patients in the high-HAQ group also had significantly more persistent disability according to the SF-36: five scales at each follow-up visit and all eight scales at the majority of the visits. Individual RA patients with HAQ ≥1 probably have considerable persistent disabilities according to the SF-36. The HAQ score could be used as a clinical indicator suggesting comprehensive multidisciplinary assessments of the components of disability and corresponding interventions, in addition to the established use of HAQ at group levels and in parallel with the medication strategy based on DAS-28.

  • 945.
    Thyberg, Mikael
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Arvidsson, Patrik
    Uppsala University/County Council of Gävleborg, Ga¨vle,Jönköping University, Jönköpng Sweden,.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Nordenfelt, Lennart
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Ersta Sköndal University Colege Stockholm .
    Simplified bipartite concepts of functioning and disability recommended for interdisciplinary use of the ICF.2015Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, nr 19, s. 1783-1792Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To argue for and propose bipartite concepts of functioning and disability, to tally with the structure of the ICF classification list, concepts of social models and clinical needs.

    METHOD: The ICF concepts are discussed in relation to the history of ideas regarding disability concepts and the needs for such concepts in interdisciplinary rehabilitation.

    RESULTS: Bipartite concepts are presented; they refer to actual functioning, simply body functions/structures and participation, including functioning in standardized environments. Participation refers to actually performed "activities", with "activities" simply denoting things that people may do. Bipartite concepts are congruent with the ICF classification and the structure of social models of disability, suitable for clinical and interdisciplinary use and easy to understand. The issue of standardized environments represents a methodological issue rather than the conceptual issue of defining functioning and disability. An individual perspective on activity and activity limitations, i.e. the middle part of the tripartite ICF concept, is somewhat similar to concepts of traditional language that were regarded as too generalizing already in 1912, when the interactional concept of "disability in a social sense" was introduced in rehabilitation practices.

    CONCLUSION: Bipartite concepts of functioning and disability are recommended for interdisciplinary use of the ICF.

    IMPLICATIONS FOR REHABILITATION: The ICF classification is useful, but the ICF concept of activities in an individual perspective is confusing. We suggest a use of the term "activities" simply to denote things that people may do and "participation" to denote actually performed activities. Estimations of ability should be explicit about how they are related to environmental factors.

  • 946. Thålin, Charlotte
    et al.
    Daleskog, Maud
    Paues Göransson, Sophie
    Schatzberg, Daphne
    Lasselin, Julie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Laska, Ann-Charlotte
    Kallner, Anders
    Helleday, Thomas
    Wallén, Håkan
    Demers, Mélanie
    Validation of an enzyme-linked immunosorbent assay for the quantification of citrullinated histone H3 as a marker for neutrophil extracellular traps in human plasma2017Ingår i: Immunologic research, ISSN 0257-277X, E-ISSN 1559-0755, Vol. 65, nr 3, s. 706-712Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There is an emerging interest in the diverse functions of neutrophil extracellular traps (NETs) in a variety of disease settings. However, data on circulating NETs rely largely upon surrogate NET markers such as cell-free DNA, nucleosomes, and NET-associated enzymes. Citrullination of histone H3 by peptidyl arginine deiminase 4 (PAD4) is central for NET formation, and citrullinated histone H3 (H3Cit) is considered a NET-specific biomarker. We therefore aimed to optimize and validate a new enzyme-linked immunosorbent assay (ELISA) to quantify the levels of H3Cit in human plasma. A standard curve made of in vitro PAD4-citrullinated histones H3 allows for the quantification of H3Cit in plasma using an anti-histone antibody as capture antibody and an anti-histone H3 citrulline antibody for detection. The assay was evaluated for linearity, stability, specificity, and precision on plasma samples obtained from a human model of inflammation before and after lipopolysaccharide injection. The results revealed linearity and high specificity demonstrated by the inability of detecting non-citrullinated histone H3. Coefficients of variation for intra- and inter-assay variability ranged from 2.1 to 5.1% and from 5.8 to 13.5%, respectively, allowing for a high precision. Furthermore, our results support an inflammatory induction of a systemic NET burden by showing, for the first time, clear intra-individual elevations of plasma H3Cit in a human model of lipopolysaccharide-induced inflammation. Taken together, our work demonstrates the development of a new method for the quantification of H3Cit by ELISA that can reliably be used for the detection of NETs in human plasma.

  • 947.
    Tingström, Joanna
    et al.
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Hjelmstedt, Anna
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Welin Henriksson, Elisabet
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Ambrosi, Aurélie
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Sonesson, Sven-Erik
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Wahren-Herlenius, Marie
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Anti-Ro/SSA autoantibody-positive women's experience of information given on the risk of congenital heart block.2016Ingår i: Lupus, ISSN 0961-2033, E-ISSN 1477-0962, Vol. 25, nr 5, s. 536-542Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Congenital heart block (CHB) may develop in fetuses of women with anti-Ro/SSA autoantibodies, and carries substantial morbidity and mortality. The aim was to evaluate how information on CHB is imparted and identify areas of improvement.

    METHODS: A questionnaire was distributed to anti-Ro/SSA antibody-positive women who had either participated in a surveillance programme but whose expected child did not develop CHB (n = 100, denoted Doppler-Assessed Pregnancies (DAP) group) or given birth to a child with CHB (n = 88, denoted CHB-Affected Pregnancies (CAP) group).

    RESULTS: The response rate was 83% (157/188). Most women received the information on CHB when they were already pregnant (DAP group 60%, CAP group 83%). However, a majority of them would have wanted the information before pregnancy (DAP group 52%, CAP group 56%), and most stated that it would not have influenced their decision to have a child (DAP group 77%, CAP group 58%). The ability to both understand the information and to perceive the information as sufficient were significantly higher when someone trained in paediatric cardiology gave the information.

    CONCLUSIONS: Our findings indicate that information on CHB should be given to women before pregnancy. The data further highlight the importance of having specific knowledge for giving relevant and understandable, yet sufficient information.

  • 948.
    Tingström, Joanna
    et al.
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Hjelmstedt, Anna
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Welin Henriksson, Elisabet
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Sonesson, Sven-Erik
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Wahren-Herlenius, Marie
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Ro/SSA autoantibody-positive pregnancy: reactions to serial fetal Doppler echocardiographic surveillance2015Ingår i: Lupus, ISSN 0961-2033, E-ISSN 1477-0962, Vol. 24, nr 14, s. 1540-1545Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The risk for congenital heart block (CHB) associated with maternal Ro/SSA autoantibodies is low, but the possibility of treating early stages of disease has seen the introduction of Doppler echocardiographic surveillance programs with serial examinations during the CHB susceptibility weeks of pregnancy. The aim of the present study was to understand how Ro/SSA autoantibody-positive women having undergone Doppler echocardiographic surveillance programs and giving birth to children without CHB experienced their pregnancy and frequent ultrasound examinations.

    METHODS: A validated questionnaire based on data from an interview-study was distributed to Ro/SSA-positive women supervised with Doppler examinations during their pregnancy (n = 100).

    RESULTS: The response rate was 79%. The majority of the women (61%) reported that the increased number of ultrasound examinations influenced their pregnancy, but in a positive way, with qualified information and additional support from health care personnel in conjunction with the examinations. Further, the visits to the clinic provided opportunities to see the ultrasound picture of the expected infant. However, one-third of the women also reported stress in relation to the examinations.

    CONCLUSIONS: Fetal echocardiographic surveillance holds many and predominantly positive effects for Ro/SSA-positive women during pregnancy in addition to the medical advantages.

  • 949.
    Tjernberg, Ivar
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Medicinska fakulteten. Kalmar County Hospital, Sweden.
    Hamsten, Carl
    Karolinska Institute, Sweden; University Hospital, Sweden.
    Apostolovic, Danijela
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    van Hage, Marianne
    Karolinska Institute, Sweden; University Hospital, Sweden.
    IgE reactivity to alpha-Gal in relation to Lyme borreliosis2017Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, nr 9, artikel-id e0185723Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background An association between tick bites, the development of immunoglobulin E (IgE) antibodies to galactose-alpha-1, 3-galactose (alpha-Gal) and red meat allergy has recently been reported. Here we wanted to elucidate the relation between tick exposure, IgE antibodies to alpha-Gal and Lyme borreliosis (LB). Methods In the highly LB endemic area of Kalmar County, Sweden, serum samples and health inquiries from 518 blood donors were included. All sera were investigated for multiple IgG antiBorrelia antibodies using a multiplex assay (recomBead, Mikrogen). In addition, three serially collected sera over a six month period from 148 patients with clinically defined erythema migrans (EM) were included. IgE antibodies against alpha-Gal were determined using ImmunoCAP (Thermo Fisher Scientific). Results In blood donors reporting previous LB (n = 124) IgE to alpha-Gal was found in 16%, while in donors denying previous LB but with multiple anti-Borrelia antibodies (n = 94; interpreted as asymptomatic LB) 10% were IgE alpha-Gal-positive. Finally, in donors without Borrelia antibodies denying previous LB (n = 300) 14% showed IgE to alpha-Gal. No significant difference in proportions among the groups were found. In EM patients, IgE to alpha-Gal was found in 32/148 (22%) at diagnosis, 31/148 (21%) after two-three months and 23/148 (16%) after six months. A significant reduction of proportion and level of IgE to alpha-Gal was found between the second and third sample (pamp;lt; 0.01). A positive IgE anti alpha-Gal was more common among men compared with women both in blood donors and in EM patients (p amp;lt;= 0.01). Conclusions IgE to alpha-Gal reactivity was common in a tick endemic area but showed no significant relation to previous LB. IgE anti-alpha-Gal reactivity in EM patients peaked within three months of diagnosis of EM, after which it waned indicating that recent tick exposure is of importance in alpha-Gal sensitization. Furthermore, IgE anti alpha-Gal was more common in men compared with women.

  • 950.
    Tjärnlund, Anna
    et al.
    Karolinska Univ Hosp, Karolinska Inst, Dept Med, Rheumatol Unit, S-17176 Stockholm, Sweden.
    Lundberg, Ingrid E.
    Karolinska Univ Hosp, Karolinska Inst, Dept Med, Rheumatol Unit, S-17176 Stockholm, Sweden.
    Rönnelid, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi.
    Response to: 'Detection of myositis-specific antibodies: additional notes' by Infantino et al2019Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, nr 4, artikel-id e30Artikel i tidskrift (Övrigt vetenskapligt)
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