Costanzo, Antonio

Spinelli, FRANCESCA ROMANA

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SPINELLI, FRANCESCA ROMANA

Archivio della ricerca- Università di Roma La Sapienza

ForewordForeword: Seminars inResearch 2014 JointExperiences in Rheumatologyand DermatologyAntonio Costanzo1 and FrancescaRomana Spinelli2It is a pleasure for us to present this specialissue of The Journal of International MedicalResearch, which brings together a series ofbrief communications focusing on the use ofbiological therapy in rheumatology anddermatology based on recent research intothe pathogenic mechanisms of immune-mediated inflammatory diseases of the skinand joints. The articles were written bymembers of the faculty of a Seminar heldon 4–5 December 2014 in Sarteano, Italyand facilitated by an unrestricted grantfrom PEzer Italia. The contributors arerheumatologists and dermatologists withsubstantial experience in the treatment ofchronic inFammatory rheumatic and der-matological conditions such as rheumatoidarthritis, psoriasis, psoriatic arthritis, andspondyloarthropathies.Although the pathogenic mechanisms ofimmune-mediated inflammatory diseasesare not fully understood, these apparentlyunrelated conditions actually share animmune aetiology that is mediated by cyto-kines and immune cells. Advances in theunderstanding of the inflammatory path-ways has allowed the development of anumber of effective biological agents target-ing specific disease mechanisms, particularlyagents that inhibit proinflammatory cyto-kines such as tumour necrosis factor (TNF)and interleukins. These drugs have demon-strated their ability to control disease activ-ity and to delay the progression of tissuedamage. However, although targeted thera-pies provide excellent anti-inflammatoryactivity in rheumatological and dermato-logical conditions, some concerns remainabout their cardiovascular safety and poten-tial metabolic effects. To ensure the fulltherapeutic potential of any biological ther-apy, clinicians should be aware of theseissues in order to use biological agents safelyand effectively.This supplement covers six interestingtopics: (i) gene/molecular research onimmune-mediated diseases; (ii) immune-mediated diseases and treatment immuno-genicity; (iii) immune-mediated diseases andtreatment comorbidities; (iv) immune-mediated diseases and obesity; (v) immune-mediated diseases and cardiovascular risk;and (vi) real-life experiences.The first section contains papers onrecent advances in genetic and molecularresearch on immune-mediated diseases.Journal of International Medical Research2016, Vol. 44(1S) 3–5! The Author(s) 2016Reprints and permissions:sagepub.co.uk/journalsPermissions.navDOI: 10.1177/0300060515593267imr.sagepub.com1Department of Neurosciences, Mental Health andSensory (NESMOS), Sapienza University of Rome, Rome,Italy2Dipartimento di Medicina Interna e Specialita` Mediche –Reumatologia, Sapienza Universita` di Roma, Rome, ItalyCreative Commons CC-BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction anddistribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(https://us.sagepub.com/en-us/nam/open-access-at-sage). at Univesita La S pienza on November 16, 2016imr.sag pub.comDownloaded fr m Among articles presented, Campanati et al.report that the TNF-a inhibitor, etanercept,reduces the production of the proangiogeniccytokine vascular endothelial growth factor(VEGF) in the mesenchymal stem cells thatare implicated in the ‘psoriatic march’– thehypothesized cascade of events linking psor-iasis and cardiovascular comorbidities. In aseries of articles, Chimenti et al. investigatethe action of proteins involved in inflamma-tory pathways and their role in modulatingthe immune response and inflammation.Cacciapaglia et al. describe the effect ofTNF-a inhibition on disease activity andlevels of circulating reactive oxygen speciesin patients with rheumatoid arthritis, sug-gesting a cardioprotective role of earlytreatment with TNF-a inhibitors. Ganzettiet al. provide evidence that the expression ofinterleukin 1-b in the salivary secretions ofpatients with psoriasis is significantlyreduced in response to TNF-a inhibitors,suggesting that salivary interleukin 1-bcould play a role as a noninvasive oralinflammatory biomarker for monitoringinflammation in psoriasis.In the second section, Vultaggio et al.explore the mechanisms of tolerance andadaptive immune responses to biologicalagents, pointing towards new assays thatmay provide useful tools for monitoringimmunogenicity and preventing adverseevents. A paper by Potenza et al. evaluatesheart rate variability analysis as a clinicaltool to assess the influence of etanercept onautonomic cardiovascular regulation inpsoriatic patients; while Chimenti et al.evaluate the serum levels of the TNF-ainhibitor adalimumab in patients with psori-atic arthritis undergoing long-term therapyaddressing the implications of the develop-ment of antidrug antibodies. Chimenti et al.also investigate serological markers asso-ciated with disease activity in patients withrheumatoid arthritis treated with rituximab,a genetically-engineered chimeric monoclo-nal antibody targeted to CD20þ B cells.The third section examines the potentialrole of comorbidities in immune-mediateddiseases, encompassing papers on suiciderisk and psychiatric comorbidity by Pompiliet al.; treatment of immunocompromisedpatients with psoriasis (De Simone et al.);and the long-term safety of etanercept inpsoriasis, with particular emphasis on infec-tions (Orsini et al.). Generali et al. analysedata from a longitudinal study in a largecohort of Italian subjects followed-up over a13-year period to determine the prevalenceof antinuclear antibodies and antiextract-able nuclear antigens and their predictivevalue for the development of an auto-immune disease.In the fourth section, the influence ofobesity on treatment efficacy is addressed ina study by Giunta et al., which investigatedthe effect of body weight and body massindex on the efficacy of etanercept inpatients with psoriasis.The implications of immune-mediateddiseases on cardiovascular risk are examinedin the fifth section, in a case–control studyfrom Erre et al. investigating the role ofasymmetric dimethylarginine and arterialstiffness in rheumatoid arthritis patients; areview on the role of post-translationalmodifications – citrullination and carbamy-lation – in the pathogenesis of rheumatoidarthritis and atherosclerosis, by Spinelliet al.; and data fromMurdaca et al. showingthe beneficial effects of long-term treatmentwith bosentan on endothelial dysfunction inpatients with systemic sclerosis and pulmon-ary arterial hypertension.The final section reports the experiences ofthe contributing rheumatologists and derma-tologists treating patients in ‘real-life’ clinicalsituations. In this section, Chimenti et al.describe the ability of anti-TNF therapy toinduce remission and reduce disease activityin rheumatoid arthritis patients; Faleriet al. discuss the unmet needs in patientswith psoriasis highlighting the import-ance of multidisciplinary assessment and4 Journal of International Medical Research 44(1S) at Univesita La Sapienza on November 16, 2016imr.sagepub.comDownloaded from management; Babino et al. report comedica-tion patterns in patients with psoriasis treatedwith etanercept; and Pezzolo et al. raise theissue of chronic kidney disease in patientsreceiving long-term therapy for psoriasis. DeSantis et al. and Conti et al. investigated thevalue of nailfold videocapillaroscopy andspeckled variance optical coherence tomog-raphy as diagnostic and monitoring tools inimmune-mediated inflammatory diseases.The role of methotrexate as a concomitanttherapy with etanercept in patients withrheumatoid arthritis is described in a paperby Becciolini et al.; and Anginelli et al. reporta case of the safe and successful treatment ofscleromyxoedema with high-dose intraven-ous immunoglobulins.We believe that this special supplement ofThe Journal of International MedicalResearch highlights a range of key issuessurrounding the management of immune-mediated inflammatory diseases that willnot only contribute towards a better under-standing of the pathophysiology of thesecomplex inflammatory conditions, but willbe of practical value in informing the effect-ive use of biological therapies in thesechronic diseases.Foreword 5 at Univesita La Sapienza on November 16, 2016imr.sagepub.comDownloaded from 

Foreword: Seminars in Research 2014 Joint Experiences in Rheumatology and Dermatology

Antonio Costanzo

Francesca Romana Spinelli

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Journal of International Medical Research

Foreword: Seminars in Research 2014 Joint Experiences in Rheumatology and           Dermatology

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Foreword: Seminars in Research 2014 Joint Experiences in Rheumatology and Dermatology

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