05 Lifestyle for lupus patients: exercise, diet, and well-being: perspectives from clinical practice

As systemic lupus erythematosus (SLE) is a chronic condition with a significant impact on physical and mental health, all potential interventions to improve quality of life are relevant for SLE patients. Among the possible non-pharmacological interventions, exercise and diet have a pivotal role.1 2 For SLE patients aerobic exercise programs are safe and effective on improving aerobic and functional capacity, in addition to tolerance to exercise. Physical activity enhances cardiovascular well-being in SLE patients by reducing their body weight and waist circumference, while improving their maximum oxygen consumption, endothelial function and insulin sensitivity. Moreover, several studies also suggest a reduction in fatigue and a beneficial effect of exercise on depression, anxiety, pain, poor-quality sleep and, more generally, on health-related quality of life (HRQoL). Diet can have a role in reducing modifiable cardiovascular risk factors; a benefit on SLE activity and HRQoL is also reported. The most robust evidence is available for polyunsaturated fatty acids enriched diets; however, we cannot draw definitive conclusions on whether there is any kind of diet that is better than another for SLE patients. Patients with SLE who smoke have an increased risk of disease flare, particularly skin manifestations, a poorer HRQoL and a reduced response to antimalarial drugs. The more intense and the longer tobacco consumption is the higher the risk of poor control of disease activity. Therefore, these facts can provide additional motivation for patients to stop smoking. Alongside clinical advantages, evidence-based activities promoting healthy lifestyles could contribute both to patient empowerment in disease self-management and to the sustainability of public health services. Learning Objectives Describe the link between lifestyles, disease activity and long-term outcomes in SLE Discuss the current state of studies on non-pharmacological interventions in SLE References Fangtham M, Kasturi S, Bannuru RR, et al. Non-pharmacologic therapies for systemic lupus erythematosus. Lupus 2019;28(6):703–12. Rodriguez Huerta MD, Trujillo-Martin MM, Rua-Figueroa I, et al. Healthy lifestyle habits for patients with systemic lupus erythematosus: A systemic review. Semin Arthritis Rheum 2016;45(4):463–70

Thinking for Three: Mothers' and Fathers' Narratives on Transition to Parenthood

Background: The birth of the first child represents a challenging event in the new-parents' life. Although literature highlighted that this period is experienced in a different way by the new mothers and new fathers, little is known about the broader evolutionary challenge that the transition to parenthood entails, also due to the difficulty of starting to think for three. Objective: The present study aims to explore the new-parents' autobiographical narratives after childbirth, to examine the meaning they construct of this event, and investigate the differences between the experience of new mothers and new fathers. Methods: Thirteen couples were recruited for the study. After childbirth, an individual open interview was conducted in order to collect information of the personal experience of becoming a parent. All interviews, audio-recorded and transcribed verbatim, were analyzed by T-Lab software in order to explore similarities and differences between them, using thematic analysis to perform unsupervised clustering of narrations to highlight the emerging themes, and we evaluated the elementary contexts of the narratives. A subsequent in-depth analysis regarding the process of delivery was conducted through the LIWC Results: Similar but not overlapping themes emerged from narratives. Overall, parents have to face three crucial issues: giving a meaning to the childbirth experience, reorganizing family life, and managing the newborn. However, new-mothers and new-fathers live this period not only with different roles, but also referring to different contexts and seem to house two different spaces: one mental and one physical. Fathers more than mothers highlighted the social aspects of childbirth. Conclusion: Results highlight that childbirth represents an important turning point, which implies the transition from thinking for two to thinking for three. In this process, the two parents play, narratively, two different roles. Limitations, strengths, and implications are discussed

Sphingosine 1-phosphate receptor 1 is required for MMP-2 function in bone marrow mesenchymal stromal cells: implications for cytoskeleton assembly and proliferation

Bone marrow-derived mesenchymal stromal cell- (BM-MSC-) based therapy is a promising option for regenerative medicine. An important role in the control of the processes influencing the BM-MSC therapeutic efficacy, namely, extracellular matrix remodelling and proliferation and secretion ability, is played by matrix metalloproteinase- (MMP-) 2. Therefore, the identification of paracrine/autocrine regulators of MMP-2 function may be of great relevance for improving BM-MSC therapeutic potential. We recently reported that BM-MSCs release the bioactive lipid sphingosine 1-phosphate (S1P) and, here, we demonstrated an impairment of MMP-2 expression/release when the S1P receptor subtype S1PR1 is blocked. Notably, active S1PR1/MMP-2 signalling is required for F-actin structure assembly (lamellipodia, microspikes, and stress fibers) and, in turn, cell proliferation. Moreover, in experimental conditions resembling the damaged/regenerating tissue microenvironment (hypoxia), S1P/S1PR1 system is also required for HIF-1α expression and vinculin reduction. Our findings demonstrate for the first time the trophic role of S1P/S1PR1 signalling in maintaining BM-MSCs' ability to modulate MMP-2 function, necessary for cytoskeleton reorganization and cell proliferation in both normoxia and hypoxia. Altogether, these data provide new perspectives for considering S1P/S1PR1 signalling a pharmacological target to preserve BM-MSC properties and to potentiate their beneficial potential in tissue repair

The Role of DNA Amplification and Cultural Growth in Complicated Acute Appendicitis

Bacterial growth of peritoneal fluid specimens obtained during surgical procedures for acute appendicitis may be useful to optimize further antibiotic therapy in complicated cases. DNA amplification represents a fast technique to detect microbial sequences. We aimed to compare the potential of DNA amplification versus traditional bacterial growth culture highlighting advantages and drawbacks in a surgical setting. Peritoneal fluid specimens were collected during surgery from 36 children who underwent appendectomy between May and December 2012. Real-time polymerase chain reaction (RT-PCR) and cultures were performed on each sample. RT-PCR showed an amplification of 16S in 18/36 samples, <em>Escherichia coli</em> (in 7 cases), <em>Pseudomonas aeruginosa</em> (3), <em>Fusobacterium necrophorum</em> (3), <em>Adenovirus</em> (2), <em>E.coli</em> (1), <em>Klebsiella pneumoniae</em> (1), <em>Serratia marcescens/Enterobacter cloacae</em> (1). Bacterial growth was instead observed only in four patients (3 <em>E.coli</em> and 1 <em>P.aeruginosa</em> and <em>Bacteroides ovatus</em>). Preoperative C-reactive protein and inflammation degree, the most reliable indicators of bacterial translocation, were elevated as expected. DNA amplification was a quick and useful method to detect pathogens and it was even more valuable in detecting aggressive pathogens such as anaerobes, difficult to preserve in biological cultures; its drawbacks were the lack of biological growths and of antibiograms. In our pilot study RT-PCR and cultures did not influence the way patients were treated

Occurrence of hashimoto thyroiditis among the first- and second-degree relatives of systemic lupus erythematosus patients with Hashimoto thyroiditis

Occurrence of Hashimoto thyroiditis among the first- and second-degree relatives of systemic lupus erythematosus patients with Hashimoto thyroiditis

Mitochondria of a human multidrug-resistant hepatocellular carcinoma cell line constitutively express inducible nitric oxide synthase in the inner membrane

Mitochondria play a crucial role in pathways of stress conditions. They can be transported from one cell to another, bringing their features to the cell where they are transported. It has been shown in cancer cells overexpressing multidrug resistance (MDR) that mitochondria express proteins involved in drug resistance such as P-glycoprotein (P-gp), breast cancer resistant protein and multiple resistance protein-1. The MDR phenotype is associated with the constitutive expression of COX-2 and iNOS, whereas celecoxib, a specific inhibitor of COX-2 activity, reverses drug resistance of MDR cells by releasing cytochrome c from mitochondria. It is possible that COX-2 and iNOS are also expressed in mitochondria of cancer cells overexpressing the MDR phenotype. This study involved experiments using the human HCC PLC/PRF/5 cell line with and without MDR phenotype and melanoma A375 cells that do not express the MDR1 phenotype but they do iNOS. Western blot analysis, confocal immunofluorescence and immune electron microscopy showed that iNOS is localized in mitochondria of MDR1-positive cells, whereas COX-2 is not. Low and moderate concentrations of celecoxib modulate the expression of iNOS and P-gp in mitochondria of MDR cancer cells independently from inhibition of COX-2 activity. However, A375 cells that express iNOS also in mitochondria, were not MDR1 positive. In conclusion, iNOS can be localized in mitochondria of HCC cells overexpressing MDR1 phenotype, however this phenomenon appears independent from the MDR1 phenotype occurrence. The presence of iNOS in mitochondria of human HCC cells phenotype probably concurs to a more aggressive behaviour of cancer cells

Salivary Proteomics Markers for Preclinical Sjögren’s Syndrome: A Pilot Study

Primary Sjögren’s syndrome (pSS) is a complex autoimmune disorder that particularly affects the salivary and lachrymal glands, generally causing a typical dryness of the eyes and of the mouth. The disease encompasses diverse clinical representations and is characterized by B-cell polyclonal activation and autoantibodies production, including anti-Ro/SSA. Recently, it has been suggested that autoantibody profiling may enable researchers to identify susceptible asymptomatic individuals in a pre-disease state. In this pilot study, we used mass spectrometry to analyze and compare the salivary proteomics of patients with established pSS and patients with pre-clinical SS, identifying a common protein signature in their salivary fluid. We found that several inflammatory, immunity-related, and typical acinar proteins (such as MUC5B, PIP, CST4, and lipocalin 1) were differently expressed in pSS and in pre-clinical SSA+ carriers, compared to healthy controls. This suggests that saliva may closely reflect exocrine gland inflammation from the early phases of the disease. This study confirms the value of salivary proteomics for the identification of reliable biomarkers for SS that could be identified, even in a preclinical phase of the disease

Systemic lupus erythematosus: one year in review 2023

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a wide range of clinical manifestations and a relapsing-remitting course. New data regarding pathogenic pathways, biomarkers and clinical manifestations of SLE are emerging, and new drugs and therapeutic protocols have been proposed to improve the control of disease activity. Furthermore, new insights into comorbidities and reproductive health in SLE patients are constantly emerging.This annual review aims to summarise the most relevant data on SLE that was published in 2022