Comparative study on anatomical traits and gas exchange responses due to belowground hypoxic stress and thermal stress in three tropical seagrasses.
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Brito-Zerón Pilar, Acar-Denizli Nihan, Ng Wan-Fai, Zeher Margit, Rasmussen Astrid, Mandl Thomas, Seror Raphaele, Li Xiaomei, Baldini Chiara, Gottenberg Jacques-Eric, Danda Debashish, Quartuccio Luca, Priori Roberta, Hernandez-Molina Gabriela, Armagan Berkan, Kruize Aike A, Kwok Seung-Ki, Kvarnström Marika, Praprotnik Sonja, Sène Damien, Bartoloni Elena, Solans Roser, Rischmueller Maureen, Suzuki Yasunori, Isenberg David A, Valim Valeria, Wiland Piotr, Nordmark Gunnel, Fraile Guadalupe, Bootsma Hendrika, Nakamura Takashi, Giacomelli Roberto, Devauchelle-Pensec Valerie, Knopf Andreas, Bombardieri Michele, Trevisani Virginia-Fernandes, Hammenfors Daniel, Pasoto Sandra G, Retamozo Soledad, Gheita Tamer A, Atzeni Fabiola, Morel Jacques, Vollenveider Cristina, Horvath Ildiko-Fanny, Sivils Kathy L, Olsson Peter, De Vita Salvatore, Sánchez-Guerrero Jorge, Kilic Levent, Wahren-Herlenius Marie, Mariette Xavier, Ramos-Casals Manuel, Sjögren Big Data Consortium
Аннотация
METHODS: The Big Data Sjögren Project Consortium is an international, multicentre registry created in 2014. As a first step, baseline clinical information from leading centres on clinical research in SjS of the 5 continents was collected. The centres shared a harmonised data architecture and conducted cooperative online efforts in order to refine collected data under the coordination of a big data statistical team. Inclusion criteria were the fulfillment of the 2002 classification criteria. Immunological tests were carried out using standard commercial assays.
RESULTS: By January 2018, the participant centres had included 10,500 valid patients from 22 countries. The cohort included 9,806 (93%) women and 694 (7%) men, with a mean age at diagnosis of primary SjS of 53 years, mainly White (78%) and included from European countries (71%). The frequency of positive immunological markers at diagnosis was 79.3% for ANA, 73.2% for anti-Ro, 48.6% for RF, 45.1% for anti- La, 13.4% for low C3 levels, 14.5% for low C4 levels and 7.3% for cryoglobulins. Positive autoantibodies (ANA, Ro, La) correlated with a positive result in salivary gland biopsy, while hypocomplementaemia and especially cryoglo-bulinaemia correlated with systemic activity (mean ESSDAI score of 17.7 for cryoglobulins, 11.3 for low C3 and 9.2 for low C4, in comparison with 3.8 for negative markers). The immunological markers with a great number of statistically-significant associations (p<0.001) in the organ-by-organ ESS- DAI evaluation were cryoglobulins (9 domains), low C3 (8 domains), anti-La (7 domains) and low C4 (6 domains).
CONCLUSIONS: We confirm the strong influence of immunological markers on the phenotype of primary SjS at diagnosis in the largest multi-ethnic international cohort ever analysed, with a greater influence for cryoglobulinaemic-related markers in comparison with Ro/La autoantibodies and ANA. Immunological patterns play a central role in the phenotypic expression of the disease already at the time of diagnosis, and may guide physicians to design a specific personalised management during the follow-up of patients with primary SjS.