DDer - Artículos
https://hdl.handle.net/10481/30974
2024-03-28T20:01:00ZThe paradigm of IL-23-independent production of IL-17F and IL-17A and their role in chronic inflammatory diseases
https://hdl.handle.net/10481/84718
The paradigm of IL-23-independent production of IL-17F and IL-17A and their role in chronic inflammatory diseases
Navarro-Compán, Victoria; Arias Santiago, Salvador Antonio
Interleukin-17 family (IL-17s) comprises six structurally related members (IL-17A to IL-17F); sequence homology is highest between IL-17A and IL-17F, displaying certain overlapping functions. In general, IL-17A and IL-17F play important roles in chronic inflammation and autoimmunity, controlling bacterial and fungal infections, and signaling mainly through activation of the nuclear factor-kappa B (NF-κB) pathway. The role of IL-17A and IL-17F has been established in chronic immune-mediated inflammatory diseases (IMIDs), such as psoriasis (PsO), psoriatic arthritis (PsA), axial spondylarthritis (axSpA), hidradenitis suppurativa (HS), inflammatory bowel disease (IBD), multiple sclerosis (MS), and asthma. CD4+ helper T cells (Th17) activated by IL-23 are well-studied sources of IL-17A and IL-17F. However, other cellular subtypes can also produce IL-17A and IL-17F, including gamma delta (γδ) T cells, alpha beta (αβ) T cells, type 3 innate lymphoid cells (ILC3), natural killer T cells (NKT), or mucosal associated invariant T cells (MAIT). Interestingly, the production of IL-17A and IL-17F by innate and innate-like lymphocytes can take place in an IL-23 independent manner in addition to IL-23 classical pathway. This would explain the limitations of the inhibition of IL-23 in the treatment of patients with certain rheumatic immune-mediated conditions such as axSpA. Despite their coincident functions, IL-17A and IL-17F contribute independently to chronic tissue inflammation having somehow non-redundant roles. Although IL-17A has been more widely studied, both IL-17A and IL-17F are overexpressed in PsO, PsA, axSpA and HS. Therefore, dual inhibition of IL-17A and IL-17F could provide better outcomes than IL-23 or IL-17A blockade.
The Supplementary Material for this article can be found online
at: https://www.frontiersin.org/articles/10.3389/fimmu.2023.1191782/
full#supplementary-material
Frontal Fibrosing Alopecia Quality of Life Index: A Validated Disease-Specific Questionnaire Involving Women
https://hdl.handle.net/10481/80722
Frontal Fibrosing Alopecia Quality of Life Index: A Validated Disease-Specific Questionnaire Involving Women
Porriño Bustamante, María Librada; Montero Vílchez, Trinidad; Fernández Pugnaire, María Antonia; Arias Santiago, Salvador Antonio
Quality of life (QoL) can be affected in patients with alopecia. The few studies that evaluate
QoL in FFA use unspecific questionnaires. The aim of this report was to design and validate a specific
questionnaire to assess the impairment of QoL in FFA patients. A specific questionnaire, called the
Frontal Fibrosing Alopecia Quality of Life Index (FFA-QLI), was designed and validated using the
Dermatology Life Quality Index (DLQI). One-hundred and one women with FFA were included.
Cronbach’s alpha value was 0.865, and the intraclass correlation coefficient between all the items in
the questionnaire was 0.870. The FFA-QLI correlated positively with the DLQI (r = 0.729, p < 0.001).
Patients with severe FFA showed a higher FFA-QLI (19.72) score compared to those with a mild
disease (14.11) (p = 0.002), and the area under the curve for identifying severe disease was greater in
the FFA-QLI than in the DLQI. The cut-off points were used to select patients with mild, moderate,
and severe impairment in QoL. A score < 21 in the FFA-QLI corresponded to a low impact on QoL;
values > 35 matched with greater QoL impairment; and values ranging from 21 to 35 corresponded to
moderate QoL alteration. To conclude, a validated disease-specific questionnaire to assess QoL in FFA
patients is here presented, with a greater power to discriminate severe cases of FFA than the DLQI.
Potential Predictors of Cardiovascular Risk Improvement in Patients with Hidradenitis Suppurativa Treated with Adalimumab: A Pivotal Study of Factors Associated with Carotid Intima– Media Thickness Reduction
https://hdl.handle.net/10481/80548
Potential Predictors of Cardiovascular Risk Improvement in Patients with Hidradenitis Suppurativa Treated with Adalimumab: A Pivotal Study of Factors Associated with Carotid Intima– Media Thickness Reduction
Sánchez Díaz, Manuel; Salvador Rodríguez, Luis; Cuenca Barrales, Carlos; Arias Santiago, Salvador Antonio
Introduction: Hidradenitis suppurativa (HS)
has been linked to higher cardiovascular risk
(CVR) due to its inflammatory burden. There is
little evidence on how biologic treatment could
modify the cardiovascular risk of patients with
HS. The aims of the present study were to
explore the modification of CVR in patients
under adalimumab treatment and to explore
the potential factors associated with CVR
improvement.
Methods: A prospective longitudinal study was
performed. A cohort of patients with HS treated
with adalimumab was followed up. Carotid
intima–media thickness (IMT) and other
clinical and biochemical CVR factors were collected
at baseline and 32 weeks after starting the
treatment.
Results: Twenty-seven patients with severe HS
were included. Overall, there were no differences
in IMT between baseline (633 lm) and
32 weeks follow-up (634 lm). However, 40.7%
(11/27) of the patients presented an improvement
in IMT. This group (IMT responders) had a
higher prevalence of dyslipidemia, diabetes
mellitus, higher HbA1c levels, consumed more
tobacco, and had higher BMI at baseline.
Moreover, these patients had lower IHS4 scores
at baseline and tended to have a greater IMT
basal value, indicating a higher burden of subclinical
atherosclerosis.
Conclusions: Adalimumab treatment might
benefit a subset of patients with HS in terms of
cardiovascular risk reduction. In light of the
results of the present study patients with classical
cardiovascular risk factors, and those with
higher burden of subclinical atherosclerosis and
with less inflammatory load, may be more likely
to improve their IMT during adalimumab
treatment.
Type D Personality as a Marker of Poorer Quality of Life and Mood Status Disturbances in Patients with Skin Diseases: A Systematic Review
https://hdl.handle.net/10481/80497
Type D Personality as a Marker of Poorer Quality of Life and Mood Status Disturbances in Patients with Skin Diseases: A Systematic Review
Sánchez Díaz, Manuel; Montero Vílchez, Trinidad; Quiñones Vico, María Isabel; Sierra Sánchez, Álvaro; Ubago Rodríguez, Ana Dolores; Sanabria de la Torre, Raquel; Molina Leyva, Alejandro; Arias Santiago, Salvador Antonio
Type D personality is characterized by social inhibition
and negative affectivity. Poorer outcomes and worse
quality of life have been linked to type D personality in
patients with a variety of non-dermatological diseases.
Despite increasing evidence of the importance of type
D personality in skin diseases, there are no reviews on
this subject. The aim of this review is to summarize the
current evidence regarding type D personality and skin
diseases. A systematic search was performed using
Medline and Web of Science databases from inception
to 11 October 2022. Studies addressing the presence
of type D personality, its associated factors, its impact
on the outcomes of the disease or the quality of life of
the patients were included in the systematic review. A
total of 20 studies, including 3,124 participants, met
the eligibility criteria and were included in the review.
Acne, hidradenitis suppurativa, psoriasis, melanoma,
atopic dermatitis, chronic spontaneous urticaria and
pruritic disorders were the main diseases assessed.
Type D personality was more frequent among patients
with skin diseases than among controls. Type D personality
was found to be associated with poorer quality
of life and higher rates of psychological comorbidities
in patients with skin diseases. In conclusion, type D
personality appears to be a marker of patients with increased
risk of poorer quality of life and higher rates
of psychological comorbidities. Screening for type D
personality in specialized dermatology units might be
beneficial to identify patients who are more psychologically
vulnerable to the consequences of chronic skin
diseases.
Sexual Dysfunction and Quality of Life in Patients with Hidradenitis Suppurativa and Their Partners
https://hdl.handle.net/10481/79414
Sexual Dysfunction and Quality of Life in Patients with Hidradenitis Suppurativa and Their Partners
Cuenca Barrales, Carlos; Montero Vílchez, Trinidad; Arias Santiago, Salvador Antonio; Molina Leyva, Alejandro
Hidradenitis suppurativa (HS) is a chronic skin disease that profoundly affects patients’
quality of life (QoL) and sexuality. Few data are available on the impact of HS on patients’ partners.
We aimed to explore the QoL and sexual function of patients’ partners and the factors associated
with their impairment and to compare the QoL and sexual function of single patients and those in
a stable relationship. We conducted a cross-sectional study at Hospital Universitario Virgen de las
Nieves (Granada, Spain) and at theWroclaw Medical University (Wroclaw, Poland). Patients over the
age of 16 years attending their scheduled follow-up and their partners, if any, were included. The
Dermatology Life Quality Index (DLQI) and the Family Dermatology Life Quality Index (FDLQI) were
used to estimate the QoL of patients and partners, respectively. The FSFI-6 was used to determine
sexual dysfunction in women and the IIEF-5 for erectile dysfunction in men. Thirty-four single
patients and twenty-eight patients in a stable relationship and their partners were included. Patients
had a very large impact (DLQI 12.5 7.5) and their partners a moderate impact (FDLQI 10.3 7.1)
in their QoL due to HS. Women with HS had a high prevalence of sexual dysfunction (13/32, 40.6%)
and men of erectile dysfunction (19/30, 63.3%). Male partners also had a high prevalence of erectile
dysfunction (10/17, 58.8%), while only one female partner had sexual dysfunction (1/11, 9.1%).
Factors related to disease severity, intensity of symptoms and body mass index were associated
with poorer QoL in partners and time of disease evolution with greater erectile dysfunction in male
partners. In conclusion, HS not only profoundly affects the QoL and sexuality of patients but also of
their partners. Several risk factors have been identified, which should be taken into account in the
holistic approach of the disease.