PubMed Health⌕ Search

Biomedical subjects

C P Mavragani

Publications and source records attributed to C P Mavragani.

7 recordsLinked to original sources

Lupus nephritis: current issues.

Despite the development of new modalities, cyclophosphamide (CYC) remains the preferred initial treatment for severe proliferative lupus nephritis. Controversies continue about the best route, dosage, and duration of CYC treatment. For recalcitrant disease, new immunosuppressive and immunomodulating agents, immunoablative high dose CYC, nucleoside analogues, apheresis, and the biological response modifiers can be considered.

Cyclophosphamide↗

Sjögren's syndrome: autoantibodies to cellular antigens. Clinical and molecular aspects.

Autoantibodies to cellular autoantigens are usually found in sera of patients with systemic autoimmune rheumatic diseases. Patients with Sjögren's syndrome (SS) frequently present autoantibodies to both organ and non-organ-specific autoantigens. The most commonly detected autoantibodies are those directed against the ribonucleoproteins Ro/SSA and La/SSB. The presence of the antibodies in SS is associated with early disease onset, longer disease duration, parotid gland enlargement, higher frequency of extraglandular manifestations and more intense lymphocytic infiltration of the minor salivary glands. Over the past several years, the structure and function of these autoantigens have been extensively studied. Several centers, using different techniques, have investigated the B cell epitopes on the protein components Ro 60 kD, Ro 52kD, and La 48 kD. Finally, increased evidence of direct involvement of anti-Ro/SSA and anti-La/SSB autoantibodies in the pathogenesis of tissue injury has been contributed by several studies.

Amino Acid Sequence↗

Rheumatoid arthritis in the elderly.

Rheumatoid arthritis of late onset (LORA) referred as the subset of rheumatoid arthritis with age of onset over 60 years old, seems to differ from young onset disease (YORA) by a more equal sex distribution, a higher frequency of abrupt disease onset, more large joint complaints and less extraarticular features. Different immunogenetic associations are also reported between the two age groups. The percentages of rheumatoid factor (RF) and C-reactive protein (CRP) positivity differ in various surveys in both groups examined. Favorable prognostic factors could be considered the absence of rheumatoid factor activity and the presence of pitting edema of the hands. Greek patients with LORAS appear not to have differences in comparison to their younger counterparts. Disease modifying drugs and low doses of prednisone are the mainstream of therapy with need for further caution in the aged group.

Age of Onset↗

Recurrent pregnancy loss and autoantibody profile in autoimmune diseases.

OBJECTIVE: To explore the association of non-organ-specific autoimmune responses against three distinct Ro antigen-related reactivities (Ro52, Ro60, p57) with a history of pregnancy loss in women with autoimmune disorders. Materials and methods. Seventy unselected anti-Ro/SSA-positive women were studied in a retrospective cohort study. Forty anti-Ro/SSA-positive women were age matched to an equal number of women with autoimmune disorders who were anti-Ro/SSA negative in a case-control study. The association of reactivities against three distinct antigen specificities (Ro52, Ro60, p57) with recurrent pregnancy loss was investigated. Independence and modification of these associations from the effect of antithyroglobulin, antithyroid peroxidase and anticardiolipin antibodies were also examined. RESULTS: In the cohort study, reactivity against each of the three antigen specificities (Ro52, Ro60, p57) was independently associated with a history of recurrent pregnancy loss. In the case-control study, the effects were still independent and were not modified when other autoantibodies were considered. In particular, the number of reactivities against Ro52, Ro60 and p57 peptides, and the presence of antithyroglobulin antibodies, were independent predictors of recurrent pregnancy loss (odds ratios 3.35 per each additional reactivity and 5.54 in the presence of antithyroglobulin; P=0.002 and 0.025, respectively). CONCLUSIONS: In women with autoimmune disorders, a history of recurrent pregnancy loss is independently associated with reactivity against each of the three antigen specificities (Ro52, Ro60, p57) and also with the presence of antithyroglobulin antibodies, suggesting that cumulative autoimmune responses against these non-organ-specific and organ-specific antigens correlate with the risk of stillbirth and spontaneous abortion.

Abortion, Habitual↗

Pregnancy outcome and anti-Ro/SSA in autoimmune diseases: a retrospective cohort study.

OBJECTIVE: In the present retrospective cohort study, the association of anti-Ro/SSA antibody with pregnancy loss and adverse pregnancy outcome in women with autoimmune diseases was investigated. MATERIALS AND METHODS: Obstetric histories of 154 anti-Ro/SSA-positive women with autoimmune diseases [78 systemic lupus erythematosus (SLE) and 76 non-SLE] were analysed and compared to a control group of 142 anti-Ro/SSA-negative women (71 SLE and 71 non-SLE) matched for disease diagnosis and age at the time of anti-Ro/SSA diagnosis. Obstetric history was also obtained and analysed from a group of healthy women, frequency matched to anti-Ro/SSA-positive women on age at study entry. RESULTS: The rate of pregnancy loss and adverse pregnancy outcome did not differ significantly between anti-Ro/SSA-positive women, anti-Ro/SSA-negative women and healthy controls. Anti-Ro/SSA-positive SLE women reported a significantly higher rate (18.0%) of therapeutic abortions compared to anti-Ro/SSA-negative women (5.6%, P=0.0244) and healthy controls (4.6%, P=0.0013). Anti-Ro/SSA non-SLE-positive women reported a significantly higher rate (23.7%) of recurrent pregnancy loss in comparison to anti-Ro/SSA-negative women (7.04%, P=0.0063) and healthy controls (6.4%, P=0.0004). CONCLUSIONS: Although anti-Ro/SSA antibody does not adversely affect pregnancy outcome in SLE patients, it appears to be associated with recurrent pregnancy loss in non-SLE patients.

Abortion, Spontaneous↗