Clinical Manifestations and Treatment of Autoimmune Diseases

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 31 October 2024 | Viewed by 10956

Special Issue Editors


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Guest Editor
1. Complex Structure of Internal Medicine, University Hospital "Maggiore della Carità", Novara, Italy
2. Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
3. IRCAD-Interdisciplinary Research Center of Autoimmune Diseases, Novara, Italy
Interests: lung diseases; respiratory insufficiency; lung lesions; lung masses; vaccines; antibiotic therapy; respiratory physiotherapy; spirometry
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Guest Editor
1. Internal Medicine Unit, Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy
2. Maggiore della Carità Hospital, 28100 Novara, Italy
Interests: biomarkers; immunology; toxicology; immune response
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Autoimmunity is one of the most common ways in which the immune system can fail. The mechanisms by which the human immune system protects us and can harm us are complex and fascinating. Autoimmune diseases are numerous and involve any medical specialty, ranging from mild to serious, chronic and tumultuous conditions. The field of autoimmune diseases is particularly active; in recent years, many interesting discoveries have been made regarding disease classification criteria, biological markers of inflammation activity, and synthetic and biological therapies. A further boost to research in this context was driven by the SARS-CoV-2 pandemic and consequent vaccinations. This is a good time to draw state-of-the-art lines in this field. With this Special Issue, we aim to fill these gaps, at least in part, by inviting researchers to contribute to improving the understanding and treatment of autoimmune diseases step by step. Articles may include any topic related to autoimmunity, from the biology and physiology of the immune system to clinical diseases, autoimmunity as an epiphenomenon of other conditions, response to vaccines and therapy. I hope that this Special Issue is greeted with productivity and enthusiasm as everyone's help is needed to make further progress in this crucial topic of human health.

Dr. Daniele Sola
Dr. Stelvio Tonello
Guest Editors

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Keywords

  • autoimmunity
  • immunobiology
  • vaccine
  • leucocytes
  • immune system

Published Papers (7 papers)

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Research

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14 pages, 1142 KiB  
Article
Sociodemographic and Clinical Determinants of Fatigue in Multiple Sclerosis
by Smaranda Maier, Zoltán Bajkó, Ruxandra Roșescu, Laura Bărcuțean, Emanuela Sărmășan, Septimiu Voidăzan and Rodica Bălașa
Life 2023, 13(11), 2132; https://doi.org/10.3390/life13112132 - 29 Oct 2023
Viewed by 998
Abstract
Fatigue is the most common and disabling symptom in patients with multiple sclerosis (PwMS), representing one of the main determinants of reduced quality of life among PwMS due to its interference with social activities and work capacity. This study aimed to identify the [...] Read more.
Fatigue is the most common and disabling symptom in patients with multiple sclerosis (PwMS), representing one of the main determinants of reduced quality of life among PwMS due to its interference with social activities and work capacity. This study aimed to identify the sociodemographic determinants of fatigue in a cohort of 150 PwMS and 100 healthy controls (HCs). Fatigue was assessed using one of the most suitable and appropriate tools for measuring the degree of fatigue: the Modified Fatigue Impact Scale (MFIS). By comparing the median scores for the MFIS, we observed that the PwMS group had significantly higher MFIS scores than the HCs (p = 0.0001). In PwMS, MFIS scores correlated positively with age, total number of relapses, total disease duration, disability status, and Beck Depression Inventory-II score and negatively with cognitive performance. Patients with relapsing-remitting MS had significantly lower fatigue levels than those with secondary progressive MS (p = 0.0010). Fatigue levels were significantly lower among male than female PwMS (p = 0.0120). Other determinant factors of fatigue in our study proved to be the marital and occupational status, as well as the presence of children, but in a linear multivariate regressions analysis with MFIS score as the dependent variable, the fatigue levels were influenced only by sex, occupational status, marital status, children status, and BDI-II test results. Considering the significant impact of fatigue on the quality of life of PwMS, clinicians must diagnose fatigue as early as possible, identify its modifiable determinants, and manage it effectively to increase their quality of life. Full article
(This article belongs to the Special Issue Clinical Manifestations and Treatment of Autoimmune Diseases)
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8 pages, 254 KiB  
Communication
Significance of Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) for the Monitoring of Treatment Response to Cyclosporine in Patients with Psoriasis
by Aleksandra Frątczak, Bartosz Miziołek, Agnieszka Łupicka-Słowik, Marcin Sieńczyk, Karina Polak and Beata Bergler-Czop
Life 2023, 13(9), 1873; https://doi.org/10.3390/life13091873 - 6 Sep 2023
Cited by 1 | Viewed by 1071
Abstract
Neutrophil gelatinase-associated lipocalin (NGAL) may promote development of inflammation in psoriasis, whereas proprotein convertase subtilisin/kexin type 9 (PCSK9) may account for dyslipidemia in some psoriatic patients. The aim of the study was to analyze the influence of cyclosporine therapy on serum levels of [...] Read more.
Neutrophil gelatinase-associated lipocalin (NGAL) may promote development of inflammation in psoriasis, whereas proprotein convertase subtilisin/kexin type 9 (PCSK9) may account for dyslipidemia in some psoriatic patients. The aim of the study was to analyze the influence of cyclosporine therapy on serum levels of NGAL and PCSK9 in patients with psoriasis vulgaris. Methods: Serum samples were obtained before and after three months cyclosporine therapy. Patients were grouped into responders and non-responders to cyclosporine depending on whether they achieved at least 50% reduction of Psoriatic Activity Score Index (PASI), or not. Serum levels of PCSK9 and NGAL were assayed using commercially available ELISA tests. Lipid levels were measured with an enzymatic method. Results: There were 40 patients enrolled. A significant decrease in serum NGAL level was seen in cyclosporine responders. No similar dependance was found for PCSK9. Serum PCSK9 concentration correlated with total cholesterol (TChol) and LDL at baseline and after three month treatment. Conclusions: Cyclosporine therapy contributes to the reduction of the NGAL serum but not the PCSK9 concentration. Correlation between the PCSK9 serum level and TChol as well as LDL concentration may help to understand drug induced dyslipidemia after cyclosporine. Full article
(This article belongs to the Special Issue Clinical Manifestations and Treatment of Autoimmune Diseases)

Review

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17 pages, 692 KiB  
Review
Sarcoidosis and Autoimmune Inflammatory Syndrome Induced by Adjuvants
by Anna Starshinova, Yulia Zinchenko, Anna Malkova, Dmitriy Kudlay, Igor Kudryavtsev and Piotr Yablonskiy
Life 2023, 13(4), 1047; https://doi.org/10.3390/life13041047 - 19 Apr 2023
Cited by 4 | Viewed by 2812
Abstract
Currently, sarcoidosis remains one of the diseases with unknown etiology, which significantly complicates its diagnosis and treatment. Various causes of sarcoidosis have been studied for many years. Both organic and inorganic trigger factors, provoking the development of granulomatous inflammation are considered. However, the [...] Read more.
Currently, sarcoidosis remains one of the diseases with unknown etiology, which significantly complicates its diagnosis and treatment. Various causes of sarcoidosis have been studied for many years. Both organic and inorganic trigger factors, provoking the development of granulomatous inflammation are considered. However, the most promising and evidence-based hypothesis is the development of sarcoidosis as an autoimmune disease, provoked by various adjuvants in genetic predisposed individuals. This concept fits into the structure of the autoimmune/inflammatory syndrome, induced by adjuvants (ASIA) that was proposed in 2011 by Professor Shoenfeld Y. In this paper, the authors reveal the presence of major and minor ASIA criteria for sarcoidosis, propose a new concept of the course of sarcoidosis within the framework of ASIA, and point out the difficulties in creating a model of the disease and the selection of therapy. It is obvious that the data obtained not only bring us closer to understanding the nature of sarcoidosis, but also potentiate new studies confirming this hypothesis by obtaining a model of the disease. Full article
(This article belongs to the Special Issue Clinical Manifestations and Treatment of Autoimmune Diseases)
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Other

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12 pages, 1107 KiB  
Case Report
Unveiling the Mystery of Adult-Onset Still’s Disease: A Compelling Case Report
by Daniele Sola, Carlo Smirne, Francesco Bruggi, Chiara Bottino Sbaratta, Aubin Cardin Tamen Njata, Guido Valente, Maria Cristina Pavanelli, Rosetta Vitetta, Mattia Bellan, Lorenzo De Paoli and Mario Pirisi
Life 2024, 14(2), 195; https://doi.org/10.3390/life14020195 - 29 Jan 2024
Viewed by 997
Abstract
Adult-onset Still’s disease (AOSD) is a rare systemic inflammatory disorder. Diagnosis can take a long time, especially in the presence of confounding factors, and it is, to some extent, a process of exclusion. AOSD has life-threating complications ranging from asymptomatic to severe, such [...] Read more.
Adult-onset Still’s disease (AOSD) is a rare systemic inflammatory disorder. Diagnosis can take a long time, especially in the presence of confounding factors, and it is, to some extent, a process of exclusion. AOSD has life-threating complications ranging from asymptomatic to severe, such as macrophage activation syndrome (MAS), which is also referred to as hemophagocytic lymphohistocytosis (HLH). This condition is correlated with cytokine storm production and monocyte/macrophage overactivation and typically occurs with rash, pyrexia, pancytopenia, hepatosplenomegaly and systemic involvement. Exitus occurs in approximately 10% of cases. For the treatment of MAS-HLH, the Histiocyte Society currently suggests high-dose corticosteroids, with the possible addition of cyclosporine A, anti-interleukin (IL)-1, or IL-6 biological drugs; the inclusion of etoposide is recommended for the most severe conditions. In all cases, a multidisciplinary collaboration involving the resources and expertise of several specialists (e.g., rheumatologist, infectiologist, critical care medicine specialist) is advised. Herein, we provide a detailed description of the clinical case of a previously healthy young woman in which MAS developed as a dramatic onset manifestation of AOSD and whose diagnosis posed a real clinical challenge; the condition was finally resolved by applying the HLH-94 protocol (i.e., etoposide in combination with dexamethasone). Full article
(This article belongs to the Special Issue Clinical Manifestations and Treatment of Autoimmune Diseases)
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7 pages, 227 KiB  
Case Report
A Case of Polymyositis Associated with Cytomegalovirus Infection in a Patient with Hashimoto’s Thyroiditis
by Ergeta Ktona, Blerta Budani, Ioannis Kostas-Agnantis and Alma Idrizi
Life 2023, 13(12), 2331; https://doi.org/10.3390/life13122331 - 12 Dec 2023
Viewed by 852
Abstract
Polymyositis is a rare condition with an unknown etiology occurring more frequently in adult women. There is a lack of evidence on the coexistence of PM and CMV infection in a patient with hypothyroidism due to Hashimoto’s Thyroiditis. However, the growing occurrence of [...] Read more.
Polymyositis is a rare condition with an unknown etiology occurring more frequently in adult women. There is a lack of evidence on the coexistence of PM and CMV infection in a patient with hypothyroidism due to Hashimoto’s Thyroiditis. However, the growing occurrence of both CMV infection and the simultaneous occurrence of autoimmune diseases points out a relationship, while the association direction remains unclear. Case outline: A 32-year-old woman recently treated for HT hypothyroidism was admitted to the hospital two weeks after being treated for common flu by the family doctor, complaining about a worsening condition with muscle pain, weakness, frequent falls, and fatigue. The first tests showed a normalized thyroid function, with elevated values of troponin and serum creatinine kinase (CK). The immunological tests revealed the presence of a high titer of CMV IgG antibodies and raised levels of CMV DNA. Pelvis MRI images demonstrated markedly elevated signals on the STIR sequences in the pelvis, thighs, and calves, indicating active and severe multifocal myositis. The diagnosis of PM was confirmed with the muscle biopsy on day 7 of hospitalization. The patient showed significant improvements within two weeks after the medical therapy and physiotherapy. Full article
(This article belongs to the Special Issue Clinical Manifestations and Treatment of Autoimmune Diseases)
11 pages, 4827 KiB  
Case Report
Co-Occurrence of Rheumatoid Arthritis and Lung Cancer—Coincidence or Not?
by Ioana Munteanu, Constantin Gheorghevici, Catalin Constantin Coca, George Alexandru Diaconu, Alexandra Emilia Sandru, Nicolae Feraru, Andreea Popa, Roxana Nemes and Beatrice Mahler
Life 2023, 13(10), 2089; https://doi.org/10.3390/life13102089 - 20 Oct 2023
Viewed by 1097
Abstract
Bronchopulmonary cancer is the leading cause of cancer deaths globally. Rheumatoid arthritis is one of the risk factors for lung cancer, and those who use methotrexate have a higher risk of developing lung cancer. We present the case of an 80-year-old patient who [...] Read more.
Bronchopulmonary cancer is the leading cause of cancer deaths globally. Rheumatoid arthritis is one of the risk factors for lung cancer, and those who use methotrexate have a higher risk of developing lung cancer. We present the case of an 80-year-old patient who is a former smoker and is known to have rheumatoid arthritis, being treated using methotrexate; they were brought by ambulance to the emergency room for coughing with ineffective expectoration, dyspnea on slight exertion, and right-lateral chest pain with onset about one month prior and progressive worsening. Imaging showed a 7 cm/6 cm LID tumorous lung formation with parietal invasion and C7 rib lysis, as well as diffuse fibrotic interstitial changes predominantly in the lower lobes. An ultrasound-guided transthoracic lung biopsy was performed, and histopathological examination established the diagnosis of invasive squamous cell lung carcinoma, G2. In conclusion, the chest pain interpreted by the patient as rheumatic pain delayed the diagnosis of lung cancer; the patient presented rather late to the hospital once respiratory failure set in. Full article
(This article belongs to the Special Issue Clinical Manifestations and Treatment of Autoimmune Diseases)
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11 pages, 1336 KiB  
Study Protocol
Prevalence of Long COVID Symptoms Related to SARS-CoV-2 Strains
by Teresita Aloè, Federica Novelli, Gianfranco Puppo, Valentina Pinelli, Emanuela Barisione, Elisa Trucco, Roberta Costanzo, Maria Grazia Covesnon, Federica Grillo, Patrizia Zoccali, Manlio Milanese, Sara Maniscalco, Elena Tagliabue, Ines Maria Grazia Piroddi, Simonetta Venturi, Maria Serra, Francesca Scordamaglia, Marta Ferrari and Antonella Serafini
Life 2023, 13(7), 1558; https://doi.org/10.3390/life13071558 - 13 Jul 2023
Cited by 2 | Viewed by 2458
Abstract
Background: Few studies have assessed the differences of patterns of Long COVID (L-COVID) with regards to the pathogenetic SARS-CoV-2 strains. Objectives: To investigate the relationship between demographic and clinical characteristics of acute phase of infection and the persistence of L-COVID symptoms and clinical [...] Read more.
Background: Few studies have assessed the differences of patterns of Long COVID (L-COVID) with regards to the pathogenetic SARS-CoV-2 strains. Objectives: To investigate the relationship between demographic and clinical characteristics of acute phase of infection and the persistence of L-COVID symptoms and clinical presentation across different SARS-CoV-2 strains. Methods: In this observational-multicenter study we recorded all demographic and clinical characteristics, severity of infection, presence/persistence of symptoms of fatigue, dyspnoea and altered quality of life (QoL) at baseline and after 6 months, in a sample of Italian patients from Liguria between March 2020 and March 2022. Results: 308 patients (mean age 63.2 years; 55.5% men) with previous COVID were enrolled. Obese patients were 21.2% with a significant difference in obesity prevalence across the second and third wave (p = 0.012). Treatment strategies differed between waves (p < 0.001): more patients required invasive mechanical ventilation in the first wave, more patients were treated with high-flow nasal cannula/non-invasive ventilation in the in the second and more patients were treated with oxygen-therapy in the fourth wave. At baseline, a high proportion of patients were symptomatic (dyspnoea and fatigue), with impairment in some QoL indicators. A higher prevalence of patients with pain, were seen in the first wave compared to later infections (p = 0.01). At follow-up, we observed improvement of dyspnoea, fatigue and some dimensions of QoL scale evaluation such as mobility, usual activities, pain evaluations; instead there was no improvement in remaining QoL scale indicators (usual care and anxiety-depression). Conclusions: There were no significant differences in the prevalence of the most frequent L-COVID symptoms, except for QoL pain domain that was especially associated with classical variant. Our results show substantial impact on social and professional life and usual care activities. These findings highlight the importance of multidisciplinary post COVID follow-up care including mental health support and rehabilitation program. Full article
(This article belongs to the Special Issue Clinical Manifestations and Treatment of Autoimmune Diseases)
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