Immunology

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A New Disease Activity Score for Antiphospholipid Syndrome?

EurekAlert!

APS is a systemic autoimmune disorder. It is characterised by the presence of antiphospholipid antibodies and a broad spectrum of clinical features, causing obstetric as well as thrombotic, microvascular and non-thrombotic (TMN) symptoms. These can range in severity, and people may have

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Serum IL-1Ra levels are elevated in Lg vessel vasculitis - 21 active, Rx naive LVV pts (13 GCA, 8 TAK), IL-1Ra higher in TAK (465 pg/mL) & GCA (385 pg/mL) vs NLs (170). IL-6 also incr. in LVV, but IL-1β & IFN-γ incr in GCA & ^ IL-17in TAK. IL-1Ra correlate w/ CRP in GCA & https://t.co/TFDpK5DqcJ
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

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Dr. John Cush @RheumNow( View Tweet )
20-40% of Autoimmune hepatitis (AIH) is associated with other autoimmune diseases - lead by autoimmune thyroiditis, type 1 DM, ulcerative colitis, Crohn disease, & celiac (but less so for RA, PBC, SLE, Sjögren syndrome, vitiligo). AIH Dx Abs include ANA, ASMA, LKM1. https://t.co/FphWZwwohx
Dr. John Cush @RheumNow( View Tweet )
Taking a closer look: B-Cell depletion beyond the blood At #ACR25, we have seen an exciting wave of cellular and immune therapies reshaping the landscape of autoimmune disease treatment. Following the landmark case series by the Erlangen group, multiple cellular therapies have https://t.co/GIrPwlGKE2
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/HepyZrYW5L

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Dr. John Cush @RheumNow( View Tweet )
Off the Shelf: CAR-T Dr. Akhil Sood reports on abstract 0663 (iPSC-Derived Off-the-Shelf anti-CD19 CAR T cells Deliver Improved Clinical Outcomes in Lupus with Reduced or No Conditioning Chemotherapy) presented at#ACR25. https://t.co/mj4b5cCInC https://t.co/s34atFCMlx

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Dr. John Cush @RheumNow( View Tweet )
Are we putting the CAR-T before the horse? CAR T-cells have been a revolutionary development in rheumatology. We have seen a population of patients with severe refractory autoimmune conditions almost overnight presented with the prospect of not just improvement, but of a cure. https://t.co/gF9FXjAZ7F
Dr. John Cush @RheumNow( View Tweet )
B Cell Depletion: Check the Lymph Node Dr. Akhil Sood reports on abstract 2695 (B-cell depletion and lymphoid follicle disruption upon different B-cell depleting agents) presented at #ACR25. https://t.co/bvZMGWNzfe https://t.co/dB6iQlgoYx

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Dr. John Cush @RheumNow( View Tweet )
IgG4: Rare, but new treatments on the horizon IgG4 is a rare autoimmune disease with excessive IgG4 immunoglobulins that can affect multiple organs yielding plasma cell deposition (inflammation) and fibrosis. https://t.co/v07Kp5tQXg https://t.co/rIvOF0mrM1

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Dr. John Cush @RheumNow( View Tweet )
B Cell Depletion: Check the Lymph Node Dr. Akhil Sood reports on abstract 2695 (B-cell depletion and lymphoid follicle disruption upon different B-cell depleting agents) presented at #ACR25. https://t.co/BjgIC3Kng0 https://t.co/flfyLZYW8q

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Dr. John Cush @RheumNow( View Tweet )
If you missed this pattern, you missed an autoimmune classic What’s it? https://t.co/zO48zPCkqP

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DocXus @docxusofficial( View Tweet )
The Rapidly Evolving Landscape of Cellular and Immune-based Therapies When Henry Ford unveiled the Model T in 1908, the automobile industry was forever changed. A similar transformation is now underway in rheumatology, where cellular and immune therapies are redefining how we https://t.co/RQuVETSTG4
Dr. John Cush @RheumNow( View Tweet )
Why are vaccine Abs maintained after CAR-T -depletion of pathogenic #Abs are dampened/eliminated Clonal repetoire expansion Remission=naive B cell pop'n Reset immune system sparing memory cells vs ?not all pathogenic cells eliminated in tissue #ACR25 @RheumNow @ACRheum #26S21 https://t.co/jb3dD5Ssip

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Janet Pope @Janetbirdope( 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

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Janet Pope @Janetbirdope( View Tweet )
While post-CAR-T CRS might be semi-familiar for rheumatologists, ICANS is a new concept to get our heads around, and one which is far from heterogenous. @CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/qX2jKMG2oB

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David Liew @drdavidliew( View Tweet )
I've always (very) simplistically considered post-CAR-T CRS and HLH/MAS in the same bucket, and there certainly are substantial similarities. It raises the obvious question - can we borrow therapies? @CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/2HkHxpl89u

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David Liew @drdavidliew( View Tweet )
@CarolineDiorio @ChildrensPhila eloquently told the #ACR25 BCRC pre-meeting about the lessons they've learned about CRS and ICANS, the major CAR-T toxicities. Many questions still to answer, but they've also understood a lot we can learn from. @RheumNow https://t.co/Jhk1eCLpD4

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David Liew @drdavidliew( View Tweet )
Next Generation T-Cell Engager: The Future Dr. Alfred Kim reviews abstract 0001 presented at #ACR25. https://t.co/vmZYfmKCm8 https://t.co/PkLOs9lZ8l

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Dr. John Cush @RheumNow( View Tweet )
#ACR25 Abstr#2695 Inguinal lymph node biopsies pre- and post-OBI, RTX, BLIN & CD19 CAR-T showed complete tissue depletion with CAR-T. B-cells reduced but often incomplete with protein-based depleters; OBI being the best. Still don’t agree with “immune reset” @RheumNow #ACRBest https://t.co/Sq7m9sXlLP

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Abstract 2696: Phase 1/2 study of rapidly engineered CD19 CAR T showed: - rapid depletion of CD19 B cells w/ recovery by Day 90 - Days 180 and 360: returning B cells largely naive (CD27-IgD+) - Interferon expression ↓ after CAR T treatment @RheumNow #ACR25 https://t.co/FzdFbqWwtE

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Akhil Sood MD, MS @AkhilSoodMD( View Tweet )
Abstract 2695: Deep dive into B-cell depletion (BCD) Lymph node biopsy pre/post tx: 🔹 CAR T: complete BCD + disrupted follicular architecture 🔹 RTX, OBI, BLIN: reduced BCD + preserved follicular architecture ✅ Complete LN depletion → drug-free remission @RheumNow #ACR25

Akhil Sood MD, MS @AkhilSoodMD( View Tweet )

Thank you @drdavidliew & @DrLauraCoates ❤️ for highlighting our work. Super-responders (some were IS-Free) do exist with rituximab in #SLE Abstr#1525 @RheumNow https://t.co/S4mMAYInfT

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )

Fighting fire with butyrate 🔥🚒 ♦️probiotics and prebiotics Dr. Nisha Manek on inflammation and butyrate - it reduces gut inflamm thru the NFKB pathway #ACR25 @RheumNow https://t.co/19XTrKn1iN

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sheila @RHEUMarampa( View Tweet )
Sjögren’s, decoded by Ab -->ESSDAI domains: • anti-SSA → glandular • anti-Ro52 / SCL70 → biologic activity • anti-nucleosome → pulmonary • anti-histone → pulmonary + cutaneous Distinct serologic–ESSDAI patterns may guide monitoring and management @RheumNow #ACR25 A#2295

Jiha Lee @JihaRheum( View Tweet )

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