Identification of an activated neutrophil phenotype in polymyalgia rheumatica during steroid treatment: potential involvement of immune cell cross talk

We have reported the existence of a distinct neutrophil phenotype in giant cell arteritis (GCA) patients arising at week 24 of steroid treatment. In the present study, we investigated whether longitudinal analysis of neutrophil phenotype in patients with polymyalgia rheumatica (PMR) could reveal a novel association with disease status and immune cell cross-talk. Thus, we monitored PMR patient neutrophil phenotype and plasma microvesicle profiles in blood aliquots collected pre-steroid, and then at weeks 1, 4, 12 and 24 post-steroid treatment. Using flow cytometric and flow chamber analyses we identified 12-week post-steroid as a pivotal time-point for a marked degree of neutrophil activation, correlating with disease activity. Analyses of plasma microvesicles indicated elevated AnxA1+ neutrophil-derived vesicles which, in vitro, modulated T cell reactivity, suggesting distinct neutrophil phenotypic and cross-talk changes at 24 weeks, but not at 12 weeks post-steroid.Together, these data indicate a clear distinction from GCA patient neutrophil and microvesicle signatures, and provide an opportunity for further investigations on how to 'stratify' PMR patients and monitor their clinical responses through novel use of blood biomarkers.
Source: Clinical Science - Category: Biomedical Science Authors: Tags: PublishAheadOfPrint Source Type: research

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CONCLUSIONS: Seasonal variations in infectious agents, sun exposure, and food ingestion during gestation or early infancy seem to explain the association between birth month/season and development of rheumatic diseases. PMID: 31498065 [PubMed - as supplied by publisher]
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
AbstractPolymyalgia rheumatica is an inflammatory rheumatic disease of the elderly characterised by pain and stiffness in the neck and pelvic girdle, and is the second most common inflammatory rheumatic condition in this age group, after rheumatoid arthritis. Polymyalgia rheumatica can occur independently or in association with giant cell arteritis, which is the most common form of primary vasculitis. The diagnosis of polymyalgia rheumatica is usually based on clinical presentation and increase of inflammatory markers. There are no pathognomonic findings that can confirm the diagnosis. However, different imaging techniques...
Source: Drugs and Aging - Category: Geriatrics Source Type: research
​BY ALEXANDRA SALAS; JENNIFER TUONG; IVAN KHARCHENKO; VICTOR RIVERA; &AHMED RAZIUDDIN, MDA 27-year-old man with a past medical history of ADHD managed with Adderall presented to the emergency department with bilateral upper leg weakness associated with soreness since the day before. He had run 2.5 miles before his symptoms started.The symptoms progressively worsened until he was not able to walk or get up from a sitting position. He was also experiencing weakness in his arms. He had no associated trauma, headache, vision changes, chest pain, shortness of breath, fever, abdominal pain, nausea, vomiting, diarrhea, or g...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
We report that before start of treatment monocyte and neutrophil counts were higher in GCA and PMR patients than in HCs, while NK- and B-cell counts were lower. C-reactive protein (CRP) levels correlated positively with monocyte counts in GCA, and negatively with B-cell and NK-cell counts in PMR. During glucocorticoid treatment, myeloid subsets remained elevated whereas lymphoid subsets tended to fluctuate. Interestingly, erythrocyte sedimentation rate (ESR) outperformed CRP as marker for relapses in GCA. We defined stable treatment-free remission groups in both GCA and PMR. GCA patients in treatment-free remission still d...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Condition:   Polymyalgia Rheumatica Intervention:   Drug: Interleukin-2 Sponsor:   Peking University People's Hospital Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
A corticosteroid can quickly relieve symptoms of both polymyalgia rheumatica and temporal arteritis. But a delay could cause vision loss, a stroke or even death.
Source: NYT Health - Category: Consumer Health News Authors: Tags: Stroke Steroids Autoimmune Diseases Immune System Source Type: news
Conclusions: PMR is characterized by an important chronic subclinical inflammatory component. This pilot study demonstrates that affected patients show endothelial dysfunction that slowly responds to steroid therapy. Further studies are needed to investigate the clinical relevance of these observations and, in particular, to monitor the cardiovascular risk profile of PMR patients. PMID: 31418315 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Rheumatology - Category: Rheumatology Authors: Tags: Scand J Rheumatol Source Type: research
AbstractPolymyalgia rheumatica (PMR) affects elderly patients and is characterized by pain and stiffness of the shoulder girdle, pelvic girdle and cervical region, which can be associated with the presence of giant cell arteritis. Data on the epidemiology of this disease in Latin America are scarce. In Colombia, the Ministry of Health introduced SISPRO, a tool to collect nation-wide information from the health system. The information collected from SISPRO is available for scientific analysis. Using SISPRO data for the years 2012 –2016, an analysis was made on the prevalence and characteristics of patients diagnosed w...
Source: Rheumatology International - Category: Rheumatology Source Type: research
Abstract A common inflammatory condition, the investigation and diagnosis of polymyalgia rheumatica should be within the scope of a general physician's repertoire. While there is limited evidence to confirm the existence of polymyalgia rheumatica as a distinct paraneoplastic syndrome (Reumatismo. 2018;70(1):23), a broadened differential should be utilized prior to diagnosis of this disease. PMID: 31428379 [PubMed]
Source: Reumatismo - Category: Rheumatology Authors: Tags: Clin Case Rep Source Type: research
Publication date: Available online 20 July 2019Source: Best Practice &Research Clinical RheumatologyAuthor(s): Miguel A. González-Gay, Diana Prieto-Peña, Isabel Martínez-Rodríguez, Mónica Calderon-Goercke, Ignacio Banzo, Ricardo Blanco, Santos CastañedaAbstractGiant cell arteritis (GCA) is the most common vasculitis in individuals older than 50 years in Western countries. In addition to the typical pattern of cranial ischemic manifestations, large vessel vasculitis (LVV) involvement has emerged as a common feature of GCA. Patients with predominant LVV manifestations differ from...
Source: Best Practice and Research Clinical Rheumatology - Category: Rheumatology Source Type: research
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