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Journal = Reports
Section = Allergy/Immunology

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15 pages, 1650 KiB  
Article
Plasma CXCL4–DNA/RNA Complexes and Anti-CXCL4 Antibodies Modulation in an SSc Cohort under Iloprost Treatment
by Anna Mennella, Katia Stefanantoni, Raffaella Palazzo, Giuseppe Ocone, Immacolata Pietraforte, Simona Truglia, Ilaria Bisconti, Alba Pisacreta, Valeria Riccieri, Roberto Lande and Loredana Frasca
Reports 2024, 7(3), 66; https://doi.org/10.3390/reports7030066 - 2 Aug 2024
Viewed by 989
Abstract
Background: Systemic sclerosis (SSc) is an autoimmune disease characterized by vascular and immunity alterations and skin/internal organ fibrosis. Aberrant levels of plasma CXCL4, CXCL4–RNA/DNA complexes, type I IFN (IFN-I) and anti-CXCL4 antibodies characterize SSc. These parameters influence each other: CXCL4–self-DNA/RNA complexes are triggers [...] Read more.
Background: Systemic sclerosis (SSc) is an autoimmune disease characterized by vascular and immunity alterations and skin/internal organ fibrosis. Aberrant levels of plasma CXCL4, CXCL4–RNA/DNA complexes, type I IFN (IFN-I) and anti-CXCL4 antibodies characterize SSc. These parameters influence each other: CXCL4–self-DNA/RNA complexes are triggers of IFN-I in plasmacytoid dendritic cells (pDCs), and anti-CXCL4 autoantibodies amplify this effect. Here, we assess the modulation over time of plasma CXCL4 and the related parameters of CXCL4–DNA/RNA complexes, anti-CXCL4 antibodies, IFN-α and TNF-α in an SSc cohort under the synthetic analogue of prostacyclin PGI2 (iloprost) treatment to address contribution of these parameters to pathogenesis and their role as biomarkers. Methods: We analyzed immunological parameters at baseline (T0) and after 3 (T3) and 6 (T6) months in 30 SSc patients. Responders were the patients that lowered their disease activity parameters after six months of treatment. Results: Anti-CXCL4 autoantibodies correlated with both IFN-α and TNF-α levels in SSc plasma. Responders significantly down-regulated serum IFN-α. In seven patients with a shorter disease duration, improvement coincides with a decrease in plasma IFN-α, CXCL4 and TNF-α. Iloprost efficiently blocks pDCs IFN-α production induced by CXCL4–DNA/RNA complexes in vitro. Conclusions: The data suggest a possible role of iloprost as a disease-modifying drug, mainly accompanied by down-regulation of plasma IFN-I levels. Since CXCL4, IFN-I and TNF-α down-modulation was evident and significant in improving SSc patients with a shorter disease duration, these results warrant future investigations on the early use of iloprost to slow SSc progression. Full article
(This article belongs to the Section Allergy/Immunology)
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Figure 1

Figure 1
<p>CXCL4-related parameters in the SSc plasma. IFN-α (<b>a</b>), ΤΝF−α (<b>c</b>), CXCL4 (<b>b</b>), immune complexes CXCL4–DNA (<b>d</b>) and CXCL4–RNA (<b>e</b>) and anti-CXCL4 (<b>f</b>) autoantibodies were determined by ELISA assay in SSc patients (N = 30) and healthy donors (HD, N = 17) before treatment (T0), at 3 months (T3) and 6 months (T6). Horizontal bars are the means; vertical bars are the standard error of the mean (SEM); <span class="html-italic">p</span>-values are calculated by paired Wilcoxon signed rank test. The mean plus 2 SD (standard deviation) of antibody reactivity or positivity for CXCL4–DNA or CXCL4–RNA of HD was used as cut-off (black line in panels (<b>d</b>–<b>f</b>)).</p>
Full article ">Figure 2
<p>CXCL4-related parameters in responder SSc patients. Disease activity score (EScSGAI, (<b>a</b>)) and plasma IFN-α (<b>b</b>), CXCL4 (<b>c</b>) and TNF-α (<b>d</b>) were measured in responder patients (N = 16) at the time points in <a href="#reports-07-00066-f001" class="html-fig">Figure 1</a>. Data are plotted as mean plus standard error of the mean (SEM); <span class="html-italic">p</span>-values are calculated by paired Wilcoxon signed rank test.</p>
Full article ">Figure 3
<p>CXCL4-related parameters in non-responder SSc patients. Disease activity score (EScSGAI, (<b>a</b>)) and plasma IFN-α (<b>b</b>), CXCL4 (<b>c</b>) and TNF-α (<b>d</b>) were measured in non-responder patients (N = 14) at the time points in <a href="#reports-07-00066-f001" class="html-fig">Figure 1</a>. Data are plotted as mean plus standard error of the mean (SEM); <span class="html-italic">p</span>-values are calculated by paired Wilcoxon signed rank test.</p>
Full article ">Figure 4
<p>Principal component analysis plot of responder and non-responder SSc patients. Correlation circles of 7 variables and the first and second dimensions of responder patients (N = 16) at baseline (T0; 51% of the total variance explained) and at 6 months (T6; 48.5% of the total variance explained) and of non-responder subjects (N = 14) at baseline (T0; 63.5% of the total variance explained) and at 6 months (T6; 70.6% of the total variance explained).</p>
Full article ">Figure 5
<p>Disease activity and CXCL4-related parameters in eaSSc patients. Disease activity score (EScSGAI, (<b>a</b>)) and plasma IFN-α (<b>b</b>), CXCL4 (<b>c</b>) and TNF-α (<b>d</b>) were measured in early patients (N = 7) at the indicated time points. Data are plotted as mean plus standard error of the mean (SEM); <span class="html-italic">p</span>-values are calculated by paired Wilcoxon signed rank test.</p>
Full article ">Figure 6
<p>Disease activity and CXCL4-related parameters in the responders with long-lasting SSc. Disease activity score (EScSGAI, (<b>a)</b>) and plasma IFN-α (<b>b</b>), CXCL4 (<b>c</b>) and TNF-α (<b>d</b>) were measured in the responder patients (N = 9) with a disease duration &gt; 5 years at the indicated time points. Data are plotted as mean plus standard error of the mean (SEM); <span class="html-italic">p</span>-values are calculated by paired Wilcoxon signed rank test.</p>
Full article ">Figure 7
<p>Iloprost reduces TLR-triggered pDC-derived IFN-α in vitro. IFN-α released in the supernatant from healthy pDCs stimulated with immune complexes CXCL4–DNA (<b>a</b>) and CXCL4–RNA (<b>b</b>), or TLR7/8 ligand R848 (<b>c</b>) and TLR9 ligand CpGA (<b>d</b>) alone or in the presence of the indicated doses of iloprost at 24 h. IFN-α content was measured by ELISA assay. Horizontal bars are the means; vertical bars are the standard error of the mean (SEM); <span class="html-italic">p</span>-values are calculated by two-tailed Student’s <span class="html-italic">t</span> test for paired samples from 5–8 different donors.</p>
Full article ">
8 pages, 2852 KiB  
Case Report
ADEM as an Initial Presentation of SLE: A Case Report
by Yousuf Sherwani, Ayham Alsaab and Mohan Sengodan
Reports 2024, 7(3), 53; https://doi.org/10.3390/reports7030053 - 5 Jul 2024
Viewed by 1241
Abstract
Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder of the white matter. The pathophysiology is thought to be immune-mediated as in most cases the condition follows an infection or triggering incident. More recent literature has demonstrated that there may be a link [...] Read more.
Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder of the white matter. The pathophysiology is thought to be immune-mediated as in most cases the condition follows an infection or triggering incident. More recent literature has demonstrated that there may be a link between autoimmune conditions and ADEM. Here we present a case of ADEM in a middle-aged woman with systemic lupus erythematosus that recovered well after treatment with corticosteroids and rituximab. Full article
(This article belongs to the Section Allergy/Immunology)
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Figure 1

Figure 1
<p>Fluid -attenuated inversion recovery (FLAIR) axial image of white matter lesions in the internal capsule. The arrow shows areas high signal changes consistent with edema and/or inflammation.</p>
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<p>FLAIR axial MRI image reveals white matter lesions in the midbrain. The arrow shows areas high signal changes consistent with edema and/or inflammation.</p>
Full article ">Figure 3
<p>FLAIR axial MRI image reveals white matter lesions in the basal ganglia. The arrow shows areas high signal changes consistent with edema and/or inflammation.</p>
Full article ">Figure 4
<p>FLAIR axial MRI image reveals white matter lesions in the pons. The arrow shows areas high signal changes consistent with edema and/or inflammation.</p>
Full article ">
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