Review
Gastroenterology & Hepatology
Goncalo Boleto, Matheus Vieira, David Saadoun, Patrice Cacoub
Summary: CryoVas is a small-to-medium vessel systemic vasculitis caused by the deposition of mixed cryoglobulins and immune complexes, mainly triggered by HCV infection. The recent use of DAAs and B-cell depleting strategies, such as rituximab, has greatly improved the management of chronic HCV infection and HCV-related CryoVas. Despite advancements in recent years, there are still challenges in the therapeutic management of severe and refractory HCV-associated CryoVas.
CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY
(2021)
Review
Medicine, General & Internal
Elena Treppo, Luca Quartuccio, Gaafar Ragab, Salvatore De Vita
Summary: HCV infection can lead to rheumatologic manifestations such as mixed cryoglobulinemia, which may progress to cryoglobulinemic vasculitis and non-Hodgkin lymphoma. Antiviral therapy is essential to eradicate HCV, while immunosuppressive therapy can be used for organ-threatening manifestations.
Review
Virology
Cesare Mazzaro, Luigino Dal Maso, Laura Gragnani, Marcella Visentini, Francesco Saccardo, Davide Filippini, Pietro Andreone, Anna Linda Zignego, Valter Gattei, Giuseppe Monti, Massimo Galli, Luca Quartuccio
Summary: Chronic HBV infection can cause liver damage and lead to cryoglobulinemic vasculitis in some patients. Therapeutic options for HBV-related CV are currently lacking, with nucleos(t)ide analogues showing efficacy in controlling HBV replication and inducing clinical responses in mild-to-moderate CV patients, while plasma exchange and high-dose corticosteroids may be necessary in severe cases.
Article
Immunology
Ming-Ling Chang, Jur-Shan Cheng, Ya-Hui Chuang, Li-Heng Pao, Ting-Shu Wu, Shiang-Chi Chen, Ming-Yu Chang, Rong-Nan Chien
Summary: This study investigates the evolution of cryoglobulinemia in Asian HCV-infected patients after sustained virological response (SVR) following direct-acting antiviral (DAA) treatment. The results show that cryoglobulinemia rates decrease in SVR patients over a 4-year follow-up period, with a shift towards single cryoglobulinemia. Improvements in cryoglobulinemia-associated markers are observed post-therapy, and baseline IgM levels can predict the occurrence of post-therapy cryoglobulinemia.
FRONTIERS IN IMMUNOLOGY
(2022)
Review
Medicine, General & Internal
Mahmood Danishwar, Zahid Jamil, Salman Khan, Michael Nakhla, Ishtiaq Ahmad, Muhammad Ashar Ali, Daryl T. Y. Lau
Summary: Treatment with direct acting antivirals (DAAs) has greatly improved HCV therapy, but cryoglobulinemic vasculitis (CryoVas) can persist and recur after HCV cure. This review found that 63.7% to 90.2% of patients achieved a complete clinical response (CR) after DAA treatment, but 4% to 18% experienced relapse of CryoVas symptoms. Neuropathy, nephropathy, and dermatological complications were the most common manifestations of CryoVas, and B-cell clones persisted in a significant percentage of patients, potentially contributing to relapse. Certain gene variants were associated with a higher incidence of CryoVas persistence and recurrence.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Immunology
Laura Gragnani, Serena Lorini, Silvia Marri, Caterina Vacchi, Francesco Madia, Monica Monti, Clodoveo Ferri, Anna Linda Zignego
Summary: This study provides a detailed analysis of CV patients treated with DAA-based regimes and followed-up for more than 72 weeks. It identifies clinical and laboratory predictors of disease outcome and proposes two new scores, CV and Global Severity Index, as reliable tools for predicting CV clinical response. These findings can fill a gap in the clinical management of HCV-related CV.
AUTOIMMUNITY REVIEWS
(2022)
Article
Rheumatology
Amir M. Mohareb, Naomi J. Patel, Xiaoqing Fu, Arthur Y. Kim, Zachary S. Wallace, Emily P. Hyle
Summary: Despite recommendations from AASLD and CDC, this study found that only a small proportion of rheumatology patients initiating TCZ or TOF undergo HBV screening.
JOURNAL OF RHEUMATOLOGY
(2022)
Review
Gastroenterology & Hepatology
Anna L. Zignego, Silvia Marri, Laura Gragnani
Summary: Recent advances in the treatment of mixed cryoglobulinemia syndrome have shown significant progress, with interferon-free, DAA-based therapy leading to high SVR rates and clinical/immunological responses in most patients. However, challenges remain in managing partial or non-responders.
MINERVA GASTROENTEROLOGY
(2021)
Article
Multidisciplinary Sciences
Dario Roccatello, Savino Sciascia, Carla Naretto, Antonella Barreca, Laura Solfietti, Laura Battaglia, Lucia Viziello, Roberta Fenoglio, Daniela Rossi
Summary: A considerable number of patients suspected of cryoglobulinaemic vasculitis show negative or trace amounts of cryoglobulins, which may represent a subset of hypocryoglobulinaemia or a separate entity. This study identified 237 patients with clinical suspicion of autoimmune disorder and < 0.5% cryocrit using a modified precipitation technique. Among these patients, 22.7% had a history of HCV infection, while 28.6% had idiopathic hypocryoglobulinaemia. The findings suggest that deeper investigation is needed for patients with high clinical suspicion of vasculitis even if they test negative for cryoglobulinaemia.
SCIENTIFIC REPORTS
(2022)
Review
Chemistry, Analytical
Vigneswaran Narayanamurthy, Z. E. Jeroish, K. S. Bhuvaneshwari, Fahmi Samsuri
Summary: Proper diagnosis is essential in avoiding disease consequences, especially for severe issues like hepatitis C virus (HCV) that can cause significant damage to the liver. Developing strategies for appropriate selection of POCT for HCV detection, initiating proper antiviral therapy, and defining associated risks is critical for achieving optimal outcomes. Alternative strategies are needed to enhance HCV diagnosis, with molecular assays being precise but requiring additional approaches for infected populations to improve detection.
ANALYTICAL METHODS
(2021)
Article
Rheumatology
Pankti Reid, Laura C. Cappelli
Summary: Immune checkpoint inhibitors (ICIs) can effectively treat advanced cancers but may cause immune-related adverse events (irAEs), including rheumatic manifestations. This article discusses treatment recommendations for rheumatic irAEs, the impact of treatment decisions, and the safe use of ICI therapy in patients with preexisting autoimmune diseases.
BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY
(2022)
Article
Medicine, General & Internal
Jennifer Ngo, Robert Andalon, Luis Delgado, Mariam Gilmore, Kelly Downey, Patrick Wu, Made Sutjita
Summary: The effects of HCV on the nervous system primarily manifest through vasculitic processes in the peripheral nervous system. Although the causal relationship is still unclear, recent literature suggests an association between chronic HCV infection and transverse myelitis. This case report presents a rare instance of acute transverse myelitis occurring concurrently with a new diagnosis of HCV infection.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2023)
Review
Rheumatology
Marie N. Kolopp-Sarda, Pierre Miossec
Summary: Cryoglobulins (CG) precipitate in the cold and dissolve at 37 degrees C, leading to vasculitis and occlusive vasculopathy. Optimal conditions for CG detection are crucial, and looking for underlying diseases is especially important in mixed CG.
CURRENT OPINION IN RHEUMATOLOGY
(2021)
Review
Virology
Cesare Mazzaro, Luca Quartuccio, Luigi Elio Adinolfi, Dario Roccatello, Gabriele Pozzato, Riccardo Nevola, Maurizio Tonizzo, Stefano Gitto, Pietro Andreone, Valter Gattei
Summary: Chronic hepatitis C virus (HCV) infection is often associated with extrahepatic manifestations such as cryoglobulinemia, lymphomas, and cardiovascular disease. Direct-acting antiviral agents (DAA) therapy can significantly reduce the risk of these extrahepatic manifestations, improving patients' quality of life and survival.
Article
Microbiology
Tsai-Ling Liao, Yi-Ming Chen, Shie-Liang Hsieh, Kuo-Tung Tang, Der-Yuan Chen, Ying-Ying Yang, Hung-Jen Liu, Sheng-Shun Yang
Summary: This study investigates the roles of BAFF and exosomal miRNAs in the extrahepatic manifestations of HCV infection, revealing an association between HCV-infected hepatocyte-derived miRNAs and host TLR7 genetic background with BAFF expression. The findings suggest a potential mechanism for HCV infection-related autoimmunity and provide insights into the development of extrahepatic diseases, offering a possible target for treatment.
Letter
Medicine, General & Internal
Michele Gilio, Salvatore D'Angelo, Giuseppina Tramontano, Irma Kushta, Ignazio Olivieri
INTERNAL AND EMERGENCY MEDICINE
(2020)
Article
Rheumatology
Florenzo Iannone, Ennio G. Favalli, Roberto Caporali, Salvatore D'Angelo, Francesco Paolo Cantatore, Piercarlo Sarzi-Puttini, Rosario Foti, Fabrizio Conti, Antonio Carletto, Elisa Gremese, Alberto Cauli, Roberta Ramonda, Adalgisa Palermo, Oscar Epis, Marta Priora, Francesca Bergossi, Bruno Frediani, Fausto Salaffi, Giuseppe Lopalco, Fabio Cacciapaglia, Antonio Marchesoni, Martina Biggioggiero, Serena Bugatti, Silvia Balduzzi, Antonio Carriero, Addolorata Corrado, Sara Bongiovanni, Alessia Benenati, Francesca Miranda, Elena Fracassi, Daniela Perra, Gianfranco Ferraccioli, Giovanni Lapadula
Summary: The study evaluated the clinical effectiveness of golimumab in biologic inadequate responder patients with RA, SpA, and PsA. Golimumab showed similar effectiveness in SpA and PsA patients, but was less effective in multi-failure RA patients, especially as monotherapy. Male patients had better outcomes.
Article
Immunology
Francesco Santoro, Francesco Monitillo, Pasquale Raimondo, Agostino Lopizzo, Gaetano Brindicci, Michele Gilio, Francesco Musaico, Michele Mazzola, Domenico Vestito, Rossella Di Benedetto, Mohammad Abumayyaleh, Ibrahim El-Battrawy, Carmen Rita Santoro, Luigi Flavio Massimiliano Di Martino, Ibrahim Akin, Giulio De Stefano, Rosario Fiorilli, Michele Cannone, Annalisa Saracino, Salvatore Angarano, Sergio Carbonara, Salvatore Grasso, Luigi Di Biase, Natale Daniele Brunetti
Summary: Among hospitalized patients with COVID-19, 14% developed prolonged QTc intervals after 7 days, with age, basal heart rate, and dual antiviral therapy identified as independent predictors. The incidence rate of life-threatening arrhythmias (LTAs) during hospitalization was 3.6%, and was associated with a poor outcome.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Rheumatology
Xenofon Baraliakos, Laure Gossec, Effie Pournara, Slawomir Jeka, Antonio Mera-Varela, Salvatore D'Angelo, Barbara Schulz, Michael Rissler, Kriti Nagar, Chiara Perella, Laura C. Coates
Summary: The MAXIMISE trial demonstrated that secukinumab significantly improved axial disease symptoms in patients with PsA, particularly those with inadequate response to NSAIDs.
ANNALS OF THE RHEUMATIC DISEASES
(2021)
Article
Rheumatology
Giuseppina Abignano, Gianna Angela Mennillo, Giovanni Lettieri, Duygu Temiz Karadag, Antonio Carriero, Angela Anna Padula, Francesco Del Galdo, Dinesh Khanna, Salvatore D'Angelo
Summary: The study demonstrated that SSc patients with impaired esophageal transit scintigraphy findings have higher GIT 2.0 reflux scores, while esophageal emptying activity is negatively correlated with reflux scores.
JOURNAL OF RHEUMATOLOGY
(2021)
Review
Immunology
Roberto Giacomelli, Antonella Afeltra, Elena Bartoloni, Onorina Berardicurti, Michele Bombardieri, Alessandra Bortoluzzi, Francesco Carubbi, Francesco Caso, Ricard Cervera, Francesco Ciccia, Paola Cipriani, Emmanuel Coloma-Bazan, Fabrizio Conti, Luisa Costa, Salvatore D'Angelo, Oliver Distler, Eugen Feist, Nathan Foulquier, Marco Gabini, Vanessa Gerber, Roberto Gerli, Rosa Daniela Grembiale, Giuliana Guggino, Ariela Hoxha, Annamaria Iagnocco, Suzana Jordan, Bashar Kahaleh, Kim Lauper, Vasiliki Liakouli, Ennio Lubrano, Domenico Margiotta, Saverio Naty, Luca Navarini, Federico Perosa, Carlo Perricone, Roberto Perricone, Marcella Prete, Jacques-Olivier Pers, Costantino Pitzalis, Roberta Priori, Felice Rivellese, Amelia Ruffatti, Piero Ruscitti, Raffaele Scarpa, Yehuda Shoenfeld, Giovanni Triolo, Athanasios Tzioufas
Summary: Autoimmune diseases share common clinical features but have different pathogenic mechanisms and targeted organs. Applying precision medicine principles may improve treatment success by tailoring therapy to individual characteristics and reducing adverse events.
AUTOIMMUNITY REVIEWS
(2021)
Letter
Rheumatology
Francesco Ursini, Piero Ruscitti, Salvatore D'Angelo, Fabio Cacciapaglia, Rossella De Angelis, Corrado Campochiaro, Francesco Caso, Maria De Santis, Ilenia Di Cola, Simone Parisi, Vincenzo Raimondo, Giuseppina Abignano, Luisa Costa, Jacopo Ciaffi, Lorenzo Dagna, Annamaria Iagnocco, Florenzo Iannone, Riccardo Meliconi, Roberto Giacomelli, Clodoveo Ferri
ANNALS OF THE RHEUMATIC DISEASES
(2021)
Article
Rheumatology
M. Manara, I Prevete, A. Marchesoni, S. D'Angelo, A. Cauli, A. Zanetti, A. Ariani, Alessandra Bortoluzzi, Simone Parisi, Carlo Alberto Scire, Nicola Ughi
Summary: The Italian Society for Rheumatology used the ADAPTE methodology to modify existing international clinical practice guidelines on axial spondyloarthritis (SpA) management for the Italian context. Through the efforts of experts and a working group, they developed 14 recommendations covering assessment, pharmacological and non-pharmacological treatment, and follow-up to support the management of patients with axial SpA.
Letter
Dermatology
Antonio Carriero, Ennio Lubrano, Valentina Picerno, Angela Anna Padula, Salvatore D'Angelo
Summary: Paradoxical psoriatic arthritis (PPsA) may be linked to guselkumab treatment, possibly due to cytokine imbalance.
CLINICAL AND EXPERIMENTAL DERMATOLOGY
(2022)
Article
Rheumatology
Teresa Carbone, Valentina Picerno, Vito Pafundi, Ernesto Esposito, Pietro Leccese, Angela Anna Padula, Salvatore D'Angelo
Summary: The COVID-19 pandemic has significantly impacted rheumatological clinical practice and autoimmunity testing demands, resulting in a decrease in laboratory test volumes and first rheumatological visits and diagnoses in 2020. However, an equivalent or higher percentage of positive autoimmunity results were recorded in outpatient services during 2020 compared to the prepandemic state, with new diagnoses mainly affected by less severe diseases.
JOURNAL OF RHEUMATOLOGY
(2022)
Article
Medicine, General & Internal
Salvatore D'Angelo, Enrico Tirri, Angela Maria Giardino, Marco Mattucci-Cerinic, Lorenzo Dagna, Leonardo Santo, Francesco Ciccia, Bruno Frediani, Marcello Govoni, Francesca Bobbio Pallavicini, Rosa Daniela Grembiale, Andrea Delle Sedie, Rita Mule, Francesco Paolo Cantatore, Rosario Foti, Elisa Gremese, Paola Conigliaro, Fausto Salaffi, Ombretta Viapiana, Alberto Cauli, Roberto Giacomelli, Luisa Arcarese, Giuliana Guggino, Romualdo Russo, Amy Puenpatom, Domenico Capocotta, Francesca Nacci, Maria Grazia Anelli, Valentina Picerno, Corrado Binetti, Florenzo Iannone
Summary: This prospective observational study collected data from rheumatology clinics in Italy and found that golimumab (GLM) as a second anti-TNF drug is effective in the treatment of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA). GLM improved disease activity and quality of life in these patients.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Medicine, General & Internal
Salvatore D'Angelo, Carlo Salvarani, Francesca Marando, Giuliana Gualberti, Lucia Novelli, Giacomo Curradi, Giovanni Tripepi, Annalisa Pitino, Roberta Ramonda, Antonio Marchesoni
Summary: This study evaluated the presence of residual disease in patients with axial spondyloarthritis (axSpA) in remission/low disease activity status. The analysis found that approximately 25% of patients still experienced residual disease, mainly characterized by pain and fatigue.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Immunology
Teresa Carbone, Vito Pafundi, Vito Ciardo, Maria Infantino, Antonella Muscella, Salvatore D'Angelo
Summary: This study developed an automated system that uses a conversion table to correlate fluorescence signal intensity values (FI) with end-point titers for antinuclear antibody (ANA) analysis. The system was validated in a real-life laboratory setting, and showed high agreement between visual readings and the conversion table for samples with single staining patterns. This method reduces hands-on time and improves result harmonization in routine laboratory work.
IMMUNOLOGIC RESEARCH
(2023)
Article
Rheumatology
Roberta Ramonda, Mariagrazia Lorenzin, Maria Sole Chimenti, Salvatore D'Angelo, Antonio Marchesoni, Carlo Salvarani, Ennio Lubrano, Luisa Costa, Ylenia Dal Bosco, Elena Fracassi, Augusta Ortolan, Mario Ferraioli, Antonio Carriero, Elisa Visalli, Riccardo Bixio, Francesca Desiati, Alberto Bergamini, Elisa Pedrollo, Andrea Doria, Rosario Foti, Antonio Carletto, Antonio Spadaro
Summary: In a real-life clinical setting, Secukinumab (SEC) has been shown to be effective and safe for axial spondyloarthritis (axSpA) patients, particularly in naive patients. The drug has a high retention rate and significantly improves disease activity and functionality.
THERAPEUTIC ADVANCES IN MUSCULOSKELETAL DISEASE
(2022)
Review
Rheumatology
Antonio Carriero, Ennio Lubrano, Valentina Picerno, Angela Anna Padula, Salvatore D'Angelo
Summary: Dactylitis is a common clinical feature in 30-50% of psoriatic arthritis (PsA) patients, serving as a marker for disease severity, independent predictor of cardiovascular morbidity, and impairing motor functions. Current treatment strategies primarily involve corticosteroid injections, with a lack of evidence from randomized controlled trials specifically targeting dactylitis as a primary endpoint.
THERAPEUTIC ADVANCES IN MUSCULOSKELETAL DISEASE
(2021)
