RHEUM Survey> In RA, seropositivity correlates best with what?
Dr. John Cush @RheumNow( View Tweet )
Retrospective cohort study of 546 DM or clinically amyopathic DM pts. 5 factors were signif assoc w/ cancers (1 point ea): 1) TIFF-1-γ Ab (OR 3.8), poikiloderma (OR 3.1), DM subtype (2.8), anemia (2.4), but ILD was protective (OR 0.39). Markedly elevated DM cancer risk seen w/ https://t.co/OdygNQY2u3
Dr. John Cush @RheumNow( View Tweet )
Hematologic Malignancies Increased in Systemic Sclerosis
Swedish national study found that among a cohort of systemic sclerosis (SSc) patients a two-fold increase risk of hematological malignancies was seen.
https://t.co/K1WuMC0mXI https://t.co/MGkvwESqIe
Dr. John Cush @RheumNow( View Tweet )
Retrospective cohort study of 546 DM or clinically amyopathic DM pts. 5 factors were signif assoc w/ cancers (1 point ea): 1) TIFF-1-γ Ab (OR 3.8), poikiloderma (OR 3.1), DM subtype (2.8), anemia (2.4), but ILD was protective (OR 0.39). Markedly elevated DM cancer risk seen w/ https://t.co/r564RbZys2
Dr. John Cush @RheumNow( View Tweet )
Study of 489,569 UK Biobank participants (40 to 69yrs) betw 2006–2010 showed incident RA in 5404. Having self reported eating disorders (anorexia nervosa, bulimia, etc) was associated with a higher risk of developing RA (ad HR 1.76; 1.12–2.76), moreso in men (HR 5.09). https://t.co/GPV3YoE3kt
Dr. John Cush @RheumNow( View Tweet )
Myelodysplastic & chr myelomonocytic leukemia pts rarely get lupus. Review of 19 w/ SLE & 5 w/ CLE; these were older (65 yrs), more male (15M/9F), w/ less renal [10%] & articular [36%] Dz w/ less dsDNA [32%]. Thought to be clonal inflammatory, & not autoinflammatory, process. https://t.co/EAvkJm6GQs
Dr. John Cush @RheumNow( View Tweet )
Robinson et al has published that Epstein-Barr virus infects and reprograms autoreactive B cells to drive the systemic autoimmune response in SLE https://t.co/vjpvILrJOt https://t.co/JfcycqHvhl
Dr. John Cush @RheumNow( View Tweet )
Genetic Risks and Severe Cutaneous Reactions to Allopurinol
A matched cohort study shows that HLA-B*58:01 and HLA-A*34:02 are strongly associated with allopurinol-induced severe cutaneous adverse reactions (SCARs), these alleles were absent in more than one-third of those https://t.co/NLpHVhr9Ww
Dr. John Cush @RheumNow( View Tweet )
NHANES study of 4,622 adults, including 296 w/ RA, shows volatile organic compounds (VOCs) & metabolites (mVOCs) exposures increases the risk of #RA (OR: 1.23 - 1.37), especially in females. https://t.co/pBNLTRkyLn https://t.co/L6nVbYlBhD
Dr. John Cush @RheumNow( View Tweet )
S.Korean study of 481 pts w/ myositis (IIM) - 12.9% (n = 62) had myositis-assoc. cancer. CA risk factos= older age, male, current smoking, dermatomyositis, TIF1γ; but lower risk w/ anti-synthetase synd, overlap myositis, arthritis, & ILD. SCRIM score had AUROC = 0.852 https://t.co/MdU1fRWWgS
Dr. John Cush @RheumNow( View Tweet )
Rheumatoid arthritis and the ‘big bang’ at #ACR25!
Is there ‘bang for the buck’ using big data to help predict who will develop RA in at-risk populations and similarly to predict response to csDMARDs, TNFi and JAKi in RA?
https://t.co/QDvdiP3q9R https://t.co/cz4j4vZkSd
Dr. John Cush @RheumNow( View Tweet )
Needle in a haystack
What T cell to target for #autoimmune diseases
T cell repetoires (TCR) not all are sequenced and many can exist to present antigens
Diff scales of approaches
Implications CAR-T
CD19
CD20
BCMA
Treg
HLAB27
etc!
#ACR25 @ACRheum @RheumNow
Alok Joglekar
#26S08 https://t.co/Qgw8Akz1xk
Links:
Janet Pope @Janetbirdope( View Tweet )
Will #PAD4 levels predict pts w #CCP positive #arthralgia who will develop #RA?
Leeds study - 79 at risk pts
PAD4 levels may predicting #rheumatoid #arthritis development
#ACR25 @RheumNow @ACRheum abst#832 https://t.co/dnAA6z3NJQ
Janet Pope @Janetbirdope( View Tweet )
#ACR25 Abstr#LB21 Are they novel somatic variants beyond #VEXAS in driving inflammation in undiagnosed SAID?Unbiased enrichment analysis in 265 UBA1-negative adults identified IDH1/2 hotspot mutations. Cd be used to screen esp those with cytopenia. Sorry pix not allowed @RheumNow
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
A deep dive into Lupus 🔬
Abstract 2601: Single-cell insights in SLE & pre-clinical autoimmunity
🔹 Plasmablast expansion → high disease activity & SLE risk
🔹 Metabolic activity varies by cell type
🔹 Established disease: ↑ glycolysis & OxPHOS changes
@RheumNow #ACR25
Akhil Sood MD, MS @AkhilSoodMD( View Tweet )
#ACR25 Abstr#2601 At single cell level using CyTOF, metabolic activity varied btw HC & autoimmune groups but clusters in At-Risk ANA+ve appeared closer to #SLE. ANA+ve who progressed to AI-CTD showed Plasmablast expansion & enhanced glycolysis. Could be used as target @RheumNow https://t.co/jtrM1wvQLk
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
A new genetic score for ILD prediction! 🫁
Developed in the Veterans RA cohort and Validation in a Swedish cohort
Model using classic RA-ILD risk factors and a cocktail of genetic risk
A cut off of 0.05 in this cohort would exclude 36% from HRCT or PFTs
Good performance https://t.co/6UsoSQAtyK
Links:
Aurelie Najm @AurelieRheumo( View Tweet )
#1723 Why is systemic autoimmunity more common in females?
Loss of X-chromosome inactivation maintenance in B cells (not T cells) amplifies interferon-driven disease, with increased autoantibodies, inflammation and renal injury. Key mechanistic advance. @RheumNow #ACR25
Mrinalini Dey @DrMiniDey( View Tweet )
#ACR25 SMILE RCT of Incomplete #SLE (ANA+ but not meeting SLICC) showed HCQ didn’t slow down SLE progression. But multiplex arrays showed reduction in autoantibodies with HCQ that were distinct from abs assoc. w progression. Would biomarker endpoints be the answer? @RheumNow https://t.co/XcvacgObVo
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Short chain fatty acids (SCFA) and the relevant microbiome have been linked to RA development and severity.
Study of monozygotic twins, where only one has RA, two diff cohorts:
lower SCFA
lower SCFA microbiome
Biomarkers, or even therapeutic target?
#ACR25 ABST0442 @RheumNow https://t.co/HW1YfkfOG3
David Liew @drdavidliew( View Tweet )
#0794 LLMs can accelerate qualitative lupus pregnancy research. Using AI to translate & analyze interviews from Portuguese, GPT-4 achieved top accuracy & coherence vs human themes. LLMs may expand inclusion & equity in rheum research. @RheumNow #ACR25 https://t.co/TAxg6Qyk0L
Mrinalini Dey @DrMiniDey( View Tweet )
Fascinating: tDR-1, a microbial sRNA, appears protective for RA in at risk ACPA+ pts:
- tDR-1 higher = less develop RA
- can predict seropos RA development
- in vitro type 1 IFN mapping checks out
Useful in itself, but importantly: why does it happen?
#ACR25 ABST0775 @RheumNow https://t.co/ep99dNAzFV
Links:
David Liew @drdavidliew( View Tweet )
tRNA-derived RNA (tDR-1), circulating microbial RNA
Associated w/ reduction in risk of RA conversion in asymptomatic CCP+ individuals (60 vs. 120+ ctrls),
‼️ tDR-1 alone over performs prediction model w/ smoking shared episode and RF w/ AUC 0.86
What is the mechanism? tDR-1 https://t.co/fuyk4NeOyA
Links:
Aurelie Najm @AurelieRheumo( View Tweet )
What can we learn from longitudinal peripheral blood multi-omic profiling in at-risk individuals?
50 RA converters vs. non converters from StopRA study
Decision tree showing highest risk for conversion to clinical RA in Individuals w/
-CCP3 ≥108 units
-T peripheral helpers https://t.co/jw53EB6tI6
Links:
Aurelie Najm @AurelieRheumo( View Tweet )
#0774
Multi-omic profiling of anti-CCP3+ “at-risk” individuals reveals Tph & cytotoxic CD8+ expansions, altered gene/chromatin profiles and predictive model (AUC 0.77) for RA conversion
PTPN22 locus accessibility & Tph ≥ 2.45% identify highest risk. @RheumNow #ACR25 https://t.co/JDSMkdmoGv
Mrinalini Dey @DrMiniDey( View Tweet )
Recent Blogs
Cush and Dao are at it again. This time it's whether men or women are better patients. Cush says men are better patients; Dao says Er, not so fast bub! This is their light-hearted, gender biased debate on the best patients: Men vs. Women.
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