Prospective Cohort Study

https://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1006&context=covid19

SARS-CoV-2

Neutrophils are innate immune phagocytes that have a central role in immune defence. Our understanding of the role of neutrophils in pathogen clearance, immune regulation and disease pathology has advanced dramatically in recent years. Web-like chromatin structures known as neutrophil extracellular traps (NETs) have been at the forefront of this renewed interest in neutrophil biology. The identification of molecules that modulate the release of NETs has helped to refine our view of the role of NETs in immune protection, inflammatory and autoimmune diseases and cancer. Here, I discuss the key findings and concepts that have thus far shaped the field of NET biology.

Neutrophil extracellular traps in immunity and disease

International Consensus Statement on an Update of the Classification Criteria for Definite Antiphospholipid Syndrome(APS)

Our objective was to update the EULAR recommendations for the management of systemic lupus erythematosus (SLE), based on emerging new evidence. We performed a systematic literature review (01/2007-12/2017), followed by modified Delphi method, to form questions, elicit expert opinions and reach consensus. Treatment in SLE aims at remission or low disease activity and prevention of flares. Hydroxychloroquine is recommended in all patients with lupus, at a dose not exceeding 5 mg/kg real body weight. During chronic maintenance treatment, glucocorticoids (GC) should be minimised to less than 7.5 mg/day (prednisone equivalent) and, when possible, withdrawn. Appropriate initiation of immunomodulatory agents (methotrexate, azathioprine, mycophenolate) can expedite the tapering/discontinuation of GC. In persistently active or flaring extrarenal disease, add-on belimumab should be considered; rituximab (RTX) may be considered in organ-threatening, refractory disease. Updated specific recommendations are also provided for cutaneous, neuropsychiatric, haematological and renal disease. Patients with SLE should be assessed for their antiphospholipid antibody status, infectious and cardiovascular diseases risk profile and preventative strategies be tailored accordingly. The updated recommendations provide physicians and patients with updated consensus guidance on the management of SLE, combining evidence-base and expert-opinion.

https://ard.bmj.com/content/annrheumdis/78/6/736.full.pdf

2019 update of the EULAR recommendations for the management of systemic lupus erythematosus

The antiphospholipid syndrome (APS) is based upon presence of clinical and laboratory criteria. The clinical criteria comprise pregnancy morbidity (according to strict definitions) en vascular thrombosis. Presence of so-called antiphospholipid antibodies (aPL) is the laboratory criterion. Under the umbrella of aPL fall both lupus anticoagulants, IgG and IgM anticardiolipine antibodies, and IgG and IgM anti-β2 glycoprotein antibodies. The diagnosis of APS heavily relies on these laboratory criteria, in particular because the clinical features are not rare in the general population. This chapter deals with the development and current use of classification criteria for APS. The problems with definitions of a positive laboratory tests, which resulted in a lot of confusion in the field and the practical use of aPL profiles, are highlighted. It is concluded that laboratory criteria for obstetric and thrombotic APS probably should be different; that aPL should be considered as risk factors in the context of other risk factors for thrombosis, cardiovascular disease, and pregnancy complications; and that there is a need for well-designed clinical studies to answer the many questions in the field.

Classification Criteria for the Antiphospholipid Syndrome

Background Systemic lupus erythematosus (SLE) predominantly affects women during their fertile period. During pregnancy SLE patients are prone to pregnancy complications and may experience increased disease activity. Objectives To investigate disease activity around/during pregnancy and pregnancy complications in a European cohort according to antiphospholipid antibody (aPL) status. Additionally data on lifetime pregnancy outcomes and comparison of first and consecutive pregnancies were analyzed. Methods All ongoing pregnancies of >16 weeks gestation of SLE patients (according to the ACR revised criteria) receiving joint care from rheumatologists and gynecologists in two tertiary centers in the Netherlands between 2000–2015 were included. Disease activity (using SELENA-SLE(P)DAI around and during pregnancy), flare rate according to the SELENA- SLEDAI definitions and pregnancy complications were assessed by medical chart review. Results From 96 women (84% Caucasian) 144 pregnancies were included. Before ( Conclusions This is the first study in patients with SLE demonstrating that incidence rates of pregnancy complications do not decrease in consecutive pregnancies compared to first pregnancies, in contrast to findings in the general population. Except for HELLP-syndrome, pregnancy complications were not significant different between aPL groups. Despite overall low disease activity and the absence of aPL in the majority of patients, almost half of the patients developed a complication during their pregnancies. Disclosure of Interest B. Blomjous: None declared, C. Abheiden: None declared, S. Kroese: None declared, J. van Laar Grant/research support from: MSD, Pfizer, Roche, Eli Lilly, BMS and Crescendo, R. Derksen: None declared, I. Bultink: None declared, A. Voskuyl: None declared, A. Lely: None declared, M. de Boer: None declared, J. de Vries Grant/research support from: Pfizer, R. Fritsch-Stork: None declared

https://ard.bmj.com/content/annrheumdis/76/Suppl_2/184.1.full.pdf

Pregnancy outcome in women with systemic lupus erythematosus, a multicenter cohort-study

[This corrects the article DOI: 10.1155/2017/8245879.].

/pdf/corrigendum-to-maternal-and-perinatal-outcome-in-women-with-1ngx4tag.pdf

Corrigendum to “Maternal and Perinatal Outcome in Women with Systemic Lupus Erythematosus: A Retrospective Bicenter Cohort Study”

International rheumatology networking: The 2008 american college of rheumatology/european league against rheumatism exchange program

[This corrects the article DOI: 10.1155/2017/2810202.].

Ruth D E Fritsch-Stork

Papers

Classification Criteria for the Antiphospholipid Syndrome

Pregnancy outcome in women with systemic lupus erythematosus, a multicenter cohort-study

Corrigendum to “Maternal and Perinatal Outcome in Women with Systemic Lupus Erythematosus: A Retrospective Bicenter Cohort Study”

International rheumatology networking: The 2008 american college of rheumatology/european league against rheumatism exchange program

Corrigendum to “Hydroxychloroquine Use in Lupus Patients during Pregnancy Is Associated with Longer Pregnancy Duration in Preterm Births”