Evaluación de la presencia de anticuerpos anti proteínas/péptidos carbamilados y su asociación con variables de actividad reumatológica y periodontal en pacientes con ar temprana y familiares en primer grado de consanguinidad

Introducción: La Artritis Reumatoide (AR), es una enfermedad inflamatoria autoinmune caracterizada por destrucción del cartílago y hueso además de producción de autoanticuerpos. La AR está asociada a modificaciones postraduccionales como la carbamilación, proceso que induce la formación de autoanticuerpos dirigidos a diferentes proteínas. Estos anticuerpos se asocian a severidad y progresión de la enfermedad y se han observado antes de la aparición de los síntomas clínicos, por esto la importancia de estudiar estadios tempranos de AR (ART) y familiares consanguíneos (FDR). Se conoce que hay diferencia en la presencia de anticuerpos anti proteínas/péptidos carbamilados entre ART y controles sanos, pero no entre FDR comparado con controles por lo que este trabajo explora cuál es la asociación entre la presencia de anticuerpos anti proteínas/péptidos carbamilados con variables reumatológicas en estos individuos. Metodología: Los anticuerpos anti fibrinógeno carbamilado (anti-FCS-Carp) y anti péptidos de fibrinógeno carbamilados (anti-Ca-Fib2 y anti-Ca-Fib3) en pacientes con ART y FDR pareados con controles fueron medidos por ELISA. Las asociaciones se analizaron por Chi cuadrado y test exacto de Fisher. Las comparaciones por prueba de McNemar y se realizó una regresión logística condicional ajustando posibles variables de confusión (edad y consumo de cigarrillo) para establecer la asociación entre anti-FSC-Carp o anti-Fib-Carp y la condición de AR y FDR. Resultados: Se observó mayor frecuencia en la aparición de anticuerpos anti-CCP en FDR (19.3%) comparado con el grupo CTRL (6.45%), mostrándose una asociación de riesgo tres veces mayor en este grupo de individuos (OR 3.6 95%IC: 21.44-11.05 p=0.002).Así mismo, este grupo de sujetos presentaron mayor número de articulaciones dolorosas (37.9%) vs CTRL (22.58%) (OR 2.18 95%IC: 1.17-4.23 p=0.007), y mayor número de articulaciones inflamadas en FDR 15.32% vs 4.03% de los controles, (OR 5.6 95%IC: 1.63- 30.18 p=0.002). en el grupo de ART el EC se encontró en un 52.9% y de estos el 54.9% presentaban al menos un alelo y el 11.8% expresaron dos alelos HLA-DRB1 EC en el grupo FDR La presencia de EC estuvo en el 53.2% y el 45.2% presentaban al menos un alelo y el 8.1% expresaron dos alelos HLA-DRB1 EC . En cuanto a la frecuencia positiva de los anticuerpos anti-FCS-Carp positivo en el grupo de pacientes comparado con el grupo control se encontro una diferencia de 47.1% vs. l7.8%, respectivamente, (OR 7.6 95%IC: 2.3-39.88 p= 0.0001), y en cuanto a la frecuencia positiva de los anticuerpos contra los péptidos carbamilados solo los anti-Ca-Fib2 positivos se encontraron en mayor porcentaje 47,1% pacientes vs 13,7% en CTRL (OR 6.6 95%IC: 1.97- 35.0 p = 0.0005), los anti-FCS-Carp se asociaron con el alelo no EC *1501 (p= 0.033) y con el alelo EC*1402 (p=0.027) , los anticuerpos anti-Ca-Fib2 se asociaron con la presencia de FR positivo (p = 0.022) y con anti-CCP positivo mayor a 60 U (p = 0.032) y con alelos HLA-DRB1 EC *0405 (p= 0.050) y los anti-Ca-Fib3 se asoció con DAS28-VSG (p= 0.046) y con el alelo HLA-DRB1 EC *1402 (p=0.050) . Por otro lado, se observó un mayor porcentaje de los anti-FCS-Carp positivo en el grupo de FDR comparado con de los CTRL 25.00% vs 14.52%, respectivamente (OR 2.625 95%IC: 1.11-6.85 p=0.015). Los anti-Ca-Fib2 positivos estaban presenten un mayor porcentaje 34.68% vs 15.32% FDR respecto a los CTRL, respectivamente (OR 4.0 95%IC: 1.80-10.04 p=0.001)., Los anti-Ca-Fib3 positivos predominaron también en un mayor porcentaje en los FDR 33.06% vs 11.29% CTRL (OR 4.85 95%IC: 2.11- 12.98 p=0.001), los anticuerpos anti-FCS-Carp se asociaron con la presencia del alelo EC *1402 (p=0.035) y también se encontró asociación con niveles de PCR (p=0.016) y se correlacionó débilmente con FR (r =0.26 p=0.0034) y, con la presencia de articulaciones dolorosas (r = 0.18 p=0.0425)los anti-Ca-Fib2 se asociaron con la presencia del alelo HLA-DRB1 EC *1501 (p=0.03) y los anti-Ca-Fib3 demostraron una asociación con FR positivo (p= 0.0012) además se encontró que la condición de FDR se asocia con la presencia de anti-Ca-Fib3 (OR 2.976 95%IC: 1.084-8.166 p=0.034) y con la presencia de articulaciones dolorosas (OR 2.28295%IC: 1.047-4.971 p=0.038) Conclusión: La respuesta humoral en ART puede estar restringida en parte a regiones específicas de la cadena β de fibrinógeno carbamilado pudiéndose considerar a futuro como otro biomarcador de esta enfermedad en un subgrupo de pacientes. Los autoanticuerpos anti péptidos anti-Ca-Fib3 y anti- Ca-Fib2 pueden ser importantes marcadores en sujetos sanos con riesgo genético (FDR) debido a la relación encontrada con manifestaciones inflamatorias articulares que podría sugerirlos potenciales biomarcadores tempranos para el desarrollo de AR.Departamento Administrativo de Ciencia, Tecnología e Innovación (Colciencias)Hospital Militar CentralIntroduction: Rheumatoid Arthritis (RA) is an inflammatory autoimmune disease characterized by the destruction of cartilage and bone as well as the production of autoantibodies. RA is associated with post-translational modifications such as carbamylation, a process that induces the formation of autoantibodies directed to different proteins. These were associated with a severity and progression of the disease and have been observed before the onset of clinical symptoms, for example, the importance of studying the temporal stages of RA (ART) and blood relatives (FDR). It is known that there is a difference in the presence of carbamylated protein / peptide antibodies between ART and healthy controls, but not between FDR and controls, so that this work exploits the association between the presence of carbamylated proteins / peptides antibodies with rheumatological variables. in these individuals. Methodology: Antibodies against carbamylated fibrinogen (anti-FCS-Carp) and anti-carbamylated fibrinogen peptides (anti-Ca-Fib2 and anti-Ca-Fib3) in patients with ART and FDR. The associations were analyzed by Chi square and Fisher's test. The comparisons by the McNemar test and a logistic regression of the situation were adjusted to the possible confounding variables (age and cigarette consumption) to establish the association between anti-FSC-Carp or anti-Fib-Carp and the condition of AR and FDR. Results: A higher frequency was observed in the appearance of anti-CCP antibodies in FDR (19.3%) compared to the CTRL group (6.45%), showing a risk association three times higher in this group of individuals (O 3.6 95% CI : 21.44-11.05 p = 0.002) .Similarly, this group of subjects had a greater number of painful joints (37.9%) vs CTRL (22.58%) (OR 2.18 95% CI: 1.17-4.23 p = 0.007), and more Inflamed joints in FDR 15.32% vs 4.03% of controls, (OR 5.6 95% CI: 1.63- 30.18 p = 0.002). in the ART group the EC was found in 52.9% and 54.9% presented in less than one allele and 11.8% expressed two alleles HLA-DRB1 EC in the FDR group The presence of EC was in 53.2% and 45%. , 2% present at least one allele and 8.1% express two HLA-DRB1 EC alleles. Regarding the positive frequency of anti-FCS-positive Carp antibodies in the group of patients compared with the control group, a difference of 47.1% versus 17.8%, respectively, was found (OR 7.6 95% CI: 2.3-39.88 p = 0.0001), and in terms of the positive frequency of the antibodies against the carbamylated peptides, only the results of anti-Ca-Fib2 positive were found in a higher percentage of 47.1% patients vs 13.7% in CTRL (OR 6, 6 95% CI: 1.97-35.0 p = 0.0005), the anti-FCS-Carp was associated with the non-EC allele * 1501 (p = 0.033) and with the EC allele * 1402 (p = 0.027), the anti- Ca-Fib2 was associated with the presence of positive FR (p = 0.022) and with anti-CCP positive greater than 60 U (p = 0.032) and with alleles HLA-DRB1 EC * 0405 (p = 0.050) and anti-Ca Fib3 was associated with DAS28-VSG (p = 0.046) and with the allele HLA-DRB1 EC * 1402 (p = 0.050). On the other hand, a higher percentage of anti-FCS-positive Carp was observed in the FDR group compared to the CTRL 25.00% vs 14.52%, respectively (OR 2.625 95% CI: 1.11-6.85 p = 0.015). The results of anti-Ca-Fib2 positive were present in a higher percentage of 34.68% vs 15.32% FDR with respect to the CTRL, respectively (O 4.0 95% CI: 1.80-10.04 p = 0.001)., The results of anti-Ca -Fib3 also predominated in a higher percentage in the FDR 33.06% vs 11.29% CTRL (OR 4.85 95% CI: 2.11- 12.98 p = 0.001), the anti-FCS-Carp antibodies were associated with the presence of the allele EC * 1402 ( p = 0.035) and it was also associated with CRP levels (p = 0.016) and it was weakly correlated with FR (r = 0.26 p = 0.0034) and, with the presence of painful joints (r = 0.18 p = 0.0425) the anti- Ca-Fib2 was associated with the presence of the allele HLA-DRB1 EC * 1501 (p = 0.03) and the anti-Ca-Fib3 demonstrated an association with positive FR (p = 0.0012) also refer to the condition of FDR are associated with the presence of anti -Ca-Fib3 (OR 2.976 95% CI: 1.084-8.166 p = 0.034) and with the presence of painful joints (OR 2.28295% CI: 1.047-4.971 p = 0.038) Conclusion: The humoral response in ART may be restricted in part to specific regions of the beta chain of carbamylated fibrinogen, we could consider a future as another biomarker of this disease in a subgroup of patients. Antibody autoantibodies anti-Ca-Fib3 and anti-Ca-Fib2 may be important in subjects with genetic risk (FDR) due to the relationship with inflammatory artifacts that may suggest them to early biomarkers for the development of RA.Magíster en Ciencias BiológicasMaestrí

Porphyromonas gulae y los anticuerpos PPAD no están relacionados con la citrulinación en la artritis reumatoide

Introducción: Porphyromonas gulae posee la enzima PPAD, al igual que P. gingivalis, responsable de la citrulinación relacionada con la fisiopatología de la artritis reumatoide y la periodontitis; esto implica la presencia de dos especies de bacterias productoras de PPAD en la boca, así como la presencia de proteínas citrulinadas. No existen informes ni estudios previos que investiguen una asociación entre la PPAD de P. gulae en la artritis reumatoide (AR). Objetivo: Evaluar la presencia de P. gulae y anticuerpos antipéptido citrulinado de P. gulae PAD en pacientes con AR y su posible relación con marcadores de actividad clínica. Sujetos y métodos: Se incluyeron un total de 95 pacientes con AR y 95 controles. Se midieron la velocidad de eritrosedimentación (VSG), la proteína C reactiva, los anticuerpos antiproteínas citrulinadas (ACPA) y el factor reumatoide (FR). Índice de actividad-28 (DAS28) y SCDAI. Se estableció el diagnóstico periodontal. Presencia de P. gulae y P. gingivalis. Se utilizó un ELISA para determinar anticuerpos contra los péptidos citrulinados del PAD de P. gulae. Resultados: Se observó una frecuencia de P. gulae del 15,8% en el grupo AR y del 9,5% en el grupo control. Se encontraron mayores niveles de ACPA en los pacientes P. gulae-positivos del grupo AR, sin encontrar diferencias significativas, pero si en los pacientes positivos para P. gingivalis con significación estadística (p = 0,0001). La frecuencia de anticuerpos anti-VDK-cit y anti-LPQ-cit9 frente a PPAD de P. gulae fue mayor en el grupo AR que en el grupo control sin diferencia significativa. No se halló ninguna relación con las variables clínicas a pesar de la presencia de anticuerpos contra el péptido P. gulae y anticuerpos antipéptido citrulinado de la PPAD de P. gulae en pacientes con AR Conclusiones: No fue posible establecer una conexión con las variables clínicas en AR y P. gulae; como resultado, la presencia de P. gingivalis sigue contribuyendo significativamente al aumento de anticuerpos contra proteínas/péptidos citrulinados de fuentes exógenas de citrulinación en AR y periodontitisIntroduction: Porphyromonas gulae have the enzyme PPAD, as P. gingivalis, which is responsible for citrullination related to the pathophysiology of rheumatoid arthritis and periodontitis; this implies the presence of two species of PPAD-producing bacteria in the mouth as well as the presence of citrullinated proteins. There are no previous reports or studies investigating an association between P. gulae PPAD in rheumatoid arthritis (RA). Objective: To assess the presence of P. gulae and anti-citrullinated peptide antibodies of P. gulae PAD in patients with RA and their possible relationship with clinical activity markers. Subjects and methods: A total of 95 patients with RA and 95 controls were included. Erythrocyte sedimentation rate (ESR), C-reactive protein, anti-citrullinated protein antibodies (ACPAs) and rheumatoid factor (RF) were measured. Activity index-28 (DAS28) and SCDAI. The periodontal diagnosis was established. Presence of P. gulae and P. gingivalis. An ELISA was used to determine antibodies against citrullinated peptides of P. gulae PAD. Results: A P. gulae frequency of 15.8% was observed in the RA group and 9.5% in the control group. Higher levels of ACPA were found in the P. gulae-positive patients of the RA group, finding no significant difference, but if in patients positive for P. gingivalis with statistical significance (p = 0.0001). The frequency of anti-VDK-cit and anti-LPQ-cit9 antibodies to PPAD of P. gulae was higher in the RA group than in the control group without significant difference. No relationship was found with the clinical variables despite the presence of P. gulae and anti-citrullinated peptide antibodies of P. gulae PPAD in patients with RA Conclusions: It was not possible to establish a connection with clinical variables in RA and P. gulae; as a result, the presence of P. gingivalis continues to contribute significantly to the increase in antibodies against citrullinated proteins/peptides from exogenous sources of citrullination in RA and periodontitis

Anti-carbamylated protein and peptide antibodies as potential inflammatory joint biomarkers in the relatives of rheumatoid arthritis patients

*Q3Objective: Antibodies against carbamylated proteins/peptide (CarP) have been associated with severity in rheumatoid arthritis (RA) patients. However, their role in risk groups, specific targets and relation with periodontal disease (PD) is uncertain yet. The aim of this study was evaluated the association between the levels of anti- CarP with clinical manifestation, human leukocyte antigen (HLA) alleles, periodontal activity markers, PD diagnosis, PD severity, and presence of Porphyromonas gingivalis (P gingivalis) in relatives of patients with RA. Methods: One hundred and twenty-four individuals with a family history of RA in first-degree relatives (FDR) and 124 healthy individuals gender- and age-matched, RA activity was assessed. Antibodies against carbamylated protein anti-FCS-Carp and 2 carbamylated peptides of fibrinogen were selected (anti-Ca-Fib2, anti-Ca-Fib3). Results: Anti-FCS-Carp-positive, anti-Ca-Fib2 and anti-Ca-Fib3 were more frequent in FDR than controls (25.0% vs 14.5%, 34.7% vs 15.3% and 33.1% vs 11.3%, respectively). Anti-FCS-CarP were associated with the HLA-DRB1-SE* 1402 allele (P = .035) and highly sensitive C-reactive protein levels (P = .016), the anti-Ca-Fib2 antibodies were associated with the HLA-DRB1-SE* 1501 allele (P = .03), with non-SE* 0901 allele (P = .01), the anti-Ca-Fib3 was associated with positive rheumatoid factor (P = .0012). The FDR condition was associated with the presence of anti-Ca-Fib3 (odds ratio [OR] =4.7; 95% CI = 1.8-11.7; P = .001) and painful joints (OR = 2.2; 95% CI = 1.01-4.68; P = .045); we also detected an important trend toward the presence of P gingivalis (OR = 1.9; 95% CI = 0.9-3.7; P = .062). Conclusion: The presence of anti-FCS-Carp, anti-Ca-Fib3 and anti-Ca-Fib2 antibodies may have a role for these antibodies as early biomarkers in the development of RA, probably including additional mechanisms related with other non-SE alleles; the anti-peptide antibodies proposed in the present study may represent a simpler way to identify antibodies directed to a specific target.N/

Niveles elevados de leptina y adipsina se asocian con la actividad clínica en pacientes con artritis reumatoide temprana con sobrepeso e infección periodontal

Las adipocinas están asociadas a la patogénesis de la artritis reumatoide (AR) y son biomarcadores potenciales de la actividad de la enfermedad, la periodontitis y la obesidad. El objetivo era establecer la asociación entre el perfil de adipocinas, la actividad de la enfermedad de la AR, el índice de masa corporal y la infección periodontal. En este estudio se evaluaron 51 pacientes con AR temprana y 51 controles, incluyendo marcadores reumatológicos séricos, niveles de adipocinas, detección de Porphyromonas gingivalis y anticuerpos séricos anti-Porphyromonas gingivalis, y mediciones clínicas y periodontales. Se realizaron análisis estadísticos con SPSS® V26, con un modelo de regresión logística para confirmar las asociaciones. Los resultados muestran que los niveles elevados de leptina eran más frecuentes en pacientes (p = 0,001) que presentaban simultáneamente una mayor frecuencia de Porphyromonas gingivalis (p = 0,004). Los pacientes con presencia concomitante de Porphyromonas gingivalis, alta puntuación de actividad clínica y sobrepeso se correlacionaron con altos niveles de leptina (OR, 7,20; IC 95%, 2,68-19,33; p = 0,0001) y adipsina (OR, 2,69; IC 95%, 1,00-7,28; p = 0,005). La conclusión es que los niveles elevados de leptina y adipsina se asocian a una mayor actividad clínica en pacientes con AR temprana con sobrepeso e infección periodontal, por lo que el sobrepeso y Porphyromonas gingivalis pueden potenciar la actividad de la AR. Esto puede representar un mecanismo patológico entre estas condiciones, donde las adipokinas parecen tener un papel clave.Adipokines are associated with the pathogenesis of rheumatoid arthritis (RA) and are potential biomarkers of disease activity, periodontitis, and obesity. The aim of this was to establish the association between adipokine profile, RA disease activity, body mass index, and periodontal infection. This study evaluated 51 patients with early-RA and 51 controls including serum rheumatological markers, adipokine levels, detection of Porphyromonas gingivalis and serum anti-Porphyromonas gingivalis antibodies, clinical and periodontal measurements. Statistical analyses were run with SPSS® V26, with a logistic regression model to confirm associations. The results show high levels of leptin were more frequent in patients (p = 0.001) who simultaneously showed a higher frequency of Porphyromonas gingivalis (p = 0.004). Patients with concomitant presence of Porphyromonas gingivalis, high clinical activity score, and overweight were correlated with high levels of leptin (OR, 7.20; 95% CI, 2.68–19.33; p = 0.0001) and adipsin (OR, 2.69; 95% CI, 1.00–7.28; p = 0.005). The conclusion is that high levels of leptin and adipsin are associated with greater clinical activity in early-RA patients with overweight and periodontal infection, whereby overweight and Porphyromonas gingivalis may enhance RA activity. This may represent a pathological mechanism between these conditions, where adipokines seem to have a key role

P050 Oral inflammatory changes associated with inflammatory bowel disease in spondyloarthritis associated with early endoscopic findings

BACKGROUND: Spondyloarthritis (SpA) is a heterogeneous group of chronic autoinflammatory disorders that can present extra-articular gastrointestinal manifestations. Among them is mainly inflammatory bowel disease (IBD). Although IBD mainly affects the intestinal tract, it can include early manifestations evident in the oral cavity. No comparative data on these oral manifestations in patients with SpA were found in the literature. OBJECTIVE: To identify oral clinical manifestations due to changes in the oral mucosa associated with IBD in patients with SpA without a diagnosis of IBD and associate them with endoscopic and histological findings. METHODS: 80 patients with SpA and 52 healthy controls were evaluated. They were assessed intra- and extra-orally, following the modified World Health Organization guideline. In addition, by clinical parameters of rheumatological, gastrointestinal and laboratory activity. Ileocolonoscopy was performed with digital chromoendoscopy with magnification and histological analysis. Comparative analyzes were performed by Chi square tests, Fisher's exact tests, confirmed by univariate regression and discriminant analysis of multiple correspondences. Institutional ethics committee approval cod-2017-023. RESULTS: The patients with SpA had 56% male gender, mean age of 42.8 years (SD ± 10.4) and a BMI in the range of 23.9 - 28.4. The healthy controls, 54% of the male gender with an average age of 41 years (SD ± 13.6) and a body mass index-BMI in the range of 22.9 - 27.6. The patients reported smoking only in 6.2%, however as a smoking history in 31% and passive smokers (15%), the majority employed (41%), married (56%) and professionals (49%). Of the healthy controls, they smoked (15%), with a history of smoking (31%), passive smokers (21%), the majority employed (77%), with their own home (67%), and professionals (54%). The patients with SpA reported a greater presence of some signs and symptoms of gastrointestinal origin 69%, while in the controls it was 7.7% (p = 0.001). Forty one of them were referred to colonoscopy with magnification being in 17.1 % changes in the mucosa of the rectum and in the same frequency changes in the mucosa of the sigmoid colon. Regarding the ileum, changes in the mucosa were evidenced in 41.5% of the cases. The presence of oral lesions was evident and predominated in them (63%) compared to controls p = 0.050. The main oral lesions associated with IBD were gingivitis (55%) (p = 0.001), followed by aphthous stomatitis (3.8%), angular cheilitis (2.6%) and perioral erythema with scaling (1.3%). 100% of the patients who presented alteration of the colonic mucosa presented oral lesions associated with IBD (p = 0039), which was also significantly associated with the presence of gingivitis/aphthous stomatitis (p = 0.029). CONCLUSION: Patients with SpA without a diagnosis of IBD have more oral signs and symptoms compared to healthy controls. Gingivitis is important given its association with early endoscopic and histological findings. Manifestations in the oral cavity can precede intestinal manifestations, therefore the clinical assessment by the oral pathologist in conjunction with gastroenterology and rheumatology allows a timely referral to gastroenterology and an endoscopic and histological evaluation, impacting the quality of life of patients

Aplicación de criterios de cribado de la enfermedad inflamatoria intestinal en pacientes con espondiloartritis y su asociación con la enfermedad y la actividad endoscópica

Existe poca bibliografía sobre la aplicación de criterios de cribado de la enfermedad inflamatoria intestinal (EII) en pacientes con espondiloartritis (EPS). Este estudio tenía como objetivo aplicar criterios de cribado de EII en un grupo de pacientes con EspA sin diagnóstico de EII y correlacionarlos con los hallazgos endoscópicos y la actividad de la enfermedad. Se incluyó a un total de 82 pacientes con EspA. Se realizó la prueba de cribado de la EII y una ileocolonoscopia con cromoendoscopia digital con aumento y análisis histológico. Los datos se analizaron con la prueba de Chi-cuadrado/prueba exacta de Fisher y análisis de correspondencias múltiples. Los principales criterios de cribado encontrados en el 48,7% de los pacientes estaban asociados a antecedentes de infección (p = 0,037). La hemorragia rectal se asoció al diagnóstico de espondilitis anquilosante, inflamación aguda, entesitis y alteración de la arquitectura tisular en el íleon (p < 0,050). La diarrea se asoció a una mayor puntuación de la actividad de la enfermedad (p = 0,02). Los criterios de cribado menores se asociaron con una articulación inflamatoria dolorosa (p = 0,05), una puntuación elevada de la actividad de la enfermedad (p = 0,001) y niveles elevados de calprotectina (p = 0,050). El dolor abdominal (36,9%) se asoció con compromiso axial/periférico (p = 0,017), dolor lumbar inflamatorio (p = 0,01), entesitis (p = 0,021), mayor puntuación de actividad de la enfermedad (p = 0,023) e inflamación aguda del íleon (p = 0,046). La diarrea de 4 semanas y el dolor abdominal fueron los criterios de cribado mayor y menor más prevalentes, respectivamente, estando relacionados con manifestaciones tempranas de compromiso inflamatorio intestinal y mayor puntuación de actividad de la enfermedad. Esta prueba de cribado ofrece la posibilidad de derivar oportunamente a los pacientes con EAE de reumatología a gastroenterología.There is little literature on the implementation of screening criteria for inflammatory bowel disease (IBD) in patients with spondyloarthritis (SpA). This study aimed to apply IBD screening criteria in a group of patients with SpA without IBD diagnosis and correlate them to endoscopic findings and disease activity. A total of 82 patients with SpA were included. The IBD screening test and ileocolonoscopy with digital chromoendoscopy with magnification and histological analysis were performed. The data were analysed with Chi-square test/Fisher’s exact test and multiple correspondence analysis. The major screening criteria found in 48.7% of the patients were associated with a history of infection (p = 0.037). Rectal bleeding was associated with the diagnosis of ankylosing spondylitis, acute inflammation, enthesitis and tissue architecture alteration in the ileum (p < 0.050). Diarrhoea was associated with a higher disease activity score (p = 0.02). Minor screening criteria were associated with painful inflammatory joint (p = 0.05), high disease activity score (p = 0.001) and high calprotectin levels (p = 0.050). Abdominal pain (36.9%) was associated with axial/peripheral compromise (p = 0.017), inflammatory back pain (p = 0.01), enthesitis (p = 0.021), higher disease activity score (p = 0.023) and acute ileum inflammation (p = 0.046). Diarrhoea of 4 weeks and abdominal pain were the most prevalent major and minor screening criteria, respectively, being related to early manifestations of inflammatory bowel compromise and higher disease activity score. This screening test grants a chance of opportune referral of SpA patients from rheumatology to gastroenterology

Porphyromonas gulae : principal patógeno periodontal en mascotas encontrado en pacientes con artritis reumatoide

Introducción. Actualmente la Artritis Reumatoide se asocia fuertemente con la periodontitis por el proceso de citrulinación generado por las enzimas Peptidil-Arginina-Deiminasa (PAD) presentes en la Porphyromonas gingivalis. La P. gulae patógeno de mascotas presenta en su estructura factores de virulencia similares a P. gingivalis. Objetivo. Evaluar presencia de P. gulae y de anticuerpos anti péptidos citrulinados de PAD de P. gulae en pacientes con AR y su posible asociación con marcadores clínicos de actividad. Métodos. Se incluyeron 95 pacientes con AR y 95 controles pareados por edad y sexo. La presencia de P. gulae y P. gingivalis se estableció mediante qPCR, la presencia de anticuerpos anti péptidos citrulinados de PAD de P. gulae (VDK-cit y LPK-cit) se determinó mediante ensayo de ELISA in-house. Se hicieron asociaciones con datos clínicos mediante las pruebas estadísticas Kruskal Wallis, U de Mann Whitney y Análisis discriminante de correspondencias múltiples. Resultados. Se observó una frecuencia de P. gulae en el grupo de AR de 15.8% frente a controles de 9,5%, sin asociarse con actividad clínica articular ni diagnóstico de periodontitis. De los 180 individuos evaluados, 17 tuvieron presencia de anticuerpos anti-péptidos citrulinados de PAD de P. gulae. Conclusiones. A pesar de la presencia de P. gulae y anticuerpos anti péptidos citrulinados de PAD de P. gulae en pacientes con AR, no fue posible establecer la relación con las variables clínicas, lo cual podría indicar un aporte menor de este microorganismo al mecanismo biológico y molecular de la citrulinación común entre Artritis Reumatoide y periodontiti

HLA-B Allele, Genotype, and Haplotype Frequencies in a Group of Healthy Individuals in Colombia

6 páginasBackground The sequencing of alleles of the HLA-B, a human leukocyte antigen (HLA) class I gene, was established as the most polymorphic of chromosome 6 and of the entire human genome. In this locus, the HLA-B*27 allele is highly polymorphic and has clinical relevance. Literature about the subtypes and singular frequency of these alleles in Colombia’s healthy population is scarce. Objective The aim of this study was to establish the HLA-B allele, genotype, and haplotype frequencies in a healthy Colombian population and analyze their association with the sex and geographical distribution of the individuals studied. Methods This is a nonexperimental and descriptive study. The data from whole-blood samples whose HLA genes were genotyped by protocol with the Luminex 100/200 xMAP technology were evaluated. HLA-B*27 positivity was confirmed by the new-generation sequencing technology. The associations between the HLA-B alleles and demographic variables were evaluated by χ2 and Fisher exact tests. Results Twenty-seven HLA-B genotypes were identified in 255 individuals, with the highest frequencies for HLA-B*35 (44.7%), B*40 (19.6%), and B*44 (16.8%). Additionally, 89 HLA-B alleles were found; the most common were HLA-B*35:01 (6.7%) and B*40:02 (6.5%). Nine individuals tested positive for the HLA-B*27 allele with genotype and allele frequencies of 3.5% and 1.8%, respectively; the HLA-B*27:05:02 subtype predominated. Conclusions Here, we report the most common HLA-B allele, genotype, and haplotype frequencies in a healthy Colombian population group and analyzed their association with the sex and geographical distribution of the individuals studied. Results for the HLA-B*27 allele confirm racial mixing in Colombia with a high degree of Caucasian influence, as well as the repopulation of Colombia's central region, attributed to the migration phenomena. Results agree with data published in Colombia that was obtained from cord blood samples

Adipokines and periodontal markers as risk indicators of early rheumatoid arthritis: a cross-sectional study

Objective: To establish the association between adipokine levels and markers of periodontal involvement as risk indicators of early stages of RA (eRA) and the interaction between the presence of markers of periodontal disease with adipokine in eRA individuals. Materials and methods: Fifty-one patients with a diagnosis of eRA and 51 healthy controls matched for age and sex were studied. Clinical joint condition, clinical and serological markers of disease activity, serum adipokine levels (leptin, adiponectin, resistin, adipsin, vaspin, and IL-6), periodontal diagnosis, presence of Porphyromonas gingivalis, and related IgG1 and IgG2 antibodies were evaluated. Comparisons were made between eRA and healthy controls for periodontal indicators and adipokines. A subgroup analysis was realized with a non-conditional logistic regression to establish the association between the levels of leptin in individuals with eRA and controls according to the periodontal condition, presence of P. gingivalis, or high titers of IgG antibodies against P. gingivalis. Results: The condition of overweight or obesity is associated with the diagnosis of eRA (p = 0.05), and these individuals also have higher levels of leptin (p = 0.001) and vaspin (p = 0.007). Higher frequency of P. gingivalis (p = 0.001) was found in the eRa group. Individuals with eRA with higher IgG2 titers against P. gingivalis had higher levels of leptin (OR: 1.66 (CI 95% 1.01–2.73)); however, individuals with periodontitis or P. gingivalis with eRA were associated with highest levels of leptin (OR: 1.86, CI 95% 1.19–24.3; and OR: 2.04, CI 95% 1.37–3 respectively). Conclusions: eRA individuals have high levels of leptin and vaspin. However, the presence of periodontitis and related-periodontal disease markers showed an effect only in leptin levels in eRA individuals. Clinical relevance: Emphasizing in personalized medicine, monitoring serum leptin levels and periodontitis markers can improve the early diagnosis of RA

HLA-B Allele, Genotype, and Haplotype Frequencies in a Group of Healthy Individuals in Colombia

6 páginasBackground The sequencing of alleles of the HLA-B, a human leukocyte antigen (HLA) class I gene, was established as the most polymorphic of chromosome 6 and of the entire human genome. In this locus, the HLA-B*27 allele is highly polymorphic and has clinical relevance. Literature about the subtypes and singular frequency of these alleles in Colombia’s healthy population is scarce. Objective The aim of this study was to establish the HLA-B allele, genotype, and haplotype frequencies in a healthy Colombian population and analyze their association with the sex and geographical distribution of the individuals studied. Methods This is a nonexperimental and descriptive study. The data from whole-blood samples whose HLA genes were genotyped by protocol with the Luminex 100/200 xMAP technology were evaluated. HLA-B*27 positivity was confirmed by the new-generation sequencing technology. The associations between the HLA-B alleles and demographic variables were evaluated by χ2 and Fisher exact tests. Results Twenty-seven HLA-B genotypes were identified in 255 individuals, with the highest frequencies for HLA-B*35 (44.7%), B*40 (19.6%), and B*44 (16.8%). Additionally, 89 HLA-B alleles were found; the most common were HLA-B*35:01 (6.7%) and B*40:02 (6.5%). Nine individuals tested positive for the HLA-B*27 allele with genotype and allele frequencies of 3.5% and 1.8%, respectively; the HLA-B*27:05:02 subtype predominated. Conclusions Here, we report the most common HLA-B allele, genotype, and haplotype frequencies in a healthy Colombian population group and analyzed their association with the sex and geographical distribution of the individuals studied. Results for the HLA-B*27 allele confirm racial mixing in Colombia with a high degree of Caucasian influence, as well as the repopulation of Colombia's central region, attributed to the migration phenomena. Results agree with data published in Colombia that was obtained from cord blood samples