Binding of Superantigen Toxins into the CD28 Homodimer Interface Is Essential for Induction of Cytokine Genes That Mediate Lethal Shock

Bacterial superantigen toxins bind directly to the dimer interface of CD28, the principal co-stimulatory receptor, to induce a lethal cytokine storm, and peptides that prevent this binding can suppress superantigen lethality

The 2023 ACR/EULAR Classification Criteria for Calcium Pyrophosphate Deposition Disease

ObjectiveCalcium pyrophosphate deposition (CPPD) disease is prevalent and has diverse presentations, but there are no validated classification criteria for this symptomatic arthritis. The American College of Rheumatology (ACR) and EULAR have developed the first-ever validated classification criteria for symptomatic CPPD disease.MethodsSupported by the ACR and EULAR, a multinational group of investigators followed established methodology to develop these disease classification criteria. The group generated lists of candidate items and refined their definitions, collected de-identified patient profiles, evaluated strengths of associations between candidate items and CPPD disease, developed a classification criteria framework, and used multi-criterion decision analysis to define criteria weights and a classification threshold score. The criteria were validated in an independent cohort.ResultsAmong patients with joint pain, swelling, or tenderness (entry criterion) whose symptoms are not fully explained by an alternative disease (exclusion criterion), the presence of crowned dens syndrome or calcium pyrophosphate crystals in synovial fluid are sufficient to classify a patient as having CPPD disease. In the absence of these findings, a score >56 points using weighted criteria, comprising clinical features, associated metabolic disorders, and results of laboratory and imaging investigations, can be used to classify as CPPD disease. These criteria had a sensitivity of 92.2% and specificity of 87.9% in the derivation cohort (190 CPPD cases, 148 mimickers), whereas sensitivity was 99.2% and specificity was 92.5% in the validation cohort (251 CPPD cases, 162 mimickers).ConclusionThe 2023 ACR/EULAR CPPD disease classification criteria have excellent performance characteristics and will facilitate research in this field

Independent Sets in Hypergraphs with Applications to Routing Via Fixed Paths

The problem of finding a large independent set in a hypergraph by an online algorithm is considered. We provide bounds for the best possible performance ratio of deterministic vs. randomized and nonpreemptive vs. preemptive algorithms. Applying these results we prove bounds for the performance of online algorithms for routing problems via fixed paths over networks

T-Cell responses to pandemic swine-origin H1N1 influenza vaccination in patients with Rheumatic Diseases

Fil: Elkayam, Ori. Tel Aviv University. Tel Aviv Medical Center. Department of Rheumatology; IsraelFil: Arad, Uri. Tel Aviv University. Tel Aviv Medical Center. Department of Rheumatology; IsraelFil: Amir, Sharon. Tel Aviv University. Tel Aviv Medical Center. Department of Rheumatology; IsraelFil: Caspi, Dan. Tel Aviv University. Tel Aviv Medical Center. Department of Rheumatology; IsraelThe cellular response of IL-2 producing CD8+ cells following vaccination against pandemic influenza H1N1 is impaired in patients suffering froma RA, SLE, PsA and AS in comparison with healthy controls. The IFN producing CD8+ T-cell response was similar in patients and controls. Following HINI vaccination, the percentage of IFN prducing CD4+ cells increased in the SLE, PsA and AS groups while it decreased in RA and healthy groups

Ultrasound Assesment of Enthesis Thickenin in Psoriatic Arthritis : patients treated with adalimumab compared to Methotrexate

Fil: Elkayam, Ori. Tel Aviv Medical Center. Department of Rheumatology; IsraelFil: Caspi, Dan. Tel Aviv Medical Center. Department of Rheumatology; IsraelFil: Paran, Daphna. Tel Aviv Medical Center. Department of Rheumatology; IsraelFil: Arad, Uri. Tel Aviv Medical Center. Department of Rheumatology; IsraelFil: Balbir, Alexandra. Rambam Health Care. Department of Rheumatology; IsraelFil: Wollman, Jonathan. Tel Aviv Medical Center. Department of Rheumatology; IsraelFil: Litinsky, Irena. Tel Aviv Medical Center. Department of Rheumatology; IsraelIn patients with PsA, treatment with ADA, compared to MTX, significantly improved signs of disease activity, as well as several ultrasonic parameters of enthesis, such as Achilles tendons and facial aponeurosis, within 3 months of treatment. US monitoring of enthesis is an additional useful tool in the monitoring of psoriatic enthesopathy