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关键词： ankylosing spondylitis   anti-tnf therapy   cardiovascular risk   carotid intima-media thickness   inflammation   lipid profile  

摘要： BACKGROUND:A chronic inflammatory condition, ankylosing spondylitis (AS), raises the risk of cardiovascular (CV) disease because of ongoing systemic inflammation. OBJECTIVE:To evaluate the impact of anti-TNF therapy on CV risk markers and surrogate indicators of subclinical atherosclerosis in patients with AS, and to examine the influence of modifiable lifestyle factors such as smoking, physical activity, and body mass index (BMI) on CV outcomes. METHODOLOGY:This descriptive observational study was conducted at the Department of Rheumatology, Fauji Foundation Hospital, Rawalpindi, from April 2022 to March 2024. The study included 246 patients with AS who had been on anti-TNF medication for at least three months. At baseline, six months, and 12 months, clinical and laboratory parameters such as blood pressure, BMI, lipid profile, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were measured. Doppler ultrasonography was used to measure the carotid intima-media thickness (CIMT) in 197 individuals (80.08%). Multivariate regression was used to account for physical activity, smoking, age, and BMI. RESULTS:Among 246 patients (189 males, 76.8%; mean age, 41.2 ± 9.7 years), significant reductions were observed over 12 months in inflammatory, lipid, and cardiovascular markers (all < 0.001). CRP decreased from 15.2 ± 5.7 to 5.3 ± 3.9 mg/L, with 177 (71.95%) showing >50% reduction. ESR declined from 38.4 ± 10.6 to 17.4 ± 7.8 mm/hour, with 166 (67.48%) showing >50% reduction. Low-density lipoprotein (LDL) decreased from 131.5 ± 18.7 to 113.4 ± 14.9 mg/dL, with a ≥10% reduction in 153 (62.20%), while high-density lipoprotein (HDL) increased from 38.9 ± 6.8 to 47.2 ± 7.3 mg/dL, with a ≥10% increase in 134 (54.47%). Systolic BP dropped from 136.9 ± 12.2 to 126.8 ± 10.9 mmHg, with a ≥10 mmHg reduction in 121 (49.19%). BMI also declined significantly from 27.6 ± 3.8 to 26.3 ± 3.2 kg/m². Among 197 patients with Doppler ultrasound, CIMT regressed in 142 (72.08%), wi

关键词： Peritoneal dialysis   Peritoneal equilibration test   Peritoneal solute transport rate   Cytokine   IL-8  

摘要： Background: Several cytokine levels in dialysate, particularly interleukin-6 (IL-6), have been investigated as potential biomarkers for peritoneal solute transport rate (PSTR). However, studies examining the relationship between systemic cytokine levels and PSTR have yielded contradictory results. In this study, we aimed to assess 12 kinds of cytokines in serum and explore their potential relationship with peritoneal transport function. Methods: Patients undergoing peritoneal dialysis (PD) from September 2022 to September 2024 were retrospectively analyzed at our PD center. The patients were categorized into fast and non-fast PSTR groups based on the 4-h dialysate creatinine /plasma creatinine ratio (D/P Cr). The systemic levels of 12 cytokines (IL-1 beta, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17 A, TNF-alpha, IFN-alpha, and IFN-gamma) in both groups were measured using flow cytometry and compared. The relationship between serum cytokine levels and baseline peritoneal transport status was analyzed by univariate and multivariate logistic regression analyses. Results: A total of 284 patients were enrolled in this study. According to the D/P Cr, 171 patients (60.2 %) were classified as non-fast PSTR group, while 113 patients (39.8 %) were classified as fast PSTR group. Among the 12 cytokines analyzed, serum IL-8 exhibited a significant difference between the two groups (P = 0.01). IL-8/IL-10 and IL-12p70/IL-10 ratios were also significantly higher in fast PSTR group. In the subgroup of incident PD patients, multivariate analysis revealed that total cholesterol (OR 0.559, 95 % CI 0.323-0.966, P = 0.037) and serum IL-8 (OR 1.040, 95 % CI 1.006-1.075, P = 0.021) were significantly and independently associated with baseline fast PSTR. Conclusion: The systemic IL-8 level is positively correlated with PSTR in patients undergoing PD, which may serve as an indicator of baseline peritoneal transport function.

关键词： Interleukin-33   Ischemic stroke   Immunosuppression   Inflammation  

摘要： Cerebrovascular disease is the second-leading cause of death and disability worldwide, with stroke being the most common cause. In ischemic stroke, several processes combine to produce immunosuppression, leaving the post-stroke body susceptible to infection, which in turn affects neuroinflammation. Interleukin-33 (IL-33), a member of the interleukin-1 family (IL-1), functions as a modulator of immune responses and inflammation, playing a crucial role in the establishment of immunologic responses. IL-33 has been shown to have a protective effect on brain injury and represents a potential target by modulating inflammatory cytokines and stimulating immune regulatory cells. With an emphasis on preclinical and clinical studies, this review covers the impact of IL-33 on immune system mechanisms following ischemic stroke.

关键词： adalimumab   inflammatory bowel disease   infliximab   paradoxical psoriasis   TNF-alpha inhibitors  

摘要： Paradoxical psoriasis is a well-described phenomenon following treatment with Tumour Necrosis Factor alpha (TNF-alpha) inhibitors in adult patients with Inflammatory Bowel Disease (IBD). The incidence and optimal treatment strategies are not well described in children with IBD. This subgroup of patients is disproportionately impacted by TNF-alpha inhibitor-induced psoriatic eruptions. Our systematic review and meta-analyses aims to describe the incidence, presentation, and management options for TNF-alpha inhibitor-induced psoriasis in paediatric patients with IBD. A systematic literature search was conducted using Medline, Embase and Cochrane databases for studies published up to February 2025. Retrospective cohort studies (n = 16), prospective cohort study (n = 1), and a cross-sectional study (n = 1) met inclusion criteria. Studies focusing on patients > 18 years or TNF-alpha inhibitors used for non-IBD conditions were excluded. A total of 3349 paediatric patients with IBD treated with TNF-alpha inhibitors were analysed, with 255 (7.6%) developing paradoxical psoriasis. Meta-analysis of 13 studies meeting sample size criteria yielded a pooled incidence of 6.8% (95% CI: 0.04-0.10). Infliximab (IFX) accounted for 151 (79.1%) of cases, whereas adalimumab (ADA) contributed to 40 (20.9%) cases. The median time to clinical eruption was 15.0 months (12.0-18.0). Among affected patients, 22.3% (51/229) discontinued their prescribed TNF-alpha inhibitor and 5.7% (13/229) were subsequently switched to an alternative TNF-alpha inhibitor. Ustekinumab (UST) was the most common non-TNF-alpha alternative (14/94). TNF-alpha inhibitor-induced psoriasis is a common adverse effect in paediatric IBD, with a significant proportion of cases necessitating treatment discontinuation. Long-term outcomes following a switch to non-TNF-alpha biologics remain unclear, highlighting the need for further prospective studies.

摘要： OBJECTIVE: The key to maintaining pregnancy is the balance between pro-inflammatory and anti-inflammatory responses, in which immune cells such as B and T lymphocytes play a pivotal role. While the function and regulation of B-regulatory cells (Br...