Accelerated Atherosclerosis in Patients with Systemic Lupus Erythematosus and the Role of Selected Adipocytokines in This Process

Systemic lupus erythematosus (SLE) can affect various systems and organs. The most severe forms of the disease affect the kidneys, the central nervous system, and the heart. Cardiac and cardiovascular system diseases are inter alia caused by atherosclerosis, vasculitis, and thromboembolic events. Patients with SLE are at a higher risk of developing accelerated atherosclerosis. This process in SLE patients cannot be explained solely based on classical risk factors. Recently, some adipocytokines/adipokines have been indicated in the development of atherosclerosis, inflammation, and immune processes. It has also been postulated that adipokines might regulate the immune response and hence the atherogenic process. In this work, the factors contributing to accelerated atherosclerosis in SLE patients with special respect to vasculitis/vascular injury are presented, and selected adipocytokines, that is leptin, resistin, and adiponectin, with their relation to atherosclerosis and SLE, are under discussion

Assessment of selected B cells populations in the workers of X-ray departments

Objectives: Workers of X-ray departments are occupationally exposed to long-term low levels of ionizing radiation (LLIR), which may affect their humoral immunity. The aim of the study was to assess the influence of LLIR on the number and proportion of B cells (CD19+), B1 cells (CD5+CD19+) and memory B cells (CD27+CD19+) in peripheral blood of such workers. Materials and Methods: In the study group of 47 X-ray departments workers and the control group consisting of 38 persons, the number and percentage of CD19+, CD5+CD19+, CD27+CD19+ cells as well as CD5+CD19+/CD19+ and CD27+CD19+/CD19+ cell ratios were assessed using flow cytometry. Additionally, the study group was divided into 2 groups by the length of employment below and over 15 years and analysis adjusted for age and smoking habit was performed. Results: The total number of CD19+ cells showed significant increase in the group of workers in comparison with the persons from the control group, whereas the percentage of CD5+CD19+ cells as well as CD27+CD19+/CD19+ and CD5+CD19+/CD19+ cell ratios were lower. Percentage, number of CD5+CD19+ cells and CD5+CD19+/CD19+ cell ratio were significantly lower in the workers with length of employment longer than 15 years in comparison with those employed below 15 years. Moreover, we found positive associations between the number of CD19+ cells and employment as well as smoking habit, whereas the number of CD5+CD19+ cells was positively associated with cigarette smoking alone. Percentage of CD5+CD19+ cells as well as CD5+CD19+/CD19+ and CD27+CD19+/CD19+ cell ratios were negatively correlated with employment. Conclusions: The study suggests association between the suppressive influence of low level ionizing radiation on circulating in peripheral blood, especially of B1 cells as well as of memory B cells, in workers of X-ray units, which is adverse in relation to microbiological threat

Problemy diagnostyczne na podstawie obserwowanego przypadku chorej z nużliwością mięśni prążkowanych, współwystępowaniem zespołu toczniopodobnego i rozpoznaną boreliozą

Współistnienie u tego samego chorego dwóch lub więcej choróbz autoagresji nie jest zjawiskiem rzadkim. Najczęściej z innymichorobami współwystępuje toczeń rumieniowaty układowy (TRU).Nużliwość mięśni prążkowanych jest chorobą, której współistnieniez TRU nie jest zbyt częste, lecz sporadycznie pojawiały się jużopisy takich przypadków.W niniejszej pracy przedstawiono opis chorej z rozpoznaną nużliwościąmięśni prążkowanych, u której wykonano tymektomię i pokilkunastu latach od tego momentu rozpoznano zespół toczniopodobny.Dołączenie się boreliozy jeszcze bardziej skomplikowałoobraz kliniczny choroby. W pracy przedstawiono trudności diagnostyczne,jakie wystąpiły w obserwowanym przypadku

Addison’s Disease in the Course of Recurrent Microangiopathic Antiphospholipid Syndrome—A Clinical Presentation and Review of the Literature

The article presents a male patient with adrenocortical insufficiency in the course of antiphospholipid syndrome (APS). It also describes recurrent exacerbations of his clinical status, characteristic of microangiopathic antiphospholipid syndrome (MAPS) which had been misdiagnosed as a disseminated intravascular coagulopathy (DIC) syndrome due to sepsis with multi-organ failure, including heart, kidneys, and liver. Issues related to pathogenesis, clinical symptoms, differential diagnosis, and treatment of APS in the context of presently distinguished subtypes of this syndrome have been addressed. The role of vascular endothelial cell activation and the influence of coagulation patterns on the development of APS continuum clinical symptoms have also been mentioned. In addition, this paper highlights that the diagnosis of APS should be considered in patients with adrenal insufficiency and abdominal pain, even without any prior history of thromboembolic diseases, as well as in the course of DIC, especially without predisposing factors

Selected aspects of cardiovascular system in patients with systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease, in which one of the causes of death is the occurrence of acute coronary syndromes. They are connected with a chronic inflammatory process in the vascular wall, which leads to accelerated development of atherosclerosis. In this work, the potential risk factors in the development of cardiovascular disease in SLE and the role of autoantibodies, which have a significant impact on the progression of inflammatory processes in vascular endothelium were discussed. The following antibodies involved in the initiation of the inflammatory process were described: anti-endothelial cell antibodies (anti-endothelial cel antibodies – AECA), anti-neutrophil cytoplasmic antibodies (anti-neutrophil cytoplasmic anti-bodies – ANCA), anti-phospholipid antibodies (anti-phospholipid autibodies – aPL), antibodies against double-stranded DNA (antibodies against double-stranded DNA – anti-dsDNA) and antibodies against histone proteins (anti-DNA-histone complex). The role of classical factors in the development of subclinical atherosclerosis were indicated. Particular attention was paid to specific factors which play the most important role in the pathogenesis of this disease: proinflammatory cytokines, autoantibodies and chronic glucocorticosteroid therapy. Additionally, the role of thromboembolic complications in the etiology of acute coronary events in patients with SLE was discussed. So far, primary and secondary prevention is not clear in patients with SLE. The special role of early diagnosis based on imaging studies in order to reduce the number of deaths due to cardiovascular complications in patients with SLE was highlighted.Toczeń rumieniowaty układowy (systemic lupus erythematosus – SLE) jest chorobą autoimmunizacyjną, w której jedną z przyczyn zgonów są ostre zespoły wieńcowe, powstające na podłożu przewlekłego procesu zapalnego w ścianie naczyń, prowadzącego do przyspieszonego rozwoju zmian miażdżycowych. W niniejszej pracy przedstawiono potencjalne czynniki ryzyka odgrywające znaczącą rolę w rozwoju chorób sercowo-naczyniowych w przebiegu SLE. Podkreślono rolę autoprzeciwciał, które w istotny sposób wpływają na progresję procesu zapalnego toczącego się w śródbłonku naczyń, w tym przeciwciał zaangażowanych w inicjację procesu zapalnego: przeciwciało skierowane przeciw komórka śródbłonka (anti-endothelial cel antibodies – AECA), przeciwciała przeciwko cytoplazmie neutrofilów (anti-neutrophil cytoplasmic antibodies – ANCA), przeciwciała antyfosfolipidowe (anti-phospholipid autibodies – aPl), przeciwciała przeciwko dwuniciowemu DNA (antibodies against double-stranded DNA – anti-dsDNA) oraz przeciwciała przeciwko białkom histonowym (anti-DNA histone complex). Wskazano również możliwą rolę czynników klasycznych i swoistych dla SLE w rozwoju subklinicznej postaci miażdżycy. Szczególną uwagę zwrócono na charakterystyczne, najważniejsze czynniki w patogenezie choroby, tj. cytokiny prozapalne, autoprzeciwciała i przewlekłą glikokortykosteroidoterapię. Dodatkowo poruszono rolę powikłań zakrzepowo-zatorowych w etiologii ostrych incydentów wieńcowych u pacjentów z SLE. Dotychczas nie określono jednoznacznych wytycznych dotyczących profilaktyki pierwotnej i wtórnej u chorych na SLE. W celu zmniejszenia odsetka zgonów z powodu powikłań sercowo-naczyniowych u pacjentów z SLE zwrócono uwagę na szczególną rolę wczesnej diagnostyki opartej na badaniach obrazowych

Assessment of selected B cells populations in the workers of X-ray departments

Objectives: Workers of X-ray departments are occupationally exposed to long-term low levels of ionizing radiation (LLIR), which may affect their humoral immunity. The aim of the study was to assess the influence of LLIR on the number and proportion of B cells (CD19+), B1 cells (CD5+CD19+) and memory B cells (CD27+CD19+) in peripheral blood of such workers. Materials and Methods: In the study group of 47 X-ray departments workers and the control group consisting of 38 persons, the number and percentage of CD19+, CD5+CD19+, CD27+CD19+ cells as well as CD5+CD19+/CD19+ and CD27+CD19+/CD19+ cell ratios were assessed using flow cytometry. Additionally, the study group was divided into 2 groups by the length of employment below and over 15 years and analysis adjusted for age and smoking habit was performed. Results: The total number of CD19+ cells showed significant increase in the group of workers in comparison with the persons from the control group, whereas the percentage of CD5+CD19+ cells as well as CD27+CD19+/CD19+ and CD5+CD19+/CD19+ cell ratios were lower. Percentage, number of CD5+CD19+ cells and CD5+CD19+/CD19+ cell ratio were significantly lower in the workers with length of employment longer than 15 years in comparison with those employed below 15 years. Moreover, we found positive associations between the number of CD19+ cells and employment as well as smoking habit, whereas the number of CD5+CD19+ cells was positively associated with cigarette smoking alone. Percentage of CD5+CD19+ cells as well as CD5+CD19+/CD19+ and CD27+CD19+/CD19+ cell ratios were negatively correlated with employment. Conclusions: The study suggests association between the suppressive influence of low level ionizing radiation on circulating in peripheral blood, especially of B1 cells as well as of memory B cells, in workers of X-ray units, which is adverse in relation to microbiological threat

Evaluation of selected population of lymphocytes and concentrations of immunoglobulins in workers of interventional cardiology wards using low doses of ionizing radiation in cardiovascular procedures

INTRODUCE The aim of the study was to determinate the effect of low X-ray doses on the percentage and number of peripheral blood lymphocytes T (CD3+), T helper (CD4+), T cytotoxic (CD8+), lymphocytes B (CD19+), activated T lymphocytes (CD3+CD25+) and activated T helper lymphocytes (CD4+CD25+) as well as serum immunoglobulins (IgM, IgG and IgA) concentration in workers of an interventional cardiology ward. MATERIAL AND METHODS The study was performed among a group of 40 workers (28 women and 12 men) and a control group of 35 persons (25 women and 10 men). Flow cytometry was used for the analysis of lymphocytes and the turbidimetric method for assessing serum immunoglobulin concentrations. RESULTS The study showed a decreased percentage and number of CD3+CD25+ and CD4+CD25+ cells as well as IgG concentration in interventional cardiology ward staff in comparison to the control group. A negative correlation between the length of employment and percentage of CD3+CD25+ was found. CONCLUSION The study indicates suppressive impact low doses of ionizing radiation on activated T cells, activated T helper cells as well as IgG production that is adverse in relation to the existing risk of infections caused by different microorganisms.WSTĘP Celem pracy była ocena oddziaływania niskich dawek promieniowania jonizującego na odsetek i liczbę limfocytów T (CD3+), limfocytów T pomocniczych (CD4+), limfocytów T cytotoksyczych (CD8+), limfocytów B (CD19+), aktywowanych limfocytów T (CD3+CD25+) i aktywowanych limfocytów T pomocniczych (CD4+CD25+) oraz stężeń immunoglobulin IgM, IgG i IgA u pracow-ników oddziału kardiologii interwencyjnej. MATERIAŁ I METODY Badanie przeprowadzono w grupie 40 zatrudnionych (28 kobiet i 12 mężczyzn) oraz w grupie kontrolnej 35 osób (25 kobiet i 10 mężczyzn). Badania limfocytów krwi obwodowej przeprowadzono z wykorzystaniem cytometrii przepływowej, a stężenia immunoglobulin w surowicy oznaczono metodą turbidymetryczną. WYNIKI W badanej grupie pracowników – w porównaniu z grupą kontrolną – wykazano znamienne obniżenie liczby i odsetka limfocytów CD3+CD25+ i CD4+CD25+ oraz stężeń immunoglobuliny IgG. Wykazano także istnienie negatywnej korelacji między okresem zatrudnienia badanych pracowników a odsetkiem limfocytów CD3+CD25+. WNIOSEK Badanie wskazuje na supresyjne oddziaływanie niskich dawek promieniowania jonizującego na aktywowane limfocyty T, aktywowane limfocyty T pomocnicze i produkcję IgG, co nie jest korzystne w odniesieniu do istniejącego ryzyka zakażeń drobnoustrojami